You have to hand it to Charlie Gibson, the ABC anchor who hosted ABC's healthcare town hall in the White House last night. First there was the deft way he elbowed aside his former GMA colleague Diane Sawyer and turned her into a highly-paid "mike girl" who did little but walk the microphone around and hand it to members of the studio audience. No question about who was in charge. Then there was the selection of the audience itself, filled with just enough ordinary people to provide cover for the ringers like the head of the AMA and the CEO of Aetna.
There was the way that the usual right wing talking points -- we can't afford it, government bureaucrats interfering with our freedom of choice, unfair government competition with private enterprise, letting the market do its job -- dominated Gibson's questions. Nothing wrong with the questions in and of themselves -- the event was set up to give President Obama an opportunity to respond to questions like this, which he did well -- up to a point.
What was remarkable was the way Gibson asked the questions. He seemed personally aggrieved all night long, and he displayed a sour, aggressive disposition. Early on, asking about the affordability of healthcare reform, his tone was irritably dismissive and skeptical. As the night went on, he got edgier and edgier. He seemed to be taking all this talk of reform as a personal attack. By the time they were talking about the "public option," Gibson was visibly upset and wagging an angry finger in the face of the President of the United States.
It was hard not to interpret Gibson's tone and body language as saying something like this:
If the rabble who can't afford healthcare are given access they'll swamp the system and that might affect my medical care. I want things to stay the way they are and the market to sort things out.Gibson's style seemed so over the top that it made Obama's urbane, reasonable remarks sound all the more intelligent and public-spirited. So why wasn't I feeling better about the night?
Because it seemed like a charade, an exercise in futility. Forget the vague and unspecified "public option." Without single-payer, any reform isn't worth the paper it's written on. By taking single-payer off the table, Barack Obama is in danger of making the same mistake Hillary Clinton made 16 years ago. The Democrats still haven't learned anything. They're still trying to negotiate a compromise with the beneficiaries of a corrupt and broken system, one that makes Wall Street seem like a paragon of virtue and efficiency. I'm worried that it won't work, and that we'll miss a great opportunity.
There are many ways to structure single-payer. It's implemented in many different ways in other industrialized nations. Some of them include a role for insurance companies and other market mechanisms, and some don't. Fine. Compromise on those. But if you give up on single-payer right out of the gate, you risk building a house of cards that will eventually collapse of its own weight. Calling it reform doesn't change that.