Healthcare’s 13 Tyrants

David Sirota

For those still clinging to quaint notions of the American ideal, these have been a faith-shaking 10 years. Just as evolutionary science once got in the way of Creationists’ catechism, so has politics now undermined patriots’ naive belief that the United States is a functioning democracy. 

Thanks to our undemocratic system and our corrupt campaign finance laws, the healthcare industry doesn't have to fight a 50-state battle.

The 21st century opened with a handful of Supreme Court puppets appointing George W. Bush president after he lost the popular vote – and we all know the costs in blood and treasure that insult wrought. Now, the decade closes with another cabal of stooges assaulting the one person, one vote” principle – and potentially bringing about another disaster.

Here we have a major congressional push to fix a healthcare system that leaves one-sixth of the country without coverage. Here we have 535 House and Senate delegates elected to give all 300 million of us a voice in the solution. And here we have just 13 of those delegates holding the initiative hostage.

In the Senate, both parties have outsourced healthcare legislation to six Finance Committee lawmakers: Max Baucus (D-Mt.), Kent Conrad (D-N.D.) Jeff Bingaman (D-N.M.), Mike Enzi (R-Wy.), Charles Grassley (R-Iowa) and Olympia Snowe (R-Maine). The group recently announced it is rejecting essential provisions like a public insurance option that surveys show the public supports. Meanwhile, seven mostly southern House Democrats have been threatening to use their Commerce Committee votes to gut any healthcare bill, regardless of what the American majority wants.

This, however, isn’t about the majority. These lawmakers, hailing mostly from small states and rural areas, together represent only 13 million people, meaning those speaking for just 4 percent of America are maneuvering to impose their healthcare will on the other 96 percent of us. 

Census figures show that the poverty rates are far higher and per-capita incomes far lower in the 13 legislators’ specific districts than in the nation as a whole. Put another way, these politicians represent exactly the kinds of districts whose constituents would most benefit from universal healthcare. So why are they leading the fight to stop­-rather than pass – reform?

Because when tyranny mixes with legalized bribery, constituents’ economic concerns stop mattering.

Thanks to our undemocratic system and our corrupt campaign finance laws, the healthcare industry doesn’t have to fight a 50-state battle. It can simply buy a tiny group of congresspeople, which is what it’s done. According to the Center for Responsive Politics, health interests have given these 13 members of Congress $12 million in campaign contributions – a massive sum further enhanced by geography. 

Politicians trade favors for re-election support – and the best way to ensure re-election is to raise money for TV airtime (read: commercials). In rural America, that airtime is comparatively cheap because the audience is relatively small. Thus, campaign contributions to rural politicians like these 13 buy more commercials – and, consequently, more political loyalty. 

The end result is an amplifier of tyranny: Precisely because the undemocratic system unduly empowers legislators from sparsely populated (and hence cheap) media markets, industry cash can more easily purchase tyrannical obstruction from those same legislators. In this case, that means congresspeople blocking healthcare reform that would most help their own voters.

Of course, there is talk of circumventing the 13 obstructionists and forcing a vote of the full Congress – one not subject to a filibuster, a 60-vote rule, a committee bottleneck or any other deliberately impossible hurdle. 

Inside the Washington palace, that prospect raised hackles. Though the congressional leadership currently has the power to mandate such a maneuver, the media court jesters and political aides-de-camp have reacted to such plans by raising predictable charges of improper procedure, bad etiquette and poor manners. Indeed, D.C. tends to get prickly anytime the clamoring masses demand that national priorities come before Versailles rituals and parliamentary procedure.

But the real crime would be letting the tyrants trample democracy and kill healthcare reform for everyone else. 

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David Sirota is an awardwinning investigative journalist and an In These Times senior editor. He served as speech writer for Bernie Sanders’ 2020 campaign. Follow him on Twitter @davidsirota.
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