Blue Cross and Blue Dog Democrats: Reflections on “Health Reform” Under “The Unelected Dictatorship of Money”

The United States’ "representative democracy," crippled by "too much [corporate and military] representation and too little [actual popular] democracy" (Arundhati Roy) abounds with Kafka-esque, Orwellian, and Vonneguttian absurdity.  Take, for one example among many, the determination of the United States Congress’s fifty-two "Blue Dog Democrats" [1] to de-rail any sort of mildly robust public health insurance plan that might be able to remotely counter the nation’s for-profit health insurance firms. 

Along with Republicans, "Blue Dogs" insist that any "public option" to emerge from Barack Obama’s health reform process  NOT be sufficiently subsidized and otherwise structured to "undermine" (offer a meaningful alternative to) the private insurance firms that dominate our health system.  "Blue Dogs" wouldn’t want to do anything that might harm those glorious, vampire-like institutions, which are viewed as "honest and trustworthy" by 7 percent of the American people (Robert Weissman, "Business is Even More Unpopular Than You Think," Common Dreams, January 16, 2008).  Each year these parasitic corporations saddle America’s over-priced health care system with an unnecessary $400 billion of administrative and profit costs.  The estimated annual death count of their regular efforts to deny needed health care to millions of Americans – efforts that include investing many billions of dollars in trying to influence and bribe politicians through campaign contributions and massive lobbying campaigns – runs well into the tens of thousands.

"Blue Dogs" will tell you that they are "deficit hawks."  They are proud of their declared obsession with minimizing government expenditure.  Since they also tend to be military hawks as well, however, their oft-proclaimed "fiscal conservatism" does not extend to the gigantic corporate-welfare scheme that is the Pentagon system – a gigantic taxpayer subsidy to high-tech "defense" firms like Boeing, Raytheon, Lockheed Martin, Rockwell-Collins, and Halliburton.

"Blue Dogs" recoil in horror at the specter of Obama’s supposedly "leftist" "health reform" costing taxpayers $1trillion over ten years.  They fret about how Medicare and Social Security trust funds are at risk, they say, of becoming "insolvent," therefore requiring benefit cutbacks and perhaps privatization.

They say nothing, of course, about how interesting fact that the federal government spends $1 trillion annually on the bloated U.S. "defense" (empire) budget, which accounts for nearly half the military spending on Earth and pays for more than 760 military bases spread across more than 130 countries. The notion of the military-industrial complex going bankrupt is of course preposterous; the Pentagon system enjoys an open-ended taxpayer commitment that is considered beyond serious question (Edward S. Herman and David Peterson, "Riding the ‘Green Wave’ at the Campaign for Peace and Democracy and Beyond," Electric Politics, July 22, 2009).

"Blue Dogs’" passion for saving dollars and avoiding insolvency does not extend to ordinary working Americans’ health care expenditure. Untold millions of middle-, working-, and lower-class Americans have been driven to bankruptcy by the nation’s for-profit health-care system.  The shrinking percentage of Americans with insurance often find that their plan does not cover or fully cover the specific medical problems they have, the tests or drugs they require, or the sort of medical intervention they need. Ever-escalating premiums, exorbitant co-pays and more dig deeply into the battered savings accounts of the American people, the citizens who enjoy the fewest health-care benefits in the Western world – a singular  accomplishment for the "world’s greatest democracy."

Some liberal Democrats think that it would be better to call the Blue Dogs the "Blue Cross" or "Blue Cross and Blue Shield Democrats" to signify their captivity and service to the private health insurance industry.  They have a point. As reigning New York Times liberal Frank Rich noted in his weekly column last Sunday, "the 52 conservative Blue Dog Democrats['campaign] …cash intake from insurers and drug companies outpaces their Democratic peers by an average of 25 percent, according to the Washington Post." (Frank Rich, "Is Obama Punking Us?" New York Times, August 9, 2009, section 4, p.8).

But it isn’t just the Blue Dogs who oppose the serious progressive health reform that is desired and required by most Americans. The "mainstream" Obama-Democratic plan that has the Blue Dogs and the Republicans so fearful and angry falls far short of what is required to meeting the health care and fiscal needs of the popular majority.  It leaves the parasitic for-profit insurances and drug companies in essential control of the nation’s health care future.  As such, it guarantees that citizens will be stuck with overpriced, wasteful care, endless premium inflation, cringing dependence on the employer class for health care, mandated coverage without affordable care for many, the constant fear of losing coverage, and recurrent private and public battles with insurers and their tyrannical, costly, profit-protecting bureaucracies and outsized political influence for years to come.

As originally conceptualized and floated in 2008 and early 2009, the president’s health scheme is a potential disaster for serious reform. The progressive left labor journalist and policy analyst Roger Bybee worries with reason that Obama’s "plan, manacled to private insurers, may ultimately deepen public cynicism about the possibility any substantive help with their increasingly desperate health care situation" (R. Bybee, "Health Reform Via Guaranteed Choice," Z Magazine, December 2008). The plan has often seemed all-too fated to repeat the experience of "HillaryCare" during the 1990s, when the Clinton administration’s sickeningly complex and market-driven, corporate-serving scheme for national coverage crashed and burned, discrediting the cause of reform for many years.

When Obama gave an uninspiring prime-time press conference in support of Democrat-led health reform last July, much of the public didn’t follow his logic on why it should support his curiously corporate-captive version of "change."  All too common was the reaction of Rowena Ventura, 44, an uninsured worker who had just moved her ailing mother into a house she shared with her disabled husband "You see," she said, gesturing at the president on her television, "he’s saying he wants to continue private insurance, but then he says they’re part of the problem. Well, which is it? It’s just ridiculous." (K. Sack, "For Public, Obama Didn’t Fill in Health Blanks," New York Times, July 23, 2009, A1).

It is true that eighty-five Democrats in the House technically support Rep. John Conyers’ (D-MI) HR 676, a bill that would transcend corporate-managed health-care ridiculousness by introducing a basic single-payer health insurance system.  Under the "Canadian" (and Australian and New Zealand-esque) single payer model, advanced in the U.S. Senate by Bernie Sanders (I-VT), the government (identical with the people in democratic theory, as Noam Chomsky says) would evict for-profit insurance companies from health care and guarantee high quality health care for all Americans regardless of wealth and income.

Sadly, however, many congresspersons in the "single-payer" category don’t really mean it.  They don’t think "their" side can win.  Unlike the Blue Cross Blue Dogs, they aren’t willing to cast their votes against the mainstream Blue Cross Obama-Democratic plan.  When push comes to shove, they’ll cave and sign on with the hopelessly inadequate and strongly diluted Obama bill that gets rolled out and sold as a "progressive" effort (and absurdly denounced as "socialist" by the right wing noise and disruption machine)next fall. As the Washington-based journalist and leading single-payer activist Russell Mokhiber explains:

"Well, there are a group of 85 members of the House who support single-payer bill HR 676. They are all Democrats and unfortunately it’s not a real serious effort. And it’s not a real serious effort because, unlike the Blue Dogs – and this is why the Blue Dogs get all the attention – because the Blue Dogs, even they are a much smaller group – they say, unless you meet our demands, we’re not going to vote for the Obama plan. And the single-payer advocates have never said that. The single-payer advocates say, ‘We prefer single-payer, but it’s not going to happen, therefore, we’re going to go for a public plan.’"(Cyrano’s Journal Online, August 9, 2009, read at http://www.bestcyrano.org/?p=3474)

All of which leads to reasonable suspicion what while "Blue Dog Democrats" are indeed "Blue Cross, Blue Shield Democrats," the latter category reaches far beyond the 52 representatives listed on the official Blue Dog roster.  Consistent with that suspicion, the top six Democrats in the House when it comes to crafting "health reform" have collectively received $953, 398 from insurance industry political action committees (PACs) since the onset of the 2008 election cycle. Those strategically placed House Democrats include House Speaker Nancy Pelosi (D-CA, $175,500 from insurance PACs), House Majority Leader Stenny Hoyer (D-MD, $ 356,000 courtesy of insurance PACs), House Majority Whip Sam Clyburn (D-SC, $107,098), House Ways and Means Committee Chair Charles Rangel (D-NY, $226,300). House Education and (single-payer co-sponsor) Labor Chair George Miller (D-CA, $62,000), and House Energy and Commerce chair Henry Waxman (D-CA, $26,500). Miller is technically a single-payer/HR 676 co-sponsor.

Then there’s the three Blue Cross Democrats sitting on the U.S. Senate Finance Committee to join three Republicans in an aristocratic committee trying to kill the "public [insurance] option" altogether. Recently the New York Times reported that the nation’s health "reform" was being "carved out at a table of six" millionaire Senators seeking a "grand bargain" in the office of Senate Finance Committee chairman, Max Baucus.  The big six, mainly from small population states are: Baucus (D-MT), Charles Grassley (R-IA), Kent Conrad (D-ND), Olympia Snowe (R-ME), Jeff Bingaman (D-NM), and Michael Enzi (R-WY). By the Times’ account, Obama’s so-called "public option" was falling to the finance committee’s cutting floor along with the notion of taxing the wealthy to pay for universal extended coverage." "Already," the Times reported, "the group of six has tossed aside the idea of a government-run insurance plan that would compete with private insurers. They have also dismissed the House Democratic plan to pay for the bill’s roughly $1 trillion, 10-year cost partly with an income surtax on high earners." (New York Times, July 28, 2009, A1)

Democrats Baucus, Conrad, and Bingaman have collectively received a remarkable $2.5 million from the insurance industry since the onset of the 2008 election cycle.  The largest amount by far went to health "reform" point man Baucus, recipient of more than $950,000 in insurance PAC money since 2007. 
For what its worth, Blue Cross, Blue Shield has given Baucus $125,200 during that time – his fifth largest contributor. The company gave more than $2.5 million to congressional candidates in 2007-08, evenly split between Democrats and Republicans.  For the current election cycle, its partisan donation balance has shifted in favor of the Democrats, reflecting the current congressional prevalence of that party (data from the Center for Responsive Politics’ "Open Secrets" Web site).

There are no technical Blue Dog coalition members in the U.S. Senate, but there appear to be some strategically placed Blue Cross, Blue Shield Democrats in the nation’s upper legislative body.

For his part, Obama received $2.25 million from the insurance industry and was Blue Cross, Blue Shield’s top campaign cash recipient (to the tune of $148, 000) in the 2008 election. His militantly watered-down health reform agenda, which retains critical parasitic profits and related exaggerated costs for the private insurers, is consistent with that sponsorship and with the $19 million Obama has received from the health sector, many of whose key players (including drug industry CEOs) stand in incestuous and overlapping profit and board-membership relationships to the leading insurance firms.

Obama knows very well that you can’t have meaningful progressive health reform without removing the for-profit insurance vampires from the equation. He said as much quite explicitly late in his career as a state legislator during a speech in downtown Chicago. The solution, he said, was an "everybody in, nobody out" single payer system, of which, he said, "I happen to be a proponent." The way to get it, he argued, was for the Democrats to take back Congress and then the presidency.

Well, the federal legislative and executive branches have been "taken back" by the Democratic Party.  Sadly, however, the United States’ corporate-managed "dollar democracy" and its narrow "one-and-a-half party system" (Sheldon Wolin) has yet to be taken back from concentrated wealth. Obama’s single-payer speech (viewable on YouTube at http://www.youtube.com/watch?v=fpAyan1fXCE)
was delivered before the future president knew he had a serious shot at the White House. Once you enter the high-stakes, big business-coordinated arena of "in-it-to-win-it" and "winner-take-all" presidential politics, social-democratic principles go out the window.  You become subject to what the left writers Edward Herman and David Peterson call the United States’ "unelected dictatorship of money," which "vets the nominees of the Republican and Democratic parties, reducing the options available to U.S. citizens to two candidates, neither of whom can change the foreign or domestic priorities of the imperial U.S. regime" (Herman and Peterson, "Riding the ‘Green Wave’"). If we want major and basic reforms like single-payer health insurance, like meaningful labor law reform, like a significant reduction in the military budget and like a serious government-enforced reduction in carbon emissions we have no choice but to challenge that dictatorship in a many-sided struggle for peoples’ power over and against the Privileged Few. 

Paul Street ([email protected])is the author of many articles, chapters, speeches, and books, including Empire and Inequality: America and the World Since 9/11 (Boulder, CO: Paradigm, 2008);  Racial Oppression in the Global Metropolis (New York: Rowman & Littlefield, 2007), Empire and Inequality: America and the World Since 9/11 (Boulder, CO: Paradigm, 2004), Segregated School: Educational Apartheid in the Post-Civil Rights Era (New York: Routledge, 2005); and Barack Obama and the Future of American Politics (Boulder, CO: Paradigm, 2008).


1. For a useful description and history of the "Blue Dogs," see a recently updated Wikipedia entry: "The Democratic Blue Dog Coalition is a group of currently 52 moderate and conservative Democratic Party members of the United States House of Representatives, first formed in 1995.The Blue Dogs promote, among other things, fiscal conservatism and accountability. …The Blue Dogs are the political descendants of a now defunct-in-name Southern Democratic group known as the Boll Weevils, who played a critical role in the early 1980s by supporting President Ronald Reagan’s tax cut plan. The Boll Weevils, in turn, may be considered the descendants of the Dixiecrats and the ‘states’ rights’ Democrats of the 1940s through ’60s. ‘Blue Dog Democrat’ is derived from the term ‘Yellow Dog Democrat.’ Former Texas Democrat Rep. Pete Geren is credited for coining the term, explaining that the members had been "choked blue" by "extreme" Democrats from the left The Blue Dog Coalition was formed in 1994 during the 104th Congress to give more conservative members from the Democratic party a unified voice after the Democrats’ loss of Congress…In 2005, the members of the Blue Dog Coalition voted 32 to 4 in favor of the bill to limit access to bankruptcy protection (S 256).In the summer of 2009, The Economist magazine said ‘[t]he debate over health care… may be the pinnacle of the group’s power so far’ and quoted Charlie Stenholm, a founding Blue Dog, as saying that ‘this is the first year for the new kennel in which their votes are really going to make a difference.’"  

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