THE TREATMENT MARCH 17, 2010
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Harold Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago and a Special Correspondent for The Treatment.
The New Deal was famously described as an arrangement whereby the South was forced against its will to accept billions of dollars every year. Something similar might be said of the current health reform. Washington is on pins and needles waiting to discern the votes of Blue Dog Representatives whose constituents have the most to gain from health reform.
I was reminded of this fact by Michael Tomasky's recent column. He draws attention to a nice Urban Institute report by Genevieve Kinney and colleagues. Urban's report examines insurance coverage across congressional districts. Looking over the results, Tomasky notes that Representatives who are waffling or pledging to vote against this bill not only undermine President Obama, they also hurt tens of thousands of their own uninsured constituents. Consider Mike Ross, who represents the Arkansas's 4th. Census data indicate that more than 100,000 of his constituents are uninsured. The same is true of Henry Cuellar, Jim Matheson, Dan Boren, Mike McIntyre, and several others.
There is another irony, noted by NPRs Peter Overby. Fifty-three of the hundred congressional districts with the highest uninsurance rates are represented "either by Republican lawmakers who are fighting the overhaul, or by conservative Blue Dog Democrats who have slowed down and diluted the overhaul proposals." In many Blue-Dog districts, one in five working-age adults has no health insurance coverage.
Check out this NPR interactive U.S. map. It shows vast regions of Red-State America with very high numbers of the uninsured: Georgia, Arkansas, Louisiana, Texas, coastal North and South Carolina, the Mississippi delta, southern Missouri, much of Oklahoma and Idaho, parts of Kentucky and West Virginia, and more. Millions of others in the same areas would benefit from affordability credits and from consumer protections provided by an insurance exchange. Some wavering Democrats represent hardscrabble blue-collar districts in Ohio, Pennsylvania, and the Midwest. Many of their constituents require affordability credits and other protections embodied in the current bill.
The contrast with Blue-state America is both stark and inescapable. Massachusetts, New Jersey, New York, Pennsylvania, Connecticut, northern California, Wisconsin, Minnesota, and Illinois have much higher rates of health insurance coverage. No wonder Scott Brown found such a ready audience.
Right now, health reform is a heavy lift in many districts. Constituents don't know what these measures actually would do. Hard times breed political discontent, and many people harbor cultural, religious, and generational ambivalence towards President Obama himself that infect the politics of health reform.
Once again, Americans who have the most to gain from activist government are often the very people most distrustful of such measures. In the short-run, these perceptions may cause problems come November and even come 2012. In the long-run, I believe this is an opportunity. Once health reform embeds itself within the fabric of American life, I'm betting that millions of Red-State Americans will not wish to see it go.
7 comments
"Once health reform embeds itself within the fabric of American life, I'm betting that millions of Red-State Americans will not wish to see it go. " Or to see the Democrats go either. And that's what's at stake for the Republicans and why they are fighting against HCR as though for their very existence. I wish to distinguish conservatives from demagogues, the former who oppose this version of HCR for philosophical reasons (although their "slippery slope" view of government action is getting rather tiresome), whereas with the latter it's all about power, how to obtain it and how to keep it. To me, those who who have been blessed in this life with intelligence or wealth owe much to the lesser among us (or as Jesus put it, it is harder to put a camel through the eye of a needle than for a rich man to make it to heaven), and the worst among sins is hypocricy (see the Seven Woes in the Gospels). Those who would mislead the uninformed, the lesser among us, have received their reward in this life.
- raylward
March 17, 2010 at 10:51am
And of course, the Red States rank lowest in health rankings by state: http://www.americashealthrankings.org/measure/2009/overall.aspx Blue States such as New Hampshire, Socialist Vermont, Hawaii (Kenya), rank at the top. Mississippi, as with just about any quality of life measure, ranks dead last, but that doesn't deter Haley Barbour from urging the citizens of that state to oppose health care reform.
- dubyadoubte
March 17, 2010 at 11:30am
Just goes to show that you can't fix stupid.
- tnmats
March 17, 2010 at 11:49am
Or as a labor organizer I knew once used to say sarcastically after a frustrating exchange with an anti-union co-worker: "I didn't get to where I am today by standing up for my rights!"
- ironyroad
March 17, 2010 at 11:53am
tnmats, yes you can't but it would be fun to try to beat some sense into these people. you know, if this does fail my attitude is screw these red state monkeys. Democrats should turn their focus to the states, or a coalition of states, for their own regional Public option, exchanges, etc. Let Mississippi burn. I say we should pass a Constitutional amendment that no state shall receive more money from the Federal Government than it puts into it (plus or minus 5%, and minus Natural disasters or acts of War). The red state monkeys would jump at the chance because they are so stupid they don't know the good thing they got.
- blackton
March 17, 2010 at 11:59am
Blackton, you can fix ignorance but stupid is forever. You just can't beat any sense into some, no matter what. One group I'd like to see get what they ask for is seniors on Medicare and/or VA benefits and scream "government get out of my health care!". I would gladly oblige in spades. That attitude is one that agitates my father, a 76 yr. old VA/Medicare beneficiary, to no end. He rails against the stupidity of those that say but are on Medicare, and will the first to tell you he loves his gov't health care and thinks ALL should be in Medicare (I should mention he hates insurance cos. with a passion since he used to buy his own insurance when working). He even called an acquaintance, who's on SS disability and Medicare, stupid to his face for getting gov't benefits but griping about government. And I do like your idea of having red states get what they put in. It would somewhat hurt my home state, North Carolina, but we wouldn't be hit as hard as other red states.
- tnmats
March 17, 2010 at 12:41pm
Mr. Chait, you say: "Once health reform embeds itself within the fabric of American life, I'm betting that millions of Red-State Americans will not wish to see it go." Don't bet on attitude changes. Take a look at how the GOP has now become the champion of Medicare but fought it tooth and nail for decades. The poster child for "socialized medicine" being the end of the republic is none other than their patron saint, Ronald Reagan. Never heard much about that past stance in the latest fracas over HCR, have you? Same with Social Security. The GOP has fought it for decades and suddenly it becomes SS's best friend. You can find other examples of gov't programs they fought but now are champions of. Never underestimate the lies and cognitive dissonance of the GOP and their followers. They may like the programs but will still hate the Democrats and blame them for all ills.
- tnmats
March 17, 2010 at 12:53pm