Hardly a week passes without a negative Obamacare headline staring at me from the New York Times. The Affordable Care Act, also known as “Obamacare” was passed with great fanfare in March 2010 and was variously labeled as “the greatest advance in healthcare since Medicare and Medicaid” and as the “the most positive thing that this country has done since the civil rights legislation that was passed back in the ’60s.”

The Republican House has voted dozens of times to repeal Obamacare without ever offering a viable alternative. However, it certainly appears that the Affordable Care Act is dying a slow death all by itself without Republican assistance. Look at a few headlines from the last couple of years:

Big Changes in Fine Print of Some 2015 Health Plans

Seeking Rate Increases, Insurers Use Guesswork

Data Shows Large Rise in List Prices at Hospitals

Double Digit Rate Hikes Loom for Obamacare 2016

Sorry, We Don’t Take Obamacare

Think Your Obamacare Plan Will Be Like Employer Coverage? Think Again

Health Insurers Use Process Intended to Curb Rate Increases to Justify Them

Aetna will leave most Obamacare exchanges, projecting losses

Health-care exchange sign-ups fall far short of forecasts

Obamacare Marketplaces Are in Trouble. What Can Be Done?

These news headlines illustrate exactly why I think that the Affordable Care Act cannot continue to exist in its present state: a medical care system intended to ultimately cover everyone and reduce medical costs while relying on corporations whose sole reason for existence is profit.

Michael Moore’s brilliant and prescient film “Sicko”, released almost 10 years ago, made this abundantly clear (by the way, while he is dismissed as a kook by the right, Mr. Moore to me is a sage, prophet and patriot). “Sicko” pointed out that anything less than a single payer program, like “Medicare for all”, any program involving corporations and profit contains the seeds of its own destruction. The medical insurance companies must show a profit and must, like all capitalist enterprises, increase profit and grow. Stasis and balance are not part of the capitalist system. And how does a health insurance company grow and increase profit? By gaining more customers, paying less in benefits or charging more for premiums, a recipe for the failure of any corporate-run effort toward providing universal coverage.

Health care is a public issue and should be a public service like education, highways, water, and electrical service. It should not be viewed as a commodity to be bought and sold. One should not have to buy a health insurance “policy”, as if buying car insurance. Access to affordable healthcare should be a right and should be enshrined among all of our other rights, as it is in European countries. It is interesting to glance back at the “Second Bill of Rights”, proposed by Franklin Delano Roosevelt in 1945 and which surely would have been enshrined in the constitution had he lived. One of the articles in this wonderful document is: “The right to adequate medical care and the opportunity to achieve and enjoy good health”.

It might be useful to consider what health insurance companies do to earn their massive revenue and profits. Well they do essentially what the state bureaucracies operating the Canadian National Health program or the British National Health Service do. They take money from government or private sources and, based on the nature and level of service provided, pass it along to doctors, hospitals and drug distributors. Not very complicated is it? In countries with national health systems, this process is conducted very efficiently and economically. In the US, with United Healthcare, Cigna, Humana, Aetna and a host of other companies performing this simple function, it becomes very expensive because these companies have to make a profit to pay shareholders and to pay their CEOs’ multi-million dollar salaries. Something is indeed wrong with this picture.

So what do you suppose happens at Board meetings or at high level executive meetings in these companies? How do the highly paid “big guns” of United Healthcare or Humana or Aetna sit around their big shiny tables and brainstorm corporate strategy or new products or new markets for future growth? Well, considering what they actually do, they’re embarrassingly limited. A “new product” has to be a new “policy” which provides less service to the consumer or less compensation to the doctor or hospital. A new growth strategy is “how do we get more people or companies to sign up and buy our “product” or “how can we discourage the sick and chronically ill from signing up and encourage more young and healthy people to sign up? Or maybe the best and most simple strategy of all – let’s raise the prices of the health insurance policies we sell. Or better yet, let’s disguise an increase by having the consumer pay a higher deductible and keep the price the same. Or, let’s make the language describing the benefits we provide really confusing and deceptive, surreptitiously raising the deductible or the copay. Or, best of all, since we’re an integral part of Obamacare, how can we squeeze the government for more customers, for bigger subsidies, more money so we can increase profit? These are corporate strategies like none other – no investment in research, invention, engineering, design improvement, raw materials selection, creativity or test marketing. These healthcare corporations must be the envy of all other corporations – my God, they make profit, pay their shareholders, pay millions to their CEO’s for merely performing a simple bureaucratic function and with massive government assistance.

The history of providing healthcare in the US is depressing. While European countries and our neighbor to the north moved inexorably toward government funded universal coverage, effort after effort in the United States failed miserably. Proposals were condemned as “socialist” or “communist” or labeled as “interfering with doctor – patient relationships” or a making doctors “slaves”. President Truman’s valiant 1949 effort to provide a national program failed because of powerful conservative opposition from the likes of Senator Robert Taft who claimed it was “right out of the Soviet constitution”. The American Medical Association opposed the program also, with one of their pamphlets reading, “Would socialized medicine lead to socialization of other phases of life? Lenin thought so. He declared that socialized medicine is the keystone to the arch of the socialist state.”

President Johnson’s “Great Society” efforts in the 1960’s led to Medicare and Medicaid for the elderly and the poor, both supported by the medical establishment, but not to universal coverage for everyone else. President Clinton’s efforts to provide universal coverage, led by then first lady Hillary Clinton, also met with failure because of opposition from health insurance companies and the entire rest of the healthcare industry, exerted through intense lobbying of members of congress.

Another important reason that national healthcare efforts failed over the years was because of the growth of employer-provided health insurance and the companies that administered such plans. During World War II when competition for workers was fierce and employers were not allowed to raise wages, expanding employee benefits was the only way to attract workers so companies began to offer health insurance as one of those benefits. Also of course, companies could deduct the cost of employee health insurance coverage as a cost of doing business. So it’s no surprise that over the years employer provided insurance dampened the demand for universal coverage. The provision of employer provided medical insurance also gave health insurance companies the opportunity to become firmly planted in America’s corporate landscape.

Access to good health insurance is a prominent and consuming concern for most Americans. If your employer covered you and you switched jobs, you might lose your coverage. Employers could change the levels of coverage, requiring larger deductibles or copays to maintain the profit margins for the companies administering the insurance. And buying affordable coverage became almost impossible for the self-employed. I will never forget a statement made by one of my favorite nonfiction authors, Susan Jacoby, remarking in her book “Never Say Die: The Myth and Marketing of the New Old Age”, what an incredible relief it was for her to turn 65 and finally be covered by Medicare. Thank God, the struggles were over – no more worries about medical insurance. One of my brothers, self employed, pays about $25,000 per year to insure him and his spouse and is counting the days to age 65 and Medicare. Another, who receives his medical insurance from his employer, has seen his costs and deductibles rise while his coverage has diminished. And I myself, despite having always worked for employers who covered me and, for an additional charge, the children and the spouse if necessary, the size of deductibles and/or copays was always a concern, as was the cost of drugs required by a family member. And I could still have lost everything I owned if stricken by a catastrophic illness. What a relief for me when I turned 65 and for my spouse when she too became eligible for Medicare, that our worries were over. This is the way it should be for all Americans at all phases of their lives. A Canadian, a Dane, a German, a Frenchman, is simply and logically covered – for everything – no limits or exclusions, from the moment of birth to the moment of death.

The powerful influence of corporations has colored and flavored all recent “advances” in healthcare. First was the intrusion of health insurance corporations into Medicare with “Medicare Advantage” programs, through which they received funds directly from the government to administer and profit from their own enhanced versions of Medicare, further solidifying their positions on the corporate landscape. And the George W. Bush Medicare expansion to provide drug benefits was virtually written by the pharmaceutical corporations, guaranteeing huge profits for themselves through the disallowance of negotiated drug prices. And finally, Obamacare itself was written by the medical insurance companies with the complicity of their congressional lackeys. Retention of private corporations in the program and the exclusion of a “public option” were ways to radically increase the number of their customers at government expense. Like charter schools, the Affordable Care Act became simply another way to shovel public money into corporate coffers.

Obamacare’s invitation to “Come, compare policies and select the one that’s best for you and your family” rings hollow. These “policies” are extremely complex. Who is really prepared to weigh and compare deductibles, exclusions, copays, benefits, networks, costs and the many other variables in a typical health insurance company policy? This complexity is designed to result in one thing – concealment of gradual and incremental cost shifting from the insurer to the patient in order to increase profit, not improve healthcare.

Obamacare’s reliance on the fabled capitalist “market” and “competition” is also chimerical. With insurers now leaving the exchange markets in droves, there will soon be little or no competition. Also, the reduction of insurers into fewer and fewer players through buyouts and mergers will undoubtedly result in market collusion to maintain or improve profit, not competition to improve service or gain customers.

Another problem with Obamacare is administering the mandate requiring individuals to buy insurance and providing the subsidy for those qualified to receive assistance. The “punishment” for not buying insurance, imposed in end-of-year tax returns, is not immediate and therefore not effective. And the subsidies are “tax credits” and whether paid up front or at the end of the year are needlessly complex and confusing. All this complexity is the result of retaining the needless role of private corporations in providing health insurance. And many individuals are opting to remain uninsured and simply pay the penalty.

Many individuals covered by employers or purchasing private insurance prior to the ACA have seen their plans change dramatically, rendering President Obama’s assertion that “if you like your health care plan, you can keep your health care plan” and Senate Majority Leader Harry Reid’s claim that “you can keep your family’s doctor or keep your health care plan if you like it” totally fallacious. What actually happened is that insurers administering employer plans sometimes reduced benefits to match the minimums required under Obamacare or sometimes increased deductibles and/or increased copays. Individual plans also changed shape and size after Obamacare. Many self-employed people or people not covered by employers found plans they had purchased before Obamacare increase in price or reduce benefits.

The claim by Obamacare advocates that “market forces” and “competition” would work to keep prices down and benefits up is also false. When maintaining certain levels of benefits or a low price cuts into profit, those efforts are abandoned. This is why the biggest insurer, United Healthcare, has withdrawn from most state insurance marketplaces and why another healthcare giant, Aetna, has abandoned them altogether.

Obamacare has been reduced to the level that in order to maintain the involvement of private insurers, more government money has to be given to them. And to involve private insurers in the first place, Obamacare is incredibly complex and unwieldy. Just go to the website and take a look at what is offered, how subsidies are offered and so on. Your eyes will glaze over, your heart rate will increase, you will perspire and you will need a dose of healthcare yourself, then and there. And even though you hate your job, you will stick with your present employer because your insurance, no matter how meager, is provided for you. And even though your deteriorating physical condition dictates that you should retire now, you will stagger into work until you are 65 just so you can finally stop worrying about medical insurance. And when you finally do have Medicare, you will realize once and for all how important it is to provide health insurance as a right to everyone, regardless of age, employment, health or income.

Also, another important part of Obamacare, the expansion of Medicaid to cover the poor, was foolishly left up to the discretion of the states. Thus, states whose governors or legislators opposed Obamacare, or likely more accurate, disliked the skin color of our president, rejected Medicaid expansion.

So what to do now? When and how can we look at the provision of healthcare like a grownup nation instead of like an immature teenager, pandering to health insurance companies, and spending twice as much on healthcare as necessary? I am sure that the present difficulties will be handled for now by injecting more government money into the program to prop up insurers’ profits. But only a truly national program, arbitrarily enrolling every American of every age and of every measure of health, will provide a pool large enough that everyone can be covered at a reasonable cost. And the modest tax increase necessary to do this will be more than compensated for by reduced personal costs for each American.

The most recent headline in the Times about Obamacare’s problems, today October 3, 2016, reads, “Ailing Obama Health Care Act May Have to Change to Survive”, introducing an article rehashing much of what I have written above and concluding that inclusion of a public option, dropped during the writing of the law at the behest of private insurers, may now be necessary.

So Obamacare cannot survive as written and surely will die, unless changed completely from what was planned by corporations and their congressional servants. Above I have offered its obituary. Below I suggest an appropriate epitaph:

HERE LIES OBAMACARE
BORN 2010 LIVED BRIEFLY THEN DIED CIRCA 2016
CONCEIVED TO SERVE A PUBLIC NEED
KILLED BY PRIVATE CORPORATE GREED

Why is it that in the United States of America we can’t ever seem to get anything completely done? We look at this problem or that problem and wrangle about how to “make it better” – like maybe “cut child poverty” or “increase the number of people who have ‘access’ to healthcare” but never decide to wipe out child poverty completely or cover all of our citizens with health insurance as so many other nations have succeeded in doing.

Not long ago, before he went on leave, in the New York Times was a column by likely the most caring of their stable of mostly great columnists, Nick Kristoff, who eloquently and sensitively describes the problem of child poverty in the United States and how President Joe Biden’s 1.9 trillion dollar American Rescue Plan will “cut child poverty in half”. Kristoff went on to quote Jason Furman, Harvard economist, asserting that  Biden’s bill is the the “most ambitious proposal to reduce child poverty ever proposed by an American president”. He further goes on to speculate about whether we’re able to “shrink” child poverty.

So what’s wrong with all this? While the intention is truly honorable and greatly needed, it’s the use of words and phrases like “cut in half”, “reduce” and “shrink” that concern me. We never seem to come up with a plan to get rid of child poverty once and for all. Isn’t it possible to do this in the world’s richest country? I would certainly think so. Do Democrats and Republicans both deem child poverty unacceptable? I would think that they do and therefore we need to stop beating around the edges of this problem and attack it head on.

So perhaps we should ask why child poverty exists here in the richest nation in the world? And why do we insist on referring to “child poverty”rather than “poverty”? Does child poverty exist in well-to-do or middle class families. Or can children be well off in poor families? Of course not, so let’s stop separating “child poverty” from the larger and more real problem of family poverty. Why we have poor families, why we have poverty in the first place, is that simply we do not ensure that families have enough money to live honorably and securely. It’s the never-ending curse of “low wage jobs”, where the head of a family can work full time and still be poor, or that the head of a family can work multiple jobs or both parents can work and still not earn enough to keep a roof over the family and keep food on the table, much less take care of health and education needs.

I mean, how long can we continue to kick the poverty can down the road? President Johnson waged his “War on Poverty” well over 50 years ago and so many aspects of his program certainly did “reduce” poverty. But did it rid this wealthy country of the disgrace and shame of harboring minions of poor people, homeless people and sick people? No it did not. And direct efforts to “reduce” poverty ever since them have been cumbersome and incremental efforts limited by work requirements, means testing and the like rather than direst direct financial support. Even President Biden’s much ballyhooed antipoverty efforts lately have been defined by “tax credits”, providing help for those with jobs who actually file tax returns, but little or nothing for the extremely poor who do not have any regular income and thus cannot access tax credits.

If we are serious about taking care of our children and their families, we would attack the problem of “low wage jobs” directly so that anyone who worked 40 hours a week could afford decent housing and all the other advantages that enable one to live an honorable and hopeful life. And let’s stop listening to the excuses of business owners who say that increasing employee pay would “drive them out of business”. I say too bad. Any business that cannot pay a living wage to its workers should not be in business and should relinquish its role to other entities that can provide the same service while paying its employees  reasonably.

For example, fast food companies have long protested increasing wages to a living level because they would have to raise prices of menu items. This is simply not true. In other developed countries fast food workers are paid a living wage and menu items have not skyrocketed. Apparently the fast food owner, franchisee, or corporation would simply have to be satisfied with less profit. 

This is further illustrated in another very entertaining and informative article by Nick Kristoff focusing on Denmark. 

And unfortunately we have chosen yet another incremental program to “reduce hunger” in poor families – the food stamp program or SNAP (Supplemental Nutrition Assistance Program) as it is now called. So rather than ensuring that families receive enough money to live properly, we accept their poverty but lend a hand to enhance their ability to purchase food for their families. Again, why the beating around the bush, helping people to live better while staying in poverty but never really getting  ahead. SNAP’s official description underscores its incrementalist approach: “SNAPprovides nutrition benefits to supplement the food budget of needy families so they can purchase healthy food and move towards self-sufficiency”. Oh sure, how generous.

The same incremental principle has been applied when we try to even up the playing field in terms of internet access. Since poor families often cannot afford broadband connections, rather than make sure they have enough money to purchase this essential benefit, we instead provide yet another program to assist them. This proposed $50 per month subsidy for broadband connection for poor is merely one more source of assistance for poor families that can end or be withdrawn when the other political party is in power. This is no way to end poverty or end the curse of “low wage jobs”, the main cause of poverty.

And then there is the issue of healthcare incrementalism. President Obama’s signature major legislative accomplishment, the Affordable Care Act, despite its accolades, simply increases the number of people who could afford to buy medical insurance. It has expands coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010. It did so by expanding Medicaid to cover those with low incomes, and by subsidizing private insurance for people with higher earnings. There’s those words again – “increases”, “expands” and “subsidizes”.

And since it functions through the existing jungle of corporate control of healthcare, it does so through funneling more money to healthcare corporations, either directly, in order to “cover preexisting conditions” or something similar, or indirectly, by subsidizing purchasers of healthcare insurance. And, most significant of all, it does not, will not and will never cover everyone.  As I noted in my article about Obamacare, it contains the seeds of its own destruction and ultimate demise, in that the only way it can “extend coverage” is by shelling out ever more money to insurance companies, which has to be definitely limited. There will always be “holes” in the Affordable Care Act, always be groups of people that will remain outside its coverage. Truly the only way to provide medical care to all US citizens without exception and from birth to death is through a single payer program like “Medicare for All” as so many other nations successfully provide.

And yet, despite Biden’s promise to provide a “public option” for those seeking health insurance, this effort has come to nothing. He insists that any effort to extend healthcare to more people will be done through “building on Obamacare”(there’s those incremental terms again – “extend”, “more” and “building”) This will never work since the whole objective of health insurance corporations is to increase profit, not cover all Americans. They will always be trying to limit coverage in some way or increase deductibles or maximums or copays.

And then there are other incremental programs that cover additional individuals but never everyone. One is the Children’s Health Insurance Program” or CHIP,, which was started during the Clinton administration as a halfway step to obscure the fact that Hillary Clinton’s proposed program for health insurance had miserably and spectacularly failed. Ostensibly, CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In most states, thus, it constitutes only yet just another incremental approach to healthcare – covering only “some” children, but not their entire families.

Okay, right now people fortunate enough to have health insurance obtain it in myriad ways – Medicaid for the indigent, Medicare for the elderly, CHIP for children who qualify, medical insurance from employers for those who have jobs and whose employers provide it. Ah, but another problem – the apparently infinite variety of programs, higher or lower copays, higher or lower maximum reimbursements, limiting who or what can provide the care, and on and on – all are related to our profit based system and incremental approach. Why can’t all Americans be covered from birth to death, like Canada does, or Norway, or Finland, or every other developed country in the world – and at a much lower cost? How amazing it would be to simply go to the doctor or hospital, present your identification, get treated and go home, knowing that all providers were fairly compensated but that profit was not part of the system. And of course, Medicare itself is an incremental program, in that it does not provide for all of the health needs of our elderly population, containing the glaring holes of no coverage for hearing, vision or dental needs. This lack is now ostensibly being addressed by a dizzying array of “Medicare Advantage” programs, all provided by for profit corporations who reap those profits from overly generous reimbursements from the government. And their vaunted coverage of hearing, vision and dental needs is woefully insufficient.

And now there is childcare incrementalism – even if the “Reconciliation Bill” goes through entirely, it will only be “narrowing the gap” between what European countries pay for childcare and what the US pays. Reliable childcare is absolutely essential in an advanced nation like ours. Yet people struggle every day, just as my wife and I did when our children were young, to find reliable and reasonably priced childcare, when both parents choose to or must work. Rather than having to seek out childcare among neighbors, friends and relatives, Europeans are able to send their children to professionally run and staffed facilities provided by the state – what a difference from the risky, varying quality here in the “richest country in the world”. And that cost to a family is heavily subsidized by the state as well. But here, even with the long shot effort of Biden’s “Build Back Better” legislation, which may never pass anyhow, we will only be partially crossing the chasm between what we have and should have. Again, an incrementalist approach to a serious social need.

And also consider our feeble efforts to increase the minimum wage to $15 per hour, even itself, though a big step, wholly insufficient to provide a decent life for its recipients. Our feckless Congress has steadily refused to raise the minimum wage and every single bill proposed or passed at the state level to do so raises it so gradually to that by the time anyone reaches $15, the effects of inflation will have rendered it already inadequate. Fifteen dollars an hour is in itself merely an incremental goal. If the present federal minimum wage of $7.25 was adjusted for inflation since its inception it would be $22 per hour now. 

And I suppose that the most important example of the curse of incrementalism is our scattershot effort to fight the existential threat of a steadily and inexorably warming climate. Yes, we have some electric cars on the road, many more solar installations than ten years ago, and a steadily increasing number of “wind farms” on the plains, mountaintops and coasts of our country, but not nearly enough to make an impact on our shameful position as the number two carbon polluter in the world. And the country that is number one, China, has rapidly become our “rival” or our “enemy”, making necessary cooperation between the two to combat climate change all but impossible. And fossil fuel companies still enjoy privileged status among the “lawmakers” that inhabit our useless Congress and thus are still largely unregulated and still, would you believe it, subsidized by the US government. And President Biden’s “Build Back Better” program contains revolutionary legislation for the climate promising to “reduce emissions by 50 percent by 2030” so is accordingly incrementalist at best. And even this incremental approach is apposed by “King Coal” Senator Joe Manchin of West Virginia. So unfortunately, this is the best that the world’s number two carbon emitter, the United States, can do. Michael T. Klare in a brilliant article for Tom Dispatch makes it crystal clear that for the world to save itself, China and the U.S. must unite as climate partners and lead the way for other nations to follow. If they do not, climate catastrophe is inevitable. We cannot any longer be incremental in this most important fight. 

And then of course as a nation we have to contend with covid incrementalism. Certain elements of our society cannot seem to get it through their heads that we have required vaccination for serious diseases for decades, with nary a peep from anyone save the few rabid antivaxxers who are prepared to sacrifice the health of their children on the altar of misinformation and obstinance. When I was a child and the Salk polio vaccine and later the Sabin version became  available, millions of thankful parents and children lined up to get immunized, with little concern  about its origin or manufacturer or concerns about its efficacy. And I do not remember any of the corporate Pfizer – Moderna – Johnson & Johnson wrangling and profit seeking nor any politicization of vaccines that characterize the US struggle and dysfunction with covid 19 vaccines today. And, likely most important, there were successful efforts to immunize the entire world against this dreadful crippling disease so that today isolated cases of the disease lurk in but three countries – Nigeria, Afghanistan and Pakistan.

Covid 19 cannot be controlled until the entire world is vaccinated. But this effort is incremental at best since our government has chosen to protect the patents and formulae of the corporations who have developed the vaccines, despite their development being financed by billions in government subsidies. Many US citizens, including myself, have longed for this “richest country in the world” to lead in immunizing everyone everywhere, just as we did with polio vaccines. But instead we have decided to allow pharmaceutical corporations to selfishly maximize profits. Pfizer has in fact become a quasi government entity all by itself – negotiating sales of its vaccines directly with governments across the world independent of any US government role.

And finally, historically we’ve used incremental means to resolve racial segregation issues – school busing to integrate schools was really beating around the edges of the issue, rather than facing it head on and resolving issues like income disparity and racism that created segregated housing in the first place. We very badly need to address racial segregation head on which would include properly educating our population about slavery, Jim Crow and lynching in this country as well as our country’s and our hemisphere’s disgraceful genocide of its native population. Correction of our nation’s terrible inequality, especially evident in its black and other minority populations, would help too. And what about reparations? This whole issue is far to large to address here in one paragraph but we need to face it and solve it as a nation. Get it done once and for all.

And one more thing. The Democrats need to hire someone like Frank Luntz to help with their messaging. Why on earth have they always called this latest bill the “Build Back Better” bill, which has all the oomph of Hillary Clinton’s “Stronger Together” or even more maddening and obfuscating, the “$3.5 Trillion Reconciliation Bill”. This bill contains hugely important and popular legislation that will help all Americans – like making Medicare covering vision, hearing and dental needs, establishing a universal pre-K program and a childcare program for all families, making community college free, a substantial push against climate change and much more. While some very popular provisions have already been cut, to garner more Congressional support, some better messaging would have likely had a very positive effect and the entire bill would have had a much better chance at surviving and becoming law.

 

 

“Wake Up, Liberals: There Will be No 2018 ‘Blue Wave’, No Democratic Majority and No Impeachment”,
“There’s no quick fix for Trump or our damaged democracy—and the Democrats still look hopeless”
“Beyond Opposing Trump, Democrats keep searching for a message”
“Democrats in the Dead Zone”
“Can Democrats Fix the Party?”

Not a day goes by that I don’t read yet another article about the problems in the Democratic Party – no presidency, neither house of Congress and only a third of governors’ offices and state legislatures – and also not a day goes by that I don’t encounter another exhortation or reason or strategy to “resist” Trump and his agenda. It appears that all the Party can do is lick its wounds, point fingers at who or what they think was responsible for its devastating losses and oppose Trump, all totally insufficient to generate the enthusiasm and the votes needed to take back the House or the Senate in 2018, much less the presidency in 2020. “Not Trump” or “Resist” might be rallying cries for the Democratic Party but they are not strategies for winning.

And despite Trump’s record unpopularity and obvious incompetence and millions of dollars poured into them, the Democratic Party is 0 for 4 in recent special congressional elections. How can this be? While it’s obvious that Democratic victory in these four traditionally solid Republican districts would be difficult, another reason for the losses is simply that the Democrats no longer have a clear message other than opposition to the president and the Republican Congress. The latest disappointment, the contest in Georgia’s Sixth District, the lame Jon Ossoff and his DCCC supporters erred seriously with a campaign right out of the vanilla Hillary Clinton playbook – fight government waste, trim regulations, support Israel, promote “civility in politics”, “personal responsibility”, etc – nothing for the guy who’s working two jobs, can’t pay the electric bill, has a chronically sick kid and a pregnant wife and just had his used car repossessed.

Clearly the party needs to stand for something and truly, when I ask myself what the Democratic Party stands for today I am at a loss. This point was perfectly illustrated in the 2016 presidential campaign when what the standard-bearers of the respective parties stood for were in sharp contrast to each other. The authors of “Shattered: Inside Hillary Clinton’s Doomed Campaign” painfully describe the difficulty the campaign had in even coming up with the reason Mrs. Clinton was running for president. The best the campaign could manage was – “I would have had a reason for running or I wouldn’t have run.” In addition the authors describe a board in the campaign’s Brooklyn office totally covered with sticky notes listing “what Hillary is for” – actually so many that the net result was nothing. So it should be no surprise that the Democratic candidate lost the election. It would seem that at the very least it should be clear what a candidate stands for and why s/he is running for office. And during the the campaign there was never any doubt as to where Hillary’s Republican opponent stood and why he was running. He was going to bring manufacturing and mining jobs back, keep Muslims out of the country, build that wall and “Make America Great Again”.

These thoughts have prompted me to reflect on my own political convictions. Since my early twenties, when I finally shook off the last vestiges of the parental cocoon of Republicanism in which I had been wrapped since childhood, I realized that the Democratic Party best represented what “I am for”:

• concern for the health and welfare of my fellow man;
• concern for the working man and the union that represents him;
• a living wage for a full day’s work;
• limiting the power of corporations and big business and ensuring that they paid their fair share of taxes;
• progressive taxation for individuals with the wealthy paying their fair share of taxes;
• a dignified and comfortable retirement for everyone;
• affordable and adequate healthcare for everyone;
• good public schools and and an education for everyone who wanted it;
• a reasonable “floor” under our society beneath which no one could fall, meaning unemployment insurance, welfare for the poor and Social Security for the elderly;
• a safe and healthy environment through regulation and conservation;
• accepting that we are a nation of immigrants that requires laws that foster a steady flow of new blood and energy from foreign lands;
• a belief that the government can be a force for good in people’s lives;
• promoting the importance of voting, that this right should be guaranteed to all citizens.

It seems that these personal convictions have always been staples of the Democratic Party but if so, why is it so difficult today to shout them loud and clear? Obviously the Democratic Party is ill. Its symptoms are obvious: no clear message, ossified leadership, forsaking its working class roots, selling out to Wall Street, economic issues eclipsed by social issues, writing off the working man and relying instead on the minority vote, representation by corporate Democrats like the Clintons, Nancy Pelosi, Chuck Shumer and Debbie Wasserman Schultz and the “Republicans in Democrat clothing”, cross dressers like Senators Joe Manchin and Heidi Heitcamp. What prescription can we offer to address these symptoms? What can we administer to the Democratic Party to get it well? It doesn’t need some expensive drug to treat or mask symptoms or that produces negative side effects, like identity politics,  cultural issues, opposing Trump or defending Obamacare. What the Democratic Party needs is a robust return to the basics of good health – fresh air, good food and lots of exercise. And what are those for the Democratic Party? A return to the principles articulated and espoused by the greatest Democrat of all  –  Franklin D. Roosevelt.

On January 6, 1941, President Roosevelt gave his “Four Freedoms” speech to Congress, “a vision of the world that would be worthy of our civilization”. He announced simply and eloquently that the United States should dedicate itself to advancing these four freedoms everywhere in the world:

• Freedom of speech and expression, the best defense against the corruption of democracy;
• Freedom of worship, our shield against the forces of bigotry, intolerance, and fanaticism;
• Freedom from want, a commitment to erasing hunger, poverty, and pestilence from the earth;
• Freedom from fear, a freedom dependent on collective security, a concept carried forward with our leadership in the United Nations.

Certainly, the Democratic Party, in reviving and resuscitating itself could start here – embrace of these “four freedoms” certainly compels a robust Democratic response to Trump’s attacks on the press and the environment, his recklessness and ignorance in foreign policy and his racism and bigotry.

Another place for the Democratic party to start should be reviewing and dedicating itself to Roosevelt’s “Second Bill of Rights”, those principles having been included in of all places, the Charter of the European Union. It might be useful to go back to the speech in which they were outlined. In Roosevelt’s words spoken to the nation on January 11, 1944:

“This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights—among them the right of free speech, free press, free worship, trial by jury, freedom from unreasonable searches and seizures. They were our rights to life and liberty.
As our nation has grown in size and stature, however—as our industrial economy expanded—these political rights proved inadequate to assure us equality in the pursuit of happiness.
We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. “Necessitous men are not free men.” People who are hungry and out of a job are the stuff of which dictatorships are made.
In our day these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.
Among these are:

—The right to a useful and remunerative job in the industries or shops or farms or mines of the nation;
—The right to earn enough to provide adequate food and clothing and recreation;
—The right of every farmer to raise and sell his products at a return which will give him and his family a decent living;
—The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;
—The right of every family to a decent home;
—The right to adequate medical care and the opportunity to achieve and enjoy good health;
—The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;
—The right to a good education.

All of these rights spell security. And after this war is won we must be prepared to move forward, in the implementation of these rights, to new goals of human happiness and well-being.
America’s own rightful place in the world depends in large part upon how fully these and similar rights have been carried into practice for all our citizens. For unless there is security here at home there cannot be lasting peace in the world.”

Incredibly meaningful meaningful principles, aren’t they? Surely here in the wealthiest nation on earth, we ought to be able to guarantee everyone a home, an education, a decent paying job, medical care and a dignified and worry-free retirement. These are principles that the Democratic Party has forgotten and that if they were embraced anew,  the Democratic Party would regain its rightful place as the party that really cares about people, the party that for decades stood up for the common man.

Everything in FDR’s “Four Freedoms” and “Second Bill of Rights” can be readily extended and translated to what should be the major tenets of the Democratic Party today – including strengthening Social Security, strengthening unions, increasing the minimum wage, and endorsing single payer healthcare. And all of what the Democrats should stand for is supported by the American people. Poll after poll have indicated that most Americans support the principles enumerated above and oppose the cruel Republican agenda of Trump, Ryan and McConnell. The following statistics tell the story:

• 64% are significantly worried about global warning;
• 71% want the US to honor the Paris Agreement on climate change;
• By a ten point margin (49% to 39%) voters polled oppose removing regulations on businesses and corporations;
• Oppose removing regulations specifically intended to combat climate change by a margin of 61% to 29%;
• 58% want federally funded health insurance for all; 85% of black voters and 84% of Latino voters favor placing the government in charge of managing the health care system in the United States;
• a sizable majority — about three in five Americans — say the government has a responsibility to ensure everyone has health care;
• 64% would pay higher taxes to guarantee healthcare for everyone;
• 60% of Americans would favor replacing Obamacare with a federally funded national health plan;
• 74% are opposed to cuts in Medicaid;
• 61% of Republicans and 95% of Democrats would maintain or increase funding for health care in general;
• a majority of Americans support “expanding Medicare to provide health insurance to every American”;
• a plurality of voters support “a single payer health care system, where all Americans would get their health insurance from one government plan”;
• 61% percent of Republicans and 93% of Democrats would maintain or increase spending for ‘economic assistance to needy people in the U.S;
• two thirds of the American people say that the government should care for those who cannot care for themselves;
• 70% want nuclear disarmament;
• 72% want the US out of Iraq and Afghanistan;
• 73% want the government to maintain or increase government support for green energy;
• almost 70% favored Obama’s Clean Power Plan;
• 80% approve of Planned Parenthood receiving federal funds for non-abortion health assistance for women;
• 70% of Americans support a constitutional right to terminate a pregnancy;
• 60% of Americans support doubling the national minimum wage to $15 per hour;
• 60% are favorable toward unions;
• 63% of Americans say money and wealth distribution is unfair;
• Americans are overwhelmingly opposed to tax policies that benefit corporations and the rich;
• 90% agree that there are already too many tax loopholes for the wealthiest Americans and corporations;
• 80% agree that it would help grow the economy if the country made sure the wealthiest Americans paid their fair share of taxes;
• voters broadly agree that Republicans in Congress put the interests of corporations and the wealthiest Americans ahead of average Americans;
• 61% say that the wealthy pay too little in taxes;
• 80% feel strongly that Trump should release his tax returns;
• about 80% of voters from both parties want to reverse Citizens United and get money out of politics;
• 70% say that the government should regulate financial services and products “to make sure they are fair for consumers”;
• 79% say Wall Street financial companies should be held accountable with tougher rules and enforcement for the practices that caused the financial crisis;
• a broad majority (77%) says that there is too much power in the hands of a few rich people and large corporations;
• by a 10-point margin (49% to 39%), voters oppose removing regulations on businesses and corporations;
• 66% of Americans believe there are “very strong” or “strong” conflicts between the rich and the poor, an increase of 19 percentage points since 2009;
• three-quarters of all American adults favored Mr. Obama’s decision to re-establish ties with Cuba;
• a plurality – 39% of Sanders supporters backed Palestinians while just a third backed Israel; support for Palestinians has tripled among US youth;
• 92% favor universal background checks for gun purchases;
• 80% favor letting undocumented immigrants stay here legally;
• 60% favor legalization of recreational marijuana;

So, with the American people solidly behind a progressive agenda, my fellow Democrats, let’s get well. Let’s flush the dangerous and corrupting drugs of Wall Street big money and Clintonian centrism down the toilet and get out into the clean fresh air. Let’s stop supporting already doomed Obamacare, get profit out of healthcare and support Medicare for All; let’s support unions and collective bargaining; regulate big corporations and eagerly “welcome their hatred” as Roosevelt did; let’s support public schools and get corporations out of education; let’s fight to get money out of elections; let’s fight for fair taxation for corporations and individuals; let’s reject the cruelty of the Republican budget and support the Progressive Caucus’ “People’s Budget” ; let’s promote peace, negotiate with our enemies and put the military-industrial complex out of business; let’s support women and their right to control their bodies; let’s reject the influence of the pollsters, idea people, analysts and fundraisers like Neera Tanden, Robbie Mook and John Podesta who helped blow the last election; let’s stop beating around the bush with “identity” messages, “stronger together” banners and advocacy of social issues and get down to the reality of supporting our base with an economic message that will bring our voters together – the original Democratic base of American workers, plus our more contemporary base of minority voters. Let’s support all the traditional Democratic issues mentioned above but let’s wrap them all tightly in an economic message that everyone can support and everyone can understand – President Franklin D. Roosevelt’s Four Freedoms and Second Bill of Rights. If the Democratic Party is brave enough to do this, to eschew the money and resultant influence of corporations and billionaires and rely on common people as Bernie Sanders so successfully did, we can look forward to a Democratic House in 2018, the House and Senate and the presidency in 2020.