Right now, here is a great deal of frustration on the part of the health care reformer movement regarding the apparent success of the insurance lobby (read: teabaggers) to muddy the waters of the debate, shout down advocates and get granny cowering under her afghan, worried that she’s about to be shipped to the Soylant Green factory.

On Wednesday, Barack Obama will allegedly enter the fight in earnest, laying out what he wants out of a health care bill. Some fear that he will capitulate to the pressure, cave on a public option and basically endorse some sort of window dressing for reform, such as co-ops, and wash his hands of it all. This is unlikely.

The real sense is that Obama will resort to incrementalism, proposing the smallest doses of medicine that the right wing can swallow and putting his weight behind forcing the spoon through their pursed lips. This will probably take the form of the changes America has shown the least resistance to vis a vis private insurance: removing pre-existing condition snares, lifetime payout caps, and allowing insurance mobility when one changes jobs.

A needed start, but the real transformation will face the same resistance whether it comes tomorrow or today. The question neeeds to be answered, not by legislators, but by citizens: is our health insurance system obsolete?

It is just this discussion that the conservatives have been trying to derail with their divide-and-conquer strategy of obnoxious town hall putsches. By stoking the fears of a worsened health care system, the citizens are kept off balance from realizing that what they have right now really sucks.

The fact is that before genuine reform can come, the people have to decide that change is needed not simply for financial reasons, but for moral ones. This is tough in the Darwinian environment which Americans are told is our natural state. Americans are go-getters, individualists, non-gay cowboys, and so forth. Health care for all Americans? Why, it’s downright un-American!

Thats the chaw for the masses. Between the upper classes, the argument goes more like this: health care is a privilege bestowed on the productive citizens by dint of their hard work. It is only unaffordable to those who have fallen by the wayside in our “tough love” economy. If the weak had the talent to be the prime movers, or were of more than of average use to the over class, affordable health care would be within their reach.

You hear this shit a lot among Libertarians. Never mind that the country already decided long ago through Social Security, Medicare and Medicaid that dog-eat-dog rules need not apply in the wealthiest country in the world. But there is also the small matter of how the “unproductive” citizens have been getting fucked in the wallet since the seventies, when wages began to flatten out (and even decline) while the productivity of the American worker continued to increase on a steady curve, as it has for a hundred years. This has created  an increasing flow of profits to their employers that has failed to reemerge in the worker’s lives in the form of the things they really need, such as affordable and dependable health insurance.

So the matter is societal, dare I say social, and must be addressed on those terms. Do people in the richest nation in history deserve a health care system that works for everyone, as due their hard labor and decades of diminishing rewards, or will it remain an entitlement for millionaires and politicians?

Here (compressed for your pleasure) is everything the Republicans have to say about improving healthcare for the public. As you can see, it is long on nightmares and short on reform:

The right wing argument basically consists of two points: we cain’t affird it right now, and even were we could, we’re a free markit system dagnabbit!

The first point  is evergreen and deserves little credit. When hasn’t it also been made in a time of plenty? No, our budget is not made of inexhaustible flubber, but Washington has never lacked the will to shovel billions into enterprises like half-assed wars and banking bailouts, with the fruits of that largesse flowing upwards to the wealthiest friends of the Treasury secretary, arms merchants and boutique mercenary corps’. Forgive me if I feel that if there is a will, we will find the way.

As for the free market, how much longer are we going to be hentai-raped with that one? The free market exists to provide what the government shouldn’t, and the government for what the free market can’t. Has anyone heard a fresh scheme emerge from the “free market” that will correct the issue at hand: that the cost of health care is growing beyond the means of even the well-to-do?

If the private insurance system as it is now constituted cannot fulfill the need for which it exists, then it has outstayed its welcome. But its replacement, if it is to be fair to what the public wants, will not be inexpensive.

It need not, however, be a millstone. The majority of countries that enjoy our standard of living choose public health care, and their plans range from a government supervised free market to straight socialized medicine. Most are pretty happy with what they have. We, plainly, are not. What has to change are our priorities, and that means our fundamental attitude towards who deserves health care: all, or some.

We will not see an improvement until we are willing to say, flatly that affordable health care is a citizens’ right, paid for by our productivity, and with roots in our sense of justice. The Republicans? They’re still trying to convince you and I that strapping a man to a table and drowning him is what makes this country great.

Fuck ’em. And happy Labor Day.