At Tuesday's markup in the Senate Finance Committee for health care reform, Senators Rockefeller and Schumer, in their advocacy of public option amendments, elicited responses from Senator Grassley that came close to framing the actual issue that is of concern to Republicans. Grassley, like others in his party, has mostly taken the rhetorical position that hot button code words like "death panels," and "socialism" would be sufficient answer to those who propose a public option, never mind a single payer, approach to health care reform. The public mark up, well covered by the media, finally provided an occasion to challenge the hypocrisy of the Republican stance.
Speaking against Rockefeller's amendment, for example, Grassley asserted that a "government-run plan will ultimately force private insurers out of business."
Whatever the validity of the argument, it may be as close as we get to a specific acknowledgement by Republicans that the capitalistic profit motives of health insurers trump the health needs of Americans.
Senator Schumer, in his turn, asked Senator Grassley if he supports the government-backed health care program Medicare.
"I think that Medicare is part of the social fabric of America just like Social Security is," Grassley responded.
Pressed further by Schumer as to why Grassley felt that Medicare, which he nominally supported, did not logically require him to support the proposed public option, Grassley made an interesting and revealing response:"It's not easy to undo a Medicare plan without also hurting a lot of private initiatives that are coupled with it." In other words, since private insurers have found comfortable ways to make money by using the structure of Medicare, then for that reason, and not the relative success Medicare has had in efficiently distributing health care benefits to those who need them, he supports Medicare.
In the discussion which is yet to come, it should become more and more clear that Republicans and Democrats are talking past each other in the debate over health care. Democrats argue from the position that health care is increasingly unaffordable and that health care outcomes are less good than they should be. Republicans argue from the position that health care is simply a product to be marketed, like any other, with regard to incentives for profit and without concern for widespread distribution of health care to those who cannot afford it.