One of the more interesting moments I caught in the Iowa Debate was the Kucinich-Dean exchange on single-payer universal healthcare. Dean, to his credit, was up front in stating that voters whose primary issue was single-payer should vote for Kucinich, and then touted the virtues of his plan which, Kucinich rightly argued, would maintain the strangehold of the insurance industry on the practice and policy of healthcare. What perhaps was most surprising about Dean’s defense of his plan, however, was its central argument that it was simply the best the Democrats could get away with – that his plan “was written to pass Congress.” Dean cited the failures of the Carter and Clinton healthcare plans to buttress his claim.

I think Michael Tomasky, in Left for Dead, offers a more convincing reading of the Clinton healthcare failure:

…the A.M.A. and the insurance lobbies fought the Clinton proposal with the same intensity they’d have have brought to a fight against single-payer. A political calculation to trim the sails is useful and defensible if, without sacrificing too much in the way of principle, it gets you more votes. The Clinton calculation did not do that. And in this instance, given the number of co-sponsors single-payeralready had in the House of Representatives and the appeal of the plan’s salient features, it may actually have been the case that a single-payer system could have been sold to the public. The seller, though, had to be willing to confront one of Washington’s most powerful lobbies – something the Clintons weren’t up to; but this, too, is something people clearly say they want their leaders to do more of.

Among the people calling on their leaders to do more of that? Howard Dean. Kucinich was right to ask him who, if not the President of the United States, would be in a position to stand up to the insurance industry. Dean, unfortunately for those of us drawn by the strength of his organizing and the clarity of his alternative vision, was left looking not for the first time like what he’s referred to rightly as “the Republican wing of the Democratic party.”

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