Where Are Reform's Beneficiaries?
"The main constituency for health reform consists of people who don’t think the present system is fundamentally sound," writes Matt Yglesias. "That’s a big part of the reason the public plan element of Obama’s proposals has become such an emotional touchstone for the left. The public plan is a fairly modest part of a fairly modest package of reforms, but it’s the slice of the package that holds out the prospect of eventual transformation of the system into something quite different and less driven by corporate profits."
That's a smart point: The primary constituency for health-care reform has a political attachment to it, and in particular, to the public option portion of it. This is not, however, the most obvious constituency for health-care reform. That honor goes to the uninsured, the underinsured, the unemployed and others lower on the income ladder who are likely to directly benefit from the bill, rather than abstractly benefit from seeing their ideological preferences included in the bill.
They, however, are not in the streets or at the town halls. Broadly speaking, they're politically marginalized: They don't vote or march or yell. They don't believe the political system is really responsive to them — which may be because it's not (pdf). Which of course means the political system is even less responsive to them, as no politicians fear the uninsured because the uninsured don't vote.
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