Thanks to our undemocratic system and our corrupt campaign finance laws, the healthcare industry doesn’t have to fight a 50-state battle. It can simply buy a tiny group of congresspeople, which is what it’s done. According to the Center for Responsive Politics, health interests have given these 13 members of Congress $12 million in campaign contributions — a massive sum further enhanced by geography.
Remember, politicians trade favors for reelection support — and the best way to ensure reelection is to raise money for TV airtime (read: commercials). In rural America, that airtime is comparatively cheap because the audience is relatively small. Thus, campaign contributions to rural politicians like these 13 buy more commercials — and, consequently, more political loyalty.
The end result is an amplifier of tyranny: precisely because the undemocratic system unduly empowers legislators from sparsely populated (and hence cheap) media markets, industry cash can more easily purchase tyrannical obstruction from those same legislators. In this case, that means congresspeople blocking healthcare reform that would most help their own voters.

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