Dean’s reservations have been widely echoed on the left. The healthcare bill’s big winners, they complain, are the insurance industry, pharmaceutical companies, hospitals and doctors. Because it lacks both the “public option” (a government-run insurance company competing with private ones to drive down costs) and the Medicare buy-in that was initially highly touted, then quickly shot down by Holy Joe Lieberman, some Democrats fear that the party is both providing inadequate coverage and setting itself up for a voter backlash.

Once the public realizes that the bill mandates everybody to buy private health insurance — pretty much the way everybody has to carry auto insurance — there’s sure to be unhappiness not only on the tea-party right, but also among working people who ordinarily lean Democratic. Politics Daily’s David Corn saw it coming. “I feel as if I’m watching a cheesy horror flick and some poor unsuspecting person is about to open the wrong door,” he wrote last September, “and you want to scream, ‘Hey, don’t open that door!’”

To be sure, the bill provides generous subsidies for individuals and small businesses currently unable to afford coverage. And it doesn’t kick in for a couple of years, when one hopes the current recession will be a bad memory.

© 2009 by Gene Lyons. Distributed by Newspaper Enterprise Association

Even so, Salon’s estimable Glenn Greenwald sees it as a sellout: “The healthcare bill,” he writes, “is one of the most flagrant advancements of … corporatism yet, as it bizarrely forces millions of people to buy extremely inadequate products from the private health insurance industry — regardless of whether they want it or, worse, whether they can afford it,” even with some subsidies.

MSNBC’s self-dramatizing Keith Olbermann goes further, vowing to become what the Russians used to call a “refusenik.” “I hereby pledge,” he announced, “that I will not buy this perversion of healthcare reform. Pass this at your peril, senators. And sign it at yours, Mr. President. I will not buy this insurance. Brand me a lawbreaker if you choose. Fine me if you will. Jail me if you must.”

As diverting a spectacle as that might be, for Democrats to heed such overheated rhetoric would be catastrophically foolish. Olbermann and others spent the 2008 primaries charging that Democrats skeptical of Barack Obama had racist motives. Now that he’s poised to sign the most far-reaching enhancement of the American social contract since Lyndon Johnson, President Obama has now been rendered impure in their eyes.

Here are a few truths: First, we’ve been living in a one-dollar, one-vote corporatized democracy for a long time. If this is news to you, then you’re probably also shocked to learn that the U.S. Constitution, by awarding two senators to each of what H.L. Mencken called “the cow states” — no insult to the cows in my own barn — was deliberately crafted to make fundamental change difficult. Who made “moderates” like Blanche Lincoln of Arkansas, Ben Nelson of Nebraska and Joe Lieberman of Aetna mini-presidents? Alas, the founding fathers did.

Living in such a polity, anybody who thought entrenched interests like the insurance, pharmaceutical and hospital industries weren’t going to find ways to make money off healthcare reform probably wasn’t paying attention back at the beginning, when Obama said that despite the abstract appeal of a Canadian-style single-payer system, it was a political non-starter. As Greenwald points out, that told you right there that the White House was going to settle for the best corporate compromise it could get.

Sure, there’s a risk of backlash. The problem is no universal or near-universal health-insurance plan — public or private — can be voluntary. Mandates are, well, mandatory to prevent opportunists from gaming the system: Buying insurance only after they get sick. Nobody can insure “previously existing conditions” if clients come and go at will.

Insurers forbidden by law from canceling policies also need a base of healthy rate payers. Public or private, it’s a two-way street; costs can’t be cut without a bigger risk pool.

Indeed, a gradual counter-backlash seems likelier, as all but the most perfervid tea partiers gradually recognize that their families are more secure, and that none of the GOP scare stories — “death panels,” rationing, etc. — have any basis in reality. Retreat now is unthinkable. Imperfections notwithstanding, once universal coverage is established in principle, there’ll be no going back.

Seems like the ADL may have gotten the message.

The first example in Keating’s article was something that Richard Land, the president of the Southern Baptist Ethics and Religious Liberty Commission, said recently: “I want to put it to you bluntly. What they are attempting to do in health care, particularly in treating the elderly, is not something like what the Nazis did. It is precisely what the Nazis did.” Land also said he was giving “the Dr. Jose Mengele Award” to Dr. Ezekiel Emanuel, an oncologist and medical ethicist who’s also the brother of White House chief of staff Rahm Emanuel and an advisor to the White House on healthcare reform. (I’ve written before about the various falsehoods being spread about Emanuel; you can read that post here.)

As Keating pointed out, that comparison to the Nazis, and of Emanuel to Mengele, a man who doomed untold numbers to death and performed gruesome medical experiments on live victims, a man so cruel that even at Auschwitz he became known as the Angel of Death, drew no public response from “any major Jewish organization.”

Well, apparently ADL national director Abraham Foxman wrote to Land on Oct. 9 about the latter’s comments, and the two spoke by phone. Land has now written a letter of apology to Land in which he says:

It was never my intention to equate the Obama administration’s healthcare reform proposals with anything related to the Holocaust. My concern, which is clear when the remarks are reviewed in context, was about the potential denial of healthcare to the elderly, the infirm, the disabled and the unborn…

Now that I have had the opportunity to speak with you personally and reflect on my words, I deeply regret the reference to Dr. Josef Mengele. I was using hyperbole for effect and never intended to actually equate anyone in the Obama administration with Dr. Mengele. I will certainly refrain from making such references in the future. I apologize to everyone who found such references hurtful. Given the pain and suffering of so many Jewish and other victims of the Nazi regime, I will certainly seek to exercise far more care in my use of language in future discussions of the issues at stake in the healthcare debate.

(Hat tip to Ben Smith.)

Notably, of course, Land didn’t apologize for the substance of his comments, and reiterated allegations about the Obama administration’s proposals that are demonstrably false. And he doesn’t seem to have apologized to Emanuel himself.

South Carolina Sen. Jim DeMint has even gone so far as to say the U.S. is “where Germany was before World War II,” making, it would seem, an extraordinary analogy between President Obama and Adolf Hitler. It seems incredible, but then you see the posters waved by protesters at town hall meetings featuring Obama as an SS trooper, and you realize that DeMint is being taken at his word by a significant fraction of the general populace.

Yes, the GOP went there. So let’s go there too.

Over my break, I started reading Ron Chernow’s engrossing “The Warburgs,” a history of the German Jewish banking family that was probably second only to the Rothschilds in its international success. In the early 1920s, when the Nazi Party was still only a minor player in German politics, the Warburgs became a target for vicious propaganda. Among numerous other sins, the Warburgs were blamed for directly contributing to Germany’s defeat in World War I.

With Jews suddenly prominent in so many areas, the Nazis could hold them responsible for every novelty from industrial consolidation to financial speculation to avant-garde thought … In this atmosphere, it no longer sufficed to charge the Warburgs with isolated acts of betrayal. Now every random fact of their existence had to be closely spun into a fantastic conspiracy … The theory was infinitely elastic, weaving every thread of Warburg history into a lurid tapestry. The Nazis didn’t worry about internal contradictions. The Warburgs were secret stooges both of Wall Street and Russian revolutionaries … The point was not to be accurate but to breed suspicion and confusion … No lie was too preposterous or fantastic.

In 1925, Adolf Hitler described this propaganda technique in “Mein Kampf” as “the big lie.”

[I]n the big lie there is always a certain force of credibility; because the broad masses of a nation are always more easily corrupted in the deeper strata of their emotional nature than consciously or voluntarily; and thus in the primitive simplicity of their minds they more readily fall victims to the big lie than the small lie, since they themselves often tell small lies in little matters but would be ashamed to resort to large-scale falsehoods. It would never come into their heads to fabricate colossal untruths, and they would not believe that others could have the impudence to distort the truth so infamously.

What makes that passage so monstrously mind-bending is that Hitler was accusing the Jews of engaging in the big lie, when in fact the Nazis would be history’s greatest practitioners. Jim DeMint suddenly appears in a different light, because he is actually deadly accurate when he compares the present climate to pre-WWII Germany. The GOP’s avid willingness to wield the big lie makes the comparison valid.

Another troubling thing: I do not know when you first began to insist that Sarah Palin’s baby boy would need to appear before one of your panels, but I can tell you this, Mr. President, it is not going to fly with the American people. If you are going to try to ram the death panels through Congress, I have three words of advice: Easy does it. Certainly there are people we can all agree are of borderline value. For instance, there is this guy I know named Harold who is a total monster. Everyone hates him. No matter how friendly we are to him, he never returns our greetings, but instead gives us the stink-eye, and a sneer. It is hard for me to believe that even Jesus would argue on his behalf at one of your panels. But the little Palin baby? No way, no how.

There would need to be a system of checks and balances so that we could all rest assured that favoritism was not a part of determining who would receive healthcare. Some people would say that if someone more closely resembled an Alturien than an American citizen, that person might be considered for the death pile. But that strikes me as being very cavalier. Life is precious, Mr. President, and just because somebody’s appearance makes you think of space aliens and anal probes rather than car seats and root beer, it is no reason to throw them away, as you have proposed. Obviously, if there is going to be a lot of killing going on in your healthcare program, panels would have to be made up of people with impeccable credentials. Otherwise, this would be a real deal-breaker for a lot us. For God’s sake, what if someone like Harold ends up as a judge on the panel, instead of coming before it, like the little Palin baby, or someone’s perfectly good grandparents?

This death panel of yours will require people of sensitivity, fairness, efficiency and patience. And that is why I would like to volunteer to serve: I am fair, fast and fun. Mr. President, I am at your service.

Best wishes,

Anne Lamott