Is the Obama Health Care Plan Really Better Than Nothing? July 27, 2009
Posted by rogerhollander in Health.Tags: bruce dixon, california nurses, co-payments, corporate media, Dennis Kucinich, health, health care, health care reform, health costs, health insurance, health insurance industry, healthcare, healthcare reform, kucinich amendment, lyndon johnson medicare, massachusetts health care, Medicaid, medical costs, medicare, national health, obama health plan, obama plan, private insurance, public option, roger hollander, single payer, uninsured
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The health care debate inside and outside the matrix
by Bruce Dixon
Like just about everything else, your take on the national health care debate depends on whether you’re inside or outside the matrix.
Within the bubble of fake reality blown by corporate media and bipartisan political establishment, the health care news is that theObama Plan is at last making its way through Congress. It’s being fought by greedy private insurance companies, by chambers of commerce, by Republican and some Democratic lawmakers.
Under the Obama plan, we’re told, employers will have to insure their employees or pay into a fund that does it for them. Individuals will be required under penalty of law to buy private insurance policies and for those that can’t afford it or prefer not to use a private insurer there will be something called a “public option.” This “public option, the story goes, is bitterly fought by the bad guys because it will make private insurers accountable by competing with them, forcing them to lower their costs. Both the president’s backers and opponents agree that the whole thing will be fantastically expensive, and the president proposes to fund it with cuts in existing programs like Medicaid which pay for the care of the poorest Americans and a tax on those making more than $300,000, later raised to $1 million a year.
The “public option” has that magic word “public” in it, and that’s reassuring to progressives and to most of the American people. Taxing the rich is a popular idea too. So if you rely on corporate media, the administration, or some of the so-called progressive blogs to identify the players and keep the score, it seems a pretty clear case of President Obama on the side of the angels, battling the greedy insurance companies, Republicans and blue dog Democrats to bring us universal, affordable health care.
That whole picture has about as much reality as the ones the same corporate media and most of the same politicians drew for us about Iraq, 9-11, weapons of mass destruction and some people over there who wanted us to free them. Iraq and the White House were and remain actual places, and there really is a problem called health care. But the places, problems and solutions are very different from the bubble of fake reality blown around them.
What sustains this fake reality is the diligent suppression from public space of any viewpoints, observations or proposals to Obama’s left. As long as the illusion that nobody has a better idea, that the only choice we have is Obama’s way or the Republicans’ way can be maintained, the crooked game can go on.
But bubbles are delicate things. Keeping this one intact requires so many vital topics to be avoided, so many inquiring eyes to be averted, so many fruitful conversations to be squelched that it’s hard to see how the president, the bipartisan establishment and the corporate media can pull it all off.
The real Obama Plan: doesn’t cover the uninsured till 2013, if then.
The first clue that something is deeply wrong with the Obama health care proposal is its timeline. According to a copyrighted July 21 AP story by Ricardo Alfonso-Zaldivar,
“President Lyndon Johnson signed the Medicare law on July 30, 1965, and 11 months later seniors were receiving coverage. But if President Barack Obama gets to sign a health care overhaul this fall, the uninsured won’t be covered until 2013 – after the next presidential election.
“In fact, a timeline of the 1,000-page health care bill crafted by House Democrats shows it would take the better part of a decade – from 2010-2018 – to get all the components of the far-reaching proposal up and running.”
According to a peer reviewed 2009 study in the American Journal of Medicine, 62% of the nation’s 727,167 non-business bankruptcies were triggered by unpayable medical bills in 2007. Most of these had health insurance when they fell ill or were injured, but with loopholes, exclusions, high deductibles and co-payments, or were simply dropped when they got sick. In 2008 that figure was 66% of 934,000 personal bankruptcies and in 2009 it could approach 70% of 1.1 million bankruptcies. And 18,000 Americans die each year because medical care is unaffordable or unavailable. Waiting till 2013 means millions of families will be financially ruined and tens of thousands will die unnecessarily.
If the Johnson administration with no computers back in the sixties could implement Medicare for 45 million seniors in under a year, why does it take three and a half years in the 21st century to cover some, but not all, of America’s fifty million uninsured? And why does the Obama Plan make us wait till after the next presidential election? Politicians usually do popular things and run for election on the resulting wave of approval. Delaying what ought to be the good news of universal and affordable health care for all Americans till two elections down the road is a strong indication that they know the good news really ain’t all that good. And it’s not.
Inside the matrix of TV, the corporate media and on much of the internet, discussion of the Obama plan’s timeline, the human cost of another three years delay, and the comparison with Medicare’s 11 month rollout back in the days before computers are almost impossible to find. We can only wonder why.
The Obama plan is about health insurance, not health care.
As BAR has been reporting since January 2007, the Obama plan is not a health care plan at all, it is a health insurance plan. Based largely upon the failed model in place in Massachusetts since 2006, the Obama plan will require employers to provide coverage or pay a special tax. Everybody not covered by an employer will be required to purchase insurance under penalty of law, in much the same manner as you’re currently required to buy car insurance.
“In my state,” testified Dr. Steffie Woolhandler of the Harvard Medical School last month before Congress, “beating your wife, communicating a terrorist threat and being uninsured all carry $1,000 fines.”
As in Massachusetts, the health insurance plans people are forced to buy will cost a lot and won’t cover much. In a July 20 National Journal article Dr. David Himmelstein says,
“Nearly every day that he is in the clinic, Himmelstein says, he sees a patient who has problems paying for care “despite this reform.’ Some of them had free care before the 2006 law took effect but are now expected to handle co-payments. If you’re not poor enough to get a subsidy, say you’re making $30,000 a year, you’re required to buy a policy that costs about $5,000 a year for the premium and has a $2,000 deductible before it pays for anything. For substantial numbers of people, it’s effectively not coverage,’ Himmelstein said. The policy he described is about the cheapest Massachusetts plan available, according to the Physicians for a National Health Program report, which Himmelstein co-wrote.”
A family of four making under $24,000 a year in Massachusetts gets its insurance premium free, but is still expected to cough up deductibles and co-payments and live with loopholes and exclusions that often deny care to those who need it. And in both the Massachusetts and Obama plans, funds to pay those premiums come out of the budgets of programs like Medicaid that already pay for care for the poorest Ameicans.
The Obama plan’s “public option” is a bait-and-switch scam
A July 21 pnhp.org article titled “Bait and Switch: How the Public Option Was Sold” outlines how the public option is neither public, nor an option.
“Public option” refers to a proposal… that Congress create an enormous “Medicare-like” program that would sell health insurance to the non-elderly in competition with the 1,000 to 1,500 health insurance companies that sell insurance today…
“Hacker (its author) claimed the program, which he called “Medicare Plus” in 2001 and “Health Care for America Plan” in 2007, would enjoy the advantages that make Medicare so efficient – large size, low provider payment rates and low overhead…
“Hacker predicted that his proposed public program would so closely resemble Medicare that it would be able to set its premiums far below those of other insurance companies and enroll at least half the non-elderly population.”
The White House is committed to twisting arms in the both houses of Congress and reconciling the two versions of Democratic bills to emerge from the House and Senate. What emerges will be the Obama plan. According to the Congressional Budget Office, the Senate version of the Democrats’ pending health care legislation leaves 33 million uninsured and omits the public option altogether. The House version includes a “public option” estimated to cover only 10-12 million people, a number far too small for it to create price pressure on private insurance companies, while leaving 16 or 17 million uninsured. Instead of setting prices for health care, it will be forced to pay whatever tthe private insurers already pay, and perhaps more.
As private insurers use their marketing muscle to recruit younger, healthier people who’ll pay for but not use their benefits, the public option will be a dumping ground for the customers they don’t want… the middle-aged, the poor, those with pre-existing conditions. And of course the Obama plan’s “public option’ will be managed by contractors from the private insurance industry.
Private insurers spend a third of every health care dollar on non-health related things like bonuses, denial machinery, advertising, lobbying and bad investments. Medicare spends 2 or 3% on administrative overhead. Bush’s “enhanced Medicare” administered by private insurance contractors, spends about 11% on overhead. That’s about what we should expect from the Obama public option. So much for change.
So far, discipline is holding. Nobody in corporate media, the administration, or among Democrats in Washington has gotten round to telling us that the public option has been eviscerated. But its powerful appeal and the awesome power of the word “public” are offered by Obama supporters as the central reasons to shut up, clap harder, and get behind the president on this.
Taxing the rich, paying for health care. How the Obama Plan stacks up against single payer.
Along with being funded by cuts in Medicaid, the Obama plan is supposed to be funded by taxing those who make $300,000 or more per year. That’s not a bad thing. The wealthy don’t pay nearly enough taxes. But the US already spends more on health care than anyplace else on the planet while leaving a greater portion of its population uninsured than anybody.
The Obama plan will not contain costs. It will subsidize the insurance vampires well into the next decade. On the other hand, single payer would eliminate the private insurance industry altogether. In many advanced industrial countries, most of the practices private insurers follow here, such as cherry picking healthy patients while dumping and denying sick ones, are illegal. Why can we do that?
Single payer, according to a study by the California Nurses Association would eliminate 550,000 jobs in private insurance while creating 3.2 million new ones in actual health care. It would be responsible for $100 billion in wages annually and a source of immense tax revenues for local governments.
So is the Obama plan really better than nothing?
The Obama plan seems calculated to buy time for private insurers, to end the health care discussion for a decade or more without solving the health care problem, do so in a way that discredits the very idea of everybody in- nobody out health care. It will leave tens of millions uninsured, a hundred million or more underinsured, and the same parasitic private interests in charge of the American health care system that run it now.
The Obama plan as it now stands requires us to let another 18,000 die for each of the next three years and allow more than a million additional families to be bankrupted by medical expenses before we can judge whether or not the plan is working. It’s easy to imagine Obama partisans telling us in mid 2013 that it’s still too early to be sure.
The Kucinich amendment, which allows the few states wealthy enough to try it the liberty to fashion their own single payer regimes is intended to attract progressives and single payer votes in Congress without breaking the bubble. By itself, it should not be a reason to support this bill.. The wealthiest state in the union is probably California, and it’s handing out IOUs instead of salaries this month. It’s hard to see what would be lost if this health care bill went down in flames, and we started over again next year.
Can he get away with it?
Maybe. Maybe not. If the corporate media and the president can keep discussion of the devilish details to a minimum, if they can silence, co-opt and intimidate the forces to Obama’s left — if they can keep most of the public inside their bubble of fake reality, Barack Obama may achieve his goal of thwarting the reform that most of the American people want — an everybody in, nobody out single payer health care system on the model of Canada or Australia, or Medicare for All. It won’t be close, it won’t be easy, and with nothing to be gained, progressives shouldn’t make it any easier.
Since the president’s success depends mostly on keeping people silent and in the dark, he will probably be unable to mobilize the 13 million phone numbers and email addresses collected during the recent presidential campaign, and now held by OFA, his campaign arm. If an organizing call went out to them, too many would try to read the bill and discuss the options, and such a discussion could easily get out of hand. When OFA called house meetings on health care last December, the most frequently advanced question was why we couldn’t or shouldn’t get a single payer health care system.
Single payer isn’t dead yet. It’s very much alive among Barack Obama’s own supporters. To succeed, he has to bury it alive, to keep them in the bubble, in the dark and quiet, or clapping so loudly they cannot hear themselves or each other think. It’s not over.
© 2009 Black Agenda Report
Health Insurance Whistle-Blower Knows Where the Bodies Are Buried July 15, 2009
Posted by rogerhollander in Health.Tags: amy godman, California Nurses Association, cigna, cna, denis moynihan, for profit health, health, health care, health care reform, health insurance, health insurance industry, health insurance lobby, health premiums, healthcare, healthcare reform, hmos, insurance exectuives, max baucus, pharmaceutical industry, roger hollander, senate finance, single payer, wendell potter, whistle blower
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Wendell Potter is the health insurance industry’s worst nightmare. He’s a whistle-blower. Potter, the former chief spokesperson for insurance giant CIGNA, recently testified before Congress, “I saw how they confuse their customers and dump the sick—all so they can satisfy their Wall Street investors.”
Potter was deeply involved in CIGNA and industrywide strategies for maintaining their profitable grip on U.S. health care. He told me: “The thing they fear most is a single-payer plan. They fear even the public insurance option being proposed; they’ll pull out all the stops they can to defeat that to try to scare people into thinking that embracing a public health insurance option would lead down the slippery slope toward socialism … putting a government bureaucrat between you and your doctor. They’ve used those talking points for years, and they’ve always worked.”
In 2007, CIGNA denied a California teenager, Nataline Sarkisyan, coverage for a liver transplant. Her family went to the media. The California Nurses Association joined in. Under mounting pressure, CIGNA finally granted coverage for the procedure. But it was too late. Two hours later, Nataline died.
While visiting family in Tennessee, Potter stopped at a “medical expedition” in Wise, Va. People drove hours for free care from temporary clinics set up in animal stalls at the local fairground. Potter told me that weeks later, flying on a CIGNA corporate jet with the CEO: “I realized that someone’s premiums were helping me to travel that way … paying for my lunch on gold-trimmed china. I thought about those men and women I had seen in Wise County … not having any idea [how] insurance executives lived.” He decided he couldn’t be an industry PR hack anymore.
Insurance executives and their Wall Street investors are addicted to massive profits and double-digit annual rate increases. To squeeze more profit, Potter says, if a person makes a major claim for coverage, the insurer will often scrutinize the person’s original application, looking for any error that would allow it to cancel the policy. Likewise, if a small company’s employees make too many claims, the insurer, Potter says, “very likely will jack up the rates so much that your employer has no alternative but to leave you and your co-workers without insurance.”
This week, as the House and Senate introduce their health care bills, Potter warns, “One thing to remember is that the health insurance industry has been anticipating this debate on health care for many years … they’ve been positioning themselves to get very close to influential members of Congress in both parties.” Montana Sen. Max Baucus chairs the Senate Finance Committee, key for health care reform. Potter went on, “[T]he insurance industry, the pharmaceutical industry and others in health care have donated … millions of dollars to his campaigns over the past few years. But aside from money, it’s relationships that count … the insurance industry has hired scores and scores of lobbyists, many of whom have worked for members of Congress, and some who are former members of Congress.”
The insurance industry and other health care interests are lobbying hard against a government-sponsored, nonprofit, public health insurance option, and are spending, according to The Washington Post, up to $1.4 million per day to sway Congress and public opinion.
Don’t be fooled. Profit-driven insurance claim denials actually kill people, and Wendell Potter knows where the bodies are buried. His whistle-blowing may be just what’s needed to dump what’s sick in our health care system.
Denis Moynihan contributed research to this column.
© 2009 Amy Goodman
Spreading the Wealth Around to the Insurance Industry and Friends June 22, 2009
Posted by rogerhollander in Health.Tags: ama, canada health, dean baker, drug companies, drug patents, germany health, health care, health care industry, health care reform, health care system, health costs, health insurance, health insurance industry, healthcare, healthcare reform, medical supply industry, medicare, pharmaceutical industry, roger hollander, single payer
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2 June 2009by: Dean Baker, Truthout | Perspective, www.truthout.org
This is the time when the excrement starts hitting the fan. The lobbyists are in overdrive, rounding up members of Congress just like the cowboys of the Old West would bring in the herd.
The industry groups will also have their friends in the news media working overtime hyping any possible obstacle to health care reform. And they are filling the airwaves with scary ads, warning that people will never be able to see a doctor again if meaningful health care reform passes.
Since there are trillions of dollars at stake, the effort is understandable. The basic story is simple. The insurance, pharmaceutical and medical supply industries, along with the hospitals and the American Medical Association, have rigged the deck so that they get rich at the public’s expense. They have structured our health care system so that we pay more than twice as much per person as people in other wealthy countries, even though we get worse care by many measures.
The bloat in the health care sector is projected to grow rapidly over the next decade as health care consumes an ever larger share of the economy. The Centers for Medicare and Medicaid Services (CMS) reports that just the increase in health care spending share of the economy over the next decade will cost us $4.3 trillion. That is equal to a health care tax of $57,000 for an average family of four.
Who benefits from the taxpayers generosity? CMS projects that $1.4 trillion, or $18,500 per family will go to the hospitals. Doctors and the pharmaceutical companies are each expected to score about $550 billion, costing families $7,300. And the insurance industry’s share of GDP is projected to rise by $360 billion, or $4,800 for an average family.
These massive transfers are not the result of the wonders of the free market. These folks are getting money out of our pockets because their friends in Congress have rigged the deck so the money flows from us to them. For example, the government grants the pharmaceutical industry patent monopolies that prevent normal competition in the prescription drug market.
Unlike every other country in the world, the United States lets the drug companies use their government-granted monopolies to charge whatever they want. As a result, we pay nearly twice as much for our prescription drugs as people in countries like Canada and Germany.
Similarly, doctors are able to tightly control the supply of both US trained physicians and the number of doctors that can enter the country from abroad. If custodians had the same control over the labor market for janitors, they would all be making $80,000 a year. We pay close to twice as much for our doctors as people in other wealthy countries. The gap is especially wide for highly paid specialists like neurosurgeons and cardiologists.
Of course, the insurance industry is a total mess. They pocket more than 15 cents for every dollar they pay out to providers. By comparison, the administrative costs of Medicare are less than 2 percent of its revenue. If the insurers ever had to compete with a publicly run insurance plan on a level playing field, they would be blown out of the water.
We know that private insurers can’t compete because we already had this experiment with the Medicare program. When private insurers had to compete on a level playing field with the traditional government-run plan they were almost driven from the market. That is why they got their friends in Congress to pass Medicare Advantage. This program spreads the wealth around by giving the private insurers a subsidy of more than 11 percent per patient.
As Congress debates health care reform, we should be very clear what is going on. It is easy to devise reforms that will reduce costs without jeopardizing the quality of care.
That is not the fight. The fight is over whether Congress will leave in place structures that will siphon an ever-larger amount of money out of taxpayers’ pockets and put this money in the hands of the insurance industry, the hospitals, the drug companies and the doctors.
Getting a robust public plan, that both individuals and employers can buy into, will be the key indicator of whether Congress is still determined to redistribute income into the hands of the insurers, the drug companies and the rest. A robust Medicare-type plan will not only reduce the insurance industry’s tax on our health care, it will also be able to bargain for lower prices from the drug companies, the medical supply companies, and other health care providers.
For this reason, most of the industry is united against any sort of serious public plan. Their latest compromise is a system of small cooperative insurers that will have no bargaining power. That’s a cute joke, but it has nothing to do with health care reform.
So, keep hold of your scorecard. Unless Congress creates a serious public plan, you can expect to be hit with the largest tax increase in the history of the world – all of it going into the pockets of the health care industry.
Dean Baker is the Co-director of the Center for Economic and Policy Research. CEPR’s Jobs Byte is published each month upon release of the Bureau of Labor Statistics’ employment report.
Health Care is a Right, Not a Privilege June 9, 2009
Posted by rogerhollander in Health.Tags: bernie sanders, cigna, doctor shortages, drug companies, health, health care, health care costs, health care reform, health care system, health costs, health insurance, health insurance industry, healthcare, healthcare reform, medicare medicare for all, private health insurance, roger hollander, single payer, united health
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Senator Bernie Sanders
www.opednews.com, June 8, 2009
Let’s be clear. Our health care system is disintegrating. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11 – but this occurs every year.
In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on health care than any other nation – and health care costs continue to soar. At $2.4 trillion dollars, and 18 percent of our GDP, the skyrocketing cost of health care in this country is unsustainable both from a personal and macro-economic perspective.
At the individual level, the average American spends about $7,900 per year on health care. Despite that huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. From a business perspective, General Motors spends more on health care per automobile than on steel while small business owners are forced to divert hard-earned profits into health coverage for their employees – rather than new business investments. And, because of rising costs, many businesses are cutting back drastically on their level of health care coverage or are doing away with it entirely.
Further, despite the fact that we spend almost twice as much per person on health care as any other country, our health care outcomes lag behind many other nations. We get poor value for what we spend. According to the World Health Organization the United States ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventable deaths.
As the health care debate heats up in Washington, we as a nation have to answer two very fundamental questions. First, should all Americans be entitled to health care as a right and not a privilege – which is the way every other major country treats health care and the way we respond to such other basic needs as education, police and fire protection? Second, if we are to provide quality health care to all, how do we accomplish that in the most cost-effective way possible?
I think the answer to the first question is pretty clear, and one of the reasons that Barack Obama was elected president. Most Americans do believe that all of us should have health care coverage, and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way. In that regard, I think the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly-funded, single-payer Medicare for All approach.
Our current private health insurance system is the most costly, wasteful, complicated and bureaucratic in the world. Its function is not to provide quality health care for all, but to make huge profits for those who own the companies. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible (30 percent) of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for far less.
In recent years, while we have experienced an acute shortage of primary health care doctors as well as nurses and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the numbers of physicians. Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It’s not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion or Cigna CEO Edward Hanway who made more than $120 million in the last five years. The reality is that CEO compensation for the top seven health insurance companies now averages $14.2 million.
Moving toward a national health insurance program which provides cost-effective universal, comprehensive and quality health care for all will not be easy. The powerful special interests – the insurance companies, drug companies and medical equipment suppliers – will wage an all-out fight to make sure that we maintain the current system which enables them to make billions of dollars. In recent years they have spent hundreds of millions on lobbying, campaign contributions and advertising and, with unlimited resources, they will continue spending as much as they need.
But, at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Like the civil rights movement, the struggle for women’s rights and other grass-roots efforts, justice in this country is often delayed – but it will not be denied. We shall overcome!
To keep up to date on the health care debate in the Senate, sign up for the Bernie Buzz newsletter here.
http://www.sanders.senate.gov/buzz
Gutting the Health Care Plan: The Scorpion and the Congress June 9, 2009
Posted by rogerhollander in Health.Tags: big pharma, canada helath, canadian health care, canadian healthcare, clintons, health, health care, health care costs, health care reform, health costs, health insurance, health insurance industry, healthcare, healthcare costs, healthcare reform, Medicaid, medicare, paul rogat loeb, pharmaceutical industry, private health insurance, rick scott, Robert Reich, roger hollander, singel-payer, single payer, tommy douglas
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Will serious health reform meet the fate of the scorpion and the turtle? In that fable, the scorpion pleads with the turtle to carry him across a river. The turtle resists, fearing the scorpion’s sting, but the scorpion reassures him that he’d do nothing so foolish, since both would drown if he did. Finally the turtle agrees. Halfway across, the scorpion betrays his promise with a lethal sting. As the turtle begins to drown, he asks why he took both their lives. “It’s just who I am,” the scorpion replies.
I fear we’re about to get stung again. When people look back at the failure of the Clinton-era health care initiative, they point, accurately, to an opaque process that produced a baroque Rube Goldberg mess that satisfied no one. That happened even before the insurance industry went on the attack with their Harry and Louise ads. But another missing element parallels our current challenge-appeasement of the insurance companies as the plan’s centerpiece, and the inevitability that these same interests will betray us again.
The Clintons assumed the insurance companies were too powerful to confront, so the plan had to go along with them. But once they assumed any bill had to get the companies’ approval, no plan could work, because it had to build in ways for the companies to maintain their profit margins and the immensely wasteful overhead they spend on advertising, processing claims, and turning down as many sick people as they can. Their approach also creates corollary wastes, like the third of the expenses of the average medical office that go toward dealing with insurance company paperwork.
Our health care crisis is so dire that the simple single-payer approach, as in Canada, should be at least seriously debated. Compared with us, most Canadians are satisfied with their system, in contrast with a recent US poll where 49 percent said our health system needed fundamental changes and 38 percent said it should be completely rebuilt. Canadians get a full choice of doctors (unlike in the US, where households have to switch doctors when employers change their insurance or insurance companies change their preferred provider lists). Tommy Douglas, the Canadian New Democratic Party leader who pushed through national health care in the mid-60s (replacing a system like ours), was recently voted Greatest Canadian in a recent contest, beating hockey star Wayne Gretzky and Prime Minister Pierre Trudeau.
Even if single payer isn’t politically achievable yet, there’s no reason to take it off the table from the beginning. Doing so means most Americans never get to hear the contrast in cost savings, in allocation ease, in impact on ordinary citizens and their health outcomes. They never get to hear the story that might allow them to overcome current fears about losing the health care they have, being unable to see their preferred doctor, or being condemned to the Purgatory of endless waiting. Maybe we’ve been so conditioned that we can’t quite get the support for a full-fledged switch. A recent Kaiser Foundation poll still gives single-payer a narrow 49 to 47 percent majority, vs 67 percent for including a fully competitive public option, and maybe that isn’t enough. But at least we need to tell the story, so the probably inevitable compromise works down from full public coverage, as opposed to considering options that gut even the option of serious public coverage entirely.
Instead, because we’ve accepted the premise that the private insurance companies have to be included, we’re now starting to consider including a public option only if it includes poison pills that will doom it to fail, like requiring it be triggered by a set of exceedingly unlikely circumstances deferred to the indefinite future. Or requiring it to play by rules so onerous that it can’t achieve its straightforward cost savings. Or turning it over to the states, so Big Pharma and Big Insurance interests can simply, as Robert Reich warns, “buy off legislators and officials as they’ve been doing for years.”
But why assume that the insurance companies are our friends? Why appease them at all? It’s not as if they’ve played a helpful role in our current system. Rather, they’ve gamed it in every possible way, leaving our country with the highest health care costs in the world and worst health outcomes of any advanced industrial country. While they’ve made promises to cut costs, their promises are only that (like the scorpion’s), and they’re already lobbying with everything they have to gut any seriously competitive public option. Add in examples like former HCA/Columbia CEO Rick Scott. after his company paid a $1.7 billion fine (the largest in US history) for defrauding Medicare, Medicaid, and the program that serves our armed forces, he is now organizing attacks on any public program (hiring the PR firm that coordinated the “Swift Boat” attacks on John Kerry). We need to challenge the insurance companies, not appease them. There’s no evidence that suggests they’re constructive players, or are likely to do anything except defend their own parochial interest.
The insurance companies and other major financial interests are talking a good line of late. They have no choice if they don’t want to be cut out of the game. But ultimately, they are who they are, and their behavior reflects this. It makes no sense to embrace a partner who you know will ultimately betray you.
Maybe the public private mix is the best compromise we can get at the moment. But we must raise our voices now to demand a full debate on the other alternatives, like single payer, and then if necessary settle for something that gives a public option a chance, under equitable rules, to see how it plays out in efficiency, service, and cost. Trusting the insurance companies and stacking the deck to guarantee that private options will prevail merely assures we continue our dysfunctional system until its human and financial costs drown us all.
Paul Rogat Loeb is the author of The Impossible Will Take a Little While: A Citizen’s Guide to Hope in a Time of Fear, named the #3 political book of 2004 by the History Channel and the American Book Association. His previous books include Soul of a Citizen: Living With Conviction in a Cynical Time. See www.paulloeb.org To receive his articles directly email sympa@lists.onenw.org with the subject line: subscribe paulloeb-articles.
Baucus to Meet with Single-Payer Advocates June 2, 2009
Posted by rogerhollander in Health.Tags: baucus 13, bernie sanders, H.R. 676, health, health care, health care reform, health insurance, health insurance industry, healthcare, healthcare reform, John Conyers, max baucus, roger hollander, senate finance, single payer
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by John S. Adams
HELENA – Sen. Max Baucus is set to meet with five single-payer health care advocates in Washington, D.C., this week.
![[Senate Finance Committee Chairman Max Baucus, D-Mont., talks with reporters after a closed-door committee meeting on financing an overhaul of the health care system, on Capitol Hill in Washington, Wednesday, May 20, 2009. (AP Photo/Manuel Balce Ceneta)]](http://www.commondreams.org/files/article_images/baucus-2.jpg "baucus-2.jpg")
Senate Finance Committee Chairman Max Baucus, D-Mont., talks with reporters after a closed-door committee meeting on financing an overhaul of the health care system, on Capitol Hill in Washington, Wednesday, May 20, 2009.(AP Photo/Manuel Balce Ceneta)Baucus, as chair of the Senate Finance Committee, has made health care reform his top priority this session. However, Baucus has consistently said single-payer – a system in which the federal government acts as the nation’s sole health insurance provider – is off the table.
“For more than a year, Senator Baucus has met with thousands of people, representing hundreds of views on how to reform our health care system,” Baucus spokesman Ty Matsdorf stated in an e-mail. “This meeting is no different. Max hopes to talk, and listen, to these folks totry and find the best way to make sure every Montanan has access to quality, affordable health care.”
Last week, members of Baucus’ staff held 20 listening sessions across the state on health care reform. At several of those meetings, Montanans expressed anger over Baucus’ steadfast refusal to consider a single-payer option.
Last month Baucus had 13 protesters removed from Senate Finance Committee hearings after the protesters demanded that single-payer advocates be given a seat at the table during health care reform hearings.
According to the Web site SinglePayerAction.org, Baucus will meet with Dr. David Himmelstein, associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program (PNHP); Dr. Marcia Angell, senior lecturer, Harvard Medical School and former editor-in-chief of the New England Journal of Medicine; Dr. Oliver Fein, associate dean, Cornell Weill Medical School and president of PNHP; Rose Ann DeMoro, executive director of the California Nurses Association; and Geri Jenkins, president of California Nurses Association.
Angell said the group plans to urge Baucus to give serious consideration to Congress’ two primary single-payer bills, S. 703, by Sen. Bernie Sanders, I-Vt., and H.R. 676, by Rep. John Conyers, D-Mich.
“We will make a case that there should be full hearings on Sanders’ bill, and we’ll make the case that the (Congressional Budget Office) should cost-out the Sanders and Conyers bills,” Angell said in an interview Monday. “We’ll make the case that single-payer advocates should have a chance to meet with the president. We will argue for holding public hearings on health reform that include single payer witnesses.”
Matsdorf said the June 3 meeting was scheduled prior to last week’s well-attended health care listening sessions, but Angell said she believes the pressure Montanans put on Baucus in recent weeks helped open the door for Wednesday’s meeting.
“I think Sen. Baucus may be surprised at the amount of push-back he has gotten for just ruling (single-payer) off the table,” Angell said. “It may indicate that he’s starting to feel pressure, and that’s all for the good.”
Copyright ©2009 Great Falls Tribune
The Health Insurance Industry’s Vendetta Against Michael Moore November 25, 2010
Posted by rogerhollander in Health.Tags: ahip, amy goodman, apco, denis moynihan, health care, health care america, health insurance, health insurance industry, health reform, healthcare, healthcare reform, insurance industry, michael moore, roger hollander, sicko, wendell potter
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Michael Moore, the Oscar-winning documentary filmmaker, makes great movies but they are not generally considered “cliff-hangers.” All that might change since a whistle-blower on the “Democracy Now!” news hour revealed that health insurance executives thought they may have to implement a plan “to push Moore off a cliff.” The whistle-blower: Wendell Potter, the former chief spokesman for health insurance giant Cigna. He was quoting from an industry strategy session on how to respond to Moore’s 2007 documentary “Sicko,” a film critical of the U.S. health insurance industry. Potter told me that he is not sure how serious the threat was but he added, ominously, “These companies play to win.”
Moore won an Oscar in 2002 for his film about gun violence, “Bowling for Columbine.” He followed that with “Fahrenheit 9/11,” a documentary on the presidency of George W. Bush that became the top-grossing documentary film in U.S. history. So when Moore told a reporter that his next film would be about the U.S. health care system, the insurance industry took notice.
AHIP (America’s Health Insurance Plans), the major lobbying group of the for-profit health insurance corporations, secretly sent someone to the world premiere of “Sicko” at the Cannes Film Festival in France. Its agent rushed from the screening to a conference call with industry executives, including Potter. “We were very scared,” Potter said, “and we knew that we would have to develop a very sophisticated and expensive campaign to turn people away from the idea of universal care. … We were told by our pollsters [that] a majority of people were in favor of much greater government involvement in our health care system.”
AHIP hired a public-relations firm, APCO Worldwide, founded by the powerful law firm Arnold & Porter, to coordinate the response. APCO formed the fake grass-roots consumer group “Health Care America” to counter the expected popularity of Moore’s “Sicko” and to promote fear of “government run health care.”
Potter writes in his new book, “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans,” that he “found the film very moving and very effective in its condemnation of the practices of private health insurance companies. There were many times when I had to fight to hold back tears. Moore had gotten it right.”
The insurance industry declared its campaign against “Sicko” a resounding success. Potter wrote, “AHIP and APCO Worldwide had succeeded in getting their talking points into most of the stories about the movie, and not a single reporter had done enough investigative work to find out that insurers had provided the lion’s share of funding to set up Health Care America.” Indeed, everyone from CNN to USA Today cited Health Care America as if it were a legitimate group.
Moore concedes, “Their smear campaign was effective and did create the dent they were hoping for-single payer and the public option never even made it into the real discussion on the floor of Congress.”
Moore has called Potter the “Daniel Ellsberg of corporate America,” invoking the famous Pentagon whistle-blower whose revelations helped end the Vietnam War. Potter’s courageous stand made an impact on the debate, but the insurance industry, the hospitals and the American Medical Association prevailed in blunting the elements of the plan that threatened their profits.
A recent Harvard Medical School study found that nearly 45,000 Americans die each year-one every 12 minutes-largely because they lack health insurance. But for the insurance lobby, the only tragedy is the prospect of true health care reform. In 2009, the nation’s largest health insurance corporations funneled more than $86 million to the U.S. Chamber of Commerce to oppose health care reform. This year, the nation’s five largest insurers contributed three times as much money to Republican candidates as to Democrats, in an effort to further roll back insurance industry reform. Rep. Anthony Weiner, D-N.Y., an advocate of single payer health care, declared in Congress that “the Republican Party is a wholly owned subsidiary of the insurance industry.” Potter agrees, saying the Republican Party has “been almost bought and paid for.”
The health insurance industry is getting its money’s worth. Moore said that the industry was willing to attack his film because it was afraid it “could trigger a populist uprising against a sick system that will allow companies to profit off of us when we fall ill.” Now that is truly sick.
Denis Moynihan contributed research to this column.
© 2010 Amy Goodman
Amy Goodman is the host of “Democracy Now!,” a daily international TV/radio news hour airing on 800 stations in North America. She was awarded the 2008 Right Livelihood Award, dubbed the “Alternative Nobel” prize, and received the award in the Swedish Parliament in December.