Democrats and Republicans vs Health Care
I’d like to do a longer introduction to this interview with Dr. Andy Coates of the Physicians for a National Heath Program, but I think it speaks for itself. Although its tempting to support the Democratic Party’s health care plan in order to do something about the unavailabillty of basic medical coverage for millions of people (including myself at various times) the plan that is before Congress now is worthless.
The Affordable Healthcare for America Act will not control costs and will leave millions exposed. It may get through Congress, but the resulting failure to meet expectations will only transfer Americans’ resentment for health care failures from HMOs to the government. A future Republican administration will simply repeal it. The Democrats will never attempt even so much as this again. What a waste.
As Dr. Coates writes on his blog, two-thirds of Americans support ‘Medicare for all’. The Democrats might have gone this route, who knows, but they might have connected with the public on this. Obama, Pelosi, Reid and Baucus never so much as breathed a word about single-payer health care for what must seem like obvious reasons of political cowardice and HMO graft.
Read the entire article here: http://mrzine.monthlyreview.org/coates091209.html
The crux of each bill is compulsory private health insurance. The government will use its power to compel every individual to purchase private health insurance, or enroll in Medicaid. The bills don’t make private health insurance affordable; they propose to subsidize private insurance premiums for those who live on modest means.
For example, the House bill will subsidize the premiums of those whose income is 400 percent of the federal poverty level and below. Taxpayers would pay for this. But it would still mean that people who earn 200 percent to 400 percent of the federal poverty level would have to pay 8 to 12 percent of their income for private insurance premiums, or pay a fine and stay uninsured.
That would be the so-called “choice.” For the uninsured, paying for expensive insurance would amount to an enormous wage cut. And then they’ll get skimpy coverage, with high co-pays, high deductibles and all those other onerous and unworkable measures that come with very expensive private insurance.
One of the justifications that Obama and the Democrats used for these bills is that they will control the cost of health care. Are they telling the truth?
Total health care spending will not be brought under control by either of these bills. It will not bend the cost curve. As health care costs continue to increase dramatically, the crisis of unaffordable health care will continue, for ourselves and our families, with increased out-of-pocket costs, new mandatory premium payments, and ongoing medical bankruptcies will remain acute.
What about the so-called public option? What impact will it have on the health care system?
The proposals for the public option as they stand are meaningless from the point of view of reform, and ridiculous as a way to influence the insurance market. There are so many compromises it might be renamed the incredible shrinking public option. And also, as a TV talking point, it has often eclipsed a focus on what’s really in the bill.
But I think that there’s more fundamental point. The public option was never a proposal for workable reform. It’s actually a neoliberal concept. Marie Gottschalk, a professor at the University of Pennsylvania, has written an article in the new Socialist Register 2010 entitled “U.S. Health Reform and the Stockholm Syndrome.”
She argues that when it comes to health reform, American reformers are like hostages who identify with, and even defend, their captors. I heard her speak in New York, where she said it seemed that, if a window opened to permit real health reform, many “reformers” wouldn’t even try to climb out.
What do you mean that the public option is in fact a neoliberal proposal?
The public option idea is basically that the insurance market will magically meet our needs, as long as there is consumer choice and fair competition. This is the ideology popularized by Ronald Reagan. If only a government agency could be added alongside these giant, highly profitable insurers with their oligopoly control, then the marketplace would magically reform itself. Does that make any sense?
The insurance market rewards insurers that avoid paying for the care of sick. The public option would have to play by the same rules and compete on the same market. So in the best-case scenario, the public option would tend to enroll the sickest patients and, in turn, would have higher, not lower, expenses. The Congressional Budget Office recently made this very point in a report on the House bill.
- Selling Out Health Care Reform: Interview with Dr. Andy Coates. By Ashley Smith. Monthly Review Zine. http://mrzine.monthlyreview.org/coates091209.html
- Home Care Patients Worry Over Possible Cuts. By Robert Pear. New York Times. December 4, 2008. http://www.nytimes.com/2009/12/05/health/policy/05home.html?hp
- PRELIMINARY ESTIMATE OF THE EFFECTS ON THE DEFICIT OF H.R. 3962, THE AFFORDABLE HEALTH CARE FOR AMERICA ACT, AS INTRODUCED ON OCTOBER 29, 2009 http://www.cbo.gov/ftpdocs/106xx/doc10688/hr3962Rangel.pdf
It wouldn’t hurt to write your Representative, Senator or President to let them know you support single payer, Medicare for All, or however you want to put it. Its a symbolic gesture at this point, but it made me feel better.
If we organize patiently, and create links between people who are hurting from the instability of medical coverage and medical professionals who want to extend coverage to all, then we just may be able to turn around the inevitable campaign to repeal this hack job a few years and get something real. Here’s hoping