Category Archives: national health care

Single Payer Amendment before the Senate at Two Minutes to Midnight

Bernard Sanders (Independent – Vermont) will see his single- payer health plan amendment read before the Senate today. Senate Majority Leader Harry Reid is going to allow a vote on the amendment as well. Reid loses nothing by doing this. In return for some very late exposure of single-payer, the progressives will vote ‘yes’ on the final bill – a bill lacking a public option, or much that is progressive.

The single- payer health plan amendment is being reported more for the Sen. Tim Coburn’s procedural demand that the entire text of Sanders’ amendment be read into the record. This is expected to take 12 hours and is still ongoing.

Coburn (Republican – Oklahoma) talks as if Sander’s bill and Reid’s bill was the same thing. It’s laughable, as Obama, Reid, Baucus and Pelosi worked strenuously to keep single-payer out of the health care debate. The distinction is academic to most voters. Any intervention of government in health care will play to the Republican’s wall-to-wall anti-communist rhetoric. The failure of the Obama plan to control costs or provide universal coverage will encourage those who would prefer to do nothing over the rising cost of health care and the worsening in quality of life.

In a two-track debate, the Republicans will come out ahead on this one. Including single-payer or national health care advocates in the debate might have brought the Republicans and Right-wing Democrats pro-market (and anti-cost control) assumptions into question. Obama would have to be a very astute politician to manage a play like that. It appears that he is not, unless his constituency is Joe Lieberman and the heath insurance industry.

Digbysblog sums up what’s wrong with this bill from a progressive, free market or socialist perspective (courtesy Glenn Greenwald’s Salon column):

Obama can say that you’re getting a lot, but also saying that it “covers everyone,” as if there’s a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don’t get it from their employer. I guess you can call that progressive, but that doesn’t make it so. In fact, mandating that all people pay money to a private interest isn’t even conservative, free market or otherwise. It’s some kind of weird corporatism that’s very hard to square with the common good philosophy that Democrats supposedly espouse.

Nobody’s “getting covered” here. After all, people are already “free” to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won’t make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn’t or didn’t want to write. Indeed, it actually looks like the worst caricature of liberals: taking people’s money against their will, saying it’s for their own good — and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don’t miss the money as much when they never see it.

In the end, Obama seems to have gotten the bill he wanted but lost his base in the process. Or rather, he caused the base to realize that what they saw in him was only a hopeful reflection of themselves.He never was a progressive, he was always a blue dog Democrat with a better story to tell. People voted for FDR, but they got Jimmy Carter.

You can read Sanders’ proposal and even the entire bill here:

– The United States spends $7,129 per person on health care, which is almost double the amount spent by nearly any other industrialized country. Despite this fact, we still do not insure all of our citizens.
– There are currently 46 million Americans without health insurance, 100 million Americans who cannot access dental care, and 60 million Americans who do not have access to primary care.
– The United States ranks among the lowest of developed countries are far as health outcomes, according to both life expectancy and disease metrics.
– One reason we spend our money so ineffectively is that there is tremendous waste in our system. Healthcare providers spend $210 billion on administrative costs, mostly to deal with insurance paperwork, and the ranks of administrative personnel have grown by 25 times the number of physicians in the past 30 years.
– This waste and the high costs of insurance associated with it place a tremendous burden on American employers and makes it difficult for them to compete internationally.

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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.

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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

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