The health insurance industry admits that they won't keep health care costs down

The insurance industry is admitting here that it won't keep health care costs down. Do we really want Congress to mandate us to buy this faulty product? This really is a health insurance industry bailout.

By Shailagh Murray
The Washington Post
November 26, 2009

Critics of the Democratic bills point to cost control as a chief deficiency. Karen Ignagni, president of America’s Health Insurance Plans, said the Senate bill includes only “pilot programs and timid steps” to reform the health-care delivery system, “given the scope of the cost challenge the nation faces.”

Unless lawmakers institute changes across the entire system, Ignagni said in a statement Wednesday, “Health costs will continue to weigh down the economy and place a crushing burden on employers and families.”

http://www.washingtonpost.com/wp-dyn/content/article/2009/11/25/AR2009112503474.html

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AHIP president Karen Ignagni says that unless lawmakers institute changes across the entire system, health care costs will continue to weigh down the economy, placing a crushing burden on employers and families. There could not be a more explicit admission that the private insurance industry is not and never has been capable of controlling our very high health care costs. Yet their administrative excesses along with the administrative burden they place on the delivery system are major sources of waste in our health care system.

We need everyone covered, and we need costs controlled in a system designed to provide us greater value. Neither will occur under the proposal before Congress. Although the private insurance industry can’t do it, an improved Medicare program would be designed specifically to accomplish those goals, and at a much lower administrative cost.

Karen Ignagni says that the lawmakers must institute the necessary changes across the entire system (because the insurers can’t). Let’s join her in demanding that Congress take the actions necessary, and then thank her for her efforts, as we dismiss her superfluous industry from any further obligations to manage our health care dollars.

You can read this blog entry online here.

To all the Christians who are more worried about the lazy bums who would receive health care than about the needy who don't receive health care

I've written a few entries mentioning Christianity in relation to health care. It makes me incredibly angry that the majority of self-proclaimed Christians (at least the seeming majority) are more concerned about a lazy person unjustly receiving health care rather than a destitute person NOT receiving health care. It's just such a hypocrisy! Their religion is purported to be so loving and generous, yet on so many fronts (and the health care front which is near and dear to my heart) they are so mean hearted and callous.

So I've had several discussions with different progressive friends over this topic. One of my friends, who wishes to remain anonymous, is convinced that the religious prefer to keep the poor in need because that way the down-and-out are beholden to the Christians for charity and handouts. Giving charity makes the Christians feel good, and as a side benefit, the poor are easier targets for evangelism.

At the Fort Wayne conference held for local clergy to inform them about the current state of health care, one of the pastors made a statement to unknowingly support my friend's belief. The pastor said he didn't want the government to take the role of helping people because then Christians would be robbed of the gifts God gives the giver - his church goers would be robbed. So, in essence, he preferred to do spot helps here and there that all too often don't lift a person out of poverty or destitution so that his church goers would be blessed - rather than help to make a systemic change to help the masses out of destitution - all so his believers could receive gifts from God through the destitute. I really had to work extremely hard to keep from rolling my eyes when this clergy made his unthinking statement.

Anyways, what keeps the religious from helping the down and out even if the government has programs to help the poor? Can't the religious still help on top of the government help? So I view that clergy's remark in one of two ways (in addition to being more concerned about the blessings God gives the giver over the condition of the down and out). First, it was just an excuse so he wouldn't have to support a non-conservative position - thus contradicting his world view. Or second, he felt the government's help would be so successful that there would no longer be a chance for Christians to show their charity to the down and out. If he believed the second, then I have even less respect for that clergy. He'd prefer to keep people in poverty so that the religious could receive gifts from God - rather than lifting those people out of poverty. Now I don't really think he believed the second premise - after all, the conservatives think the government can do nothing well and is a necessary evil (they don't seem exactly to be calling for anarchy). So that leaves me to think he was making an excuse. So he'd rather make an excuse, than try to figure out how to systemically help the destitute. Lame! Especially lame from a so-called man of God.

Later I was talking to my friend Joel about this whole lack of compassion on the Christian front (or more accurately the loud Christian front). My friend was a pastor and so knows the Bible pretty well. Joel is a compassionate and nonjudgmental Christian - the kind I can easily respect. His take was that Jesus never asked for payment from those he healed or helped - and he never did a check of the worthiness of the recipient of his help. He helped the prostitutes, the criminals, the adulterous, etc.

I have a lot of extremely religious extended family. When I first became seriously active in promoting single payer, I was shocked at one of my cousin's first response - my cousin who is EXTREMELY religious. He had a VERY angry response - but the part I remember most was was right along this line, "Why should I care for lazy bums who don't work?" Really? Mr. Christian, that is your first response? That is how you live your religion? I am NOT impressed! Your breed of religion is not at all attractive - actually, it's quite repulsive. But I never thought of it in terms that Joel had put it - here this Christian was judging the worth of the person receiving "charity" rather than freely giving - following Jesus' example. Joel's perspective really points to how the Christians are being very un-Christ like.

Which brings me to one more thought I've had for a quite a while. I had a very close friend who pretty much has that same reaction - not wanting to support the lazy. When backed into a corner, she says she doesn't like welfare/single payer because it hurts the poor, but that is not her INITIAL response on health care. Her initial response to me was that she didn't want to pay for health care for those who weren't working. She felt like those who work and are responsibe shouldn't have to subsidize the lazy. With her, it took me a while to figure out why her response really bothered me - it was something different. Then I realized what it was. She proclaims so much abundance from living in Christ - she talks about it all the time - so many blessings and such assurance in her being taken care of by God. Yet when it comes to health care she is not acting from a position of abundance but rather from a position of paucity. She is incredibly blessed on soooo many fronts - but she feels like "subsidizing" health care for others would threaten her abundance. That God could bless her on all the other fronts, but not with health care if she was forced to sacrifice some of her money (her perception) to help the lazy. The fact that she proclaims abundance and security in God, but when it comes to health care then she feels the threat of paucity - I find it so disingenuous. I don't think she really feels abundant at all - I think she just tries to convince herself she feels abundant because that is what she is told she should feel - but when it comes to health care, her true feelings sneak out.


I'm really angry at this right-wing Christian front! I'm not quite sure why I'm so angry at them. The heart of it is the hypocrisy. But then again, we all have at least some degree of hypocrisy. But I think this is a mean hypocrisy. Maybe it's because they hold themselves better than me (I've seen it personally) while at the same time their actions on this health care front are so lacking compassion - which I feel is inferior to my position. Maybe it's just because I'm so surrounded by them and face the ugliness on a regular basis.; afterall, I live in the heart of the Bible belt and was born into a Bible thumping extended family. Hmmmmmm. I don't know - but the hypocrisy and meanness on health care from the conservative Christians does get my gall! They should be the ones out there leading the cause universal health care!

On disappointment

The only kinds of fights worth fighting are those you are going to lose, because somebody has to fight them and lose and lose and lose until someday, somebody who believes as you do wins. In order for somebody to win an important, major fight 100 years hence, a lot of other people have go to be willing - for the sheer fun and joy of it - to go right ahead and fight, knowing you're going to lose. You mustn't feel like a martyr. You've got to enjoy it.

I F Stone

Shocked, shocked to find socialism in America

Do critics of Obama's health reforms realize how socialistic we already are?

By Walter Rodgers

from the September 16, 2009 edition

East Otis, Mass. - The less some Americans know, the more strident and voluble they become. Take socialism. The wailing about it over healthcare reform proves my proposition.

Shrill critics menacingly brandish "socialism" to terrify the unthinking, forgetting – or willfully ignoring – that while the United States is capitalist, it's also hip deep in various modes of socialism.

Republicans apparently don't know that it was their beloved President Theodore Roosevelt who in 1912 proposed national health insurance for all.

Some American critics of socialized medicine cite nightmarish accounts of bungled medical treatment abroad, boasting that America has the best medical system in the world.

As a foreign correspondent, I lived in Britain, Germany, Israel, and the Soviet Union and did not discover any sapping of a nation's vital essences because the public enjoyed publicly funded national health insurance.

As a US citizen who lived more than two decades abroad, I found socialized national health insurance programs are often more compassionate and charitable than what I have seen with profit-driven, private insurance companies in the United States.

Some years ago my former wife took my sons on a driving tour of Britain and became involved in an accident. My elder son had a badly broken leg and was taken to a hospital for six weeks until his leg healed. Although I didn't live in Britain at the time, the British National Insurance system paid all his hospital and doctor bills. When I offered to reimburse the hospital, the British charitably declined and only charged me $35 for a crutch my son used to hobble aboard a plane home to America.

A decade ago, a federal report shocked the nation by suggesting that our modern medical system was one of the leading causes of death in America. It called for cutting the rates of medical mistakes in half within five years. But it's only gotten worse. Today, preventable medical injuries kill some 200,000 Americans each year.

Earlier this year, a friend entered a suburban Chicago hospital to have a gall bladder removed. The surgeon was scheduled to go on vacation immediately after finishing the operation. In the process of making a large incision, the doctor unknowingly nicked the lower intestine and punctured the aorta. My friend nearly bled to death before the surgeon discovered his error.

Where is the statistical evidence that private healthcare outperforms national health insurance programs? The United States ranks 37th on health outcomes, according to the World Health Organization, and it has one of the highest infant mortality rates among developed countries, suggesting that socialized medicine may afford better patient care in some situations.

Opponents of the White House healthcare plans deliberately distort the extent of government involvement in such programs, when the only thing to be "socialized" was the so-called public option health insurance plan – and that may be dropped. Doctors and hospitals would remain private. Critics appear to have deliberately polarized public opinion to scuttle President Obama's initiatives.

Meanwhile, members of Congress enjoy "cradle to grave" socialist medical and retirement benefits that outstrip those of the old Soviet Central Committee members.

Many thousands of the poorest Americans and illegal aliens already have access to taxpayer-funded socialized medicine and hospitals through existing Medicaid benefits. One physician tells me that Medicaid recipients get free hospital care plus stipends at taxpayers' expense. Yet tens of millions of working Americans whose taxes subsidize Medicaid have no access to any health insurance of their own.

Particularly lame are the complaints of healthcare critics in the southeastern US who benefit from the regional socialism of the Tennessee Valley Authority, a government-owned-and-operated supplier of electricity for tens of millions.

America's Social Security program is Bismarckian socialism. Medicare, especially with its prescription drug benefit program is socialistic. Government aid to parochial schools is sleight-of-hand socialism.

Socialism's most vocal critics are often beneficiaries of corporate welfare with all its perks: expense account meals, free NFL box seats, free corporate cellphone use. One firm for which I worked held foreign correspondent meetings in Rome, enabling the executives to visit tailors and shop for Christmas presents in Italy. Exploiting US tax codes, corporate America has long enjoyed its own brand of socialism subsidized by taxpayers.

Like most Americans, I am not overly keen on socialism. History shows that it can curb important personal freedoms and stultify entire economies. But it is not inherently evil. And by the way, if you enjoy your 40-hour workweek, with weekends off, you owe those to an earlier generation of socialist-leaning labor leaders who championed that and so much more that Americans now take for granted.

Walter Rodgers is a former senior international correspondent for CNN. He writes a biweekly column for the Monitor's weekly print edition.

The three little pigs and the house of twigs

OMG, so perfect! Obama supporters are telling single payer advocates to compromise. When you do a "compromise single payer" plan you don't get ANY of the major benefits of single payer!

No real reform

Howard Deans admits that without public option the health insurance reform bills don't really bring any insurance reform.

He also states that there will only be reform if the resulting health insurance is affordable. So the public option which will be more expensive than private insurance will make health insurance for all affordable? I just don't get it!

He argues that only with public option will there be reform. Really? A public option that includes only 2% of the public is a real reform?

Visit msnbc.com for Breaking News, World News, and News about the Economy

And dradt! Even our most progressive Senator won't draw a line in the sand for single payer!

Teabaggers laugh and heckle woman who tells the story of losing her daughter and grandchild due to lack of health care

I experienced this anger and booing at Souder's (my Congressman) Middlebury Town Hall. Luckily the venue I spoke in was larger and therefore less face to face than the one in this video. I think the smaller venue in the video made it even more personal and viscious! Man, these are the scary, scary, scary people we are dealing with!

(I wonder how many of them who were heckling and laughing considered themselves Christians. I suspect a good number of them.)

Email your Senators to support Sanders single payer bill and amendment

Use the link here to EASILY send an email to your Senators to support Sanders single payer bill and amendment to allow states to implement single payer. Do it daily!

Single Payer News Conference in DC

View the single payer news conference on C-span here.

Boy, the media really likes to get it wrong. An author at TPM reported on the event, and revolved his whole story around mabye 2 or 3 minutes of a 70 minute press conference - missing the whole point of the conference! Of course he revolved it around the most controversial, but least important bit (taking Senator Sanders to task to support single payer). Read here.

This article reminds me how important it is to not trust a reporter. They have total power over the story and they often have different objectives than you do: 1) to tell a story with their slant or ideas rather than necessarily telling what happened 2) to create a sensational story. And if your ideas are not already in the mainstream, it is most likely they will put an ugly slant on the story.

And here is an article where an OpEdNews writer takes to task the TPM article linked to above. And I realized this OpEdNews writer lives in a town maybe 20-30 miles from me! Who knew there were such advocates in my area? Yay!

Minority rule in the Senate

Just one more problem for any kind of progressive reform such as healthcare. Read here.

Rejecting the Narrative for Health Reform in America, Believing in a Better Way

To read the whole thing, click here.

Here are some highlights that caught me most.

To the extent that politicians in Washington, D.C. have not attempted reform of this magnitude with a concerted effort for a decade (perhaps, decades depending on how you regard Hillary Clinton's past efforts), the recent votes on health reform in the House two weeks ago and in the Senate this weekend are historic. But, they are no more than contrived milestones in history if you truly assess what the Democrats and their supporters hope this bill will achieve.

The rhetoric of a dominant political culture in America has taken righteous outrage and enthusiastic fervor for real healthcare reform and channeled it into a fight for a weak public option...

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So, with Medicare and Medicaid being signed into law under the Social Security Act of 1965, you had one of the most sweeping overhauls of health care policies in America in the history of the United States.

You also had a template developed that would be followed consistently decades after Johnson's presidency: fill gaps in coverage but do not challenge privatized health insurance or the medical profession's right to set fees.

With Medicare and Medicaid, government intervention created huge profits for the medical-industrial complex in America. That's also what would happen with current health reform being discussed.

Compromise should be for the legislative process but Americans compromise the democratic process by willfully compromising before the legislative process has even been completed.

Instead of focusing on the goal of covering the more than 45 million Americans without health care coverage, progressives or liberals are distracted by senators Blanche Lincoln, Mary Landrieu, Ben Nelson, and Joe Lieberman who may or may not block health reform. They willingly consume themselves with worst-case scenarios for healthcare and suggest what they will be willing to settle for so long as these senators allow historic health reform to pass through Congress.

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Instead of focusing on the goal of banning for-profit healthcare providers once and for all and ensuring we never have to have a crisis of healthcare like this in America ever again, progressives and liberals are willing to defend the sham that is health reform and suggest we can come back to it and build off it later and develop it eventually someday later into a single-payer system if that is what we must do.

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And, so we see "democracy as stupefaction." We see people whose sensibilities have been deadened, who are willing to have their expectations managed and lowered.

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Obama has staked his presidency on health reform. He has put his chips all-in on this one and if Republicans can use that to their advantage, why can't progressives? Why can't progressives counter conservative market-based proposals with progressive humane proposals, which ensure a better future for all Americans?

Why shouldn't we use America's two-party system to our advantage in the same way that the GOP uses it to their advantage?

Christianity and Healthcare in the U.S.

I've been incredibly disgusted with the Christian community that stands up yells death panels, socialism, government take-over of health care, Obama is a Nazi, etc. And I'm disgusted by the Christians who are far more concerned about lazy people receiving health care they don't deserve than about the hurting, injured, sick, and abused people! And really, that isn't all the Christians. There are some out there that are loving and compassionate to those that aren't a part of their church family. I wish we had more Christians like the author of this article. Then maybe we could get a health care system in our country that was actually compassionate and fair to everyone.

To all my nonbelieving, sort-of-believing, and used-to-be-believing friends: I feel like I should begin with a confession. I am sorry that so often the biggest obstacle to God has been Christians. Christians who have had so much to say with our mouths and so little to show with our lives. I am sorry that so often we have forgotten the Christ of our Christianity.

Forgive us. Forgive us for the embarrassing things we have done in the name of God.

The other night I headed into downtown Philly for a stroll with some friends from out of town. We walked down to Penn's Landing along the river, where there are street performers, artists, musicians. We passed a great magician who did some pretty sweet tricks like pour change out of his iPhone, and then there was a preacher. He wasn't quite as captivating as the magician. He stood on a box, yelling into a microphone, and beside him was a coffin with a fake dead body inside. He talked about how we are all going to die and go to hell if we don't know Jesus.

Some folks snickered. Some told him to shut the hell up. A couple of teenagers tried to steal the dead body in the coffin. All I could do was think to myself, I want to jump up on a box beside him and yell at the top of my lungs, "God is not a monster." Maybe next time I will.

The more I have read the Bible and studied the life of Jesus, the more I have become convinced that Christianity spreads best not through force but through fascination. But over the past few decades our Christianity, at least here in the United States, has become less and less fascinating. We have given the atheists less and less to disbelieve. And the sort of Christianity many of us have seen on TV and heard on the radio looks less and less like Jesus.

At one point Gandhi was asked if he was a Christian, and he said, essentially, "I sure love Jesus, but the Christians seem so unlike their Christ." A recent study showed that the top three perceptions of Christians in the U. S. among young non-Christians are that Christians are 1) antigay, 2) judgmental, and 3) hypocritical. So what we have here is a bit of an image crisis, and much of that reputation is well deserved. That's the ugly stuff. And that's why I begin by saying that I'm sorry.

Now for the good news.

I want to invite you to consider that maybe the televangelists and street preachers are wrong — and that God really is love. Maybe the fruits of the Spirit really are beautiful things like peace, patience, kindness, joy, love, goodness, and not the ugly things that have come to characterize religion, or politics, for that matter. (If there is anything I have learned from liberals and conservatives, it's that you can have great answers and still be mean... and that just as important as being right is being nice.)

The Bible that I read says that God did not send Jesus to condemn the world but to save it... it was because "God so loved the world." That is the God I know, and I long for others to know. I did not choose to devote my life to Jesus because I was scared to death of hell or because I wanted crowns in heaven... but because he is good. For those of you who are on a sincere spiritual journey, I hope that you do not reject Christ because of Christians. We have always been a messed-up bunch, and somehow God has survived the embarrassing things we do in His name. At the core of our "Gospel" is the message that Jesus came "not [for] the healthy... but the sick." And if you choose Jesus, may it not be simply because of a fear of hell or hope for mansions in heaven.

Don't get me wrong, I still believe in the afterlife, but too often all the church has done is promise the world that there is life after death and use it as a ticket to ignore the hells around us. I am convinced that the Christian Gospel has as much to do with this life as the next, and that the message of that Gospel is not just about going up when we die but about bringing God's Kingdom down. It was Jesus who taught us to pray that God's will be done "on earth as it is in heaven." On earth.

One of Jesus' most scandalous stories is the story of the Good Samaritan. As sentimental as we may have made it, the original story was about a man who gets beat up and left on the side of the road. A priest passes by. A Levite, the quintessential religious guy, also passes by on the other side (perhaps late for a meeting at church). And then comes the Samaritan... you can almost imagine a snicker in the Jewish crowd. Jews did not talk to Samaritans, or even walk through Samaria. But the Samaritan stops and takes care of the guy in the ditch and is lifted up as the hero of the story. I'm sure some of the listeners were ticked. According to the religious elite, Samaritans did not keep the right rules, and they did not have sound doctrine... but Jesus shows that true faith has to work itself out in a way that is Good News to the most bruised and broken person lying in the ditch.

It is so simple, but the pious forget this lesson constantly. God may indeed be evident in a priest, but God is just as likely to be at work through a Samaritan or a prostitute. In fact the Scripture is brimful of God using folks like a lying prostitute named Rahab, an adulterous king named David... at one point God even speaks to a guy named Balaam through his donkey. Some say God spoke to Balaam through his ass and has been speaking through asses ever since. So if God should choose to use us, then we should be grateful but not think too highly of ourselves. And if upon meeting someone we think God could never use, we should think again.

After all, Jesus says to the religious elite who looked down on everybody else: "The tax collectors and prostitutes are entering the Kingdom ahead of you." And we wonder what got him killed?

I have a friend in the UK who talks about "dirty theology" — that we have a God who is always using dirt to bring life and healing and redemption, a God who shows up in the most unlikely and scandalous ways. After all, the whole story begins with God reaching down from heaven, picking up some dirt, and breathing life into it. At one point, Jesus takes some mud, spits in it, and wipes it on a blind man's eyes to heal him. (The priests and producers of anointing oil were not happy that day.)

In fact, the entire story of Jesus is about a God who did not just want to stay "out there" but who moves into the neighborhood, a neighborhood where folks said, "Nothing good could come." It is this Jesus who was accused of being a glutton and drunkard and rabble-rouser for hanging out with all of society's rejects, and who died on the imperial cross of Rome reserved for bandits and failed messiahs. This is why the triumph over the cross was a triumph over everything ugly we do to ourselves and to others. It is the final promise that love wins.

It is this Jesus who was born in a stank manger in the middle of a genocide. That is the God that we are just as likely to find in the streets as in the sanctuary, who can redeem revolutionaries and tax collectors, the oppressed and the oppressors... a God who is saving some of us from the ghettos of poverty, and some of us from the ghettos of wealth.

In closing, to those who have closed the door on religion — I was recently asked by a non-Christian friend if I thought he was going to hell. I said, "I hope not. It will be hard to enjoy heaven without you." If those of us who believe in God do not believe God's grace is big enough to save the whole world... well, we should at least pray that it is.

Your brother,

Shane

Will the mandated health coverage be affordable?

Gruber:

Lawmakers debating health care on Capitol Hill have spent months worrying about the potential cost. But mostly it’s been the total cost of the bill, not how much individual families who could soon be required to buy insurance for the first time might have to pay.

That could be a costly miscalculation, says health economist Jonathan Gruber of the Massachusetts Institute of Technology. “Let’s put it this way: It is 10 times as important as the public option and has received one one-hundredth of the coverage,” he says.

Gruber says economists have different ways of defining exactly what is and is not affordable for people. One way is by looking at disposable income, or whether people have money left over after paying for other necessities. “We think no one should have to go without food or shelter to have health insurance,” he says.

Another test is whether people would buy something voluntarily. “And if they would then clearly it’s affordable,” Gruber says.

But there’s also a third test — and it’s that affordability is in the eye of the beholder. And for a lot of beholders in the real world, health insurance costs are quickly becoming unaffordable.

(Under the proposed legislation) no family would have to spend more than 10 percent of its income on health insurance premiums; poor families wouldn’t have to spend more than 2 percent on premiums.

But premiums are only the start of what people spend on health insurance. There are also deductibles, copayments and other out-of-pocket costs. And Gruber says that when it comes to that sort of spending, the House bill is far more generous than the Senate bill.

For example, someone making two times the poverty level, or about $22,000 a year, in the House bill would get “something like a $500 deductible plan,” he says. “On the other hand in that same range in the Senate … now we’re talking a $2,500 deductible plan.”

Dr. McAnne of PNHP:

Of course, Gruber is also an advocate of “let’s pass this bill now and then we can fix it later on” – a tacit acknowledgment that affordability will remain a crucial issue.

Gruber says that he can’t think of anything more to do that isn’t in the Senate bill. But you readers know better. We need to dump this plan and immediately go to work on one that will make health care affordable for everyone – an equitably-financed, single payer, improved Medicare for all. Do really we need to wait for Gruber’s ultimate test for affordability – a revolt?

Read the whole piece here.

Health Insurance and Pharma are the big winners with the proposed Health Insurance Reform

We need only look at the check lists of two of the most powerful people in health care reform to see who is benefiting most from the proposed legislation in Congress.

Karen “Killer” Ignagni, President and CEO of America’s Health Insurance Plans (AHIP) won the following:

• Still in business making billions of profits for Wall Street investors and CEO’s of insurance companies
• No cost controls that would decrease profits
• Mandate giving us at least 30 million new customers and fined if they don’t buy coverage
• Still able to deny doctor recommended care
• Still able to increase premiumKill or weaken public option
• Investment in 3000 lobbyists and 1.4 million a day paid off

Then there is Billy “The Kid” Tauzin, President and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA.) He was able to check off everything on his list:

• Get a meeting with President Obama behind closed doors and make a deal to protect PhRMA profits
• No drug reimportation from Canada or Mexico
• Extend protections for lucrative biologic drugs
• No negotiating drug prices for Medicare Part D
• U.S. drug market continues to be the most profitable

Read more here.

Reflexivity and health care reform

What Might Have Been; What Still Might Be

Many progressives, even though they’ve been working for a PO-based health care reform bill, have 1) never given up Medicare for All as the goal of their activity, and 2) decided, in the first quarter of 2009, that Medicare for All could not pass the new Congress. They then reacted to their realization by concluding that since Medicare for All couldn’t pass, they would not advocate for it anymore politically, but would transfer their activist commitment to getting a strong public option. Last Spring, they had in mind a Jacob Hacker-type PO, which they saw as the road to Medicare for All. So, in short, they took Medicare for All off the table as something to push for, and they did so because they thought the impossibility of its passing was "reality." ...


This process is a classic example of reflexivity: one’s judgment of what is possible leads to one’s choice of action, which impacts a later judgment of what’s possible, which impacts one’s choice of a similar action as before, and so one goes round and round in a deflationary cycle that ends with action defending a PO-based reform that is only a shadow of what one started out to support.

But, going back to the first step, why did progressives conclude that since Medicare wasn’t possible in the short-run, but the public option was, that, in this round of reform, at least, they ought to advocate for the PO explicitly and directly, and push as hard as they can to get as robust a PO as possible? This certainly seems like the commonsensical, and straightforwardly rational thing to do, but it clearly wasn’t, because it drew them into a reflexive downward spiral of decreasing PO robustness within every stage of the legislative process, until now they are facing a PO predicted to enroll only 3 million people, or perhaps even “triggers,” which won’t be operative until 2014, which may allow state opt-outs before the exchange and the PO are operative, and which may even contain the Stupak anti-choice language.

What progressives could have and should have done instead, regardless of what they believed about the ultimate feasibility of getting it passed, was to have taken the seemingly completely irrational course of refusing to take Medicare for All off the table, mobilized the 87 co-sponsors of HR 676, and insisted that they would defeat any reform bill that wasn’t HR 676. Had all progressive movement groups held to that position, and all progressive legislators too, and loudly announced that they would oppose, and vote against, all committee bills that weren’t HR 676, and loudly announced, as well, that Nancy Pelosi’s synthesis bill had better be HR 676 if she wanted their votes. they would have brought forth a completely different world, an entirely different reality this Fall.

Imagine if, at the first stage of this process, the progressives had not agreed to take HR 676 off the table in the House and S 703 in the Senate. The first thing that would have happened is that the MSM and cable news would have talked about Obama’s rebellious Party ideologues who were contradicting all the tenets of pragmatism, who were allowing the perfect to be the enemy of the good, who were insisting on single-payer, and who were refusing to accept his leadership and undermining his newly-elected authority. Since this opposition in the ranks would have been big news back in January and February, the progressives would have gotten interviews. Single-payer, enhanced Medicare for All, would have been presented to the broader public back then. It, and not the PO, would have been touted as one of the main reform policy positions, even while it was also characterized as the ideologue position. The support for Medicare for All in Congress, however, whether ideological or not, would have connected to a popular movement for Medicare for All, very early on, and enabled that movement. To avoid a fight with the progressives and lots of press articles about how ineffective he was being as a leader, President Obama might have concluded that the best way to go was to feed this popular movement, to find its leaders, to get them into the White House, and to help them to mobilize the public in favor of Medicare for All.

Why would he do that? Because every good politician knows that when the crowd starts to move, you need to get out in front of it, if you expect to have any control over it at all. The crowd needs to trust you as one of its leaders. And after all, any health care reform bill is a great victory for his Administration, even if it destroys the insurance companies as a viable political force that can’t provide campaign contributions either to Democrats or anyone else.

What Was The Point Of The Opt Out?

Now that the remaining holdouts have made their intentions known on health care, it’s worth wondering why Harry Reid added the opt out provision to his bill.

The opt out doesn’t seem to have brought along any of the critical votes needed to get to 60 votes and secure a cloture vote through the regular process. Joe Lieberman didn’t want the public option before, and he doesn’t want it with the opt out. Blanche Lincoln wavered before, and she seemed adamant now that the public option had to come out. Mary Landrieu, the same. Ben Nelson basically intimated this week that removing the public option would satisfy his concerns about the abortion provisions.

The reason to add a state opt out to the public option, one would assume, would be to bring conservative Democrats on board with the bill. But it doesn’t look like it’s done that at all. Moreover, it doesn’t give those conservatives much room to say that they extracted changes that would satisfy them. If Reid had just put in the HELP Committee’s public option, he could have watered it down with an opt out, letting the Lincolns and Landrieus of the world say that they got something. Now, they’d have to essentially kill it, either with a trigger designed not to trigger, or the elimination of the measure altogether.

This seems to be a persistent problem with the Democrats, trying to design the perfect solution, pre-compromised, and then being surprised when the conservative Dems demand more changes in their direction. The bill has of course been compromised eight ways to Sunday already, of course, and yet the axis of Nelson and Lieberman and Lincoln and Landrieu aren’t satisfied.

At this point, these conservaDems don’t have the likely 60 votes to change the public option in the bill. So who knows what will happen in the future. But from a tactical standpoint, I have no idea why the opt out was introduced.

Um, same could be said for single payer. Why pre-compromise? And single payer you could have presented the overwhelming positives - you can't do that with these bills coming out of Congress! When will they ever learn?

On Solidarity

Excerpts on a piece by Spanish health care professionals:

Our health system is basically free at the time of use, except for a prescription co-payment of 40 percent. The co-payment is waived for seniors.

The funds for financing the system come from taxes, particularly income taxes, so the burden on each individual depends on their income level. This allows the wealthy to show solidarity with the weak, those who have jobs to express solidarity with those who are unemployed, the younger to help the older, and those who enjoy good health to assist the sick.

Also ...

As you may know, the Federation of Associations for the Defense of Public Health (FADSP) is an organization of Spanish health professionals which for more than 25 years has sought to protect and improve our national health system, of which we have reason to be proud....

This does not mean that our system is perfect, of course, or that it lacks important areas for improvement. But its achievements are many and it is highly cost-effective: our country dedicates only 6 percent of our GDP to keep the system running.

Our health system is basically free at the time of use, except for a prescription co-payment of 40 percent. The co-payment is waived for seniors.

Wow - solidarity, justice, and cost effectiveness both at the national and personal level. I wish our country had a piece of that!

If you talk about helping the poor, they call you Christian, but if you actually try to do something to help the poor they call you a socialist.

I continue to be disgusted by the Christian conservative position against universal health care.

Is anyone else here having trouble with the fact that we are even having this conversation (on health care)? Is anyone else having trouble believing this topic is really controversial?...

I can’t believe I am standing today in a Christian church defending the proposition that we should lessen the suffering of those who cannot afford health care in an economic system that often treats the poor as prey for the rich. I cannot believe there are Christians around this nation who are shouting that message down and waving guns in the air because they don’t want to hear it. But I learned along time ago that churches are strange places; charity is fine, but speaking of justice is heresy in many churches. The late Brazilian bishop Dom Hélder Câmara said it well: “When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a Communist.” Too often today in the United States, if you talk about helping the poor, they call you Christian, but if you actually try to do something to help the poor and working people, they call you a socialist. Jim Rigby

On the abortion issue he goes on to say: It’s amazing to hear Christians who talk about the right to life as though it ends at birth. They believe every egg has a right to hatch, but as soon as you’re born, it’s dog eat dog. We may disagree on when life begins, but if the right to life means anything it means that every person (anyone who has finished the gestation period) has a right to life. And if there is a right to life there must be a right to the necessities of life. Like health care.

I, myself, am not a Christian. But I considered myself one for about 20 years - so I have an inkling of what it's all about. And even if you've never called yourself a Christian, if you live in the U.S. you know that it is supposed to include an emphasis on love and compassion. In the conservative Christian circles, I've seen anything but an emphasis on love and compassion. We are all hypocrites on some level, but on the conservative Christian front, I find this hypocrisy is truly impressive - and disgusting.

Weak Public Option Myths That Liberals Believe

By Kevin Gostola - read here.

Are Republicans only concerned with fiscal responsibility when Democrats try to pass legislation?

From an Ezra Klein blog post today.

Part D Republicans

Bruce Bartlett tees off on the Republicans who voted for the deficit-busting Medicare part D but now say their concern for the debt prevents them from supporting the deficit-improving health-care reform bill.

Just to be clear, the Medicare drug benefit was a pure giveaway with a gross cost greater than either the House or Senate health reform bills how being considered. Together, the new bills would cost about $900 billion over the next 10 years, while Medicare Part D will cost $1 trillion.

Moreover, there is a critical distinction -- the drug benefit had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit, whereas the health reform measures now being debated will be paid for with a combination of spending cuts and tax increases, adding nothing to the deficit over the next 10 years, according to the Congressional Budget Office. (See here for the Senate bill estimate and here for the House bill.)

Maybe [Trent] Franks (R-Ariz.) isn't the worst hypocrite I've ever come across in Washington, but he's got to be in the top 10 because he apparently thinks the unfunded drug benefit, which added $15.5 trillion (in present value terms) to our nation's indebtedness, according to Medicare's trustees, was worth sacrificing his integrity to enact into law. But legislation expanding health coverage to the uninsured -- which is deficit-neutral -- somehow or other adds an unacceptable debt burden to future generations.

Conyers is tire of "saving Obama's can"

As the Mad As Hell doctors posted in relation to this article: "Snap. Conyers tells it like it is. Too bad he capitulated and voted for the bailout bill."

Here are a few bits from Conyers in the article:

• “I’m getting tired of saving Obama’s can in the White House,”
• Asked if the president had shown enough leadership on health care, Mr. Conyers said, “Of course not, of course not.”
• “...give us anything and we will declare victory.” That's pretty much how Conyers characterized the Presidential approach.
  

Four major problems with the House health care bill

You've heard the bad from a conservative view - now hear it from a progressive view. And yes, the bill does do SOME good things - but at what cost?

Unfortunately, to me it looks like the bad and ugly outweigh the good. You'll have to study it and decide for yourself.

Here's my personal four point summary of why I don't support this House health care bill:

1. Under-insurance doesn't equal adequate health care. Those that can't afford the more expensive plans (which will include a lot of people) will be under-insured with expensive catastrophic plans that don't really help them avoid bankruptcy when they get sick and don't necessarily provide them care when they get sick.
   

2. This legislation further codifies unequal health care in our country. That's just the opposite direction of where we want to go. Already our health care is amazingly stratified all the way from those who don't qualify for government aid and can't pay insurance on up to those with the BEST health insurance or money to pay for even the most expensive care out of pocket. Under the health insurance exchange being proposed, that statification would be increased as people would be forced to purchase one of four levels of health insurance based on ability to pay. Martin Luther King said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
   

3. We are further empowering the health insurance industry. Again, just the opposite direction of where we want to go. Giving them more power will make it harder to change directions. For-profit insurance is not the answer if you want to keep the health of the public at top priority rather than profits. This is a bailout for the health insurance industry (our tax money goes to insurance companies through personal subsidies), and we can see how the banks have rewarded us for bailing them out!
   

4. Insurance companies can still deny your claims; therefore, medical bankruptcies and lack of care will continue. Even if you are the privileged in this system to have "decent" health insurance, you can still easily go bankrupt - nothing in the legislation stops this. The insurance companies can have an amazingly laundry list of things they don't cover, which YOU will have to pay for out of pocket and don't log against your annual out of pocket cap. The majority of people who went medically bankrupt in the last five years had health insurance when they became ill. (The fact that the insurance companies can't technically deny you for pre-existing conditions or cancel your policy doesn't change the fact that they can deny the majority of your claims when you are sick and actually need to use your insurance.

You can read PNHP's further detailed response response in a blog from yesterday.

Lower CBO scores simply mean lower federal cost - not necessarily lower health care cost

Thank you Dr. Carroll for the following:

As we all obsess over CBO scores and the cost of reform, it’s important to remember that the CBO only cares about federal expenditures. That’s all.

What that means is that as CBO scores come down, it doesn’t mean that health care is cheaper. It just means that the federal government is paying for less. Making changes to the bills that lower the CBO scores do NOT make health care cheaper.

A lower CBO score may mean that states will have to pick up more of the cost. That’s probably not a good thing.

A lower CBO score may mean that employers have to pick up more of the cost. That’s potentially not a good thing.

A lower CBO score may mean that individuals have to pick up more of the cost. That’s really not a good thing.

Know what a lower CBO score does NOT mean? It doesn’t mean that health care got cheaper or easier to get. And expensive health care is positively a bad thing. Think about that the next time politicians are bragging about lower CBO scores.