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The Incredible Shrinking Health Care Reform

by: Norman Solomon, t r u t h o u t | Perspective

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Industry forces are fighting a public plan for health care. (Photo: chibart / flickr)

    Like soap in a rainstorm, "health care reform" is wasting away.

    As this week began, a leading follower of conventional wisdom, journalist Cokie Roberts, told NPR listeners, "This is evolving legislation. And the administration is now talking about a glide path towards universal coverage, rather than immediate universal coverage."

    Notions of universal health care are fading in the power centers of politics - while more and more attention focuses on the care and feeding of the insurance industry.

    Consider a new message that just went out from Organizing for America, a project of the Democratic National Committee, which inherited the Obama campaign's 13-million email list. The short letter includes the same phrase seven times: "health insurance reform."

    The difference between the promise of health care for everyone and the new mantra of health insurance reform is akin to what Mark Twain once described as "the difference between lightning and a lightning bug."

    The "health insurance reform" now being spun as "a glide path towards universal coverage" is apt to reinforce the huge power of the insurance, pharmaceutical and hospital industries in the United States.

    President Obama says that he wants "things like preventing insurers from dropping people because of pre-existing conditions." Those are not fighting words for the present-day insurance industry. Behind the scenes, massive deals are taking shape.

    The president of America's Health Insurance Plans, Karen Ignagni, "noted that the industry had endorsed many of the administration's proposed changes, including ending the practice of refusing coverage for pre-existing conditions," The New York Times reported on August 3. A couple of days later, in a profile of Ignagni, the newspaper added, "Rather than being cut out of the conversation, her strategy has been to push for changes her members can live with, in hopes of fending off too much government interference."

    This year, no more significant news article on health care politics has appeared than the August 4 story in The Los Angeles Times under the headline "Obama Gives Powerful Drug Lobby a Seat at Healthcare Table."

    It's enough to make you weep, or gnash your teeth with anger or worry about the consequences for your loved ones - or the loved ones of people you'll never meet.

    During his campaign last year, Obama criticized big pharmaceutical firms for blocking efforts to allow Medicare to negotiate for lower drug prices. But since the election, the LA Times reports, "the industry's chief lobbyist" - former Congressman Billy Tauzin - "has morphed into the president's partner. He has been invited to the White House half a dozen times in recent months. There, he says, he eventually secured an agreement that the administration wouldn't try to overturn the very Medicare drug policy that Obama had criticized on the campaign trail."

    The story gets worse. For instance, "Tauzin said he had not only received the White House pledge to forswear Medicare drug price bargaining, but also a separate promise not to pursue another proposal Obama supported during the campaign: importing cheaper drugs from Canada or Europe."

    Meanwhile, with a "mandate" herd of cash cows on the national horizon, the health insurance industry is licking its chops. The corporate glee is ill disguised as the Obama administration pushes for legal mandates to require that Americans buy health insurance - no matter how dismal the quality of the coverage or how unaffordable the "affordable" premiums turn out to be for real people in the real world.

    The mandates would involve "diverting additional billions to private insurers by requiring middle-class Americans to purchase defective policies from these firms - policies with so many gaps and loopholes that they currently leave millions of our insured patients vulnerable to financial ruin," says a letter signed by more than 3,500 doctors and released last week by Physicians for a National Health Program.

    Days ago, a New York Times headline proclaimed an emerging "consensus" and "common ground" on Capitol Hill. In passing, the article mentioned that lawmakers "agree on the need to provide federal subsidies to help make insurance affordable for people with modest incomes. For poor people, Medicaid eligibility would be expanded."

    It's a scenario that amounts to expansion of health care ghettos nationwide. Medicaid's reimbursement rates for medical providers are so paltry that "Medicaid patient" is often a synonym for someone who can't find a doctor willing to help.

    But what about "the public plan" - enabling the government to offer health insurance that would be an alternative to the wares of for-profit insurance firms? "Under pressure from industry and their lobbyists, the public plan has been watered down to a small and ineffectual option at best, if it ever survives to being enacted," says John Geyman, professor emeritus of family medicine at the University of Washington.

    A public plan option "would do little to mitigate the damage of a reform that perpetuates private insurers' dominant role," according to the letter from 3,500 physicians. "Even a robust public option would forego 90 percent of the bureaucratic savings achievable under single payer. And a kinder, gentler public option would quickly fail in a health care marketplace where competition involves a race to the bottom, not the top, where insurers compete by NOT paying for care."

    While the health care policy outcomes are looking grim, the supposed political imperatives are fueling the desires of Democratic leaders on Capitol Hill to produce a victory that President Obama can tout as health care reform. Consider this quote from "a prominent Democrat" in the August 10 edition of Time magazine: "Something called health-reform legislation will pass. The political consequences of not passing anything would be too great."

    The likely result is a glide path to disaster.

  

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Norman Solomon is co-chair of the national Healthcare NOT Warfare campaign, launched by Progressive Democrats of America. He is the author of a dozen books including "War Made Easy: How Presidents and Pundits Keep Spinning Us to Death." For more information, go to: www.normansolomon.com.

Comments

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Its pretty simple. Lower

Its pretty simple. Lower the requirement age for Medicare by 5 years every 5 years. This will give the people who work for insurance companies time to find jobs in the alternative energy industry. Put TARP money into green technology and create jobs there. If folks aren't working, then there are no payroll deductions to fund Universal Care or Medicare.

We have truly, truly become

We have truly, truly become a Fascist nation when corporations can influence government with more ease and more quickly than the voters can. A once proud nation reduced to the edicts of drooling, greedy CEO's. Shame.

Simple steps:1. a public

Simple steps:1. a public option available to anyone. 2. forget about "mandates" to buy health insurance. This combination allows you to be part of a government-run plan if you want and to reject it if you don't. So simple... that's why Washington doesn't get it.

Why can't we let the

Why can't we let the insurance companies continue to do business any way they want to - while instituting a full-coverage government medical care program for all comers? Those who want to continue to have their medical care mediated by insurance companies can freely do so. Those who'd prefer to have government-sponsored health care could freely do so. Happiness for all sides!

I can tell you one thing

I can tell you one thing that ISN'T going to shrink: the premiums for older Americans. This does not get enough attention. The insurance companies will have to cover everyone, with no price increases for pre-existing conditions. As a trade-off, they will be able to drastically increase the rates for older Americans - some reports indicate insrers will be able to charge older Americans up to 7 1/2 times the premiums of younger people. I looked at the rates for my current plan - a person 60-64 pays just under 2 1/2 times the premium of someone 19-24. With the government ready to FORCE Americans to purchase health insurance, granny may have to give up food and housing to pay her insurance premiums. Maybe this is the "euthanasia" Republicans are screeching about!

Looks like we the people

Looks like we the people lack representation everywhere. We should elect people’s representatives to negotiate directly with the industry/banks/corporations, without intermediaries They receive quick benefits and “bailouts” from government, while we the people have to wait for the “debates” “further analysis” and “compromises”, which is the process by which Congressmen/women “consult” with the industry/bank/corps on what to give to the people. Curiously congress’ members –elected by the people- do not consult with the people. If the industry/banks/corps approve, we may get something, otherwise northing. The direct representation will preserve the democratic process while giving people more participation.

Stop the Baucus Caucus! How

Stop the Baucus Caucus! How many times must one reiterate the obvious, namel: we need to get a ten million patient march on Washington going NOW, a march led by 100,000 patients in wheel chairs! Stop the Baucus Caucus!

I, too, allowed myself to

I, too, allowed myself to briefly hope that there would be actual reform but it is clear that the insurance industry simply will not allow it. We can divide Americans into three categories: 1) Those that agree with anti-reform propaganda and oppose reform; 2) Those that marched against the invasion of Iraq and saw how much good that did and bailed out of the process; 3) The apathetic who won't do anything about anything. Since the corporations took over instructing Congress from the populace we no longer have a great country, and that's pretty sad.

Another good one, N.Solomon.

Another good one, N.Solomon. For a good companion article, I recommend Bruce A. Dixon's article on top of Home Page of BlackAgendaReport on organizing between now and Labor Day...the fight for single-payer isn't over. www.blackagendareport.com

To Dan Treecraft - That's

To Dan Treecraft - That's what Obama's trying to do but the republicans don't want to take business away from private insurance companies. So, they won't vote for the bill to include a government insurance option. Dan, Obama just can't magically start a government insurance program, congress has to vote the money for it and vote it into existence.

Uh, pardon me, but, uh, what

Uh, pardon me, but, uh, what do ya mean "the insurance industry will not allow it?" They are a criminal cartel, prosecute them under the RICO statutes! Don't we have even one Jim Garrison left?

Anything short of

Anything short of single-payer universal care is a waste of time and money. There is no viable "compromise" or hybrid system that allows Big Insurance and Big HMOs to participate. Its them that need to be euthanized. These coops and pools being discussed will only cause more confusion and won't lower costs. Here's who stand to lose if we reform the system to provide coverage for all: Ron Williams - Aetna; Total Compensation: $24,300,112. H. Edward Hanway - CIGNA Total Compensation: $12,236,740 These are just two of the alpha males at the top. There are countless others who are investors and other officers of these corporate giants who are lobbying hard to convince the public that single payer is unsustainable. Wall Street invests heavily in these firms and the dividends are sweet. They can't stand the idea of a public option. I agree with free enterprise for most businesses. It just doesn't work for health care. Profits are derived from denying care. Has free enterprise improved this product? Have your premiums gone down due to competition? Do you get a better product for your money than before? Do you have an option not to buy? Ask a resident of Canada or the UK if they would prefer the American-style private insurance system. I don't have to tell you what the response will be. These are democracies, not some Soviet-style communist dictatorships. They could vote out their system anytime they felt it was not working.

Want to create a permanent

Want to create a permanent expanding lobby for single-payer? Extend Medicare to 18-year-olds. Problem solved.

I live in the UK and work

I live in the UK and work with the medical profession and hospitals in the UK, France and Germany plus others. The Single Payer systems works and while not perfect, it is better than anything else and keep getting better. It is so much better than the present US system/policy that it is beyond comments and comparison! Most patients are on a National Health System. All citizens have access to National Health as a citizen of their respective country and/or are entitled to health care in other EU countries, if they wish. Some citizens do take out insurance with private companies like BUPA in the UK. As BUPA has to compete with National Health System, their rates and policies are reaasonable. Those insured with BUPA in the UK have access to private hospitals and clinics if they wish. BUT SO DOES A NATIONAL HEALTH CARE PATIENT in many cases, if they choose a private clinic that works with the National Health Service and there are services available. you see, IT IS A MATTER OF CHOICE OF WHICH CLINIC, WHICH DOCTOR ETC. INCLUDING MEDICAL CARE IN OTHER EU COUNTRIES! I have been watching the debate in the USA and the reaction of your politicians and the insurance industry and citizens. IF THE AMERICAN PUBLIC DOES NOT TAKE THEIR DEMANDS INTO THE STREET AND ACTIVELY PROTEST FOR ANY LESS THAN A SINGLE PAYER SYSTEM THEN YOU WILL GET WHAT YOU DESRVE. Anything less and you are or selling yourselves short! ....and letting the insurance industry, corporate interests and corrupt politicians take this human right away from you!

Democrats need to

Democrats need to concentrate on the strategy to make those opposing single payer system well known to the voters of their district. Then forget about passing a health care reform during this session. Wait until the election return congressmen in favor of a truly reformed health care system similar to Canadian system. The reformers will then have no opposition. GOP will be history. Health care shenanigans will be the last nail in the coffin of GOP.

One commenter objected to

One commenter objected to mandatory participation. You can't cover everyone unless everyone participates. You can't allow the young and healthy to game the system, which they do now. That adds a significant amount to the premiums the rest of us have to pay as these people get their expensive, ER treatment for free. It also makes it impossible for insurers to charge reasonable rates because they are not insuring a broad spectrum of society, so they have to jack up the rates to account for the gaming. That in turn causes more people to drop out. It's a vicious circle. Universal coverage mandates universal participation.

This is a test of U.S.

This is a test of U.S. citizens. Will they let themselves be fooled as in the early 1990s by the original Harry and Louise ads? Or will they wake up and protect their basic interests? It is difficult to be optimistic about this.

I guess the biggest

I guess the biggest disappointment I have is how the Media chooses to not really communicate clearly and with any passion about the deaths of Americans without healthcare. But, gee, they seem to get a good deal of advertising dollars from the companies with the most to gain by keeping things as they are, just like our "elected" political monarchy. Money Talks. Thank god for people like Olbermann and Rachael and Huffington to at least provide some alternative information. Keep the Internet Free -- it is our last hope.

H.R.3200: The bloated bill

H.R.3200: The bloated bill currently under consideration needs to be slimmed down, simplified, and the implementation timetable needs to speed up so that we can see some effects other than committee reports and agendas before the year 2013 (significantly, after the next presidential election). If this thing passes in anything like its present form and President Obama has a statesmanlike hair on his ssa he will veto it and tell Democrats in Congress to start over. This is like a test.

Gee, Its become a very sad

Gee, Its become a very sad measure of affairs in America when President Obama, Great Orator, Hopeful Leader, Man of the People is obviously becoming the MERE MEASURE of just how Corporate Run and Operated our Government truly has become... We have a President who himself is on a glide path of decent from our once hope-filled, Strong as a Mighty Oak in the Wind Man Savior of America for the People down to the beat up Rodney King of Presidents who leans smilingly towards his 'beathers', the now obviously deadly, partisan Republican Opposition to ALL he stands for and WE voted for, and humbly ask and begs to them-- 'Can' We All Get Along?'.... as he keeps compromising towards some non existent middle ground... The Republicans simply see Weakness to exploit him to political death with, and the Blue Dogs--- aka-- THE BLEW-IT DOGS, hear his pleas and simply see 'pork' opportunity...... So, what we have here is the OBVIOUS INDEED..!!..... The President is now the 'Neutral Arbitrator'' who sits at the head of the Table of the US(eless) CONGRESS of CORPORATE FACILITATION... where Congressmen and Senators haggle over the needs of GLOBAL Corporations in their Districts and GLOBAL Corporate Donors who get them elected. If the reach a GLOBAL Corprate Consensus, then the President-CEO scores big Political Points. If not, he's handed his political butt... SO..., Welcome to The C.R.A.P.--> The Corporate Run American Paradise.... Where its all exclusively about Corporations plus Political Butts equals Legislative Outcomes in a Land where WE THE PEOPLE have been transformed into nothing more than THE AMERICAN CONSUMER... And this is all considered the modern American formula for creating PARADISE ON EARTH...

i have had it with

i have had it with representatives who don't represent anyone but corporations. The words public service mean service to the public not private corporations. We have a very sick government, if it were an animal it would be put to sleep. We are surrounded by lies, deception and hypocrisy on a daily basis, much of this coming from various factions of the government. I feel our representatives have fallen to a new low and would rather play games than do actual service to those that voted them in office. They are bought and paid for by the elitist members of society and represent only those that paid them. I think these clowns should be impeached, recalled and voted out of office as soon as possible. Those that committed criminal and immoral acts should be prosecuted to the full extend of the law.

Surprisingly on Lou Dobbs

Surprisingly on Lou Dobbs they did a section on Canada's medicaire that was favourable. Do Canadians like their plan. Of course.It may not be perfect but at least it exists. I wonder how much they pay these so called Canadian plants on TV to critisize it?Why did they not poll a few Canadians on the street. Quebec,Canada.

You're right about not

You're right about not listening to the people. If our Congress were doing the voters' bidding, they would kill the health care government control bill - the majority of the voters do not want it. Even with the vast problems with the Insurance companies, their performance is still vastly superior to the current government run programs.

Neither the government nor

Neither the government nor the corporations can "make" anyone do anything. They can propagandize, threaten, bribe and punish by many means but we all have opportunities to make choices that matter every day. Yes, there are consequences for civil and corporate disobedience. Nobody ever said freedom or justice or human dignity were "free". How much do you want it? It's an awful responsibility, after all. The simple version: killing and stealing and lying and capitulating to fear will not create a better world. Ever. What then, is the option? No institution of any kind can or will give one freedom. One obtains freedom by living freely, moment by moment, day by day, choice by choice, as best one can. Freedom and justice are like any other human endeavor, one gets better by practicing.

Go to WHITEHOUSE.COV, CLICK

Go to WHITEHOUSE.COV, CLICK ON "CONTACT US" and tell Pres. Obama that you've picked up on the morph from "health care reform" to "insurance reform" and you DO NOT LIKE IT! Tell him in your own words what he has refused to tell us: Exactly what the basic minimum healh care reform bill must contain: A medicare-like, gov't run program that is available to every American from "day one" who wants to enroll in it whether they already have private insurance, employer subsidized insurance or none at all. If that leads to Medicare for All, so much the better!

The option and information

The option and information of how to die painlessly should be easily available. It would be better for the economy and the taxpayer if suicide kits were sold over the counter. Living in pain and being useless to yourself and others is no way to live. Call it self help if you like, but it would save the nation billions of dollars in health costs. The freedom to choose when to die shall not be withheld.

I just got on the

I just got on the WHITEHOUSE.GOV (not .cov) page and make my comment for single-payer. I now reside in a third-world country (Nicaragua) and they are the poorest country in Latin America (beside Haiti) and they have pretty basic healthcare but at least everyone has access and you can have private if you want. I am a US citizen, but I would rather be able to have the Canadian service, if possible. The US is just a joke. We can afford all kinds of military crap but the States are going bankrupt and there are people without water service, without healthcare, a growing third worldness, an overpopulated prison system. Decline of the empire, I'd say. Wake up. We create reality with out minds. What are we thinking? Someone on this blog said it. Think, talk, act, choose freedom. It's a daily chore.

Dear mysterioso: I love the

Dear mysterioso: I love the way your mind works! Such apt solutions!