Democrats’ hype about health care reform will hurt them

http://www.pnhp.org/blog/2009/…..hurt-them/

But why should we assume that a public program for the non-elderly will enjoy Medicare’s advantages? Medicare enjoys those advantages precisely because it is a single-payer. How can a “Medicare-like” program for the non-elderly be expected to function with Medicare’s efficiency when it won’t be a single-payer – when it will be merely one of more than 1,000 insurers scrambling to make a sale? Won’t the “Medicare-like” program have to open offices around the country and hire a sales force and advertise? Won’t it have to hire bureaucrats to “manage care” like Aetna and Cigna? If it doesn’t, won’t it develop a reputation for being kinder and gentler to sicker patients and attract a disproportionate number of the sick, and won’t that drive up the new program’s premiums?

It is impossible to know what Obama and the vast majority of “public option” advocates think about these issues because there is no “public option” proposal or bill to discuss. There is only the naked claim that a “public option” will “make the insurance companies compete” and that competition always leads to lower costs.

Jacob Hacker is one of the very few people who has actually written in some detail about the public program he envisions competing with the insurance industry. Hacker has recommended that anyone who buys a policy from the “Medicare-like” program receive subsidies from the federal government that people who buy policies from private insurers would not receive. Obviously, this policy would give the new program an advantage over private insurers. But the insurance industry’s lobbyists are no dummies. They understood this might be a feature of “public option” legislation and they have already persuaded key Democrats in the Senate, including Sen. Chuck Schumer (NY), to ensure that the new program enjoys no such advantages.

If the “Medicare-like” program really does turn out to possess some or all of Medicare’s advantages, or if the law Congress passes actually does subsidize purchase of the public program’s policies but not those of the private insurers, then the “public option” idea should permit the public program to undersell the insurance industry and drive the insurance industry off the market. In that event, we will have achieved a single-payer system by a process of “creeping capitalism.” But in view of how eagerly Democrats like Sen. Schumer and people like Hacker are reassuring the insurance industry and their Republican allies that the “public option” will not lead to a single-payer system, it is reasonable to predict that the “public option” will, if it is established, have little or no effect on premium levels across the country and will not bring us closer to a single-payer system.

In fact, if the Democrats, in their zeal to mollify the insurance industry, strip the public program of all advantages and subsidies and the public program suffers adverse selection, the public program might well be bankrupted by the insurance industry. In that event, the industry and its right-wing allies will chortle about how single-payer and “public option” advocates were naïve to think that publicly run health insurance programs could be more efficient than private insurance companies. The single-payer movement, and the entire universal coverage movement, will have suffered a serious setback.

“Public option” vs. single payer does sound like pseudo-change it is seriously hard to believe in, smoke and mirrors we as a citizenry know so well, Lucy and the football. I have been calling Congresspeople and encouraging single payer plan and then adding, please if you can’t go that far, a “robust public plan,” but as Mr. Sullivan points out, the structure of a plan with profit-making in it sabotages its “common-goodness” and puts non-profit portion at the bottom again, setting up yet one more time the blueprint of a two-tiered America, the two Americas John Edwards spoke of oh so long ago.

According to Karen Dolan Physicians for a National Health Program report with the Single Payer universal non-profit plan “The potential savings on paperwork, $350 billion per year, are enough to provide comprehensive coverage to everyone without paying more than we already do.”

Dolan explains that most healthcare advocates would agree that the single payer plan would be the most profound remedy for the U.S. health crisis. But they will also claim it is not politically possible. She uses the word “dead” to describe its status and encourages the teaming of both camps of progressives to work together, those wanting the single payer and those pragmatically pushing the public option, i.e., both public and profit systems combined.

Like both camps above, I too believe that the only real solution to our health crisis is a universal, single-payer, “Medicare for All” approach. Only through a public system that puts patient care and not corporate profits as the bottom line can we achieve the promise of health care as a human right, and effectively bring down exponentially skyrocketing healthcare costs at the same time. Even the best public option runs the risk of being the dumping ground of the nation’s sickest people while only slightly cutting overall administrative costs. A public option system does not achieve the goal of health care as a universal human right.

A public option may indeed be crafted in such a way to become the wedge that ultimately wins the prize, as public plans under-price costly private plans. The public option could offer public plans designed to adhere strictly to the Congressional Progressive Caucus’ laudable principles of universality, affordability, equality. They could be carefully constructed as to be so cost effective that the Republicans fear that they will crowd out private insurance due to their affordability becomes a reality.

But a public option could also be crafted in such a way to expressly prohibit that outcome by allowing private insurers to cherry-pick the healthiest patients, eventually bankrupting a public plan stuck with the nation’s sickest people. If private insurers are allowed to continue the current practice of cultivating and covering the healthiest Americans, the sickest will be dumped into a public plan, thus creating a financially unsustainable situation for the public plans.

So the political and business elite are so powerful that the admittedly best program for the common good is not seriously “on the table” and the pitfalls of a compromise, which is not even guaranteed, are discouraging.

This is an excellent SANE AND SIMPLE animation of the SANE AND SIMPLE universal single payer plan.

http://www.grahamazon.com/sp/whatissinglepayer.php

45 million people are presently without health insurance today, 25 million are under-insured

60 people die each day from lack of insurance in this country

18,000 die each year from lack of health insurance

45% of all personal bankruptcies are due to health insurance costs.

One person goes bankrupt every 30 seconds in America due to health care costs

($90,000 went to the Dems from insurance/pharmaceutical companies last election; $65,000 to Repubs)

We deserve and have the RIGHT to a universal single payer plan.

libby

I’m a single-payer advocate who is extremely concerned about the know-nothing campaign that has been waged by the “public option” (PO)movement over the last two years. The PO movement, led by Health Care for America Now, has resolutely refused to describe the PO they have in mind. Their literature and petitions all resemble Sen. Feingold’s post — the phrase “public option” appears over and over, unadorned with a single detail about what the PO is supposed to look like.

Sen. Feingold states several times we need “a strong public option,” but he doesn’t describe what a “strong” PO is, as opposed to a weak one or any other type. How in the world do citizens hold activist groups and members of Congress accountable when we haven’t the faintest idea what we’re being asked to support? HCAN, Howard Dean, Moveon.org,the AFL-CIO, SEIU and the other advocates of a “robust public option” might as well have asked us to support the Robust Flying Spaghetti Monster. You never saw one? No problem, please sign this petition for the RFS Monster anyway.

The mushy PO bumper-sticker campaign is now reaping what it has sowed — bad results from Congress and, at this late date, almost no way to hold Congress accountable for such horrendous results. I’ll comment on just the handiwork of the Senate Health Education Labor and Pensions (HELP) committee which released a second draft of its “reform” bill last week. We are going to get worse results from the Senate Finance Committee (the other committee with jurisdiction over health care reform in the Senate)in a week or two, and we’ve already gotten awful results from the House where three House committee chairs (Waxman, Rangel, and Miller) have drafted a “tri-committee” bill.

The PO contained in the Senate HELP committee draft legislation is so weak that the Congressional Budget Office predicts it will be unable to set its premiums below those of the insurance industry and, not surprisingly, will have no effect on cost and may not even be able to attract customers. (Does everyone understand that the PO is supposed to be a government-run health insurance company that sells health insurance to the non-elderly in competition with the 1,300 or so insurance companies already hustling to sell health insurance to the non-elderly?) In a July 2 letter to Sen. Kennedy (who chairs the HELP committee), the CBO said:

“The new draft also includes provisions regarding a ‘public plan,’ but those provisions did not have a substantial effect on the cost or enrollment projections, largely because the public plan would pay providers of health care at rates comparable to privately negotiated rates—and thus was not projected to have premiums lower than those charged by private insurance plans….” (see page 3) http://www.cbo.gov/ftpdocs/104…..ELPltr.pdf

Were the advocates of the PO surprised? Are they upset? Do they plan to ask Americans to support some specific criteria that will actually turn the HELP committee’s pathetic little PO into something that could actually kick some insurance company butt? Who knows. The leadership of the PO movement is on autopilot. They have one mantra “Tell Congress we want a robust public option.”

What’s at stake here is not merely the serious blowback the Democrats will suffer when “the heart” of their bill (as PO advocates are wont to say) turns out to be a cute little bauble that accomplishes nothing. What’s at stake here as well is the wellbeing of the entire universal coverage movement, including the single-payer movement. The PO provision in the Democrats’ bill is going to be used by progressive members of Congress as the fig leaf they need to vote for the funneling of hundreds of billions of tax dollars to the insurance industry, the most fervent foe of single-payer legislation in America. Strengthening the insurance industry at a time when, if they were not subsidized, they would begin to die on the vine is the last thing Democrats should be doing.

The insurance industry is the problem, not the solution. It is a parasite on the US health care system. If you’re trying to get rid of a parasite, you don’t feed it. You cut it out, and if you haven’t got the nerve to cut it out, you starve it. You sure as hell don’t feed it the rich diet Democrats are proposing to feed Aetna, Prudential and the other bloated insurers that suck up hundreds of billions of dollars that should be going to patient care. The Democrats’ “reform” bills are, in essence, a huge insurance industry bailout, probably to the tune of $1 trillion over the next decade.

I have just been invited to debate a PO advocate on Pacific Radio Sunday morning. As soon as I get the details, I’ll pass them on. I’m also finishing up a paper on the PO bumper-sticker campaign which I’ll try to remember to announce here when it’s done. In the meantime, you might want to read a piece I wrote for the blog maintained by Physicians for a National Health Program entitled “Democrats’ hype about health care reform will hurt them.” The last third of that paper addresses the incredible hype we’ve all been subjected to about the PO.
http://www.pnhp.org/blog/2009/…..hurt-them/

The next time that Sen. Feingold or anyone else asks you to promote a PO sight unseen, say, “No thank you. When you show me a blueprint for a PO that can set its premiums below those of the insurance industry, solicit me again. Till then, please don’t clutter up the Web with talk of a ‘robust’ public option.”

Kip Sullivan

THAT’S what I’m talking about! *G*

Thanks and bless ya, Senator Feingold!

WOOT!!!

Here’s the Amazon link to his book,

http://www.amazon.com/Health-C…..038;sr=1-1

[…]

Another very important but often overlooked reason for greater health expenditures in the US is that, more than in any other advanced country, large parts of the system are owned by investors. As a result, the entire system behaves like a profit-driven industry, as I described two years ago in my book A Second Opinion.[2] The commercialization of our health system dates back only a few decades, but its consequences are profound. Investors now own about 20 percent of nonpublic general hospitals, almost all specialty hospitals, and most freestanding facilities for ambulatory patients, such as walk-in clinics, imaging centers, and ambulatory surgical centers. These medical care businesses, like other businesses, need profits to satisfy their investors, and for this purpose they use marketing and advertising, directed at physicians and the general public.

Here the author explains why healthcare isn’t like any other industry

Nearly a half-century ago, Stanford economics professor Kenneth Arrow, later a Nobel laureate, convincingly argued that medical care cannot conform to market laws because patients are not ordinary consumers and doctors are not ordinary vendors.[4] He said that sick or injured patients must rely on physicians in ways fundamentally different from the price-driven relation between buyers and sellers in an ordinary market. …

A lot more at the link

http://www.nybooks.com/articles/22798

finding the link …

brb