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The Obama Administration isn’t willing to confront any of the large corporations that are draining the wallets of average Americans.
The giants on Wall Street have talked the administration into pretend reforms of swaps and other derivatives, the financial instruments of mass destruction that brought last year’s crash. They talked the administration out of reinstating Glass-Steagall. With real reform off the table, the banksters can focus on gutting the pathetic remnants of consumer protection.
We can see this clearly in health care reform because there has been so much coverage. The President’s speech to Organizing For America makes it perfectly clear that he is running away from the public option as fast as he can.
Among Democrats and progressives, there are a whole set of views about how we can deal with health care. But know this. The bill you least like would provide 29 million Americans with health care. The bill you least like would bar denial of health insurance for pre-existing conditions. The bill you least like would set up an exchange where people can use some leverage and bargain for better rates [...]
This is a flat statement that we are going to hate the final bill. Instead, we are asked to unify behind a law that won’t do anything to benefit most people. The administration has cut deals that favor rich and powerful interests, the drug companies, the health insurance companies, the hospital companies, the doctors and all the rest. They all get richer. There isn’t anything else for any of us average citizens except increased bills.
The plain fact is that the Bill We Like the Least forces people to buy insurance from private companies that have done the near impossible, they have united Americans–all of us despise them. These companies will profit mightily, with no benefit to the rest of us. Obama asked nothing from them except that they not lobby Congress. Drug companies give up a few dollars, balanced by concessions. Hospital companies give up little. Doctors get raises.
Scarecrow thinks that the Obama administration has cut a deal with the insurance companies to kill competition for them, just the kind of concession it made for all the other players in the health business. I agree.
This is all wrong.
The medical business is a financial disaster. There is only one practical one way to handle financial disasters: Everybody Takes A Haircut. When a business fails, there are two choices, you either liquidate or you reorganize. We can’t liquidate health care, so we have to reorganize it.
When you reorganize a business, everyone takes a haircut. The debt of secured creditors is written down to the value of their collateral. The unsecured creditors get something on the dollar, or maybe even see their debt converted to equity. In the end, we get a viable business, and the community benefits from continued jobs and a flow of taxes.
That translates directly to health care reform. We aren’t going to write down assets, but we must rearrange things so that everyone gets less income. We can’t go on pouring money into the outstretched hands of Medical Services Businesses. That business is going to have to suck it up. Every single player gets a haircut. Everyone takes less. There isn’t any other way.
Proposals like those to increase money to doctors and hospitals in future years run directly contrary to the haircut rule. I don’t think we should bargain away our power to drive down prices, and I don’t want to give up money for nothing more than a promise that the AMA will not lobby against change.
The Obama Administration is willing to let average Americans take a huge haircut, in the form of tax support for the MedBiz funneled through insurance companies, and forcible creation of more purchasers. They not only don’t insist that on a haircut, they hand MedBiz players the username and password to your bank account.
The President didn’t get elected to serve the interests of corporations and their rich owners. He got elected to change the rules, to make the economy work for everyone, not just the rich. We need for him to do that.
Tags: financial crisis, financial regulation, health care reform, public option
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That’s because those same corps fill O’s wallet.
I don’t understand why they’re not regulating swap derivatives like they’re insurance if they walk and quack like insurance and pose the same structural risks if undercapitalized and systemic risks if they exacerbate a downward spiral.
Not that such a turn of events would ever come to pass…
Know this. The bill we like least would require us to subsidize premium payments for people who would receive crap insurance and be burdened, even at the most subsidized levels, with medical costs they could not afford. Nowhere in the bill we least like is there any mention of caps on co-pays or deductibles. Nothing in the bill we like least works toward reducing costs, either of insurance or medical services.
Know this too. Something in the bill we like least requires people to buy crap insurance, on pain of penalties to be inflicted by the IRS, even if they could have derived no benenfit from the insurance they failed to buy.
Know this also. If the Democrats trot out the sick and the families of the dead at their next nominating convention, and ask us to vote for them because they care, we will all know they are hypocrites and liars and they will be booed off the stage.
Some stats to think about:
number of adults in U.S. = 228,182,000
number of disabled adults = 32 million disabled adults (aged 18 or over)
which would appear to indicate that there are 196,182,000 adults who could be working
Current unemployment rate is 9.8 per cent(though we all know such is a lie) so that means 19,225,836 people have only unemployment compensation(if that) to live on.
So how are 19+ MILLION people going to have health insurance if there is a mandate?
And that doesn’t even begin to address the issue of nothing really occurring until 2013.
I’ve been censored here for calling Obama the name of a popular cookie, but the plain fact is that he is just another political whore.
It IS as Greg Palast said long ago (or so it seems): “the best democracy money can buy.
I hope ALL who read FDL and it’s sub blogs join the movement to remove the idea that corporations have the same rights as a living breathing person (otherwise known as ‘corporate personhood’).
Good luck getting the industry to re-elect the tools that stood with the “interests” and against the people. I ain’t phone-banking jack. I ain’t precinct walking squat. Call me for a donation – good luck with that. I’ll be spending MY time with the DFH’s, the ill or infirm, the local guys, the food bank.
Kinda quiet here tonight. Where are all the pods to defend their beloved leader?
Reminds me of a song:
(With apologies to Stephen Sondheim)
If that was the deal, the healthcare industry negotiated in bad faith. They have been lobbying Congress sextuple-teaming Congressmen since the day that Obama was elected. He really isn’t obligated to keep his end of the bargain anymore–especially since AHIP went to the Republicans and declared war.
Obama has been out to get what he can out of the bill, and if that includes strong public option, fine. What he could get in July when he negotiated those deals was a lot less than he can get now. And a big reason is that we have not followed the advice to STFU and have followed a strategy of first backstopping the public option by getting firm commitments from the Congressional Progressive Caucus. Helping us has been the fact that the tea-bagger shenanigans in August really had a backlash among independents and not a few Republicans; it is no mystery why self-identified Republicans have dropped to 20% of the population.
I think it is easy to get whiplashed by the inside-the-Beltway rumor mill, which overlaps somewhat with the great GOP Wurlitzer and read too much into anonymous sources.
The confusion comes from the fact that unlike the previous regime, Obama is giving Congress space in which to work without a whole lot of micromanagment. And that means that the interests that drive those members of Congress become more apparent. Think of the disappointments in particular Congressional “heroes” of progressives who were found to be just as controlled by money as their Blue Dog colleagues. And think of how clarifying the debate over healthcare reform has been in smoking out those who are most touched by healthcare industry dollars. Who would have known of Mike Ross without this debate? Who would have thought Kent Conrad of North Dakota (where the state owns a bank forgodsake) would be so hepped up on private co-ops. In the emerging financial industry regulation debate, we are learning some things about Barney Frank that we had known already about Chris Dodd.
There is a great need, masaccio, to establish some lines in the sand on financial reform and begin committing the Congressional Progressive Caucus to them–essentially repeating the strategy followed on healthcare reform or developing a better strategy.
The revolution will not occur in the streets; it will occur on the telephones and faxes to Congressional office and the mobilizing of each of our personal networks to do the same. For the next 12 months, expect to be phoning and faxing to hold Congress firm on some compromised point that does not yet vitiate reform. Apparently, the Congress doesn’t do simple legislation like opening Medicare to all or simply repealing all of the garbage acts of the past three decades.
As if these oligarchs and megacorps won’t line up to defeat Obama in 2012. What can he possibly be thinking?
Glad to see I’m not the only one that’s SOOOOOOOO disappointed with this President. And masaccio didn’t even mention the stuff that has me the most disappointed. And that is not holding those that broke the law and Constitution over the last 8 years accountable, because that means that any President from now has learned the lesson that Presidents can’t be held accountable because it would be “too partisan.” Once this lesson is learned, it’s only a matter of when the next big outbreak of lawlessness begins, not a matter of IF.
11-dimension chess. We peons just don’t understand it.
It’s shit like this that makes me hope the House votes nearly unanimously against a crappy health care bill.
I think Obama, Corporatist Democrats, Rahm, everyone needs to get their ass kicked in the legislative process to realize the American people don’t want what they’re selling.
I heard that Baucus went to “DEFCON 1″ after hearing about Reid wanting to push a PO. I think the entire administration needs to go to DEFCON 1. And fast.
Seriously. 3rd Party. Time to NY-23 the White House.
At the gym this morning, one of my bankruptcy colleagues was bemoaning the future he sees for his kids, who are in college, graduating in the next year or two. He thinks our standard of living will be lower in the next years.
It’s not going to sit well with people if entrenched interests don’t take a haircut like they have to.
The bill you least like would….
Sounds like the Prez has been spending way too much time talking to Harry Reid.
The medical
businesscrime wave is a financialdisastertsunami.We’re all going under, and our sweet-talking President is already looking like an irredeemable failure. From what I’ve seen so far, he’s got nuthin’.
Doesn’t sound like leadership to me.
sorry masaccio, i could not disagree more with you. healthcare is a financial disaster because we misallocate resources. we don’t need everyone to take a hair cut, we need to reallocate the resources we have. which means some areas take a whopping haircut and others areas get more resources. we are right now spending enough money (total national health expenditures) to pay for first dollar coverage (that means no deductibles, no copays and no coinsurance) for every single resident if we would only spend that money on healthcare instead of useless administration.
we don’t need to do something stupid, like pay primary care docs less so we end up with even fewer of them. are you aware of the serious shortage of primary care docs? it’s really bad were i live — i had to wait 8 months because that was the first available new patient appointment (the first three docs i called were not taking ANY new patients).
what we need to do first, is capture the $400 billion / year that is wasted on unnecessary administrative overhead. that haircut will be primarily one the insurance companies have to take. with that one change, we have enough to insure the uninsured and with first dollar coverage for everyone, take care of the under insurance problem as well.
this is not rocket science. every other industrialized country on the planet has figured it out. and it doesn’t mean less money to everyone. it means first reallocating what we do spend, and then make the necessary changes (take the ama out of determining ctp codes, change our medical device and drug patent and related law, global budgeting, etc, etc).
So how the hell did “sweeping health reform” turn out to be the best thing that ever happened for insurance companies?
Maybe Obama’s future is in motivational speaking, because he’s sure as hell no politician.
I agree we need to think about the financial reform bill. The great thing about health care reform is that we had some natural advantages: the public option was a campaign promise, it is fairly easy to understand, the rest of the bill was pretty good, and the crazy right wing shot it’s bolt early.
It’s a lot harder with financial reform. Understanding the financial apparatus of this country has never been a strength of liberals. The issues are complex and not easily reduced to slogans. The amount of money involved dwarfs the health insurance industry, at least in nominal terms. FinBiz is global, and most of the “capitalists” here are perfectly comfortable moving their money off-shore.
And, the administration is full of Goldman Sachs people and their ilk, and they have the ear of the President. I’m not very hopeful.
Selise, I flatly don’t agree. There is too much money in the system. It is choking the life out of 60% of the nation, and killing people. We need the money for other things.
Everyone takes a haircut, or MedBiz will swallow us all.
Gotta weigh in here. U.S. medical industry has high overhead “because they can.” It’s a symptom, not a cause. If you try to cut overhead but leave the industry with its current economic power, they’ll just reallocate it to some other boondoggle. That is, coping with administrative costs is no magic bullet, nor is it “not rocket science.”
Not sure, but I think other developed countries have better and cheaper medical services because the govts determine that thru regulation & price controls. Not by picking at it piece by piece, but by a wholistic approach.
We ain’t even close to that happening in the U.S., which is why any form, including “robust public option,” is likely to turn out to be a dismal failure with all sorts of negative unintended outcomes.
KarenM’s diary is promoted, upstairs!
Rep. Anthony Weiner tests the bar on hypocrisy for the GOP
Excellent blog. Well said.
Hello. How do you know all of these things? No bill has been written. Do you have a secret source?
Good Evening masaccio and Firedogs,
roger that. been convinced for some time now that the HCR fight has provided a reliable template for just how things will go with this crew going forward – hell, it’s been their mo from the jump – so very grateful so many are hep to it so early on
i think you are wrong on this (except for the rocket science part, i agree there – it’s not).
the overhead i’m referring to is not “because they can” it’s all from dealing with the complexity of our multi payer private insurance non system. a big chunk of it is on the provider side, but most of it is on the insurance side. eitiher regulations (swiss strength) or single payer can address that (single payer maybe more efficiently, but regulation has worked).
and with either swiss strength regulation or single payer, the providers do not have much market power.
larry summers = clue
:(
of the four bills now in play (sfc, help, tricommittee and ecc are the ones i know about) can you say any better about the bill you like best?
Yeah, I expect to see Ashton Kucher pup up and say the nation has been punked.
what percent of gdp is acceptable to you so that no one in this country dies from lack of access to health care and no one in this country goes bankrupt due to health care bills?
p.s. i’m assuming you don’t want people to continue to die and go bankrupt because of access or cost. i’m not wrong to assume that, am i?
“The President didn’t get elected to serve the interests of corporations and their rich owners. He got elected to change the rules, to make the economy work for everyone, not just the rich. We need for him to do that.”
With his election Obama became a representative of the plutocracy. Those who made his election possible are being told, “your own your own, again.” The Great Fleecing continues.
Other nations do better than we do at a much lower level of GDP. We need to move that way.
what i described to you was a way to do that. the first major reform (private insurance to national single payer) would allow us to provide comprehensive first dollar healthcare to everyone without spending any more (maybe less) money on healthcare than we do now. the follow on reforms would then provide cost control on the rate of increase.
look at the data from canada — before they went single payer their % of gdp was the same as ours (with the same rate of growth). after implementing single payer, their costs did not go down, but they did control the rate of growth and now they spend far less than we do (they should probably spend a little more, but not a lot). you can see what i’m talking about in the first figure of an old diary of mine:
http://seminal.firedoglake.com/diary/5899
we could do the same.
…. imposing the same hair cut everywhere, regardless of the level of waste, means keeping some wasteful components while starving some necessary ones. in some places we just need to spend more and in others there is a massive amount of waste. please, let’s be try to take these realities into account.
Aren’t we lucky to have elected a moderate Republican instead of an FDR-type Democrat. My heavens, he or she would likely have committed all that money to reducing unemployment and closing the output gap instead of rescuing Wall Street from the external shock it sustained that it never could have foreseen or prepared for. Gee, an FDR-type Democrat would probably even have set up another Pecora Commission, just like that frightful FDR did as soon as he was elected, and conducted another witch hunt on Wall Street.
p.s. masaccio, i thought you were a supporter of hr 3200 – am i wrong about that?
I’m hoping the healthcare reform effort crashes and burns. Obama has done a miserable job on this issue, and we need to start from scratch and do it right with single payer. From the day he brought Rahm Emmanuel into the White House it has been apparent that the entrenched economic interests were going to have the upper hand.
“Change” my ass….
This is war. You can’t attack the enemy unless you meet him or her with overwhelming force at the point of contact. Breaking the back of the most powerful private interests in the United States is going to take a long time. They broke Clinton. Obama took the lesson. He doesn’t want to be fish food. This is going to take eight years.
I support HR 3200: it’s what there is.
This post isn’t about which health care bill to support. This post is about my deep feeling that the Administration needs to confront entrenched interests more aggressively.
Knut at 35 is probably right. It will take forever to change things, and maybe I’m too impatient. Or maybe nothing changes unless people insist.
i agree completely that entrenched interests should be confronted more aggressively. i just want us to be smart about it — and imo an across the board haircut doesn’t make any sense from either a public health perspective or an economic perspective.
imo it is up to us to insist because there is no reason whatsoever to expect the current administration or the party leadership to do it. dem party leaders have for at least 2 decades catered to the interests of their corporate allies while throwing people under the bus.
btw, according to the cms report from last week, hr 3200 is predicted to increase total national health expenditures, not affect the rate of increase and also squeeze medicaid (and maybe medicare) patients by making access to providers more difficult:
http://fdlaction.firedoglake.com/2009/10/23/the-health-care-reform-political-time-bomb/#comment-55795
that’s why i was so surprised when you argued against a policy that should control costs while providing comprehensive healthcare and equal access.
i still have no idea exactly what policy you are advocating in favor of, other than hair cuts all around even if that means providing less healthcare than we are now (and possibly saving less money when compared to other reform alternatives that provide for more healthcare).
personally, i don’t care if our healthcare policy results in some fed budget deficit, so long as the costs are removed from of the private sector (households and firms) and state and local govs and also so long as economic parasitism is shrunk in favor of economic activity that provides some real benefit. turns out that shrinking economic parasitism is what saves the most money while maximizing available healthcare for people. it’s a twofer.
That nutz. If I hear one more Obama’s playing 11-dimensional chess argument I’m going to pull my hair out.
The man had the votes for a robust Medicare+5% public option in the House and he went out of his way to kill it.
He went out of his way to define the public option as a controversial idea and to label single-payer (the most common system worldwide) as too radical.
Obama is no friend of progressive causes, and we should not allow him to get eight years. There must be consequences for betrayal of this magnitude.
He’s quickly losing the base and the other side won’t vote for him anyway. Can you say Jimmy Carter 2.0?
The premise of considering the health care system as akin to a distressed business was bound to lead to this rather absurd conclusion, that all must pay in equal amounts for its failure. When a business fails by what obligation should other innocent bystanders suffer the consequences. There is no such obligation. You let the enterprise fail and workers find other work.
Healthcare is not a business and the sick are not customers or consumers, they are beneficiaries of care and have no choice in needing to receive it.
A much better analogy is when businesses collude to elevate prices you need to break them up in order that services are provided at a fair price. The above analogy fails miserably for the simple fact that insurers and others are currently doing just fine they are under no distress at all. Their profits couldn’t be higher.
It is the waste by insurers primarily, as you point out, and their monopoly as middlemen that are at the root of the problem. By what reasoning should patients have to do without because the system they are under is inefficient. This line of reasoning is just completely off base and it is no wonder. Once you start working from a faulty premise it is just downhill from there.
Your points are convincing and straightforward, the level of current health expenditures is more than enough to meet the health care needs. It is a matter of spending it wisely and efficiently to the detriment of insurers, drug makers and others but certainly not to the detriment of patients.
My only qualm is one that relates to whether it is best to insist on a single payer system at this point rather than for a PO which if implemented adequately will in time lead to a single payer system, My inclination is to make the transition by way of a PO and to assure that it has the elements needed to succeed.
This won’t happen. Medicare has had decades to transform into Single-Payer, and with yet another “market-based” approach to reform foisted onto us, it is no closer today to making that transformation than it was the day it was established.
Additionally, a hodge-podge Public Option that is bound to failure by becoming a dumping ground for the sick and/or poor (requiring subsidies) is only going to create the same climate we’re already seeing with the stimulus. We all knew the stimulus was too small, and argued that you weren’t going to be able to go back to the well for more, because once it didn’t accomplish everything it should have (if it were bigger), the opposition was going to call the whole thing a farce and a failure.
Just to clarify, Medicare is an entitelemnt it is not an insurance plan. Medicare recipients do not pay premiums it is funded through taxes on everyone, so it is in fact a single payer system for those over 65. And it works fairly efficiently, aside from some provisions that don’t allow it to bargain for better drug prices and such things.
Since its inception it has never served as an impetus for a general extension to a tax based single payer system for lack of public demand not because it is undoable.
Whether the PO will be sustainable depends on how it is implemented. The PO is in essence is a single payer system in miniature. Even if it draws a disproportionate amount of costlier participants it could remain viable by drawing a sufficient amount of lower risk participants. Because it is more efficently run than private insurers the ultimate premiums the PO would offer may still be lower than that of the private insurers. And therefore draw more of all participants regardless of their risk and cost.
The issue of subsidies is irrelevant, since if there is a mandate to have everyone covered, all those who are unable to meet their premiums will be subsidized, no matter who provides that coverage.
I don’t see the PO as an end. To advocate for it is to in fact advocate for a single payer system that will expand as long as it continues to offer lower premiums than private plans. I think that at this point since it is the only thing under discussion it may serve as a transition.
One can of course argue that we should advocate instead for a comprehensive single payer system now, but that task is much harder.
The modern business corporation is now mankind’s dominant organizational model. Corporations have superseded government. Well perhaps that’s too strong and one might say they have or are in the process of co opting government. It’s all frightfully complex because governments create corporations through charter and law. Perhaps the best way to view it is that governments and corporations are partners. So it is hardly a surprise that corporations have every seat at the table.
Few appreciate that the financial crisis is an existential crisis for the current corporate form and thus for Westerns governments themselves. And the crisis is not over, by a long shot.
I am a little sketchy on how to characterize the Chinese model. There corporations are strong but there is no pretense that they are independent of government or in opposition to it. In some ways this is a healthier model as the pretenses and delusions about our situation lead to things like the bankrupting of the Treasury on military adventurism and taking corporate risk directly onto its books. (an ongoing process as virtually every mortgage is now being taken on by the GSE’s)
There is an almost universal consensus among the financial cognoscenti that America is in relative and absolute economic decline. This is part threat and part opportunity for the corporate model. Threat to the extent so many major corporations are US based but opportunity because corporations are essentially stateless.
As a partial aside the James Kunstler model of devolution and dystopia is based upon the idea that corporations will collapse, and then too so will government. At least government as a source of money, as we know it. There is in part in these types of views a desire for such an outcome because of a hatred of the corporate form of government and how corporations shape every single part of our culture. I am agnostic on this to the extent that government has not covered itself with glory the last 10,000 years and today they threaten to blow the whole world up with nukes.
We are only at the beginning of this financial/economic crisis. The jury is out on the outcome. There is no plan B if the financial giants collapse. Which is why Obama had to choose plan A, bail bail and bailout some more. If he were to try to lead another way there would be nobody among the elites to follow. It might be said if he even had a vision of something different he could not possibly have risen to the presidency.
gamd521 @ 42,
no, No, NO!
a public option is most certainly not a single payer system in miniature. it is an addition to a multi payer system, which remains a multi payer system. it can not capture all or even most of the efficiencies of a single payer system. it is funded by premiums, just as private insurance is (where there are subsidies, the subsidies apply also to the private insurance programs the po will have to compete with).
please, stop conflating the po with single payer. it’s just not true. and advocating for a po is NOT advocating for a single payer system unless you can show how the transition would occur (there are good reasons to think that a po is dead end and will NOT lead to single payer).
a po may be viable (here i agree with you that if it can offer better coverage for lower premiums and cost sharing, it will succeed and grow if not limited by regulation. but there are good reasons to doubt it will be able to do that.)
this is a really good point. thanks for making it. agree with the rest of your comment also.
i know this is a difficult question, and i respect that different people will come to different conclusions on the best way to proceed. imo by challenging each other (po advocates and sp advocates) to justify our thinking, arguments, etc we will, both of us, strengthen our understanding of both policy and strategy…. and maybe even how we can best work in synergy.
p.s. i apologize if my comment above is too harsh. i’ve od’ed on hearing others (hcan reps in particular) conflate the po with single payer, but that is no reason to take it out on you.
as gamd521 wrote, medicare is single payer for people over 65. i think you probably meant that medicare has not expanded to something like hr 676 to cover everyone regardless of age?
agree with the rest of your comment.
The World According to Goldman Sachs
From the department of actions speak louder than words:
“When it comes to cost risk benefit analyses, the cardinal rule is always to pawn the costs & risks off on others while reserving the benefits for yourself.”
Robert Rubin, former chairman of Goldman Sachs & U.S. Secretary of the Treasury
http://www.pbs.org/wgbh/pages/frontline/warning/
yes, that’s right it is maintained by way of premiums as opposed to general taxes. It is a mischaracterization in that sense.
Obama screwed us hard. Obama talked about the public option in his campaign to get us to elect him and then stabbed us in the back by making deals wiht the criminal insurance industry. Thats what happened and there is no other way to explain it.
Obama does not deserve our respect or our votes. He has fucked us all with his back room deals and lies…a corporate humpin political pussy in it only to help his corporate backers.
Nice going Obama…thanks for all your help.