Delicious
Digg
StumbleUpon
Newsvine
Facebook
Google
Yahoo
TechnoratiCan We Get It Right This Time?
Are most presidential contenders proposing universal health care plans that can actually work? Absolutely not. But a lot has changed since I watched health care reform crash and burn from my perch as a Senate health staffer in 1994. State debates on reforms can continue re-shaping the landscape as we lead into the primaries next year.
Seven candidates spoke at the Forum on Universal Health Care sponsored by the Campaign for American Progress Action Fund and SEIU, webcast live last week from the University of Las Vegas, Nevada: Senator John Edwards, Governor Bill Richardson, Senator Barack Obama, Senator Hillary Clinton, Senator Chris Dodd, Rep. Dennis Kucinich and Senator Mike Gravel. (Details on the Forum at: http://www.centerforpolicyanalysis.org/id2.html),
One thing is still true: public-sector financing is the most efficient mechanism for collecting money fairly from everyone, and so the most effective way to assure universal health coverage. Then as now, such a single-payer system is a mighty threat to the private for-profit health insurance industry, which has allocated millions in rate payers� premiums in California alone to oppositional ballot and legislative campaigns. Their campaigns resonate with at least some Americans who find the government, well, disturbing.
Three things have changed since the 1990s: We�ve learned through painful experience that fragmented, market-based health care plans don�t work. Our system costs more and more as we cover fewer and fewer. State by state, program by program, big reform announcements have been impaled by unstable funding, and by cumbersome enrollment and retention procedures. We�ve exhausted the inefficient ways that don�t work to collect money from people if you want everyone in the system.
Second, for those businesses that still operate in the U.S., forking over a significant percent of profits to the insurance industry is a increasingly irritating pebble in the corporate shoe. Third, recent polls favor a government-financed solution, and in a landmark event the California legislature approved a single payer plan in 2006, though vetoed by the governor.
So, most of the candidates at the Forum addressed the idea of a single payer plan with respect � a far cry from the dismissive tone of the 1990s. All of them expressed the need to address universal coverage as part of their platform. Several acknowledged that effective cost control is impossible with 20% of the population lacking coverage, but still vulnerable to health catastrophes. They acknowledged that U.S. health care outcomes are deplorable, especially considering our $2 trillion annual health care bill. Clinton went after insurance companies for wasting 30% of every health care dollar on profits and administration, and discrimination against the sick.
Chris Dodd discussed how social and economic security affect heath, noting that, �In the 20th century we extended life expectancy in this country by 30 years.� Only 5 of those years can be attributed to improved health care. We know empirically, he said, that better nutrition and housing, better wages and working conditions jobs, better incomes decent retirement, decent wages and working conditions have improved people's health, while income inequalty has not.
The big differences are still around single payer. Most candidates are dancing around proposals to expand the Federal Employees Health Benefits Plan, to throw a chunk more money here and there to the state children�s health insurance programs (S-CHIP) and Medicaid, or, in Edwards� case, as he describes it, to let a �single-payer� Medicare type plan compete with market-based plans, in the hope that the public sector would eventually win out.
Kucinich, the lone single payer supporter � so far - raised important questions:
�If you have competition between insurance companies, everyone knows what happens. That doesn't drive down costs, it drives up profits. That's a fact. If you say you're going to give people a choice, either be on a private plan or be with the government, the private companies start cherry picking the people in the best health, and you end up with adverse selection. The most medically compromised end up on programs that the government is paying for, and then the government program starts to go down. You end up in an insurance death spiral.
�Even the insurance companies are for universal health care if the government is subsidizing them. What a deal that is for the insurance companies, but what a rotten deal for the American people. People are losing their homes because they can't pay the doctor bills. And so what it ultimately comes down to is who has the courage and the willingness to take a stand and can reach out to the American people and to say we're going to change this.�
So there I think is the challenge leading up to next February�s primary. For all of us who use and provide health care - generally for all of us who are eager for something important to start heading the right way in our country for people - this is the year to marshal what we really know about what works and what can work, to find out even more, to connect that with the political will that already exists, and see how much farther we can go.
Ellen R. Shaffer is Co-Director of the Center for Policy Analysis, which conducts research and advocacy on access to health care, and also on global trade and health. Former Senate trade staff. Author of a study modelling the implementation in California of Rep. Barbara Lee's HR 3000, the U.S Universal Health Service Act.
30 Comments so far
Show AllThe Unspoken problem with Universal Health care.
If it's free, it gets used, A lot.
Countries with socialized medicine are familiar with the "Take as much as you want so long that it's free" mentality. Americans took on the same attitude in the 1990's when they were given something new. These were the "Unlimited co-pay days". Insurance companies were hit hard by there overuse and reacted by limiting or raising co-pays while preserving preventative care benefits. Why is this great? Because, the fact that private insurers can make the changes to balance things out. They can re-act to current circumstances, but best of all, they bear all the risk, not the public, and what's even better? If rates increase or there are unfavorable changes in coverage, the consumer is free to leave and purchase coverage from a long line of competitors.
Socialized medicine has approached the problem of overuse by rationing care and raising taxes. Rationing care does not mean that some people will go without treatment, except in the cases where one dies while on a list or when one is discriminated because of his or her old age. Rationing care also means that the amounts of procedures to be preformed in a certain area are pre-determined. It is a system of action not re-action. Simply put, a person might be placed on a waiting list if they aren't first in line for an unanticipated need for a certain type of care or procedure. You may be placed on a list for something as simple as MRI, mammogram, or in many cases, surgery. (It is important to note that most emergencies, i.e. car accidents, are treated immediately)
However, what's most worrisome about rationing out health care, are the treatments withheld because of poor foresight or lack of resources. There are countless examples of Canadians paying out of pocket for their surgery in the U.S., rather than wait several months at home. I met a Canadian couple whose relative was placed on a six month waiting list for his bypass operation. He spent $30,000 for his surgery in Seattle. Not all Canadians are as fortunate.
The U.K. has a mature socialized medical system. It's sometimes referred to as a "Two Tier" system. The first tier includes everybody. The second tier is reserved for those who can afford private insurance. (Mexico's system is similar.) The second tier are the fortunate and do not want to deal with the shortcomings of their public system. (Last I heard was, approximately 15% of the population in the U.K. held private insurance and this number was expected to increase.) Now ask yourself, why anyone who has free health care purchase additional coverage?
Health Insurance and Life Insurance for Texans
www.InsureMeDFW.com
The Farmer and Universal Health Care
Imagine you're a farmer out in the country. You know what type of crops to plant and when to plant them. You take pride every year when you see your goods being sold to market and fell good about providing nutrition for both youth and adults. You know very well that some of your crop will spoil before they make it to the shelves. However, there is nothing you can do to prevent this, once it leaves your farm, someone else has the responsibility of delivering or storing your crop.
Now imagine that about half of the population in the big cities has a great idea to stop crops from spoiling. They protest that the government should be the ones to grow and ship the crops. These idea holders have little knowledge of farming, but have heard that in some countries, government run farms appear to be just as efficient as ours. This is the basis of their argument. The government should run all farms and see that the shipment is delivered in a timely fashion, to ensure there are no spoiled products.
As a farmer you know that spoiled crops are inevitable, unless you grow them right next to the store. But there are many who hold you responsible, for what is really the nature of produce. Although it's clear to you and all other farmers, that it's just the reality of farming, but to try and change the opinions of those in the far away cities would be impossible.
Those who cling to this new idea are happy to consume your crops. However, they haven't a clue as to what it takes to make them grow and to ship. They just want fresh produce and don't care to educate themselves about what farming is about.
The following year's political season is filled with promises of government collectivization of farms. "Fresh produce" for all they say. This appeals to many, and the polls indicate that most people are in favor.
With dust in their eyes, they cannot recognize the benefits of the current system. They can pick and choose which ever store they wish to shop at and always have a variety of produce to choose from. They can complain to the store management if the tomatoes are never fresh. Management, in turn, will probably call a new produce vendor to keep his customers happy.
Shortly after the elections, an agricultural collectivization act is past. All farms are now government run. The harvest is expensive, but the government does its best and it turns out to be a great season. The Gov. then ships the harvest to the cities and the inevitable occurs. There are some spoiled goods. Now the city folk find themselves in a tight spot. Who can they complain to, and who would listen? Now they are stuck.
I know the idea of Free Health care for all seems great, but it is a trap. You will be stuck with what ever the government says. What if you really needed a surgery and the Gov. deems it unnecessary or what if a preventable mistake occurs during a procedure? Maybe you feel your doctor is incompetent but he's going to be your surgeon, who do you turn too?
The reality is that your grievances will be ignored, you may be denied a life saving treatment or possibly a therapy that would improve your life. Today we have choices upon choices, and doctors are fully aware that you may drop them at any time. They save lives and alleviate pain, but at the end of the day, they still need to feed their families. So long they compete for our $, Dr.'s will always be at the mercy of the consumer. If you place your health in the hands of the government, you will no longer have control of your health, it will belong to the Feds.
Less Gov. is Better Gov. So Long It's a Fair Gov.
www.InsureMeDFW.com
The Conyers-Kucinich health care plan is the only one to include alternative & complementary care options as well as universal/single payer. Their plan accomplishes two additional things: (1)provides a preventive approach to health care, thus helping to reduce health care costs and sparing much human misery; (2) includes those of us who have changed our world view from "fighting disease" to "reestablishing balance & stability." The present traditional medicine worldview that predominates in health care insurance shuts out millions of us. This paradigm change can be applied to a broader view of events as well.
It's time to take on the insurance and pharmaceudical industries that control our health care options!
Afraid you're right, Phillipe. Dennis Kucinich is the only candidate advocating a single payer system and the press acts as if he doesn't exist. But there is a possibility of doing it state by state. And I'm not talking about the Massachusetts plan. Here in Oregon,John Kitzhaber, highly respected former governer has come on board for a single payer plan - at last. He's also a former doctor so he knows what's going on from both sides. If any state succeeds in passsing a single payer plan, other states will pay close attention to how it pans out. We all know it's what's needed.
You will NEVER see a single payer health care system. I work in K-street in DC, and I see too many private interests represented by the best lawyers and lobbysts money can buy working very hard at making sure that if a national health care is voted in, it will be through us. Who is representing the people in Congress? DO you have a lobby giving money to your senator? You don't, uh? That's what I thought. Well, then all you'll get will be a modified version of what's happening today in Massachusetts, but don't count on a single payer system. This country does NOT belong to the people but to corporation. This society has been amazing tat giving the little guy the illusion of freedom and democracy, but frankly that's what it is, an illusion. The day you'll see a national health care system based on a single payer fund in this country that'll mean that you'd be looking at America from the other end of a successful revolution aznd many many things will be different then, but we're not there yet. In case you haven't noticed the populace is busy with TV shows and that stupid activity called baseball has just started.
It's important for progressives/populists/activists to demand linguistic accuracy on this topic. The problem is not the number of uninsured. The problem is access to affordable and quality health care.
This distinction seems petty, but the program (arguably) is tightly wedded to the insurance industry itself. So when I read an article which cites the number of uninsured (instead of the essential problem: access to health care), my feelers automatically go up. Is this another program to funnel billions or trillions to an already exploitive industry?
So articles (like this) that make this distinction are more likely to be above-board. Articles that ignore or deliberately blur it are suspect.
Progressives have suffered enough 'domestic violence' from their abusive tormentors within the Democratic Party. Sooner or later we've got to summon enough courage to walk out; we know from experience over the past several election cycles that our abusers will NOT 'change'. They keep using the FEAR card...and we [actually, not I] continue to come back to the abusive relationship.
We should have walked out years ago; but better late than never. The right-wing Dems have called our bluff so many times that they KNOW we will come back and hold our noses while voting for whatever clown they nominate. Why should they 'fix' a strategy that isn't 'broken'?
I invite everybody here to take The Pledge:
"I will not vote for or support any candidate for Congress or President who does not support a speedy end to the war in Iraq." --
--votersforpeace.org
In addition, let's stand up on ALL the issues that matter--but aren't mentioned by the Dem Party 'leadership'...things like repealing the Patriot Act, restoring Habeas Corpus, instituting single-payer universal healthcare, renouncing NAFTA and other 'free trade' boondoggles that Bill Clinton gave us...the list goes on. Progressives CAN win if we campaign on issues, rather than on who can raise the most money.
I learn more here about the motivations and techniques of those I oppose than hanging out among people I already agree with.
I don't need to agree with progressives on policy to see how they don't have much influence for the scale of change they want from the mainstream dems. the dems have little reason to change until they actually lose votes, and if you won't pull your votes away from them, the actual pressure they care about, votes, just stays in their pockets.
I saw Nader voting progressives excoriated and attacked with fury and venom after 2000 as if they owed their votes to someone they didn't agree with enough to vote for. Nader voters were attacked for standing their ground by people who would not move from their own. Just because there is some larger group is no reason the smaller one does not have valid positions, and the dems wanted those voters to eat their objections and vote for someone they didn't agree with.
I saw one single observant Nader voter in one place I hang out fire back that they had no right to his vote, that those who claimed to understand it had no guts for the change they claimed to want, and that in his view, he hadn't elected Bush over Gore, the Dems had elected Bush over Nader..and why didn't THEY change sides if they already agreed with him .
The kind of entitlement mentality the Dems have for votes from the progressives is the same kind o thing you see echoes of to this day in Hillary's campaign, as if she's simply entitled to be the candidate.
Sorry, I smell a snake in the grass. I think it is on MtnGoat's agenda to see the Dems go down in flames in this next election cycle, giving the Repubs back the country. Divide and conquor. It's an interesting dilemma, because yes, we do need to refuse to go along with the DLC,and the outcome may well be a Republican win - and considering the current situation, pretty disastrous. I'm not suggesting MtnGoat particularly likes Repubs, but I am certain he likes Dems a lot less. MytGoat, is that why you're in this neighborhood instead of your own?
It's interesting that while it's clear the Chuck Hagel, former CEO of the company that morphed into ES&S and later became Senator from Nebraska (a real, unlikely come-from-behind win) is running for President, he hasn't actually declared yet, is the only anti-war Repub candidate. He's also very conservative. Not what the majority of the country wants.
This will be a very interesting year. I think the progressives need to send NOW the message that we will not support any DLC candidate. Give the Dems time to get used to that idea.
I forget where, but someone pointed out that the Repub base gets their conservative candidates, but the Dem base gets stuck with DLC losers, suggesting a lot of Repub crossover voting.
We need a game plan.
Ya, I have a democrat for a representative. Although you could hardly tell by the way he votes. I'm ready for a third party if I can't vote for Kucinich. The mainstream[owned] news just ignores Kucinich, hey it's what thier paid for. Thier masters don't want someone they don't own getting in there.
On health insurance. We pay at least twice as much per capita as nations with universal health care and that includes the over 40 million unisured. We are seen as cash cows to be milked by insurance companies. I say get rid of them and they can go out and get real jobs like the rest of us.
I don't know about the Greens but the progressive block should consider forming an independent party because the big money interests that control the Democratic party will never allow them to have a real voice within it. There is nothing the DLC and DNC fear more than independent canditates -- that's why they constantly spread the lie about Nader costing them an election which they actually won but didn't have the guts to fight for. I'm gratified to read that others get the reality that without alternatives we are voiceless.
Interesting statement coming from you, MtnGoat, considering how sympathetic your former statements have been toward the corporations.
AMEN to the argument for single-payer, 'Medicare for All' proposal....and HOSANNAHS to the ONLY candidate advocating for it (who just happens to be the ONLY candidate who refuses to feed at the corporate trough...so far as I know).
The mainstream media don't even DARE to bring up the single-payer, not-for-profit healthcare proposal; and they leave the public thinking they must choose from among the very narrow 'universe' of the various plans for subsidizing the insurance companies. We don't need 'access to insurance'; we've already got that (if we're willing to meet the prices demanded by John Hancock and his corporate brethren who live in those huge glass skyscrapers); we need universal healthcare.
A single-payer, universal, not-for-profit healthcare program is the second-biggest secret being kept by the mainstream media. The biggest secret, of course, is the Kucinich presidential campaign itself. If we can break through the barrier set up by the 'public obfuscation' media, Mr. Kucinich could very well shock the voters into recognizing we have a genuine choice.
The Kucinich campaign is spending considerable time in New Hampshire; and I suspect he is making much better headway than he's given credit for. A win or a strong showing in that primary would FORCE the media at least to acknowledge his candidacy. It would show the public that, contrary to the pronouncements of the punditocracy, Dennis Kucinich CAN win.
Given the fact that his proposals are perfectly in tune with a populist/progressive agenda (judging by most public opinion polls), DK could catch fire.
To the author of this article Kucinich is the only candidate worth quoting. Many of the comments speak to the incomparable value of his positions on health care and other subjects. Yet in the popular media, so far as I am aware, he is only rarely mentioned, and then merely in a list of "second tier" candidates. How about barraging our local papers and other media with complaints about their failure to cover the only candidate who is for the people and not owned by his corporate (or corpirate - I like that) sponsors.
Perhaps the readers who like Kucunich for president, myself included, should e-mail the big news stations for more coverage of him as there doesn't seem to be much.
MtnGoat, people needing health care don't have options. They simply lose their homes, go hungry, cut their meds in half. Every year another million Americans end up without health care insurance, and get sicker until they end up in emergency rooms. This has to be paid for, so the insurance industry jacks up the rates, and employers pass pass more and more of the financial burden onto the workers. We have the world's most expensive, inefficient and broken health care system. We spend more money and serve fewer citizens than any other country in the world. It has to change. Everyone (except perhaps you) knows that. It won't change as long as the health insurance industry is involved, ripping off a third of our health care dollars for administrative, advertising, and CEO benefit costs. Single payer systems only need about 2%-3% of health care dollars for administrative costs. The rest goes where it's supposed to, to health care. Medicare is a good example of that. 2%. I understand this goes against your philosophy, but when trying to provide health care for 250 million people, Economics 101 needs to be considered as well.
Rebel Farmer, hou can you question Obama's independence from corporations? How else can he raise $25 million in so short a time, come out with an idea for insurance pools, decide we can't leave Iraq after all and not be beholden to the money financing him?
Dennis is the only real candidate of the people - too bad they don't know it.
Right on dudes.
Here's his website. http://kucinich.us/
Contribute to Dennis. Watch him kick ass in the debates.
formernadervoter - I totally agree, but Kucinich should be the VP because his agenda is SO big that Sec'y of HHS would be too confining. A new Department of Peace maybe. Furthermore, the more I learn about Obama the more I question his indepencence from corporate money and special interests.
Kucinich is obviously the only one who gets the need for single payer.
He would make a great Secretary of Health and Human Services in a John Edwards/Barack Obama Administration.
Went to see Kucinich on Monday. I have to admit that he looks a little like an elf. But quite frankly, after hearing him, I wouldn't care if he was a big, giant, pink frog. I had tears in my eyes and hope in my heart when I left. He's proven, by his track record in the House, that he walks the talk. He's real! So, I say again, vote for Kucinich in the primaries. Get all your friends, of all parties, to vote for him. Then when Hell-ary or O-bummer get the nomination, switch parties or go Independent. I'm tellin' ya this could send a really LOUD message to the Dems and their phoney "lesser of two evils", bought and paid for candidates.
Boy, that felt good to get THAT off my chest!
John Freeman you hit it right on the head--Dennis Kucinich, the REAL DEAL. Hard to believe he actually got mentioned in the above article. As long as Americans talk and don't walk, we'll always have choices like Hell-ary or O-bummer.
What's the benchmark today for how well a candidate is doing? HOW MUCH MOOLA ARE THEY RAISING?! Candidate Kucinich REFUSES to take corporate bucks. THAT should be enough right there to get the public's attention. But, alas, no. No single payer. No department of Peace. No immediate withdrawal from Iraq. No resurgence of labor unions. No resucitation of "We The People". Why? Because D.K. ain't a freakin' pretty boy with media sale-ability. Damn! I'm frustrated with the people of this country and their walking-through-life-asleep attitudes!!!
PUSH D.K.! I want my country back!!!
I agree with the call to vote for Dennis Kucinich. The rest seem like sell-outs when compared to his platform. For once in my life I would like to see someone win other than the pretty boy running for class president.
John Freeman
Mtn Goat - That's WAY to easy to answer! The corporations just jack up the cost of insurance to those who do pay to cover the "expense" of those that don't. It's the same method that merchants use to cover the cost of shopplifting...the cost is just passed on to the consumer with higher prices. See? It's really simple! Corporations win and you lose.
One solution for us is to vote for Kucinich in the primaries (register Democrat if you have to). That might send a message to the other Democratic candidates that "universal" medical coverage for all Americans is NOT acceptable. Single payor is the only fiscally responsible option. PERIOD!!
Note to adamsrw: do you spell corpirate that way on purpose?
What's not to like about it?
When the people who govern us are no longer in the employ of corporations and their ideologues, systems which serve the real needs of real people will just naturally evolve. Until that time, we will be left with what is good for corporations and the super rich--the prohibition against Medicare seeking bids from drug companies being only one of recent examples.
jon
Connecting the dots: from human behaviors to ecosystem decline
http://StudentsForTheEarth.org
It's an absolute disgrace that this country is still allowing corpirate America to act like vultures. Getting fat off the carcasses of those too weak/poor to survive in our economic Darwinistic society.
It's too bad. By 2008, the public will be ready to elect anything but a Republican - the corporate money is fleeing the Republicans at top speed. The Democrats will do anything to prevent Dennis getting the nomination, or even noticed. I'm going to get a Kucinich bumper sticker and send his campaign a donation. What's wrong with the rest of those clowns on health care?
By the way, I accused Obama of getting corporate money, and then read that he claims all his money came from individuals, not corporate or pac money. I stand corrected. I'm still disappointed in the positions he's taking.
The best recent attempt at a single payer system has been the Conyers-Kucinich Bill.
We do not need to re-invent the wheel. Most modern nations have national health care and we can apply much of what is already don here in the US.
Dear Dennis Kucinich:
I don't know if you heard that Gore may be running as a Green candidate. After all, the grassroots Green Party includes every progressive value while the Dems are held in Big Money's iron grip. People are saying that you have been planted here in order to keep progressives in the Dem's fold. I don't want to believe that.
But imagine what change it would cause in the Dem Party if you and all other progressive candidates switched to Green! Or even threatened to unless Dems adopted the entire Green Party platform.
People are not turned on by standard safe Democrat issues or by Dem politician's promises. They realize that progressives have never won and will never win in this new corporate Democratic Party. They've been saying that in the end, you will roll over and endorse the corporate candidate like you did before. Sorry, but that's what's out there.
The Republicans took all three branches of government and state governments by giving the former non-voting religious right what they wanted, but Dems refuse to give progressives an inch, so many of us refuse to vote. Dems rubber stamped lots of Republican issues and are seen as wimps because they are afraid get off the corporate dole.
So yes, I may vote for progressive Dems, but I will do it as a Green Party member. I hope you will also consider switching and taking your supporters with you. If you do, and with this volatile electorate, you can win.
Best regards