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Zero Public Option + One Mandate = Disaster
Not long ago, the most prominent supporters of the public option were touting it as essential for healthcare reform. Now, suddenly, it's incidental.
In fact, many who were lauding a public option as the key to a better healthcare future are now condemning just about anyone who insists that the absence of a public option makes the current bill unworthy of support.
Consider this statement: "If I were a senator, I would not vote for the current healthcare bill. Any measure that expands private insurers' monopoly over healthcare and transfers millions of taxpayer dollars to private corporations is not real healthcare reform."
That statement is as true today as it was when Howard Dean, former chairman of the Democratic National Committee, made it three months ago in a Washington Post op-ed. But now, a concerted political blitz is depicting anyone who takes such a position as a menace to "real healthcare reform."
After devoting vast amounts of time, money, energy and political capital to banging the drum for the public option as absolutely vital during 2009 and through this winter, countless liberal organizations and prominent Democrats in Congress have made a short-order shift.
You are now to understand that the public option isn't essential -- it's expendable. And all of the sudden, people who assert that a public option is a minimal requirement for meaningful healthcare reform are no longer principled -- they're pernicious.
This dynamic goes way beyond the routine malleability of political positions. While the whips crack on Capitol Hill, what we're seeing is a stampede of herd doublethink.
*****
I continue to believe that guaranteed healthcare -- a.k.a. single-payer or enhanced Medicare for all -- is the only way to solve this country's enormous healthcare crisis. But early last year, before the public option shrank and shrank some more and then disappeared under the bus of the Obama administration, it appeared to possibly be a significant step forward.
But the White House, even while claiming to want a public option, was cutting deals with the pharmaceutical and hospital industries while ditching the public option. For those who doubt that the administration engaged in double-dealing to such an extent, I recommend the March 16 article by Huffington Post writer Miles Mogulescu, "NY Times Reporter Confirms Obama Made Deal to Kill Public Option."
A postscript from Mogulescu voices a broader outlook. I'll quote a couple of paragraphs here:
"Whenever I write blogs which are critical of Obama and Congressional Democrats for making corporatist deals, I get numerous comments from people who believe they are progressive but say they will never vote for Obama or Democrats again, that they will stay home at the next election, or that they will vote for small third parties who have no chance of winning. It's not my intent to encourage those views. Do people making these comments really think bringing Republicans back to power would make things better? . . .
"Progressives need to have a sophisticated and nuanced relationship with elected Democrats. After the 2008 elections, too many progressive organizations demobilized believing their job was simply to take orders from the White House to support Obama's agenda, whatever it was. That was a mistake. It's equally a mistake for progressives to overreact in the opposite direction and think they can abandon electoral politics and do nothing to prevent the Republicans from regaining power. What's needed is a powerful grassroots progressive movement to force elected officials to do the right thing more often and to counter-balance the power of big money in politics. The periods of progressive change in American politics, like the Progressive Era, The New Deal, and the Great Society, have come when strong progressive movements have forced elites and elected officials to enact somewhat progressive legislation."
The dynamic now in full force on Capitol Hill was aptly described by Dean in his Post op-ed midway through December: "In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform healthcare."
A week after Dean's article, the Senate approved the healthcare bill that is now on track to be "deemed" by the House -- with the avid support of Dean and numerous other public-option enthusiasts, and also for that matter with the support of Rep. John Conyers and many other single-payer enthusiasts (including, as of Wednesday, Rep. Dennis Kucinich).
The quality of the Senate healthcare legislation hasn't improved in the three months since Dean condemned it. What has gone over the top is the cacophony of voices and pressures to tout doublethink as virtuous pragmatism.
*****
But there are big problems with skipping lightly past the absence of a public option in the current bill. And none is bigger than the reality of the individual mandate in the legislation.
It's remarkable and sadly revealing that boosters of the bill have scarcely mentioned -- much less publicly come to terms with -- the dire implications of a nearly enacted law that requires people to have health insurance and offers no option other than further enriching the private insurance industry.
Last year, when the subject came up, progressive supporters of the White House's general approach were quick to offer assurances that a public option would mitigate the unpleasant aspects of mandated coverage. After all, the story went, people could select a nonprofit government-run entity for insurance coverage rather than being forced to choose between corporate insurance policies.
But now, if the pending bill becomes law, people will be forced to choose between corporate insurance policies.
Meanwhile, all the hype about how 30 million more Americans "will be covered" fails to deal with the quality and cost of their purported coverage, much less how much real access to healthcare will actually result.
For many, the available coverage would be bottom-of-the-barrel quality -- and even then, given thin personal finances, would cause added strains to pay for premiums. In the absence of public-option health insurance run for purposes other than maximizing profits, the built-in unfairness of an individual mandate becomes magnified.
What's more, the very concept of healthcare as a human right will be fundamentally undermined by placing the health-insurance burden on individuals. Many who receive government subsidies will routinely struggle to make ends meet, while making do with shoddy health plans as part of a new configuration of healthcare apartheid. And, inevitably, the extent of government subsidies will be vulnerable to attacks from politicians eager to cut "entitlements."
On a political level, the mandate provision is a massive gift to the Republican Party, all set to keep on giving to the right wing for many years. With a highly intrusive requirement that personal funds and government subsidies be paid to private corporations, the law would further empower right-wing populists who want to pose as foes of government "elites" bent on enriching Wall Street.
With this turn of the "healthcare reform" screw, the Democratic Party will be cast -- with strong evidence -- as a powerful tool of corporate America. But the Democrats on Capitol Hill and the organizations eagerly whipping for passage are determined to celebrate the enactment of something called "healthcare reform."
*****
"When I use a word," Humpty Dumpty said, "it means just what I choose it to mean -- neither more nor less."
"The question is," Alice replied, "whether you can make words mean so many different things."
"The question is," Humpty Dumpty responded, "which is to be master -- that's all."
Many well-informed and insightful people are now hoping that the current healthcare bill will become law and then lead to something better. But few backers want to dwell on its requirement that everyone get health coverage from the private insurance industry -- a stunning, deeply structural transfer of humongous power and wealth that would greatly boost the leverage of an already autocratic corporate state.
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9 Comments so far
Show AllTo me this is just more evidence that the present system is broken and fails to represent the interests of the general public.
Real change is needed! And, their is only way to bring about real change in any government gone bad.
Yup. And here's how the devil may be driving the details.
On May 10, the Supreme Court will hear McDonald v. City of Chicago in which they are expected to interpret the 2nd ammendment to mean that local gun control laws are unconstitutional. Then, formerly meek and compliant law-abiding citizens can become rightous gunslingers.
And if enough such citizens should be really, really pissed...
Obama + Congress = Disaster
This entire process has confirmed again how right wing America really has become. The progressive part of the American electorate is really quite small and the only reason people like Obama get elected is because he made it clear from the beginning that he was a conservative democrat even though people on the left didn't want to hear this. When you only have two parties in a right wing country this is what you get. Extreme and moderate right wing parties.
Well of course the present system is broken. The public favors a single payer solution by a large majority.
I can think of no more important cause than election reform. To the extent that we are able to get big moneyed interests out of politics and the voice of the people empowered, we will move toward a real Democracy. To that same extent we will attract good people to Congress who see a real opportunity to do something good.
Then again the Constitution is a clear statement of our right to replace our government when it fails to represent the people.
How much longer can a system last that brought us to the brink of economic meltdown and cannot fix it's problems? ... cannot respond effectively to climate change ... is held captive to the destructive and expensive military/industrial complex ... and fails to provide jobs for it's people.
I have gotten so many sign-this/ call-your-rep/ donate-now emails wanting support of the current 'health care' legislation, I mean, from Credo Action and others I formerly trusted, that it mystifies and disappoints me. It was my understanding that the mandate is still in the bill, and Solomon verifies this. That, and the lack of any real reform or controls on the BigMed/BigPharma totally poisons the proposed law.
Note how the HuffPo Mogulescu quoted material uses several basic frames in its argument. One is that progressives 'have' to deal with the Dems because the only alternative is the Repugs - your basic 2-party-only frame.
Another assumes we caring activist progressives will always be on the outside yelling for basic social improvements while the "elites and elected officials" continue to run things. I'm just saying this is not part of some natural law; it's not inevitable that we be ruled by 'elites' who are at the same time superior to us yet not subject to the rules and values we live by.
Yes, we can reject the whole thing if we see fit to do so.
Bla Bla Bla Bla
You all are f—king stupid if you follow the pattern of thinking that you are fed in order to following the rabbit down the wrong hole. This should not be about political power it is about health.
In health terms, if one person is sick and cannot afford to go to hospital or see a doctor he or she can cause the deaths of hundreds…… that is what “social health” is all about, its also about what you eat, if you smoke, how much you exercise, and most importantly whether you see a doctor regularly.
If in your country you have 3000 people die in what you call a terrorist attack you spend the next 8 years killing millions of people in other countries, spending 100s of billions of dollars, loosing thousands of American lives…. to keep America “safe”.
By having s global national health insurance scheme, with an option that anybody can buy private insurance if they are not satisfied with what the national health insurance provides, at least you can make sure that the person who is sick can see a doctor before he infects your kids or dies for lack of care.
45,000 people died for lack of health insurance last year in America. If you want to save money in the system, stop the conspiracy and collusion between health companies, hospitals, drug makers (a near monopoly), suppliers, and insurance providers.
You think terrorists and rouge states are dangerous yet less people died from terrorists last year than were killed by sharks. And you think sharks are dangerous, what will really kill you are these politicians and their financiers in the health industry sucking you dry, of blood and money.
In the last year there have been many thousands of lies told by many hundreds of elites about what is in the 2,700+ pages and about how it will pass. These pages indeed add up to economic doomsday for many people. The epicenter where the devastation will be the worst will be for those with incomes between 133% and about 250% of the poverty threshold. Think of Port-au-Prince for the level of household budget devastation that will fall on many people in this range.
The somewhat more generous subsidies of the now pushed aside House legislation are history; the more restrictive and more limited Senate subsides are the only thing left on the table.
In the 133% to 250% of poverty range, in the epicenter in other words, the premium subsidies will be much larger than they will be for people in the 250% to 400% range, but people in this range (unless they live in extremely low cost of living areas) are in no position to pay much of anything for health care, particularly if they are not reliably employed 365 days a year every year without fail. (And how many can say they are more or less guaranteed continual employment these days? Given today's cost of living, these people are basically taxed out already.
Furthermore, people in this range, even if they scrape up money to pay premiums, will seldom be in position to pay these items:
--deductibles
--co pays
--uncovered items
--prescription medications
--vision care
--dental care
Premiums only get your foot in the health care door. You are not allowed to actually come in the room until and unless those other items are paid in full. If you pay premiums but don't have enough money to pay the other items, BOTH your health care and your personal finances will be heavily damaged.
Based on the current poverty thresholds, here are the income ranges that will be where the mandate and the other tax hikes will fall most severely:
1 $14,400 to $27,100
2 $19,400 to $36,400
3 $24,400 to $45,800
4 $29,300 to $55,100
5 $34,300 to $64,500
6 $39,300 to $73,800
7 $44,200 to $83,200
8 $49,200 to $92,500
Since subsidies tail off to insignificance and eventually to zero from 250% to 400% of poverty, those in that range who live in higher cost areas and/or who have unusual expenses and/or who have only sporadic employment will face personal financial devastation as well.
The one and only European country that has a system that is supposedly similar to the 2,700+ pages is Switzerland. But when the details are checked, you find that the system in Switzerland is not even remotely like what is proposed for the US. In Switzerland:
--The cost of basic health insurance and health care is only roughly 40% and 50-60% respectively of the costs in the US.
--Health insurance companies are strictly not allowed to earn a profit for the basic coverage that everyone is supposed to buy.
--Any health insurance company that denies payment for care or tries to kick someone out of coverage will be quickly corrected by the government. Health insurance companies that repeatedly try to cheat people as US companies do will be very heavily fined and eventually dissolved by the Swiss government if they don't desist.
--The subsidies are far higher.
--The cost of living in cities in Switzerland is lower than what it is in most American cities.
--The penalties for those who simply don't comply are much less.
--The percentage of the population that is poor and the percentage of the population that is near poor is far less than in the US.
--The number of and the percentage of people who are "in and out of" employment is much less than in the US.
I expect there will be a lot of slander and libel regarding the Swiss system in the years ahead; it will be interesting to see the Swiss themselves explain the differences between their system and the 2,700+ pages.
Much more later.
http://www.unity-progress.blogspot.com
This IS the Civil Rights movement of our day! First and foremost it is a MORAL ISSUE and we have to stay focused on that. It speaks in the most profound way the kind of country we want to be! We always embrace "freedom of choice" and it's been used plenty in the fear bytes of the opposition to bury single payer and the public option. But how many people are buried in dead end jobs, how many artists have to give up their dreams and their calling to try and make sure their families are covered against medical disasters. How many musicians have to hold endless benefits because the places that reap the benefits of a "healthy art scene" won't invest in keeping artists healthy?
Single Payer is the best way we can extract our nation from the grip of corporate greed that has, as its basis, profits before people. The health insurance industry does not provide one ounce of direct health care. They interfere with a person's choice of doctors, and they practice medicine without a license by defining for physicians and other health care providers what they will and will not cover. An interesting study by Taxpayers Against Fraud, www.TAF.org listed the top 20 defrauders of the taxpayer and the government in terms of dollars. Nineteen of the 20 were in some health related for profit industry. And this is the model we want to use as the foundation of our health care system?
I think I need to go further back in history than the Civil Rights movement. What we need is an Emancipation Proclamation,(no not complete enough coverage). Maybe we ought to ask some constitutional scholars if the current plan as proposed violates the 13th Amendment prohibiting slavery. Because enslaved is what we are now, and further enslaved is what we shall become with this gift to the insurance companies. They're laughing all the way to the bank from the millions of new policies being delivered to them on a platter.
I believe, before any vote is taken on this, we need to insist on a full, respectful publicly broadcast hearing on Single Payer HR 676. The single payer advocates were shut out of the first hearings on health reform and put behind their own goal line on President Obama's "level playing field" when he put a gag order on it. This issue may represent 17% of the economy (and single payer IS a cost-saver), but it affects 100% of the population.
No action should be taken on this bill before that is done and the merits of single payer examined openly and fairly. And just to be fair, this time the industry representatives will be "uninvited".
I hate to see the good provisions of the current bill held hostage. We desperately need the expansion of the community health centers to provide primary care and doctors to underserved areas. There is a separate bill already filed for that which could be considered.
Don't give up on SINGLE PAYER!!! As Alice Walker says, "The most common way that people give up their power is to think they don't have any." For the most comprehensive information on single payer go to Physicians for a National Health Program www.pnhp.org. They've been working on this for 25 years! And God bless Bill Moyers for being one of the few journalists to give them a voice. You can view or download transcripts of the 3 or 4 shows he has dedicated to this at the PBS website (Bill Moyers Journal).
So, my final synthesis of the current proposed legislation:
YOU DON'T ABOLISH SLAVERY BY "TWEAKING" THE PLANTATION SYSTEM AND THEN FORCING THE SLAVES TO BUY COTTON.