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How Pharma and Insurance Intend to Kill the Public Option, And What Obama and the Rest of Us Must Do
I'ved poked around Washington today, talking with friends on the Hill who confirm the worst: Big Pharma and Big Insurance are gaining ground in their campaign to kill the public option in the emerging health care bill.
You know why, of course. They don't want a public option that would compete with private insurers and use its bargaining power to negotiate better rates with drug companies. They argue that would be unfair. Unfair? Unfair to give more people better health care at lower cost? To Pharma and Insurance, "unfair" is anything that undermines their profits.
So they're pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers.
Max Baucus, Chair of Senate Finance (now exactly why does the Senate Finance Committee have so much say over health care?) hasn't shown his cards but staffers tell me he's more than happy to sign on to any one of these. But Baucus is waiting for more support from his colleagues, and none of the three proposals has emerged as the leading candidate for those who want to kill the public option without showing they're killing it. Meanwhile, Ted Kennedy and his staff are still pushing for a full public option, but with Kennedy ailing, he might not be able to round up the votes. (Kennedy's health committee released a draft of a bill today, which contains the full public option.)
Enter Olympia Snowe. Her move is important, not because she's Republican (the Senate needs only 51 votes to pass this) but because she's well-respected and considered non-partisan, and therefore offers some cover to Democrats who may need it. Last night Snowe hosted a private meeting between members and staffers about a new proposal Pharma and Insurance are floating, and apparently she's already gained the tentative support of several Democrats (including Ron Wyden and Thomas Carper). Under Snowe's proposal, the public option would kick in years from now, but it would be triggered only if insurance companies fail to bring down healthcare costs and expand coverage in he meantime.
What's the catch? First, these conditions are likely to be achieved by other pieces of the emerging legislation; for example, computerized records will bring down costs a tad, and a mandate requiring everyone to have coverage will automatically expand coverage. If it ever comes to it, Pharma and Insurance can argue that their mere participation fulfills their part of the bargain, so no public option will need to be triggered. Second, as Pharma and Insurance well know, "years from now" in legislative terms means never. There will never be a better time than now to enact a public option. If it's not included, in a few years the public's attention will be elsewhere.
Much the same dynamic is occurring in the House. Two members who had originally supported single payer told me that Pharma and Insurance have launched the same strategy there, and many House members are looking to see what happens in the Senate. Snowe's "trigger" is already buzzing among members.
All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.
This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.
65 Comments so far
Show AllLet your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.
Your representative and senators live and work in the same filthy, disease ridden brothel as Borax Obysmal. The walls are papered with cash and everybody there looks like Margaret Hamilton in "The Wizard of Oz".
Nothing short of the electoral destruction of the two totally corrupt, totally incompetent ruling political parties will get single payer. And president Phat Chantz says fat chance.
I dunno. The game appears to be "fixed" in Washington and Congress sure has a knack of not answering or even writing insults back. My newly elected Senator Mark Warner is a perfect example for a guy who was endorsed last year by the US Chamber of Commerce. Between Gilmore and Warner, I chose neither.
The US Chamber of Commerce is the Kiss of Death.
That's exactly why I withheld voting for Warner aside from the fact that he was elevated to win and didn't bother to run a campaign. I would hate to see Terry Mcaulliffe win the gubenatorial race for governor and then replace Webb because Webb is somehow "too liberal" to the monied wing of the party. That would make two hardliner DLCer senators misrepresenting VA !
The public option is an unworkable fraud--it's only true raison d'etre is to mollify the Democrats' donor base among the high-rolling HMOs and Big Pharma.
For documentation about the pitfalls of the public option plans, see the following link:
http://www.pnhp.org/facts/singlepayer_faq.php#public-option
Is there some subtle distinction between "public option" and
"single payer"?
Actually, there is a second part that covers all: universal coverage. Single payer is just that - a single entity that pays the bills. It could still be limited, say, to people who can't afford conventional health insurance. Universal coverage means everyone is covered, top to bottom, cradle to grave.
Gee, kinda sounds good, don't it?
We can try begging the White House to listen to us but it appears the President Obama censors even on his own site:
http://www.alternet.org/media/140443/obama%27s_%22open_government%22_project_censors_popular_proposal_to_%22end_imperial_presidency%22/
As for Congress, Washington is too well guarded and since the game is "fixed", the only thing we can do is vote them out and pay attention election after election and keep doing the same until we get the representation that supports single payer.
Another thing not mentioned is that people who are employed are generally conditioned into settling for whatever health benefits their employer gives them no matter how measly they are. Until more employers are somehow forced into not providing employees any benefits, people will fall for the Big Insurance bait. Otherwise, I agree that Big Pharma and Insurance have plenty of money to control Congress.
Here is a little trick I discovered that gets your links printed in full so that they will work.
When you see they are cut off by the margins go to edit and put the mouse somewhere before the margins and hit return. That way they can be used when you copy and paste them in your address window.
It used to be easy but not anymore.
Ah, the links. Thanks Jim. I'll keep that note in mind.
I just drag through the link to the beginning of the line below, and copy; on a mac.
The Corporate Tools (a.k.a. Congress & the President) will not allow single payer as an option to profit care because their campaign coffer$ will suffer.
The FCM (Fawning Corporate Media) will not allow an explanation nor a discussion of single payer health care because their advertising $$ from profit care - Big Insurance and Big Pharma - will suffer.
We don't have a democracy; we have an auction.
Again I say-think strategically, think long term. I no longer think that begging our "representatives" to please, please. pretty please consider a strong public option or a single payer alternative is the way to go. The way to go is to challenge these legilators in 2010 primaries, to take them on again in 2012, to challenge Obama again in primaries or, how about this-- to use Single Payer as the basis for a third party option-- let's fight. If we go down fighting it's more honorable than being co-opted by the corporate whores who are in Congress now and say they represent us.
I agree. But the problem is finding candidates to run against them, candidates who could (a) conceivably win and (b) we knew for sure wouldn't be immediately bought off the day after the election.
One other thing we can do is make sure we donate only to individual candidates, not to any generic congressional campaign committees. Whenever I get called asking for donations to these outfits I tell them no because I'm sick of having them put up and help elect so many blue dog DINOS who are indistinguishable from Republicans.
Plenty of people might be candidates, but for the co$t.
We need local initiatives to tightly control campaign spending -- as in each candidate gets $X.00 per election, no more, no less. Media in the area have to offer equal time to all candidates.
Obviously Congress will pass no such thing because ALL the lobbyists and whoever provides their payola will be against it. But if we pass it at local levels, we can create a chance to elect local representatives who might pass it state levels and finally for the feds.
"I agree. But the problem is finding candidates to run against them, candidates who could (a) conceivably win and (b) we knew for sure wouldn't be immediately bought off the day after the election."
So, don't find candidates.
On an issue such as single-payer, universal-coverage, we don't have time. No time. We need to target individual Congresspeople to go down at the next election and take them down, no matter who's running against them.
Not all members, not even a lot of them, but a small number, say like Max Baucus, and take them down - noisily, visibly, clearly, forcefully.
There is an old Little Johnny joke: Little Johnny was going to a new school, so his mother visited his teacher before the first day of school. She told the teacher, "Now, you are not to strike little Johnny if he is bad, for he is very sensitive. All you have to do is strike the boy next to him and little Johnny will take notice."
What we have in Congress are a bunch of little Johnnys. Take one down next to them and they will take notice.
If single payer is not enacted before Max Baucus is up for re-election, let's take him down!
If the boys sitting next to bad Johnny are his accomplices such as say Mark Warner and Evan Bayh sitting next to Baucus, then taking out Warner and Bayh might weaken Baucus's case for staying corporatist. At this point though, Baucus has been in Washington for 30 years to change for the better. 2014 will be too easy a year to throw Baucus out if he runs for another term.
P.S.: Sen Warner made it clear to us VA voters that he is opposed to single payer and is proud of the US Chamber of Commerce endorsing him. Out in Hoosier, my aunt received a reply from Sen Bayh denouncing single payer as a "immature plan". Bayh was elected in 1998 and Warner just last year so penetrating those accomplices won't be as difficult as the more professional ones such as Baucus.
The public option? There should be no 'options' but rather a single tier system that incorporates every citizen regardless of socio-economic standing. Anything less will result in the gross under funding of the "public option" with the usual blame placed on the fact that "it's the governments fault and government can't run things effectively". This is a standard pattern out of any corporate playbook whenever the public gains a foothold in running their own affairs.
Having said that, real universal healthcare coverage won't occur anytime soon due to the fact that too many politicians owe their elected positions to the support they received from Big Pharma & Insurance. The public must unite to jettison any potential politician who is a corporate stooge. What we need instead are politicians who will serve the public interest. For this to occur the public must be able to recognize a corporate sycophant when they see one (i.e. 95% of the current Congress and Administration) and logically come to the conclusion that what's best for Wall Street is generally counterproductive to the average Joe Shmoe.
Obama could theoretically take advantage of his popular support and over ride the tremendous pressure he's under by his corporate friendly Congress and departments, but I seriously doubt that he possesses that kind of courage. Right Wing ideologues from Geithner and Summers to Joe Biden and Baucus are far more representative of today's government than the likes of Kucinich, Nader and Conyers.
I don't think it's really a matter of political courage, Space. I think that he is exactly what he said he was: someone who would reach across the aisle "to get things done." That rang all kinds of alarms for me and, sadly, I was right. The Republican party has, since 1980, moved so far to the right, and all the time the Dems have kept playing the game of trying to meet in the middle, ignoring the fact that the Repubs have wrenched the "middle" so far to the right that it would be well off of any political map drawn up before 1980. And Obama is now bent on moving that middle even farther to the right.
It's tragic that the Repubs have now essentially become a rump party and the Dems have their first chance in 30 years to enact a truly Democratic agenda along the lines of LBJ's domestic agenda in the 1960s, but instead they were bewitched by this phony and his flowing claptrap about "change" and "the failed policies of the past."
Rainborowe
Well gag me. The "public option" is not even close to "single payer" and even with the "public option" medical practice will still be loaded down by useless paperwork and self-serving bureaucrats.
Don't get sick. Don't get old. You are not a "citizen," but a Consumer.
-30-
"Don't get sick. Don't get old. You are not a "citizen," but a Consumer."
I get your point, Ole, but the last part is our decision as individuals, no one else's. We have sacrificed our citizenship on the altar of consumption.
Well put. This is why I seldom bother writing to my Congress critter and senators. The game is "fixed" once the election is over. Most people don't take the system's infrastructure into consideration, something I did when I gave up and suddenly shifted my vote to Obama. If Nader had won, the system would have still won even with his presence. The only way I see out of this is to continuously find better pols election after election and keep throwing out the bums until we get better representation.
It's not the bums. It's the system that attracts the bums. As a previous poster mentioned, having strict limits on campaign contributions and/or spending, and limiting the power of lobbyists is the way to change the system. Otherwise you can vote every 2 years until you die and little will change. The only other effective means of making effective changes is large scale, loud, frequent, and disruptive protests.
That could be true but I'm not so sure we can really alter the minds of those "fixed" puppets in Washington other than to drive them to fear by limiting their days in office election after election until they really feel the fear. The longer they stay in Washington, the more professional crooks they become and the more "fixed" they get with it. Trying to get the old guards to listen looks as easy as trying to revive a dead patient. I'll find it easier to get others to team up and perhaps rattle my senators Warner and Webb but after getting two or three terms, I know how difficult it will be to rattle them to their senses.
I think Reich is sincere on a personal level, but the game plan has already been agreed to by Dem Party leaders and their insurance-pharma campaign funders.
If he were realistic, Reich would say: Let this be a lesson to stop voting for Dem-Repugs, who won't represent your interests. Instead, he's just shilling for the Dems, pretending that it's all the public's fault for not screaming loud enough.
I'm tired of hearing that argument, which is just bull.
-TIA
Yeah, but you make it sound like voting for 3rd parties hasn't already been tried. It has been and I literally have the T-shirt to prove it.
We can all look at ourselves as being pimps because we keep electing the same prostitutes that roam the halls of congress and the white house and strengthening the same sick system that we are now suffering. I, for one, am going to try to kick the pimp habit and vote for a greener and hopefully (for a while at least) lesser prostitute on the next go around. Whoever votes against a viable public option in health care for all loses my vote. I don't care which party they belong to.
"To Pharma and Insurance, "unfair" is anything that undermines their profits."
True, but it seems to apply only to U.S. consumers of this industry. Not only does Congress give major tax breaks to big pharma but they allow them to sell these drugs for far more money in this country than they sell them for in other countries whose governments refuse to pay what we are paying.
So essentially, we have a government working "of, by and for the corporations" and for the people of other countries.
And we're paying taxes for what reason?
We pay taxes to subsidize corporate excessive welfare that denies the common man and enriches the already wealthy...so, struggle on, average person, get to work (if you can find it) and keep paying the man for the priviledge of breathing freedom, justice and liberty (???) Greener pastures are just ahead...
AGREE WITH REICH - DISAGREE WITH MOST COMMENTERS HERE.
It's true that the "public option" is far inferior to National Health Insurance ("single payer.") We should write, call, demonstrate, do civil disobedience to get single payer "on the table," so more people can find out about it.
BUT we should also support the public option now, because it has a chance, and it would be a step forward. Please note that, if the industry version of "reform" passes, we will be significantly WORSE off than now. Everyone will have to buy insurance whether it's any good or not, whether they can afford it or not.
True, congress is corporate controlled. That doesn't mean they can't be moved on particular issues, if they see real costs in towing the corporate line.
Actually the support of a Public Option could prove the kiss of death to ever getting single payer.
If the PUblic Option implemented it will be designed to fail. When it fails (And the Corporations and their bought people in Congress will ensure it does) it will then be claimed it was because the GOVERNMENT tried to provide Health care and made a royal mess of it.
On the other hand if the Public option is not implemented and the Corporations have to deliver, there a better then even chance they will fail in that regard and the NEXT go round will put them on the defensive.
I believe that if there is a REAL public option that has the basic features of single payer (covers everything, no deductible, no preexisting conditions clause, no cherrypicking through lengthy applications, not tied to work or income, cradle to grave at one price), people would flock to it so fast that it would quickly gain economies of scale and the cost savings of reduced paperwork. HOWEVER, the government could screw it up by making it look more like corporate health insurance, in which case your prognostication would likely be correct. If it's done right a public option would easily outcompete private insurance.
That said, simply enacting single payer in the first place would shortcut all this nonsense and compromise. But, as previously stated by many above, the corporate whores in Washington are too corrupt to do that.
If that kind of public option were a realistic possibility, then single payer would be, too. But, alas, there is no such possibility. The kind of public option being bruited about in Washington--most recently by Schumer, at the request of Baucus--would be a farce: it would have to be self-funding, would have to charge premiums and impose deductibles, could not take funds from the government, and could offer fees no higher than those of Medicare.
The fix is in--any reform short of single payer will be a sham and a scam.
Lol, vote these guys out of office, and guess what will happen, some other tool will take his place. Single-payer nor a fair public option will never happen because this government is way to corrupt, and here I thought prostitution was illegal in most states+DC. Anyways, if you want real change, stop posting and start disobeying.
here are our real choices: paper or plastic cash or credit. prostitution is legal in d.c
pay a politican and they'll turn a trick for some corp.screwing us!
The public option is an unworkable fraud--it's only true raison d'etre is to mollify the Democrats' donor base among the high-rolling HMOs and Big Pharma.
For documentation about the pitfalls of the public option plans, see the following link:
http://www.pnhp.org/facts/singlepayer_faq.php#public-option
I sent the following to Senator Snowe:
"I am writing as a concerned citizen of the USA. It appears that health care reform is doomed to remain in the control of insurance companies and pharmaceutical companies. Without a public option available to the citizens of this country, our broken health care system will remain so. It is clearly anti-patient to allow insurance companies to dictate the terms of health care. Insurance companies have an obligation to their shareholders to deliver maximum profits, they have no such obligation to their subscribers, except as defined in their policies, which they are free to alter in either terms or premiums.
I beg you not to eliminate the public option from the legislation that goes through Congress this year. The public, or single-payer, option offers economies of size and the simplicity of one payer, one claim form, one set of standards and one drug formulary, and no inherent incentive to deny care.
I know all members of Congress are going to be cajoled and pressured by the insurance and pharmaceutical lobbies. The people of this nation are not represented by lobbying interest on K Street. We are the victims of this capricious and often malignant system. Our only clout is a ballot once in six years, and that is often subject to the influence of those same K Street brokers. We are at the mercy of the strength and integrity of those who represent us in Congress. Please stand with us."
Doubt it will help, but it's one small voice on the people's side of the scale....
Very eloquent and nicely said.
Be careful what you ask for when you beg for a public option. This whole proposal has been contrived mainly to keep the private insurers in business while offering a sham "reform" to a credulous public.
The guidelines that Senator Chuck Schumer set forth for any public option make it clear that this is a fraud designed to undermine and discredit the idea of publicly financed insurance. Here are the absurd conditions Schumer laid out in the New York Times:
1. The public plan must be self-sustaining. It should pay claims with money raised from premiums and co-payments. It should not receive tax revenue or appropriations from the government.
2. The public plan should pay doctors and hospitals more than what Medicare pays. Medicare rates, set by law and regulation, are often lower than what private insurers pay.
3. The government should not compel doctors and hospitals to participate in a public plan just because they participate in Medicare.
4. To prevent the government from serving as both "player and umpire," the officials who manage a public plan should be different from those who regulate the insurance market.
Once enacted--and this is surely the kind of thing that will emerge from the House-Senate conference--the public plan will be end up saddled with the oldest and sickest and poorest, while the private plans cherry pick the young healthy profitable cohort. Saddled with unmanageable costs, imposing high premiums and deductibles just like the private plans, the public plan will prove untenable.
Sad to say, but your letter only plays into the hands of the HMOs. If you aren't demanding single payer, you're playing the HMOs' game.
There are two ways to go: Schumer's "plan" tries to "compete" with existing corporate health insurance, a recipe created to appease the gullible public (i.e. "look! we did something!), and designed to fail. The other option is to create a plan similar to single-payer, which would force existing corporate health insurance to compete with IT. This is what Congressman Jim McDermott and others are fighting for. McDermott is very clear that the term "public option" is generic-- it has to be done right.
Olympia Snow has moved the public option from yes or no to later or never.
She has now given Senators and representatives the excuse they need to postpone the decision.
If done correctly, this can be strung out through the next election cycle - maybe two cycles.
In the Shock Doctrine, Naomi Klein shows how the "white" government (apartheid government) in South Africa turned over political power (or the illusion of political power) and kept the economic power.
Once disenfranchised Africans can now vote and elect their own representatives. The South African economy is controled by the past rulers (white) who have the ability to close down the economy and take the money.
Snow has given the illusion of choice, knowing full well that control will remain with the corporate masters
Great move Olympia
Yes let's push for the public option and get what's gettable. Then let's kick out congressmen who are stooges bought by pharm money and elect REAL progrssives. Then single payer may become doable.
The public option is not half a loaf--it's no loaf.
Read the following:
http://www.pnhp.org/facts/singlepayer_faq.php#public-option-right-direction
"This is it, folks. The concrete is being mixed and about to be poured."
But into whose shoes? Our's or the CorporateFascists and their congressional lackies.
Inform your respective congress-persons that universal single payer shall be the new health plan, and if not, you will be supporting the Single Payer Party (SPP) in future election cycles.
"Public option" appears to be a fraud intended to divert attention from single payer. It is inconceivable that Robert Reich is not aware of this.
From http://www.pnhp.org/facts/singlepayer_faq.php#public-option :
Response by Drs. David Himmelstein and Steffie Woolhandler:
The “public plan option” won’t work to fix the health care system for 2 reasons.
1 - It foregoes at least 84% of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even 95% of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16% of the roughly $400 billion annually achievable through single payer - not enough to make reform affordable.
2 - A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan - which started as the single payer for seniors and has now become a funding mechanism for HMOs - and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients; with profitable ones in private plans and unprofitable ones in the public plan.
Keep advocating for single payer.
Extol its virtues: universal health care; instead of paying premiums to insurance companies you pay the government (single payer) and thus it will cost very little extra if not less since it will be nonprofit; insurance companies will no longer deny or limit health care only you and your doctor will decide what and how much care is needed; you will have your choice of doctor; prescription drugs will cost less since there will be one buyer who can get a better deal through volume purchases.
Don't believe the re-framing the incumbents are trying to do. Single payer is doable. Reich is right, tell everyone to make noise and let congress know your wishes.
When the manufacturers came for our families with their cancer, the doctors were the good Jews, dancing gaily with peer-review in the gas chambers to show us it was safe, until the doors clanged shut. Now some of the doctors are all gone – they tend to die early. A few of them are dead men walking. We will miss them.
When the manufacturers came for our families with their neurotoxic chemicals that cause madness, the psychiatrists took away many of our Holy visions with their drugs. Now we walk through the valley of the living dead.
I won’t condemn Pharma and Insurance without also dragging in the doctors.
Bless all who survive the deaths of family members, even the doctors and their families. Bless the dead men walking. Bless the living dead. Bless all of the naïve. Bring them to life.
Strong thoughts. I salute you. You have passed through the curses of despair to a plateau of Blessing. Good on you...the old man from Manchuria with the Crane, the bindlestick, and the staff says, "There are Still Mountains Beyond, Delight!"
The time to rise up and take to the streets is NOW.