Who Sits at the Health-Reform Table?

by Tom Klammer

President Obama held a town hall on Health Care Reform last week, broadcast nationwide on ABC with Charlie Gibson and Diane Sawyer. Once again, even though a majority of the public and now even a majority of doctors in the US favor a single-payer system, single payer was still off the table.

The president of the AMA, which opposes single payer, nowadays representing about a 19 percent minority of doctors, was prominently on display.

Ron Williams, CEO of Aetna, the health insurance company that in the 1850’s provided insurance to slave holders for their slaves, was part of the discussion too. In 2007, Ron Williams received $19,924,027.00 in total compensation as CEO of that health insurance company.

But the part of the healthcare problem that caught my eye was a woman in a bright yellow jacket, seated on the front row in the East Room of the White House. "Dr. Gail Wilensky, who ran Medicare in the Bush Administration," gushed ABC's Diane Sawyer by way of introduction.

Wilensky (the Dr. in front of her name is for a PhD in economics, not a degree in medicine) got to ask the last question in the prime-time portion of the show, right before the late-night news. She tossed out some big numbers and asked "What do we do in ways that CBO will count so that we can actually get everybody covered?"

It is worth noting here that CBO, the Congressional Budget Office, has 'scored' other plans, but not single payer. If the single payer numbers were run by CBO, she might have the answer to her question.

Wilensky was also present at one of the Senate Finance Committee hearings in May where the Committee Chairman, Senator Max Baucus, joked about needing more police as he had single payer advocates arrested for vocalizing their wish to be included in the debate.

At www.singlepayeraction.org , I read that "Baucus held three days of health care hearings and heard from 41 witnesses — not one of which was a single-payer advocate," and that, "Earlier this month, Baucus said that he will use the power of his office to seek to have the criminal charges against the Baucus 13 dismissed," and that as of June 25, "Prosecutors said this week they have not heard from Baucus or his office about the matter."

Doctors, nurses, other advocates are kept away from the table and face criminal charges. Wilensky and Aetna are at the table and get invited to the White House.

A Troubling Past

So who is Wilensky? I'll answer that by pasting in a portion of an op-ed I wrote in the Kansas City Star in March 2000:

"Under the Balanced Budget Act of 1997, besides cutting Medicare funding, Congress formed the Medicare Payment Advisory Commission with 17 commissioners, a full-time director and a staff of 30 analysts.

"The commission, charged with advising Congress on how to spend Medicare money, is headed by Gail Wilensky, former chief of the Health Care Financing Administration under President George Bush. Sound like a good idea?

"I first ran across Wilensky's name when I was researching HCR ManorCare, the national chain that owns an Overland Park nursing home where my father lived for 13 days in 1998 before I moved him to another facility. Wilensky serves on ManorCare's board of directors and its audit committee.

"She also serves on the boards of United Health Group (an HMO and other health companies), Pharmerica Inc. (which provides medications to nursing homes), Advanced Tissue Sciences Inc., Neopath Inc., Quest Diagnostics Inc., St. Jude Medical Inc., Shared Medical Systems Corp. and Syncor International."

One wonders whose interests she considers when making her recommendations to Congress.

On Aug. 19, 2003, I had occasion to speak about Wilensky again when I was invited by Sen. Kit Bond’s staff to speak at a hearing in the Federal Courthouse in Kansas City, Missouri, before the Subcommittee on Aging of the Committee on Health, Education, Labor, and Pensions of the United States Senate.

Here is a portion of my statement:

“Immediately after getting my father out of Manor Care, I began researching that company and the other big players in long-term care, and what I found then was Enron and WorldCom and Arthur Andersen. I looked at the SEC filing for the half dozen giants in the field and found that they all lavished multimillion dollar compensation packages on their CEOs and other top executives.

“Integrated Health Services sought a 50 to 60 million dollar golden parachute for departing CEO, Dr. Robert Elkins, who had led them to bankruptcy, and a federal bankruptcy judge approved it. In addition to lavish salary and bonuses, HCR Manor Care CEO, Paul Ormond, realized a gain of $23.7 million from stock options exercised in fiscal 2001.

“Seems like all these companies have money to burn, yet they continue to work together to lobby for more money, with no strings attached, wrapping themselves in a phony free market flag while typically getting 70 percent or more of their billions of dollars of total revenues from tax dollars and Medicare and Medicaid.

“In 1999, I found Gail Wilensky, then head of the congressionally mandated Medicare Payment Advisory Commission, was also serving on the board -- and I will correct here, it was the audit committee, not the compensation committee, of HCR Manor Care -- as well as on the boards of health care related companies. She later resigned from MedPAC due to the appearance of conflict of interest.

“But today we have former For Profit hospital lobbyist, Tom Scully; he is the administrator of Centers for Medicare and Medicaid Services. It seems all the corporate interests are always very well represented.”

So it was in 2003. And in the White House and on ABC last Wednesday, it seems all the corporate interests were still very well represented.

I didn’t see any evidence of single-payer advocates on the show. I e-mailed Dr. David Himmelstein of Harvard Medical School, co-founder of Physicians for a National Health Plan just to make sure that I didn't miss something. He confirmed that they were once again "off the table."