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Universal Health Care Closer Than a Moon Shot for US
Here's a good way to celebrate the 40th anniversary of the Moon landing: Exceed that achievement with one of greater value. Going to Mars would be nice. Getting universal health care would be cheaper. It would do more good to millions of people than expeditions to outer worlds to pick up rocks and plant flags. It should also be easier. Yet we put a man on the moon within eight years of setting the goal but haven't managed to bring about a civilized health system in six decades of trying. Maybe 2009 will be different. To the nation's credit, health reform is holding its own against other circuses (Michael Jackson, Sonya Sotomayor, moonshot nostalgia), though it remains a Bataan march through the good, the bad and the ugly.
The good: I'd say odds are 60-40 (a familiar number these days) that reform will make it through Congress this year. Detractors don't have Hillary Clinton to kick around like they did in 1994. Democrats have been clever to keep their proposals unimaginative. They pander to private insurers by sticking with the majority of the present system. They lean on employers to pick up a modestly larger tab either by covering more employees or contributing a minute percentage of operating costs to a federal insurance fund that will. The cost of the program, $1 trillion over 10 years, is still cheaper than fighting useless wars and possibly less deadly (insurgents having nothing on private insurers and hospital infections).
Single-payer would have been cheaper, more effective and more fair. It would end the insurance cartel's chokehold on patient choice and its arbitrary gradations of covered and uncovered procedures, which defeats the purpose of insurance. But maybe it's time to quit dreaming and submit to progress by increments and illusions.
The bad: They call it universal care. It's not quite that. The Congressional Budget Office's best-case scenario sees the number of uninsured reduced by 37 million by decade's end, leaving 17 million uninsured. The non-partisan CBO also says that the plan won't lower costs as advertised. How could it? Its underlying premise -- public-sector insurance competing with private insurers -- leaves untouched the dysfunction at the heart of the system: For-profit insurers make double-digit profits by minimizing benefits and eligibility while maximizing premiums. The plan doesn't change that. It feeds it.
Worse, to offset some of the costs of the health care overhaul, Democrats are proposing to add a surtax of 2 to 5.4 percent on the "wealthiest Americans" by 2013 (individuals making $280,000 and up and families making $350,000 and up). I'm all for progressive taxation. But this is sheer opportunism. Universal health care is a universal responsibility. To be successful politically and economically, everyone should have a stake in it. We all pay for Medicare, even though some of us will never make it to Medicare age. We should all pay for universal care, especially since all of us need health care regardless of age. If families making more than $1 million a year should pay a 5.4 percent income surtax, why not at least reduce or reverse fractions of the tax cuts going to the under-$250,000 set? Since when is an individual making $100,000 not wealthy? I make far less than that but would happily trade my insurance premiums for twice the equivalent payroll tax if truly universal care were the result.
The ugly: I was digging up old newspaper clips about the Moon landing the other day and there, on the back of a July 17, 1994 New York Times commemoration of the landing, was a special report on the "advertising blitzkrieg" over Bill Clinton's attempt to reform health care. The report quoted a television ad opposing the plan. "Announcer: A lot of politicians promise health reform. What would it mean to you and your family? What most politicians are promising would mean a big bureaucracy. Loss of jobs. Waiting lines. Limiting your right to choose doctors. Rationed medical care."
The same scripts, the same old lies, are being recycled today. Dollar for dollar, the best insurance systems are government-run -- Medicare, Medicaid, S-Chip (the children's insurance program). With some state exceptions (Florida's Medicaid system is particularly stingy) they provide more access and better care at lower costs than most private and employee-provided insurance, mine included. The models are in place to establish a fantastic universal care system.
Between lies and timidity, that's not where we're headed. As vision goes, the Democrats' version of reform is the equivalent of the International Space Station -- a low-orbit clunker imprisoned by old-world gravity and make-work objectives. Health care's moon shot still awaits.
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25 Comments so far
Show AllIt so very odd. The USA rushed off to wars in Afghanistan and Iraq with the subsequent loss of hundreds of thousands of lives, and here thay are introducing a system that will take a DECADE just to get 37 million people out of the 54 million and climbing onto health care.
When you have single payer Universal care everyone is covered the day after the bill is passed.
Why is that difficult?
GwNorth, "Why is that difficult?" It isn't difficult, its impossible. It's impossible for the same reason that back in '64 when the end of poverty forever in this country was in sight, America refused with a bullet. White American society is based on a model of Exclusion from cradle to grave and they like it that way. Do you really think that White America would really, willingly, ever make an equal place for everyone at the table in any part of this society? Not while this country is operated on a foundation of Authoritarian Patriarchy, White Male Supremacy, Gender Slavery, Constant War, and feral blood drinking Oligarchy.
As a sign my words are true, after the monsters have approved their reforms, through technical "glitches" in the designs of the programs, even more people will be denied health care OR the care will be so shoddy it kills them...THAT'S how White America does Health Care Reform, just like they did welfare "Reform", just like they "Reformed" the BK laws....as the recent round of folks pushed into squalor, degradation, and debasement are about to discover...Exclusion, first, last, always...
Sorry, never had to be this way...White America chose this path as its preferred model of living, if you can call it that....
Pieces of 8
Is it about black and white, or more about class warfare in general?
Class warfare of course,
Although race and racism are still alive and well; it is plain to see that whites go bankrupt from "health care" costs; millions of whites are uninsured.
Does anyone think that insurance companies will do any favors just because someone is white? It seems to me the only color they see is profit green.
You guys make me sick. Literally, I feel terrible after reading your stuff.
Yes, there's a long history of evil perpetrated on the innocent by those in power. There are many examples in American history to which you allude.
But, over time, with the work of some exceptional individuals and the society in general, things do get better, life becomes more equitable. Don't ignore this "arc of history."
Single payer is no utopia. Single payer is the most cost efficient method of providing health care to all Americans.
Keep advocating for single payer.
phasor: what is the problem? I can see no disagreement.
I obvioulsy do advocate single payer, along with a majority of Americans for a few decades. (just like the rest of the developed world and a growing portion of the developing world)
Things do get better in absolute terms (even many poor people have cars and cell phones, for example). However it makes me sick when I look at the record of corruption and abuse. Things get better not through great individuals alone, all social progress comes from collecive action from the ground up, from the people.
If the record makes you sick, don't look at it. Is this just a matter of the glass half full/empty?
"if ignorance is bliss, then knock the smile off my face"
"You guys make me sick. Literally, I feel terrible after reading your stuff."
If you feel terrible after reading the truth, it isn't the truth, per se, or the messengers of truth that make you sick, rather it is the knowledge that you've been had by the elites. Can we please refrain from shooting the messenger? The elites love that, but the people can't tolerate it. One of the key facets of our problem here in the USA is our addiction to the opiates dispensed by the elites, and the delusions that keep us addicted. When we criticize the elites, the opiates, and the delusions, we're trying to motivate ourselves to slough the elites off our backs, bury their opiates and delusions, and replace them with the alternatives. The alternatives are embraced in many places around the world. The alternatives are real. Localism, permaculture, rights to livelihood, social democracy. Thinking, talking about these, and especially putting them into practice should make you feel better, after you first get over the mistake of embracing the elite status quo.
But, over time, with the work of some exceptional individuals and the society in general, things do get better, life becomes more equitable. Don't ignore this "arc of history."
Are you referring to things here in the US, or do you mean abroad as well? And just who are these 'exceptional individuals'? If you'd rather close your eyes to the 'evil being perpetrated," then carry on (few, if any, of us posting here feel good about what is happening). It is true that "over time" things change, but one wonders how much time we really have, and an arc can bend both ways.
"White American society is based on a model of Exclusion from cradle to grave and they like it that way."
The majority of the people who hold a psychotic hatred for (yourself possibly?) are being excluded.
Hey asshole, most of your demonic "White American" monolith wants universal single-payer also. They always have.
Racism always looks for excuses. Someone else must be to blame, it can't be my failure, it can't be my mistake.
Now if we don't have real health care reform its whitey's fault.
It doesn't fly anymore.
Hi Henry8,
Almost any social issue is bound to look for someone or some group to scape goat.
I read your responses on the US Marines and the military in general as well as maxpayne's on the Pentagon and upon looking up more on that, I stumbled across an earlier heartbreaking article of the death of Frank Kucinich, brother of Dennis Kucinich and also an honorable Vietnam War Veteran who founded some of the greatest veteran organizations. This reminded me of my old friend JWVerez and I thank his wife for posting the heads up for his getting well sort of and making it to alternative practitioners given that healthcare in TX is flaky at best. There are very few pols like Kucinich who have a heart for the people's healthcare and he had this in mind long before he lost any of his siblings. In addition to planning to write a letter to my next Independent candidate who plans to run for local office to consider the newly Main Street Party (thank you BeForKids) , I am seriously considering writing a letter to Congressman Kucinich asking him to leave the Democratic Party and help empower the newly proposed Main Street Party as well. Since you live in TX, could you, JWVerez, and whoever else on this site living in TX help bring up the Main Street Party or is it impossible to bring up any 3rd parties?
Jennifer, getting a 3rd party other than Libertarian on the TX ballots isn't easy but I saw Beforkids's platform for the Main Street Party and I would like to pass the word around. There's more openness in El Paso unlike Northern Texas so maybe there's hope. Once my husband recovers, since his company's co-managers convinced me to take his place since June, I've been busy with work that I have been unable to get back to local politics but the Main Street Party is something I think my husband will love to push for. When he could pull people's fears out in the company he worked for and help turn the company around for the better, I think he can help do the same even if he can't walk or travel much. My neighbors, friends, his employee, and mine and his family who loved him and kept him alive despite the political sewage will be happy to speak up for Main Street. Even in Texas where the economy has supposedly done better, there's just as much internal bleeding throughout the state and it is getting to be just like New York and California. Just like I refused to give up saving my husband, I shall refuse giving up bringing the Main Street Party to life out here in El Paso and possibly get some help spreading it to the rest of the state and beyond. Henry8 too wouldn't mind it given that like my husband and I, he is also fed up with Obama taking our votes for granted. Take care.
According to an update of the 2002 Institute of Medicine study, every year 22,000 Americans die due to lack of health care coverage. That's 60 lives each day, or six 9/11 attacks each year. Delay of true universal health care kills more Americans than are dying in our wars in Iraq, Afghanistan and Pakistan, but our Congress refuses to act for fear of losing their cushy campaign bribes from the insurance and pharmaceutical industries and their lobbies, many of whom are staffed by former Congress members or their aides.
As long as health care is allowed to be a for-profit business, rather than a necessary public service and human and civil right for all, we will not have true health care reform and universal health care here.
As long as corporate and lobbying money calls the tune and corporations are legally considered "persons" with First Amendment rights and money equals speech, we will not have true democracy here.
I always thought that one of the best ways to defend our nation was to make health care more affordable and better quality. When people talk about defending the country and terrorism, they don't often come across the fact that 6 times as many Americans die from shoddy health care coverage and plenty more from shoddy treatments than a mere 9/11 attack would generate. Worse, I've come across even a few very well educated who would argue that insurance companies and the pharmaceuticals are very patriotic. They'll argue that without them, more jobs would be lost and that they wouldn't be able to sponsor for all those football, NASCAR, etc ... shows or whatever ! I see nothing wrong with killing the corporate sponsored entertainment even if it means losing TV viewers. At least more American doctors will be more motivated to do as great a job as foreign doctors since they won't have to worry about drug price gouging or insurance companies paying less to doctors. I get better cures experimenting with plants rather than buying petroleum manufactured pills from Big Phrma. I have also been informed that some doctors who take cash straight tend to perform better. Most of these doctors accepting only cash have privately admitted that they would be completely sympathetic to a single payer system and treat that as cash upfront and lower the costs out of generosity.
"As long as health care is allowed to be a for-profit business"
Anyone who wants to engage in economic activity on a well-managed field of competition to deliver best value should be free to do so, and should be duly rewarded. But most USan big businesses are deeply entrenched in a perverted status quo that virtually requires them to violate the rules of fair competition and fail to deliver best value. Health insurers are particularly in violation having eroded the value of US healthcare to 1/2 the healthcare value in other countries. Add to this the ethical/spiritual insult of commoditizing health, and US healthcare value is further eroded in an unquantifiable way. US healthcare is both a grotesque market perversion AND a grotesque ethical violation.
We on the far-left recognize that economic policy should be well-managed fields of competition to deliver best value. And in the case of healthcare, the ethical imperative probably demands that best value be achieved via the public sector. This approach has proven to work in the VA, Medicare, the children's system, and in most other countries, with Cuba leading the way.
What's a "coser"? Someone who doesn't use spell-check?
Did anyone really expect the institutionally corrupt Congress would give us a single-payer type system? Despite propaganda blitzkriegs from the corporate media oligopoly, a clear majority of Americans want single-payer and have for a few decades.
Unless the people organize themselves in massive collective action, the crooks in power don't have to listen. They have shown time and again that they can ignore the wishes and preferences of the people and get away with it. The two-party Duopoly has us backed into a corner, and there is only one way out.
Paying for health "insurance" every month versus a federal (or a state) single payer option seems to me comparable to renting vs owning a home. With private insurance, you "rent" your coverage month-to-month. Miss a payment, violate the terms of your rental agreement (by getting a truly serious illness, or having a pre-existing condition) your contract can be cancelled -- no recourse. With public/single payer, we all own the policy. It's paid for by taxes (plus a small premium that everyone pays every month -- like Medicare for the 65+). It's there, it's yours and no one can kick you out (or off). Your shelter is not owned by someone else who has the legal (if not moral) right to deny it to you, because by doing so, the value of their ownership (profits) goes up.
"Single-payer would have been cheaper, more effective and more fair. It would end the insurance cartel's chokehold on patient choice and its arbitrary gradations of covered and uncovered procedures, which defeats the purpose of insurance. But maybe it's time to quit dreaming and submit to progress by increments and illusions."
Yeah, the same is true for war, torture, spying, the destruction of the Bill of Rights... Maybe we should accept all of them. "Maybe it's time to quit dreaming and submit to progress by increments and illusions."
The rejection of Dingle Payer demonstrates much about our governance:
We are not a democracy--75% of Americans want government sponsored, universal Health care but it is not enough to move a bought out Congress. Would 85% be enough?90%?
Private advantage trumps public good
Profits are more important than a human right to Health care
Reform of our corrupt politics will have to happen before we get rational Health care.
This country will have to loose its society before it can regain it.
You've seen this before,
"When presented with the option of a government-administered health insurance plan similar to Medicare to compete with private health insurance companies, 72 percent are in favor and just 20 percent oppose. Even 50 percent of Republicans favor that option." http://www.cbsnews.com/stories/2009/06/19/opinion/polls/main5098517.shtml
Over two thirds of Americans want a Medicare-for-all single payer option.
Obama and congress will pass the public option. They just need to be reminded and prodded.
50% of Republicans want it too. This is a no loose issue for Democrats and a vulnerability for Republicans.
We must demand single payer. We must continue to demand single payer. Single payer must happen. Single payer will happen, remind politicians that 2010 elections are fast approaching.
I agree, the status quo must change. Advocate for single payer.
"For-profit insurers make double-digit profits by minimizing benefits and eligibility while maximizing premiums. The plan doesn't change that. It feeds it."
How does it feed it? Who won't join the rush to join the cheaper public option that will leave the for-profiteers high and dry?
"I'm all for progressive taxation. But this is sheer opportunism."
What progressive taxation isn't Pierre? What's so bad about sharing the wealth cons stole from the public these last 40 years?
"Democrats have been clever to keep their proposals unimaginative."
Please tell me you're joking..?
Btw, I disagree with Tristam's statement that we should all have to pay for USP. If we sharply taxed the 1% (I say by half. I think John Grisham could get by on $60 million), not to mention the 67% of corporations that pay no income tax whatsoever, we probably wouldn't need to tax non-wealthy Americans any more than we already do.
There's also marijuana legalization. Regulate it, TAX it, and you've got more money for the public coffers. Then there's the excise tax. I'm sure there's more money under the couch.
The idea of single payer actually had a surprising boost from House Republicans on July 17 when 19 of them voted with 25 Democratic members of the Education and Labor Committee to approve an amendment to the House version of the health care "reform," HR-1200. The amendment would allow the various states to design and implement their own single-payer universal health care systems.
And why did the R's vote with the D's on this amendment? Not because they like "socialism," but because they consider the creation of such systems a states rights issue rather than a federal one.
Might this be a wedge for getting other Republicans to refuse to vote for the current health care plan(s) unless they include the states rights provision?
Early last week, to save money from a program that is running hundreds of millions of dollars a year over budget, the state of Massachusetts announced it would cut off from its insurance plan 30,000 legal, tax-paying immigrants.
On Thursday, the Boston Medical Center sued the state for financing "its landmark health insurance law, a model for national healthcare overhaul, on the backs of poor residents by cutting payments to the hospital that cares for many of them to pay for expanded coverage." The cuts, says the hospital, "could financially unravel the urban hospital's key services."
THIS is the program they want to duplicate everywhere? So, so bad.