Dear President Obama: A Modest Medicare Proposal
Dear President Obama,
I understand you're thinking of dumping your "public option" because of all the demagoguery by Sarah Palin and Dick Armey and Newt Gingrich and their crowd on right-wing radio and Fox. Fine. Good idea, in fact.
Instead, let's make it simple. Please let us buy into Medicare.
It would be so easy. You don't have to reinvent the wheel with this so-called "public option" that's a whole new program from the ground up. Medicare already exists. It works. Some people will like it, others won't - just like the Post Office versus FedEx analogy you're so comfortable with.
Just pass a simple bill - it could probably be just a few lines, like when Medicare was expanded to include disabled people - that says that any American citizen can buy into the program at a rate to be set by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) which reflects the actual cost for us to buy into it.
So it's revenue neutral!
To make it available to people of low income, raise the rates slightly for all currently non-eligible people (like me - under 65) to cover the cost of below-200%-of-poverty people. Revenue neutral again.
Most of us will do damn near anything to get out from under the thumbs of the multi-millionaire CEOs who are running our current insurance programs. Sign me up!
This lets you blow up all the rumors about death panels and grandma and everything else: everybody knows what Medicare is. Those who scorn it can go with Blue Cross. Those who like it can buy into it. Simplicity itself.
Of course, we'd like a few fixes, like letting Medicare negotiate drug prices and filling some of the holes Republicans and AARP and the big insurance lobbyists have drilled into Medicare so people have to buy "supplemental" insurance, but that can wait for the second round. Let's get this done first.
Simple stuff. Medicare for anybody who wants it. Private health insurance for those who don't. Easy message. Even Max Baucus and Chuck Grassley can understand it. Sarah Palin can buy into it, or ignore it. No death panels, no granny plugs, nothing. Just a few sentences.
Replace the "you must be disabled or 65" with "here's what it'll cost if you want to buy in, and here's the sliding scale of subsidies we'll give you if you're poor, paid for by everybody else who's buying in." (You could roll back the Reagan tax cuts and make it all free, but that's another rant.)
We elected you because we expected you to have the courage of your convictions. Here's how. Not the "single payer Medicare for all" that many of us would prefer, but a simple, "Medicare for anybody who wants to buy in."
Respectfully,
Thom Hartmann
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154 Comments so far
Show AllHealth insurance is just a lockbox into which you put money that you may need. An administrator uses health risk tables and treatment costs to calculate how much money that needs to be, then adds his salary. If the law states that, once chosen, you HAVE to remain committed to the 'lockbox' for your whole life, you are set (without the commitment the insurer's risk is higher, and hence you get charged more).
Would government be tempted to raid the lockbox? That's a risk, but other countries seem to have dealt with it. It would be very difficult to hide the fact that the money has been stolen. Its much easier to hide stealing under our current system, with its acres of fine print and lawyers, etc. Consider that in the last eight years, during which 144,000 Americans died for lack of health insurance, health insurer profits went up 438%. Clearly, robbery has been happening. Its just that under the private 'divide and conquer' system we have now, its easier to hide the theft.
Tom
This is the best summary of the health care package. Allow those who want single payer have it and those who want private insurance have their plan. Expand cost of single payer premium to subsidize those who are in poverty and cannot pay the premium.
Obama is a hugh dissappointment !
Obama should present the arguement Tom has laid out. very
simple very straight forward. Obama has devious aims which are not in the interest of most Americans. He is not to be
trusted. It seems Henry Kissenger and his cronies groomed
Obama right out of Law School to run for President and it worked. Now all Obama seems is a front man for Henry and his cronies.
withall his talk he has done nothing to
help people losing their homes
ending the military expansion in Middle east
help the Palistinians who are being
sequested in their poverty and
oppression
health care most sensible and cost effective
economy ( no or very little support to
produce American effecient cars)
environment ( horrible energy bill )
Obama is just a front man for Henry and his grand scheme to have our country dwindle in power so we can have a world order run and controlled by the Rich Bankers who run the IMF and the current Fed REserve BAnk.
He has given our treasury to the FED RES BAnk which is nothing more than a cartel of rich bankers whose only interest is their own pocketbook. The millions of americans who are loosing their homes is due to the Feds not demanding that banks renegotiate these ponsi-scheme sub-prime loans to a low fixed loan.
He has expanded our military presence for no good reason into Afghanistan Iraq Pakistan ( he ran on a policy of getting out of war !)
He has given our economy ( car industry ) to the Feds ! Geithner and Rubin are the car czars !. What a good way to destroy the only industry worth saving in this country. These guys again are wall-street con-men only interested in their own selfish aims.
Why have not the innocent-until-proven-guilty men locked up and tortured in Gutmo been given a trial ! It is almost a year since Obama has been elected and he has done nothing.
It is amazing the naivite some of you people show. In the 20th century government killed more of their own people than diseases did and you want to give them power of life and death over you. What fools you are.
Still waiting on that mea culpa, Al.
Has anyone noticed that after we thrashed ActionJackson and he disappeared, that 'blacksocialist' appeared, was deconstructed,fading into the mists of time and that Alex123 has materialized with the same faulty constructs?
Alex 123, Sic Semper Tyrannus, now go home and see if Momma can suture your segmentations up and don't bother the grown-ups here. We have real work to do.
...careful you don't drool on your shirt.
Really? All disease? Infectious disease only? Got any stats from health agencies to back that up?
Looking a 1993 as one example, 16.4 million died from infectious diseases, according to the WHO. Or take just one disease - small pox - which is estimated to have killed 300 to 500 million people during the 20th Century (http://www.sciencedaily.com/releases/2008/01/080131122956.htm). Let's add malaria with estimates of 150 to 300 million dead over the 20th Century (http://cmr.asm.org/cgi/content/full/15/4/564). I could tack on some more diseases, but we are already at 450 million to 800 million with just those 2.
Now here is the real question: Will you have any integrity at all and come back to say "mea culpa," or will you just ignore counter evidence now that your little rant about naiveté and people being fools was exposed?
I like this idea, but would this do anything about Medicare's unfunded liabilities (currently in the tens of trillions?). I am not an economist, so I really have no idea. Anyone?
Universal single-payer would be even simpler, not to mention even more ethical.
"Modest proposals" my ass. Modest never got us anywhere.
Why are people scared of USP when 3/4 of the public wants it?
The Left is being bullied by the right-wing minority.
All Americans without a job should just go on welfare now. Hell, let everyone w/o health insurance go on welfare. Flood the offices.
Actually, 90% of the people OPPOSE it and are willing to either stop working or even take up arms if such a proposal is considered.
You proved me right, Alex123. Thank you.
...your penname shows you can count,
so I imagine you just misspelled
opposite or opossum.
90 percent of Americans oppose what? Single payer?
Let's see your sources--let's see one creditable professional poll that says that.
I can show you about ten polls--from the most reputable national polling organizations--that show that 60-65 percent of Americans have favored single payer for at least a decade.
I'm ready to go toe to toe on this one.
Put up or shut up.
You could but I notice you DON'T. thegreatrockyhill didn't post any source, so why should I?
You have zero integrity refusing to provide any backing sources like that. Also, scroll up. There is a mea culpa you forgot.
I can only assume that your intent is to completely tarnish the reputation of the viewpoint you are trying to express.
He's a troll. He'll never show credible sources.
yes, he's just a troll, wouldn't worry myself with him. Thank you for the links about infectious disease deaths. Good work.
The worst thing that can happen at this point is to bring the President down. God knows the pressure he must be enduring to go ahead with the overhaul of such an inmoral health care system. There is so much we do not know; but one thing we know is how evil special interest groups are sometimes. There is a massive campaign going on, to defeate the overhaul of a system which has been incredibly profitable for: doctors, insurance companies, hospitals, pharmaceuticals; this will not be an easy feat. We as individuals are nothing compared to the mighty power of politicians, special interest groups, and big business. We have lived in a system that has programmed us to be passive and dislike arguments. Well the time has come for all of us to destroy that status quo. This is the big fight for all of us " average" americans and we have to win!. Let's rally behind the President and have faith. He is the only one so far who has had the guts to go forward with this, so lets don't digress here, and keep focused.
Jea,
Since you feel the President is approachable, why don't you ask him why my husband's medicine isn't legal again yet? It's a simple, softball question you could have the privilege of lobbing at him, the next time you line up for one of his down-home town meeting forums he sets up to discuss 'healthcare reform' and then ceaselessly discusses only warped forms of for-profit healthcare in the forms of recission based insurance and obscenely profitable, patented, synthetic chemicals marketed to treat conditions that were better alleviated one hundred years ago by the 50% cannibis sativa pharmacopia.
This works for me. I will never voluntarily purchase private insurance. It doesn't cover the medicine I'm interested in receiving so that makes it "unattrative" going in the front end. And private, for-profit 3rd party payers work hard at not paying claims so that makes it equally "unattractive" going out the back end.
I work in healthcare. I understand all too well where our healthcare dollars are really going - and that would not be into the hands of physicians, clinics and other providers of real healthcare services. There's something totally obscene about multi-million dollar healthcare CEOs whose value to their companies is determined by the kinds of "profitability" that comes from the number of people they refused to enroll, and the number of claims they refused to cover.
But I would buy coverage through Medicare, if only for the very real "American Value" of being able to participate in a true shared-risk system. If I never need to use my own coverage, then I will have enjoyed the gift of good health. And, in addition, it's just possible that the premiums I paid will also help lower the cost of coverage just enough that a single Mom I won't ever meet can take her child to a family physician - and not to the ER. That would make me happy.
Good Idea. Let's see how the "Right" trys to spin this one?
SW Kidder,I am glad you work in healthcare. I love the way you think. I know you have a lot of company on the frontlines there, we have met so many of you,husband is chronically ill. It must be hell to work for the vampires and watch them deny care to those you chose to serve, knowing that for the vampires having everything would never be enough to fill the hole in their souls. That's why Universal Single Payer is the way to drive a stake into the vampires' hearts and save the rest of us from the undead.
HANDS ACROSS AMERICA for UNIVERSAL SINGLE PAYER AUG 23, 1PM ET
Thom,
I think you can safely cut the Dear out of your salutation.
He certainly doesn't have any affection for us.
I don't think Sarah Palin has anything to do with Obama's health care waffling. It's who he is.
His solution to America's hugely unpopular belligerent militarism? Expand it.
His solution to Wall Street Corruption and white collar criminals in the banking industry? Reward them.
His solution to the suspension of the rule of law and a shredded constitution? Obstruct justice and stonewall.
His solution to the health care crisis?
A biiiiiig handout to the corporations that undermined the health care system in the first place.
Whatever populism was present in this man in his 20's is long gone. It's party time for Obama and we are footing the bill.
He said he didn't mind being a one term president. Let's take him at his word, if we can stand it that long.
Obama has to find a way to make some progress. I'm not ready to be overly cynical about Obama's motivations. Single payer public option is ideal. However, it is looking as though it would be a trip to martyrdom serving no one. Maybe I'm wrong and we'll never know unless it is tried, but I imagine someone has been counting votes on Capitol Hill. So a reasonable fall-back is needed. Hartmann makes a good suggestion as a fall-back. A variation on that suggestion would be even simpler: change Medicare to apply to everyone 55 and older. Over time, the age limit just gets lower and lower. Over time, the gaps and weaknesses in Medicare can be addressed. Let's get constructive. Do not let the perfect become the enemy of the good. Everything at once is not really part of human nature, as much as we would wish for it.
OK, I never read the responses to my posts because I don't need the abuse. And I didn't this time either. But I was thinking after my rant that I don't know much about Hartmann so I did a little research. This is his house for sale in Montpelier: http://www.realtor.com/realestateandhomes-detail/41-Northfield-Street_Montpelier_VT_05602_1079353944 A pretty sweet little pad and I think most of us would be happy to have his money and freedom to retire to a place like that before you're fifty. But it is not the McMansion with 20 acres of land in some ritzy Republican neighborhood like I expected and apparently he grew up with a working class background and he has done a lot of volunteer work or something. And he drives a Prius. So he doesn't sound like a phony like Moore and the Kennedys. I stand corrected and retract my rant this morning.
I think this is a great idea, and I hope it gets covered by some of the corporate media (perhaps MSNBC).
If you agree that this is a good idea, forward this letter to your favorite progressive TV shows, websites, newspapers, etc. I recommend forwarding it to a few friends as well. It's not CommomDreams readers that we need to convince.
Furthermore, I would like to someday see one of these phonies actually walk the walk. If the Kennedys, Moore, Hartmann are so concerned with the common man then why can't they live like him, live in his neighborhoods, drive his car, live on his income and just give the rest away to charity. Instead they live in mansions in the same neighborhoods as the people they are criticizing. Is this not total hypocrisy? Until their actions match their words, their words have absolutely zero credibility.
ATLAW--You need to get a dictionary. Hypocrisy is not being rich and having all the stuff that money can buy while doing things to try and make the condition of the have-nots better. Hypocrisy is asserting one thing and doing the opposite. Being rich and spending one's life trying to make the condition of the poorest among us, in my young days, used to be called a blessing or, if one was Jewish, a mitzvah.
Rainborowe
Do you even know who Thom Hartmann is? He lives in a crappy little house boat and gives back a ton to the community. Don't hate him b/c he's successful. You have no idea what you're talking about.
Hey!...Higgins likes the house boat.
"Absolutely zero credibility." We'll have to take your word for that, since you are obviously an expert on the subject.
PS. I make below average income. And I don't trust you for a second Hartmann. Why should I trust some filthy rich guy telling me he's going to save me from other filthy rich guys? Why don't you just send me some of all your piles of money, you are a greedy corporatist who's made a bundle, why don't you just send some to me if you are so keen on helping people? Sure if I buy something from a corporation some rich guy with more than he deserves gets a little piece of whatever I have but why do you think I want to buy into your ideas or buy your books or listen to you when you are also some filthy rich guy who has more than he deserves? Look at what the Democrats having been doing for years. A bunch of crooked rich jerks full of promises but making the same handouts to corporations, starting the same wars that the Republicans do. I see no difference between their lies and yours.
Isn't Thom Hartmann a multi-millionaire CEO? He started and ran a couple of companies and owns his own media company now. He's got to be worth millions and he's been a top executive at a couple different companies. Why is he always going on about "multi-millionaire CEO's". I guess like Michael Moore the money he makes ranting about multi-millionaires is what allows him to stay a multi-millionaire and like Michael Moore he probably rides around limos, flys a private jet, stays at the Ritz Carlton and lives in a fancy neighborhood with a bunch of multi-millionaire Republicans who are his good friends. He probably votes for Republicans too.
...is ATLAW a synonym for simple?
He lives on a houseboat somewhere near Portland, OR. He's not a Republican; he's a Democrat and he comes from a pro-union blue-collar family in Michigan. He's also a capitalist: he started several businesses, ran them himself and then sold them at a profit and currently owns the media corporation he also started. I listen to him on AAR every day and I haven't heard him "going on about multi-millionaire CEOs" but if he did it would be in the context of what those people are doing and how they came to be CEOs--very few of them actually worked their way up or founded their own corporations as he did.
Rainborowe
We should let Obama know that there will be only two criteria his heath-care reform will be judged by i) it has to bring down health care expenditures to less than 7% of the GPD –to match the average of the other developed countries– and ii) it has to make coverage universal while improving the quality of care to match that of the UK and France. Everything else will be considered failure.
What matters here is that whatever will be created to compete with the clepto-medical complex i) be strictly non-profit, ii) be forbidden to pay out-of-control salaries to its execs, employees, and doctors, iii) be large enough to have Walmart-level bargaining power (i.e., de facto extortionary power) over the physician leeches and the pirate peddlers of fantasy-priced medical supplies, iv) have legislative foundations that cannot be perverted by future caveman administrations, and v) not be allowed to exclude anybody from coverage or to charge different fees to different people.
Obsessing about single-payer, the public option, health care coops, etc, should not let us forget that the final goal of any worthy reform of the heath-care system is to attain what is above, i.e., to stop the parasitizing of the national economy by the clepto-medical complex and abolish the stone-age relict of universal coverage not being guaranteed from birth on.
A simple problem (40+million Americans abandoned by the health insurance companies with millions more underinsured and/or the victims of behind-the-scenes insurance shenanigans) deserves a simple solution (a Medicare buy-in) but ignores Congress's need to include a little something for each member's patron.
Busque la verdad!
Dr. David Scheiner, reputedly Obama's former doctor, has supported a similar idea to Hartmann's. It appears there's organized resistance to it. An article in CD some weeks ago discussed the possibility that Dr. Scheiner was disinvited from an MSM discussion because of his views.
At any rate, it always seemed to me that Medicare offered the best existing framework for reform. I recently turned 65 and haven't been disappointed by Medicare. Hartmann has fleshed out its expansion in a plausible way. Medicare does the job for its enrollees, and enjoys nearly universal popularity. We ought to expand it to cover the people who suffer, can't work, and die every day because they can't afford to treat their treatable medical conditions.
I'm dismayed to see congresspersons giving in to the healthy, wealthy zealots braying at the town halls because they think they might not be so wealthy if poor people received what human decency demands. Thanks to the loud voices of these "conservatives" drowning out everyone else, the compassion one sees in the MSM for Michael Vick's dogs greatly exceeds that shown for poor people who suffer and die for lack of health care.
First of all, Dr. Scheiner is not "reputedly" Obama's former doctor. He most certainly WAS Obama's primary-care internist for 22 years in Chicago.
Moreover, Scheiner does not support "buying into" Medicare. He supports Medicare for all--period: single payer.
He has discussed the possibility of lowering the age of eligibility for Medicare by increments--reducing it by one decade every few years: 55 this year, 45 a couple of years later, and so on, until everyone is covered. But that means expanding full Medicare coverage for all gradually, not turning it into a halfway HMO by buying in with premiums. If the thing charges premiums, it's not really publicly financed and hence not real single payer.
vanmungo August 17th, 2009 11:21 pm: Thanks.I said "reputedly" because my first result in searching for his name was Fox News, which called him Obama's doctor.
The two men aren't exactly in agreement, but they seems pretty close. At any rate, I think an incremental reduction of the age limit would be a good idea. Even going only to 55, which would leave millions uninsured, it would still bring in millions who have a tough time getting insurance. If you're 55, you have to prove you're disabled before you can get on Medicare, and proving that can take years. Plus, reducing the age limit would allow many of these older people now not working because of medical complaints to work up to age 62 or older, thus offsetting much of the cost.
Now there's not even a public option?? The Public option WAS the compromise.
This (buy into Medicare" option letter) should be an internet petition that we can send to the president. It makes the most sense to me- what's not to like?
thom your one of the three smartest guys i've heard on the radio
however your wrong about this one. this isn't asking or begging
this is a power of the people issue where we must as citizens
take control of this country and make it a democracy again.
be honest it hasn't been since roosevelt. its that time and
no matter how we wave to it sans violence we must! give
your pal noam chomsky ask how he's feeling about this.
its time to rock and roll!
I have volunteered for President Obama's campaign and have made over 2,000 phone calls over a 2 month period. I, like many progressives, doctors, nurses, etc., strongly believe a single payer system to be the easiest, most effective way to deal with the health care crisis.
With the understanding that we live in a world of compromise, progressive have settle on the compromised position of a public option in order to accommodate the interests of the much too powerful insurance industry and its representatives in Congress, the Republican party.
The elimination of the public option would be an unacceptable capitulation to the will of the minority (70% of Americans have consistently supported single payer over many years) and for this reason, it will not be something that I, and many other progressives would support.
The President, and the Democratic party should better pay attention to the following: any health care bill that shall pass without a strong public option will simply be seen by progressives like myself as a mandate to deliver more customers to private health insurance companies; and if that is what comes to pass you will have lost my support for the foreseeable future.
If the Democratic party capitulates to the pressures of big business and deny the people the choice of a strong public option, it will be the final nail in the coffin of the party as the representative of working people. I, for one, will actively begin working to build a truly progressive party to the left of the apparently centrist, corporate driven Democratic party.
This is a nonstory.
The public option being peddled by the mainstream "liberal" Democrats--including mountebanks like Waxman, Reid, Kennedy, and Pelosi--was a meaningless, token gesture--consumer fraud. It was so shriveled and innocuous that eliminating it changes nothing. Either way we'll be worse off with this legislation than without it.
See the following:
"Bait and Switch: How the Public Option Was Sold"
http://www.tikkun.org/article.php/20090723213400363
Thom's letter is so clear and simple. It should be used as an organizing tool.
Joe
Thom's letter is indeed clear and simple--as an example of needless surrender in advance rather than fighting for what is right and workable.
A public-option scam by any other name is just as rotten: an unworkable, unnecessary concession to a ravenous beast that will devour it anyway.
How were progressives rewarded for their feeble, "May I please have a public option, sir?" strategy rather than boldly fighting for single payer? See where all this mincing and bowing and scraping gets you?
Powerful interests do not reward courtesy and gentility and politeness. They steamroll it.
They must be met with a determination and tenacity that matches their own.
Thom Hartmann's article is an example of the "May I, please, sir?" mentality of self-effacement and bargaining oneself down before the battle is even joined.
It's time to cut the nonsense and fight for the only serious, workable reform: nonprofit single-payer Medicare for all.
Excellent idea. Obviously the best answer by far. Logically absolutely irrefutable. AND MUST NOT BE MENTIONED BECAUSE IT CUTS INTO THE PROFITS OF THE RULING CLASS.
They have more than they could spend in ten lifetimes but they want more.
It makes no difference to them that their profits are at the expense of pain, poverty, humiliation, of the poorest 30%.
"The poor will always be with us." The Bible says so. Who are you liberals to set your hand against the word of God?
If you don't believe this line of reasoning is widespread just visit any mega church in any mill town.
God has no physical body and therefore doesn't need health insurance. If it's good enough for God, it's good enough for the American people who, in 2012, will vote the Republicans back into the White House because progressives will abandon Obama by the hundreds of thousands, thus eliminating the narrow edge he would have needed to stay in office. Next time, no amount of Democratic fear mongering, outright lying or even groveling will save them. The legacy of The Great Yuppie Coward, Barack Who's Sane? Obama, will be to reduce the Democrats to a long and justly earned spell in the wilderness of national politics. We have, at last, truly reached the point where it makes no substantive difference if the nation is ruled by Republicans or Democrats.
...are you married to a coffee table in Massachusets?
This is NOT a good idea--it's another distraction from true single payer, like the infernal, elusive "public option," which keeps shrinking in scope with each actual real-world incarnation, to the point that it's a shriveled joke in current bills--a fig leaf for a nonreform that is just a boondoggle for the HMOs and drug companies.
The cost efficiencies of single payer come from having EVERYONE in the same pool--everybody in, nobody out--with revenues raised through taxes rather than premiums. In Hartmann's plan, you end up AGAIN with a two-tiered system: over-65 tax financed true single payer, under-65 in what is really just another HMO with premiums and deductibles.
Why all the contortions to offer up to massa something less than complete emancipation from our HMO slaveholders? These half-baked schemes will not work. Only single-payer will work to achieve substantial costs savings and high-quality universal coverage. Period.
Enough with the bowing and scraping and mincing.
That's all Hartmann is serving up here--another variation on the same old minced meat.
Would Obama's elimination of taxes for people making under 1/4 million make up for what they would pay into Medicare?
"...elimination of tax for all under $250,000"?!?!?
Please find an eye and ear doctor.
Hope you can pay for it!
I'm not sure what Hartmann means by "buying into" Medicare. Are you?
I understand the following about Medicare (according to SSA):
Medicare Part A is free to everyone 65 or older. Part A "helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care".
Medicare Parts B, C and D require monthly premiums.
State Medicaid programs can help pay the Medicare Parts B, C and D premiums, IF you are so poor that you have no more than $4000 in the bank.
See: http://www.ssa.gov/pubs/10043.html
Could "buying into Medicare" mean that people could pay monthly premiums for Medicare Parts B, C and D, just like those 65 and older do now?
I'm not suggesting what he means, because I don't know what he means.
Part B does not really involve premiums--it's 75 percent covered by tax revenues; the patient pays the other 25 percent, so it's more like a copay than a premium.
Part C is the Bush-contrived partial privatization of Medicare--it's really a boondoggle for HMOs that adds overall cost to the system and pads the profits of HMOs.
Part D is another Bush-contrived and Democrat-approved boondoggle--this time for Big Pharma.
The point is that the MAIN portion of Medicare--Part A and most of Part B is a single-payer, tax-financed plan. ALL seniors automatically in, none out.
What Hartmann is proposing is really another public option by another name.
For analyses of the inherent shortcoming of these bow-and-scrape public option schemes, please see the following:
http://www.pnhp.org/facts/singlepayer_faq.php#public-option
http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/
Thanks for the information about Medicare. But, I still don't know what Hartmann means when he says people under 65 could "buy into" the system.
I'll look at your links.
I just read Kip Sullivan's most recent essay, called "Reply to critics of How the 'public option' was sold," in which he gives a good history of single-payer going back decades, and reveals the major part that "yes but" Democrats (his term) have played in the failures to enact it.
Buying into Medicare means making Medicare partially dependent on self-financing through premiums rather than creating a single risk pool through taxation.
This is unworkable.
Why do progressives like Hartmann approach struggles for social justice by giving half the game away before they even have a seat at the table?
Do they imagine that the rich and powerful think, "My, those progressives are so wonderfully polite and accommodating---let's reward them for their good manners by giving away half our profits!"
What arrant stupidity and naivete--and cowardice.
I think I now understand the difference. Currently, Medicare Part A is 100% paid from general tax revenues. Premiums for Medicare Part B are 75% paid from general tax revenues, and only 25% paid by insureds.
Under Hartmann's proposal, people could "buy into" Medicare by paying 100% of the premiums for both Part A and Part B. These premiums, Hartmann says, would reflect "the actual cost," and below-200%-of-poverty people (those making less than about $22,000/year) would have their premiums subsidized.
I can see that the current system is better. But, Hartmann's system is non-profit, at least. Taking profit out of health insurance is something, at least. Isn't it? It's not easy for me to see that Hartmann's system would be "unworkable," as you say.
It's unworkable because it won't benefit the people who need it most.
National health insurance can work only by creating a single national risk pool to achieve two kinds of cost efficiencies--the inclusion of ALL the young and healthy people helps to subsidize costs for the old and sick, and the monopsony purchasing power keeps fees and costs down.
Creating a two-tier system that makes part of the system optional keeps the private HMOs in the game--they can aggressively market the young and the healthy, leaving the public option saddled with the oldest, sickest, poorest, and most expensive. So the major cost efficiencies of a single risk pool are eliminated. And as long as the private insurers can snag the lion's share of the non-Medicaid/non-Medicare market, there will be no way to control the runaway costs that arise from price gouging and sprawling private billing bureaucracies.
Second, the need to charge premiums and impose deductibles will make this option unaffordable for tens of millions of the people who need it most.
So what's the point of even pushing what is just another public option plan?
As I said, it's the self-defeating negotiating strategy of giving half the game away before you even get a seat at the table. Do you see the HMOs and Big Pharma making huge concessions? No--they attempt to steamroller even the tiniest, most meaningless reform.
To oppose these monsters, we have to stand firm and adamant for what WE (the vast majority of Americans) want and need, the only PROVEN system (in the rest of the industrialized world for fifty years): nonprofit Medicare for all.
Hey, I finally get it! Under Hartmann's plan, the for-profit insurance companies (and HMOs) could cherry-pick the young/healthy and sell them lower cost policies, and that would make the price of Medicare premiums for everyone else much higher (even though Medicare is non-profit, and even if the premiums were priced at "actual cost"). (Moreover, the young/healthy could opt out of health insurance entirely, until they were older/sicker.)
That makes sense. Every one of your comments has been correct. Sorry to be slow on the uptake about this.
Now, I just wonder if Hartmann sees the flaw in his plan. I generally think of him as the smartest progressive media pundit. Sadly, even Rachel Maddow had a representative from AARP on her show advocating for a public-option plan.
Thanks for your efforts to straighten people out on this thread.
Thanks for the clarification.
Thom's proposal is a different way of framing the public option. And it's brilliant that way. Typical Hartmann. The corporate Democrats will see it for what it is. And its a good enough idea for it to get to all of them. They will reject it, along with ANY public option.
I suspect this is what will happen after that:
President Obama, who I assume will remain a corporate Democrat for a while longer, will not sabotage his base: corporations. So he will support the Blue Dogs and attempt to get the Senate Finance version through with no serious public option tied to Medicare.
Then . . . at least 64 progressive Democrats will not vote for any bill without a Medicare-like public option (like Thom's superb proposal). That means the Dems have only about 193 votes. Few if any Republicans will vote for any bill in the House. They will need 218 votes in the house for this to pass.
So NOTHING will pass. THEN Single Payer will come up for a vote. It will get maybe 100 votes. (Hopefully many more.) THEN we'll get a chance in 2010 to run real progressives against the Blue Dogs in 2010 primaries, using this is a key progressive issue.
Make a massive show of support for SINGLE PAYER or "shovel ready" MEDICARE FOR ALL by joining:
HANDS ACROSS AMERICA for SINGLE PAYER RALLY
August 23, 2:00(CST) your local mainstreet
There should be the only two criteria that progressives should let Obama know that he will judged by. i) He has to bring down health care expenditures to less than 7% of the GPD --to match the average of the other developed countries-- and ii) he has to make coverage universal while improving the quality of care to match that of the UK and France. Everything else will be considered failure.
What matters here is that whatever will be created to compete with the clepto-medical complex i) be strictly non-profit, ii) be forbidden to pay out-of-control salaries to its execs, employees, and doctors, iii) be large enough to have Walmart-level bargaining power (i.e., de facto extortionary power) over the physician leeches and the pirate peddlers of fantasy-priced medical supplies, iv) have legislative foundations that cannot be perverted by future caveman administrations, and v) not be allowed to exclude anybody from coverage or to charge different fees to different people.
Obsessing about single-payer, the public option, etc, should not let us forget that the final goal of any worthy reform of the heath-care system is to attain what is above, i.e., to stop the parasitizing of the national economy by the clepto-medical complex and abolish the stone-age relict of universal coverage not being guaranteed from birth on.
At this point, I feel like getting back to the switchboard for one more attempt at HR 676 as Nader proposed. After that, let's stop writing letters to these stupid puppet pols and hire us progressive independents for Congress. Throw both parties out please.
Jennifer,
I agree! What a mess.
However, I'm not surprised that Obama caved. He was never committed to single-payer or any kind of a public option.
Did you notice that although the stock market tumbled today, health care industry stocks went up? I wonder why?!? The CEOs and other industry executives are salivating! They can't wait to sign us up and to take our money!
Sign me up!
I just posted this article on:
http://www.barackobama.com
This proposal for medicare for anybody is the simplest-most-elegant-beautiful-in-its-practicality solution. Give Hartmann a medal of freedom. Better yet, get him on the news shows, and talk show circuit. Were it possible to put this in front of the general public, maybe it would force Congress and the president to jettison the unnecessarily complicated "reform" option they've been foisting upon us.
This proposal for medicare for anybody is the simplest-most-elegant-beautiful-in-its-practicality solution. Give Hartmann a medal of freedom. Better yet, get him on the news shows, and talk show circuit. Were it possible to put this in front of the general public, maybe it would force Congress and the president to jettison the unnecessarily complicated "reform" option they've been foisting upon us.
Why are most willing to accept, stimulus money, cash for clunkers, bail out money to wall street and the auto industry, medicare, etc, all of which are social gifts via taxes and yet will not accept socialized medicine. Here's an idea, slash the military/defense budget in half and drop medicare. I think this would total about i trillion,at any rate, put all of that $ into a totally "free" health care system. The greedy insurance companies can peddle their cruelty elsewhere. And to the Yeah,Yeah, it will never happen crowd, that attitude is what allowed such a mass collective giveaway of our power to govt. and corps in the first place. The level of pissedoffedness of the general public of late, may be indicative of the sleeping giant waking up. Anything is possible,
ciao
"We elected you because we expected you to have the courage of your convictions."
At what point in Obama's campaign did he show any evidence of convictions, much less courage of them? So far the only convictions I've seen have been the same ones GWB had, and those are the policies of the fascist "War on Terror" that Obama has been happily continuing with his secret courts and secret prisons.
Face it, what we're seeing is the Wanker's 3rd term. He couldn't have done it better, himself. And Obama can do it without help from Cheney--amazing.
Rainborowe
A call-in-listener, to Thom Hartmann's radio show, proposed this bullet point relating to the medicare buy in option:
"Medicare is a shovel ready project."
Medicare's administration is all ready in place. It can be tweaked to account for its growth. It's revenue neutral. All the actuaries have to do is year by year determine the premium payment. All of us need to call our Reps. and Senators, and the president, and let them know that there is fair, reasonable, and equitable solution to health insurance.
NO-BAMA is fast shaping up to be the "HERBERT HOOVER of our age." I cannot say enough bad about him, only that he has been more disappointing than I ever expected.
Howdee...Thanks for putting the ass in Tex-ass!
This is a brilliant idea. My wife started pushing for it when we were lobbying in D.C. for single payer last month. Just make "medicare buy-in" the public option. Will it put the health insurance industry out of business? Largely, yes. They deserve to be out of business.
Unfortunately, a small group of dedicated right-wing loonies are loudly spreading horse shit lies and the mainstream corporate media is only too happy to make these clowns look like a significant "movement." In 2003 we had hundreds of thousands of people across the country shutting down major thru ways in cities big and small to protest the war and it got SHUT OUT of the media. Now a much smaller group starts spewing idiot points and disrupting public meetings and the same corporate media is inflating them up to the point where they seem set to change the debate.
We are not playing on a level playing field. The corporate owned media is doing everything in its power to derail health care reform. 22 thousand people die a year in this country because they do not have health care and the corporate media thinks the big story in a bunch of illiterate dupes who "don't want the government interfering with medicare" or "instituting socialism" or "killing Grammie."
So a great idea like Thom's is of limited value if we cannot FORCE the conversation back to reality--the reality where 22 thousand die a year in the richest nation in history. Where for profit health insurers protect their wealth by killing sick people. The reality where we rank 42nd in the world in life expectancy.
To force the conversation back into that reality will require a public committment to policy debate that I have not really seen in my lifetime. The real problem is NOT a few morons acting up at town halls and it really isn't even the stranglehold the corporations have on the media and on the Congress. The real problem is the tens of millions of Americans who desperately need health care reform, or who have family who desperately need it, and who still cannot be troubled to get off their asses to write and call their representatives, attend meetings and demonstrations, and otherwise organize for a stronger, more just society.
Watching Stephen Colbert doesn't count as activism. Get involved in this fight, if you are not already, and start shaming the people you know into getting involved. This is about health care, but its also about this infantile nation finally growing up and taking responsibility for establishing a responsible, caring society, instead of turning everything over to the corporations, who sell us our own destruction in the form of consumer amusements.
Briggs Seekins
briggsseekins.wordpress.com
Every so often, I hear some whispers about letting people aged 55-65 to buy into Medicare. Since I'm in that age range, this would be good for me (but it still wouldn't help a lot of people). Right now, I have a job that provides a group health plan, but I'm trying to prepare for the possibility that I'll show up for work one morning--and the place will be boarded up.
With the dismal job market, plus my age, I'm pretty much unemployable. Being covered by Medicare (if single-payer remains a political impossibility), I could get a couple of part-time jobs with no benefits and also do handyman work--without worrying about major health-care expenses.
In the workplace right now companies are laying off and givng early retirement to people 50 and over. With this fact known we could lower Medicare elgibility to age 50 and solve many problems. Get rid of that disasterous drug bill and putting in place a real drug reform bill and more problems with funding could be solved. Last but not least we are going to have to revisit out tax system. Real Progressive Taxation needs to be reinstituted. Absolutely no problems will be solved until progressive taxation is brought back.
Thom, I think that you know very well that your plan which in one form or another has already been suggested by others is too simple for a President trained at Harvard. You probably also know that Obama is somewhat of a religious nut (by his own admission he now prays all day long instead of only in the morning) who is not very enamored by "public programs" but prefers "spiritual programs" as shown by his uncritical support and increased funding of such nonsensical and possibly unconstitutional programs. The so-called "left" elected a lemon.
At the very least Obama could have demanded that the S-CHIP program be absorbed by medicare and dare the Blue Dog Democrats and Republicans to vote against children. The fact that he has not done so yet shows that the frequent comparison of Obama with JFK who did nothing on "civil rights" is right on the mark. Like Palin, Obama is a quitter.
President Obama avers that he will save 500 billion dollars in ten years from Medicare. Where does that number come from? To me it appears that he must have been playing "Monopoly" and drew a card "go straight to Jail and thereby save 500 billion from Medicare". Whatever, how the hell is he and are subsequent administrations going to enforce this? Medicare police?
Offer current Americans a one-time chance to join "Medicare Choice", after which they are stuck with either private insurance plans (the status quo) or Medicare. And I do mean STUCK (well, until they are 65): no dumping sick people onto Medicare's doorstep. You either want to buy into 'socialized medicine' or you want what you already have.
Offer future Americans a one-time chance, when they are 25, to also either join "Medicare Choice" or choose to run the private insurance Musical Chairs game.
This way, the stupid Americans can keep their choices, and continue to get dumped by their private insurers when they get sick, and the smart Americans with stay with a gov't-run, reasonable system that they also can't get out of. The ONLY way to lower insurer risk is to enforce lifetime commitments out of the insured and the insurer. That's how single payer and nationalized plans are able to lower costs and pass them on to their subscribers.
This is, of course, a separate issue from 'universal healthcare'. Personally, I think we should insure everyone, but give the poor the same one-time choice as the wealthy, and then pay for their insurance when they can't pay for it themselves.
This morning, Amy Goodman, Democracy Now!, interviewed Chad Terhune and Keith Epstein, who wrote the Business Week article, The Health Insurers Have Already Won. Amy reported that Stephen Hemsley, the CEO of United Health Care, makes $102,000 per hour. This company is poised, with the Obama "health insurance reform" bill to take in even higher profits. United Health Care is the biggest provider of S-Chip and also Medicaid.
And, something else I didn't know -- this corporation even has a department called "The Golden Rule" department. If that isn't a euphemism, I don't know what is.
In addition, Amy and Angela showed a clip from Robert Greenwald's new documentary, Sick For Profit. There is a link on the Democracy Now! website.
Here's the link to the interview:
www.democracynow.org/2009/8/17/business_week_the_health_insurers_have
Thom makes a great suggestion; my only improvement would be to have Medicare eliminate the amounts they pay different in different areas. I live in what Medicare classifies as a "rural area", and the payback amounts to doctors and hospitals is lower than "urban areas". There is a hospital less than a mile from my house that has a top notch cardiac care unit, and the other hospital that is two miles in the other direction is also very highly rated. Many doctors in my area refuse Medicare patients because of the lower reimbursement rate paid by Medicare. Change that part, change the Part D area about negotiating for lower prescription rates and the fixes Thom suggested- boom! "Problem" solved, period. Great suggestion.
Unfortunately, Obama, behind closed doors, has already waved the ability of the government, and anyone else, to negotiate prices of prescriptions.
Great idea. How do we Americans implement it?
Hartmann used to run an ad agency and he often gripes about how Democrats don't know how to use simple language to sell an idea. Think about how Republicans have practically changed standard word usage---as well as influenced public atttitudes---by repeatedly referring to the estate tax as the "death tax." They're lousy at politics but masters of propaganda
The beauty of Hartmann's proposal is NOT that it represents the perfect utopian solution, but that it can be readily SOLD to the public and not easily challenged by Republicans, Blue Dogs, or insurance lobbyists. Just about everyone is either on Medicare or has a loved one who is. Polls show that it is popular. And the way it is set up makes it immune to two of the wingnuts' red-flag fear-mongering propanda points---abortion coverage and "death panels."
My only addendum to Hartmann's idea is to call it the "Medicare Choice" plan. We need to drill home the idea that people can stick with what they have if that's what they're comfortable with. I suspect that a lot of the resistance in the health care debate so far is from people who like their current doctor or plan and think that reform necessarily means change.
On Yahoo, I noticed that, today, stocks are tumbling. However, health-care stocks are NOT losing ground. I wonder why?!? Of course, CEOs and other executives of the health insurance industry are probably salivating about the fact that Obama plans to GROW their market for them, with the implementation of his "health insurance reform" bill.
TOP STORY ON YAHOO FINANCE:
Health insurers escape broad selloff- MarketWatch
U.S. stock-market investors are following in the footsteps of billionaire investor Warren Buffett by rotating into health-care stocks, with that defensive sector the sole industry group not losing ground to Monday's sharp equity-market decline.
Thom has a good idea, but it seems that he still doesn't get it. Obama is a good employee who is working for the best interest of those who contributed so much to his campaign.
Those people are not the suckers who were praying for change.
Thom gets it. He's not really talking to Barack Obama -- he's talking to you, same way Rush Limbaugh isn't really talking to Obama but to his own listeners. The difference is, people who agree with Limbaugh's perspective have been showing up, and we're sitting back while they do it, and just making fun of how nutty many of them seem, and how consistently they can be led around to do things against their own interests.
How many of us are "spontaneously" rushing down to the steps of the Capitol, or to the Ellipse facing the White House, to loudly protest the death of the watered-down "public option," let alone how many of us have been fighting against the easy, quiet death of the only useful solution, Medicare for All, which was killed on day one by Our Savior? How many have been coming to our "centrist" Democrat congressmembers' and Senators' offices to demand that this titanic boondoggle of a corporate feeding frenzy be dropped totally, in favor of a plan that would actually serve the health of American people, their economy, and their tax bills? Ummmmm, that would be, hold on while I count again to make sure, OK, I got it -- nobody.
Limbaugh says "make him do it," and they go. Obama says "make me do it," the single-payer advocacy groups say "make him do it," and we blog.
Organize! www.commonplans.blogspot.com
You mean just as you're blogging right now, just as you're selfishly promoting your own little blog rather than providing links to the main single-payer activist sites?
I guess this is an example of your saying, in effect, "Do as I say, not as I do."
What matters here is not single-payer, the public option, etc. What matters --and it should be demanded loudly-- is that whatever will be created to compete with the clepto-medical complex i) be strictly non-profit, ii) be forbidden to pay out-of-control salaries to its execs, employees, and doctors, iii) be large enough to have Walmart-level bargaining power (i.e., de facto extortionary power) over the physician leeches and the pirate peddlers of fantasy-priced medical supplies, iv) have legislative foundations that cannot be perverted by future caveman administrations, and v) not be allowed to exclude anybody from coverage or to charge different fees to different people.
We should never forget that the final goal of any worthy reform of the health-care system is to attain what is above, i.e., to stop the parasitizing of the national economy by the clepto-medical complex and to abolish the stone-age relict of universal coverage not being guaranteed from birth on to everybody. The police and the army are non-profit and they (are supposed to) protect everybody from the moment of birth on...
Why blame Obama when, during the whole 8 years of anti-Bush rage, progressives did not form any lobbies as formidable as the ones in place, and certain to remain in place as they were all adapted from the successful pro-merger/monopoly lobbies of the Clinton years, having adapted themselves from the merger-mania go-go '80s Reagan-Bush 1 years? It's not like we didn't have time, manpower, or sufficient motivation.
Anyone who was watching Obama put his administration together saw this coming. First, there was the "team of rivals." These were all personal rivals, not ideological ones. They included only right wing Democrats and moderate Republicans. Nobody from the Progressive Caucus or their staffs were offered anything. Not a single person in any cabinet or sub-cabinet policy position with a perspective on anything that could properly be called "change." Obama appointed Treasury and bailout managers that were executives from the same credit-market-wrecking, at-the-till firm as those appointed by Bush. There was the creation of a health care "team" that included nobody from the 80-odd sponsors of HR 676, even though they were the largest continuing sponsorship group on health care reform. And nobody from consumer-oriented health care think tanks -- only the industry think tanks and lobbyists -- and many of them meeting with the President and White House staff in secret, just as under Bush.
And where were we, while all these other people were lining up to continue the Washington habit of lining the pockets of those who line the campaign coffers, instead of looking after the quality of life of the American people? Nowhere, as usual, and as always when Democrats win elections -- no matter how many times, we keep doing it. Even now, almost nobody who reads Common Dreams is organizing self-interested citizen groups. Where are the organizers? What energy are we expending on our own train to match the fuel being shoveled into the engine of the Washington corporate train? When will we put together enough live bodies to stand in the path of this corporate train and force it to stop? Will it be before Waxman-Markey drives us off the global warming cliff? I hope so, but I doubt it, unless people are quickly moved to action.
Start organizing. Please start organizing at home. www.commonplans.blogspot.com, esp. sections entitled "How To Get Started" parts 1 & 2.
Great comments on the team of rivals. Amazing how people extolled this nothingness as somehow sublime. Not one person on the whole economic team who had warned of this mess in time to have done something and there were plenty out there on both sides of the aisle.