Twitter
StumbleUpon
Facebook
Delicious
Digg
Newsvine
Google
Yahoo
TechnoratiA Bailout for the US Healthcare Industry
The fractured U.S. healthcare debate, replete with wild distortions of Canada's medicare, must seem incomprehensible to many north of our border.
News images of fabricated "death panels" or traumatized seniors on U.S. Medicare -- a government-funded program -- urging legislators to keep the government's hands "off my Medicare" must seem especially hard to fathom.
Equally puzzling, no doubt, has been the reaction of the administration and many of its allies in Congress whose response to the attacks is to move further away from comprehensive reform.
Entering the year with a Democratic president and strong majorities in both houses of Congress, and a clear public mandate to end our long health-care nightmare, President Barack Obama and Congressional leaders decided to compromise from the outset, and not pursue the most effective reform, Medicare for all.
Gambling they could bring along conservative opponents, the administration and Congressional leaders instead advanced a more limited plan that preserves the role of the insurance industry. Prospects of broader reform were further undermined by some liberal and progressive groups and labour unions, who chose to merely endorse the proposals of the administration and top Congressional Democrats, rather than fighting for a national system like single-payer, which many of them have long endorsed.
Overnight, the left flank was effectively gutted from the beginning of the fight. Most of the pressure has thus come from the right and those who embrace the status quo -- leading to further compromises by both Obama and the leading Democrats.
This retreat was clearly articulated by the former president, Bill Clinton, who chastised a conference of worried netroots activists Aug. 13, saying "I want us to be mindful we may need to take less than a full loaf."
But mobilizing activists for a half loaf has proven to be a challenge, as the White House and Congress have learned to their dismay in recent weeks as they struggle to counter those denouncing them from the right.
Even the grassroots network built by candidate Obama that set new standards for campaign activism last year has, the New York Times noted Aug. 15, failed to produce much enthusiasm for the current health plan, and most liberal constituency groups have not fared much better.
What's left is a proposal that will force the uninsured to buy private insurance with subsidies for low-income earners and only limited constraints on industry price gouging and care denials that characterize the collapsing insurance-based system.
In sum, it looks like another massive corporate bailout, following the earlier version for the banks, this time for an equally unpopular insurance industry, which will fuel even more public cynicism of the reform process and political system.
To residents of all other industrialized countries, terrors over a government role in promoting and protecting the health and safety of its citizenry, and the reluctance of political leaders to effectively respond to these attacks must be especially confounding. Among major nations, only in the U.S. is health care not a fundamental right, but bartered for profit by a maze of health-care corporations. The result is that the U.S. continues to fall far behind other industrial nations in a variety of measurements, from access to care to equality in treatment, and even in the much discussed issue of waiting times for medical care.
While the U.S. spends twice as much as every other nation on per capita health care, there remain more than 45 million Americans with no health coverage and tens of millions more with insurance who are routinely denied medical care because their insurer doesn't want to pay for it.
Medical bills account for 62 per cent of personal bankruptcies. Half of all Americans skip doctor visits or immunizations for their children because of high out-of-pocket costs, troubling news indeed with the U.S. already leading the globe in swine flu infections and deaths.
The nation's registered nurses and many doctors continue to press for real change, a national or single-payer system that would look familiar to Canadians and the rest of the industrial world. It is still possible to achieve stronger reform, but time is running out.
26 Comments so far
Show AllI speak as just one statistic in the shameful 'healthcare' system of the U.S.... all it took for me to be virtually homeless (I am immensely fortunate to have a support network of family and friends, but even so, it is no small worry thinking about how on earth I can achieve any sort of independence, or even adequately continue healing once I am ambulatory again) is one accident which is rapidly depleting my savings and making me dependent upon a terribly beseiged and burnt out indigent-care system since I have not been fully employed nor insured for about a year now. I dread every doctor visit because the long waits and shuffling from one place to another to another is guaranteed to take up the entire day. I can totally understand how it is that many in my position choose to not go through with recommended, sometimes essential procedures because the choice is between health care and eating. The healthcare providers are overworked and surly and I can see they receive abuse from frustrated, sometimes enraged patients who are expected to put up with shabby treatment and hoop-jumping that would tax the resilience of the able-bodied, let alone people in dire need of help. In my younger days traveling abroad I do recall hearing people in Europe as well as in Mexico talk about how much easier it was to get affordable care and medicine outside the U.S.... Had they only known how much worse it would get!..... We need a decent public health care system and the parasitic insurance companies and big pharma should have to put in years of community service to make up for the misery their profiteering has caused. This privatization of the commons and bailout of these least trustworthy 'industries' has got to stop....
It's enough to make one sick. Oops! Better not; no insurance. Oh, well, the very best health insurance is an uncompromised immune system, anyway, and that can't be bought.
INSURANCE DESTROYS ACCOUNTABILITY -- INSURANCE DESTROYS DEMOCRACY
Democracy is where no one is allowed to enrich himself upon your misery. But not so in capitalist medicine which allows those with a rich diet and pleasure filled lifestyle to destroy our healthcare system and our economy.
For those who walk into a fast food restaurant do it knowing full well that half of the calories they are about to eat will be pure fat. Comes now a democratic healthcare system to save the day:
(1) Those who eat a diet that is 25% or higher in fat must pay for all their medical expenses until all their savings have been exhausted.
(2) Those who have no medical expenses shall at the end of each year receive a check for $2,000.
(3) We give the medical industry over $8,000 each year for every man, woman and child in America. This must be reduced by half to equal the healthcare costs of other industrialized nations.
1) The Mediterranean Diet can be up to 40% fat. It is not necessarily the amount of fat, but the quality. Fried and processed foods are a disaster.
2) A twist on the $2,000 rebate would be to allow everyone to have a medical savings account. Right now you have to have insurance to get the tax break. We should give that $1,000-2,000 directly to Medicaid recipients so they, too, could have medical savings accounts. Medicare recipients should also have them. If everyone paid cash for primary care, costs there would drop 30-50%, as they have in medical practices that have gone to cash only. And docs make as much or more money. With health freedom of choice guaranteed, and the FDA muzzled, you would see long term catastrophic costs start coming down.
The problem, as you point out, is not who should pay for these outrageous costs but how shold health care work so that costs drop.
See: "Why Stomach Acid Is Good For You" by JV Wright, MD and L. Lenard, PhD and then start thinking about how this one change in medical practice (and perspective) would eventually save billions, may be tens of billions.
The US is fairly rapidly devolving into a political and economic system that privately understands that it is not competitive with nor as legitimate as other countries that are supposedly in its class.
One sign of the devolution is that nowadays, it is becoming increasingly obvious that legislation can be passed when it is known full well that the government finances can not afford it, and/or when it is known that a substantial number of people will not be able to comply with the requirements.
Look for example at one of the specific certain failures of the fake health reform that has been proposed. It has been a fact of life for decades that low income people in high cost areas drive vehicles without auto insurance, which is against the law, but they get away with it, provided that they don't have any accidents and that they are not pulled over by the police.
If the health insurance "mandate" passes and there is no substantial reduction of the cost of premiums, which is exactly the most likely future as we speak, then clearly, the same kind of thing will happen with "required" health insurance. There will be millions who can not buy it, regardless of any subsidy levels that are realistically plausible. There will be millions more who can technically afford it, but who will hold on to their money for fear of homelessness due to unemployment that is already in excess of 20% and is rising.
Subsidies will definitely not be adequate given the massive unemployment threat, and subsidies will certainly not be adequate in the high cost of living areas for lower income people.
For most people, health insurance is many multiples of what auto insurance costs. The auto insurance market, although far from perfectly "free market" is more competitive than is the health insurance market.
Interestingly, whereas uninsured drivers have been strongly associated with minority and immigrant populations, individuals with no health insurance will racially at least constitute a much more representative, average sample of the population.
Up until recently, US laws were designed so that only the very poorest would not be able to comply, which frequently has meant that mostly minorities would not be able to comply. But the proposed “health insurance reform” threatens to introduce a new, much larger, more reckless scale of lawmaking malpractice. A much larger percentage of the population will not be in a position to comply with the current proposals as compared with prior laws.
Notably, many more relatively poor white people (who are not as prevalent in the lowest income categories) will now be just as subject to involuntary noncompliance as poor minorities have been in the past. You could say that poor white people are now becoming ghettoized. Of course, there are many other reasons besides being "forced" to buy something unaffordable that are involved in the ghettoization.
Increasing and/or large scale ghettoization of the population is one of the most reliable indicators of the existence of a third world type of economy and society.
Is there a point where the rest of the Private Sector digs their collective heels in and decides that the "Medical Industrial Complex" is capturing far too much of their share of the pie.
It would appear the answer is NO.
The rest of the Chamber of Commerce seemed indifferent to the Big Three's demise, in no small part due to the weight of increasing health care costs. How many other economic sectors will need to bite the dust before the Chamber realize that Big Health Insurance, while they can create a great deal of profit, really doesn't create leverage to spur real growth in other sectors of the economy?
The Chamber of Commerce types appear to be dumber than rocks, but of course they may be suffering from an image problem due to having only bad propaganda at their disposal, laugh out loud.
Seriously, the US private sector will apparently never rebel against the health industry taking everything and causing further and further collapse of the former US middle class, which is strong evidence for the theory that "national private sectors" as independent entities don't really exist anymore in a world economy dominated by massive multi-national corporations.
But won't the US national private sector spring back into existence if the world economy in general and world trade in particular collapses substantially? Or when China can no longer make a profit by dumping cheap goods in America? I would assume so.
But of course by that point the US private sector (creator of zero jobs in the last ten years and counting) will be devastated even worse than now.
A lot of people on the left and the right complain about the possibility of a "mandate" whereby everybody would have to have insurance. That's not really very important. What's important is how the whole thing is set up. Profit taking and insurance company meddling in health care must be minimized (to the point you could drown them in a bathtub?).
Don't forget, HR676 is a mandate. So is Medicare.
A mandate is where a government uses it's power to command a lower level government or even individuals to pay for something or to perform an action. The concept is inherently very regressive and backward due to inherent inefficiency of downward commands where economies of scale are lost, and also because, in most mandates, the government in question is trying to accomplish something it is responsible for by using the resources of others.
Further, the mandating government is almost invariably, at least partly and usually largely, making financial demands irrespective of the true ability to pay of the ones ordered to pay. (Whereas by contrast a progressive tax system rates high by definition with respect to honoring the ability to pay principle.)
In other words, it's a cheap and anti-progressive shortcut move by the Government. It is also an implicit up front admission by the government that it is not economically and/or not politically competent to achieve the objective, even though it is ultimately responsible for the objective. This is obviously a disturbing revelation.
Here is an analogy. A mandate would be like I as a parent telling my 15 year old teenager "I order you to buy a basketball and a backboard/net so that you will spend more time on basketball and less time hanging around low lifes in the neighborhood. If you don't do so, you are grounded for three months." Versus if I buy the basketball and the backboard myself and then deduct some or all of the cost from the allowance. The latter way (me as the "government" buying it and setting it up) is the progressive way and the former way (the mandate) is the right wing or backward way.
Note that with mandates, there is no guarantee that the action wanted ever happens. Rather, the penalty scenario can easily occur.
hopefully the thieves will get their way. imagine the rage which it will unleash, a rage that may well fuel some effective political action.
Great article and great comments. DeMoro points out the same process that has happened on militarism, civil liberties, finance, and now health care - where the Dems convince most of the Left to lay low, while the Right moves into full battle mode and so, in spite of two consecutive landslide electoral repudiations of the rightward drift in the U.S, the drift continues and even speeds up.
When do we hit the streets?
So, it's official?
"Bailout" has come to mean "ripoff"?
HealthCare Reform ...AKA "The 2009 Health Care Industry Relief and Welfare Act." For Billion dollar Health Care Corps. no others need apply.
You and the author have it exactly right. The whole system is a failed system and this is a defense of the status quo. I believe I will ignore any insurance mandate.
This is something I wrote on an earlier posting by Robert Kuttner and re-posted in slightly altered form on my weblog, http://sunstateactivist.org/ssablog/?p=279 It seems just as apropos to this article, since DeMoro addresses the likelihood of popular rage at the passage of a health care "reform" bill that is actually a disguised form of the extremely unpopular corporate bailouts. It seems to me that we need to keynote opposition to this faux-reform plan and in support of a truly progressive "(enhanced) Medicare for all" on this provocative of public rage, which will be politically productive only if it is challenged toward the appropriate target.
.............................................................
The people of this country are entitled to a furious attack on elite domination in every thing from war-making to health-providing. Since they (along with the usual suspects of the Republican know-nothings) are the forces that allow the financial firms and drug industries to continue to dominate our political system, it is quite “useful” for the people to follow the example of Jesus and wrathfully throw out of the temple the money-changers AND their liberal enablers. In short I’m suggesting that the very kind of anger at a sell-out administration and Democratic Party and a sell-out liberal establishment that is so often displayed in the comments on these CD pages must become the language as well of people on the streets of this country
Well stated as always, Jerry.
However, I fear for you, since I'm pretty sure that in the darkness of night, a Sedition Clause will be clandestinely attached as a rider to the No Insurer Left Behind legislation.
There is no Sanity Claus, alas!
· Yr Obd't Servant
Damn it, there is a sanity claus, Virginia, and you and I may just slip under it!
Too many USAns are in the clutches of Sean insHannity's claws.
What kind of reform can we expect if voters, with their insistent demands for affordable health care, keep clouding the congressional debate on how best to ensure if not enhance the obscene profits of the private health insurance industry?
"...or traumatized seniors on U.S. Medicare -- a government-funded program -- urging legislators to keep the government's hands "off my Medicare" must seem especially hard to fathom."
No, not at all hard to fathom. I wish liberal commentators would stop this distortion of what the old guy said.
He was making perfect sense. The bill shaping up in the house will make potentially deep cuts to Medicare to pay for the the baliout of the private insurance companies. So government (or more accurately, congress) should indeed keep it's hands off Medicare unless it is to enhance and expand it.
It is the same tactic the last Bush used, remember the,...what was it called the "blue skies act" or something that was actually all about chopping down forests? or the "patriot act" which was about subverting civil rights?
Here, you may have the "Kennedy healthy america act" that makes deep cuts to your existing medicare system for the old, probably the closest thing you have to what advanced democracies have for all their citizens, and the money transfered to the pharmaceutical firms.
Clinton sez: ""I want us to be mindful we may need to take less than a full loaf.""
***
"We", Kemo Sabe???
The People will not get so much as edible crumbs. Theirs will be the growths of mold carved from the edges of a loaf which has spent two weeks in the day-old bin.
Bubba, though, retains his prime seat at the bakery's banquet table, where the good stuff is served fresh from the oven.
Clinton could easily afford to spend more on lunch for himself and his ex interns at a posh restaurant than most Americans fork over every year to their insurance company.
...and his lunches are tax deductable so it will be you picking up the tab for Obama's billion dollar gift to the health insurance corporations.
jlocke123 August 26th, 2009 12:57 pm...........More like a few trillion dollar gift.
"In sum, it looks like another massive corporate bailout, following the earlier version for the banks, this time for an equally unpopular insurance industry, which will fuel even more public cynicism of the reform process and political system."
Yup...
Insurance and pharmaceutical executives became very jealous when Dubya and Obama adorned the banks with a series of generous bailouts.
Pharmaceutical companies immediately went into merger and acquisition mode in hopes of creating companies that are too big to fail to enhance the need for bigger bailouts.
Insurance and pharma industries are aggressively shaping US "health care reform" to be a NO INSURER LEFT BEHIND and NO DRUG MAKER LEFT BEHIND corporate welfare program.