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TechnoratiPublic Option is Just Another Private Party – and We’re Not Invited
The Show Must (not) Go On
The elaborate Congressional circus whimsically referred to as ‘healthcare reform' - the one that has held the nation captive since President Obama's earliest weeks in office - came complete with dancing clowns, disappearing acts and trained tigers jumping through hoops.
But today the magic is gone.
The performance is degenerating. The public is beginning to understand what the political players knew all along - that this three ring circus was never meant to be more than a sideshow.
Americans have been forced to bear witness to embarrassing public displays of angst over their government spending a paltry $85 billion (or so) annually on health care for millions of Americans when about 20 times that amount has been gifted to the still-unaccountable robber barons responsible for the ongoing financial crisis.
Today, anyone not in a comatose state has surely grown tired of the smoke and mirrors. Surely Americans have noticed the eerie disconnect between the carefully staged healthcare ‘debate' with its fixation on the cost of an increased government role, and the nonexistent debates on the (far more costly) war in Afghanistan or the obscenely expensive government program to bail out Wall Street.
It was against this surreal backdrop that House Speaker Nancy Pelosi agreed to support an even more frail version of what never was a particularly ‘robust public option' for health care consumers in the first place. The move marked not the beginning, but the continuation of an unraveling process that began before the ‘health care debate' ever got off the ground.
Dropping the part of their plan that would have allowed insurance premiums to be set by the government in favor of ‘negotiating rates' with insurers is only the latest in a series of compromises by House Democrats that puts industry interests ahead of (what we used to call) the ‘public good.' Concepts of ‘meaningful cost containment' and ‘greater competition' in the insurance market have vanished into thin air.
It's hard to believe that only a few months ago we were promised that the ‘public option' would accommodate 120 million people. Today that number is down to 10-12 million - and god only knows what it is they'll be getting into.
In other words, Wall Street, the insurance industry and their Democratic lap dogs (only some of whom are blue) have made a mockery of the entire premise of health care reform - greater public access.
Public Loss, Private Gain
An article published a few months ago in the Wall Street Journal reassured investors that "elements of health-care reform potentially most onerous to industry have little chance of being included in any overhaul bill that might make it through Congress."
The authors must have been clairvoyant.
How else could they have known that Speaker Pelosi would ultimately ‘see the light' and decide in favor of the insurance industry with respect to how payments for care would be made under a ‘public option.' When the Speaker announced recently that she no longer supported payments based on Medicare rates (as she had promised progressives she would), and would instead support tying rates to those of the big insurance companies, Wall Street must have been so relieved that its investors would have one less ‘onerous element' of health care reform to worry about. Insurers too can sleep well knowing that whatever plan eventually comes out of Congress, it is almost certain that the ability to compete or to put downward pressure on costs will have all but disappeared. Pelosi also dropped a number of tentative provisions to promote consideration of "Medicare for All" models and to allow states to experiment with single-payer plans.
Little wonder then, that Wall Street analyst Richard Evans, in a report published November 3rd, was able to proclaim with complete confidence that the health insurance industry needn't worry too much about the prospect of a government-run health plan - at least not as it now is taking shape in Congress.
Any government plan, Evans assured investors, "is likely to resemble a competitor that the for-profit insurers already know ... It appears the public option would be required to negotiate price with providers, pay back its start-up capital, cover its operating costs, and earn sufficient reserves ... In other words, it looks like a Blues [Blue Cross] plan."
If Evans is right - and he probably is - those investors who worry that the public option is little more than a gateway drug to socialized health care (translate: single payer) can rest easy knowing that Congress - once something, anything, gets passed - is likely to wash their hands of ‘the problem' into the unforeseeable future.
"Whether reforms pass or not, the degree of political capital and legislative bandwidth consumed by the effort are simply staggering, despite the fact that health reform remains well below economic concerns on voters' radar screens ... From this, we infer that, after the health reform effort reaches an end, the near- to midterm odds of Congress again turning its attention to anything related to healthcare is as close to zero as it has ever been."
Evans goes on to advise investors that Pharmacy Benefits Managers (known in the industry as PBMs) will be "clear winners" if the current iteration of a ‘public option' is passed into law. "PBMs have the potential for positive earnings surprises," he predicts.
The PBMs, it should be said, are dominated by three large players and several mid-size players, including Walgreens, CVS/CareMark, Prime Therapeutics, MedImpact, as well as a slew of ‘captive' (part of a managed care company) PBMs. Those include Wellpoint, Aetna, Cigna and others.
Corporate Control over Public Health Insurance
In a comprehensive executive summary at the Physicians for a National Health Program (PNHP) website, Kip Sullivan, JD writes: "Both the Senate and House versions of the proposed ‘public option' require that corporations with expertise in health insurance administer the option." Sullivan believes this is very bad news for the public.
He warns that private sector firms will likely play a role "that closely resembles the role that defense contractors play in the production of weapons for the Pentagon. Just as Northrop Grumman carries out all tasks necessary to create a fighter plane, so private corporations (not public employees) will carry out all tasks necessary to create the ‘option' health insurance programs." This function, he says, "is obviously very different from, and more significant than, merely processing claims."
The options in the current Senate and House bills, writes Sullivan, "will not resemble the traditional Medicare program but will in fact consist of numerous insurance programs (or plans) functioning at the level of individual insurance markets, that is, at the level of states and regions within states. Once you understand this, you begin to grasp what it means to say that private corporations will ‘administer' the option program. You begin to comprehend that the multiple local option programs might actually be owned by, or administered by privately owned corporations, possibly health insurance companies."
Public Option Not an Option for Most
According to Robert Laszewski, president of Health Policy and Strategy Associates, the current House proposal works pretty well for families making $20,000 or $30,000 a year. "A family making $27,000 a year will pay about $1,000 (annually) toward their health insurance," he told Jim Lehrer on PBS' News Hour. Under the option now being considered, a family making $55,000 annually would pay about $5,400 - that's nearly $500 per month - nothing to sneeze at. A family making $73,000 will pay $8,700 toward their health insurance bill.
"We're just not doing anything for the middle class here," Laszewski told Jim Lehrer.
Laszewski believes Congress will need to get "either more savings or more revenues into this program in order to make it affordable for families in the middle range. And the people we're really talking about here are people between about 300 percent and 400 percent of poverty level income" - currently a huge segment of the population.
Of course, the open secret is that a single payer system is inevitable in the long run. And by the time Americans finally get coverage for all, no one will care what it is called. Congress will eventually be forced to follow the lead of states like Pennsylvania, California, Illinois, Ohio and Massachusetts, all of whom are currently working to implement their own single-payer healthcare.
If the Democrats' option turns out to be little more than window dressing for Congress to throw hundreds of billions of dollars per decade at the insurance industry, and if (as seems likely) the public option fails to either effectively control prices or open up the system to all who need it, Americans will pay a huge price - both as patients and as taxpayers.
In the meantime, Congress should stop pretending they're doing something, and actually do something to help the American people. If legislators got to work saving Americans' homes and jobs instead of distracting them with sides shows and ‘voodoo healthcare' they'd have to actually deal with the mess they've made of this country.
Now that would be a show worth watching.
20 Comments so far
Show AllIn May my Congressman Jason Altmire Dem 4th district said to me,"You again--I keep on seeing you at these town meetings and I will tell you now what I told you then, "you are not going to get Single Payer." And in a town meeting with Senator Casey he sAId to the group jeering, yelling and deriding him, "look I'm just as afraid of government run Health care as you are." I did not boo. I sat dejected and feeling betrayed. Niether politician will ever get my vote again--not that either is very worried about it. They and others in the Democratic party have told me directly what an inconsequential minority I am. They just want me out of their hair. Let them lose big in 2010 and let the loss become defined because support from the progressive left was lacking. Then let them come to us in 2012 and ask for our support. Let us only give it on condition--- if we want to have anything at all to do with them. They will not respect us until they feel our wrath at the voting booth. They have to fear losing us more than losing corporate money. They have to be so discredited as sell outs that they fear taking that corporate money. We have a long way to ge before we get there. Vote Green, challlenge in primaries if you stay Democratic, don't support your union leaders who will almost certainly tell you to vote Democratic. They have hurt us, they have shown us no respect. WE HAVE TO HURT THEM.
What else can we expect from the most corrupt government corporate money can buy?
"You have no choice. You have owners." George Carlin
Its time to build a new political party and kick these reactionary clowns out of power.
More like HOODOO healthcare; for all the DEM "good" they're doing, they may as "well" be stone reliefs on the columns of CONgress. Since no single-payer, SINGLE TERMS for DEM ALL, their "red" running dogs and miserepublican masters!
your wrong about public campaign financed elections. they WILL
STILL TAKE BRIBES because that is the nature of the political
beast! until people who aren't politicians take office or
we get into the street like our european counterparts we will
be stuck in the dictatorship WE LIVE IN PRESENTLY. its time
to get our asses by the millions to dc and change this
country. we have to take this back by all means necessary!
Change can happen with rotten people in office.
As is, the bribe-takers have a lock on elections because the bribe money pays the media and the voters trust the media slightly - and therefore wa-a-ay too much.
Even people who would rather act well cannot act well and stay in office in most districts.
Without purchasable elections, even psychopathic monsters would be under some compunction to satisfy an only moderately nutsy electorate.
This is an excellent article. Thank you Sandy.
I keep remembering Obama saying that the economic goal of health care reform was to "slow the RATE of growth" of the cost of insurance. And now it's not clear if the bills under consideration would even achieve that pathetic goal.
"...your mean-spirited tone seems unnecessarily hostile."
Not hostile--just outraged. Especially when it comes to bartering for people's health.
Now THAT'S mean-spirited!
So far as these Democrat insurance company lapdog Benedict Arnolds go, we all need to work to REMOVE THEM FROM OFFICE!
The murderous racket that passes for our healthcare system will not change until hundreds of thousands of Americans stand up and demand change by protesting in the streets, at congressional reps' offices and in barring insurance company entry-ways. http://www.commondreams.org/headline/2009/10/28-11
Not until we build a strong Single-Payer movement and all speak with one voice will this murderous economic racket lose momentum.
Enough with the party politics, enough playing games with taxpayer money and funneling favors and billion dollar bailouts to your Wall Street buddies Washington.
It's clear now Congressional Democrats are no better than their smarmy GOP counterparts.
We need a strong grassroots movement for Single-Payer and coordinated direct-action campaigns across the country to hold these empty suits accountable to the 45,000 Americans who die each year because they have no healthcare.
Join the grassroots direct-action protest movement for health justice in this country: http://mobilizeforhealthcare.org/
And please give my modest little blog a look and sound-off while you're at it: http://pubofidealism.wordpress.com/
- Clergyman P-Ray
"According to Robert Laszewski, president of Health Policy and Strategy Associates, the current House proposal works pretty well for families making $20,000 or $30,000 a year. "A family making $27,000 a year will pay about $1,000 (annually) toward their health insurance," he told Jim Lehrer on PBS' News Hour."
Um, what about the co pays and the deductibles? The House bill does NOT work for families in that income bracket, except for those who don't get any actual health care. In fact, the huge health insurance corporations are counting on a large number of people to be too tapped out from the premiums and all the other taxes and basic costs of living to actually dare to get health care and face the deductibles and co pays under the policies they were forced to buy by the American right wing government.
Health reform can never happen in the US until you have campaign finance reform.
As long as the insurance industry can throw millions at congressmen, congress will never consider any real reform. The basic problem is only greedy, power hungry egoist scumbags tend to run for public office.
The US should change the motto from "In God We Trust" to "Fuck You, I Got Mine"
"The only means of strengthening one's intellect is to make up one's mind about nothing, to let the mind be a thoroughfare for all thoughts." - John Keats
Wow, I couldn't imagine having to pay $500/month for health care!
To gregsdiary:
You wrote: "The entire premise of health care reform is not "greater public access" it is taking out the profit-motive from where it doesn't belong. If the author of this article hasn't figured that out by now--they never will. I just wish this author and others like them would "stop pretending they're doing something" for healthcare reform when clearly they are not."
There's plenty of room for disagreement with respect to the "entire premise of health care reform" I happen to agree with your primary point about the 'profit motive,' although your mean-spirited tone seems unnecessarily hostile. You seem to have missed the point I was making entirely. That is, that without greater access to healthcare - healthcare for all - it won't matter much what the motive is. People like myself who work hard every day to support their families, who may (like myself) be dealing with incurable or terminal illnesses, will still be left out on the curb to die. As far as your comment: "I just wish this author and others like them would "stop pretending they're doing something" for healthcare reform when clearly they are not." I would be very careful about making assumptions about people you know nothing about. What have you done to improve the system - or the world - lately?
"Wall Street, the insurance industry and their Democratic lap dogs (only some of whom are blue) have made a mockery of the entire premise of health care reform - greater public access."
The entire premise of health care reform is not "greater public access" it is taking out the profit-motive from where it doesn't belong.
If the author of this article hasn't figured that out by now--they never will.
I just wish this author and others like them would "stop pretending they're doing something" for healthcare reform when clearly they are not.
With a very few valiant exceptions, the members of Congress, Democrat and Republican, could care less whether Americans live or die. They stopped listening to their constituents years ago and now they don't even bother to pretend.
I voted for the Democrats in 2006 and for Obama in 2008 because it seemed to me essential to get rid of the Republican rampage through the Constitution. The Constitution isn't doing any better today and the green jobs and healthcare we were promised have gone to pay for more war in Afghanistan and Iraq, and more private jets for Wall Street.
Soldiers fighting overseas give up their families, their friends and often their health and their lives. We have to be prepared to do the same thing if we are going to win back government by the people and for the people. The economy is wrecked for us but not for the Congress or the rich. Congress has blue ribbon health care paid for by us; millions of us don't even have homes anymore. 57% of our taxes go to the military, Health and Human Services get 6%, and Housing and Urban Development get 4%. Is this what America is supposed to look like?
Non-cooperation and boycotts are hallowed elements of non-violent resistence, used by both Gandhi and Martin Luther King. We have to stop cooperating with the banks and the corporations. We have to withdraw our money from this twisted economy. Like the soldiers overseas we will have to make huge sacrifices and a lot of little ones too.
If you're lucky enough to still have a job, cash your paycheck and leave only enough in the bank to cover bills you can't pay in cash. Close out your savings accounts. If you're really lucky and have a job with a pension fund or IRA get out of it. If you own stocks sell them. Don't let the banks have the use of your money for even one night if you can avoid it.
Stop shopping. Yes, I know I keep saying this. Essential food, essential medicine, essential transportation. Nothing more. Buy the children's Christmas presents second-hand through the charities. No holiday travel, no new Christmas decorations unless they come from the thrift shops. Christmas is the biggest time of the year for consumerism and consumerism (we're told) is 70% of our economy. Well, we're taking our economy back. The corporate elites are spending the money they make from us to bribe Congress (it's politely termed lobbying) to stab us in the back. Every time you don't buy something remember you're denying them a dollar they would use to buy your Senator or Congressman.
Last but not least, stop watching TV. The mainstream media, all five coporate owners of it, are only there to pass on lies and the programming is only there to capture your eyes and sell them to the advertisers. Selling your eyes and ears is a multi-billion dollar business for them. Tell them you're not for sale. The only exception I would make would be Free Speech TV or Link TV.
I'm sure you can think of hundreds more ways to boycott and refuse to cooperate with the economy which is so happy to leave millions of Americans, including millions of children, out in the cold. Let's get together and be creative.
Lynn Woolsey, progressive Dem Rep from CA, was on the Bill Press show today. She confirmed one of the points made in this article that the current bill once passed will NOT be a gateway to single-payer. She said it'll be the last congress does on the subject "at least in her lifetime" (her words).
SEAGLASS__What a delightful comment!! It makes one realize we have more problems in this country than health care, like, say proper ways of expressing oneself. We are all disgusted with the way things are going, but try counting to ten and running around the block before offering opinions.
I enjoyed SEAGLASS's spirited comment!
Sauce for the goose.
· Yr Obd't Servant
ENOUGH ALREADY! I wish Nancy and REID and Obama would STFU about this SHIT TACO they've pushing out their collective anal ports! It's NOT HEALTH CARE REFORM !! It's NOT even Health Ins. REFORM! It's a HUGE Federal ( AKA Taxpayer financed) giveaway to the SAME Fucking Vampires that are already sucking us dry! The Dems. think passing this piece of crap is going to be a BIG plus for them politically and when the Ins. Mafia hikes rates into the friggin sky they'll whine abd moan and blame them for not playing along with the plan, but that's not going to FOOL anyone out here much. It's hard to believe these bastards really think were all so stupid! Maybe we are for electing these lying sacks of Shit.
ditto