Talking About Health Reform, But Not About A Cure
Health care reform is a vital and engaging concern for America - and for Americans.
But you would not know it from Thursday's White House Forum on Health Reform, which was so narrowly focused and uninspiring that it almost made Hillary Clinton's bumbling efforts of the 1990s look good.
President Obama sounded some of the right notes:
Now I know people are skeptical about whether Washington can bring about this change. Our inability to reform health care in the past is just one example of how special interests have had their way, and the public interest has fallen by the wayside. And I know people are afraid we'll draw the same old lines in the sand, give in to the same entrenched interests, and arrive back at the same stalemate we've been stuck in for decades.
But I am here today because I believe that this time is different. This time, the call for reform is coming from the bottom up, from all across the spectrum - from doctors, nurses and patients; unions and businesses; hospitals, health care providers and community groups. It's coming from mayors, governors and legislatures - Democrats and Republicans - who are racing ahead of Washington to pass bold health care initiatives on their own. This time, there is no debate about whether all Americans should have quality, affordable health care -- the only question is, how?
Unfortunately, that is a mighty major "only question."
And the people who in the past have answered it wrong were in the room and at the table Thursday. Indeed, they were bragging about their successes in blocking past reform initiatives. "I don't see what happened in the '90s as a failure," Congressman Joe Barton, the Texas conservative who is the ranking Republican on the House Energy and Commerce Committee, told a breakout session at Thursday's forum.
Barton was not an outlier.
The East Room at the White House was packed with the political players, union leaders and corporate lobbyists -- some of them good, many of them bad -- and a few administration-designated "Everyday Americans," who helped to illustrate the depth of the crisis that the insiders have allowed to metastasize over the past decade or so.
Only a handful of serious reformers got in the room.
Thanks to pressure from the Leadership Conference for Guaranteed Healthcare, Physicians for a National Health Program, Unions for Single Payer Health Care and the Progressive Democrats of America, an invitation was extended to House Judiciary Committee chair John Conyers, D-Michigan, the sponsor of H.R. 676, legislation that seeks to create a the single-payer insurance program that would take profiteering out of the health care system.
A few other real reformers were heard from -- including Californian Congressman Pete Stark.
And Dr. Oliver Fein, the director of Physicians for a National Health Plan was in the room.
But right before the doctor from Physicians for a National Health Plan on the White House list of "Community Leaders and Stakeholders Expected to Attend" were the CEOs of Pfizer and Pharmaceutical Research and Manufacturers of America (PhRMA).
And while the doctor was not included on any of the lists of breakout session speakers, the CEOs were, along with representatives of the U.S. Chamber of Commerce, America's Health Insurance Plans, the Blue Cross Blue Shield Association and the Business Roundtable.
In other words, the overwhelming weight of opinion at what was supposed to be a wide-ranging discussion of health reform was -- at best -- on the side of tinkering with the existing for-profit system.
Change we can believe in was not on the agenda.
Who could have put it there?
Dr. Quentin Young, the Chicago physician who served as the Rev. Martin Luther King Jr.'s personal physician and whose medical office once included a young Chicago activist named Barack Obama on its patient list, ought to be at the table. Here's Young discussing his support for single payer.
And where, on the lost list of members of Congress present, was the name of U.S. Rep. Tammy Baldwin? Elected to Congress as an outspoken advocate for single-payer health care, the Wisconsin Democrat is a member of the key committee in the House that deals with health care issues -- Energy and Commerce -- and she has succeeded in developing bipartisan coalitions that allow for state experimentation with various reform plans. In other words, she's a principled yet very practical player in the debate.
Baldwin should have been speaking.
So, too, should have been the working nurses of the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), the union that represents 85,000 RNs in all 50 states.
Ardent advocates for real reform, CNA/NNOC members correctly argue that: "Insurance-based reform will fail, and undermine public trust; only Medicare for All can achieve administration goals"
Here's what the nurses are saying:
While welcoming President Obama's call for achieving "comprehensive" healthcare reform this year, "a laudable commitment and a huge departure from the dismal healthcare policies of the past eight years," the California Nurses Association/National Nurses Organizing Committee warned that most of proposals floating around Congress would default on the promise and principles set by the administration.
"And, they would almost certainly fail to contain the rising costs that put so many families in peril or to repair our broken healthcare system," said CNA/NNOC Co-president Geri Jenkins, RN.
"That's the reason the majority of the nation's nurses and doctors -- the very people who have the most daily interaction with our healthcare system and see its failures and tragedies up front, favor a single-payer approach, or expanding Medicare to all."
"To achieve the lasting and cost-effective reform the president seeks and most Americans desire, we must confront the source of the present crisis -- an insurance industry that has been steadily pricing people out of access to care, or bankrupting them if they attempt to use it," Jenkins said. "Insurance company practices drive skyrocketing costs, a problem that won't be solved by more technology, electronic medical records, or any other stopgap measures some propose."
Jenkins welcomed the principles outlined by the administration for reform, and the call for progressive tax changes to help finance them, but warned that any reform "premised on expanding an insurance-based system will likely fail, frustrate the public desire for a real solution to our healthcare crisis, and undermine the political capital the administration has earned for reform."
"Private insurance plans aren't universal because they exclude people based on pre-existing conditions or age or anyone else they think will be expensive to cover. They don't guarantee choice of physician or hospital, but limit you to their network of providers.
"The insurers won't assure affordability because they are constantly raising premiums, deductibles, co-pays, and other fees to generate high revenues and profits. They can't guarantee safety and quality because they actively discourage the delivery of care or deny treatments, diagnoses, or referrals they don't want to pay for. And, they will never be fiscally responsible because there is no independent oversight, decisions are made in secret in closed boardrooms or CEO offices, and, their priority is profits, not care," Jenkins said.
"Medicare for all, however, does succeed in all eight areas. It removes the incentive for price gouging, and it takes control of our health away from the insurance companies, and puts it where it belongs, in the hands of patients, families, and their doctors and nurses," said Jenkins.
This reform, she added also promotes national recovery by creating 2.6 million new jobs, infusing $317 billion in new business and public revenues, and injecting $100 billion more in wages into the U.S. economy, according to a recent CNA/NNOC study.
HR 676, the U.S. National Health Care Act by Rep. John Conyers, is the plan that best meets the grand vision painted by our president. "We call on Congress and the administration to work with us to enact it," Jenkins said.
The point here is not to give up on the Obama administration as a vehicle for real reform.
White House forums of the sort that was held Thursday are "for the cameras" events that set the tone -- not the policy -- of an administration.
The president knows that single-payer is the right fix for what ails the American health care system.
He was once a reasonably consistent advocate for a single-payer system, appearing at events in Chicago organized by Dr. Young and Physicians for a National Health Care Plan.
As recently as last August, Obama told a health care forum in New Mexico that, "If I were designing a system from scratch, I would probably go ahead with a single-payer system."
The insurance industry and its allies don't want to start from scratch and make a system that works.
They want to keep patching up a system that doesn't work -- that fails to provide care to roughly 50 million Americans, that leaves another 50 million under-insured and that is defined more by its cost overruns than its quality -- so that they can keep profiteering.
Thursday's White House sessions provided a great forum for advocates of "patching up" and "tinkering" with a broken system.
But that's not the treatment that is needed. That's a prescription for failure.
Obama is better positioned that any president in decades -- perhaps ever -- to design a system from scratch.
The special interests, corporate insiders and congressional compromisers who made the mess and fear the change won't remind him of that fact - as Thursday's forum so amply illustrated.
Real reformers should keep banging on the doors and demanding a place at the table.
Single payer is not "an alternative."
It is not one of "various treatment options."
It is the cure.
© 2009 The Nation