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
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,"
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
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.
© 2023 The Nation
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