Squeeze Insurance Profiteers, Not Medicare

At a critical moment in the tense health care debate -- when the U.S.
House and Senate are scrambling to forge compromise reform plans that
might be passed before the Congress embarks upon its traditional August
recess -- President Obama is retooling his health-care reform message.

Instead of the bold rhetoric of last year's campaign, or even of
last month's press conferences, the president is now pitching reform as
more of a consumer-protection gambit.

"No one is talking about some government takeover of health care," Obama explained to the crowd at his latest town hall meeting in North Carolina on Wednesday.

Rather, the president argued that his reform vision would make insurance companies more responsible.

"We have a system today that works well for the insurance industry,
but it doesn't always work well for you," Obama told 2,000 people
gathered in a Raleigh high school gymnasium. "What we need, and what we
will have when we pass these reforms, are health insurance consumer
protections to make sure that those who have insurance are treated
fairly and insurance companies are held accountable."

Obama wants to do this by:

* requiring insurers to set annual caps on how much they can charge for out-of-pocket expenses,

* requiring insurers to fully cover routine tests to help prevent illness,

* requiring insurers to renew any policy as long as the policyholder paid the premium in full,

* barring insurers from refusing coverage because of pre-existing
conditions, scaling back insurance for people who fall very ill,
charging more for services based on gender and/or placing limits on

* barring insurers from denying children family coverage through age 26.

These are pretty good ideas.

Unfortunately, they tinker around the issue of affordability -- the great challenge for tens of millions of Americans who have access to health care but lack the resources to pay for the coverage they need.

For those who would seek to control costs in a responsible manner,
the dangerous trend in the health-care debate at this point is toward
schemes that would see the federal government providing money to
low-income families so that they can buy care from high-income
insurance companies.

That's nothing more than a giveaway to insurance companies. And it will not control costs.

In fact, if the Medicare "reform" experience of recent years is an
indicator, the likelihood is that costs will skyrocket as insurers hike
prices to pay for advertising and maintain excessive profits. And how
much does anyone want to bet that the advertising will highlight the
"services" they are required to provide by Obama's consumer

Whenever anyone talks about controlling health-care costs, the
important thing to remember is that private, for-profit insurers drive
costs up in order to make money.

That's what's maddening about the focus of so much of the congressional negotiation that is currently going on.

As Obama's message illustrates, some attention is being paid to the
problem of insurance companies that collect money from healthy people
and then refuse to care for sick people.

That's good.

But scant attention is being paid to the problem of insurance
companies that charge Americans -- be they well or ill -- too much.

Instead, in order to draw support from conservative "Blue Dogs" and corporatist "New Democrats," congressional leaders are talking about putting the screws to Medicare -- a public program that is popular and that actually delivers care to tens of millions of Americans.

Congressional officials tell the Associated Press that Senate
Finance Committee chair Max Baucus, D-Montana, has reportedly forged a
tentative agreement with wavering Democrats and supposedly moderate Republicans in the Senate to
cut "squeeze an additional $35 billion out of Medicare over the next decade and larger sums in the years beyond."

"Under the plan," AP is reporting, "an independent commission would be
empowered to recommend changes in Medicare annually, to take effect
automatically unless Congress enacted an alternative... The commission
would be required to recommend $35 billion in savings over a decade
from Medicare."

When used by Washington insiders to describe changes in how a
safety-net program, the word "savings" usually translates as "cuts."

So, as of today, health care "reform" is shaping up as scheme to
impose consumer protections on insurers while squeezing Medicare with
cost controls that will be implemented not by Congress but by an
"independent commission."

Honest reform must include consumer protections. But that's just a starting step.

The question remains: What will be done to make coverage affordable?

Here's a notion: Instead of setting up an independent commission to
squeeze Medicaid and Medicare, how about an independent commission to
squeeze insurance company profits?

Here's an even better notion: Instead of trying to make insurance
companies do the right thing, why not set establish a single-payer
program that takes as its mandate the coverage of all Americans in a
system that controls costs by operating on a not-for-profit model?

After all, that's what a wise legislator said when he was asked
about controlling costs while delivering health care to all Americans.

Here's what he said.

"I happen to be a proponent of a single payer universal health care
program. I see no reason why the United States of America, the
wealthiest country in the history of the world, spending 14 percent of
its Gross National Product on health care, cannot provide basic health
insurance to everybody. And that's what [single-payer advocates are]
talking about when he says everybody in, nobody out. A single payer
health care plan, a universal health care plan. And that's what I'd
like to see."

The legislator's name was Barack Obama.

© 2023 The Nation