Jul 12, 2010
A close reading of the new health care
legislation, which will conveniently take effect in 2014 after the next
presidential election, is deeply depressing. The legislation not only
mocks the lofty promises made by President Barack Obama, exposing most
as lies, but sadly reconfirms that our nation is hostage to unchecked
corporate greed and abuse. The simple truth, that single-payer
nonprofit health care for all Americans would dramatically reduce costs
and save lives, that the for-profit health care system is the problem
and must be destroyed, is censored out of the public debate by a media
that relies on these corporations as major advertisers and sponsors, as
well as a morally bankrupt Democratic Party that is as bought off by
corporations as the Republicans.
The 2,000-page piece of legislation,
according to figures compiled by Physicians for a National Health Plan
(PNHP), will leave at least 23 million people without insurance, a
figure that translates into an estimated 23,000 unnecessary deaths a
year among people who cannot afford care. It will permit prices to
climb so that many of us will soon be paying close to 10 percent of our
annual income to buy commercial health insurance, although this
coverage will only pay for about 70 percent of our medical expenses.
Those who become seriously ill, lose their incomes and cannot pay
skyrocketing premiums will be denied coverage. And at least $447
billion in taxpayer subsidies will now be handed to insurance firms. We
will be forced by law to buy their defective products. There is no
check in the new legislation to halt rising health care costs. The
elderly can be charged three times the rates provided to the young.
Companies with predominantly female work forces can be charged higher
gender-based rates. The dizzying array of technical loopholes in the
bill-written in by armies of insurance and pharmaceutical
lobbyists-means that these companies, which profit off human sickness,
suffering and death, can continue their grim game of trading away human
life for money.
"They named this legislation the Patient
Protection and Affordable Care Act, and as the tradition of this nation
goes, any words they put into the name of a piece of legislation means
the opposite," said single-payer activist Dr. Margaret Flowers when I heard her and Helen Redmond
dissect the legislation in Chicago at the Socialism 2010 Conference
last month. "It neither protects patients nor leads to affordable care."
"This legislation moves us further in the
direction of the commodification of health care," Flowers went on. "It
requires people to purchase health insurance. It takes public dollars
to subsidize the purchase of that private insurance. It not only forces
people to purchase this private product, but uses public dollars and
gives them directly to these corporations. In return, there are no caps
on premiums. Insurance companies can continue to raise premiums. We
estimate that because they are required to cover people with
pre-existing conditions, although we will see if this happens, they
will argue that they will have to raise premiums."
The legislation included a few tiny
improvements that have been used as bait to sell it to the public. The
bill promises, for example, to expand community health centers and
increase access to primary-care doctors. It allows children to stay on
their parent's plan until they turn 26. It will include those with
pre-existing conditions in insurance plans, although Flowers warns that
many technicalities and loopholes make it easy for insurance companies
to drop patients. Most of the more than 30 million people currently
without insurance, and the 45,000 who die each year because they lack
medical care, essentially remain left out in the cold, and things will
not get better for the rest of us.
"We are still a nation full of health care hostages," Redmond said. "We
live in fear of losing our health care. Millions of people have lost
their health care. We fear bankruptcy. The inability to pay medical
bills is the No. 1 cause of bankruptcy. We fear not being able to
afford medications. Millions of people skip medications. They skip
these medications to the detriment of their health. We are not free.
And we won't be free until health care is a human right, until health
care is not tied to a job, because we still have an employment-based
system, and until health care has nothing to do with immigration
status. We don't care if you are documented or undocumented. It should
not matter what your health care status is, if you have a disease or
you don't. It should not matter how much money you have or don't,
because many of our programs are based on income eligibility rules.
Until we abolish the private, for-profit health insurance industry in
this county we are not free. Until we take the profit motive out of
health care we cannot live in the way we want to live. This legislation
doesn't do any of that. It doesn't change those basic facts of our
health care system."
Redmond held up a syringe.
"I take a medication that costs $1,700
every single month," she said. "I inject this medication. It costs $425
a week for 50 milligrams of medication. I would do almost anything to
get this medication because without it I don't have much of a life. The
pharmaceutical industry knows this. They price these drugs accordingly
to the level of desperation that people feel. Billy Tauzin, the former
CEO of [the trade organization of] Big Pharma, negotiated a secret deal
with President Obama to extend the patents of biologics, this new
revolutionary class of drugs, for 12 years. And Obama also promised in
this deal that he would not negotiate drug prices for Medicare."
Obama's numerous betrayals-from his
failure to implement serious environmental reform at Copenhagen, to his
expansion of the current wars, to his refusal to create jobs for our
desperate class of unemployed and underemployed, to his gutting of
public education, to his callous disregard for the rights of workers
and funneling of trillions in taxpayer money to banks-is a shameful
list. Passing universal, single-payer nonprofit health care for all
Americans might have delivered to Obama, who may well be a one-term
president, at least one worthwhile achievement. Single-payer nonprofit
health care has widespread popular support, with nearly two-thirds of
the public behind it. It is backed by 59 percent of doctors. And it
would have helped roll back, at least a bit, the corporate assault on
Medical bills lead to 62 percent of
personal bankruptcies, and nearly 80 percent of these people had
insurance. The U.S. spends twice as much as other industrialized
nations on health care, $8,160 per capita. Private insurance
bureaucracy and paperwork consume 31 percent of every health care
dollar. Streamlining payment through a single nonprofit payer would
save more than $400 billion per year-enough, PNHP estimates, to provide
comprehensive, high-quality coverage for all Americans.
Candidate Obama promised to protect
women's rights under Roe. v. Wade, something this legislation does not
do. He told voters he would create a public option and then refused to
consider it. The health care reform bill, to quote a statement released
by PNHP, has instead "saddled Americans with an expensive package of
onerous individual mandates, new taxes on workers' health plans,
countless sweetheart deals with the insurers and Big Pharma, and a
perpetuation of the fragmented, dysfunctional, and unsustainable system
that is taking such a heavy toll on our health and economy today."
"Obama said he was going to have everybody
at the table," Redmond said, "but that was a lie. Our voice was not
allowed to be there. There was a blackout on our movement. We did not
get media attention. We did actions all over the country but we could
not get coverage. We had the 'Mad as Hell Doctors' go across the
country in a caravan, and they had rallies and meetings. If that had
been a bunch of AMA Republican doctors, Cooper Anderson would have been
on the caravan reporting live. NPR would have done a series. Instead,
they did not get much coverage. And neither did the sit-ins and arrests
at insurance companies, although we have never seen that level of
activity. They turned us into a fringe movement, although poll after
poll shows that the majority of people want some kind of single-payer
for-profit health system is driven by insurance companies whose goal is
to avoid covering the elderly and the sick. These groups, most in need
of medical care, diminish profits. Medicare, paid for by the
government, removes responsibility for many of the old. Medicaid, also
paid for by the government, removes the poor people, who have a greater
tendency to have chronic health problems. Hefty premiums, which those
who are seriously ill and lose their jobs often cannot pay, remove the
very sick. If you are healthy and employed, which means you are less
likely to need expensive or complex treatment, the insurance companies
swoop down like birds of prey. These corporations need to control our
perceptions of health care. Patients must be viewed as consumers.
Doctors, identified as "health care providers," must be seen as
Insurance companies, which will soon be
able to use billions in taxpayer dollars to bolster their lobbying
efforts and campaign contributions, know that single-payer nonprofit
insurance means their extinction. And they will employ considerable
resources to make sure single-payer nonprofit coverage is denied to the
public. They correctly see this as a battle for their lives. And if
human beings have to die so they can survive, they are willing to make
us pay this price.
The for-profit health care industry, along
with the Democratic Party, consciously set out to confuse the public
debate. It created Health Care for America NOW! in 2008 and provided it
with tens of millions of dollars to supposedly build a public campaign
for a public option. But the organization had no intention of
permitting a public option. The organization was, as Dr. Flowers said,
"a very clever way to distract members of the single-payer movement and
co-op some of them. They told them that the public option would become
single payer, that it was a back door to single payer, although there
was no evidence that was true."
Physicians for a National Health Plan
attempted to fight back. It worked with a number of organizations under
a coalition called the Leadership Conference for Guaranteed Health
Care. The group, which included the National Nurse's Union and Health
Care Now, sought meetings with members of Congress. Flowers and other
advocates asked Congress members to include them in committee debates
about the health care bill. But when the first debate on the health
care reform took place in the Senate Finance Committee, chaired by Sen.
Max Baucus, a politician who gets over 80 percent of his campaign
contributions from outside his home state of Montana, they were locked
out. Baucus invited 41 people to testify. None backed single payer.
The Leadership Conference, which
represents more than 20 million people, again requested that one of
their members testify. Baucus again refused. When the second committee
meeting took place, Flowers and seven other activists stood one by one
in the room and asked why the voices of the patients and the health
care providers were not being heard. The eight were arrested and
removed from the committee hearing.
Single-payer advocates were eventually
heard on a few of the House and Senate committees. But the hearings
were a charade, part of Washington's cynical political theater. It was
the insurance and pharmaceutical lobbyists who were in charge. They
dominated the public debate. They wrote the legislation. They
determined who received lavish campaign contributions and who did not.
And they won.
"We are talking about life and death,
about the difference between living your life and dying," Redmond said.
"And once again it came down to the Democratic Party trumping the needs
of the people."
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