We need a Coffee Party to wake up the American people, and there are fewer better wake up calls than Steven Brill's outstanding recent Time cover story, "Bitter Pill." Indeed, if you have time to read only one essay this month, make it this one. It not only reveals how we can protect Medicare from the right-wing assaults (and a president who seems all too anxious to cut a deal) -- but also what ails America's health care system, indeed the whole political system, and what must be done to fix it.
If I had to put it all in a few lines, I would say that the Tea Party is half right; often our government is not working for the people and we ought to be pissed off. Unfortunately, the Tea Party channels this anger to the wrong address. The main issue is not that the government is too big, but that it is often captured by special interests, especially corporations. It often does their bidding rather than ours.
As Brills shows, in stark detail, the force driving up the cost of Medicare and private insurances is a health care-industrial complex that is even more powerful than the one built around the military. It spends over three times more on lobbying in Washington than the defense and aerospace industries and over four times as much as oil and gas interests. This money has been proven well-spent: the industry has made scores of billions of dollars each year by acts such as successfully pressuring Congress to prohibit Medicare from negotiating drug prices with the pharmaceutical companies.
Meanwhile, pharmaceutical companies spend about as much money promoting drugs as they do conducting research, often getting people to use medications that they do not need or more expensive ones where generic would do. (Such marketing is facilitated by the industry getting the government to lift the ban on advertising drugs on TV -- a ban which is in place in other developed nations.) The health care-industrial complex ensures that executives of hospitals rake in exorbitant salaries while health corporations record obscene profit margins.
You might expect insurance companies to pressure hospitals to hold costs down because insurers get to keep the difference between what they charge customers and what they pay out to health care providers. However, Brills shows, more and more hospitals have formed semi-monopolies, buying up other hospitals in the area as well as private practices, thereby leaving insurers unable to squeeze them due to the fact that insurance companies may have no place to which they can send the insured for treatment.
Brill proves, beyond a reasonable doubt, that Medicare is not the problem, but part of the cure. It provides health care at much lower costs than other insurance schemes, although it, too, cannot arm wrestle with many health providers and is overcharged by them. For example, for a stress test for which people without Medicare are charged almost $8,000, Medicare pays only $550. While the costs of processing a claim cost private insurer about 30 dollars, they cost Medicare less than four.
We can try to tackle these issues one at a time. Fight polluters to save the environment and stop the earth from overheating; vie with the NRA to get some minor gun control measures -- favored by the majority of Americans -- enacted; and try to protect Medicare from those seeking to undo it, and so on and on. Or, smell the coffee, and realize that unless we unite to form a progressive movement, out to serve the common good, strong enough to serve as a counterweight to special interests, we shall make little progress on any of these fronts, health care in particular.
Amitai Etzioni is a University Professor at The George Washington University and author of Hot Spots: American Foreign Policy in a Post-Human Rights World, published by Transaction.
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