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Byron Williams

Byron Williams

Posted: July 26, 2009 02:56 PM

Debate on Health Care Is More About Politics Than Policy


Health care for all raises a series of fascinating questions.

Why does health care tend to poll better in theory and declines as it becomes closer to fruition? Why does America struggle with an issue that is fait accompli in other industrialized nations?

Why have presidential administrations dating back to 1935 offered the Utopian dream of affordable health care for every man, woman, and child only to have those efforts thwarted by the opposition?

Representing an estimated 15 percent of the economy, the health care industry is a fragmented behemoth consisting of, but not limited to, hospitals, HMOs, physicians, and pharmaceutical companies. Though they possess a variety of interests, many are galvanized in opposition to any new health care legislation and dedicated to maintaining the status quo that they are the ultimate benefactors.

The other problem that has plagued health care as an issue is cost. There are the upfront cost, currently estimated at $1.3 trillion; and if those costs cannot be controlled then there is the problem of health care inflation. Therefore, the possibility of a $1.3 trillion government program spiraling out of control is unfathomable.

Another aspect making health care legislation so challenging is what I define as an "intangible-tangible." It is an intangible until one becomes ill or hurt. At that point, health care becomes a tangible item -- assuming one has it.

The services that we receive are tangible, but the way health care is usually paid for tends to be intangible in the sense that it does not come directly out of pocket. Most of the debate is conducted while health care is in the intangible stage.

It is tough for President Barack Obama to make the "what's in it for me" argument needed to sway a majority of Americans to his side, especially since there has yet to be a clearly defined piece of legislation put forth.

It is difficult to expect a majority of Americans to support legislation that has yet to arrive, already expected to cost a daunting $1.3 trillion. But the $1.3 trillion cost is based on a 10-year period, making the projected health care cost on an annual basis on par with the cost America is currently spending on war. The differences being the cost associated with war are borrowed dollars. Any proposed health care legislation, as the president has already stated, must responsibly control cost, expand coverage, and provide choice.

Though cost is often discussed, it is not ultimately what the health care debate is about -- at least in the public conversation. To be sure, there are myriad public policy aspects to this legislation, some are quite complicated, but that's not driving the debate on Capitol Hill.

When Republican Sen. Jim DeMint of South Carolina stated in an e-mail: "If we're able to stop Obama on this, it will be his Waterloo. It will break him," it became the most accurate barometer for the political health care debate.

At last week's press conference the president suggested the health care debate was not about him. I disagree; it is definitely about him.

DeMint's comments were not about the 47 million people who don't have health care; it was about stopping the president's agenda.

If stopping Obama on health care would be his Waterloo, would it also be fair to conclude the passage of health care would be the Republicans' Waterloo?

If President Obama were successful on health care, he would have accomplished something that was beyond the reach of Presidents Roosevelt, Truman, Johnson, Carter, and Clinton. He would have ushered in the most significant domestic legislation since Roosevelt signed the Social Security Act in 1935.

Social Security helped Democrats become the dominate political party for more than a generation, are not the same stakes at play if the president signs health care legislation that meets his criteria of cost, coverage, and choice?

As a result, the GOP is forced to advocate for a status quo that has its own spiraling cost that leaves out 47 million individuals, by using the primordial tactics of fear.

Seldom, in American history, has the use of fear to sway public opinion in the short-term proven to serve the public interest in the long-term. Unfortunately for the Republican Party, as the old Texas saying goes: "You dance with who brung ya!"

Byron Williams is an Oakland pastor and syndicated columnist and blog-talk radio host. He is the author of Strip Mall Patriotism: Moral Reflections of the Iraq War. E-mail him at byron@byronspeaks.com or visit his website: byronspeaks.com

Follow Byron Williams on Twitter: www.twitter.com/byronspeaks

 
 
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This user has chosen to opt out of the Badges program
06:51 PM on 07/28/2009
The current bill is loaded with deals for special interests.

12 million of those listed as uninsured, are actually insured by Medicaid. They can use it when they need. 20 million of those listed are young men and their families, at 250% of poverty, who choose to not buy insurance. They choose, that's in interesting idea. Now you will take money away from those people by forcing them to pay.

The bill is also partially paid by $622 billion cuts in Medicare. The seniors will really be unhappy when they read this.

The current bill will just reward the special interest at the cost of the people.
Quit pitching for the special interests. Demand debate to get a bill that really helps people.
This user has chosen to opt out of the Badges program
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12:53 PM on 07/28/2009
What would happen if we all gave up our health insurance? Just said enough! After all, I've read here on Hufpo many times how we can just go to the E.R. if we need treatment. The repugs say the E.R. is there for us anytime.
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HUFFPOST SUPER USER
EbonBear
opinionated hairy man
10:10 AM on 07/28/2009
I think a lot of Republicans miss the point of a public healthcare option. They keep complaining that it won't turn a profit and will operate in the red. IT'S NOT SUPPOSED TO! Healthcare is not a product to be brought and sold like a cheeseburger, it's a service provided for the public good. Not everything has to make a profit. The US obsession with profits stymies this debate. The Post Office is a means of moving mail around for the mutual benefit of all. The fire service puts out fires for the mutual benefit of all. Public healthcare treats illnesses for the mutual benefit of all. It doesn't matter if it makes a profit, it just matters that you minimise the losses.

Guys, ITALY manages this. So do France, Germany, the UK, every other nation in the western world manages some form of universal healthcare without any of the horror stories that the right is touting. No, they're not perfect, far from it but they are a bunch better than you're poor, you get sick and you die. If you are honestly telling me that the US is so incapable of doing this that you're not even going to try then one has to ask: Why do you hate America?
05:11 AM on 07/28/2009
"Why have presidential administrations dating back to 1935 offered the Utopian dream of affordable health care for every man, woman, and child only to have those efforts thwarted by the opposition?"

Because the people are smart enough to know there is no such thing as a Utopia.
HUFFPOST COMMUNITY MODERATOR
montecarlo408
10:31 AM on 07/28/2009
Not for the everyday citizen, but as the blue blooded upper crust GOP if there is a utopia, and I'll bet you'll get an affirmative answer.
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TheCommons
I didn't quit. You just bored me.
12:57 PM on 07/28/2009
Yet the people don't seem smart enough to understand that the other leading nations in the industrialized have done a far, far better job than us in achieving affordable health care for every man, woman, and child in those countries.
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yukoner1
Living way up the left coast.
12:55 AM on 07/28/2009
Sitting here as a Canadian who for 45 of my 54 years has had absolutely no worry about health insurance, it is so tempting to look down at Americans and their struggle for health care reform. Except, of course, it was not any easy struggle in Canada. Single payer Health Care began in one Province (Saskatchewan) and was fought tooth and nail by doctors (who went on strike) and the health care establishment. (The Premier of the Province, Tommy Douglas was recently voted by Canadians as the greatest Canadian of all time.) Eventually, universal Health Care was accepted and in 1965 Medicare was established country wide. There have been problems but NO national government, leftwing, centrist or rightwing has dared to eliminate Universal Single Payer Health Care in Canada. Each province or territory has it's own rules., but there are national principles that all must abide by. In the Yukon we pay no fees for our care though that varies by jurisdiction. We are free to choose our own doctor and the only ONLY role of the Government is to pay the bill. We pay higher taxes on alcohol and tobacco and income to pay for our care. On the other hand, my restaurant has 12 employees and we not only pay nothing for their health care, we have nothing to do with it: they are all covered individually. I wish you all the luck, you're going to need it to get a truly decent health care system.
HUFFPOST COMMUNITY MODERATOR
montecarlo408
10:37 AM on 07/28/2009
Thanks for the encouragement. I don't think the whiners on here realize that this is a huge deal and that when this money is on the line, the establishment aren't going to go quietly into the night. This isn't about Pres. Obama. It's much bigger than that. We're talking about the end of an era.
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HUFFPOST SUPER USER
opprobrious
More speech. Less Flagging.
02:45 PM on 07/28/2009
Here's a recent poll on how Canadians actually feel about their system:

http://www.harrisdecima.com/en/downloads/pdf/news_releases/071009E.pdf
09:36 PM on 07/27/2009
I doubt that the 'conservatives" who are derailing real health care progress by endlessly repeating the untruthful talking points from the insurance industry are really Christians. Otherwise they would be quite worried about burning in hell for their constant lying.
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01:07 PM on 07/28/2009
They lie because they are greedy. Hell is too good for them.
07:07 PM on 07/27/2009
"I find it fascinating that American critics will root out any flaw and use it as excuse enough to keep the status quo, which, remember, means tens of millions of Americans have no insurance coverage, and millions more have the privilege of being ruined financially in life and death decisions. It's also exceedingly disingenuous to frame the discussion completely around an either/or scenario. If the American system is one extreme and the Canadian system is at the other, then the US has the opportunity to find the best of both systems and creating something uniquely American. I mean, the Canadian system isn't something you order and it comes in a crate that you pry open with a hammer an sickle."

More at:http://www.thelaloblog.com/1/post/2009/07/shona-holmes-does-not-speak-for-me.html
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HUFFPOST SUPER USER
opprobrious
More speech. Less Flagging.
03:06 PM on 07/28/2009
The Canadian system is funded by both the federal and provincial governments but administered by each province under the guidance of the federal Health Act. It works not unlike your medicare so you could simply extend medicare coverage to all citizens as a starting point and tweek it from there. And BTW, the provinces talk to one another and participate in "best practice" initiatives all the time.
What no one tells the average American is that Canadians also have access to extended medical insurance that covers things like prescriptions, short term and long term disability, dental etc. Private clinics are also available in some provinces as well for elective procedures, MRI's etc. This isn't the Soviet Union.
In reality, the biggest challenge to the Canadian healthcare system is twofold: 1. Your for-profit/eliminate the most costly patient system tends to put upward pressure on our costs and 2. powerful Canadians who have worked feverishly to subtly undermine key aspects of our system in an attempt to prove that it doesn't work by trying to make it fail.
Yet despite all that, Canadians would never go back to a for-profit system:

http://www.harrisdecima.com/en/downloads/pdf/news_releases/071009E.pdf
06:36 PM on 07/27/2009
The basis for any public option should be:
Coverage for EVERYONE who applies
Structured premium payments of not more than 100 per individual, 300 per family
Deductibles capped at $2000 and based on income (means testing every year like the va)
No mandates forcing people to purchase insurance (a windfall for private carriers)
No triggers (also a windfall to private carriers)
No subsidies to private insurance carriers
No taxes on employer provided benefits
If someone has private insurance and wants the public option, they can drop private with no problem and be covered immediately under public.
No mandates on employers to buy into the public option to cover employees. Has to be free choice.
Everyone with coverage gets treated for new or pre-existing conditions.
Fairly negotiated reimbursement to private pracitce, specialty doctors and hospitals
Fairly negotiated prices for medications, even on name brand stuff which has no generic equivalent.
AND IT HAS TO BE EFFECTIVE IMMEDIATELY. Within 1 month of the above bill passing, Americans must be able to start buying in and using it.
It must be administered by an autonomous federal agency. Monies paid in must not be co-mingled with any other money, does not go into the general fund so it can be looted.
The ONLY payouts from this fund will be for: payments to practicioners, pharmacies and admin. In 5 years if we see significan overages, those overages will be used to suplement medicare and fund medical research.
See my next post on funding
06:36 PM on 07/27/2009
47 million un insured
20 million under insured
Subtract 10 million poor/indigent/mentally ill, etc, who are uninsured and will have to get free care = 37 mill un-insured who can pay.
18.5 million can pay $50/mo = 925,000,000
18.5 mill can pay $100 = $1,850,000,000
20 mill under insured will switch and can pay $100 = 2,000,000,000
That is a grand total of $4,775,000,000
That is FOUR BILLION, SEVEN HUNDRED SEVENTY FIVE MILLION DOLLARS IN PREMIUM PAYMENTS PER MONTH. FIFTY SEVEN BILLION THREE HUNDRED THIRTY MILLION PER YEAR IN PREMIUMS FOR ONE SET OF PEOPLE.
That does'nt count the millions who'll switch from private companies if they can pay $100 or 200 per month and have their entire family covered even with pre-existing conditions. Repeal bush tax cuts asap another 700 billion.
After thinking about it more, institute a 1 penny federal sales tax on EVERY item. I can hear the opponents shouting about making the poor poorer, but my statement is 1 cent on each item NOT on every dollar or hundred dollars. From candy bars to big screen tv's to your house. 1 cent on everything. If your grocery bill was $100. for 53 items, your bill would be $100.53. That's not putting people in the poorhouse especially when we've been dealing with price increases. Also, if you're saving 300-500 per month on insurance, you have that money to spend and put back in the economy, save, or invest.
07:00 PM on 07/27/2009
DREAM ON MY FRIEND.

The public option is dead, aint gonna happen. WHY? Because the Federal govt. is ran by and for money, and the private insurers and drug companys have loads of money. WE DONT.

The politicians know this and will not vote in a public option which will change the gig for the for profiteers. The public option would force price reductions, and negotiate prices for drugs, reducing their sales and profits.

Guess how much money the private insurers and drug companys have to spend on defeating the public option..............hundreds of millions......to flood the airwaves to defeat the public option. To scare jim and jill sixpack, to defeat Obama care entirely.

So the politicians choose not to pick this fight, and will simply declare victory on reducing the number of uninsured.

The battle on cost reduction will be lost. In fact Obama care will only RAISE spending on health care as millions of formerly uninsured will now see a doctor. And guess what, they will need cholesterol lowering drugs, be prediabetic, hypertensive, needing more care and more drugs.

Obama care will FAIL miserably in reining in cost for health care and we will be back at this debate in the next decade when costs will be even higher.
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CelticMajic
The answer lies in each of us individually
04:31 PM on 07/27/2009
One of the major sticking points is should the taxpayer be responsible for life style choices that result in ill health? eg smoking, over eating, unhealthy eating, drug abuse, some aflicted with aids etc?
08:21 PM on 07/27/2009
In Canada we apply heavy sin taxes which effectively subsidizes the health care costs of people that consume junk food , smoke etc. ....I am sorry it appears that a strong public option might be off the table ...equal universal health care is a right for all. The Canadian system is decent middle ground approach I believe...private doctors and professional corps billing one single source ....your system needs campaign finance reform..in Canada politicians cannot take donations from corporations and or unions...and only small personal donations ....your politicians will always be slaves to their contributors and sell out their constituents
HUFFPOST SUPER USER
Konnie
01:14 PM on 07/28/2009
in the usa we encouraged the B$^tards to run up costs cause we are all about
profit and bonuses, big profits and big bonuses! we didn't start back before the greed
and before health care became just another profit making commodity like you canadians and the rest of the civilized world..........its too late.
we doomed.

guess we will just have to book flights to India for those medical-tourist trips......
the round trip airfare, health care received by american trained doctors, and recouperation at a resort is cheaper than just the operation here..........
isn't that sad.
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HUFFPOST SUPER USER
CJWebber
I think we all love teachers.
10:17 PM on 07/27/2009
Should the taxpayer be responsible for life-style choices that result in ill health?

Yes. Just as much as the taxpayer (you) benefits from the taxes of those who are concerned about fitness/nutrition. People who contribute more than they receive in benefits.

Otherwise, you would have someone between you and your doctor making decisions on healthcare. Someone who is judging your lifestyle. Exactly what you have now.
04:30 PM on 07/27/2009
The toadying federal and state governments allowed the insurance cartel convert the Blue Cross / Blue Shield from socialist cooperatives to for-profit companies a few years ago. The directors of the BS/BS and many government regulators received nice new salaries and bonuses.

Just another economic rape of the American people by Big Business and the GOP.
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CelticMajic
The answer lies in each of us individually
04:45 PM on 07/27/2009
and so you come to the conclusion that these same toadying federal and state governments should now run the nation's healthcare?
01:56 PM on 07/29/2009
The free-market has absolutely failed the American with respect to health care. The government does a pretty good job of getting the mail delivered, conducting wars collecting taxes, making Social Security payments, signing treaties and fighting fires etc.

When the Rethugs are not de-regulating in the interests of the mega-corps and shifting the power away from the public, the US government has historically performed many of its functions well.
03:39 PM on 07/27/2009
This (politics over policy) is self-evident, all you have to do is look at the repub talking points. No where is there solutions or even recommendations how to improve health care and access for Americans, access to health insurance they have mentioned, but not access to health care. All the repubs talk about is how to stop or slow down reform to be a 'waterloo' for Obama.
03:50 PM on 07/27/2009
Obama stated in his last press conference that there were 120 Republican recommendations included in the current legislation as it stands.
03:29 PM on 07/27/2009
Let's look at some facts for a change.

These are the top 7 health insurance companies based on profit over the trailing 12 months, if they're not in this list then they're making less profit than these:

AFLAC Inc. 10.68%
Aon Corp. 8.69%
Stancorp Fin'l (Standard Insurance Company) 8.15%
Assurant Inc. 7.82%
Unum Group 7.17%
Triple S Mgmt. 2.84%
American Independent 0.38%

Let's bust some fiction. Fiction 1: The argument that private healthcare is a monopoly on its face is silly, a monopoly is one company that controls an industry, there's many healthcare companies.

Fiction 2: Healthcare companies are greedy. Look at the profit margins of the top performers, you call that greed? Ridiculous. Now, I will be the first to say that there's greed with individual executives that occurs, but this is a problem in many large enterprises. The salaries that these greedy clowns make in some cases is obscene, but a drop in the bucket relative to "costs of healthcare"

Fiction 3: That government will operate our healthcare efficiently and lessor expense. Please list your government run programs that are in the black. If they're in the red than (which they are) then why would you trust government to run 20% of our economy?
04:05 PM on 07/27/2009
Fiction 4: Government will create "competition". Let's remember that government can print money, and they can bleed red ink forever (well at least until the tax payers are maxed on what they can be taxed). How long will the competition last then? Seriously, I've posted the proit margins of the best healthcare companies, these companies can not run in the red indefinitely like the government can. So once these companies go out of business laying off 100's of thousands in jobs, including a few greedy execs (the only minimal silver lining), then the government takes over, and yes, you still have marginally cheaper insurance. But wait, a few years go by, costs keep going up (remember the red ink?), all of a sudden government has gone through all the millionaires it can tax to pay for it, nothing else will be left to do but start looking for ways to save or the country goes bankrupt, that would be tax the middle class and starting to adopt some of the EU policies of rationing.

Some here exclaim EU single payor system rationing is a myth, I implore you to get past anecdotes and review the readily available material that many EU countries are facing relative to healthcare.

Sure, healthcare is expensive, read my earlier post on ways to fix it.
05:43 PM on 07/27/2009
Fiction 5 -- All of the above.
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Oldsop
Libertarian...mostly
05:18 PM on 07/27/2009
Amplifryer for president!!!!!
05:40 PM on 07/27/2009
Right. Because you live in a democracy? Wasn't this you?

Oldsop I'm a Fan of Oldsop I'm a fan of this user permalink

"We do not live in a democracy.
We live in a democratic republic."

Both of you should look up the word "monopoly" and "price fixing". Also what is 10% of say $3 trillion? Or 1% of 1/5th of the GDP?

If your governemnt programs would stop giving corporate welfare then maybe, just maybe the post office would be in the black. Have you ever known a corporation to pay in full for all that junk mail it sends out?

Or maybe if your profiteering masters didn't fraud medicare and medicade out of billions, maybe they would be okay? Do public schools go out of business because of private schools? Is Fedex going out of business because of the post office?

Do you have any evidence of the EU rationing? No? Is that why you have no citations? Nothing but maybe one fake story out of Canada about a cyst?

Based on your "percentages", I'm sure a 1% tax on the top will not be a big margin for them.
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CelticMajic
The answer lies in each of us individually
02:48 PM on 07/27/2009
believe it or not some actually disagree with the substance. Here are just a few:
Pg 22 of the HealthCare Bill MANDATES the Govt will audit books of ALL EMPLOYERS that self- insure!!
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOV'T COMMITTEE that decides what treatments/benefits you can get.
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!
Pg 42 of HC Bill - The Health Choices Commissioner will choose your HC Benefits for you. You will have no choice!
PG 50 Section 152 in HC bill - HC will be provided to ALL non -US citizens, illegal or otherwise
Pg 58HC Bill - Gov't will have real-time access to individual finances and a National ID Healthcard will be issued!
Pg 59 HC Bill lines 21-24 Gov't will have direct access to your bank accounts for electronic funds transfer.
PG 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations.
Pg 72 Lines 8-14 Gov't is creating an HC Exchange to bring private HC plans under Gov't control.
PG 84 Sec 203 HC bill - Gov't mandates ALL benefit packages for private HC plans in the Exchange
PG 85 Line 7 HC Bill - Specific for Benefit Levels for Plans = The Gov't will ration your Healthcare!
03:32 PM on 07/27/2009
This is what people don't understand. Politics this, politics that. Some people, even those "evil republicans" in office, fundamentally don't believe that socialized healthcare is the way to go. so yes, they will do everything they can to stop the "President's agenda." Why would they support something they don't believe in? You don't see democrats supporting offshore drilling.
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HUFFPOST SUPER USER
opprobrious
More speech. Less Flagging.
03:15 PM on 07/28/2009
Off-shore drilling doesn't address the fundimental underlying problem - peak oil. That makes off-shore drilling a stupid idea.

You'll be opting out of medicare and not driving on anything that isn't a private toll road, etc? Let's privatize the military, shall we?

Here's another news flash. We've been living in a mixed economy since before the term "socialism" was even coined.
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RonGallion
I am John Galt
03:59 PM on 07/27/2009
Who can be in favor of this bill? Obama! This would be the largest take over of rights, privacy, and freedom in US history. Obama hates what America stands for, he is apologizing in almost every part of the world for the US. He hates liberty and is ashamed of the US. Few know what this man is about, but by his associations it is easy to figure out. This health care bill is anything but, it is all about control and power.
07:55 PM on 07/27/2009
Ron G wrote about the healthcare bill:
"This would be the largest take over of rights, privacy, and freedom in US history."

No, Ron. That would be the phony War on Terror. And all the rest of the phony, gangsta occupations the US has perpetrated around the world.
quietfortoolong2
Consumers: the REAL job creators!!
02:08 PM on 07/27/2009
For Profit Health Care = Pay Up or Die