The Health Care Ghetto

Even worse than Joe Lieberman's threat to veto the health care bill, the Connecticut senator's ego may well have distracted Americans from the real issue in the debate over the public option: Will Americans actually be able to choose it or will it just be a health care ghetto for those of us who have been tossed out like unprofitable trash by the insurance industry?

Speaking on The Rachel Maddow Show less than twenty-four hours before Lieberman announced that he would join a Republican filibuster against a public option, Sen. Ron Wyden (D-OR) said the following about Harry Reid's proposal :

The public option will be a great tool, if people can get it. It seems to me that Harry Reid deserves a lot of credit tonight. He`s made it clear there ought to be options. But I continue to be concerned that the way this proposal is written, more than 90 percent of Americans, seven years after the bill becomes law, won't be able to hold insurance companies accountable. They won`t be able to get the public option at the exchange, the marketplace, nor will they get additional private choices. You can`t get an accountable insurance industry with just a small fraction of the population. You`ve got to have the whole customer base of the industry on the line...If folks at the grassroots level, the folks who are carrying those signs about the public option now, say, "Look, it`s not good enough that only 10 percent of the population can hold insurance companies accountable, it`s not good enough at a crucial time in American history to have choice available only to a handful of people who are poor and sick and unemployed," that`s almost like a health care ghetto." Let`s hold insurance companies accountable the right way by making them put their whole customer base on the line.(Sen. Ron Wyden (D-OR), The Rachel Maddow Show, Oct 26, 2009)

Wyden's point was clear and straight forward:  the public option will fail to bring down the costs of health care if it is designed such that it cannot possibly compete with the massive customer base forced to stay with private insurance.  "We`ve got to make sure that it`s possible for Americans," Wyden emphasized, "who feel their insurance company is abusing them, to have choices like members of Congress."

Wyden offered praise to Harry Reid for bringing the public option to the floor, but a warning that the current state of the public option in the Senate bill does not match the rhetoric about "competition" and "choice" used by the Democratic Party to explain the public option to American voters.  The solution?  Americans need to demand that their senators add amendments to the current bill that make the public option available for everyone to choose.

Enter Joe Lieberman.

The minute Joe Lieberman threatened to veto a "government run" public option -- which is itself a complete fabrication as to what the public option would be -- Wyden's key point that Reid's version of the public option would create a health care ghetto was trampled over by a media hypnotized like a crazed throng of Conrad Birdie fans.

Honestly.  Nora the piano playing cat could figure out what Lieberman is doing, ignore it, and focus back on the real issue at stake in the debate over the public option.  What is Lieberman doing?

Lieberman is inserting himself into the debate not because he gives one iota about health care or the public option or what the voters of Connecticut want (68% want a public option), but in order to get for himself -- to get for Joe Lieberman.

Over the course of his career, Joe Lieberman has taken $2,395,369 in donations from the health sector and  $1,033,402 in donations from the insurance industry (link).   So, he is threatening to veto a public option in order to guarantee those taps stay open and the cash keeps flowing. Joe will filibustering health care reform so that Joe can keep getting for Joe.  It is exactly what one should expect from a man who is the founding and only member of a party that bears his own name: self-aggrandizement.

If you are like me, however, and you care little about Joe Lieberman, but a great deal about making a public option available for all Americans to choose, then you should consider taking five minutes to watch this clip of Wyden explaining what we should be talking about instead of focusing our attention on a narcissistic Nutmegger:

(Thanks to Firedoglake for recording the clip and posting it to YouTube)

After you watch that video, send the link to your friends on Facebook and Twitter so they can watch it, too.

What is at stake in the next phase of the health care debate is not whether a self-centered senator is able to hold the Senate hostage so that he can get rewarded by his health insurance industry donors -- but whether or not the public option will be available to everyone ever abused by that industry or merely cordoned off as an undesirable, built-to-fail, health care ghetto. 

Leave Lieberman to Lieberman.  Let's talk about what matters for a change -- particularly when it matters so much to so many.

 

 

Follow Jeffrey Feldman on Twitter: www.twitter.com/JeffreyFeldman

Comments

[JustMarie]

I heartily agree with RenePA:

The healthcare bill should have a "What You Pass Is What You Get!" provision - no supplemental insurance allowed.... Then we might actually get something that allows us to challenge the for-profit healthcare insurance industry.

For-profit and healthcare insurance are a scary pairing.

[Earl K]

I am retired. I have Medicare, but, I have yet to use it. I have a really good "supplemental" insurance deal. Without government help, my premium would be $39-$49 per month. With government "help" my premium is $99 per month. The hospitals and my doctor will ignore my Medicare, but, happily accept my "supplementral" policy.

[meeneecat]

Sounds like a MEDICARE supplement that you are talking about. Supplemental insurance plans are offered to all Medicare recipients, by the government through private insurance companies contracted by Medicare. Basically supplements cover certain out-of-pocket expenses that Medicare does not pay for, such as copays...(but like all private plans, there are restrictions, limits, and often only certain doctors/procedures are covered) I have Medicare from disability insurance, and the cheapest supplement in my state is $250, so for me it is not worth it to buy the supplement, because most of my doctors take 100% of Medicare's reimbursement rate, I don't have very many co-pays or out of pocket expenses, despite having very high medical needs and lots of doctor/specialist visits each month.

You saying your "Supplement is SOOO much better than Medicare" is a little like that know-it-all with the sign saying "Keep gov't out of my Medicare"...The only reason you have a supplement to begin with, is because the plans are offered THROUGH MEDICARE.
Nice try anyway.

[Stella Holman]

Prevention is better than the cure - just keep eating the chocolate - Healthy Chocolate that is!

[raker]

I don't expect the public option plan to be something anyone would choose. It will cover less than Medicare. (To avoid poverty, Medicare beneficiaries have to buy private insurance to pick up all the unpaid balances. Medicare out-of-pocket costs are high.) Rather than a ghetto, I think of the public option as being like a soup kitchen; if you're starving, a bowl of thin broth is slightly better than nothing.

[RenePA]

How would this topic change if Congress were the recipients of what they propose for the rest of society?

The bill desperately needs a measure that says what they pass is what they also get.

[lessgovernment]

We need the government out and we need the insurance companies out. All we really need is patient - doctor relationships and our local charities. We have been brainwashed into this whole notion of insurance. I like the model of Dr. Muney. Makes much more sense. All else that is need is an inexpensive catastrophic insurance policy just like homeowners and auto insurance.

[COPerez]

Yeah...

And when you happen to live in a true "ghetto?" What then when your neighbors can't afford to help you?

And if you really think that some church is going to risk going bankrupt to help you out, you haven't been paying attention for the past 2,000 years as they've guilded their temples and synagogs and cathedrals in gold.

Single Payer. NOW.

[1differentdrummer]

I'm sure you analyzed the costs of cancer treatment or heart surgery before you wrote that, didn't you? What charity do you know that can afford one such treatment? How about ten, or a hundred? How many people get cancer in one year, millions? Is that Dr. Money or Dr. Muney? Get real, or was that humor?

[Mixpixlix]

Yes, the a GOOD public option is essential to real health care reform and insurance companies must be held accountable as soon as the bill is signed.

However, why is it that Speaker Pelosi has a website where non Californians and express their opinions to her, but Senate Majority Leader Reid is only available to Nevada residents. I've heard him boast about representing all Americans in his current position, yet he only wants to hear from those who vote for him.

We need significant health insurance reform coupled with medical accessibility and costs reform,so that no America ever has to worry about dying because of lack of care or choosing between paying the mortgage or hospital bill.

If those who hold themselves out to represent us don't want to hear from us, it's time to change leaders.

[edejan]

It's really heartbreaking that what was presented initially as something so good for the American people is turning out to be just another con job and grab by big corp.
I feel bad about being so disappointed in Pres. Obama and his entourage. I want to hope that continuing to work to vote in good politicians, like Mr. Widen, is a solution, but there are so many corrupt politicians in Washington.

[mkostura]

There is a recent article in the NYT by Cappy McGarr, a former chairman of the health insurance alliance in Texas who would totally agree that the insurers will choose which customers to retain.....they will want to dump the high cost subscribers and put them in the public option. Similar phenomenon have happened in Colorado as well. This phenomenon is not restricted to health insurance, the auto insurance industry dumps "high risk" drivers into a state run pool. The only way that this will not happen is if the other changes being proposed in health care insurance are enacted. To wit....no refusals for preexisting conditions, no dropping of coverage for existing conditions, no denial of service etc. But the devil is in the details of how these underwriting restrictions will be written.

[rad21]

Is the healthcare insurance a mere payor (intermediary between the patient and healthcare providers) or is it supposed to 'manage care' both at the level of the consumer / public and the providers (deliverer of care)?

For-profit system is designed to generate and maximize profits at every step in the system; by what ever 'legitimate' means. Hence many suggest to get rid on multiple insurance companies and replace with a not-for-profit "Healthcare System". Here the community is the patient. There is emphasis on prevention, group management of diabetes, hypertension etc. and treatments with the most cost-efficient methods.

One can follow one model or other; not both - unless there are incentives (rewards) and disincentives (penalties) for both the consumer / patient on one hand; and the providers (doctors, hospitals, and pharmaceuticals) on the other. America has been following both models (for profit and not-for-profit) with spin, marketing, science and fiction. We have been only fooling ourselves, as the recent reports suggest, where a third of healthcare expenditure (500 billion to 800 billion) is waste, fraud and abuse.

[textynn]

Welfare for more people. That's what they've got for you America. Americans are being forced to compete with workers in third world countries and you get health care if THEY choose. Wake up people. .

[textynn]

The plantation owners will not be giving up their slaves period. They can't continue to exist without them and no argument to end cheap labor serving up every dime they make to stay well against a polluted world is acceptable to them. We have to find a way to free ourselves from this tyranny.

The Elite, soon to be the only Employers, want complete control of all people. With our employer controlling our access to health care we are complete slaves to them and any injustices they choose to levy on us,including low pay will be thrust on us.. Most of us have been working to live in poverty and have health care. Take the health care dollar out of a house hold's earnings and see the true poverty rate.

[TheMediaRanger]

Here's a link that makes it extremely easy for you to contact your representatives in support of the Wyden bill:

http://salsa.democracyinaction.org/o/307/t/9290/campaign.jsp?campaign_KEY=27743

[joyce2]

It takes time to set up an insurance plan which is why the wait time if medicare for all would have been approved there would be no wait because it is set up and running just needs some finessing to make it feasible .

[Boxjob]

"Will Americans actually be able to choose it or will it just be a health care ghetto for those of us who have been tossed out like unprofitable trash by the insurance industry?"

The inveterate corruption of our political process heavily favors the latter over the former.