Huffpost Politics
THE BLOG

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors

Larry Beinhart Headshot

Medicare for All

Posted: Updated:
Print

The best thing you do for your health this year is to support the David vs. Goliath candidacy of John Tasini against Hillary Clinton for the Democratic nomination for the U.S. Senate. To be specific, if you live in New York, you can get out and vote on primary day, September 12th. If you live outside of New York, contact someone you know in New York and let them know. If you live anywhere, you can always send money. Go to Tasinifornewyork.org. David has plenty of stones, but no cash. Goliath, of course, has a huge supply of funds, much of it from the health care industry. Here's why you should care even if you live outside New York. And why you should care even if Tasini seems destined to lose. If we are ever going to fix health care in this country, we need a real dialogue on the issues. Tasini addresses the issues, with clarity and simplicity, and he offers a solution. Again, with clarity and simplicity. If we, as individuals, demonstrate with our votes and voices and our money, that we care about health care, then we will get a change. If we, as individuals, sit on our butts while the corporations who make money from manipulating the system are out there working and spending, then we will continue to have what is probably the worst health care system in the developed world and it will continue to get worse.

It may sound shocking to some to say that we have a bad health care system. Here's why I say it.

• There are at least 42,500,000 people without health insurance. All other developed countries have universal care. Most developing countries have universal care.

• We also have many underinsured, people with huge deductibles, low caps and a wide variety of excluded problems.

• We pay more, but get less. According to Salon, "The United States
spends a stunning $3,724 per person on health each year. But measuring how long people live in good health--not just how long they live--the Japanese beat Americans by four years, and the French lived three more healthy years. Yet Japan spends just $1,759 per person on health and France $2,125." That article is from June 21, 2000. US per capita spending is now up to $6,100 and the disparity between the US and other industrialized nations is even greater.

• American businesses with good benefits can't compete with foreign companies that have national health at home or with non-union, low benefit companies--foreign or domestic--that operate inside the United States. General Motors and Ford both face bankruptcy because of their high health care costs. Also because their management is too stupid to join forces with their unions to lobby for a national health plan to get them off the hook.

Our current Senator, Hillary Clinton, has a hodge-podge of 10 health-related items on her website. She's against Obesity; for drug safety; for mental health and substance abuse treatment; for more money for the National Institutes of Health; she voted for more money for HIV/AIDS; she wants to make sure we have a reliable supply of flu vaccine; and she introduced legislation to form a committee to "recommend thoughtful reforms to Medicaid." She introduced one piece of legislation, the Healthcare Quality and Technology bill. Her co-sponsor was Republican Senate Majority Leader Bill Frist. I generally don't believe in guilt by association but Mr. Frist has grown rich as a result of the healthcare frauds committed by his family's company, HCA; he's known as "the healthcare industry's man in the Senate." It's fair to say that anything he does puts industry profits ahead of the public welfare. Clinton's solution for the 42,500,000 without coverage is "to allow uninsured individuals to buy into existing health insurance programs." Median family income, for a US family of four, is $65,000. In several states it's below $45,000. An employee working fulltime at the US minimum-wage makes $10,700 a year. The average health care premium for a family of four is $10,800. So I'm not sure how it helps to "allow" people to put somewhere between 16 percent and 101 percent of their income into a health care plan.

For historical and ideological reasons American healthcare plans have been paid for by employers as benefits and administered through insurance companies. In a world of stable businesses, strong unions, lifetime employment, moderate medical expectations and low healthcare costs, that worked pretty well. But every one of those conditions has changed. Moreover, each of the changes exacerbates the others. Weak unions mean non-union companies enter the field with fewer health benefits. In some industries, like the airlines, that means that all but one--American--of the older companies has disappeared or gone through bankruptcy as a means to get out of their obligations. Lack of insurance or poor insurance pushes people away from low cost preventive care. They only seek care when things come to a crisis. That makes the whole system more expensive. That puts more pressure on companies that give good benefits. Our ideological resistance to national health comes from the idea that free market capitalism does everything better and governments do everything worse. But how, for example, can market forces deal with our epidemic of obesity? There are lots of free market forces selling us the causes of obesity: fast food, bad food, too much screen-watching time, suburban sprawl, door-to-door automobile travel and tax cut movements that take sports, music, and art out of public schools. What free market forces will encourage our families to sit together at regular, home cooked meals? What free market forces will teach our children to shop and cook, to stay off television, to walk when they can ride, and who will fight to raise taxes to put non-couch potato activities back into our schools? The medical market system only responds when it can sell a product (drugs) or a service (surgery). It's market operates so that it only responds after obesity has led to heart disease, diabetes, arthritis, cardiovascular disease, musculoskeletal problems, respiratory problems, stomach, liver, and kidney problems.
The free market fantasy is, in any case, a fantasy. We don't have a free market in medical care. Our health plans are selected for us by our employer or union or, as a last resort, some group they belong to. Anybody unfortunate enough to actually be out in the free market all alone, pays more and gets less. On the other hand, insurance companies, HMOs, hospital chains, and pharmaceutical companies have a great deal of influence. They select what research gets done, they buy influence with doctors, medical schools and journals, and they push the procedures and types of medical care that will bring the most profit with the least effort. Eighty percent of the world's Ritalin is given to children in the United States. Ritalin is banned in Sweden. It can't be that American children have 80 percent of the world's attention deficit disorder and that Swedish children have none. One is the corporate-profit model, the other is the social-interest model. The industry also exercise its influence by supporting the legislators that they love. Rick Santorum is number one on their list. Clinton is number two.

Johnathon Tasini has a solution. He calls it Medicare for All. Individuals and firms who now have medical plans could buy into Medicare. (Medicare spends only two percent for administrative costs; private health care uses up 25 percent on administration, profits, executive salaries and bonuses, marketing, and advertising.) Tasini wants Medicare to use its power in the market place to get drugs, equipment, and supplies at the best price. The savings from that would be used to extend coverage to those who can't afford it. Our political and civil health suffers from the same disease that our healthcare system does. Money is the gatekeeper. Nobody is left to speak for the public interest. You can read it in more detail, if you wish, at www.tasinifornewyork.org. Go to Hillary's website, too, and compare.

Tasini speaks for the public interest. That's probably why his positions are so clear and sensible. Clinton is running on money. Her motto could well be, "If it's good for Hillary, who cares if it's bad for the country." For your health, for the health of your family, for our national health, get out the vote on September 12. Let's dump Hillary, she is, on the record, Bush-lite in drag, and elect someone who will work for the real common good.