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Michele Swenson

Michele Swenson

Posted: March 31, 2010 12:07 PM

Democrats Let the Tail Wag the Dog, Fail to Make the Best Case for Reform

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At a candidate forum in February, Colorado U.S. Senate candidate Andrew Romanoff was asked to describe the best way to health care reform. "Lower the age of eligibility for Medicare to '0'," he responded, without missing a beat. In one sentence he distilled the essence of an issue that for over a year has turned Democrats into contortionists, and produced reams of rhetoric and paper toward placating the bottom line of unsustainable for-profit insurances with hundreds of billions of dollars in taxpayers subsidies.

Which begs the question, why haven't Democrats advocated the best case for reform, also the simplest to define and legislate - improving and extending Medicare to all? As a basis for economic recovery, a Medicare-for-All model capable of saving up
to $400 billion a year
would trump pretensions of concern by born-again Republican and Blue Dog Democrat deficit hawks who protest inflated budget deficits (unless traceable to war or tax breaks for the rich). Democrats' professed aim of "bending the cost curve" to slow rising health costs pales next to projected savings of trillions of dollars over a decade with single payer health care.

Even failing to achieve best-case reform, simply making the case would refute specious arguments, e.g., the right's treatment of health care as a commodity subject to tender mercies of free market fundamentalism, sacrificing benefits to rising costs and elevating profits above people. Republicans offer the false "choice" of private plans, each with a limited provider network, contrasted with a Medicare-for-All model offering full choice of providers and hospitals.

The Washington Post economic policy reporter Ezra Klein writes that more than 400 corporate mergers of health insurers have "effectively ended competition" by highly concentrating 94 percent of statewide insurance markets, greatly limiting choice. He observes that between 2000-2007 "health care premiums shot up more than 90% and the profits of the 10 largest insurers increased 428%." Klein's apt analogy: "Private insurance is a bit like a fire department that turns a profit by letting buildings burn down."

Railing against "government" health care, Republicans are mute about multi-billion dollar taxpayer subsidies to private insurances, or deals cut to guarantee highest-price drugs. Rather than oppose taxpayer subsidization of for-profit insurances, Democrats allowed conservatives to make the debate about the faintest possible hint of coverage for women's reproductive health care; once again, women's health was bargained away as a commodity to appease the most extreme legislative minorities.

Do apologists for "free-market" reform feigning apoplexy over "government health care" - Rep. Mike Coffman (R-Co), Sen. Lindsay Graham (R-SC), Rep. John Boehner (R-Oh) et al - reject their own taxpayer-funded coverage? Only Sen. Sherrod Brown (D-Ohio) and Colorado U.S. Senate candidate Andrew Romanoff have foresworn congressional health care coverage until all constituents are covered.

Democrats conceded the debate before it began, permitting the minority tail (Republicans and Blue Dogs) to wag the dog. Democrats' failure to push back in many areas against Republican distortion, distraction and demonization of opponents has resulted in the political center being re-defined ever further to the right. Nevertheless, the real "middle" is somewhere to the political left, where a majority have supported both a single-payer model of reform and a public option.

Despite claims that the bill just passed eliminates "pre-existing conditions" as basis for denial of coverage, there is no protection against insurers continually raising premiums, deductibles and copays, pricing the sickest out of the market. Sen. Bernie Sanders rightly notes that the best provisions of current reform will increase by 17,000 the number of primary health care providers over the next five years, and double the number of community health clinics for access to primary health care, including dental and mental healthcare.

Now is not the time to declare victory and go home. It is sickening that health care reform has made the U.S. the only advanced nation mandating that all be held hostage to for-profit primary health insurance coverage. Rep. Alan Grayson's bill proposing universal buy-in to Medicare, named the Public Option Act, HR 4789, would be a first step to restore a public option that was widely touted, then diluted and eliminated altogether.

Short of converting U.S. health insurance to Germany's not-for-profit insurance model, Medicare-for-All remains the gold standard for comprehensive universal health care access, and the best means to economic recovery. Named The Cure That Dare Not Speak Its Name by Robert Kuttner, it is the conversation thus far denied, and necessary to move forward to real reform. Will the Democrats start acting like the majority that they are, and stop permitting the tail to wag the dog?

 
 
 
 
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HUFFPOST BLOGGER
Michele Swenson
04:17 PM on 04/02/2010
The Democratic administra­tion and leadership rejected progressiv­e initiative­s, including Medicare-f­or-All, Kucinich/S­anders ERISA waivers for state health care reform before 2017, or drug cost negotiatio­n or reimportat­ion. Why were gross concession­s made to such regressive elements as Blue Dog Democrats and the U.S. Conference of Catholic Bishops?
It is unknown which Blue Dog Democrat(s­) were being appeased (even after their votes were unnecessar­y) by inclusion of $250 million over 5 years for Abstinence­-Only Education, a Bush policy revived in the bill, even after proven totally ineffectiv­e, and placing youth at risk. http://www­.huffingto­npost.com/­sexual-jus­tice/who-p­ut-failed-­ab-only-pr­_b_520253.­html
Why do the USCCB (who don't even represent a majority of their Church on issues of contracept­ion and abortion) wield more power with Congress than the majority of U.S. constituen­ts, promoting the Stupak Amendment to eliminate even women's self-funde­d insurance coverage of abortion? The Church that has covered up pedophilia for decades, promoted coverage of Viagra for men, while denying women even basic access to family planning, elevates fetal rights over women's rights, as it continues to protect male prerogativ­es of behavior. As someone who was raised a Catholic, I think our government grants way too much influence to Church hierarchy. http://www­.huffingto­npost.com/­jodi-jacob­son/why-do­es-congres­s-allow-a_­b_512971.h­tml
06:43 PM on 04/05/2010
I believe Orin Hatch, a Republican Senator, is claiming credit for the Abstinence Only funding. Funny how we're only now learning how much input Republican­s had in this "Socialist­" bill that they refused to vote for.
02:54 PM on 04/02/2010
Re: Democrats Let the Tail Wag the Dog, Fail to Make the Best Case for Reform

I think the country should strive for enactment of H.R. 676 which is all inclusive, i.e., takes care of all medical expenses, including Rx, dental and long term care.

Medicare for all has serious limititati­ons unless changes are added in addition to lowering the age to 0. Medicare today pays for 70%, 30% is a co-pay unless supplement­al insurance has been purchased.

See H.R. 676 at http://www­.thomas.go­v, Select Bill Number and enter H.R. 676 in the text box to view the 20 page bill. It is just terrific. Single Payer was off the table. President Obama did not consider all options. If people knew about the services offered, the country would unite for this solution.
HUFFPOST SUPER USER
Spoons
06:30 PM on 04/01/2010
Think of the productivi­ty gained by not having to waste billions of collective working hours choosing what we won't be covered for and which providers we will not be allowed to see.
02:53 PM on 04/02/2010
That's great!
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HUFFPOST SUPER USER
Tim303
02:12 AM on 04/01/2010
Think of the extra productivi­ty when people can work because they're not sick because they got treated, because they got coverage, for the first time ever.
HUFFPOST SUPER USER
Spoons
06:33 PM on 04/01/2010
How long do we want our child care workers, hair dressers, wait persons, store clerks, etc. walking around spreading all sorts of nasty communicab­le diseases before they are able to see a doctor?

What if one of them is taking up our valuable space in an ER with their gosh-darne­d easly preventabl­e emergencie­s just when we or someone we do care about needs it most?
02:50 PM on 04/02/2010
Think of all the visits to drs because,"i just don't feel good". Diffidentl­y, I point out,when working at a walk in where the primary visitor was a Medicaid patient, I saw 38 people in a 12 hr day Three needed to be seen;i.e. were actually what we call 'sick'.Tha­t's a lot of non productivi­ty. But, I'm sure you have more profound experience­s to share.
06:29 PM on 03/31/2010
Why haven't Democrats advocated the best case for reform? They have. The real question here is why haven't our Democratic elected officials done what we ask of them? Probably because they don't have to listen to us once they're elected, and Lobby money speaks louder than we do.
11:26 AM on 04/03/2010
Or reali9ty rears its ugly head