Fixing Health Care Does Not Require a "Bi-Partisan" Bill -- It Does Require a Public Health Insurance Option

The private insurance industry and its spokespeople in Congress are frantically making the argument that for health care reform to last and have the support of the American people, Congress must pass a "bi-partisan" health care reform plan.

Of course you never heard a word about "bi-partisanship" from the insurance industry or Republicans when they passed the notorious "Medicare Part D" prescription drug plan in 2003. Back then, they froze Democrats out of all negotiations, and passed the bill on a 220 to 215 vote in the House (with only 16 Democrats voting yes). In fact, Medicare Part D would be their idea of a "good" health care "reform": taxpayer subsidies for private insurers with no competition from a public plan. And if we went that route, the results of health care reform would look pretty much like the results of Part D as well - no cost control, giant gaps in coverage, and confusing options for consumers.

Now that the political tide has turned, and last year's economic collapse has given voters a fresh lesson in the consequences of turning public policy over to corporate CEOs and insurance giants like AIG, the Republicans and insurance companies have had an eleventh-hour conversion to the benefits of "bipartisanship" when it comes to health care reform.

It's no surprise then that in the current debate, the advocates of this position have made it clear that, to them, "bi-partisanship" means one thing: Americans should be denied the choice of a public health insurance option like Medicare. Their problem is that while a public health insurance option may not have bi-partisan support in Congress, it has big time bi-partisan support among the voters.

In fact, of course, it won't matter one whit to average Americans whether the bill passed by Congress is "bi-partisan." What will matter is that:

• Something gets passed.
• It provides health care for everyone.
• It puts the brakes on skyrocketing health care costs.

In the current context, there is no way to provide these things without also providing us with the choice of a public health insurance plan that would compete with private insurance companies, and keep them honest.

Average Americans know that they have been at the mercy of private health insurers for too long. After the health care mess that they have created, insurance companies can hardly expect everyday voters would be real keen about handing them the exclusive right to provide health insurance to everyone in America who is ineligible for Medicare, Medicaid or Veteran's benefits.

A poll conducted earlier this year by the highly respected Lake Research Partners found that voters overwhelmingly want everyone to have a choice of private health insurance or a public health insurance plan (73%), while just 15% prefer everyone having private health insurance.

And the preference for a choice between public and private health insurance plans extends across all demographic and partisan groups, including Democrats (77%), Independents (79%) and Republicans (63%). So in fact, President Obama's proposal that creates a choice of a public health insurance option is a bi-partisan plan - whether is has "bi-partisan" support in Congress or not.

Because of the budget rules passed by Congress, Obama doesn't actually need any Republicans to pass a health care reform bill. The rules allow passage without a filibuster, by a simple majority - which in the Senate means 50 votes and a vice-presidential tie breaker. That would allow passage of a truly effective health care reform plan even while losing all Republicans and 10 Democratic Senators.

Of course in this political environment that won't happen. They may squeal on their way to the vote, but in the end most Democrats and some Republicans will almost certainly feel the heat of public opinion and vote for health care reform when the chips are down.

The president's principles - which were outlined in a letter to the Senate last week - have broad support among most Democrats in both houses, notwithstanding adamant insurance industry opposition to a public health insurance plan.

The few isolated Democratic opponents in both Houses have never advanced solid policy arguments in opposition to giving Americans the choice of a public health insurance plan. The closest they've come is a frail argument that many private insurers couldn't compete. That line of argument ignores two facts:

• The point of health reform is to provide health care to all Americans, and to cut costs - not to benefit wasteful, inefficient private insurance companies that have become fat by gouging consumers and denying claims.
• If private insurers can't compete with an efficient public health insurance plan, they have no business being in the market place. After all, they would be the first to argue that the "private sector" is always more "efficient" than government.

What they're really worried about is that in order to compete they would have to cut massive CEO salaries like the $26 million Cigna paid last year to its CEO - a figure that is 65 times higher than the salary paid to the CEO of the Federal Government - President Obama. Insurance companies are worried that they would have to become more efficient and cut their profit margins in order to compete. Of course from the point of view of the taxpayer, that is one of the major goals of health care reform: to control skyrocketing costs and incentivize efficiency instead of waste.

The other argument advanced by the few Democrats who oppose a public health insurance option is the fallacious notion that it is not popular in their districts. In fact, Republicans and Independent voters are almost as sick of being at the mercy of private insurance companies as Democrats. The idea of providing consumers with a choice of a public health insurance option is popular in Arkansas and Kansas - as it's popular in Illinois and New York. It's popular in rural areas and urban areas.

The Obama plan for health care reform has massive bi-partisan support throughout the United States. Let's get busy making sure that it becomes the law of the land whether the insurance companies and the Republicans in Congress support it or not.

Robert Creamer is a long-time political organizer and strategist, and author of the recent book: "Stand Up Straight: How Progressives Can Win," available on amazon.com

Comments

[jscope]

The only way to have a slim chance at a single payer system is if enough voters from across the political spectrum make members in the House and the Senate, both Democrats and Republicans, believe they have more to lose from the voters in the 2010 election than from those who will finance their political campaigns.

The public option standing alongside the existing employer-provided private health insurance plans is confusing and will result in a "trigger"as a compromise.

A universal, single payer system can be sold as making the best sense from a practical, hard-nosed business standpoint. It is fiscally responsible when consumers of all political stripes are struggling for ways to cut their expenses. Health care is big business.S­ingle-paye­r actually mirrors the way big business is run, by merging, consolidating and downsizing, and spreading the costs of operating over a huge network. Single payer restores the doctor-patient relationship, stretches the middle class consumer dollar, spreads the cost over an entire consumer base, and ends the current politically horse-traded system that subsidizes one group at the expense of another group.

Taxpayers have been turned into a giant venture capital fund that finances the for profit health care industry. They are entitled to single payer as a return on their investment, not as a handout, not as a welfare benefit, but because they earned it the old fashioned way – they paid for it, they financed it.

T health care to the lowest cost,

[liberalOrgonian]

The repug keep saying they want the people to choose and government should get out of the way. If they only support private ins co, they will loose more credibility concerning millions of Americans without health ins. Many repug are also without insurance, they must weigh loosing more voters vs supporting ins co. This is an example of how obsolete the repugs are. They will fund wars, but seem unconcerned Americans are dieing without health care Ins.
Yet they do not want the people of US to choose an affordable plan (single payer) vs a insurance co, which most uninsured cant afford. If the ins co offered an affordable plan then this would not be an issue.
How many people are STUCK in jobs and marriages they dislike because of the fear of loosing health benefits? Let the repug show how concerned they are with this ins. crisis.

[KNAS1]

I am furious. In less than a year, two of my drs (primary care and Obgyn) have left private practice. Why, yes - those insurance companies! Both had been my drs for over l5 years and were great drs. How dare us let those greedy GOP'ers threaten us? We have seen what their way has done to Americans, the country and yea, even the world. They have taken us to near bankruptcy; ruined seniors' retirements and still they have not had enough. Remember, they wanted to privatize social security - so their cronies could get rich like the insurance companies and contribute to their campaign chests (not to mention the other under the table perks they get). If "socialized" medicine is ok for you (100% paid for by taxpayers) - why isn't it good for us? We are not asking the country to pay 100% - we just want the country to help us secure decent health care. I feel very secure in knowing that my government annuity and my social security are safe. So yes, I do want the government in my health care business! Yes, I do have insurance! Yes, I have worked for the last 30+ years. No, I have never been on welfare or asked for a handout. Congress - you cannot say the same thing because you receive handouts via your paid health care and the $$$ from big businesses so they can buy your support. How do you sleep at night?????

[blueken]

A public option would be at a disadvantage competing with the private sector. If the private sector denies coverage, you have very little recourse. A public plan would have to respond to the public, and still the private insurance industry is afraid, very afraid. Why?

[ChelseaC]

The private health insurance industry knows that once a public health care option such as HR-676 is passed (Medicare for all who want it), their days of being a wealthy cabal of influence is virtually over. It's not about what's best for Americans--it's all about lining their pockets and the politicians that except their blood money.
Without a public option to choose from, we are all slaves to this industry. Demand a public option of HR-676 from your representatives, if they fail to deliver, vote them out--from the President on down.

http://www.pnhp.org/change/

[LorettaSingbiel]

"one of the major goals of health care reform: to control skyrocketing costs and incentivize efficiency instead of waste...

LIFE is a terrible thing to WASTE on PROFITS of PRIVATE "healthcare" INSURANCE!

My treatment for a broken wrist last fall/winter...
3 hrs in emergency room
3 hrs outpatient open reduction surgery
5 visits to orthopedic doctor
19 hrs physical therapy on wrist/hand
12 hrs physical therapy on shoulder

Total $44,801.29 (thus far)

BC/BS paid $44,230.13
I paid $571.16

CHA-CHING! ... obvious price gouging and gaming the system that IS broken and NEEDS reform!!!

I wouldn't have been able to afford this without EMPLOYER-paid coverage. NOBODY'S LIFE should be at the MERCY of their EMPLOYER!!! The world needs ditch-diggers too ... and THEY SHOULD ALSO have ACCESS to EQUAL healthcare!

I'd be willing to bet my treatment would have been LESS THAN HALF that amount in CIVILIZED countries that make PEOPLE and PEACE their PRIORITY!

A CATASTROPHIC injury or CHRONIC illness in this country would certainly CHA-CHING into MORE Americans losing EVERYTHING including their LIVES!

[zest]

Capitalists want health care to be just like oil, ever increasing prices.

[LadyXoc]

If the public option is anything like Medicare, many doctors won't accept assignment; very likely insurance companies will pressure doctors not to accept it if they want to remain part of the private plans.

[blueken]

I'm sure that the private health care insurance companies will sneak in language that funnels the people with the most expensive medical conditions into the public option, just like Medicare did. Medicare is a success, not for society, but for the insurance industry. They get to shed the sick and insure the healthy. A public option is a sham.

[yulyyz]

Public health care insurance should be an option, but not as a system like Medicare (which works similar as private medical insurances do with co-pays and deductibles). Other reasons why public health care is a more viable option can be found here:

http://open.salon.com/blog/kanuk/2009/05/15/lets_compare_public_and_private_health_care_costs_eh

http://open.salon.com/blog/kanuk/2009/05/21/lets_spread_the_risk_i_mean_health_care_not_flu

http://open.salon.com/blog/kanuk/2009/03/29/health_care_comparison_universal_vs_us_-_part_ii

[buckcable]

Has anyone in Washington really studied the health care problem or do they simply want to rework the same old broken system and give it a new name? If they really want to fix it, they should document the process, eliminate duplicate efforts, streamline paper flows, minimize fraud and abuse and set fee schedules.

[apduncan1]

Unless the Senators and Congressmen are forced to pay premiums like we all do we won't see a change.

[Janskats]

The insurance mafioso have waged their "protection racket" long enough. They're firing with all their cannons against a single-payer plan. Ohmigosh, they can't have folks paying a fair price for these services and not pay into their coffers! Nope, can't have that. So, they spew all this "socialist" nonsense, or folks won't have "a choice" (like that's a word they believe in), or you're gonna have to wait until you die before you get help under such a system! Get a grip..you don't just wait under their programs..you get shafted by never getting treatment paid for to begin with! They don't break your kneecaps..they just don't let you get them fixed..even after paying and paying and paying!

Fact is, most medical practitioners and the majority of their potential patients in this country want a single-payer option! All this current propaganda is just that..baloney! No one is saying that, if you're dumb enough, you can't still go with your private plan. To each his own. But don't you dare tell me I have to be robbed blind by the insurance "industry", when they're about the most inefficient, corrupt lot to come down the pike ever! The nerve of Raucus Baucus and Grassholey and their ilk for trying to throw a wrench in the works, especially since they get their insurance paid for by the taxpayer! This isn't going away, fellas..get used to it!

[Chip W]

Single-payer isn't even on the table.
This makes me wonder, again, of the power structure in this country.
Had McCain been elected, I wouldn't expect single-payer to be considered. But with Obama, who has supported single-payer, and a Democratic House and Senate, and it's not even on the table....
Who's running the show?

[billw8017]

Before 1915, you would have been better off to NOT see a doctor. So, Theodore Roosevelt, shot while making a speech in Milwaukee, refused all medical care until he could get to Chicago and some doctors he trusted. He declared he would not put himself into the hands of the kind of quacks who had killed Garfield and McKinley. Medical care is much better now and the life expectancy of Americans has increased from 40 years at birth to almost double.

The United States has "socialized" many things, like highways, public schools and old age pensions. All of these things are freely available, are well financed by the public sector, and are of great benefit to the nation's economy and the well being of the people. The time has come to "socialize" personal medical care.

The corporate scheme is to minimize services and charge the max that the market will bear. This works well in many ways, but we see corporations, though they serve, do not exist to serve but to gather profits. The example of GM is that it profits while the economy is strong. When the economy weakens, we see them reducing dealerships, closing factories and laying people off. That is, their business model builds plentiful things for a buying public, but it depends on the inherent strength of the public economy and worsens it when it goes bad. This is fine for cars, but not for matters of life and death.

[Regeman]

SINGLE PAYER UNIVERSAL COVERAGE.

Anything else is a sham. They want us all doing ten types of paperwork and then paying for supplemental coverage for the supplemental coverage and ten new secretaries in the Doctor's office to figure it all out.

[rainjustice]

Healthcare reform and the insurance industry: As Usual, "The Large Print Giveth and the Small Print Taketh Away."
Single-payer now!
rainjustice.com

[enoughalready]

I have long been a fan of the single payer system. Medicare has worked very well for retirees in this country and if you told retirees/Medicare recipients that their Medicare would be cancelled there would be an uprising. Along with FICA taxes on your paycheck you would pay more into the public system to cover healthcare.

I was diagnosed with cancer last summer. Since then my insurance has gone up drastically. When I took out the policy they said they would never cancel me. However they did not say they would begin to price me out if I got an illness like cancer, etc.

Congress needs to understand where the country is right now. We pay their very good health insurance policy costs and yet they refuse to help us get coverage at reasonable rates. I think we should all begin protesting them and ask them to give up their coverage till they see we are dying without affordable coverage ourselves. My insurance company refused to pay for a medication that stopped the nausea and vomitting due to chemo. The medication was almost a hundred dollars a pill and I would have to take 6 of them per month during chemo sessions. I guess they simply didn't care if I could not tolerate the chemo - it was only my life I was fighting for. I'll bet the policy that Congress has pays for that medication for them if they had to have chemo.

[dianhow]

Enough I hear you
Greedy fat cat Insurance CO's exist for one purpose. To make billions at our expense.
The more they ' refuse' to cover us - the more profit they make. If we can get a 'public' option for health care this time around - then we can ' segway ' into single payer..

[ChelseaC]

Enough,
I'm so sorry about your cancer.
Yes, let's protest. On June 25th there will be a protest in downtown Washington DC.
Hang in there, I hope you get well soon.


Everyone-- demand HR-676 MEDICARE FOR ALL who want it.

http://www.pnhp.org/change/

[billw8017]

We don't need a notary public to guarantee enoughalready's story. 4/5th of bankruptcies are due to medical costs and 3/4 of these were people with insurance. This is horrific and it is the American way. You, yourself, are at risk and probably know it full well. It is shocking that not only all of the western nations have assured care but also Cuba and several banana republics, but we do not.

Marijuana mediates the nausea of chem care. It also works against asthma and glaucoma. Though illegal, it is available to those with street smarts.

[kitkatborn]

Why is this so hard? Really, if we want health care reform it should be a no-brainer, right? Tell the lobbyists to stop showing their greedy faces.

[Triumph08]

We need single payer now for the health and future of this country!