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
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Big Pharma and the health insurance companies have the best representation in Congress that money can buy. Any member of Congress who refuses to support the public option or ideally Rep. Conyers' bill HR 676 calling for single payer health care should be ready to forego the subsidized public health care they receive as members of Congress and pay for private health care for themselves and their families out of their own pockets. We must target any member of Congress who wants to deny the American people the same benefits that citizens of every other industrialized nation receives and make sure they do not get re-elected. Enough is enough.
AGreed Indeed enough That's what Nov 2008 proved.
Let's keep on them- like a fly on.....wel
Dianhow,
Indeed I get your point--LOL
I wish more people would directly answer the untruth that Medicare reimburses providers at lower rates than Private insurers. My husband on Medicare and I (privately insured) tend to go to the Dr. together. I read the EOB he gets from MCare and I compare to what my insurer pays. For the same service, MCare pays at higher rate. He, also, has much less "red tape" than I do. I have to wait for insurer to authorize procedures. He does not.
Antmousie,
People lie about this stuff in order to create FEAR as to
cripple the will of the people--so those with the wealth and power get their way.
Post your story all over the web.
You're doing a good service for the people.
england has a system that serves all well. i know because a dear friend just went through a nine hour, highly complicated operation and has no complaint about her care. it is crazy that we don't have a similar system.
And a Scottish neighbor of mine (in the U.S.) has a brother in Scotland who ahd a prostate problem and needed an operation. English socialized Medicine said they would operate - in 18 months. My neighbor said, "What if I pay for the oepration?" The reply: "He can have it tomorrow!"
This is another example of what opponents of national healthcare call rationing. But what do you call it when private insurance companies deny coverage, and all the while make huge profits on tops of 15-30% overhead costs?
Doubt it's true, but even if it is, at least he won't have to go BANKRUPT paying for his care!
Let me guess ... you have EMPLOYER-paid coverage.
Well Jan ... I won't have much respect for you if you wait until YOU lose YOUR employer-paid coverage, before you begin to advocate for EVERYONE in OUR country to "have it tomorrow"!
MOST doctors honor their Hippocratic Oath "to keep the good of the PATIENT as the highest priority".
ALL "Healthcare" insurance companies honor their HYPOCRITIC Oath to keep the good of the PROFITS as the highest priority!!!
We MUST ELIMINATE the private, for PROFIT, "health" insurance companies. They keep people off the rolls who might get sick, remove people from the rolls once they have a serious illness, and try to fight doctors and hospitals to deny care so they don't have to pay out claims.
WE ARE ALL just ONE catastrophic injury or chronic illness away from losing EVERYTHING ... including our LIVES!
But perhaps YOU, Jan, COULD ask YOUR "health" insurance company "What if I pay for the operation?" ... IF the price is right???
Most men with prostate cancer die of something else before the cancer gets them, because it advances so slow. The reason he's being asked to wait is so that people with more urgent issues can get their procedures done first, thereby assuring everybody the best outcome. It's called "triaging," and it happens in any U.S. hospital that you care to look at. With the medical infrastructure that we have here, no one would ever have to wait that long for an operation, regardless of the health insurance they had.
On a side note, I've seen this anonymous, unreferenced, detail-deprived example before, and I'm far from convinced that it's real.
that's why making the public insurance an option does NOT work.
the whole system has to be "public".
You know what is Great about America - it may take us a long time to get to the truth, but once we do, there's a bazillion voters who can change the status quo in an instant. Congratulations to our General Public. They now realize that even the health "care" BUSINESS is in the "we're greedy p.i.g.s so we are going to screw-you over" business. Now we will vote to get the change we work sweat and tears for. It is a good day.
It might also be pointed out that Canadians, on average, live TWO YEARS longer than we do. They have universal health care, costing the individual -- on average -- $54.00 CAN a month. Taxes make up the rest.
We, on the other hand, leave behind 46 MILLION of our people, and spend more per cap than Canada to achieve a worse result.
They live TWO YEARS longer than we do. Anyone spot a connection?
A friend of ours has a sister in Canada. The Canadian sister came down with breast cancer. They told her they weren't going to do anything about it because she was 70.
Canada doesn't discriminate patients because of age by any means. What they will do is if the treatment (in this case probably something like chemo) is too much of a risk to the life of the patient. She was not refused simply for being 70 - if that's what they told you they're either not bothering to tell you the whole story or they don't know. It's illegal to discriminate treatment based on age, gender, race, sexual orientation, religion etc etc etc.
Once again, Jan ...
WE ARE ALL just ONE catastrophic injury or chronic illness away from losing EVERYTHING ... including our LIVES!
But perhaps YOU, Jan, COULD ask YOUR employer-paid "health" insurance company "What if I pay for the operation?" ... IF the price is right???
Once again, the real details are conspicuously absent here in this anonymous, detail-starved example. Some (certainly not all) breast cancers move so slow, that the patient will undoubtedly die of old age before the cancer becomes a threat to her health, while the invasive operation and sedation present a very real risk to life. Is this the reason they opted for no treatment? You don't know why, do you? I doubt this is even a real example, but even if it is, there's no real information here to make a point one way or another. Just another troll drive-by.
What a lie.
Who's the hospital, name the doctor?
In none other than the Wall Street Journal, it was reported that in France, with cradle-to-grave healthcare, people have a longer lifespan but they pay ONE HALF per capita for healthcare.
The US system is broken. Many other countries have shown us the way. We don't need to lead on this issue. Only to follow.
Even more that those who have no insurance are those who have some and yet it's not enough. Those 50+% of the bankrupties in this nation due to medical costs are not just the uninsured.
Retaining a for-profit option is madness. Such providers will skim the cream, and leave the public option to deal with all those who suffer such lingering conditions as diabetes, high blood pressure, lupus -- you name it, and private insurance will refuse to insure it. As they do now, through the device known as 'screening out pre-existing conditions'.
Universal, single-payer spreads the risks, and the costs, across the entire population; thus, per person, they become more manageable. To allow private profit schemes to co-exist beside a 'public option' is to guarantee profits for the former, and impossible costs for the latter.
This would, of course, delight an industry whose entire rationale is to grind profit from human suffering.
Health insurance is not a privilege of wealth. It is a right of citizenship.
How can we legislate that in order for private insurance to be allowed to be in business they cannot turn down any applicants? That is an imperative if the public insurance is to survive. We can legislate that and level the playing field. In that way the public plan will obliterate the private insurers who only live to squeeze patients and doctors for as much as they can.That is the bible of all large corporations. It is for this reason, they must be regulated. This is life and death.. and too often insolvency. Including doctors.
I do not think we should legislate anything for the private industry--hands off. I think we should allow the private insurance companies to do what they do best--ripp people off and meanwhile, the sane poplulation can have their own plan--HR-6
We should not pay any attention to the private health insurance industry--including no subsidies. Why beg this private industry to change--we don't need them--why be beholden to these cretins?
Let the people choose and let the best plan win.
I couldn't have said it better. Bravo! Viva single payer!
I'm perfectly willing to pay taxes to cover those who need the fire department to SAVE their homes in the event of a fire ... even though I may never need to save mine.
WHY in THIS country are we not willing to pay WHATEVER IT TAKES to cover those who need healthcare professionals to SAVE their LIVES in the event of a catastrophic injury or chronic illness ... even though we may never need to SAVE ours?
A house can be replaced. A LIFE cannot!!!
It is SANCTIMONIOUSLY SHAMEFUL that the "right-to-life" in THIS "civilized" country is about MONEY, not MORALITY!!!
I think it's ironic that ANYONE can continue the line that "private is better than public," any more. The only benefits from capitalism are for the real "capitalists," i.e. the CEO's and a few others who actually delve in capital. The rest of us merely work for someone else, we are not capitalists, no, not even if we own stocks. When was the last time a stockholder's opinion was listened to by a Board of Directors?
Ditto with medicine. I have Medicare and, as a retired military, also Tricare. Tricare is a government program but the carrier is a private insurance company. The two systems have worked together superbly, much better than when I had to rely on a private insurance company. I feel doubly safe because the government oversees the private insurance company. The US does have great programs for a few people (mostly government employees-- i.e. read "socialism," not "capitalism") why not expand and adapt those?
Damned straight! I want the same coverage for the same expense that our elected representatives enjoy. Their reluctance to make that happen illustrates the hypocrisy of privilege.
Truer words have not been spoken, LTCKal and elbzee. Thanks for these insights. Private medicine is an abomination to our country. (Plus, Tricare is indeed excellent.
Voters are overwhelmingly in favor of a National Health Care option. What needs to be stressed is that employees who are currently covered by existing health care plans will have the option of switching their monthly payments into the new government health care plan. Those payments that are now going to the private insurance companies, will flow into the new plan that is set up to guarantee lower costs and better coverage for all Americans. If you deduct the need for huge profits for the health insurance companies, you should be able to stretch that money to cover a lot more people. This is what the backers of single payer and a government health care system are counting on and what the private insurance companies fear.
This is a no-brainer for Congress to pass. If they don't pass it this time, they will have to find themselves some new jobs soon. The American people have no more "patience" for a broken health care system.
Agreed. Re-elect no incumbant who votes against single payer.
It was very clear during the election that American citizens wanted REAL health care reform, REAL oversight of banking, credit, and Wall Street entities, and a REAL approach to getting out of the Middle East. Congress and even the President, however, are not listening but continuing down the same self-serving, destructive paths of the Reagan, Bush 1 and 2, and Clinton administrations, and ignoring the majority of the populace. The corporate bigwigs and Pentagon are getting away with it again--no REAL accountability but LOTS of money. Can we please finally be the leaders we supposedly are, ignore the silly attempts at the useless "show" of bi-partisan cooperation, and get something done. The Democrats do not need any Republicans to pass anything. There may be a short window to accomplish things, so we had better ignore them and get it done.
good comments jmb5573. . . I'm new around here
I'd add that the reason ALL of our leaders continue on the path of Reagan, Bushies, Clinton(s) etc. and hide behind the false impediments of Repub v. Demo, etc. is they have no choice. Again as Whip Durban said in frustration, late in May: "The "banks" own the Senate" --(plus the political system, the media, . . yadayada. . . )
This level of control by the financial industry, of all of our priorities as well as what we THINK, was a long time coming. Growing over centuries while feeding on this fraudulent system are Corporations, i.e. insurance firms, Wall St, the defense industry whichever --all complicit. Their ceos and our politicians MUST go along with the money agenda or go away. It's that simple.
with a totally different (non-debt, non-profit) money system we'd have a chance. Otherwise it's all just a tangle of ineffectual attempts to regulate what is fraudulent at its core: the money system under private central banks, owned by people with loyalties elsewhere. (see web of debt)
A drop in physician's fees? That is another fiction. I worked as a practice manager for an ophthalmologist for four years. He wanted to sign up for private health insurance networks--all of whom promised that they would pay 110% of the Medicare fee for the services rendered. Those promises were lies, but there was also a confidentiality covenant in the provider agreement that prevented us from bringing insurers to task for their lies.
If we do have a public insurance scheme--and it puts the private insurers either out of business or marginalizes them (as in France and England)--we should also consider (1) overhauling medical malpractice liability to eliminate the unbelievable overhead for malpractice insurance and (2) publicly financing medical education in exchange for five years of public service assignments to underserved areas.
I should also add that high malpractice insurance rates have eliminated the ranks of OB-GYNs. Reimbursements are too small to cover the malpractice insurance overhead of attending births, but the sky is the limit in cosmetic procedures down there!
"(2) publicly financing medical education in exchange for five years of public service assignments to underserved areas."
I have been saying this for years. The reasons:
(a) the entire med school curricula will no longer be a mouthpiece for Pharmas, which at present, generally fund med schools. It will be a comprehensive curricula based on true medical best practices and unfettered research.
(b) MDs who want to simply help people will be encouraged to join the profession again. And, admission committees attempts to exclude such people will end. At present, only "team players" (e.g. MDs who are uniquely profit oriented) are sought by schools. There is no true exception to this in the U.S. Pathetic.
(c) MDs will no longer be beholden to our current Pharma run medical system in order to repay their crushing med school loans.
To the politicians who want to "ration" healthcare, here's a proposal: How about the Alexandria, Arlington, Washington, DC and Bethesda police ration their emergency responses to politicians --
"9-1-1, what is the nature of your emergency?"
"You have to send a policeman over, right now! I think someone has broken into my house!"
"I'm sorry, Representative Jones--"
"How do you know I'm Representative Jones?"
"You're calling from his number. In any case, we can't send out a policeman, because we've reached our limit of emergency dispatches for tonight."
"But what if he has a gun?"
"Ask him not to kill you before 8 a.m., when a new quota begins."
"Arrgh! How can this be happening?"
"Sorry, Congressman, but it was felt that private security firms couldn't compete with a well-staffed police force."
Which is true, in general. What's your point? That we shouldn't have a "public option" for police? We do, in fact, have a private option, and many, if not most gated and higher-end communities have private security to supplement public police, just as we'd still have a market for private insurance to supplement a public plan.
Those who have Republican religion will repeat their talking points ad nauseam ( which is really bad if you don't have health coverage): Government does no right. Free markets do no wrong. Never mind evidence (HMO's ration health care to make profit -- duh!), and the WHO rankings of France's nationalized health care system being ranked #1 in per capita health care costs; however, the USA is ranked 37th in health system performance (France is ranked #1 in system performance and #4 in per capita expense) the followers of the Republican religion put faith over evidence. The Republican religion ushered in under St. Ronald is faith that unregulated "free markets" will make everything better despite evidence to the contrary. Even Rev. Greenspan has had to "revise" his thinking after the total collapse of his "free market" experiment. Even the COMPETITION of a public option has them shaking in their boots. If private health care delivery is sooooo good, then people should be happy to pay extra to get the same great service they currently enjoy. Everybody that has private health coverage never has to wait to see a physician, has prompt approval on all procedures and tests, gets private hospital rooms, and the best pharmaceuticals on earth at the lowest prices! Delusions must be nice. However, the Repubs will get want they want thanks to the boundless stupidity of the American people. There will be no meaningful health care reform in the USA. Count on it.
My sister has been living in france for more than 30 years. She says an American doctor won;t work for what they pay a doctor in France.
She say that she has to pay about 40 Euros when she goes to a doctor and National Health Care reimburses her 12 Euros.
A nruse from Canada told me that Canadian Health Care is terrible when you really need it.
My cousins in Germany use their national health care for all sorts of conditions - and never had a problem.
Let's keep trading apocryphal stories - it contributes nothing to the debate.
A sister in France, a neighbor in Scotland, a nurse in Canada, wow, you sure are internationally well connected. This is all nonsense of course. Watch the documentary Sicko, for starters. They don't even have cashiers in French hospitals. Get it? Even if you for some reason wanted to pay them from your pocket, there's no one there who can take your money. Your fictional anecdotes are getting tiresome.
If the average american is half as smart as me they realize that there is something really dumb in saying that we can't have a public option because it would be too efficient. Too efficient? I'd kind of like the system that works too well, thank you.
But I think that there also needs to be some education into exactly how wasteful our health care system is.
For example Canada covers everybody. The government's cost per citizen in 2006 was US$2754. The US government covers only a small fraction of its population, specifically the aged, very poor, veterans, and government employees. The cost, per total population, of doing so in 2006 was $3074.
In other words if US health care were as efficient as Canada everybody could be covered by the government and taxes would go down an average of $320 per person per year. And nobody would ever go bankrupt because of a medical problem and our life expectancy would be three years longer.
But we can't have that, it would be 'too efficient'.
I've finally come to the conclusion that if corporate America and the Republicans are against it, it must be a good idea. For-profit insurance CEOs make 65 times more than the American president? WTF! Makes you wonder how many people were denied coverage, medications and treatments and paid with their lives so the CEOs could h
Makes you wonder how many people were denied coverage, medications and treatments and paid with their lives so the CEOs could ...
play "God" with ... AND put a price on ... people's LIVES!
THIS "compassionate christian" country CONVICTS Dr. Jacks for assisted suicide, and not "healthcare" insurance companies for assisted MURDER!
THIS "compassionate christian" country INFLICTS life on those who want to die, and DEATH on those who want to LIVE!
That is INSANE and INHUMANE!
A public plan with multiple private plans will not work. People who are healthy (insurable) will opt for the public plan for more choices of doctors, drugs and hospitals. People who are not insurable will opt for the public plan--presumably it will take all comers. In the insurance industry this is called anti-selection.
The only logical path is a single payer public plan with price controls on prescription drugs, low deductibles and reasonable copays based on taxable income. It is well known that the larger the group the wider the risk spread, so you want to have the largest group possible to spread risk which will result in lower costs overall--mandatory coverage for all citizens with the same public plan.
If we don't go with a sensible plan, the situation will only worsen for both insured and uninsured individuals. According to a recent article in the Dallas Morning News, medical bills are responsible for 62% of bankruptcies nationally and 75% of those have health insurance.
Well put! An addition to that last sentence is that over the last two years, over 30% of the population, or 80 million people, were uninsured at some point (at least temporarily). We need legislation absolutely prohibiting those private insurance companies from denying coverage to anyone, regardless of preexisting conditions.
Frankly, I'd like to see the insurance companies OUT of the health care business except for selective cosmetic treatments and maybe catastrophic coverage.
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