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

[quidam56]

We must speak up and demand health care reform NOW ! People are dying and the politicians and the profit machines are raking it in. http://www.wisecountyissues.com/?p=62 I know what is deemed, defended and supported in Tennessee and Virginia as "the acceptable standards of health care". Clearly Profit Care is more important than Patient Care.

[MacQ]

Oh good. People will stop dying!

[exoevolution]

There should be NO PROFIT, when it comes to the health care of PEOPLE!

The choice for our politicians is quite clear, PROFITS for the CORPORATIONS "OR" HUMANE, AFFORDABLE, HEALTH CARE for ALL AMERICANS!

The outcome of the HEALTH CARE "debate" will speak volumes about our CORPORATE OWNED politicians & President Obama's campaign mantra of CHANGE WE CAN BELIEVE IN!

[stuporman]

there should especially be no profit when profit is a conflict of interest with health care.

[VinceTeeter]

What we need is health care, not health coverage. I am having to pay over $120 a month to get just the minimum Medicare care and drugs. This is nothing more than a tax on Social Security to pay the insurance companies, or a method of recovering Social Security from those who need it.

We need a public health office on every street corner.

[MacQ]

And you think that will be free?

[ndtovent]

Well, my hmo that I pay out the a** for is certainly not free. Far from it.

[Max Wood]

If meaningful healthcare reform does not pass before 2010 then the country is screwed. People like me (that fought tooth and nail for this President because we wanted a public option in healthcare) will not bother to go the polls next time and the GD republicans will take back over. After that I will move to a country that actually cares about its citizens more than it cares about its corporations.

[dagdavid]

I could not agree more. Forget the republicans on this one. To those blue dog dems that don't favor a public option SANS TRIGGER - take a page out of gop tactics and have the DNC threaten to run a contestant in their next primary if they do not get in line.

[jinxed]

I'm all for that...get on board or get the f**k out of the way!

[roudy]

"Bipartisan" means the worst ideas of both parties are combined and that becomes law.

[Kaelieh]

Well said.

[Realization]

The point of health care reform must include making U.S. industry competitive. That means the optimal system is single payer with economies of scale and an efficient, streamlined management. (Single payer itself is not the solution if opponents manage to hamstring it with rules that benefit Big Pharma, or whoever. It must be well designed.)

Coverage for all, focus on results so our health care is as good as that in other advanced nations, efficiency so health care costs are a comparable share of GDP as that in other advanced nations. We can do it, of course, if the party of NO doesn't wreck things. Where is that American can-do spirit?

The alternative is continued weakening of our economy and national prestige.

We also need to eliminate the trade deficit (over $700 billion per year) and rejuvenate American manufacturing and technology. That means revamping our failed trade policy and having an industrial policy like our competition. The increased tax revenue would help solve everything else.

[jinxed]

Another iten that needs to be suspended until our deficit equals ZERO is NO MORE FOREIGN AID to countries who have do not have famine conditions! We can't buy friends, we MUST lead by example because friends do not stay "bought"!

[crazyv]

I think the public option must come with certain conditions.

a. it must operate at a profit and generate a profit that is an acceptable return on capital.

b. any subsidizing of low income clients should be done through an appropriation from congress and private insurers will also be allowed to use that subsidy for their clients.

This way there is a level playing field between the public plan and private insurers. The efficient viable private insurers will be able to compete. Absent these requirements the public plan would be able to out compete the private plans not because they are more efficient but because they can run a loss or make no return on capital. It will also ensure that there is minimal interference from Congress.

While I strongly support a government plan such a plan without the discipline of a private option will be a disaster.

[LeftRight]

WHY should it turn a profit?? It's a government program. You want EFFICIENCY with government, not profit!

[Kaelieh]

When have governments ever been efficient? How many years in Iraq? How many more in Afghanistan? The blunder in Vietnam? Failing school systems? Failing apart roadways. Yes, government is very efficient.

[judgejay]

You're Crazy alright. There is no way for our government to do anything that is profitable. They waste billions each year as it is. The only thing that will happen with health care reform is a lack of choice and higher taxes. All the european countries which have government health care ration it. If a treatment is too exspensive too bad they won't pay for it. In addition you can wait months yes months just to see a doctor never mind the wait to see a specialist. This will just mean crappy health care for all and higher taxes.

[BStrimas]

What will it take for you to take the blinders off? Public health is not rationed, you are living in the country that allows you to be bankrupted for a serious illness because someone is supposed to profit at the end of the day. The only treatments that are denied in my country are ones that are deemed cosmetic or experimental. Got cancer? Need a quad bypass? Paid for - all for the insanely high price of $96 per month for me, my spouse and child. But by all means, keep allowing a corporation and not a doctor to decide what kind of medical care you need - that's not crazy at all.

[LeftRight]

And also, I would like to point something out to you. The average cost for Medicare is three cents. That means that out of every dollar that they spend in the Medicare program, three cents of it goes towards something other than medical care.

The average insurance company spends around 25-50 cents. Out of every dollar that a private insurance company spends, 25 to 50 cents of it goes to something other than medical care.

Are we SURE that we want to have Single Payer compete with that????

[Pablo175]

Please measuure medicare fraud.

Also Medicare just sets reimbursement rates low and private payers have to pay more to make up for deficiency.

[Connolly1916]

Yes, run the bastards out of business. Serves them right.

[Adartist777]

If the majority of the people of America want public health insurance, they should get it. There shouldn't even be any arguments about it. Who cares what private insurers think? They had their day! Hell, if wealthy people still want private health insurance, let those companies gouge them!

Health care should be a right, not a privilege.

[Maxiesid]

Most of us out here agree. Instead, though, I am reading in the mainstream propaganda press that President Obama is going to make it a part of his health care reform to change the rules so that you can be taxed on your medical benefits if you get them from work. During the campaign he was against this, he campaigned against it and now he is for it? Do they understand that you pay taxes on your income, then they take a part of that income to pay for your medical benefits and one of the benefits is that they match your contribution so you can have benefits at all? . Most of the time you have a job that is already paying less, but it was worth it for the medical benefits. I know the government is really into the habit of robbing the voters, but this will be the last straw. Those of us that are making it through, although just barely....­. keeping up with the mortgage payments, not defaulting, paying our way.. will be devastated if you start taxing us on something that we had no choice about buying. When the company offers health benefits you don't get to say, jeezz you are paying a huge amount for that! But they want to steal more money out of your check to tax you on it as well? We need single payer, and we need to get the for profit insurance corporations out of our health care.

[jinxed]

NO, that is what Max Baucus and Grassley want to do along with the Republicans. That was McCain's big idea during the past election cycle, remember? And while you are at it, ask Max how well his ideas went over in Montana when he tried to pedal his BS in "listening tours" recently.

[RevSpaminator]

We will NEVER see a real solution to this problem. The minority profiting off of the majority has enough money to make sure real health care reform never happens. We are just the voters. What we want doesn't matter. Just ask anyone on Wall Street how much meaningful regulatory reform they expect to see. Again, we are only the voters. Our opinions only count when polls are open, never after they close.

[Rita at Goldivas]

That is why we all need to let our congresspersons know - we are watching, and we will remember how they voted!

[RevSpaminator]

So those with the big bucks can pay to replace disliked politicians with new fresh new faces and a lot of promises of reform that no one intends to keep.

[Pablo175]

There are not enough Democrats who support a public option. The government created farm subsidies, ethanol subsidies, the post office, etc. Why does anyone think that the government can run health care. All Medicare does is charge lower rates so that doctors and hospitals have to charge private payers more. The public option will exacerbate this. It is the road to rationing health care.

[Realization]

I keep hearing the refrain about the danger of "rationing health care". I have a good health insurance plan and as far as I can tell the plan dictates what doctors I can see that are in the plan and rations care.

I had a 96 year old great aunt who died this spring. Just before she died they did a CAT scan and a bunch of other tests. She didn't ask for them. She thought it was dumb. She thought that should have been "rationed". So do I. Only reason I can see for sending that money on someone about to go, which is natural at 96, is that someone was getting paid for providing the service whether it made sense or not. Gotta control that.

[Pablo175]

Great. So lets have a group of bureaucrats sit around a table and decide who gets what healthcare.

[zipowitz]

Sorry to hear about your Aunt, my condolences.

On the topic however, she could have refused the CAT scan. But this is a part of a bigger problem, lawyers. Most of these doctors order all of these tests that people don't need because if in the event something serious happened or nature takes it's course, they don't want to get sued for negligence. So what do they do, order tests and more tests. A huge part of the costs of the medical industry is insurance against malpractice. It feeds itself.

[LeftRight]

You DO realize that Medicare is spending less than private insurers because it's being starved for cash, right?? They are still spending a mere three cents out of every dollar on non-health care items, compared to an average of 25 to 50 cents of every dollar for private insurance!!

[iamarivergirl]

I am a believer in progress. The republicans are so worried about private health insurers that can't compete might go out of business, if they can no longer make a profit out of suffering people. The makers of Conestoga Wagons went out of businesss when the railroads came in. I see no problem with private health insurers going out of business because something more progressive comes along.

[jinxed]

Well stated!

[TheLearnedEnglishDog]

The control that for-profit insurance exerts over our government is one of the main reasons this country is failing to prosper. The have figured out how to tuirn human misery into private profit, and they aren't going to willingly give up some of their turf. The people on the right who keep this going are truly disgusting human beings

[billyfromphilly]

Very well said "thelearne­denglishdo­g". I couldn't agree with you more. I believe that one of the governments primary functions should be to ensure that all of its citizens have access to basic needs. If the richest nation on earth has about 16% of its people uninsured, then it doesn't really matter how many millionaires we have does it? We fail.

When conservatives flap their yaps about "freedom", what they're really upset about is that they're one of the select few that have benefited greatly from our capitalist system, and they see everybody else as a threat and don't want them cutting in on their "rights" to be filthy rich and watch others suffer. There couldn't be a less "christian" thing to do.

[Realization]

It's not just in health care. Read a bit of economic history. The U.S. is now plagued with the "iron rice bowl", the vested interests protecting their own bit of the pie which is often a result of ripping off the available wealth. This is what was keeping Asia from developing not so long ago. Now it is driving the U.S. downhill.

A public plan to compete with private plans would provide consumer choice and be a free market option. It's competition, folks. But it would have to be well designed with little to no input form the people who want it to fail.

[RevSpaminator]

You say "the people on the right", but lets all get real for a minute. Everyone is on the take from these guys.

[Max Wood]

I agree....a­nyone that is on the side of the private insurers in this debate is a truly sick individual.

[SiberianRat]

Please write to Obama and to Congress on this--I have several times and will again. We MUST have a solid public option--there's no other fair, affordable way.

[NightOwlCafe]

As suggested on the Thom Hatman show, please call or send hand written letters. It does make a difference. Unfortunately emails often go unread.

[Rita at Goldivas]

Yes!

[TryToBeFlexible]

SIngle payer! Single payer! Single payer!