We're headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many Senators are still standing in the way.
The reform includes a broad range of measures to extend and improve care and help curb rising costs, but the epicenter of the debate is over what is called the "public option." Health care reform will mandate businesses provide insurance or pay into a general fund. Individuals will be responsible to get health insurance, with subsidies for those that can't afford it. We'll able to retain the insurance we have, or have the choice of a range of plans, including a public option, modeled after Medicare. A strong public option, competing with private insurance, is key to helping to get costs under control.
And costs must be brought under control. We now spend nearly 50% more on health care per capita than any other country, with mediocre results. We ration care by price, with some 47 million Americans uninsured. It costs the rest of us about $1000 a year to pay for the price of their care when they are forced finally to check themselves into emergency rooms.
Tell stories, not statistics, the pollsters tell us. But after adjusting for inflation, health care costs have soared by 58% since 2000; while wages for most Americans were stagnant or lost ground. As the auto companies showed, businesses increasingly can't afford health care. Families find it unaffordable. Virtually the entire long term debt challenge facing the US government is from the projected rise of health care costs. Get health care costs under control, the US has no long term fiscal problem. Fail to get them under control, the costs will bankrupt the federal government, state governments, businesses that offer health care (and increasing numbers won't) and families. Reform that gets costs under control is imperative. There is no choice.
A key to getting costs under control is the public plan. It can take advantage of its purchasing power to gain cost reductions. It can model best care practices. Private insurance -- which in most localities translates into a couple of dominant providers that don't compete on price -- will be forced to measure up with greater efficiency, innovation, and cost savings techniques.
Yet the debate in the Senate has been fixated on how to weaken or abandon the public plan rather than strengthen it. Republicans, for the most part, have taken themselves out of the adult conversation. Like first generation robots, they endlessly repeat the exact same words crafted by Frank Luntz - "government takeover," "no choice of doctor," "bureaucrats not doctors prescribing medicine." It's frankly pathetic. We have no choice as a society but to figure out how to fix this - and Republican leaders have chosen simply to peddle lies and scare stories and absent themselves from any serious discussion.
A gaggle of Democratic Senators -- led by Senator Baucus and the so-called "moderate" Senators -- have publicly thrashed around for ways to weaken or gut the public option. Outside groups like the Third Way have provided guidelines for disemboweling it. Some have suggested putting it off until private insurance competition proves it can't get costs under control -- as if that hasn't been proven over the last decades. Baucus suggested decentralized local "co-ops" would serve as the public option -- an idea notable for being both unmanageable and ineffective. Even if a network of coops somehow arose to insure that people had an option, they wouldn't have the clout to hold costs down and force private insurance to compete.
Others, remarkably, have detailed ways to deprive the public option of the power to lower costs. They call for a "level playing field" with private insurance. The public plan can't be subsidized, can't use its buying power to lower costs, can't take advantage of lower administrative overhead.
This sounds silly. We face soaring health care costs that will literally cripple our future. Surely, no Senator concerned about the country would work to undermine the key idea that would help get a lid on costs. They wouldn't, as Barack Obama warned, just "create a system where the insurance companies have more customers on Uncle Sam's dime, but still fail to meet their responsibilities." If you assume that, you would be wrong. They've done it repeatedly in the past.
For example, early in Bush's first term, Republicans decided that passing a prescription drug benefit for seniors would help cement Karl Rove's permanent majority. The benefit would help 41 million Americans with a soaring cost of care not yet covered by Medicare. It would also create massive new market for the drug companies. And, of course, Medicare could do what governments across the world do -- use its buying power to lower the cost of the drugs.
Only, when Republicans passed the law -- in the dead of night, twisting arms to get it done -- it actually prohibited Medicare from negotiating a lower price for drugs. Don't worry, they argued, competition would lower drug costs (even as they banned the import of cheaper drugs from Canada or Mexico).
Why? Well, using government muscle violated "free market" sensibilities. More importantly, the drug companies have one of the most powerful lobbies on Capitol Hill. Billy Tauzin, the chair of the key House committee ushering the bill through, left soon after to get a two million dollar a year job as a head of Big PhRMA, the drug company lobby. Tom Scully, the administration's point person who helped secret the actual cost of the bill, was already negotiating his million dollar job as the debate was going on. In all, 15 congressional representatives, aides and administration officials involved in the debate left shortly thereafter to take jobs with the drug lobby. With a $9 billion increase in annual profits at stake, the drug industry got an amazing return on its investment.
Today, seniors pay 60% more for the same drugs than the price charged veterans becuse the Veteran's Administration does negotiate lower prices.
Extreme? Not really. The health insurance companies decided they should be allowed to compete with Medicare in providing health insurance options to seniors. Seniors would get more choice; Medicare, the bureaucratic behemoth, would get agile competition. Win, win, they argued, calling the program "Medicare Advantage."
Only the insurance companies couldn't compete with Medicare straight up. So they demanded subsidies from the government to enable them to vie with the Medicare program they described as horrendously inefficient, unpopular and bureaucratic.
And they stand to pocket an estimated $177 billion in excess payments over 10 years to compete with Medicare - subsidies that Obama would sensibly cut to help pay for health care reform.
Money talks. Nine Republican Senators on the key Senate Finance Committee wrote President Obama to say they would oppose any reform with a public plan. The Center for Responsive Politics reports that the nine had had pocketed $17.7 million in contributions from insurance and health care interests over the course of their careers.. http://www.bio-medicine.org/medicine-news-1/Senators-Who-Signed-Letter-Opposing-Public-Health-Plan-Took--2417-7-Million-in-Campaign-Donations-from-Health-Care-and-Insurance-Industries-48233-1/
Not surprisingly, the 20 largest insurance and drug companies and their trade associations have pumped up their lobbying by 41% over last year -- with reported spending over $75 million in the first quarter alone.
This is the corruption of crony capitalism; a compromised congress using taxpayer's money to enrich entrenched interests. Only now, the cost of this in health care is not sustainable. Dramatic reform is vital or we all follow the auto companies and go belly up.
So if your Senator says he or she is opposed to a public option, or wants a weaker public option, or a non-profit co-op that isn't big government, or prates about the "government takeover of health care," about losing your choice of doctor, about bureaucrats not doctors prescribing medicine, don't fall for it. Either he or she is either utterly clueless or more likely is representing the interests of the industry, not the voters.
This business as usual is no longer affordable or acceptable. We shouldn't let cynicism lower our expectations. Soaring health care costs and the human tragedy of those without insurance can no longer be ignored. Reform can't be postponed. It is a stunning disservice that Republicans have taken themselves out of serious discussion. And it is an open scandal that Senators are catering to the private insurance industry that has profited from the problem rather than helping to solve it. We must expect more and demand more from those given the privilege to represent us.
These Democratic Senators have NOT agreed to support it:
Senator Blanche Lincoln (D-AR)
Senator Tom Carper (D-DE)
Senator Maria Cantwell (D-WA)
Senator Ron Wyden (D-OR)
Senator Bill Nelson (D-FL)
Senator Ben Nelson (D-NE)
Senator Mary Landrieu (D-LA)
Senator Kent Conrad (D-ND)
Senator Max Baucus (D-MT)
Senator Dianne Feinstein (D-CA)
Senator Evan Bayh (D-IN)
Senator Mark Pryor (D-AR)
Senator Joe Lieberman (I-CT)
These names are reported by The Hill here and here
Update: Senator Kay Hagan (D-NC) says she supports a public option.
Update: Senator Jeff Binghaman (D-NM) says he supports a public option.
You can also contact the White House and voice your opinion
Comments: 202-456-1111
Switchboard: 202-456-1414
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On The Show
Coming up Friday, July 10, 2009
•Senator Tom Harkin (D-IA) joins the show to talk about health care reform
•ABC News This Week host George Stephanopoulos joins the show
Thursday, July 9, 2009
Rank-and-File Members:
The current salary (2009) for rank-and-file members of the House and Senate is $174,000 per year.
Congress: Leadership Members' Salary (2009)
Leaders of the House and Senate are paid a higher salary than rank-and-file members.
Senate Leadership
Majority Party Leader - $193,400
Minority Party Leader - $193,400
House Leadership
Speaker of the House - $223,500
Majority Leader - $193,400
Minority Leader - $193,400
A cost-of-living-adjustment (COLA) increase takes effect annually unless Congress votes to not accept it.
Want a raise? Don't beg to your boss. Just vote yourself one. That's what the United States Congress just did. For the fifth year in a row, lawmakers voted not to reject their automatic "cost of living" raise that will increase the annual salary of members by $3,400 to a total of $158,103 per year.
I can't believe they sell us out just for campaign contributions.
At the risk of stating the obvious, let me posit that there are two major factors:
1. Money talks, BS walks
2. The President and the Congress do NOT represent the people
We all know this. Yet we persist in indulging in impassioned arguments, as if it would make any difference.
The real solution to this problem lies in how we address the two factors.
The first one is not difficult. Are we willing to put our money where our mouths are? Remember the number of small donations that got Obama elected. It is quite possible to raise a large sum of money. What we do with the money is another discussion.
The second one is trickier to counter. Lets put out collective heads together to find an effective way to remind Washington that hey serve us.
This is the time for action. They will vote soon. A huge stand by the people in the streets of Washington is what will get attention. Just look at the situation in Iran. Sitting on our computers is not enough. The people must take collective action, to counter the money that the powers that be are exchanging. We are not pissed enough, so they are not paying attention.
Where is the organization?
Everyone is talking and nobody is walking!!!!!
Here's a partial list:
www.singlepayeraction.org
http://www.healthcare-now.org
www.pnhp.org
http://www.1payer.net/
http://www.guaranteedhealthcare.org/
Among the organizations represented on this list are Physicians for a National Health Plan (membership 16,000 and representing the pro-single-payer views of the majority of American doctors) and the California Nurses Association, the nation's largest state nurses union. Moreover, a majority of the American people favor single payer--see the following:
http://www.healthcare-now.org/wp-content/uploads/pdf/polling.pdf
http://www.reuters.com/article/latestCrisis/idUSN31432035
In brief--don't mourn and carp, organize!
Do
I wonder if they all have offshore accounts. I have always found it hard to believe that they work against the public interest just for campaign contributions. They must be packing money away for themselves somewhere.
There's also more than one way to skin this cat....just think John Ensign, Larry Craig, Eliot Spitzer.....see a common thread?
Okay, we know the Republicans got a lot when they were in power and will get more to ensure they do not waver in their opposition to real reform.
But the Democrats are finally back at the trough again, after 8 years of foraging in the wilderness. We need to target these people hard, so they stay with us just to prove that they haven't been bought.
So who is getting what? Anybody know?
http://www.opensecrets.org/news/2009/03/health-insurers-owe-policyhold.html
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/07/AR2009030701748.html
I am ready to go.
So, that's 1. But, I am not leaving Chicago, until I see some action. Are there 4,999,999 more of you out there?
Where is Common Cause? Where is Public Citizen? Where is PIRG? Where is MoveOn.org? Where are the Unions? AARP? ACLU? American Council on Science and Health? Congress Watch? Where is the media coverage of the People's voice?
Let's tune into reality--Obama is as much a hireling of the HMOs and drug companies as Baucus/Pelosi and the Republicans. His campaign bulged with some $15 million from the health sectors, twice as much as McCain received.
It's critical to be able to distinguish your allies from your foes. Obama is not among your allies in the struggle for single payer.
There is no call to arms. Everyone is sitting on their butts, complaining. I am more frustrated with the lack of activism than I am with Congress. This is an outrage and people are giving in to the rhetoric. What happen to YES WE CAN???
Fox sponsored its tea parties for people who want to eliminate taxes during a time of great national deficits that will further weaken the dollar, undermining both the economy and our system of government. Who will sponsor parties to truly enhance our lives, the purpose of government?
If this were not so serious, it would be an amusing example of twisted priorities.
Bankruptcy is not an issue. Either we support essential things or there is no reason to gather money.
Further big pharma will obstruct anyone finding cures for diseases. They don't want cures they want as many people on pharmaceutical maintenance as possible. When they themselves find the cure to something, if the ingredients are common place, they cover up these findings. For example if the cure for AIDS was found in a pineapple they would make sure no one knew about these findings because there is no money it, They are fixing this problem by having laws passed that have enabled them to take out copyrights on plants that have been around since the dawn of time. For example University at Waco owns a copyright on Turmeric a healing herb that has been around since before man.
The advantage of single-payer is in risk pooling--everyone is in the same pool: well, sick, young, old, sick, and poor, thus averaging out the risks and costs of guaranteeing cost-efficient coverage to everyone. In the "public-option plan," everyone is NOT in the same risk pool, as they would be in single payer. In a "pub-op" plan, the oldest, sickest, and poorest would end up in the public plan; the youngest and healthiest--and hence most profitable--would be aggressively marketed by the private HMOs.
Hence the whole advantage of single-payer risk pooling would be lost: combining EVERYONE's resources (through a modest tax rather than bloated private premiums) so that the currently healthy 80 percent subsidize the unhealthy 20 percent and thus achieve cost efficiencies not obtainable if these two groups are in separate pools.
Moreover, because of these untenable costs, the public plan will have to charge premiums and impose deductibles, just like the private plans--more of the same, notwithstanding the "public" branding.
We need to say, "Single payer Medicare for all . . . or NO DEAL! We stay in the streets until we win REAL REFORM, not another corporate liberal sham/flim-flam."
The single payer plan is about combining everyone's resources and pooling risk. And the 80%
subsidize the 20% who through either bad luck or much more commonly poor choices are unhealthy.
A kind of welfare for health care.
Another entitlement program because the last four have worked so very well at changing the status quo.
Tell me what is going to make government run healthcare work so much better than Sosial Security?
Anyone reading this blog going to rely on SSN for you retirement?
Welcome in a new era of reinsurance.
The point is about cost containment--the private health-care system in this country is bleeding the economy white with its enormous 30 percent overhead, caused by (1) the redundant billing bureaucracies needed by the insurers, hospitals, and doctors to keep track of billing from 1,300 different payers; (2) profiteering that siphons off hundreds of billions each hear to stockholders and overpaid CEOs (last year the average HMO CEO made $14 million). Not ONE PENNY of this hundreds of billions wasted on billing and profiteering goes to providing health care.
Contrast this to the nonprofit, single-payer variants in all the other industrialized countries of the world: their overhead averages about 3 to 5 percent, their per capita health-care costs are HALF those of the United States while covering all their citizens, and they have better life expectancy and lower infant-mortality rates.
As Senator Tom Harkin said, "I used to sell insurance. The basic rule is the larger the pool the less expensive the health care. Today we have 1,300 separate pools - separate health care plans - and that is why health care is so expensive; 700 pools would be more efficient and less expensive and one pool would be the least expensive. That's why single payer is the answer."
Unfortunately, although the majority of Americans want single-payer, the majority of VOTERS are still buying into the decades-old "socialized" medicine scare tactic. Ironic when you think about how many of them are on Medicare. Reformers don't want to give the industry and it's usual stooges the opportunity to repeat past success at turning people against reform.
From an administrative standpoint, expanding the existing Medicare bureaucracy to encompass the public option is the most efficient and cost effective method best managed via slow, steady growth. Even if Congress passed single-payer, implementation would have to be in phases or it would be a nightmare.
Republicans are correct in one aspect. The public option will be 20% to 25% less expensive immediately because it will be non-profit. Those insured through the public plan will experience the switch the same way they do any time their employer changes providers. Private health insurance will go out of business because they cannot compete. Voila! America has a single-payer plan by default.
First of all, there is no completely specified version of what this public option will be--it could end up being the farce floated by Chuck Schumer: self-sustaining (no public funds), would have to charge premiums and impose deductibles, would have to offer higher rates of compensation than Medicare. How is that going to cut costs?
Moreover, any public option plan will be denied the cost efficiences of single-payer risk pooling.
Public options have been tried in five states, and in none of those cases did they reduce costs or increase coverage.
You were right when you called the public option a feint--but that's all it is. It's a nonstarter, from all angles.
"bureaucrats not doctors prescribing medicine" - is exactly what Obama's plan will result in... they will price-out free market solutions that work well now.
Want to reform this all? DEAL with the ridiculous Law Suits and the price goes down for all of us...
Make it illegal = forcing people into the Gov. policy!
It would help if you listened to both sides of the argument, learned them and then made up your own mind based on reality that you can see for yourself. Stop listening to people who prove themselves wrong time and time again.
You ever try to get the new insurance (after being laid off) to pay for the condition the old insurance was paying for? Nope, preexisting condition. Sorry, you are or might get sick.
Wonderful "system we have." Don't want to help your neighbors when their kid gets hit by a car and pop has been laid off? Fine. Just stand up and say it.
The system we HAVE has been designed and built on the "private model." over 40 some years. It is nuts and it makes Americans look stupid. It is time for some public input. Insist on a bill that we can all read and understand. I want a real discussion with my representatives. I want him to indicate that he completely understands what he is voting on!
In the current system, you have private HMO bean counters making medical decisions--dictating what doctors can and cannot do based on their bottom lines.
Under a single-payer system, the funding is public but the administration remains private. ALL medical decisions would be in the hands of doctors, never insurance-company penny-pinchers.
Wake-up - What's the Gov. record of service??
This is being rushed (why rush it = fear that the details will be rejected), like the stupid stimulus bill which has done NOTHING!
"There is no free lunch!"
We need to know the details of what you're supporting--would it charge premiums? Would it impose deductibles? Would it have to be self-sustaining, or could it accept government funding? Would it base its fees on Medicare, or would it have to offer higher fees?
If you can explain the details of what YOU mean by public option, which variant of it you support and which variants you oppose, and how it would give citizens an advantage over private plans, please do so--in your own words.
If you can't, that means you have no idea what you're supporting, other than a vaguely good intention that means nothing.
Public-option plans have been tried in five states, and in every case they have failed to reduce costs or increase coverage. The only PROVEN way of accomplishing both of those goals--based on a half-century of experience in the rest of the industrialized world--is a nonprofit, single-payer approach.
For a detailed analysis of the pitfalls of the public options, please see the following:
http://www.commondreams.org/print/43440
http://www.pnhp.org/facts/singlepayer_faq.php#public-option
Oh, by the way, you don't have to be a doctor to join PNHP, I told them I wasn't a doctor when I signed up so I wouldn't be arrested for practicing Healthcare activism without a license !
1. Remove health insurance from employment
2. Offer public health insurance with coverage choices where consumers pay monthly premiums and co-pays, as they do with private health insurance. This will mean that employees who now have subsidized premiums may have to pay more, so that the uninsured and those independents paying many times more with far less coverage pay the same as others. The reduction in costs to state and local governments would be huge. (if you really got creative you could give public employees an across the board wage increase to make up for part of the subsidy that they lose) Rates, etc. can be worked out. You could also contract to the private sector the administration of claims.
3. Allow private health insurance as well. Unlike the present system where they offer 'sweetheart deals' to govt agencies and large corps. based on volume, they can market to indiviudals and families as with other types of insurance.
You obviously have decent coverage or you would realize no system could be worse than the present system, unless you have a good job with good coverage.
Honestly, I'd like to know? Bush left with a half a Trillion or so in debit, Obama has x3rd that and for what? "0"!
Now you're jumping on this? THERE IS NO MONEY!
Campaign Reform, i.e. public financing of campaigns is the ONLY solution along with radical reform in lobbying restrictions.
Until then, we will have a government bought and paid for by the rich greedy selfish interests.
I hope that horrible ruling by the Supreme Court that money equals speech (!) will not block any true reform, desperately needed. Go to Common Cause or Public Citizen to get involved!
Lately I have been wondering if the laws against bribery have been repealed. Has any one arrested for bribery attempted a "free speech" defense?
Lobbying, bribery, influence peddling - it's all the same thing. How can just one be protected free speech?
Let's all get / stay involved in the political process - starting at the primary level. We've gotten our government away from the wing-nuts. Now we have to clean out Congress, get rid of legislators that put corporate interests before the people's interests. They won't be hard to spot.
It is funny to say this; however, include a viable public option and let the market decide and we will over time transform our healthcare system to a single payor system. If the nay-sayers are right that public programs like Canada's and those in our countries are no good, then of course this won't happen. This is why the public option is so scary to some people and why their arguments against a public option are actually one of the best arguments for a viable public option.
P. S. We can't go straight to a single payor system anyway as it would cause a massive economic restructuring that would be untenable in today's economic climate. That is why it must be included as an option to allow a migration to the public option over time.