Like many people who hoped the stars had finally aligned for a fundamental overhaul of our health care system, I have been going through all of Elisabeth Kubler-Ross' stages of grief and loss -- denial, anger, bargaining, depression and acceptance -- as I've watched what has been happening in the Senate. I moved toward acceptance this morning as I watched the Senate pass its bill, but -- being an incurable optimist -- I'm still hopeful that the legislation can be improved when Senate and House conferees meet to determine what the final bill will look like.
But even if all the problems of the Senate bill can't be fixed in conference, Congress must send the president a bill to sign -- and soon. My position on this puts me at odds with many of the wonderful reform advocates I have met in the six months that have passed since I switched sides in this national debate -- going from being a spokesman for the health insurance industry to being a vocal critic of it -- in testimony before Senator Jay Rockefeller's Commerce, Science and Transportation Committee last June.
Over the past few days, some organizations that have worked so hard for many years for comprehensive reform, especially those that have advocated for a single payer system like Canada's, have joined groups on the opposite end of the political and philosophical spectrum in calling for defeat of the legislation. "Kill the Bill" is in the subject line of many emails I've been getting lately.
I understand their frustration, but I believe that when they stop and think about the real consequences of what they demanding, they will realize that for all its disappointing compromises and flaws, even the Senate-passed bill should be viewed as a foundation that can be built upon in years to come. Ted Kennedy, who advocated for a "Medicare for All" type system before many of today's activists were born, would truly have been proud of this beginning. He would not have liked everything about the bill, that's for sure, but he understood what it means to live in a political world and that compromises -- even big ones -- almost always have to be made on the journey toward an ultimate destination.
We will not be arriving at that final destination with the bill that reaches the president, but we have started the journey. Progressives must keep in mind that even leaving the station has not been a possibility for 15 years. We must not forget what happened in 1994 -- the last time we thought the stars had aligned -- when opponents of reform prevailed. We must also not forget that many of the reforms in the Senate and House bills are critically important. Yes, insurance companies likely will try to game the system in their relentless quests to meet Wall Street's expectations, but many of the practices they have used for decades to do that will become illegal. We also must not forget the importance to lawmakers of the future of having a foundation to build upon. They will not have to start from scratch as current and past lawmakers have always had to do. And future lawmakers will be able to fix problems not addressed by this legislation as well as the unintended consequences that inevitably will arise.
Among the other wonderful people I have met over the past six months are people who were denied coverage -- or lost it -- because insurance companies had decided they had disqualifying "pre-existing conditions." Others, many with chronic conditions, lost coverage when they lost their jobs and have no idea how they will be able to eat, pay the mortgage and buy the medications necessary to stay alive. They are scared, and they are desperate. The stories I have heard have been heartbreaking. I just wish my former corporate colleagues, the tea baggers who tried to shut down even consideration of reform, and the "Kill the Bill" liberals could have been my traveling companions. I'm sure many of them, even the liberals who think we can wait until we can get more perfect reform, would have been stunned to hear the compelling evidence that the country they love, the country many opponents of reform continue to insist has the best health care system in the world, lets this happen to their fellow citizens. Looking people in the eyes as they tell their stories makes you understand in ways you couldn't before just how crucial it is to act now.
After speaking in Omaha and Des Moines at the end of last week, and hearing more heartbreaking and maddening stories, I flew to Tennessee to visit my parents. They had to move to an assisted living home over the summer after Dad fell and broke his arm, so I try to get down there to check on them as often as I can. I nearly panicked when I couldn't find them when I got there. Their bedroom was cold. I eventually discovered them, covered in blankets, in the common living room. Dad was sitting in the big recliner he had brought from home, so big it takes a lot of effort to get from one place to another.
I learned that the building had lost heat during the snowstorm the night before -- and that Eddie the maintenance man had gone to the considerable trouble of hauling Dad's chair to the living room so that Dad would be more comfortable.
When Eddie took me aside and whispered that he wanted to talk with me about something, I was afraid he was going to give me some bad news about Mom or Dad. Instead, he told me that he had recently lost his health insurance when his employer at his second job laid him off. He had been able to get coverage for himself since then, but not for his wife. He asked me if I could help.
For the first time I had an idea of what it must be like for a doctor to tell a patient with a terminal illness that there is nothing he can do. I wish I could have given Eddie some encouraging news and some suggestions of where to look for insurance, but the reality is that his wife probably will not be able to get coverage in the United States of America unless she gets lucky and is hired by a company that offers benefits.
If Congress doesn't pass reform legislation, Eddie's wife might never again have health insurance. It is probably more likely, in fact, that she will be among the 45,000 Americans who die every year -- 123 every day -- because they don't have insurance. So even though the Senate bill is far from being the bill of our dreams, it will help people like Eddie's wife. It might even save her life.
It is tempting to join the "Kill the bill" folks, but it would amount to cutting off our noses to spite our faces. Big Insurance and Big Pharma will not be running out of money anytime soon to spend on manipulating public opinion and influencing votes on Capitol Hill. Part of every premium dollar we send to our insurance companies, and part of every dollar we pay when we pick up our prescriptions, end up in corporate piggy banks that overpaid executives tap to hire armies of lobbyists and PR firms whenever their profits are being threatened. These giant corporations and their trade associations have been saving up and preparing for this debate for years. I know because I used to be part of it.
Reform advocates do not have such an endless supply of money. After this long fight, their resources are already dwindling. Over the past several weeks, opponents of reform have been able to spend twice as much as reform advocates on advertising. And the opponents' ads are part of a campaign carefully and disingenuously crafted by the best PR and advertising people money can buy to scare people away from the very reform that would benefit them most. So it is little wonder that polls show Americans are having second thoughts about reform.
Although the effort to achieve health care reform has been arduous and ugly, progressives can't merely brush off their hands, move on to other issues and hope the stars will align again for "real" reform. When you stop and think about the bottomless pot of money that health insurance companies constantly replenish by diverting part of our premium dollars away from paying for medical care, it is in some ways remarkable that we have accomplished as much as we have with this legislation.
So instead of sending more "Kill the Bill" emails, we need to turn our attention now to leaders in the House, insisting they stick to their guns on important elements of their bill and improve on what the Senate has passed. It will not be easy to merge the two bills to the satisfaction of reform advocates, but at the very least the House should add language to strengthen the regulation of insurance companies and close the loopholes that would allow them to circumvent the intent of the legislation.
There will be plenty to do later -- including paying close attention to how this legislation is implemented, changing the way the Senate conducts its business and getting real campaign finance and lobbying reform enacted -- but let's get this part done now. Millions of people are counting on it. Many of them won't live to see the next debate if we do exactly what the opponents of reform hope we will do, and that is to join them in trying to "Kill the Bill."
Follow Wendell Potter on Twitter: www.twitter.com/wendellpotter
Why should the 60+% percent of Americans who want meaningful health care reform be held up by the piracy known as "the filibuster"?
Also though I must add as the son of, The Head of Litigation for the Tri State area for a Major Insurer, I know just how badly people will be treated under a bill this size, corrupt and back loaded, slanted to favor the insurance companies like Wellpoint, who wrote it, for our blatantly corrupt Senate to pass...!
I agree, that given the present realities in the Senate, this is probably the best we can do right now.
But this is only the beginning.
As soon as we get some form of this bill signed into law, we must begin work on improving it.
And we need a serious, intensive examination of current Senate rules.. ALL of us who are concerned about democracy must encourage the media (primarily the blogosphere) and our politicians to pursue this examination. (Ezra Klein is making a good start)
Every other civilized country has a universal health care system without the profit motive right in the middle of it. Why must we start with health care reform like there is no other workable system in the world?
Would you want to go back to diodes and transistors instead of LCD when you watch football this weekend?
This argument fails on its head.
The US fundamentally cannot accomplish single payer. It is a country of individuals in which the individual comes first and the collective and gov come second. In these other countries the gov and collective come first and the individual is second. Their entire system allows for the dismissal of the individual and their rights for the sake of the collective. They can merely decide to impose system X upon their masses and their masses have little choice.
The US tries to maintain the individual. That's why the Kelo decision was so shocking. In europe the Kelo decision would be nothing since they already exercise eminent domain over their citizens to suit the collective.
To implement single payer you have to destroy the priority of the US from the individual to the collective. This would require a massive over throw of US fundamentals.
America is becoming civilized. Civilization is about individuals learning to live together, in a collective. There is nothing "bad" about the collective per se. What is needed is an intelligent, artful balance between the collective and the individual. We can learn a lot from Europe, an older and more mature society than ours. (and sure, Europe can probably learn a few things from us too)
And I just don't see how a single payer health care system is any kind of intrinsic threat to us as individuals. Any more than the interstate highway system is a threat to us as individuals.
1. have a mandate to hand over trillions of people’s dollars with zero cost controls, so insurers have no competition and no incentive to reduce premiums, co-pays, deductibles, or out-of-pocket expenses;
2. put up with rules to allow insurers to charge older people several times what they charge younger people, which negates the entire rationale of spreading the costs out to include the healthy population, which is how the system is supposed to pay for itself;
3. allow rules that allow interstate sales of policies, meaning insurers will headquarter in states with lax regulation and thus render meaningless the strong regulation of states like California and New York;
4. allow rules that force people to pay up to 12 percent of their income for premiums.
All of these problems ensure that the insurance companies will get richer and keep dumping bribes (excuse me, campaign donations) into legislators' pockets to delay and prevent the future improvements Potter et al. promise; meanwhile, we will get poorer and sicker while suffering under the virtually same corrupt system.
Potter, Krugman, et al. know these are valid issues, but until they get specific and explain exactly why those problems shouldn't kill this bill, I see no reason to pay them any attention.
2.insurance companies can NOW charge as much as they want, 'several times' is a vast improvement.
3. NOW you have monopolies.
4. The cost of my insurance NOW is 30% of my income. I'll take 12 in a heartbeat!
I believe the battle over HCR is part of a war where one group of people is pitted against the improvement of humanity. People who are against this improvement are able to circumscribe their human gift of thought because of capricious notions based on sentimental and often selfish garbage. That includes the ones who compromised on this and voted yes. The ethic contained in the Golden Rule is universal to all beliefs, even non belief, yet rejected by conservatives who are bent on preserving a feudal ethos.
This bill, assumes that a truce is possible in this war. What progressives need to do is make this war clear to themselves and others, or their goals will not be clear. Being aware of the repetition of history means nothing because ''I told you so'' does not produce change.
Saying that you do believe in the HCR bill, or don't believe in it, is beside the point.
Secondly, the golden rule - "do unto others as you would have others do unto you" is not the first and greatest commandment. It is (according to Jesus) to: "Thou shalt love the Lord thy God with all thy mind, and with all thy strength... the second is like.. Thou shalt love thy neighbour as thyself. (Mark 12:30,31)
Please stop declaring war where there isn't one.
Obama starts the process by meeting with industry representatives and trades the industry's right to deny coverage for a universal mandate he opposed in the election.
Single payer taken off the table with no disscussion no CBO score to find out just how much money we might save.
RESULT: No Republican votes.
State's right to create their own single payer system denied by the Baucus committee:
RESULT: No Republican votes.
insurance comnpanies granted the right to charge older and high risk patients 300% premium increases over "healthy" customers.
RESULT: No Republican votes
Robust Public option replaced by a limited option in which only a few can qualify.
RESULT: No Republican votes.
Limited public option traded away for Leiberman's expansion of Medi-care proposal
RESULT: No Republican votes. Leiberman comes out against his own proposal.
Expansion of Medi-Care eliminated
RESULT: No Republican votes
Council of Catholic Bishops demand and GET draconian anti- abortion language.
RESULT: No Republican votes
Senate bill passes and Insurance company strocks sky rocket on wall street.
This Senate bill is put forward as a grand compromise, but my question is with WHO?
I understand them wanting to do that, that's what THEY do!
I don't understand LETTING them do it!
Let's clone Alan Grayson!!
I don't think the ambition is to completely eliminate what Congress has already done as much as it to alter the finished product , Senate/House synthesis, to lessen the damaging effects and enhance the beneficial effects of legislation ----------we are seeking medical coverage for all Americans but not at the cost of further bankruptcy of middle and lower class Americans.
Virtually everything Congress has done in the last 9 years has been to effectively decimate the middle class . . . powermongers know that by getting rid of the middle class the only other opposition to control is a vastly less empowered lower group insuring greater consolidation of power for the ruling group.
All new legislation ought ot be carefully examined for its ultimate effects on the lower classes: if it weakens them further it ought to be defeated, it if strengthens them, it ought to be encouraged.
This current Senatorial offering fails that litmus test: by passing the buck to less endowed consumers it only knocks them farther down the economic ladder.
We want true reform---------------not diluted slop.
Why do you think Kaiser, who was originally only in the mining business and is a major polluter wanted to go into the medical insurance business. Why is Exxon funding teabaggers. Wake up people. These medical insurance companies are all about using and sustaining exploitation of the American people. We are their cattle and they will abuse, consume and profit from us like a rancher does his livestock. They are DANGEROUS.
Will they make money from this Senate bill? Yes. But I think many liberals have it set in their minds that they'd be essentially handed billions of dollars and make something like 50% profit. Thats simply not going to happen. If anything their profit margin will decrease since there's greater limitations on HOW they can spend the premium dollars. Can they increase premiums? sure, but that also means they run the risk of people jumping to another company.
Liberals really should be pushing for is the elimination of the anti-trust exemption. That would make a much bigger impact than the watered down-weak public option that many people seem to be fighting for.
Blatant l*i*e. More like 30%.
Are they saying he should have accepted defeat and handed the scorched earth Republicans a major victory that would prove damaging, perhaps fatal, to his subsequent legislative agenda? Or do they believe that 60 votes could have been assembled with less tawdry compromises? If the latter, what makes them think so?
The 40 'just say no' Republicans will pay a steep price in the 2010 Congressional elections for their unbridled obstructionism. And the GOP's descent into irrelevance will be the most permanent consequence of this skirmish.
Opines blames BOTH the Repubicans and Blue Dogs.
Secondly, it is as much about Republicans as it is Democrats. You basically have a single party democracy. Republicans have given up all pretenses of even trying to govern. They're going to oppose everything. That's not governing, thats pure obstructionism. In the past, even when they were in the minority, they were still willing to engage in the political process in good faith. Civil rights legislation of 1964 was a bipartisan effort.
Thats not going to be the case with anything today. They're only position is "no" and even though they are in the minority, they still are elected officials with a responsibility to govern and negotiate in good faith.