Monday, December 14, 2009


The health care debate was stymied before it began by a President who met behind closed doors with industry captains and cut deals that were good for business and bad for people. The job of Congress was to dress up industry blood sucking to look like affordable health care for all. It took six months for the House to pass a bill so convoluted and complex that you won't know you that your wallet has been lifted without giving you the health care you need and deserve until it's too late. The job of the Senate is to tidy up after the House, making sure health care corporations get absolutely everything they want.

Physicians for a National Health Program posted a wonderfully appropriate cartoon on their website. It shows a group of surgeons around an operating table, bending over a patient with US Health System written on his arm. One of the surgeons is holding aloft a large, reeking organ with Big Insurance emblazoned on it and saying to his colleagues, "Aha, I think we have found the problem". Congress made a fatal misdiagnosis when they ignored the parasitic health insurance industry.

Most Americans are aware that the number one cause of personal bankruptcy is a medical emergency. What you probably didn't' know is that most of these people had health insurance. That is the case, according to Dr. Steffie Woolhandler, a physician and Harvard Medical School Instructor. More health insurance doesn't mean more health care. Three states passed bills almost identical to HR 3200 in the '90s. Washington and Oregon quickly ran out of money and had to cut coverage and benefits. Massachusetts, still laboring under this mandate has the highest health care costs on the planet and is cannibalizing their existing safety net to continuing funding it.

Everyone who talked about health care, from the president to business leaders to Congress, agreed that controlling costs was an absolute necessity. Apparently no one wanted to be the guy who pulled the plug on a system skims that 22% off the top and wastes another 6% in redundant administrative costs. According to PNHP, eliminating this wasteful system would save $400 billion a year (that's a "b") which could be then be used to provide care. Care, not insurance, is what Americans need.

The House Bill is "sin verguenza". It has no shame. If you are uninsured, you will be forced to purchase private, for profit health insurance. There are no caps on premiums, co-pays or deductibles. Health insurers are immune from anti-trust laws so don't expect much in the way of choice. The "public option" will only apply to 2% of the public and savings would be "miniscule". If you can't afford insurance, you will get some sort of public assistance. There is no provision for taxpayers to negotiate prices with insurers, drug manufacturers or health care providers.

With everyone being forced to purchase the pricy, defective products of for-profit insurers and taxpayers picking up the tab for those who are can't, the temptations for a predatory industry who are happy to let 20 thousand people die prematurely each year to boost the bottom line, are beyond the dreams of avarice. Since enforcement mechanisms are rare to absent, it may not even cover everyone.

Ralph Nader believes that that faulty billing all ready costing the Medicare/Medicaid system hundreds of billions of dollars each year. Their opportunities are paltry compared to those offered in the House "reform" package. It's the keys to the treasury, folks.

If you get sick, insurers will no longer be able refuse coverage or drop you but they can still raise your premiums and out of pocket expenses until you run through your savings and lose your house. Then taxpayers will be responsible for paying your premiums or your health care.
Insurance companies make a lot of their money by investing premiums. That's why your premiums go up at the same time your retirement investments are evaporating. When there is a major stock market "correction", taxpayers are going be forced to bail out health insurers, taking "too big to fail" to new heights. There is the potential for a health care stock market bubble, again leaving taxpayers on the hook to pick up the pieces after the super rich walk away with the profits.

The "community organizer that we elected" reached deep into taxpayers' pockets to bail out Wall Street and send 100,000 troops to country no one but big carbon producers care about but insisted that health care "reform" be budget neutral. To that end Congress will be robbing a half a trillion dollars from Medicare and Medicaid at the worst possible time. With baby boomers coming on line for Medicare and more and more people losing their homes and jobs, Congress should be beefing up these staples of the social safety net not using them for venture capital.

As an adjunct to "non reform, reform", the House moved to monetize the highly profitable drug industry by protecting its monopoly on "biologic drugs", the cutting edge for treating some of our most intractable diseases. For the foreseeable future, these companies will be able to go on charging hundreds of thousands of dollars. Either taxpayers will be on the hook for paying their exorbitant asking price or be responsible for leaving people to die.
No, we are not letting drug manufacturers recoup losses for research. 95% of drug research is publicly funded. Drug manufacturers have never had to purchase these drugs or pay a dime in royalties. It's pure, publicly funded profit.

The job of the Senate is to strip away whatever pretensions to reform the House bill may have and hand it on a plate to a salivating health care industry. I haven't seen a single "compromise" come out of "the deliberative body" that doesn't degrade the all ready miserable HR 3200. Dropping Medicare to 55? Good luck getting there if this bill passes.

How did this happen? How did we get from single payer for all to a welfare package for an industry that makes more money when you suffer?

Under our system of government, the legislature is supposed to debate issues and write laws. The president may submit bills and voice his in support for the kind of legislation he thinks is best, but he is and administrator not a legislator. In an amazing usurpation of power and a stunning betrayal of the progressive forces that elected him, Obama, a single payer advocate as a Senator and a Presidential candidate, edged out Congress and kicked single payer to the curb.

Before a real debate could take place in the House, Obama started meeting secretly with CEOs in the health care industry. Allegedly fearing a media blitz by the industry similar to the one that sunk the Clinton's health care boat, he obtained what he thought were concessions from drug insurers, health insurers and health care deliverers. The deals were transmitted to Congress thru Max Baucus, a blue dog awash in corporate campaign dollars who held faux hearings and liaised with right wing. The Senate immediately began crafting a bill that would substantially weaken any populist tendencies that the House might aspire to.

When the Progressive Caucus in the House refused to vote for any bill without a robust public option, Obama sent Rahm Emmanuel and his minions to the House to threaten progressives with excommunication, browbeat them and questioned their loyalty. The Hacker Amendment which allowed 129 million Americans to choose public health insurance was buried. Eventually the Progressive Caucus broke and voted for a public option that might cover 2 million people and is all ready effectively dead in the Senate.

Pelosi et al insured industry profits were completely protected by stripping an amendment from the House bill that would have shielded states from litigation by for-profit health insurers if they set up their own single payer system. Ten states are currently considering doing so but face serious legal challenges.

If current legislation passes, the best Americans can hope for some kind of insurance policy from the industries that have been shortening their lives and bankrupting them in exchange for massive subsidies. These industries will then be free to then use our tax dollars to block any future reform and we will be locked into a system that doesn't work for the foreseeable future.

There is a great deal of speculation about why Obama took a dive on health care reform. Internet diva Jane Hamsher and Slate journalist Glen Greenwald believe it's all about the money. They believe Obama is afraid of losing his Democratic Congress in 2010 and equally afraid that if he doesn't toe the corporate line, health care money will start to flow to Republican coffers. It would be a real shame if we lost all those dedicated public servants (tongue in cheek) who have done so much to improve our lives.

Maybe Obama is cynical enough to believe that most Americans can't tell the difference between a Congressman who is protecting their interests and one with a slick ad campaign but who is really selling them down the river. I think our president has a bad case of galloping hubris. It takes a lot of arrogance to ignore the anger of Americans who are sick of a government that uses and abuses them. It takes a lot distain for plight of ordinary Americans to launch yet another frontal assault on their means.

Is any legislation better than nothing? No. The Democrats have no track record for fixing anything "later". "This or nothing" that the Democratic Party suits are waving at us is not a reasonable, adult choice. When it's about our money and our health, it's completely unacceptable.

Is it really important to "pass something" no matter how lame or counterproductive? There are times in life when "passing something" is a great relief and highly recommended but crafting important legislation that affects every single American isn't one of them.

Is the president really hamstrung by the right wing and members of his own Party? Only incompetence and corruption are preventing the Democrats from being effective. They own Congress and the White House. They have more power than the right wing ever had. There is absolutely no reason why Rahm can't beat up the Blue Dogs and a few wingnuts instead of the Progressives. There is absolutely no reason (except for the above) why Democrats have to start every debate with huge concessions to a minority of irrelevant extremists.

When it comes to something as personal and fundamental as the health and well being of our own bodies, the care of our children and loved ones, no one should be content to "lie back and think of England". Don't let the press and Party politics confuse you. The issue is decent health care for all not Obama's fight to save "his presidency".

For the first time in my life I am cheering on the tea baggers, the Stupak's, the Liebermans and the Nelsons hoping against hope that their overreaching will destroy Obama's pretentions to progressive values and kick over the steaming pile the "bought and paid for congress" has produced. There a chance that willingness of Democratic leadership to accomodate these Luddites will create a bill no one can vote for and hope to be re-elected. Without a doubt Congress and the President need to shake off their corporate shackles and go back to the drawing board and without a doubt, we need to build a national movement for a single payer system.

We may have to wait for Baucus's latest scandal to send him back to Montana or into the arms of the industry he represented so well. We may have to wait till next year when a few more Blue Dogs are sent packing, back to their kennels south of the Mason Dixon line. We may have to wait till we get a president who can get his priorities straight. In the meantime, Congress has a moral and Constitutional obligation to address the worst abuses of the corporate health care industry and broaden the safety net. Our job is to force them, by any means, to do so.

Americans are not expecting health care in their Christmas stockings, they are just demanding what they have worked for and paid for many times over. They need what every other developed nation all ready has; decent, affordable, available health care. There is nothing the American people have done to deserve the Halloween nightmare the President and Congress are flogging in the name of reform. We simply cannot accept a system that will continue to haunt us long after these selfish men and women have left the public arena.
Carol DW

Recommended Reading: For a better understanding of the underlying philosophy of Obama and those shaping heath care policy in his administration and the emerging divisions in Congress read Glen Greenwald's latest.

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