The Only Prescription is Change

by Jeff Fleischer

(BuzzFlash, August 6, 2009)


Say this for the Democratic National Committee. Its fundraising e-mail this week, sent under President Obama’s name, correctly places the current debate surrounding national health care in context with its opening line: “This is the moment our movement was built for.”

As Congress broke for its August recess, however, it’s become clear that too many Democrats didn’t get that memo. It is the Republicans, not the Democrats, who are proving to fully understand the stakes this issue represents.

Make no mistake. This is the best opportunity America has ever had for the kind of universal health-care reform the rest of the Western democracies long ago embraced. For all the other important domestic priorities Democrats campaigned for last year, health care was the centerpiece of the homefront platform on which they were elected.

The insurance industry is acutely aware of this, just like its allies in Congress. Which is why we’ve seen the recent all-out, kitchen-sink campaign against reform. Knowing it could be in its death throes, the for-profit health industry is lashing out with all it has left.

In the second quarter of this year, as Politico has noted, the insurance industry has already spent more than $1 million every day in its efforts to block potential competition. In the first quarter, according to USA Today, the 20 largest health insurance and drug companies had already boosted their spending on lobbyists 41 percent from the same time last year.

It’s no coincidence that the biggest Congressional beneficiaries of the industry’s largesse are John McCain, Mitch McConnell, and Max Baucus in the Senate and John Boehner and Eric Cantor in the House. Or that Freedomworks — the phony “grassroots” organization run by Dick Armey and best known for its recent teabagging – is sending operatives to heckle and disrupt town-hall forums about improving health care. For all the fraudulent arguments against a public plan — or even a strong public option — presented by Republicans and the so-called “Blue Dog” Democrats such as Baucus, that opposition is heavily fueled by an industry that knows it can’t compete with a plan that actually provides quality coverage.

Perhaps the best summation of the misguided argument against public health care was delivered by Obama himself. “Why would it drive private insurance out of business?” the president challenged his opposition recently. “If private insurers say that the marketplace provides the best quality health care; if they tell us that they’re offering a good deal, then why is it that the government — which they say can’t run anything — suddenly is going to drive them out of business? That’s not logical.”

Congressional opponents and their industry puppetmasters know there are two ways to kill health care reform, and they’re already working on both fronts. One is obviously blanket opposition to any reform, while the other is to create a bill so weak that it doesn’t threaten the industry — one that would keep the high costs without the myriad benefits. The insidious second option is starting to work, as recent poll data shows support for reform slipping as opponents have watered down various versions of the health care bills.

Much has been made of the 46 million Americans without health insurance, and that is obviously unacceptable. The support for reform among the public, however, has just as much to do with the low quality and high costs of current private insurance. While there’s nothing inherently wrong with the idea of private health care, the kind of extreme post-capitalist, for-profit system we’ve developed has brought about the need for its own demise.

The same need to maximize profit at all times that made CEO pay rise 600 percent during the 1990s — and created the wage gaps that drove the current recession — has completely infected health care. A Harvard University famously found that half of all Americans filing for bankruptcy did so at least partly because of medical bills, but less noted is that 68 percent of bankruptcy filers actually had insurance and still couldn’t afford to get sick. America infamously has the highest per-capita health costs in the world — despite factoring in an uninsured population significantly larger than the population of any U.S. state. Once health became a marketplace commodity, companies did all they could to maximize costs, raise deductibles, and minimize expenditures by denying treatment. Whereas the other Western nations not only spend less per capita, but also allow treatment of all conditions.

When Franklin Roosevelt tried to introduce national health care, or when Democrats made a similar attempt in the 1960s, conservative opposition argued that those plans would create a vast bureaucracy that would interfere with quality care. That argument may have seemed a reasonable counterpoint at the time, but the growth of the vast private bureaucracy that now governs health care completely discredited that argument. Countries with universal programs save considerably on administrative costs — just as America’s government-run Medicare has administrative costs more than 80 percent lower than its private equivalent.

Republicans and “Blue Dogs” have made much of a Congressional Budget Office report claiming Obama’s public health plan would add roughly $1 trillion to the federal deficit over the next decade. But in 2007 alone, Americans spent $2.26 trillion on insurance costs, and those annual expenditures will only go up if industry keeps getting to set the price. Moreover, the CBO report didn’t look at the side effects of a national health plan. Study after study shows that people with full coverage are more likely to see their doctor regularly and therefore to catch serious health problems earlier — resulting in better health and lower costs.

A healthier population means fewer workdays lost to illness and fewer costly visits to the emergency room. Fewer health-related bankruptcies mean fewer Americans unable to pay their creditors. Removing health-care costs from employers will also boost the economy. By now, everyone’s heard the stat that health-care costs increased the price of the average General Motors car by more than $1500. The same idea has been true across industries, and has particularly hurt small businesses and the self-employed. Without the bulk purchasing power of large companies, small businesses have faced astronomical insurance rates that make it hard to attract the best employees. Public coverage cuts those costs and means those businesses can grow more effectively and put more money back into other sectors of the economy.

Basically, national health care is good for everyone but the few who directly benefit from the current system and are doing all they can to fight for it. The track record of progressive ideas in American history demonstrates that large-scale reforms that benefit all only become more popular over time, as President Bush learned when he tried to privatize Social Security. Between Medicare, Medicaid, and the VA, the country has already demonstrated that it can provide coverage more thoroughly and cheaply than the for-profit corporations — and polls show Americans using those programs are happier with their coverage.

Yes, universal care is expensive, but removing the profit motive will ultimately keep costs lower than the exponential price increases seen under the current health care dystopia. Government might pay more, but individuals will pay less and have more money to save or spend.

That’s why it’s imperative that Democrats reject overcompromising on one of the very issues that gave them their current majority and cure a system that has been ailing for decades. Ideally, that means single payer, though political realities may dictate a comprehensive opt-in public plan that will compete with private insurance. The second option would either ultimately defeat the current system, or force it to adapt to the competition.

Either way, costs to the consumer come down and quality of care goes up. Last week, Nancy Pelosi promised that “the glory days are coming to an end for the health insurance industry in our country.” It’s up to her and other Democratic leaders to make sure that happens, or they’ll have nobody to blame if voters seek a second opinion.

Tags: , , , , ,