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View Diary: Single Payer Zealotry - Getting To Real Universal Health Care (121 comments)

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  •  I agree the facts are on your side (0+ / 0-)

    The question is how do we achieve the objective?

    We saw the power of the lobbyists with FISA. There'll be extensive lobbying against single-payer because Empire, Aetna, Oxford and the like are making billions.

    To combat that, we don't need voters to just accept single-payer, we need them to demand it.

    I believe that to reach that point would need a long and intense education blitz. Probably years of effort. In the meantime, educating voters that they need single-payer does nothing for the 47 million uninsured.

    I don't think the Obama plan sets back the cause of single-payer, and we do know that Obama has said he believes in the principle of single-payer - I believe that was still his position in the primary debates.

    •  we don't need to wait years (1+ / 0-)
      Recommended by:
      Ozzie

      hr 676 is building momentum - the u.s. coference of mayors recently passed a resolution calling for Congress to work towards the immediate enactment of H.R. 676.

      We have to seize the moment and get the chairs on the comittees of juridiction to mark up h.r. 676 and to hold hearings on the bill.

      Those chairs are Pete Stark, Charlie Rangle and John Dingle.

      What are they waiting for?  Do they have to name some more post offices, etc.

      They need to move on h.r. 676 - NOW


      ````
      peace

    •  Obama DOES set back Single Payer, many ways (0+ / 0-)
      1. The biggest devil in his details is lack of Community Rating.  He'll talk all day about how he'll make insurers offer Guaranteed Issue, but that protection is essentially meaningless with fake (not real) Community Rating to go along with it;
      1.  That means the playing field will not be level between public and private plans, as cherry picking and lemon dropping (singling out "losers", rating them up and out) will remain (for all pratical purposes) the status quo in the profit-driven sector;
      1.  Sham Kid Care plan, like "All Kids" here in Illinois.  Here we give profit-driven health insurers $1750 per child for insurance, and our kids receive $600 worth of medical care in return.  One of the HMNo's that got one of the contracts donated $150,000 back to Blagoivich the week after he signed the bill.  The minute our kids turn adult and have to switch policies, everything on their medical records can and will be used to discriminate against them by the very same health insurers we just gave boatloads of our tax dollars to.  Obama wants to take this national. That is more corporate welfare for health insurers, not so much medical care for our kids.  I call it "feeding the beast that is the problem" (see Massachusetts), and it won't solve the problem.  It will make solving the problem that much harder.  Plus, kids are the healthiest risk pool in existence.  To health insurers, our kids are "actuarial dreamboats".

      Obama said quite clearly that he will NOT support Single Payer, and he also said that by the end of his first term, "All Americans who deserve it (I'm not making his up) will have access to health coverage.  By then half a million more will die easily preventable deaths. Plus I'd like to know who does NOT "deserve" health care?  We consider it inhumane to deny health care to our prison population.  Who are the "un-deserving"?

      So our main choice is between a candidate who knows what needs to be done but refuses to do it, and one who doesn't even have a clue.  Yay.  

      •  Or does it? (0+ / 0-)
        1. & 2. The Obama plan offers a public insurance scheme to anyone who doesn't qualify for Medicaid or SCHIP, and who does not have employer-provided healthcare. It also creates a health industry regulator (the Exchange) and says the following about the Exchange:

        [A]ny American will have the opportunity to enroll in the new public plan

        Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status.

        The Exchange will require that all the plans offered are at least as generous as the new public plan.

        Now, I'm not sure I see the distinction between Community Rating vs. banning premium variance based on health status. But in any case, unless you believe the public plan will also attempt to cherry-pick, despite his parameters for it
        preventing that, then the 'at least as generous' requirement would also act against the private insurers. So, I believe you are mistaken.

        1. The Obama plan will be available in parallel with any existing States' initiatives, but requiring the States to meet the terms of his national proposal. If the Illinois scheme is as awful as you describe, why would anyone opt into it when there's a public plan available? Moreover, wouldn't much of the All Kids scheme be overtaken by the promised expansions in Medicaid and SCHIP?

        Obama's position on single payer: If we were starting from scratch, he would support a single-payer system.

        In other words, single-payer's his ideal... his current proposal is based on pragmatism not idealism.

        You can also repunctuate your quote in a way that makes it far more in keeping with dozens of other Obama quotes:

        "All Americans - who deserve it - will have access"

        He's consistently said "All Americans will have access".

        So, our choice is between someone who knows what needs to be done and is working on something that brings us closer to it, and someone who is way worse than the status quo, because McCain wants basically to make all health negotiations individual and take away the corporate group bargaining that is the only check on the insurance companies under the present system.

        •  Yes, it does (0+ / 0-)

          A sentence or two after Obama's plan says, "Insurers would have to ... charge fair and stable premiums that will not depend upon health status," it also says, "Insurers would be required to justify an above-average premium increase" (as if there would only be one; the plural "increases" is far more accurate).  How do you "justify" financial discrimination against someone because they are sick?  Isn't that the opposite of what protective pooling and Community Rating are supposed to be about?  Legislation often is written using what seems to be ambiguous and contradictory methods so legislators can make it seem like everything to everyone, and the devil is almost always in the details.

          I also like the part about "Obama will make available a new national health plan which will give individuals the choice to buy affordable health coverage that is similar to the plan available to federal employees".  Fedeseral Employee health Benefit Plan (FEHBP) is a plethora of private plans that cost (last I checked) an average of over $2000/yr. per familiy more than the national average.  The difference is that they have REAL Community Rating, while we would get something else.  Another earlier piece of legislation Obama supported stated plainly that it would offer everyone the same coverage asfederal employees "except for the way (they, meaning we, or everyone who is not a federal employee) would be rated".  Sigh.

          I will look for the clip where he said "everyone who deserves it" and you can judge for yourself, but it may take me awhile to find it again. (It was on C-SPAN.)

          •  Devil is in the parsing (0+ / 0-)

            Increases are not necessarily due to changes in the individual's status. Since premiums are prohibited from being based on the individual's health status, the part about justifying increases only makes sense if you're talking about a year-on-year increase. Everyone's health insurance costs are going up, whether they're sick or not.

            There are both similarities and differences with FEBHP. The Obama plan takes the concept of a menu of coverage choices which private insurers can choose to provide. The big difference is that Obama will offer a public insurer which will also provide those coverage options.

            I reiterate: he's said many, many times that all Americans will have access. If one time he said all Americans who deserve it, that suggests that he believe all Americans deserve it. Don't play gotcha parsing games - leave that for the idiots in the media.

            •  There's no need for parsing at all (0+ / 0-)

              ...when someone is clearly speaking the plain truth.  There is need for parsing when someone is trying to make something appear to be something it is not.

              •  You sir, (1+ / 0-)
                Recommended by:
                bthespoon

                are a formidable opponent.

                Glad we're on the same side in general :)

                BTW, for me the biggest argument for single payer:

                The current system legally requires insurance companies to deny as many claims as possible due to shareholder interest.

                That's just plain wrong.

                •  Thanks, you too..but... (1+ / 0-)
                  Recommended by:
                  sullivanst

                  I think it's hard to parse the "except for the way (everyone who is not a federal employee) is rated" line in his "FEHBP for the Public" bill.  I'd be interested to hear your interpretaion of that one.

                  I looked for the clip of Obama saying "everyone who deserves health care will have access to health coverage".  It was on C-SPAN April 30, 2008, but apparently they only keep links active for two weeks.  It was dead.  

                  While looking for that I found another link that I had forgotten about.  It claims that the legal foundation is in place to challenge the right in court, if anyone would.  It doesn't envision the approach I do (which would be more of an anti-discimination challenge for the Good of the Whole), but it is interesting.

                  Also a fellow named Terry is trying to get as many Single Payer advocates as possible to go togeher with him to Obama's Chicago office sometime in the near future. His contact info is

                  Terry B. Brauer, CEO
                  HealthCare Initiatives
                  HealthCare Management Consultants
                  773-754-7300
                  Chicago, IL  60625
                  TB@healthcare-consulting.com

                  I know he won't mind my publicizing his effort, and hope I'm not breaking any rules here?

                  The other link (about the possibility of a legal challenge) is below.

                    Legal Challenge: Right to Health Coverage

                  •  Any idea where I can find (0+ / 0-)

                    the "similar to FEHBP except for the way people are rated" language? A quick Google didn't uncover the bill.

                    Any leeway for private insurers to cherrypick would be a critical weakness in the policy. I'd definitely join any effort to oppose leaving that loophole open.

                    The "Right to Health Coverage" argument is definitely interesting, but I hope we never have to fall back on trusting the courts to accept it. We need the Executive and Legislature to make it official, explicit policy.

                    •  I like short-cutting a do-nothing Congress (0+ / 0-)

                      ..and President, because people really are dieing while they (we) fiddle, and they (we) don't seem to understand that reality...or they (we) wouldn't be able to sleep at night.

                      I will have to search to document that because I can't remember the name or number of the bill. I do promise that I'm not making it up.  www.thomas.gov is where I found it the first time. The language is well hidden in contradictory language that is supposed to make the bill appear as if it's doing somthing that it really isn't.  I've read more pseudo health care legislation than not.  Durbin has his own sham (Association Health Plan) health insurance reform legislation that he is touting.  In reality it would lessen protections for consumers (by giving federal law with less protection precedence over state laws with more protection), but he's trying to make us believe the opposite.

                      Tha plain fact of the matter is that unless the language says explicitly (with NO ambiguity) that "Medical care and coverage discrimination of any sort against sick Americans will be against the law"...(or something to that effect)...period...it probably won't do what we need.  I've found I need to look for what is not in a bill as much as for what is in it.  

                      What bothers me about Obama is not only what I saw him do (and not do) with health care reform while in the Senate here in Illinois (he helped gut it), but also how he is selling us out on getting troops out of Iraq (that will change now that Iraq is demanding same however), the environment, NAFTA, FISA, health care, and how carefully he parses his language to mean everything to everyone.  Frankly I find a crowd cheering wildly for empty platitudes more than a little bit frightening.

                      "Better Than NcSame" and Supreme Court are two great reasons (more than enough) to vote for him in spite of his lack of spine in other areas of great national importance.  I just want to vote for him with my eyes open and not my head in the sand.

                      We can't let Obama get away with what we're letting him get away with (fooling us) because if we do, he will break real progessives' hearts.

                      •  At this stage (1+ / 0-)
                        Recommended by:
                        bthespoon

                        it's a little difficult to be sure about exact details, since campaign plans are not the same thing as draft legislation. Nevertheless, I do take you at your word about the 'similar to FEBHP only gutted' type language, and will be alert for weasel words like that.

                        I don't think Obama's being allowed to "get away" with much - there are plenty of people pushing back whenever he feints towards the center. Then the debate springs up places like here as to when honest discussion of our disappointments with his policies becomes counterproductive. We do know that the Republicans latched on to Markos saying he wasn't going to donate and tried to use it to their advantage.

                        Ultimately the healthcare reforms that are passed won't be written by Obama, so we need to be working on our Representatives and also working on making sure that Obama will sign legislation that deviates from his proposals, if those differences are in our favor.

                        •  Obama is a Senator so could introduce legislation (0+ / 0-)

                          ...also could have already introduced meaningful health care legislation had he had a mind to do so.  His (in)actions lead me to believe that he's is not in that frame of mind.  You and I do basically agree, even if we both are a bit argumentative (all in good spirits for fun, of course).

                          One nit-picky difference is that you seem to think Obama started on the left and tilted to the center.

                          I think Obama started in the center and has moved to the right.  Nick of PNHP told me Obama's health plan is to the right of Richard Nixon's, and I'm inclined to believe it.

                          Please do help us be vigilant about exposing smoke and mirrors.  I for one will be most grateful.

                    •  I'm not having much luck but (0+ / 0-)

                      It might have been S.637 (but don't think so), a bill sponsored by Durbin in 2005 to create a Small Employer Health Benefits Plan (SEHBP) similar to Federal Employee Health Benefits Plan (FEHBP).  I found a summary of that in My Documents, but not the bill itself, and couldn't find the text of the bill on Thomas.

                      The bill that I remember (apparently not well enough, but definitely remember my dissappointment at finding the loophole)...I looked up after I heard Obama mention his support of it a couple of years ago, so thought I'd take the time to read exactly what he was talking about.  But the bill Obama mentioned was meant to include all Americans, not just small employers.  

                      They change language in bills about as often as Hillary changes her hair-do (a lot).  I thought Thomas might still keep a copy though.  I am really and truly sorry I'm not having better luck providing the documentation you ask for to back me up, because I know I'm telling the truth.  Help me pay close attention in the future and you will see for yourself, because smoke and mirrors are still very active in American politics (including Obama's).

                      Both Hillary and Obama's skeletal health care
                      plans included ambiguous language about Community Rating.  We have legislation on the books in Illinois called the "Small Group Health Insurance Rating Protection Act" that is not worth the paper on which it is written.  I took a small group of small business owners to talk to our state senator about it, and those were her exact words.  At first I didn't realize how much "smoke and mirror" legislation existed, but it's a lot.

                      I live in a state (Illinois) that has been under total Democratic control for years now, and nothing has changed.

        •  All Kids in Illinois IS S-CHIP (0+ / 0-)

          States get S-CHIP matching funds, and each state determines how it wants to handle them.  A few use the money to pay care providers directly, while others (like Illinois) give it directly to private health insurers instead.

          Obama is better than McSame in so many ways, but he is not the health care hero this country so desperately needs.

          We need to pay close attention, do our homework, and hold his feet to the fire.  

    •  To answer your question (0+ / 0-)

      If Obama and Clinton were trying to explain the truth about health care to the people, I think that would make a HUGE difference.  I honestly believe that most people would "get" it (because the truth rings so dang true).  If they'd try half as hard to tell the truth as they do to blow smoke and mirrors, the truth would stand half a chance.  The irony is they (especially Hillary) get all the "socialist" backlash anyway, whether or not their plan is the real deal, so why not go for it (and offer the real deal)?  

      The people are on our side.  Most know something needs to be done but too many don't know what, and we have no major candidate with the public ear even trying to explain it to them.  All we lack is the right leadership, someone (the right someone) who is willing to lead.  Unfortunately in order to become a real hero, a person needs to have real courage.

      I think if Ted Kennedy gets well enough, he may try to become the leader that the movement needs.  Al Gore and Oprah could help a great big bunch if they only would.  So far none of them has been willing to adopt the cause whole-heartedly (the way we need them to), and Obama refuses to pick up the slack.

      We're doing what we can, but boy oh boy, could we ever use their help.

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