Obama, asked Friday first of all in Montana, to compare different health care systems around the world,
THE PRESIDENT: Well, Americans spend more than any other country on earth, you probably don't notice it because more of what would be your salary and wages is going to health insurance. But we're not healthier than these people in these other countries. Most other countries have some form of single-payer system. That's not what Max [D-MT] is working on, because for us to completely change that, it would be too disruptive. So we would give you a tax credit, a subsidy of some sort, to help you obtain insurance. We would allow you to buy into a health care exchange, protect you from some of the policies that have not been very good for consumers, we would reform the insurance market for people who already have health insurance. And if we do those things then we can preserve the best of what our system offers.
All right? Okay. Gentleman right there in the back, with the green.
This diary looks more at that answer, presidential leadership, and how global climate catastrophe can be next.
First, for the sticklers, the complete Montana question and answer truncated in the intro:
Q I was laid off in January. I am currently uninsured. My two children have Medicaid right now. And my question is, without going into too much detail, can you tell us what you -- if you have kind of looked at Canada, England's system, and sort of -- can you pick and choose from those systems that work, that we see there's some success rate and apply that to what you're trying to push through right now?
THE PRESIDENT: Well, let me tell you what happens in other industrialized countries. First of all, I think it's important for everybody to understand that Americans spend $5,000 to $6,000 per person more than any other advanced nation on earth -- $5,000 or $6,000 more than any other person -- any other country on earth.
Now, if you think that -- how can that be? Well, you probably don't notice it, because what's happening is if you've got health insurance through your job, more and more of what would be your salary and wages is going to health insurance. But you don't notice it; you just notice that you're not getting a raise. But a bigger and bigger portion of compensation is going to health care here in the United States. Now that's point number one.
So clearly we've got a system that isn't as efficient as it should be because we're not healthier than these people in these other countries.
Having said that, most other countries have some form of single-payer system. There are differences -- Canada and England have more of what's called -- what people I guess would call a socialized system, in the sense that government owns the hospitals, directly hires doctors -- but there are a whole bunch of countries like the Netherlands where what they do is, it's a single-payer system only in the sense that government pays the bill, but it's all private folks out there -- private doctors, private facilities. So there are a bunch of different ways of doing it.
Now, what we need to do is come up with a uniquely American way of providing care. (Applause.) So I'm not in favor of a Canadian system, I'm not in favor of a British system, I'm not in a favor of a French system. That's not what Max is working on. Every one of us, what we've said is, let's find a uniquely American solution because historically here in the United States the majority of people get their health insurance on the job. So let's build on that system that already exists -- because for us to completely change that, it would be too disruptive. That's where suddenly people would lose what they have and they'd have to adjust to an entirely new system. And Max and I agree that's not the right way to go.
So all we've said is, in building a better system, what are the elements? Well, number one, for people like you, you should be able to get some help going into the private insurance marketplace and buying health insurance. So we would give you a tax credit, a subsidy of some sort, to help you obtain insurance.
Now, the problem is, if you're going out there on your own, then it's much more expensive than if you go in a big group. So we would allow you to buy into a health care exchange that would give you some power to negotiate for a better rate, because you're now part of a big pool. We would also make sure that if you do have health insurance that you are protected from some of the policies that we've already talked about that have not been very good for consumers. So you wouldn't be able to be banned for preexisting conditions. There would be caps on the amount of out-of-pocket expenses you would have to spend. So we would reform the insurance market for people who already have health insurance.
And if we do those things -- making it better for folks who already have insurance, making it easier for you to buy insurance, and helping small businesses who want to do the right thing by their employees but just can't afford it because they're charged very high rates, they can't get a good deal from the insurance companies -- if we do those things, then we can preserve the best of what our system offers -- the innovation, the dynamism -- but also make sure that people aren't as vulnerable. Now, that's essentially what we're talking about with health care reform.
And so when you start hearing people saying, you know, we're trying to get socialized medicine and we're trying to have government bureaucrats meddle in your decision-making between you and your doctor, that's just not true.
All right? Okay. It's a guy's turn. Gentleman right there in the back, with the green.
Barack Obama kicked off his presidential campaign where Abraham Lincoln made his "House Divided" speech in 1858, and thus the leadership comparison begins. In 1858, Lincoln supported slavery governed by state's rights, and maintained that position thru his first presidential election and years of bloody, civil war.
The people's historian Howard Zinn writes of the 1863 Emancipation Proclamation,
It was only as the war grew more bitter, the casualties mounted, desperation to win heightened, and the criticsm of the abolitionists threatened to unravel the tattered coalition behind Lincoln that he began to act against slavery . . .By the summer of 1864, 400,000 signatures asking legislation to end slavery had been gathered and sent to Congress, something unprecedented in the history of the country.
How many lives could have been saved had he picked the good fight sooner is mere conjecture. There are signs Obama is less than inspiring progress on some of today's big issues, including climatechange and health insurance reform. Way back on April, 23, 2009, a counterpunch from Chicago on the Democrats who were supporting single-payer, before they gave it up for possibly a "public option,"
the ones who would have said under slavery, "We can’t win abolition, so let’s settle for a few reforms that make the lives of slaves more bearable."
Obama was for single-payer before thinking of droppping "public option." Whether Obama has the time, will, ability, or need to fight the good fight remains to be seen, but it does not look promising (Afghanistan, anybody?). How many lives will be unecessarily lost is mere conjecture.
It is clear Washington policy is lead by corporate interests. United Healthcare's playbook was given a peak, yesterday
[It]was very key to be coming across as having expertise and knowledge and kind of deciding that "we are the department of day-to-day reality. You in Washington don’t really understand complicated healthcare; we do. So you should sit down and listen to us." . . .and they’re seen much more as a force for solution instead of just opposing everything.
Having just finished reading The Electric City by Harold L. Platt, how Samuel Insull in Chicago at the turn of last century was the first to preach the "new gospel of mass consumption" when he figured his huge electric generating central service stations fueled by cheap coal needed a rate structure that rewarded conspicuous and constant consumption to succeed, indicates the roots of corporate strategy dominating Washington. Insull became the "pragmatic spokesman of 'reasonable' reform."
In the formation of public policy for electrical service, Insull and his lieutenants dominated the debate in the Chicago City Council about the structure and maximmum leves of rates . . . highly talented lawyers and engineers overawed the aldermen with carfully prepared legal briefs and technical reports.
Sound familiar? Insull set the agenda of the debate and dictated its outcome (before being disgraced in business scandals). His first big central service station, the Fisk plant, is still operating and dirtying the air. United Healthcare is operating with an old playbook, refined if not perfected in Chicago at the turn of last century, and now, obviously, reaching the White House, with bad policies for public health.
So when the next big thing is a climate bill, and someone who appears to be a progressive reformer touting cap-and-trade for localized acid rain problems as a good example to follow for greenhouse gas reductions, even when there is no such thing as a ghg scrubber as there was for soot (and no offsets to boot as with ACES), keep in mind economist Thomas Crocker and John Dales, the creators of cap-and-trade, do not think it will work for a warming world. Consider Frank O’Donnell, president of the Washington-based environmental group Clean Air Watch, quoted in Bloomberg recently
Acid rain was a big political compromise; in essence it was a multibillion-dollar bribe. The only difference with carbon is the stakes are far bigger.
As the Washington Postwarned Sunday about the continuing problem of pollution from the site of Insull's century old paradigm
If a climate-change bill drives up the cost of opening new plants, but provides free emissions allowances or potential carbon offsets for existing facilities, companies could have an incentive to squeeze even more power out of their old plants, many of which are running well below capacity. . . Eric Schaeffer, executive director of the Environmental Integrity Project and former director of the Environmental Protection Agency's Office of Regulatory Enforcement, said the new legislation is widely viewed as a panacea. "But by establishing requirements for new plants and then effectively exempting the old ones," he said, "you create the same disconnect that has created problems under the Clean Air Act.""
If we wait much longer for leadership to stem catastrophic climate change, it will be too late, and mere conjecture how many lives unnecessarily lost.