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I don't mind disagreeing with opponents on the merits of one proposal versus another. But, I have very little tolerance for just lying about the facts or, at best, muddling the truth about the reality. And, so, it is with healthcare: the continuing myth, promoted by both the political and media jabbering low-minds, that the president and his former Secretary of State both made the same mistake on health care--they opted for something too "complex" "inflexible", "secretive" or "socialistic", or a combination of all of the aforementioned descriptions.

It's utter nonsense. They did make the same mistake--but it had nothing to do with complexity. It was entirely their immoral unwillingness to confront two powerful industries that have relentlessly killed hundreds of thousands of people, either by bankrupting those people or literally denying them care.

The myth rises again, as it pertains to the former Secretary of State, via Sunday's column fromMaureen Dowd (yes, one must acknowledge that Dowd is skilled at gossip but entirely incompetent when it comes to understanding policy):

The new cache of Clinton papers is benign — the press seems more enamored of speechwriters’ doodles than substance — but just reading through them is draining. There are reams of advice on how to steer health care, which must have filled the briefing binders Hillary famously carried. But did she absorb the lessons, given that health care failed because she refused to be flexible and make the sensible compromises suggested by her husband and allies? She’s always on listening tours, but is she hearing? As one White House health care aide advised in the new document dump, “We need to be seen as listening.” [emphasis added]
Ah, yes, she wasn't "flexible" enough...She didn't "hear". Which, in the parlance of the dissection of the Clinton-era health care reform efforts, means that she, and then-president Clinton, didn't bow down to "Harry and Louise", the multi-million dollar assault on the health care reform via the Coalition for Health Care Choices, which was just a front group financed by the Health Insurance Association of America (HIAA).

In today's version of health care "reform"the president's deal was a bit different:

After weeks of talks, drug industry lobbyists were growing nervous. To cut a deal with the White House on overhauling health care, they needed to be sure that President Obama would stop a proposal intended to bring down medicine prices.

 On June 3, 2009, one of the lobbyists e-mailed Nancy-Ann DeParle, the president’s health care adviser. Ms. DeParle reassured the lobbyist. Although Mr. Obama was overseas, she wrote, she and other top officials had “made decision, based on how constructive you guys have been, to oppose importation” on a different proposal.

Just like that, Mr. Obama’s staff signaled a willingness to put aside support for the reimportation of prescription medicines at lower prices and by doing so solidified a compact with an industry the president had vilified on the campaign trail. Central to Mr. Obama’s drive to remake the nation’s health care system was an unlikely collaboration with the pharmaceutical industry that forced unappealing trade-offs. [emphasis added]

And is it a wonder that the insurance industry is spending billions of dollars promoting the ACA? No, as Marshall Auerback explains:
As Randy Wray and I discussed in a recent paper, the health care bill just signed into law entrenches the centrality of private health insurance companies and contain no serious proposals to limit costs. More people will get hit with deductions, co-pays, annual limits (for several more years), exclusions, out of pocket expenses. This will ensure that health CARE remains too expensive to actually take advantage of their new INSURANCE. And many currently insured people are going to get higher taxes. Premiums will rise.

Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. It’s akin to going to your local grocery store, buying food, submitting the bill to a 3rd party who reviews it, reimburses the grocer for part of the cost, and then extracts a 13% charge from you for the privilege of scrutinizing the bill in the first place.

The “reform” introduced by this bill largely promotes the status quo by pulling more people into an expensive health care system that is managed and funded by private insurers with no countervailing government option. Given that over half of all household bankruptcies are due to health care costs, creating mandates to force people to turn over an even larger portion of their income to insurance companies will further erode household finances and exacerbate the problem of declining incomes. It’s the Wall Street bailout principle extended to the health insurance industry.[emphasis added]

Now, please go ahead, quote me all the statistics about how many people are signing up for health insurance. Fine. Those numbers do not contradict a fact:

The entire scheme leaves two of the most corrupt industries ever to do business on the planet in place, and laughing all the way to the bank.

Both the president and his former Secretary of State made the same grave error: they capitulated to two powerful economic industries. You can speculate all you want as to why they caved (political donation considerations, basic agreement with the "free market") and structured their "reforms" the way they did.

But, by ridiculing/not taking seriously/undermining any discussion of single-payer health care (popularly re-branded as "the public option"--which, IMHO, reminded me of the post 1980s branding of "progressive" because no one wanted to be red-baited as a "left-winger" or, god forbid, a socialist), they sowed the seeds of the calamity we now face:

Millions of people will still shell out unconscionable amounts of their dwindling income to finance these criminals (and their CEOs multi-million dollar salaries and benefits), and we are going to live for many years with an economically foolish, immoral model for health care.

Those are the facts. And they bare repeating, time and again, if we have any hope of ever having a health care system in place that makes economic sense (single-payer would operate at roughly 3-4 percent administrative costs versus the corrupt industry's 20-30 percent administrative costs) and moral sense.

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Comment Preferences

  •  Well, and plainly, said (7+ / 0-)

    The Village, which operates on gossip, finds healthcare "complicated" because it is not reducible to a bumper sticker or slogan.  Obamacare could not have come about without buying off the insurers--someone in the healthcare industry ecosystem had to be paid off to play ball.  Single payer is best for the public treasury, and probably health outcomes too, but with all the pigs at the heath care trough (hospitals, drug companies, medical device makers, etc.), it is not possible to buy them all out at once.

    •  But as the current program gives both (7+ / 0-)

      Big Insurers and the players inside Big Medicine unlimited funds, the notion of taking baby steps so we can soon be  lead to a complete overturn of  the system is probably a false one.

      Big Insurers/Big Medicine now have so much money that things will only get worse.

      And before I  get  jumped, on, yes, and yes,  I am very glad that some folks in our society now have health insurance.
      But that doesn't mean this entire situation does not have so many holes in it that I see remaining totally healthy as my only chance of surviving.

      (Just finished reading about how one woman's efforts to have a small mole below her eye removed, to the tune of a bill of $ 20,000! (A small mole!!!!!)  This type of "service inflation" means many of us could face  bankruptcy soon, especially since co-pays deductibles etc have to come out of our pocket.)

  •  Great argument in a vacuum of no GOP. (7+ / 0-)

    As it is, the ACA is 4 years old and the GOP House is still trying to repeal it.

    While you dream of Utopia, we're here on Earth, getting things done.

    by GoGoGoEverton on Mon Mar 03, 2014 at 02:25:41 PM PST

    •  My argument would be... (11+ / 0-)

      Forget the GOP...IMHO, it is a no-brainer winning electoral argument to make to every segment of voters that we need to kill the insurance companies, some of the most hated companies to deal with...the problem was and is, IMO, that people, with the ACA and with Clinton's plan, still have to confront those hated companies and that's where the "complexity" argument gains traction. Fundamentally, the structure of who does Mary or Joe Smith have to deal with remains the same.

      Follow me on Twitter @jonathantasini

      Visit Working Life.

      by Tasini on Mon Mar 03, 2014 at 02:33:08 PM PST

      [ Parent ]

      •  You honestly think the argument (4+ / 0-)
        Recommended by:
        FG, VClib, GoGoGoEverton, Satya1

        "you won't be dealing with insurance companies anymore! You'll be dealing with the federal government!" would have been a winner in our current environment?


        •  no (9+ / 0-)

          I would have run ads, if we had single payer, with a senior citizen, Medicare recipient, smiling and saying:  "Welcome to my world. We just killed the insurance industries so now you can join me in the Medicare for all plan, which has been a savior for me"...or words to that effect.

          Now, Medicare is not 100 percent perfect. But it is world's ahead of any other private health insurance plan--and it is a single payer plan...

          Follow me on Twitter @jonathantasini

          Visit Working Life.

          by Tasini on Mon Mar 03, 2014 at 02:54:30 PM PST

          [ Parent ]

          •  And the entrenched narrow interests (5+ / 0-)

            would have dwarfed your ad campaign with their resources.

            Check out Steinmo and colleagus for an assessment on that and other reasons for the failure of the Clinton plan.

            About the politics of getting ACA through Congress:  I have yet to see a really convincing argument on either side that either the current outcome was inevitable or that single payer was doable in political terms.

            One of the reasons, like it or not, that acceptance of ACA is winning over GOP opposition is that many private interests are supporting it.  Yeah, I hate them too.

            Also keep in mind that this policy is far from static.  It includes some very innovative pieces and even somehow left open the door for states to go the single payer route.  And some people in Congress are trying to make it easier for other states to follow Vermont.

            I'm not liberal. I'm actually just anti-evil, OK? - Elon James White

            by Satya1 on Mon Mar 03, 2014 at 03:07:55 PM PST

            [ Parent ]

          •  Many of us on Medicare also have insurance to (1+ / 0-)
            Recommended by:

            cover all the costs that Medicare doesn't. And we are glad to have that insurance available in the marketplace.

            "let's talk about that"

            by VClib on Mon Mar 03, 2014 at 03:17:04 PM PST

            [ Parent ]

  •  The single payer system (0+ / 0-)

    Allowable in the law in a few years?

    by DAISHI on Mon Mar 03, 2014 at 02:33:56 PM PST

    •  In 2017 (0+ / 0-)

      "let's talk about that"

      by VClib on Mon Mar 03, 2014 at 03:17:56 PM PST

      [ Parent ]

    •  What is interesting to me is that (1+ / 0-)
      Recommended by:

      there are people on both the right and the left who are convinced that a significant expansion of either single payer by state or national single payer is on the way.

      I'm not liberal. I'm actually just anti-evil, OK? - Elon James White

      by Satya1 on Mon Mar 03, 2014 at 04:18:58 PM PST

      [ Parent ]

      •  Both delusional, one based on hatred, the other on (0+ / 0-)

        false hope.

        "Government by organized money is just as dangerous as Government by organized mob." -- Franklin D. Roosevelt

        by Kombema on Mon Mar 03, 2014 at 07:35:15 PM PST

        [ Parent ]

      •  I think we will take the same path as Canada (1+ / 0-)
        Recommended by:

        and it will start in the states. Single payer at the national level is a generation away, in my opinion.

        It looks like Vermont will be first in 2017, which I think is great. Let's start in a small state and see what works well and what doesn't work both in terms of healthcare delivery and the funding sources.

        "let's talk about that"

        by VClib on Mon Mar 03, 2014 at 07:37:42 PM PST

        [ Parent ]

        •  I hope so (1+ / 0-)
          Recommended by:

          I've seen some other stuff too like Ezra Klein writing in Bloomberg that liberals don't get some important facts about single payer.  There are some different ways to roll it out and related problems that need to be solved for it to work.

          Anyway, I am also eagerly looking forward to watching Vermont's experience.

          I'm not liberal. I'm actually just anti-evil, OK? - Elon James White

          by Satya1 on Tue Mar 04, 2014 at 05:52:45 AM PST

          [ Parent ]

      •  The "right" are afraid of it, though (1+ / 0-)
        Recommended by:

        because Socialism and Death Panels! The Left....apparently we're playing chess again, am I reading Scheiber correctly?

        Once the previously uninsured start getting insurance, the natural upshot of cataloguing the law’s shortcomings isn’t to give them less insurance, as my colleague Alec MacGillis pointed out last fall. It’s to give them more. Republicans are in some sense playing into the trap Obamacare laid for them.
        Yeah, there's some concern quoted in response to that, all right--and I dare say the quote here might not actually be onto something.
        stuart stevens ‏@stuartpstevens

        @noamscheiber Exactly what critics on rt. have said. O'care will collapse current system covering 85%, create chaos, force gov in deeper.

        3:34 PM - 1 Jan 2014

        But how many more of us have to die in the meantime? Or die in the ensuing "chaos" if it actually "collapses"?

        Oh, collapse! There's that word again, and why is that, anyway? Last time it caught my attention in the economic sense, it was followed by the words "bailout" and "taxpayers"...

        This all started with "what the Republicans did to language".

        by lunachickie on Mon Mar 03, 2014 at 08:05:48 PM PST

        [ Parent ]

        •  Yeah the "chess" reference didn't (0+ / 0-)

          encourage me and I didn't buy Scheiber's whole argument.  But he did state some things I hadn't heard before and the Forbes article showed me a bit more about how much the right is afraid of this.  That author did all he could to sound the alarm to the troops.

          I'm looking forward to seeing how the Vermont "experiment" goes.

          I'm not liberal. I'm actually just anti-evil, OK? - Elon James White

          by Satya1 on Tue Mar 04, 2014 at 05:46:43 AM PST

          [ Parent ]

  •  Dowd's reasoning is one more reminder, (4+ / 0-)

    among so many, of how far to the right our political dialogue has been moved.

    I'm a Christian, therefore I'm a liberal.

    by VirginiaJeff on Mon Mar 03, 2014 at 02:34:17 PM PST

  •  Even the small concession of seeing that drug (12+ / 0-)

    Prices are not continually artificially inflated, that would have been one decent thing for President Obama to undertake.

    But being the puppet of Big Medicine/Big Insurers et al means never having to do anything but comply with the few people who hold the strings to your movements.

    When doxycycline, a drug that used to cost about $ 30 for a month's supply, now costs a person in the USA some $ 2,000 a month, something is severely whacked about the system. But Big Pharma knows the value of having so many  people diagnosed with Lyme's that are forced to each pay more than a thousand a month.

  •  I have been supportive (12+ / 0-)

    enough of the ACA, because it has helped some. But I've also been critical of components of it, particularly the fact that the criminal SCOTUS stuck a knife in the back of us all. Florida's refusal to expand Medicaid leaves it helping me not at all at the present time.  

    Even so, regardless of how you feel about the particulars as they stand right now, there is absolutely no denying this:

    leaves two of the most corrupt industries ever to do business on the planet in place, and laughing all the way to the bank.

    This all started with "what the Republicans did to language".

    by lunachickie on Mon Mar 03, 2014 at 02:46:31 PM PST

  •  Obama was able to get his plan passed (4+ / 0-)
    Recommended by:
    puakev, Satya1, jan4insight, ybruti

    If Obama advocated for single payer, it would have not gone anywhere.

    The majority of Americans get their insurance through their employer and are generally satisfied with it.  A single payer would kick everyone off their employer insurance and force them onto an unknown government plan.

    You can argue that the single payer is better all you want, but people aren't going to believe it until they see it.  I currently receive good health benefits and don't know if a government plan would be as good to what I have now.

    The only thing that I know a single payer would be better is with costs, but I have no indication that my employer will pass the costs difference to my paycheck.

    This is why Obamacare was designed in preserving the current employer insurance system we have.  It is the political reality we have to deal with.

    The good news is that there is nothing that is stopping making our system work better.  I was disappointed that the public option was killed, but you can always bring it back in the future.  If people can see that a public option is a good alternative to private insurance, then it will gain more political support for a single payer system.

  •  False argument. (2+ / 0-)
    Recommended by:
    jan4insight, GoGoGoEverton

    Sure, Obama and Clinton could have put forth a simple program as a solution to the healthcare crisis... if they were King.  But a President has to pass laws through the House and Senate.  That's a bit of a disadvantage.

    "Because I am a river to my people."

    by lordcopper on Mon Mar 03, 2014 at 04:09:10 PM PST

  •  Can we find support for reimportation now? (3+ / 0-)
    Recommended by:
    Kombema, JamieG from Md, aliasalias

    I think it would be a great kitchen table issue.  Pharma would put a lot of $$$ behind opposition, but it might be a way to call the bluff of GOP types who want to talk about controlling healthcare costs.

    I like Marsha Blackburn on Facebook. Don't hate.

    by Benintn on Mon Mar 03, 2014 at 05:02:11 PM PST

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