Crossposted from Hillbilly Report.
After supposedly taking single-payer off the table activists and the fifty million Americans with no health insurance who are just one disaster away from being financially destroyed have worried we will see little progress on Universal Healthcare. Now it seems with some bi-partisan agreement as if some progress may be made. It will come at a price, and may not be what this country really needs, single-payer.
Politico is reporting that despite fears on the Progressive side of the aisle President Obama's plan is beginning to take shape and may have some bi-partisan support:
It’s hard to believe that only three months ago, health care advocates worried that President Barack Obama would drop the health reform issue from his first-year agenda. Now, with an August deadline to pass a bill, a compromise that once seemed unimaginable is considered quite possible, both sides say.
Congress this week begins a two-month sprint to pass legislation overhauling the health care system — an aspiration that has eluded generations of American politicians. The task is exceedingly complex and faces the legislative equivalent of an Ironman triathlon, tested at every stage by monied interests, political alliances and an estimated 13-figure price tag.
http://www.politico.com/...
They also have a summary of what we may see included in such a bill:
Everybody gets in and stays in. The guiding principle of congressional efforts remains universal coverage, or something close to it. This means not just finding a way to cover 50 million uninsured Americans but also making the system more stable and affordable for those who already have insurance through their employer. Now, losing a job means losing coverage.
Why it looks likely: Lawmakers view universal coverage not as much as a moral imperative but as an economic issue. If the aim is to lower insurance premiums for everyone, then the young and the old, the sick and the healthy must be funneled into the system as a way to spread the costs of high-risk patients.
It is nice to see with all the backtracking on rhetoric from the last election we seem to be backtracking on dropping mandates. Mandates will insure that even those with pre-existing conditions will have to be covered. Lets just hope that lawmakers understand that they will have to be covered at a reasonable price to them. It is also nice to note that lawmakers seem to be admitting that this issue is as important economically as it is morally.
While this is good news, it appears as if the sticking point will remain over cost, and who pays:
The unresolved fight: how to compel participation in the system and how to pay for it. Last month, Senate Finance Committee Chairman Max Baucus (D-Mont.) said "we’re going to try to get as close as we can" to universal coverage, and the Congressional Budget Office estimates the proposals would reach about 95 percent of Americans. But the package of options for achieving even near-universal coverage requires lawmakers to find hundreds of billions of dollars in new tax revenue and spending cuts — money that it hasn’t found yet.
Americans need to let our lawmakers know that if this country can afford trillions of dollars to blow up and rebuild two countries in the middle-east, bailout failed banks, and dole out hundreds of billions in corporate welfare to companies who hide their profits offshore, and seek to use virtual slave labor and exploit children in third-world countries we can damn well afford to do something for our own populace for once. It is not only the best economic solution for small businesses, but it is the right thing to do.
One bi-partisan idea that is being floated around with bi-partisan support:
Orbitz for insurance. If there was such a thing as a sure bet in the bill, this would be it: the creation of an insurance marketplace, or "exchange," where individuals and small employers could compare plans side by side, find options with a minimum benefits package and buy coverage. Insurers would be required to take all comers, regardless of pre-existing conditions. Proponents say it would give individuals a place to find affordable insurance that could go with them from job to job.
Why it looks likely: It is the cornerstone of Democratic and Republican health care proposals. Experts from the conservative Heritage Foundation and the liberal Center for American Progress endorse it. Federal lawmakers already participate in an exchange called the Federal Employees Health Benefits Program — and they have been promising for years to provide the same choices to voters.
"That has to be the one thing that is close enough to a guarantee as you can find," said David Merritt, a health policy expert at Newt Gingrich’s Center for Health Transformation.
The unresolved fight: how to structure it. The CBO, which has been reviewing the legislative proposals to determine their fiscal impact, hinted in a report last week at the scope of options under consideration. They could be "private online clearinghouses similar to Orbitz" — the online travel-booking site — or they could involve more government involvement.
Unfortunately as mentioned above despite having money for failed wars and the greediest and least patriotic among us the main sticking point once more will be asking Americans to sacrifice:
Higher taxes — for somebody. Obama and congressional Democrats are considering an overhaul that could exceed $1 trillion over 10 years, and spending cuts will get them only so far. That means some people will take a tax hit. The hot target at the moment: levying a tax on health benefits provided through employers, which currently aren’t subject to taxation.
Why it looks likely: It’s a cash cow. The deduction on health benefits is worth more than $200 billion annually. Baucus does not want to eliminate the deduction, but he has floated a cap that would tax plans worth more than a certain amount. Liberal and conservative academics support the change. And congressional Republicans have advocated eliminating the tax-free status of employer insurance, giving the idea bipartisan credibility (although the GOP would want to return all the money to individuals in the form of tax credits).
The good news appears to be that Democrats may actually have the power to push through one thing that is desperately needed. A public plan:
Going public. Establishing a public insurance option to compete with private insurers remains one of the most contentious aspects of the reform debate. Democrats maintain a public plan will keep private insurers honest while Republicans argue that it would create another bloated government entitlement. But even some in the GOP say a bill will include at least a public "fallback" plan, which would be put in place if private insurers did not do enough to cut costs and improve access. Republicans backed this structure in the 2003 bill on Medicare prescription drug coverage.
Why it looks likely: Democrats hold the cards. They have a popular president, dominate the House and claim a near-filibuster-proof majority in the Senate. Plus, they can still use "reconciliation," a procedural tool that allows them to pass a bill with 51 votes if an agreement isn’t reached by Oct. 15.
The unresolved fight: Democrats are unlikely to settle for a "fallback" option, so they will continue to push for as robust a public plan as possible. But expect to see Republicans, physicians and private insurers resist this for as long as they can.
If you are like me however, you are quickly losing faith in the hope that our party will fight for it's own principles and in the spirit of bi-partisanship will end up scrapping even this common sense solution.
Sadly, what seems to be missing from all of this is the real solution, single-payer. John Conyers recently bemoaned the demise of this solution and HR 676:
While many lawmakers are wary of actually having to fight for the right thing in the face of moneied special interests, the facts behind the need for single-payer are unrefutable. Unfortunately several myths are generated and pushed as fact by corporate America and the insurance companies onto the American people. These facts are easily refuted:
Myth One: The United States has the best health care system in the world.
Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990
Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960
Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.
Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana
Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.
Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation.
http://cthealth.server101.com/...
So, as you can see those that argue that we have the greatest healthcare system in the world are completely off base. We are not even close. The only folks who think we lead the world in healthcare are those who have the financial means to use it, and the insurance companies who profit from it. The only reason they want single-payer defeated is because they are afraid we might actually invest in our own citizens for once:
Myth Two: Universal Health Care Would Be Too Expensive
Fact One: The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care
Fact Two: Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits.
Fact Three: State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits
Fact Four: The costs of health care in Canada as a % of GNP, which were identical to the United States when Canada changed to a single payer, universal health care system in 1971, have increased at a rate much lower than the United States, despite the US economy being much stronger than Canada’s.
Conclusion: Single payer universal health care costs would be lower than the current US system due to lower administrative costs. The United States spends 50 to 100% more on administration than single payer systems. By lowering these administrative costs the United States would have the ability to provide universal health care, without managed care, increase benefits and still save money.
So, they facts bear out that not only is single-payer more efficient but it would cover all Americans for less money than the current for profit system used in our country. The only ones who argue against single-payer simply put profits over people no matter what party they are in.
And what of the argument that single-payer would deprive Americans of needed services?? Another myth:
Myth Three: Universal Health Care Would Deprive Citizens of Needed Services
Fact One: Studies reveal that citizens in universal health care systems have more doctor visits and more hospital days than in the US
Fact Two: Around 30% of Americans have problem accessing health care due to payment problems or access to care, far more than any other industrialized country. About 17% of our population is without health insurance. About 75% of ill uninsured people have trouble accessing/paying for health care.
Fact Three: Comparisons of Difficulties Accessing Care Are Shown To Be Greater In The US Than Canada (see graph)
Fact Four: Access to health care is directly related to income and race in the United States. As a result the poor and minorities have poorer health than the wealthy and the whites.
Fact Five: There would be no lines under a universal health care system in the United States because we have about a 30% oversupply of medical equipment and surgeons, whereas demand would increase about 15%
Conclusion: The US denies access to health care based on the ability to pay. Under a universal health care system all would access care. There would be no lines as in other industrialized countries due to the oversupply in our providers and infrastructure, and the willingness/ability of the United States to spend more on health care than other industrialized nations.
Many also argue that single-payer would take freedom of choice from American consumers, another scare tactic easily disproven:
Myth Four: Universal Health Care Would Result In Government Control And Intrusion Into Health Care Resulting In Loss Of Freedom Of Choice
Fact One: There would be free choice of health care providers under a single payer universal health care system, unlike our current managed care system in which people are forced to see providers on the insurer’s panel to obtain medical benefits
Fact Two: There would be no management of care under a single payer, universal health care system unlike the current managed care system which mandates insurer preapproval for services thus undercutting patient confidentiality and taking health care decisions away from the health care provider and consumer
Fact Three: Although health care providers fees would be set as they are currently in 90% of cases, providers would have a means of negotiating fees unlike the current managed care system in which they are set in corporate board rooms with profits, not patient care, in mind
Fact Four: Taxes, fees and benefits would be decided by the insurer which would be under the control of a diverse board representing consumers, providers, business and government. It would not be a government controlled system, although the government would have to approve the taxes. The system would be run by a public trust, not the government.
Conclusion: Single payer, universal health care administered by a state public health system would be much more democratic and much less intrusive than our current system. Consumers and providers would have a voice in determining benefits, rates and taxes. Problems with free choice, confidentiality and medical decision making would be resolved.
And what of the Republican cry of "Socialism"?? Is single-payer really a socialist ideal that Americans shun??:
Myth Five: Universal Health Care Is Socialized Medicine And Would Be Unacceptable To The Public
Fact One: Single payer universal health care is not socialized medicine. It is health care payment system, not a health care delivery system. Health care providers would be in fee for service practice, and would not be employees of the government, which would be socialized medicine. Single payer health care is not socialized medicine, any more than the public funding of education is socialized education, or the public funding of the defense industry is socialized defense.
Fact Two: Repeated national and state polls have shown that between 60 and 75% of Americans would like a universal health care system (see The Harris Poll #78, October 20, 2005)
Conclusion: Single payer, universal health care is not socialized medicine and would be preferred by the majority of the citizens of this country.
Yes, many try to argue that a free market solution is the answer, but they totally ignore the fact that for millions of uninsured and underinsured Americans this approach has already completely failed:
Myth Six: The Problems With The US Health Care System Are Being Solved and Are Best Solved By Private Corporate Managed Care Medicine because they are the most efficient
Fact One: Private for profit corporation are the lease efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.
Fact Two: The same procedure in the same hospital the year after conversion from not-for profit to for-profit costs in between 20 to 35% more
Fact Three: Health care costs in the United States grew more in the United States under managed care in 1990 to 1996 than any other industrialized nation with single payer universal health care
Fact Four: The quality of health care in the US has deteriorated under managed care. Access problems have increased. The number of uninsured has dramatically increased (increase of 10 million to 43.4 million from 1989 to 1996, increase of 2.4% from 1989 to 1996- 16% in 1996 and increasing each year).
Fact Five: The level of satisfaction with the US health care system is the lowest of any industrialized nation.
Fact Six: 80% of citizens and 71% of doctors believe that managed care has caused quality of care to be compromised.
Conclusion: For profit, managed care can not solve the US health care problems because health care is not a commodity that people shop for, and quality of care must always be compromised when the motivating factor for corporations is to save money through denial of care and decreasing provider costs. In addition managed care has introduced problems of patient confidentiality and disrupted the continuity of care through having limited provider networks.
Unfortunately for millions of Americans there is only one real reason why the common sense approach of single-payer has not already been enacted:
Corporations are able to buy politicians through our campaign finance system and control the media to convince people that corporate health care is democratic, represents freedom, and is the most efficient system for delivering health care.
It is well past time in this country that we put people ahead of profit. I think Bill Maher summed it up nicely in his latest installment of "New Rules":
So, while we should all be encouraged by the emerging debate on healthcare, we should all take it with a grain of salt. We should demand that our party, and our country should not be taking baby steps and seeking to put band-aids on gaping wounds. Contact the White House, your Congressperson, and your Senators and let them know that the Health Insurance lobby can no longer hold the healtch and well-being of millions of Americans hostage any longer. Demand single-payer!!