Sunday, May 24, 2009

The Continuing Fight Over Health Care Reform

President Obama and the Congress are finally starting to tackle the issue of health care reform in the US as promised in his campaign. And none too soon! There are an estimated 47 million people in the US without health insurance. Some say that this number is misleading since some of those people have chosen for whatever reasons, not to have health insurance. But even granting that point, there are still tens of millions of people who want and need health insurance but cannot obtain it at an affordable price or even at all.

So whether it’s 47 million or 37 million or even 27 million, the question must be asked what number of uninsured Americans is acceptable? If that number is more than zero, whom shall we decide is not worthy of our making sure they will not die from lack of health insurance? This is not just a bunch of liberal hyperbole. An estimated 18,000 people needlessly die in the US each year not because their diseases are incurable but because they did not have access to health insurance.

When viewed in this way, many more people here in the US are finally starting to see that
Healthcare Is a Right! instead of arguing about who should have the ‘privilege’ of not having to worry about needless death or bankruptcy just because they get sick or injured.

So once we agree there is a problem to fix, the next step is to figure out what to do. The present system of private health insurers is obviously not working. And that brings us to a major fork in the road for our elected officials to navigate.

1. Do we keep the system of private insurers intact but impose government reforms to try and fix the problems?

2. Or do we blow up the private health insurance system and have the government assume the role of a ‘single payer’ of health insurance claims (like we presently do with Medicare for those over 65)?

Before we answer this, it is important to point out that health insurance companies are major contributors to both parties. And any alternative that would put the private health insurers out of business would result in a bloody fight to the death — a fight that most of our elected officials have no stomach for.

So first and foremost, our most of our politicians feel they have to make sure they don’t anger the insurance companies like Hillary Clinton did back in 1993 when she pushed for health care reform. Back then, the insurance industry sponsored the infamous Harry and Louise ads that helped to sink the Clintons’ plan.

While Republicans have an easy road to satisfying their base by simply crying Socialized Medicine! and perhaps denying there even is a problem, President Obama and most of the Democrats in Congress are choosing to walk a tightrope by trying to fix this mess while at the same time not alienating the health insurance industry. To try and accomplish this, they have decided on the first option from above which is to keep the private insurance system intact while making reforms. Hillary Clinton, who learned her lesson from 1993, suggested a very similar plan during her presidential campaign.

But this obviously wouldn’t satisfy the Democratic faithful so they decided to put in a little zinger in the form of a ‘public option’ for insurance which incorporates part of the second option listed above. Those people who are happy with their private insurance can keep it. But others who have been left out in the cold under the present system could buy into government issued health insurance at an affordable price. So in effect, the private health insurance companies would be forced to compete with government issued insurance to stay afloat.

For most of us, this seems reasonable. After all, the health insurance companies have had it their way by essentially choosing to insure healthy people and rejecting others who may generate too many losses. It’s a great way for them to make money, but it doesn’t serve the needs of those millions of Americans without health insurance.

Somewhat predictably, The Wall Street Journal offered this op-ed piece
The End of Private Health Insurance.

This public option will supposedly "compete" with private alternatives. As President Obama likes to put it, those who are happy with the insurance they have now can keep it -- and if they happen to prefer the government offering, well, gee whiz, that's the free market at work. The reality is far different. Not only will the new program become the default coverage for the uninsured, but Democrats intend to game the system to precipitate -- or if need be, coerce -- an exodus to government from private insurance. Soon enough, that will be the only "option" left.

And in Paul Krugman’s NYT op-ed article, Blue Double Cross, it appears that the fight that President Obama and Congress had been hoping to avoid by placating the health insurance industry is coming anyway.

…the insurance industry is busily lobbying Congress to block one crucial element of health care reform, the public option — that is, offering Americans the right to buy insurance directly from the government as well as from private insurance companies. And at least some insurers are gearing up for a major smear campaign.

On Monday, just a week after the White House photo-op, The Washington Post reported that Blue Cross Blue Shield of North Carolina was preparing to run a series of ads attacking the public option. The planning for this ad campaign must have begun quite some time ago.

The Post has the storyboards for the ads, and they read just like the infamous Harry and Louise ads that helped kill health care reform in 1993.

Here we go again!

When private insurers say they cannot compete with public insurance and still make a profit, aren’t they unwittingly making an argument in favor of going with a pure single payer system? If indeed healthcare is a right for all citizens, shouldn’t that take precedence over the need for profit by the insurance industry?

A recent Bill Moyer’s Journal had a discussion of the recent events in health care reform with a couple of single payer advocates which you can watch online in this link. Most significantly, the guests said that a proposed hybrid public-private insurance plan cannot work and has never worked anywhere else. But perhaps the most interesting part of the show was a 2003 video of then Illinois State Senator Obama.

PRESIDENT OBAMA: I happen to be a proponent of a single-payer universal health care plan.

BILL MOYERS: That was State Senator Obama, who said there was just one big obstacle standing in its way.

PRESIDENT OBAMA: We may not get there immediately, because first we've got to take back the White House, and we've got to take back the Senate, and we've got to take back the House.

What this all says is that President Obama’s present resistance to supporting single payer health insurance is far more about avoiding a fight with the health insurance industry than any perceived shortcomings of single payer.

This is underscored in a video at the very end of Moyer’s program showing an exchange between NPR health policy correspondent Julie Rovner and Senator Max Baucus who presided over the recent Congressional testimony exploring health care reform.

JULIE ROVNER: The supporters of single-payer health care point out that their plan is not on the table.

SEN. MAX BAUCUS: That's true. They do. They make that quite clear.

JULIE ROVNER: And, as they... so what do you say to them as they point out that they have significant support, and yet their plan is the one thing that is not on the table at the moment.

SEN. MAX BAUCUS: Well, just to be honest, it's not on the table - the only thing that's not - because it cannot pass. It just cannot pass. We can't squander this opportunity. We can't spend - we can't waste (political) capital on something that's just impossible.

Well maybe it’s finally time for President Obama to revive that rallying cry that candidate Obama used so effectively to inspire so many to support him all the way to the presidency, Yes We Can!

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