Health care reform vs health “insurance” reform

Friends:  These days we are being bombarded with propaganda on this matter.  Alas, most of it reflects primarily the views and desires of the insurance industry, and has little if any informative value.  This piece by long-time Philadelphia-area writer Dave Lindorff is clear and sensible.  We can’t hope to make good decisions without being able to envision them and take them seriously.

” … the simplest way to solve America’s health care crisis would be to just start a gradual expansion of Medicare, say by lowering the age of coverage to 55, and then 45, and then 35, until everyone was covered and the insurance industry was pushed out of the health sector.”

Kill Bill

By DAVE LINDORFF | March 10, 2010

When Obama came to my neighborhood this week to press for public support for his health “reform” bill, he wasn’t just greeted by teaparty hecklers. Speaking to a large group of mostly supportive students and local residents at Arcadia University in Glenside, the president at one point mentioned that “people on the left” want “single-payer.” But before he could add that that approach wasn’t going to happen, he found himself drowned out by cheers calling for Medicare for all and single-payer.

That kind of says it all.

I’m with Marcia Angell, editor of the New England Journal of Medicine. The Obama plan for health care “reform”, as well as the two versions passed by the House and the Senate, are all devious disasters that do nothing to solve the nation’s burgeoning health care crisis, and in fact, will make it worse.

The only thing to do at this point is to take the whole stinking pile of paper and put it in the compost heap. Kill it.

This whole effort was never about reform from the day last March when the new president called on Congress to begin deliberations on health care reform. It was about catering to the wishes of the big players in the Medical Industrial Complex–the big pharmaceutical multinationals, the hospital companies, the physicians and, most of all, the insurance industry. People and their health care needs had little or nothing to do with this.

That’s why we’ve ended up with proposals that would do nothing to control costs, that would force healthy young people to buy unregulated, high-cost and high-profit plans that would be money in the bank for the insurance industry, and that would finance any subsidies for the poor by cutting back on benefits for the only group of Americans who currently have a form of single-payer insurance–the elderly with their Medicare.

President Obama began this whole obscene nightmare with a lie, when he said that even though single-payer systems clearly work to open access to all and keep costs down while providing better overall health results in places like Canada and some European countries, they cannot be applied in America “because that would mean starting over from scratch.” He knew when he said it that this was a lie. America already has a well-run and successful single-payer healthcare program in place that is bigger than the entire Canadian health care system, and that’s Medicare, which was established in 1965, and which currently finances the care of 45 million Americans. You just have to be 65 or disabled to be eligible for it.

As Dr. Angell pointed out on a recent Bill Moyers Journal segment, the simplest way to solve America’s health care crisis would be to just start a gradual expansion of Medicare, say by lowering the age of coverage to 55, and then 45, and then 35, until everyone was covered and the insurance industry was pushed out of the health sector. The right-wing couldn’t use their scare tactics about a “government takeover of your medical care,” because the elderly love Medicare, and besides, far from “inserting a government bureaucrat between you and your doctor,” Medicare gives the elderly a freer choice of physician and treatment than any but the most gold-plated private insurance executive health care plan.

Obama continued this lie when he claimed, in his last mention of the issue during his State of the Union address to Congress, that he and Congress had considered every idea. In fact, he and Congress have for the last year, carefully prevented any consideration of the idea of single-payer, or of expanding Medicare to cover every American. Bills that would do that, authored by Rep. John Conyers (D-MI) in the House and Sen. Bernie Sanders (I-VT) in the Senate, were in fact blocked from hearings or votes in both Houses by Democratic leaders, at the White House’s urging, while the White House itself barred single-payer advocates from any of its discussions.

Instead the president met behind closed doors with the lobbyists of the various health care industries, to cut deals with each sector in order to gain their support for his “reform” plan. It was as if the Department of Justice had called meetings with the various crime families of the Cosa Nostra in order to cut deals before developing a plan to “tackle” the Mafia.

The plan being proposed to”reform” health care–actually they long ago stopped calling it health care reform, acknowledging that this was never even contemplated, and started instead referring to what is being contemplated as health insurance reform–is, we are told, going to cost about $100 billion a year. That wouldn’t be bad if what we got in return was universal health care, but we don’t even get that. Instead we have a measure that will reduce access to health care for the middle class by taxing benefits and encouraging higher deductibles, that will force the poor, the young and the self-employed to buy terrible, over-priced plans offering minimal coverage, that will chip away at the coverage provided to the elderly, and that will ultimately lead to higher costs for everyone, and that will still leave nearly 20 million people with no coverage. The US currently devotes 17.5 percent of Gross Domestic Product to health care, and if this “reform” in any of its guises is passed, that share of the economy devoted to health care will quickly rise past 20 percent, with no end in sight.

This is madness. Expanding Medicare to cover everyone, as I have written earlier, would actually save everyone money immediately, and the country as a whole. Consider that the most expensive consumers of health care–the elderly–are already in the system. Adding younger, healthier people to Medicare would cost incrementally much less. That’s why the Canadians spend about 9 percent of their GDP on healthcare, while covering every Canadian, while we spend nearly twice as much and leave 47 million of our citizens uninsured and unable to visit a doctor. How could it be cheaper to add everyone to Medicare? Expanding Medicare to cover everyone would probably cost somewhere between $800 billion and $1 trillion a year. That sounds like a lot of money, until you consider that we already spend $100 billion a year to care for veterans through the Veterans Administration, and $400 billion a year to care for the poor through Medicaid. We also spend $300 billion a year subsidizing hospitals that have to provide “free” charity care to the poor who don’t qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, that $400 billion a year to care for the poor through Medicaid. We also spend $300 billion a year subsidizing hospitals that have to provide “free” charity care to the poor who don’t qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, thathospitals that have to provide “free” charity care to the poor who don’t qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, that’s $800 billion a year in current expenditures saved right there.

So even if my higher figure of $1 trillion for adding everyone to Medicare were correct, we’d only be talking about an extra $200 billion annual expense. And that could be covered by increasing the Medicare tax paid as a payroll deduction. You don’t want to pay more taxes? Well wait. If you were covered by Medicare, you and your employer would no longer have to pay for private insurance, which would mean a savings to workers of thousands of dollars a year, and even more to employers who currently pay the majority of health insurance premiums for employees. The net savings would be enormous.

Nobody has talked about this.

Universal Medicare would make American companies more competitive in the global marketplace, where other companies are not responsible for health care costs of their workers. It would make Americans wealthier, because they would no longer be paying for health care out of their own pockets. It would make everyone more secure, because they would no longer have to fear losing access to health care if they lost their job, and would eliminate most bankruptcies, which are reportedly caused by medical bills.

So we know what needs to be done.

And we know that the current “reforms” on offer don’t do it.

So Dr. Angell is right. Obamacare needs to die.

There is reason to hope that it will die. Republicans oppose it, though not for any decent reason. They want unregulated private insurance and unlimited profits for health care industries. Ditto some conservative Democrats, who are also anti-government ideologues whose wallets are stuffed with health industry swag. But their reasons for opposing the health bill don’t matter. All that is needed is for a few progressive members of the House and Senate to admit that the health bills being considered are not reform, but the antithesis of reform, and to also vote against it, and Obamacare will be dead.

At that point we can start seriously demanding that the Congress and the President act to bring us real health reform in the way that really works: expanding Medicare to cover everyone.

2 thoughts on “Health care reform vs health “insurance” reform

  1. amuller Post author

    Comment received by email from Terry Plowman:

    “These days we are being bombarded with propaganda on this matter.”


    I suppose that, like beauty, propaganda is also in the eye of the beholder.

    Please remove my e-mail address from your mass mailing list, as I do not want to receive your version of health-care propaganda — especially not under the Green Delaware banner!

    I fully support President Obama’s efforts to reform the broken health insurance system, and I find the diatribe you sent annoying. Scrap a year’s worth of efforts and start over? Isn’t that the mantra of the right-wing establishment that wants to protect the status quo? Your writer thinks President Obama, who is struggling against an enormous army of naysayers, is a “liar.” We all have our different opinions about this messy topic, and I am open to those that don’t match mine. But the commentary you sent is just a rant, not a reasonable sharing of opinion.

    Please remove this address from all future mailings:

  2. kim Adams

    Thank you for such an interesting perspective, but I don’t see America going from our ridiculous out of control multi payor system to a single payor system in a single step. All seniors don’t like Medicare. Well the ones who have big retirement accounts and get their nice Social Security checks who should have never gotten a social security check because they way to wealthy anyway probably do like medicare. Poor people and lower middle class people who struggle are different story. Although I see great merit in your philosophy, it would be like asking our current politicians to vote for a 3 party political system which might finally break up their increasing ability to stay in office until they are either mummified or pickled. I believe term limits would be effective in removing these career politicians and allow for new and exciting ideas to come to the forefront.
    I had to retire from nursing after having an acute Type A aortic dissection 2003. Please forgive my sentence structure and spelling. Having worked in healthcare since I was 16 as a tech, and graduating from nursing school in 82, to the ripe old age of 47 I have seen a lot of changes and alot that should have changed. In the old days you had to be admitted the night before to have a colonoscopy or many other outpatient procedures. You spent 7 days in the hospital for a gallbladder removal. There was no open heart surgery. The ambulance was the hearse with oxygen from the funeral home. I always jokingly said he made more money if he didn’t get there in time and had a funeral instead. He did a great job and was very committed but was also very greatful when the real ambulances began to role. The real ambulances had lights, sirens and all the trimmings including a 18 year old driver (me EMTI) and prisoners from the medium security prison (the EMTII’s) in the back) Thankfully I am alive from the dissection not because of the prisoners, to see this debate and evolving healthcare system reform take place. debate you are on. Medicare is federal during an exam to
    I have tried to explain to people for years that unlike many industries and businesses in America, competition in healthcare is very different. By that I mean the more insurance companies that share the lives in a given geographic area the higher the cost.People get excited when they have 10 options for insurance coverage. For some reason I guess there is a comparison to 10 car brands selling 50 models driving down prices in the market. Because there is more choice and therefore the buyer is always able to go to the next dealer.Why is the question they don’t usually have an answer for. They control the costs from the manufacturer to the sale and maintenance and repairs as well as warranties. They also have nationwide networks which control costs. Contracts for people are based on per member per month charges-known as PPM. A national cMedicare is successful because it covers millions of people accross America so it knows the cost of treating a heart attack in every hospital Delaware or Texas or Idaho. ..Medicare can compare charges by physicans, hospitals etc and compare them to local econimies to see if they “fit” and adjust accordingly. The more insurance companies there are in an area like Delaware provides less members for each company to sell policies to therefore the costs will be higher. If there are 2 companies the premiums with be cheap if there are 20 companies they will be high. More members mean you need money from each one to cover the cost, less members mean you need alot of money from each one to cover the cost respectfully.There was a time when we joked that HMO’s would hold their membership drives on the 2nd floor of buildings with no elevators to sign up healtier members.
    The current “reform” has made a deal with the devil known as pharmaceutical companies to grant a 50% reduction of brand name drug pricing to seniors to reduce their out of pocket cost for the famous medicare doughnut hole. The problem is it doesn’t take effect until 2014 which allows the companies to price hike for 4 years thus mitigating their “losses” and most likely increasing their profits. In addition for two years their will be no COLA for seniors in essence with inflation increased insurance premiums puts them in a far worse position than 2009.Republicans have successfully blocked import of Canadian brands to the US on the basis of contamination despite the fact that many of these drugs are manufactured by the same US companies. Having watched the teaparty candidate in Delaware even suggest that govenment would be in the exam room to interfere with healthcare should disqualify her from anything short of carrying a purse for Sarah Palin. No one ever gets in the middle in that situation period. I don’t care which side of the

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