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 Marie Cocco: America’s Other Civil WarPosted on Oct 2, 2006By Marie Cocco WASHINGTON—If—and the word should be capitalized, italicized, printed in boldface and underlined—the political civil war raging over the Bush administration’s war on terror ever ends, then we will, at some point, have to return to the civil war over healthcare. Except it seems that the American people have put down their arms. More than a dozen years after Hillary Rodham Clinton’s grand experiment in reshaping the health insurance system died in a pyre of overheated political argument and hysterical claims, it turns out the public wants pretty much what Clinton tried to deliver: coverage for all Americans. A nationally mandated, guaranteed set of core benefits to replace the current patchwork that leaves even many people who have insurance with inadequate coverage for some illnesses and treatments. A national policy that refuses to let a family be crushed financially if someone becomes very ill. All this would, naturally, be financed in a way the body politic considers “fair’’—without creating an undue burden on sick people and in a way that’s related to a family’s ability to pay. The most popular means of raising additional funds is through “some form of progressive, or ‘sliding scale’ income or payroll tax (like the Medicare payroll tax) specifically dedicated to supporting health care for all.’’ No, this isn’t a script for a Democratic candidate’s campaign commercial. And they’re not talking points for an interest group pushing this healthcare solution or that. These are the conclusions of an official, nonpartisan government commission set up by Congress as part of the Medicare prescription drug legislation. What the commission now tells us—after taking soundings in 37 states, collecting tens of thousands of responses to polls and written questionnaires and listening at 98 community meetings—is that Americans see clearly what is wrong with the healthcare system, and have on their own achieved a remarkable degree of consensus on how to fix it. More than 90% of those who participated in community meetings or responded to the commission’s questions and polls said they believed every American should have affordable coverage. A clear majority wants a mandated, basic benefit for everyone and is “not comfortable with bare-bones benefit packages.’’ There’s agreement, as well, that if doing things more efficiently and reshuffling current government subsidies don’t generate enough money for expanding coverage then—ahem—people are willing to pay higher taxes. “We found, across the board, that majorities of the population were willing to pay more to ensure that all Americans are covered,’’ the commission said in its report. All of this is wildly out of sync with the non-solutions the prevailing political system has been trying to shove down the public’s throat. Congressional leaders have, for the past few years, harrumphed mostly about healthcare costs, not about the growing number of Americans without access to insurance. Secure in its willful blindness, Congress has pushed as a panacea “health savings accounts,’’ tax-advantaged plans that do little to expand coverage but do a lot to shift more and more risk and responsibility for health coverage to individuals, rather than employers or the government. But it’s just this shift—already forced upon most of us by the erosion of the employer-based health insurance system—that’s got people so spooked they’re looking for a collective solution. They’re tired of going it alone as premium hikes eat at their incomes, and as overburdened employers scale back coverage or drop it altogether. The commission found that Americans are changing other aspects of their lives just to cope with the healthcare crisis—older workers postpone retirement, mothers of young children keep working to hang on to their insurance, those with an entrepreneurial urge forgo starting their own businesses. “All these things really shake people up,’’ says Richard Frank, a Harvard Medical School economist and co-chairman of the panel, the Citizens’ Health Care Working Group. “It’s the general feeling of insecurity—that they won’t get what they need when they need it.’’
This same public anxiety drew presidential candidate Bill Clinton into the healthcare fray in 1992. But somewhere along the way, the political opposition made the fear of change trump the fear of going without care. If somehow, someday, this commission manages to renew the moribund national debate over healthcare, courage is the most potent medicine we’ll need.
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By Bryce Babcock, October 10, 2006 at 2:43 pm #
(Unregistered commenter)
Marie Cocco is right about what kind of healthcare system we need in the U.S. I think she may be right that the American people are finally beginning to realize what that system should be: a universal, comprehensive, single-payer, national health insurance program. Or what some characterize as “Medicare for all.”
She is wrong, however, in suggesting that this was the kind of plan that Hillary Clinton envisioned and tried to set up during the early days of her husband’s first term as president. In fact, Hillary’s plan was an extremely complicated system that pandered to the private insurance companies and the pharmaceutical industry. It would have failed to solve the healthcare problems in the U.S. while hiding behind a smokescreen of “reform.” The tragedy at the time was that Hillary didn’t have the courage to stand up to the private insurance companies because she was afraid that they would inevitably charge that she was attempting to foist on the U.S. a program of “socialized medicine.”
“Socialized medicine” is where all doctors work for the government and where the government owns and operates the hospitals. Under a Canadian or Japanese style single-payer national health insurance program, doctors would retain their private practices, and hospitals would continue to operate as they do now. The difference would be that all healthcare providers would submit their bills to a single, national health insurance organization rather than have to operate in the bureaucratic maze of dozens of competing private insurance companies. Under a simplified single-payer national health insurance program, administrative costs would be only a small fraction of what they are now, and so would costs to users of the program. It would also free employers from the high costs of health benefits they now have to pay to employees.
The U.S. has only to look around at what every other industrialized country in the world has learned. It’s unfortunate that Hillary didn’t have the knowledge or backbone to propose the kind of program that would really solve the healthcare problem we face in the U.S. today.
Report thisBy CP, October 4, 2006 at 9:53 am #
(Unregistered commenter)
“These are the conclusions of an official, [ nonpartisan] government commission set up by Congress as part of the Medicare prescription drug legislation.”
Official
That makes it all better. Let me get on my knees and praise
Set up by Congress,
Everyone who is paying attention and consequently through the nose, KNOWS Congress is heavily LOBBIED read BRIBED, by BIG INSURANCE, BIG PHARMA, AND BIG MEDICINE. So of course the out come is going to be the same as what Billary wanted, nothing has changed.
Of course the the public wants inexpensive and comprehrensive coverage! But the coverage you will end up with will be exactly what you are told you can have, not cover HOMEOPATHY, NOT ALLOW REAL cancer cures, not allow ANYTHING that conflicts with the profit structures of the HMO cartel.
non partisan - GET REAL!
Who are the partisans not being one sided, and what is their background and comprehensive knowledge of the HEALING ARTS of ALL BRANCHS?
Report thisBy GW=MCHammered, October 4, 2006 at 8:11 am #
(Unregistered commenter)
In a nation governed by the people, we hold the power to choose the benefits and services OUR government provides and pays for… they are not to be dictated to us by officials or business. “We The People” ARE the largest Special Interest Group and customer! It’s absurd that we must consistently remind politicians and business of this simple democratic fact.
The World Health Organization rates our healthcare system 37th in overall performance, behind Columbia and Chile, yet number-one in cost by a longshot. We deserve better and we should demand better. Currently, Healthcare is a gold brick sinking families, industries and municipalities too… we spend too much and get too little.
Holding our citizens’ body-of-health over a barrel-of-dollars is appalling. If we truly are ever to win in the Global marketplace, it won’t be by gutting our lower and middle class… it will be when we finally cut out like the cancer it is, inefficiencies and narcissistic greed where ever we find it.
PHYSICIANS FOR A NATIONAL HEALTH PROGRAM is a great place to seek ideas for positive change.
Report thishttp://www.pnhp.org
By Socrates, October 3, 2006 at 3:50 pm #
(Unregistered commenter)
People realized milennia ago that health care is NOT just a service industry. Rather, this is an industry that has the power to say: “pay or die.” Under these circumstances, they can charge “customers” whatever they want (the insistence on the word “patient” is important in this context). That’s the essential reason for the Hippocratic oath: to avoid an extortion industry.
That being said, the proposal mentioned on this page seems reminiscent of the GOP medicare prescription drug program in that it seems to simply direct federal tax money to the vast insurance machine and associated corporations (i.e., corporate welfare). We need to avoid that kind of thing happening again.
The truth is, people, that the healthcare insurance industry in the US has to go for matters to improve. It is NOT more efficient than gov’t run healthcare programs (despite the GOP propaganda that everything private has to be more efficient)...the facts are already in regarding this matter (it is more like a pyramid scheme where those at the bottom never move up). This is one of the most important, and certainly the toughest, battles to be fought for domestic progress in the US. No doubt, the health insurance industry is powerful. One of their own is the majority leader of the US Senate (after defecting from MD to the dark side).
Report thisBy GW=MCHammered, October 3, 2006 at 8:06 am #
(Unregistered commenter)
PHYSICIANS FOR A NATIONAL HEALTH PROGRAM
Report thishttp://www.pnhp.org
Our Mission: Single-Payer National Health Insurance
Greg Silver, MD (Fl.)The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 46 million without health coverage and millions more inadequately covered.
This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment though a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.
ARGUMENTS ADDRESSED AND MORE DISCUSSION AT:
http://www.pnhp.org/facts/single_payer_resources.php
Single-Payer Overviews
Single Payer: Facts and Myths
Health Economics and Financing
The Case Against For-Profit Care
Quality and Malpractice
The Failures of Other Reform Options
International Health Systems
Single-Payer Bibliography
By Stephen Smoliar, October 3, 2006 at 6:24 am #
(Unregistered commenter)
Unfortunately, health care is a service business; and, as long as it is dominated by those who put business before service, it is unlikely that the voice of the American people will be heard.
Report thisBy KISS, October 3, 2006 at 5:28 am #
(Unregistered commenter)
There were many problems with Hilliary’s health plan. One problem was the secrecy of the plan. She would not be transparent with her plan. Why should taxes be on the table for American’s and business gets a free skate? The premiums saved by big business will be enormous in savings. What about the red tape that drives Doctors crazy in reporting to the government. I am in favor of a universal health system, but let the sun shine brightly on any plan presented. Look at the mess of Medicare plan D. Will universal health be like Humana, or United? Terriber HMO’s most would agree. How restrictive? We do need a discussion that is fruitful on health in America for Americans.
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