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Status Quo Is Not an Option

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Posted on Aug 24, 2009

By Marie Cocco

The summer of disinformation seems to have accomplished its goal: to preserve for the private insurance industry an effective monopoly over how much most Americans pay for health care, and on what terms they can buy it.

No one will come out and say this. But that will be the result if the so-called public option is dropped from the proposed menu of choices in a new health “exchange” envisioned in reform proposals being considered on Capitol Hill.

It was predictable that the right wing would declare a voluntary public option a scary “government takeover” of health care. That’s what they always say. Only a few years ago, the same crowd was in a full-throated roar about how government-guaranteed Social Security benefits had to be turned into private investment accounts. They claimed—with perfectly straight faces—that we’d all do better if we retired on our Wall Street riches.

Does anyone still believe that?

It’s one thing to say the right wing is low on the believability scale and quite another to claim that those who favor a public option in health care are left-wing crazies who cling to it for ideological comfort. But this is what several otherwise level-headed media commentators have suggested lately, and worse, it’s what an anonymous White House adviser told The Washington Post when he expressed annoyance that the “left of the left has decided that this is their Waterloo.”

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Really, now.

The “left of the left” doesn’t want the type of public option currently under discussion. It wants a national, single-payer health care system modeled on Medicare. But the “left of the left” has essentially been told to shut up about a single-payer health plan because it isn’t politically feasible.

The public option already is a watered-down compromise. And it’s screwy to suggest that it’s supported only as a tenet of ideological faith. It’s actually supported by a common-sense look at what the military might call the facts on the ground.

Right now, the private insurance industry operates regional monopolies in which employers, individual consumers, doctors and other medical providers have virtually no option but to deal with one or two big insurers. The American Medical Association has estimated that 94 percent of commercial markets for health insurance are “highly concentrated” according to federal antitrust guidelines. While the insurance industry takes issue with the AMA’s findings, they’re supported by independent research, and they’re not new: A 2004 study in the peer-reviewed journal Health Affairs found similar market dominance.

In this environment, a public option that would have government support—and the reach of its purchasing power—is the only effective competitor. No politician who promotes the alternative of nonprofit cooperatives has said how these start-ups could gain the clout to compete against industry behemoths, or compel doctors, hospitals and other medical providers to offer them discounts for a small share of local patients.

An insurer without a network of providers would soon be out of business. Individuals who purchased that plan would be left where they started—at the mercy of the big, for-profit companies. In contrast, enrollees in a nationwide public plan could be sure their insurer wouldn’t disappear.

The national scope of a public plan also makes it the most powerful means of driving down costs, an achievement that private insurers have long promised and never delivered. One reason the Congressional Budget Office refuses to count theoretical federal budget savings from some proposed private industry reforms is just that—they’re theoretical. Meanwhile, specific changes to government payment practices not only are counted, but they have a track record in Medicare of holding down costs per beneficiary better than the private market.

The Commonwealth Fund, an independent health care think tank, examined the models currently competing for congressional support and found that a public plan with payments set in accordance with Medicare rates would save the federal government, employers and individuals the most by far. The savings were three times greater than those achieved with competition only among private plans. Even a modified version of a public plan with provider payment rates pegged somewhat above what Medicare pays produced greater savings.

Nonetheless, what is emerging from Congress is a health overhaul that isn’t as cost-effective as it could be and doesn’t guarantee against lost coverage—yet gives insurers millions of new customers whose purchases will be subsidized by taxpayers.

This is change the industry can believe in.

Marie Cocco’s e-mail address is mariecocco(at)washpost.com.

© 2009, Washington Post Writers Group


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By ardee, August 26 at 4:05 pm #

Thomas, August 25 at 7:09 pm #
(Unregistered commenter)

The goal of this so-called “reform” is to FORCE you to buy insurance, but let the insurance companies charge you as much as they want, with NO regulation for TEN years. It is nothing less than the ENSLAVEMENT of the American people to corporate mobsters.

By whose definition of intended reform do you arrive at such judgment? No bill has been written, no law passed, no legislation enacted, no statement by any democrat has stated this position, in fact the contrary has been trumpeted by most defenders of reform.

What we have now regarding health care seems mob like to me, costs rising rapidly, services denied, folks ousted for the crime of actually needing care yet you decry a reform effort that has come to no conclusions as yet.

If you have facts hitherto unnoticed please link to them. By the by, have you dropped the ‘G’?

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By MarthaA, August 26 at 1:55 am #

We must not allow Public Single Payer Medical Care to get off the table.

The Government IS Medicare, therefore the ONLY solution for the entire country is the PUBLIC option, but NOT Medicaid; Medicaid makes people sign everything they have away for their health care.

PUBLIC OPTION ALL THE WAY for medical care, as long as Medicaid is OUT, will be the best thing the United States has ever done for the nation as a whole.

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By Mason Wheeler, August 25 at 9:42 pm #

The most significant difference between a health program run by the government and one run by large corporations is that when the government’s version isn’t working well, ordinary people without extensive stock portfolios can replace the decision makers.

This is the message that we need to be sending, because nobody’s hearing it.

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By Kath Cantarella, August 25 at 8:39 pm #
(Unregistered commenter)

51 of the 100 largest economies in the world are companies, not countries.

” The liberty of a democracy is not safe if the people tolerate the growth of private power to the point where it becomes stronger than the democratic state itself. That in its essence is fascism - ownership of government by an individual, by a group or any controlling private power. ” President Franklin Delano Roosevelt

It would be really good if our elected reps could see their way clear to refusing to take money from the jumped-up bastards who are destroying our countries for the obesity of their bottom line.

It’s all going to come crashing down when the pendulum has swung too far. Why do the power-freaks never learn that?

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By Thomas, August 25 at 7:09 pm #
(Unregistered commenter)

The goal of this so-called “reform” is to FORCE you to buy insurance, but let the insurance companies charge you as much as they want, with NO regulation for TEN years. It is nothing less than the ENSLAVEMENT of the American people to corporate mobsters.

Report this

By ocjim, August 25 at 4:46 pm #

Whether you feel as though you have lost again to the plutocrats, you have, that is, unless you bury your compromised representatives in email, phone calls, faxes and media messages. For the latter you’ll have to create somewhat of a spectacle because that is the only thing the corporate media responds to.

If you want to continue to pay 31% for private administration costs, somewhere around 20% of your income (on the average) on health care costs, buy over-priced drugs or not buy them in order to pay the rent, see private health care executives get tens of millions in un-earned compensation, and see record banruptcies due to health care costs, then by all means, say nothing.

My plan probably won’t bankrupt me, but yours might.

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By Jim Yell, August 25 at 4:41 pm #
(Unregistered commenter)

It is clear that if the money went to health care instead of to profits, more health care could be provided. The fact is we pay more for health care per person than countries with National Health Care, but a large portion of our people do not receive care and a larger percent are driven into poverty by the cost of “For Profit Health Care” and the supposed small contribution they must pay out of their own pockets, no matter how many years they paid for said insurance without using any of the supposed benifits.

Some time ago we watched the corporate health care people move into the health institutions that had been created with a promise of lower cost. There is no lower cost when the prime motive is huge profits, profits that can not be sustained except by bankrupting their clients.

Let us stop playing this game. Get Obama and the Democrats to write a bill which will bring Universal Health care to America and get people to recognize that one of the big benifits will be employment which til now has been withheld from people because they had preexisting health problems before applying.

If we need more money, we know who stole it in the first place.

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By Outraged, August 25 at 4:33 pm #

Quote: “Only a few years ago, the same crowd was in a full-throated roar about how government-guaranteed Social Security benefits had to be turned into private investment accounts. They claimed—with perfectly straight faces—that we’d all do better if we retired on our Wall Street riches.”

Good point.  How many lost everything they had and now rely on Social Security as their only source of retirement funds?  I couldn’t even venture a guess, there’s probably statistics out there somewhere.  Consider that these same scammers knew, at that time….. of the recklessness of doing so.  Yet, there they were touting all it’s supposed “opportunities”, the golden eggs, the riches and an “if it glitters… it’s gold” sureties.  They make a den of thieves look like the flippin’ Welcome Wagon.

Simon Johnson and James Kwak, have an excellent article at the Washington Post regarding healthcare reality, an excerpt:

“If you are against the public option, you should be deeply, fundamentally, bitterly against Medicare.

Of course, not even the most strident opponents of reform are saying that Medicare should be eliminated. Not only would that be political suicide, but it would create an enormous policy catastrophe. Can you imagine putting 40 million seniors, all of whom have high expected health-care costs, into the individual market? Or can you imagine shifting retiree health-care costs back onto American companies?

Instead, the opponents of the public option are billing themselves as defenders of Medicare. House Minority Leader John A. Boehner (R-Ohio), for example, claims in a news release that projected reductions in the growth of Medicare spending mean “fewer choices and lower health care quality for our nation’s seniors.”

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/25/AR2009082501075.html

Nauseating.  If I had a dime for everytime Boehner alone, even discounting the rest, made me want to vomit, I’d definitely be mid-middle class.

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By GW=MCHammered, August 25 at 3:23 pm #
(Unregistered commenter)

Should health care be mandatory? I dunno, should auto insurance be required by all? Being without either shifts unpaid expense to those covered in either higher premiums, co pays, or less coverage/care.

Now isn’t it odd that so many of those against any government-run health care offering are those that depend on government-run Medicare and veteran’s health? Around my neighborhood it’s very true anyway. Odd too that the VA offers End-of-Life counseling. How scary is that?!(sarcasm)

http://www.hsrd.research.va.gov/news/research_news/casarett-051909.cfm

In 2000, America rated number 1 in health care cost. Our overall health system performance rated 37th while performance on level of health rated 72nd behind Argentina, Bosnia, Uruguay, and even Iran. Now there’s something to be red, white and blue proud of.

http://www.photius.com/rankings/healthranks.html

http://www.photius.com/rankings/world_health_performance_ranks.html

The IRS reports tax revenues are down 34% this year. How soon will cuts in Medicare and Veteran’s benefits follow?

http://www.aier.org/research/commentaries/1488-tax-revenue-plummets

Most making decisions about our future worked careers during the greatest economic expansion in human history: the era of America the Great with Guaranteed Retirements, the Capitalization of Credit, Cost Shifting Public Debt, and The Exploitation of national natural resources and the world’s Oil.

Now that the economy, credit and oil are all in contraction, we are left with Medicare saying it will be broke in the next decade. Can the VA and Social Security (our money) be far behind? 2025 was mentioned this week. Imagine how far our constricting retirements will go paying out thousands a month per person to an insurance company that may or may not pay for your care depending upon private-profiteering committee. Hmm.

http://www.independent.co.uk/news/world/americas/the-brutal-truth-about-
americarsquos-health care-1772580.html

It’s time to get educated (beyond corporate tv-network bias) and involved in our health care’s lack-of-system and its affect on us all as a nation of Americans:

Facts on the Cost of Health Insurance Coverage
(Health insurance premiums have increased 119 percent for employers since 1999)
http://www.nchc.org/facts/coverage.shtml

http://www.healthreform.gov
http://www.whitehouse.gov/realitycheck

Changing Channels on Health Care
http://www.truthdig.com/avbooth/item/20090814_changing_channels_on_health_care/

10 Awesome Reasons to Pass Health Reform
http://www.truthdig.com/report/item/20090816_10_awesome_things_that_would_happen_if_health_reform_passes

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By G.Anderson, August 25 at 2:11 pm #

To the right, a scary government take over of health care, means that no more billions in profits can be taken from the grazing sheep.

But, then what’s really scary is the take over of government by the big corporations, especially after they wrecked the economy, and nothing happened except they got billions of tax payer dollars for essentially screwing us. And their still running the show.

The the insurance industry and the pharmaceutical, and hospital lobby is linning up for the big payday that’s coming.

Forget about health care reform this is just another way for the corporations to collect tax dollars, without competition, and with protection by the goverment for their incompetance.

We’re up to 200,000 deaths a year from medical mistakes at this point. Soon that number will seem miniscule by comparision to what the corporate take over of health care will bring.

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By diogenes, August 25 at 1:41 pm #

Yes, I “misspoke” refering to “her” remark. It should have been simply “the” remark.

But, this does not detract from her use of the remark and the need to view and discuss this in the big picture from all sides. Just what kind of health insurance does the “right of the right” wish framed as the question, “if you did not have health insurance, were under 65, your employer did not offer it, make too much for Medicaid, the plans that you looked at were too expensive and not worth the cost, possibly have pre-existing conditions, what options would you expect to be available to you?” Or there abouts:-)

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By Folktruther, August 25 at 1:02 pm #

The status quo, contrary to Marie,  IS in fact an option, probably the option that will result from the ‘debate.’  The simple historical truth of the matter is that the US is ruled by a ruling class who controls the major corportions in neoliberal fashion and there is no public power capable of overcoming it.  The American population is stupified by TV and deluded by the learned and mass media. 

That is why a social revolution os inevitable historically; there is no other way to break the power logjam.  the neoliberals of both parties are driving the US into barbarism, as illusstrated by this struggle over medical reform.  But nobody wants to know this yet, so a revolutionary movement still is a future development.  Except for Dmitry Orlov, who is considering what is necessary fo incrreased Collapse Preparedness.

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By jmr, August 25 at 12:44 pm #

Take it easy, folks.  Cocco is characterizing “left-of-the-left” as the words of others, namely the liars and dupes of the healthcare industry.  I’ve seen the equivalent of this—“the liberal wing”—bandied about by pundits.  It gives the measure of how effective reform opponents have been in falsely framing the issue.

The words “socialized” and “socialist” are radioactive. Reform opponents know this and use it to play the yokels like a violin. If only Americans could understand that “social” means community and caring, not communism.  But they’re too busy wallowing in their consumerist trough to actually think, as the mobs at the town hall meetings illustrate.

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By Rodger Lemonde, August 25 at 11:55 am #

Consider this the start of reform. We start now and
when the lies are revealed we can get real and make
health care universal and affordable,FOR EVERYONE.

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By diogenes, August 25 at 10:27 am #

Ms Cocco is just as guilty as the MSM with her remark “left of the left” used in framing the argument.

Do I really have to point out those to the ‘right of the right’ who have been chanting, “Hands off of my Medicare,” to illustrate the absurdity of using differences in abstract political ideologies to make divisions in social realities?

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By Anarcissie, August 25 at 10:17 am #

It was my understanding that Single Payer was favored by a majority, or at least a plurality, of the citizenry, which is a pretty big “left of the left”.

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By ray, August 25 at 9:37 am #
(Unregistered commenter)

Everyone interested in this issue would do well to read and understand the following article:

  http://gregmankiw.blogspot.com/2009/08/good-read-on-health-policy.html

It is long. But in 35 years of activism I have never read anything that changed my understanding of an issue the way this article did.

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By ardee, August 25 at 5:22 am #

The “left of the left” doesn’t want the type of public option currently under discussion. It wants a national, single-payer health care system modeled on Medicare. But the “left of the left” has essentially been told to shut up about a single-payer health plan because it isn’t politically feasible.”

I am unsure as to the authors definition of “left of left”. I think its meaning is twofold; those who are not willing to buy into Democratic incompetence and; those who refuse to buy into the reform of health care that is no reform.

The left has been told to shut up about pretty much everything in fact, but, I believe, had we a President with actual balls, which we do not, he and Ms. Cocco might be surprised to find that the public actually supports single payer health care when they hear both sides of the issue.

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By ChaoticGood, August 25 at 4:55 am #

All you say is true, and the question is whether the politics of fear will be sufficient to block “reason”. 

It may very well succeed in the short term.  Americans are very fearful because there is such a primitive “safety net” in this country.  The lack of concensus about the balance between “hunger” driving capitalism versus “safety” breeding indolence is causing violent shifts.

One thing is crystal clear. The Health Insurance “racket” is running out of gas.  Even the Insurance racketeers know that they can only milk this cash cow for a short time longer and that socialized medicine like Medicare for All is the inevitable solution.

The only question is who gets to do the legislation, Democrats or Republicans and the motivation for the legislation.  Democrats will do it out of a desire for justice and fairness.  Republicans will do it out of fear of mob unruliness and bad profits.  Either way it will happen.

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