April 27, 2010

The health care scam

(My latest book God vs. Darwin: The War Between Evolution and Creationism in the Classroom has just been released and is now available through the usual outlets. You can order it from Amazon, Barnes and Noble, the publishers Rowman & Littlefield, and also through your local bookstores. For more on the book, see here. You can also listen to the podcast of the interview on WCPN 90.3 about the book.)

So after much drama, the health care bill finally became law. If anything demonstrated the fecklessness of Obama and the Democratic Party and their willingness to sell out of their supporters in order to appease their corporate overlords, it is the way that the health care bill was constructed and passed.

There is no question, as Robert Weissman writes, and which I have repeatedly pointed out, that a single payer system, the system of choice for almost every other country in the industrialized world, is more humane and more efficient than what the US currently has. (See here for all my previous posts on health care.) Even candidate Obama conceded as much during his presidential campaign. T. R. Reid's new book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care also debunks the myths of the alleged superiority of America's health care system. Even Sarah Palin admits that when she was a child, her parents took advantage of Canada's system, saying, "we used to hustle on over the border for health care", adding "I think isn't that ironic now." Yes it is, Sarah, yes it is.

The pressure for health care reform comes largely from the fact that the private, profit-seeking entities that dominate the system (insurance and drug companies and hospitals and specialist doctors) are driving up the costs and employers want to shed themselves of this burden. (Also see another comparison of costs.)

The logical thing would have been to go to a government-run single-payer system that would be cheaper because it would spread the costs over the entire population, have the power to negotiate lower prices, reduce bureaucratic duplication, and eliminate the profit element that plagues the current system and results in such horrors as the rescission of coverage after one receives a diagnosis of a disease. The despicable insurance companies also find sleazy ways to drop coverage for people who discover they have breast cancer:

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information.

Of course, Congress and the Obama administration will not do anything to harm the interests of these companies since these very organizations that profit greatly from sick people are major contributors to their coffers. And so what we finally ended up with was a mere tweaking of the existing system.

It is not that there are no good features at all in the bill. There are, such as expanding coverage and restricting some of the worst industry abuses. But these were the bones that were tossed to the Democratic Party supporters to mask the fact that the resulting plan has internal contradictions that will eventually wreck it. The Democratic party deliberately sabotaged the one big chance the country had to enact the kind of reforms that are necessary to prevent the looming catastrophe that will occur because the basic causes of cost increases have not been addressed. As Marcia Angell, former editor of the New England Journal of Medicine, says:

What this bill does is not only permit the commercial insurance industry to remain in place, but it actually expands and cements their position as the lynchpin of health care reform. And these companies they profit by denying health care, not providing health care. And they will be able to charge whatever they like. So if they're regulated in some way and it cuts into their profits, all they have to do is just raise their premiums. And they'll do that.

Not only does it keep them in place, but it pours about 500 billion dollars of public money into these companies over 10 years. And it mandates that people buy these companies' products for whatever they charge. Now that's a recipe for the growth in health care costs, not only to continue, but to skyrocket, to grow even faster.

Glenn Greenwald quotes a Kaiser Health News report that "details the massive benefits each industry [Doctors, Hospitals, Insurers, Pharma] receives (compared to their mild costs), the success they had in killing any real competition and reform in the bill (i.e., the public option, Medicare expansion, drug-reimportation, bulk price negotiations, and an end to the insurers' anti-trust exemption)" and that the bill was enacted by "invoking and strengthening precisely the same corrupt, sleazy practices that have long driven Washington."

There have been many analyses detailing how the Democrats sold out on health care, calling the Obama strategy essentially a scam on the American people. Angell says of Obama that, "He gave away the store at the very beginning by compromising. Not just compromising, but caving in to the commercial insurance industry and the pharmaceutical industry." Glenn Greenwald and Norman Solomon lay out in detail exactly how the scam by Obama and the Democratic Party was executed. It was the shocking loss of Ted Kennedy's Senate seat in Massachusetts to Republican Scott Brown that exposed the scam for all the world to see, while paradoxically hastening the passage of the final bill.

While the Democrats still had sixty votes in the Senate, they could play out this charade that they really and truly wanted real reform as represented by a single-payer system or Medicare for all (or at least expanded) or a public option, but that they had to overcome this darned filibuster threat by the Republicans, which meant that they had to appease the most reactionary elements in their own party in order to hold on to every one of their sixty party members and thus were forced to give up on the more ambitious plans. Oh, but they were so sad that they had to compromise their ideals like this.

But as Greenwald says,

[A]dvocates of the public option kept arguing that the public option could be accomplished by reconciliation -- where only 50 votes, not 60, would be required -- but Obama loyalists scorned that reconciliation proposal, insisting (at least before the Senate passed a bill with 60 votes) that using reconciliation was Unserious, naive, procedurally impossible, and politically disastrous.

But the win by Scott Brown meant that they could not overcome the filibuster after all because of the unanimous opposition of the 41 Republicans. Faced with the possibility that they might not get any health reform bill at all through the Congress, which would have meant political disaster for them, they suddenly decided that they would use the reconciliation path to passage after all. So given how much they had said about their desire for more sweeping reform plans, you would think that now they would bring back all those elements they so ardently desired and spoke so passionately about. But no. They went with the health-insurance industry friendly bill, thus exposing that this was the bill they had really wanted all along and that everything they had said suggesting otherwise were nothing but lies. If one needed any more proof, along the way it was revealed that Obama had made a secret deal early on with the pharmaceutical industry to kill the public option, thus confirming the existence of the scam.

It should have been clear to the dimmest bulb that the health care bill that Obama and the Democrats finally passed was what would have been considered in the old days a Republican plan, one whose main goal was to leave untouched (and even enhance) the interests of big business and the wealthy. It is no coincidence that it is similar in philosophy and structure to the plan introduced in Massachusetts by Mitt Romney when he was governor. He now has the unenviable task of disowning his own plan in order to appease the crazies who now running the Republican party.

What has happened in American politics is that the Democratic party has become the Republican party and the Republican Party has gone nuts.

POST SCRIPT: The ignorance of health care opponents

The party groups that demonstrated on April 15 to denounce the health care bill, among other things, as part of some socialistic takeover of America's economy are remarkably ignorant of the reality of American politics but are driven by some inchoate sense of frustration and impotence that makes them succumb to paranoia. They pose a real danger to the Republican party, risking making it into a fringe and nutty cabal.

Cartoonist Tom Tomorrow describes how detached from reality health reform opponents really are.


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The concern that a lot of people have expressed to me (that I don't share) is that the gov't can't be trusted to efficiently run a single-payer health care system. What do you think of that idea?

Posted by Scott on April 27, 2010 10:57 AM


Single payer would be just a scaled-up Medicare, which the government runs, and which no one has called for privatization.

Posted by Mano on April 27, 2010 11:45 AM

The article "Sick and Wrong" by Matt Taibbi, which you referenced in a previous article, does a masterful job of excoriating President Obama for his subservience to corporate interests during the 2009-2010 healthcare reform process:

Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system — more than enough to pay for the whole goddamned thing, if anyone had the balls to stand up and say so.

(That article used to be available online, but apparently Rolling Stone decided that they wanted to join other news organizations in demanding a subscription in order to access their archives. This, of course, makes it far harder for us to include their reporting in the general discourse. I doubt that not talking about their articles will be good for their business. This is both a foolish and selfish decision. Par for the course with corporations, sadly.)

I also highly recommend "The Legacy of Billy Tauzin: The White House-PhRMA Deal" by Paul Blumenthal. Blumenthal expertly dissects the precise way in which corporate healthcare interests dramatically influenced the resulting bill in their favor.

I stop myself short of suggesting particular action to address the injustice (such as this) done under the influence of capitalism, because I don't want to usurp your platform, Mano. Will you start making and nurturing some proposals, yourself?

Posted by John L. Clark on April 27, 2010 01:00 PM

So informative and real. The whole system is being tied down by red tape. Another department of government may have to be created to handle this. The hard working people that really know what to do like the Nurse administrators across the country.

Posted by mardi on May 2, 2010 06:18 AM

Fix the bill. Why not just incremental health insurance reform instead of sweeping changes?

Posted by Health Insurance Advocate on May 6, 2010 04:52 PM