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Health care debacle

Chicago writers chime in on the health care debate/debacle:  At In These Times, David Moberg charts the steady loss of ground by progressives, despite favorable terrain, and ponders whether any bill is better than nothing. “The weaker the bill—that is, the further from ‘Medicare for All’ —the more likely reform will fall far short of universality, fail to control costs, and even backfire politically.”  And he suggests that those who abandoned single-payer out of political expediency may have miscalculated.

Also in In These Times, James Thindwa notes that “Democrats continue to cede political space to Republicans, even as the GOP teeters on the brink of self-destruction” and lays out a plan, including a call on Obama to “go straight into Blue Dogs’ districts and call them out, loud and clear. Their opposition to healthcare reform, he should point out, is not grounded in some high-minded ideological principle, as they claim, but a straight up quid pro quo. They have been paid by the health and insurance industries to fight against ‘government healthcare.'”

At the Nation, Tom Geoghegan argues for doing away with the filibuster in the U.S. Senate, historically the tool of defenders of slavery and segregation.  It’s not a matter of Democrats versus Republicans, he says, it’s conservatives from small states wielding power, far out of proportion to the electorates they represent, in order to block progress desired by the majority.

In a letter to the Nation, Quentin Young and colleagues, argue that “a public option won’t fix the mainstream Democrats’ flawed healthcare reform proposals. Only a single-payer reform would make universal, first dollar coverage [full coverage without a deductible] affordable. It would save about $400 billion annually on bureaucracy and rein in costs over the long term through global budgeting and rational health planning.

“Even a public plan option far more robust than anything on the table in Washington would forgo most of these savings, making comprehensive coverage unaffordable.” 

It might cut into the industry’s $10 billion annual profits, but “that’s only 10 percent of their overhead. They spend much more tracking eligibility, collecting premiums, marketing to healthy (profitable) patients, demarketing to avoid the sick, and shifting costs to patients and providers. A competitive public plan couldn’t match the efficiency of Medicare, whose integration with Social Security allows automatic enrollment, disenrollment and premium collection.

“Moreover, a hybrid plan would forgo hundreds of billions in administrative savings because hospitals and doctors would still have to maintain armies of administrators and billing clerks to joust with hundreds of insurers.

“A kinder, gentler public plan would quickly fail in the healthcare marketplace. Insurers compete by not paying for care…. A public plan that did no marketing would soon be saddled with the sickest patients, whose high costs would overwhelm any administrative efficiencies and drive premiums to uncompetitive levels….

“A healthcare system dominated by private insurers cannot provide families with the affordable coverage they need. A public clone of private insurers won’t help.”

Young’s outfit, the Chicago-based national organization Physicians for a National Health Plan, now has a blog, where one item notes the devolution of the “public option” from a stealth version of single-payer to a bargaining chip:

“When the ‘public option’ campaign began, its leaders promoted a huge ‘Medicare-like’ program that would enroll about 130 million people. Such a program would dwarf even Medicare, which, with its 45 million enrollees, is the nation’s largest health insurer, public or private.”  That idea, however, is history.

“According to the Congressional Budget Office, the ‘public options’ described in the Democrats’ legislation might enroll 10 million people and will have virtually no effect on health care costs, which means the ‘public options’ cannot, by themselves, have any effect on the number of uninsured.”

And another item notes the Senate health committee’s version of a “public option” would be run by insurance companies!!!

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