In Los Angeles, nurses and healthcare activists push for universal single-payer healthcare legislation.
When President Obama convened a town-hall meeting in Rio Rancho, N.M., last month, he wanted to talk about credit card reform. But many in the crowd had a different agenda.
"So many people go bankrupt using their credit cards to pay for health care," the first questioner said to applause. "Why have they taken single-payer off the plate?"
The "single-payer" activists had struck again. As Obama and congressional Democrats work to hammer out landmark health-care legislation, they face increasingly noisy protests from those on the left who complain that a national program like those in Europe has been excluded from the debate.
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Robert Parry | 119 Million Americans Must Be Wrong â€¢
The White House and Democratic leaders have made clear there is no chance that Congress will adopt a single-payer approach - named for the idea that a single government-backed insurance plan would pay for all Americans' medical costs - because it is too radical a change.
That has not dissuaded single-payer activists, who have spent months hounding Democratic lawmakers and organizing demonstrations, including one that resulted in 13 arrests at a Senate hearing last month. The offensive continues this weekend with plans to swamp a series of "house parties" on health care hosted by Organizing for America, an Obama-backed project at the Democratic National Committee.
Opportunity and Challenge
The movement poses both an opportunity and a challenge for Obama, who is able to position himself as a centrist by opposing a single-payer plan but who risks angering a vocal part of the Democratic base.
"Obama is really the one who is puzzling to us," said Rose Ann DeMoro, executive director of the California Nurses Association, a union that has been leading many of the single-payer protests. "We were all supporters of him... . It's hard to understand how he can expect to rally support around a plan that will leave the big insurance companies in charge and keep hurting patients."
Many Republicans see the movement as evidence that Democrats are setting the country on the path to "government-run health care," as they describe it. Conservatives for Patients' Rights, an advocacy group bankrolled by ousted Columbia/HCA chief Rick Scott, unveiled a $1.2 million ad campaign Thursday that portrays Democratic plans as a "bulldozer" aimed at eliminating private insurance companies.
"It's just one step removed from a single-payer system," Scott said in an interview, referring to current Democratic proposals. "The goal is to get rid of the insurance companies, and then the government makes all the decisions."
Obama and other Democrats dispute such characterizations, saying they favor a plan that would marry private and public resources to control costs and expand coverage for 46 million uninsured Americans. Obama wrote in a letter to Democrats this week that he "strongly" backs creating a public insurance option to compete with private carriers, and also signaled that he is open to the idea of requiring coverage for all Americans.
Obama has rejected the idea of establishing a single government insurance program, however, saying the U.S. tradition of providing health care through employers would make such a shift politically and practically impossible.
"If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense," Obama said in response to the questioner in New Mexico, echoing comments he made during his presidential campaign. "The only problem is that we're not starting from scratch... . We don't want a huge disruption as we go into health-care reform where suddenly we're trying to completely reinvent one-sixth of the economy."
Advocates of a single national program argue that its benefits would far outweigh the drawbacks, noting that most other industrialized nations guarantee coverage for all at far lower costs with generally better health outcomes. They also dispute allegations by Scott and other conservatives that such a system would lead to rationing and waiting lists, saying that Americans face the same problems and worse now.
"Single-payer on its merits can win," said Tim Carpenter, national director of Progressive Democrats of America. "But we've been cut out by the doctors, the insurance companies and other special interests."
A Small Victory
The single-payer activists won a small victory this week when Sen. Max Baucus (D-Mont.), who is leading health-care negotiations as chairman of the Senate Finance Committee, agreed to meet with them after months of tension. Those in attendance said Baucus apologized for not including single-payer advocates more prominently in earlier hearings, but he also said it is too late to change direction.
Polling on single-payer insurance varies widely, based largely on how the issue is framed. In an April Kaiser Family Foundation poll about ways to increase the number of Americans covered by health insurance, the option finished last on an eight-item list, with 49 percent in favor and 47 percent opposed. Moreover, about a third of those who support a public insurance option would turn against the idea if it were an initial step toward single-payer care, the poll found.
Most mainstream progressive groups, including some that have previously advocated a single-payer approach, think Obama's strategy has the best hope for success. Many groups draw lessons from the Clinton administration, which buckled under attacks from Republicans and the medical lobby when it proposed a more centralized approach.
This time around, unions and groups such as Health Care for America Now plan to spend more than $80 million on ad buys, outreach and other efforts to support Obama and the Democrats. The DNC, using Obama's campaign e-mail list of 13 million names, kicks off its effort today with thousands of "house parties" focused on "the urgency of passing health care reform this year," according to a news release.
In an e-mail this week, Progressive Democrats of America urged its supporters to "take the single-payer message" to the meetings.
DNC spokesman Brad Woodhouse said the gatherings are open to all. "Their voices, energy and passion are welcome, and no one is looking at them as the enemy," he said. "It's just that with the system we have, single-payer is not something that's likely to happen."
Polling director Jon Cohen contributed to this report.
119 Million Americans Must Be Wrong
Friday 05 June 2009
As the health insurance industry and its defenders in Congress lay out their case against permitting a public option in a reform bill, perhaps their most curious argument is that some 119 million Americans are ready to dump their private plans and jump to something more like Medicare - and that's why the choice can't be permitted.
In other words, the industry and its backers are acknowledging that more than one-third of the American people are so dissatisfied with their private health insurance that they trust the U.S. government to give them a fairer shake on health care. The industry says its allies in Congress must prevent that.
The peculiar argument that 119 million Americans must be denied the public option that they prefer has been made most notably by Sen. Chuck Grassley of Iowa, ranking Republican on the Senate Finance Committee, which is one of two panels that has jurisdiction over the health insurance bill.
"As many as 119 million Americans would shift from private coverage to the government plan," Grassley wrote in a column for Politico.com. That migration, Grassley said, would "put America on the path toward a completely government-run health care system. â€¦ Eventually, the government plan would overtake the entire market."
Grassley's logic is that so many Americans would prefer a government-run plan that the private health insurance industry would collapse or become a shadow of its current self. That, in turn, would lead even more Americans entering the government plan, making private insurance even less viable.
Rarely has an argument more dramatically highlighted the philosophical question of whether in a democracy, the government should represent the people's interests or an industry's.
But Grassley said he is simply upholding "the promise that if you like the coverage you have, you can keep it. â€¦ That's why I'm concerned about a government-run plan that forces people out of private insurance."
The counter-argument, of course, might be that if the health insurance industry hadn't dissatisfied so many customers - indeed forcing many sick people into bankruptcy because of excessive fees, denial of coverage and gaps in permitted medical treatments - there wouldn't be so many Americans eager for a public option.
So, now to protect the health insurance industry, Congress must stop 119 million Americans from leaping into the arms of a government plan.
Grassley is joined in his position by nearly the entire Republican contingent in Congress. It also appears a few key Democrats, particularly Senate Finance Committee Chairman Max Baucus, D-Montana, agree at least in part.
Baucus has kept a single-payer option "off the table" during the debate even as he claimed "all options are on the table." He also has suggested that Congress might have to "sculpt" any public option, presumably to make it less appealing to Americans if some version survives in the reform bill.
President Barack Obama, whose mother had to fight with her health insurance company while dying of cancer, says he continues to favor including a public option in the bill as necessary to keep the insurance industry honest. Sen. Ted Kennedy, chairman of the Health and Education Committee which also has jurisdiction over the bill, also favors a strong public plan.
However, there is the additional fact that executives from health insurance companies and related industries are major campaign contributors to members of Congress on both sides of the aisle.
For instance, since 2005, Grassley's various political action committees have collected nearly $1.3 million in donations from the industries related to the health insurance debate, according to OpenSecrets.org. Grassley's top four donor groups were Health ($411,956); Insurance ($307,348); Pharmaceuticals ($233,850); and Hospitals ($197,137). Eighth on Grassley's donor list were HMOs at $130,684.
On the other hand, the health insurance industry appears about as popular with Americans as the tobacco industry, with both considered highly hazardous to your health. Except that Americans can choose not to smoke, while they run enormous risks for themselves and their families if they don't have some form of health insurance.
Health insurance companies do negotiate rates with hospitals and doctors that are far below what is charged to people who don't have insurance, sometimes as low as one-tenth what the uninsured patient might be charged.
These disparities, in effect, force many Americans to sign up for private insurance even if the insurance fees are excessive, padded with handsome profits for investors and unproductive bureaucratic costs (including investigations into whether people can be denied payments because of undisclosed "preexisting conditions").
If the health insurance industry had its way, Congress would produce a bill that simply required Americans (or their employers) to buy health insurance from private industry. That way, the government would compel citizens to become customers while denying them a choice of the public plan.
To avoid such an outcome, proponents of the public option - including those 119 million Americans who are ready to sign up - will have to overcome opposition from Republicans and some Democrats who are determined to protect the interests of the private health insurance industry.
Robert Parry broke many of the Iran-Contra stories in the 1980s for the Associated Press and Newsweek. His latest book, Neck Deep: The Disastrous Presidency of George W. Bush, was written with two of his sons, Sam and Nat, and can be ordered at neckdeepbook.com. His two previous books, Secrecy & Privilege: The Rise of the Bush Dynasty from Watergate to Iraq and Lost History: Contras, Cocaine, the Press & 'Project Truth' are also available there. Or go to Amazon.com.