Bad Solution To Health Care Problem
Nation editor, Katrina vanden Heuvel writes about new "solutions" to the health care delivery problem. Mass. plan panned.
California Dreamin' -- About Single Payer
Katrina vanden Heuvel
BLOG | Posted 08/22/2006 Portside
What will happen to me if I get sick or injured and
can't pay my bills?
On the domestic front, that's a key question on voters' minds as the November elections approach. A poll of working women, released on August 8 by the AFL-CIO, indicated that concern about access to quality medical coverage was rated the top issue by 97 percent of respondents, outpolling the income gap between women and men for the first time. MoveOn members, asked to vote on issues that they believe should define a "new positive agenda" ranked healthcare for all persons at the top of
In California, one of the country's largest states and a decisive election-year battleground, the growing momentum behind healthcare reform is pushing two sharply different approaches into public view.
The first, a proposal for universal healthcare coverage, is presented in Senate Bill 840, authored by Southern California's State Senator Sheila Kuehl (D-23). SB 840 would provide universal, comprehensive healthcare
insurance to Californians while protecting consumers' ability to choose their own doctors. Under the SB 840 model, consumers and businesses would pay an income or payroll-based premium for a "solid, comprehensive plan"
that includes medical, dental, vision, prescription
drug, hospitalization and emergency coverage. Medical care provision would remain as the mix of private and not-for-profit business that it is now. SB 840 would also mandate that California use its purchasing power to negotiate bulk rates for prescription drugs and medical equipment. (The administrative costs for medical care in
California would drop below 5 percent of total costs, compared to the whopping 25 to 30 percent currently being spent.)
On the other side, on June 16, Sandra Shewry, Governor Schwarzenegger's Director of the Department of Health Services hosted a meeting of journalists to discuss the possibility of "Massachusetts-style health reform" in
California. As it turned out, uninvited healthcare
experts and advocates showed up, as well, to deliver an early warning: Massachusetts' so-called universal healthcare plan is already bad news for the people of Massachusetts and would be a disaster for California.
The heart of the Massachusetts plan is this: every resident of Massachusetts must have health insurance by July 1, 2007 or pay a fine--but costs of health insurance and medical care itself are not controlled, nor are there adequate standards for what health insurance is supposed to cover. Big insurance wins; consumers lose.
The Massachusetts plan offers subsidies for the very poor--as it should, and allows those who can afford it to buy insurance pre-tax--but this plan squeezes middle class people who don't qualify for subsidies and can't afford to buy insurance pre-tax. The plan subsidizes people who earn up to 300 percent of the poverty level. But a typical group policy in Massachusetts costs about $4,500 annually for an individual and more than $11,000 for family coverage. Many families and business would be forced to choose between complying with the law and other vital necessities. Young and healthy people might be able to buy low premium plans, but even these are now typically considered affordable only to people whose income is greater than 499 percent of the poverty level.
Furthermore, such high-deductible, low-coverage plans often don't offer even adequate coverage.
The sort of plans available to middle-class consumers--those with deductibles that run into the thousands of dollars--mean that most consumers would wind up footing the bill for most of their own yearly healthcare in addition to the premiums that such a law would force them to pay. If such consumers found themselves truly needing extensive coverage--if they get hit by a car or contract a serious illness--they may find out that their cut-rate plan will leave them in terrible financial trouble. (About half of all bankruptcies sustained in the United States today are the result of medical expenses incurred by people who had health insurance they thought they could trust). Middle class consumers will not be able to choose the doctors they most trust but will be forced to decide among the doctors whose services are covered by the plan they can afford.
The sad joke is that plans like this are being marketed as ˜consumer driven” Healthcare consumers (that is to say, everybody) please take note: any so-called ˜consumer-driven” health plan is really an anti-consumer hit and run. California State Senator Sheila Kuehl is offering a real alternative. Her bold legislative
initiative would bring truly affordable healthcare to all.
SB 840 has already been passed by the California State Senate and the Assembly Appropriations Committee. It will likely be up for a floor vote by the Assembly later this week or next Monday. Ask your California friends to support this bill--and to contact their Assembly representatives to vote "yes' on SB 840. And urge your own state legislators to put forth similarly bold proposals.
Katrina vanden Heuvel thankfully points out some bad parts of the Mass health plan, but she misses a few things along the way, things that most others miss as well.
* Any plan that involves private insurance businesses as any part of it retains the basic problem with the old/current policy...that profits are diverted to insurers that ought to be money going to actual citizens' health care. This applies either if citizens are required (or left no option but) to PATRONIZE any private insurer, OR if the state hands public money to private insurers to administer things.
* The problem with the ubiquitous word "affordable". Who said THAT was a goal? "Affordable" can mean anything...including still having to purchase services from private insurers. If a program was funded properly by a PROGRESSIVE income tax, there would be no question about "affordability" -- health care would simply be automatic for everyone.
* The idea of SELLING health care as if it was a consumer product and not a basic right and necessity is a top obscenity.
* The idea of a state COMPELLING patronage of a private business compounds this abomination. It is tragic that the stage was permitted to be set for this by public tolerance of compulsory private auto insurance. That was pushed through years ago via the claim that, well...no one HAS to drive. That claim is impossible in the health care area. Everyone HAS to live and stay healthy.
* What about Constitutional issues? Compulsion to speak is unconstitutional except in extraordinary cases -- grand juries, reporting child abuse, etc. The Supreme Court years back determined that even MONEY is a form of speech! So, in a compulsory insurance situation, people are Compelled To Speak to private insurers with both words and money.
* The phrase "single payer" must NOT be quietly altered to refer to the public, the "the single payer", handing public money off to private insurers to administer programs. The whole POINT of Single Payer is to adapt PUBLIC administration and ovesight. If we have to change the phrase to "Insurance-Free Single Payer" to make it clear, so be it.
* It is routinely ignored that insurers are also INVESTMENT firms. Big Insurance is, indeed, the largest investment community on Wall Street. So, our health care money is sent off to investments in god-knows-what industries. Perhaps they are firms that we would object to for reasons of morals, religion, politics or business. Perhaps they are the very industries that caused our health care problems in so many cases. Perhaps they are cigarette manufacturers. (See: http://www.pnhp.org/news/2000/march/insurers_are_major_i.php
--about top health insurers invested in cigarette manufacturing.)
Perhaps one's insurer sends a "customer's) money off to invest in a firm that is a competitor to ones own business or investment property.
Bottom line here is that compulsion to purchase auto OR Health insurance is a compulsion to fund investments in Wall Street businesses, with no knowledge of, or choice about, where the investments are made.
* There NEEDS to be a demand that insurers, without being asked, reveal all their investment properties to customers.
* This investment angle presents a deadly conflict of interest in that an insurer invested in, say, a pesticide firm will be quite reluctant to find health problems caused by that business or by pesticides at all. This is rampant. Notice the common tactic of blaming virtually all diseases on either natural things (the sun, germs, tobacco plants, viruses, mosquitoes, our parents' genes, etc) or people's personal behavior (diet, lack of exercise, "smoking", drinking, ignoring seat belts, etc etc).
The implications here regarding corruption of our vital science and medical system are staggering.
Call almost any health care establishment...a Cancer "Cure" hospital, for instance. Just TRY to find out about industrial carcinogens or how to avoid them or what benign alternatives there are. They will claim ignorance of the entire subject and won't provide a bit of info. Why? Such a medical facility is joined at the hip (at the wallet) with carcinogenic chlorine/dioxin interests AND WITH insurers that insure and invest in such industries. This is the top reason we hear little or nothing about chlorine contamination of most cigarettes or about the inevitable dioxin in the smoke. (See: http://www.mindfully.org/Pesticide/Dioxins-Cigarette-Smoke.htm
* What if an insurer is invested in (or does industrial insurance with) a pharmaceutical firm? This presents the motive and corporate duty to promote that drug firm's products over others that may be safer, cheaper and/or more effective --and it creates the incentive to ignore harms that may be caused by that investment property's drugs. (The crime of secret adulteration of cigarettes with known toxins and carcinogens is routinely ignored precisely to minimize liabilities on cigarette firms...and to evade scrutiny of the pesticides, chlorine and other cigarette additives interests.)
* State compulsion/coercion to purchase private health insurance is based on claims that it's in the Public Interest to have health care. The trouble is that, because the insurers are PRIVATE, people are ALSO compelled/coerced to pay for things that have ZERO PUBLIC INTEREST, such as Advertising, corporate jets, campaign funds, CEO bonuses, lobbying expenses, and even lawn care at corporate headquarters. All this on TOP of the idea of insurer investments in Wall Street businesses.
Same scam exists in Auto Insurance area...where we ought also have a Single Payer system with perhaps a bit of the costs covered by a percent of pump price for gas so that out-of-staters contribute something.
Our motto and goal MUST Be:
Private Insurers OUT of Our Public Health Care System!