State intervention shows why new health care plan will still suck after all

Yeah, so that good decision by Kentucky Insurance Commissioner Sharon Clark to prohibit health insurers from dropping child-only insurance policies? You can thank the impending implementation of Obamacare — and the private insurance industry’s typically inhuman response mechanism — for that fucked up noise.

Please allow Dr. Margaret Flowers, of the awesome Physicians for a National Health Program, a few minutes of your time:

Sadly, the new federal health law fails to make the grade. Even the Congressional Budget Office estimates that 23 million people will still lack coverage in 2019 after the health legislation is fully implemented. The Centers for Medicare and Medicaid Services reports that health care costs will rise more quickly under the new law than if there had been no health bill.

A potent example of what to expect occurred the recent provision preventing health insurers from denying new policies to children with pre-existing conditions kicked in. The day before this protection went into effect, insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana announced that they would no longer offer new policies to individual children.

What can we conclude about the new legislation? It further enriches and empowers the very industries which are at the heart of the problem. As long as private insurers occupy a commanding role in our health system, we will never achieve universal or affordable care. Insurers make money by enrolling the healthy, screening out the sick, denying claims and raising premiums.

There is a solution that receives top marks: a single-payer national health insurance program, commonly referred to as improved Medicare for all. Single-payer means that our health care dollars are pooled in a single public fund that pays for a universal health care system. This is estimated to save $400 billion, which would cover those who need care. Surveys show this approach is supported by two-thirds of the population.

Improved Medicare for all means every person living in the United States would be guaranteed high-quality care from birth to death. Coverage would be comprehensive, including dental care, vision care, mental health services and prescriptions. And the working and middle class would pay less for health care because of the increased efficiency of a single-payer system.

But, yes: Baby steps must suffice in lieu of real, actual change, eh? It’s a good thing the Tea Party knows how to practice such informed, ideological restraint:


  1. Brendan
    Posted November 23, 2010 at 2:57 pm | Permalink

    I’m on the left. I wish we had single payer.I wish there wasn’t a filibuster either, but there is. I’ve never heard a convincing argument from single payer proponents as how there was any way to convince Ben Nelson, Evan Bayh, or Joe Lieberman to vote for a public option — let along full on single payer!

    Flower’s argument is pretty flimsy. Yes, some insurance companies are trying to score cheap political points by canceling kids’ coverage before the mandate for everyone to buy insurance kicks in. This is, of course, evil. But it was correctable, as Sharon Clark’s action just proved. It’s kind of sad that Flowers it using something the insurance companies did to pander to conservatives to beat up fellow progressives.

    By Flowers’ own math, 28 million people will gain coverage under this imperfect plan. (Most of those people who will be left out are undocumented immigrants. This is deeply wrong. But if you really think that Congress was going to support giving insurance to “illegal” immigrants in the current political environment, you probably should turn in your political analyst card.)

    Coverage for the 28 million people who will get insurance under “Obamacare” is mostly funded by a surcharge tax on people who make more than $250,000 per year. I’m having a hard time understanding why this is such a terrible thing.

    I hear single payer supporters argue that Obamacare was about enriching Humana and other insurance companies. But the reality is that insurance companies quietly funneled $86 million(!) to the Chamber of Commerce to run a campaign to defeat reform: If Obamacare was about helping insurance companies, why did they try so hard to destroy it?

    I’m all for single payer and I think that we’ll get it eventually. It wasn’t going to happen in 2009/2010. People are too scared about the economy. The good news is that Obamacare gets us 28 million people closer. I wish that folks on the left could constructively offer ways to improve on it instead of resorting to using right wing arguments against it because they are convenient. Yes, the Tea Party is ridiculous and nonsensical. Doesn’t mean we have to be too.

    Thank goodness that John Yarmuth looked at the real issues at stake and voted the way he did.

  2. jmeador
    Posted November 23, 2010 at 4:43 pm | Permalink

    Thanks for the cogent comment.

    Re: Why insurance companies would pay to derail a piece of legislation that would give them a bunch of money? Easy: Because they wound up getting exactly what they wanted out of the process (e.g. a bunch of watered down drivel that’s marginally better at doing some things, maybe, in theory, but is devoid of a public option or anything else that might herald a break with the status quo of profit gouging, and so not wind up doing much of anything at all). They weren’t spending money to fight it, per se; just ensuring that it came out the way it did. And they’re getting tens of millions of new customers added to their roles courtesy of government’s corporate reach-around.

    The Obama Administration sold out to Big Pharma from the get-go, and sold the left down the river by telling groups like Move-On to remain silent on the issue of single-payer and public option. When coupled with (1) the capitulations of a paid hack like Max Baucus, who alone received $2,880,631 from health insurance companies, and (2) the fact that there will still be human beings left behind in a broken, for-profit system seems to, I dunno, run contrary to what a majority of Americans thought they voted for in 2008.

    There’s obviously nothing wrong with taxing the rich. The problem is that that’s a red herring here: The rich CEOs of these insurance companies are still making money off the backs of people receiving low-quality care, whereas every other industrialized society on the face of the planet commands greater purchasing power with their health care dollar, and isn’t as fat as us (except for New Zealand, from what I understand…)

    So advocating for something like this reform and claiming to be “on the left” is confusing to me, considering the facts, but I digress: Yarmuth was a fan of single-payer but he, like most everyone else in that Congress, took what he could get, because that’s politics. (And they weren’t being given much by our corporate masters)

    I advise anyone who hasn’t read this, to read it, if only so they know how terribly we’ve been cheated on “reform”:

  3. Brendan
    Posted November 23, 2010 at 8:59 pm | Permalink

    Taibbi’s piece is remarkable for capturing just how ugly and backwards the process of passing the healthcare reform bill was. He’s right that Max Baucus is a hack. He’s right that the Blue Dogs argued selfishly for things that contradicted their own supposedly courageous positions. He’s right that special interest demanded loopholes in exchange for their neutrality. All valid points. Single payer is more efficient, more humane, and more cost effective in how it provides care to ordinary people. Agreed.

    But Taibbi doesn’t do much to explain what Obama could actually do to get around the crucial problem of getting anything meaningful passed in the Senate. He seems to argue that Obama had a 60 vote margin for single payer in the Senate. But Taibbi himself has railed about how a small but crucial bloc of that 60 — hacks like Baucus, Evan Bayh, Ben Nelson, and Blanche Lincoln — held things up. Those hacks were never going to vote for single payer. And given the undemocratic and extra-Constitutional filibuster bar that exists in the Senate, those 3 or 4 votes held an effective veto over which way things went. Like it or not, Obama had to take that into account.

    I also think that Taibbi ignores the real benefits of the plan. Do we really want to tell a uninsured single mom who works at Wendy’s or Target that even though she’ll get basic, guaranteed health coverage for herself and her kids through this this bill, it “sucks” for various reasons and she should’ve waited until we have the votes to pass single payer sometime in the unknown future? No. Shitty insurance is better than no insurance. Thousands and thousands of people dealing with ruined credit and massive debts because of ER bills they racked up when they were uninsured can attest to that. Again: 28 million people (actually, probably more like 30-32 million) will get coverage under this bill and won’t have to face that fear anymore.

    It’s also a stretch to portray the Obama plan as purely “a reach around” for the insurance industry. In reality, it forces insurers to stop competing on the basis of how aggressively they can cancel and deny policies and sets up real standards for exactly what care they need to provide access to — something that simply didn’t exist before at the federal level. Through regulation and community rating, it puts on the road towards Dutch or Swiss style regulation of private insurance. The Obama plan finally eliminates the egregious giveaways to insurers in the form of the privatized “Medicare Advantage” plans — something that I recall being mentioned in a few commercials attacking Jack Conway, many of them probably funded by secret insurance and pharmaceutical cash.

    Politics is almost always a question of calculating what you can get and then taking it. Notably, the members of Congress who Taibbi hails as “fighting for something real” — the “Weiners, Kuciniches, Wydens and Sanderses” — all voted for the Obama plan. (I would include Yarmuth in that group, too). Does that make them hacks or sellouts? I would say no. They decided that this was the deal available at the time and they supported it. I think that was the right choice despite all of the bill’s obvious flaws and shortcomings. (Does that mean that Bernie Sanders, of all people, is therefore not on the left, either?)

    The question is, what now? I would urge anyone who’s read the Taibbi piece to also take the time to read this article by Jacob Hacker, the guy who came up with the idea for the public option:

    Hacker likens the Obama plan to the original version of Social Security, which was also full of loopholes and half-measures introduced to ensure it got passed in the first place. It was relentlessly attacked by conservatives from the moment it passed and, of course, is back under relentless attack today. Starting in the 1940s and 1950s, progressives had to go into the trenches to fight back and forth to strengthen and expand Social Security into the deeply popular and incredibly important program it is now. Hacker lays out the ways that conservatives will likely try to destroy the Obama plan and identifies areas where progressives can fight to expand and improve it.

    To me, this kind of thinking and planning is more useful than attacking Obama’s plan again and again. Change isn’t easy and real change always takes a fight. Let’s get to it.