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 Posted March 22nd, 2010 at 3:32PM
So while things have been quiet around here, I’ve been following the healthcare debate closely. Kucinich’s change of heart mid last week coincided with mine, and so I was pleased with Representative Scott Murphy’s decision to vote in favor – and relieved when the final tallies were announced late last night.
My line of thinking is now along the lines that this legislation is (or at least, can be, optimistically assuming the best possible outcome – a great leap of faith) better than nothing. Nothing, coming after more than a year of effort on the part of the Democrats, always the consummate lesser of two evils. A failure here, pragmatically spelling the end of Hope with a capital H, and putting any future reform efforts on the back burner for another decade plus.
With two-thousand plus pages of legislation, I won’t make any claims to understanding anything beyond the easily digestible bullet points being paraded in the news. Earlier, I became hopeful that this legislation would actually affect me in the near term, with the clause allowing dependent children to stay on their parent’s plans till the age of 26. I am most definitely still dependent on my parents, and I am also under the age of 26 for another whopping three months. My eagerness to get back on the roles isn’t borne from my pre-existing condition (T2 diabetes – still very much under control), but for the recent ultimatum on my wisdom teeth – they’s gotsta go! (For years their place was secure, since apparently I have the jaw line and accompanying mouth space of one of homo sapien’s earlier ancestors. But while the top pair have come in fine, the bottoms still aren’t completely through, and the determination has been made that they need to come out. And the older I get, the less chance of my gums healing properly.)
But from what I can tell, this piece of the healthcare legislation won’t be applicable in my case. First off, although this is purportedly one of the pieces enacted immediately, I still found word that there is a six month grace period involved. Secondly, I can’t figure out whether this is applicable at all for all of the 21-26 year olds who’ve already been kicked off – can we just sign back on, or are we in a loophole? Thirdly, the wisdom teeth would most likely be deemed a “pre-existing condition” and not covered even if I was able to get insured for the next three months. (Pre-existing conditions will be a thing of the past for adults by 2014, children (real children) immediately.) Fourthly, and last, I just found out that New York has already had legislation that allows unmarried children to remain on their parent’s insurance – until the age of 30!
I don’t recall what age I was when I was kicked off of my parent’s insurance. It seemed an arbitrary age, and I remember it being before I even graduated from college. While attending, I had some very low cost plan associated with the college and assumed it would cover anything catastrophic. And I was uninsured when diagnosed with diabetes two years ago. I am not enthused at my chances of being re-enrolled, as the current for-profit healthcare system stands to gain nothing by having me insured getting proper medical treatment at an affordable cost. Therein lies the fundamental problem, an issue never at task over the past year of partisan squabbling.
Still, although I am yet another instance of an uninsured individual who will likely see nothing come from this legislation in the short term, I feel like I can only hope for the best in that the CBO estimates show some savings to be had, long term, nationally. If this effort was sunk, reform would not be attempted again, and this would undoubtedly result in a worsening of the crippled system – by the CBO’s own estimates. Further skyrocketing costs, millions more uninsured, more and more of the same.
It is hard to feel any satisfaction, or to even see this as a “victory.” Healthcare reform has been a significant issue for me for several election cycles. Watching the political process over the past year neuter the most substantial reforms has been disheartening. This legislative success looks to do nothing for the thousands still dying for lack of care. Perhaps the sense of victory will hold them over until 2014 or whenever the applicable parts of the bill come into effect. Premiums will surely increase astronomically while health insurance companies have free reign to do so.
Watching the whole debacle, I’m taken aback by the unscrupulousness of the Republicans, Waterloo-ing the issue the whole time; and by the emasculated nature of the Dems, incapable of passing substantial reform while in control of both Congress and the presidency. It’s hard to see how any progress can be made under this system.
Posted March 1st, 2010 at 12:20PM
Fatigued by the tea? Looking for a movement named after a drink popular with 21st century Americans? Look no further than the Coffee Party, a sorta-lame-at-first-glance rejoinder with a lot more going for it once you skim the surface:
Many of us had the same thought: the tactics being employed by the Tea Party movement are not likely to produce solutions to the problems that we face as a nation, and we urgently need an alternative.
It’s very hard to get people to rally around a new idea. But here I am reminding them of something that they already know: that we are all Americans. We should not divide ourselves over differences of opinion. We need to be one community. Our democracy is what unites us as a people. We must protect it, and to protect it we must engage in the political process, respecting the reality that we are diverse nation with diverse points of view.
- Annabel Park, founder of Coffee Party USA, via a live Q&A at the Washington Post
My initial reaction when getting the Facebook invite was of the “oh, that’s cute” nature. But with all the talk of participatory democracy, civic engagement, and public discourse, this nascent movement appears to be more Public Policy 201, less hysteric “Down Wit Gubment” herd mentality. And I can get behind any movement that actually addresses an issue at hand, of our fractured, tug-of-war method of governance. The schizoid two party system we have would seem amusing, but for actually living here and paying the taxes to support it.
Particularly disheartening this week was David Gregory, on Meet The Press doing his part to discredit the Mainstream Media, blithely glossing over all public opinion outside of the Tea Bagger movement, proclaiming that, “The only protests you’ve seen publicly are on the right in opposition to the [healthcare] bill.”
Truly, this would only be the case if your sole window on the world was the 6 o’clock news. Not only do I subscribe to newsletters of national movements in favor of reform (Healthcare-NOW!), but I have seen and heard of protest efforts coming from the left and center, across my local region. From demonstrations at the state Capitol, to the street corners of routes I take every day, there demonstrably are people frustrated at current national affairs, who still fall far short of the fanatical “fly a plane into an IRS building” stripe.
To say that the Right are the only ones expressing themselves is a fundamental failure of journalism, which purportedly exists to deliver news, not craft it as the NY Times has with New York’s coming gubernatorial election. I posit that perhaps 20th century news structures would not be in the dire straits they’re in if they were doing a better job at the close of the century. (Sometimes it feels like I only blog to contradict the notion of the blogosphere as a vast right-wing echo-chamber.)
The Tea Party is not an issue-based group per se, as far as limited or nonexistent government can be considered an “issue” (I consider it an ideology). It’s bizarre to think of Righties as sign-toting protesters, but then I can certainly empathize with the emotions of disconnect with government and the free press. They’re failing us all. Coffee is arguably the better direction; otherwise, politicos and big biz (I mean, the media) will continue to eagerly play us as fools. We need a fundamental redress of the systems at play, because TARP didn’t address the problems of Wall Street, and likewise with the stimulus and our economy. And while I’m not loony enough to proclaim government “the problem,” a nonfunctioning one certainly contributes to our ills.
Posted November 12th, 2009 at 1:17PM
He told the media from his Saratoga Springs office on Monday that he believes health care reform is critical, but it’s coming at too high a cost to cornerstone businesses in the North Country. That is why he voted “no” on the bill.
Murphy says the bill makes a number of important reforms which he supported, however, such as lifetime caps on insurance benefits as well as the pre-existing condition exclusion – meaning an insurance company can refuse you if you have a preexisting medical condition.
But during Saturday’s vote in Washington, Murphy sided with 39 other Democrats who also voted with Republicans, saying the plan would put affordable health care out of reach of many small businesses and that it unfairly targets some Capital Region industries, like Finch Paper in Glens Falls.
I was surprised to see Smurphy vote against the healthcare bill in the house after being a supporter of the stimulus plan – and really the overall Dem agenda coming from Washington – since being elected. A talking head on the news the other night suggested that certain house Dems from conservative districts (Murphy included) may have very well been given the OK to dissent, political self-preservation in mind.
Was the vote orchestrated as such? If so, I feel the danger is that political calculation playing out too well. Because the real question is whether anyone interested in substantial reform should have supported the bill in the first place. In his public statement, Murphy faults the measure for affordability and putting an additional burden on area businesses.
Rep. Dennis Kucinich, co-author of H.R. 676 (the single-payer bill that should have been included in this debate) was another ‘no’ Democratic vote. In part:
“We have been led to believe that we must make our health care choices only within the current structure of a predatory, for-profit insurance system which makes money not providing health care. We cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem. When health insurance companies deny care or raise premiums, co-pays and deductibles they are simply trying to make a profit. That is our system.”
“Clearly, the insurance companies are the problem, not the solution. They are driving up the cost of health care. Because their massive bureaucracy avoids paying bills so effectively, they force hospitals and doctors to hire their own bureaucracy to fight the insurance companies to avoid getting stuck with an unfair share of the bills. The result is that since 1970, the number of physicians has increased by less than 200% while the number of administrators has increased by 3000%. It is no wonder that 31 cents of every health care dollar goes to administrative costs, not toward providing care. Even those with insurance are at risk. The single biggest cause of bankruptcies in the U.S. is health insurance policies that do not cover you when you get sick.”
“But instead of working toward the elimination of for-profit insurance, H.R. 3962 would put the government in the role of accelerating the privatization of health care.
The final tally on H.R. 3962?
- A mandate to at least 21 million to buy into the broken system – resulting in an estimated $70 billion in new revenue to the health insurance industry
- A crippled public option, potentially enrolling only 6 million – available only to those people deemed unprofitable to insure privately
- Little to nothing in the way of cost containment or prevention
- A provision to allow states to implement their own single-payer (read: effective) systems was stripped from the final bill
- A four year period until the bill goes into effect, after the 2013 presidential elections. Seen the banking industry’s reaction to the grace period for new credit regulations? Enjoy watching healthcare costs balloon these next four years, and keep in mind the Journal of Public Health‘s recently published study estimating that 45,000 Americans die annually due to unaffordable, unobtainable treatment. What happened to the immediacy of reform?
It appears then that this is substantial reform in name only. Nader’s take:
Still Waiting for Health Care
…
During this overall debate on the bill, Republicans stood up one by one, as prevaricatory dittoheads, to often scream and howl (like coyotes) that this is “a government takeover of one sixth of the economy,” “would destroy the economy,” “put 5.5 million people out of work,” “destroy the doctor-patient relationship,” “be a steamroller of socialism,” “force millions of seniors to lose their current health coverage” (meaning, Medicare?) and, in a passionate appeal to the Almighty, Congressman John Fleming (R-LA) declared “God help us as the government takes over your day-to-day life.”
Never mind that this bill is just an expansion, however misdirected, of government health insurance designed to increase corporate profits and increase the corporate grip over the day-to-day decisions regarding who, when and how people get their health care or get their bills paid.
So whether Murphy’s vote was political calculation or not, I can hardly fault it.
UPDATE: More, from today’s Healthcare-NOW! newsletter:
So is the House bill better than nothing?
“I don’t think so,” writes Marcia Angell, M.D., former editor of the New England Journal of Medicine. “It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.”
Given that the bill does nothing to contain or reduce rising costs or end the private health insurance industry’s dominance, we hoped that the Progressive Caucus would stand strong. But they did not. All but two of H.R. 676′s cosponsors voted for H.R. 3962 — Rep. Eric Massa [D-NY] and Rep. Kucinich [D-OH].
Rep. Massa stated, “At the highest level, this bill will enshrine in law the monopolistic powers of the private health insurance industry, period. There’s really no other way to look at it.”
Posted August 12th, 2009 at 12:52PM
Michael Moore in the latest Rolling Stone:
If a true public option is enacted – and Obama knows this – it will eventually bring about a single-payer system, because the profit-making insurance companies won’t be able to compete with a government plan and make the profits that they want to make.
Mikey gives Obama too much credit throughout the article. Everything coming out of the White House and Congress indicates that the ‘public option’ will be a severely handicapped one – you can thank bipartisan compromise and that $1.4 million a day in insurance company lobbying for that. Significantly, Obama’s recent mention of the US Postal Service during a town meeting on healthcare portends a far more likely future for the ‘public option’ than leading to single-payer.
The option to purchase a public plan within a market of private health insurance plans would merely provide one more player in our inefficient, dysfunctional, fragmented, multi-payer system of financing health care, that is if the public option even survives the political process. It would leave in place the deficiencies that have resulted in very high costs with the poorest health care value of all nations (i.e., overpriced mediocrity in health care).
Those who believe that the people of this nation would have the wisdom to drop their private plans and join the government program are ignoring history. When Congress authorized private plans to compete with our existing public program, Medicare, many enrollees did just the opposite. One-fifth have left the traditional Medicare program and joined the private plans.
So why should we care? Why shouldn’t they have the right to choose private plans if they want them? We know that those private plans are wasting money, both in their own costs and the administrative burden they place on the delivery system, but what all too many don’t realize is that we are all paying for that waste because of the inherent structural deficiencies in our financing system. Plus we are being deprived of the reforms needed in our health care delivery system that our own single payer monopsony would bring us.
Further reading: Comparing single-payer with the ‘public option’
And for those confused between single-payer and OMFGOSH SOCIALISM…
Martin Feldstein, Harvard professor, talking about stuff he doesn’t understand
Obama has said that he would favor a British-style “single payer” system in which the government owns the hospitals and the doctors are salaried but that he recognizes that such a shift would be too disruptive to the health-care industry. The Obama plan to have a government insurance provider that can undercut the premiums charged by private insurers would undoubtedly speed the arrival of such a single-payer plan.
FiveThirtyEight >> Not All Socialist Countries are Alike
Posted November 13th, 2007 at 11:08PM
Welp, I finally got to watch Sicko tonight. I’d have to say it was one of the better (if not best) Moore movies.
If you go by some of the forums and blogs out there, you’d think everyone either idolizes or demonizes Moore. But, as par the course, those are just the loudest reactionaries on both sides of the fence. Moore is an excellent polemicist, and that draws out the worst in people.
I don’t particularly care for Moore, but I don’t spend time micro-analyzing his movies hoping to catch some sloppy editing. Sicko was not meant to be a comprehensive review of healthcare systems, whether in the U.S. or the four other countries he travels to. Similar to his prior works and any documentary or movie, really, it presented the debate in the filmmaker’s framework. Generalizations are necessary in a 2 hour film. Hopefully no one would take away everything in Sicko as the gospel truth, just as no one should do the same with a press conference or 60 Minutes report.
The oddest part of the film was the bit where he mails a check to some nutjob writing for an “anti-Moore” blog. Its connection to healthcare was tenuous at best. Obviously it was meant to rile the nutjobs (similar to many of the special features on the DVD).
And that it did. I did a quick Google, found the site. Spent too much time (read: 5 minutes) reading a few of the posts responding to said part of the film. I thought briefly of commenting, but appealing to the irrational is a pretty futile exercise. Do you pet rabid dogs? Same concept. 
Posted August 16th, 2007 at 9:41PM
In a CBS News / New York Times poll earlier this year, 90% of respondents agreed that the United States healthcare system needed either “fundamental changes†or a “complete overhaul.†Most were satisfied with their own care, but the majority (81%) said they were either somewhat or very dissatisfied with the cost of care. And a full two-thirds agreed that the government has a “responsibility to provide healthcare for all.â€
And which party, according to the March 1st poll, is seen as most capable of fixing the system? In a four to one margin – the Democrats. With the population calling for a solution that offends small government sensibilities, the Democrats have the chance, for a change, to be on the winning side of a wedge issue. (Consider the latest war in Iraq a squandered opportunity.)
In most cases, wedge issues are political and not policy oriented. They’re about creating conflict and not bettering the state of things. Is it possible for the Democrats to use an issue that actually needs resolution? They’ll need to walk a fine line.
As per the primary season, to date, the issue has produced mostly infighting among the Democratic contenders. As a result of her time as head of the Task Force on National Health Care Reform ,Hillary Clinton is viewed as most capable. The failed task force was the result of Bill Clinton’s 1992 presidential campaign, which focused on reforming healthcare. John Edwards has been pushing a detailed plan, while Barack Obama has been faulted for “vagueness.†Still, regardless of the candidate, Democrats have always been seen as more capable in dealing with healthcare woes. And this view has only been reinforced in recent years by Bush’s complete impotence on the matter.
The fact that healthcare is shaping up to be the domestic hot-button issue for the 2008 election cycle comes as a welcomed relief after years of debate over manufactured crises like gay marriage or stem cell research. Healthcare is a daily concern for millions of Americans. The costs for both insurer and insured are skyrocketing, while the number of uninsured continues to climb (47 million in 2006). The crisis has reached a sort of critical mass, with no one particularly happy with the status quo. The Democrats have the ability to push the issue during the election, and then – more importantly – to act when they’re elected. The calls to decrease costs and increase coverage are resolvable. But just because this opportunity has fallen into the collective lap of the Democratic Party doesn’t mean it’ll be capitalized upon.
Any successful campaign for reform will need to point out the inefficiencies of our current healthcare system that make it the most costly per capita in the world. Clinton’s attempts at reform in the early ‘90s were portrayed as bureaucratic and restrictive – not to mention necessitating the politically suicidal “tax increase.†The eventual Democratic nominee in 2008 needs to avoid such banal characterizations.
Reform will likely necessitate increased government spending, but this will be offset by the fact that individual and business costs associated with healthcare will decrease. Premiums for a typical family have nearly doubled in the past five years, and the situation is similar for businesses. The current healthcare system impedes growth by increasing administrative costs and discouraging small businesses, entrepreneurs, and others who might choose to work at home or change jobs. Americans spend more than double per capita what other industrialized nations spend on healthcare, but we’re consistently worse in leading indicators like life expectancy or infant mortality rates. Illustrating these sorts of inefficiencies and inadequacies is crucial in currying wider support, both for reform and for the Democratic nominee.
But all reform is not equal, and the biggest challenge now might very well be political expediency trumping sound policy. At a town hall meeting in Iowa devoted to healthcare, Hillary Clinton excused her failure to provide specifics, saying that she was waiting to hear from voters on what sort of plan they would favor. A broad swath of support for healthcare reform is indeed necessary, but crafting a plan that’s palatable to everyone (including those currently profiteering) is a recipe for disaster. Stopgap measures and half-hearted attempts will only fail, vindicating naysayers who say reform is unnecessary or unfeasible. So it becomes not an issue of whether healthcare is on the table, but rather a genuine policy debate. Every Democratic candidate will need a plan that is not only practical, but effectual. And then, we need to hold them to their word once they assume the presidency.
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