# Single-payer Health Care

Ten answers to Boehner's question on health care

House Republican leader John Boehner was on CNN Sunday morning:

“We’ve got the greatest health care delivery system in the world,” he added. “Why do we want to jeopardize that with a big government run health care system?”

Because our health care delivery system directs about 31 percent of total health spending to administrative costs.

Because our health care delivery system makes Americans more likely to go without certain medical procedures despite astronomical per capita spending on health care.

Because our health care delivery system leads to overuse of emergency rooms by insured as well as uninsured Americans.

Because our health care delivery system leaves uninsured trauma patients 50 percent more likely to die than trauma patients covered by insurance.

Because our health care delivery system causes uninsured people to be denied organ transplants on the grounds that they will lack the capacity to pay for anti-rejection medications.

Because our health care delivery system prompts insured as well as uninsured Americans to delay medical treatment for chronic illnesses.

Because our health care delivery system makes uninsured people much more likely than insured people to be diagnosed with “advanced cancers […] that could have been detected early through proper screening.”

Because our health care delivery system puts paperwork from insurance companies rather than a doctor’s recommendation in charge of the timetable for cancer surgery.

Because our health care delivery system can force cancer patients to forgo radiation or chemotherapy if they lose their insurance.

Because our health care delivery system can leave insured as well as uninsured people with crushing debts after completing cancer treatment or care for a medical emergency.

Feel free to add your own answers in the comments.

UPDATE: MyDD user Trey Rentz adds that medical bills are the leading cause of bankruptcy in the U.S.

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A few links on today's White House regional health care forum

I haven’t had a chance to watch today’s White House regional forum on health care yet (the Des Moines Register made the video available here).

According to the Des Moines Register, Senator Tom Harkin promised that health care reform will not fail this time:

“This is not something that we’re going to kick the ball down the field,” he said. “This is going to happen this year.”

The Register noted that some people at the forum favored single-payer health care reform, while others would like to see only small incremental changes. Protesters supporting a single-payer system gathered outside the forum too. I agree that single-payer makes the most sense for all kinds of reasons, but President Barack Obama will not seek that change, and Congress will not pass it. I’m willing to settle for a compromise that includes a strong public-insurance option.

Obama’s representative at today’s forum expressed optimism about finding an acceptable compromise:

Nancy-Ann DeParle, the leader of Obama’s health-reform effort, said past health-reform debates saw too many people who were wedded to specific plans. They wouldn’t compromise if they couldn’t get everything they wanted, she said. “Their fall-back position was always the status quo.”

This time, she said, people seem more willing to listen to other people’s ideas and find compromises.

Prospects for passing universal health care reform will depend on large part on whether the bill is subject to a filibuster in the U.S. Senate (meaning it would need 60 votes to pass). Obama reportedly wants to include health care reform in the budget process, so that it could pass with only 51 votes.

Chris Peterson, president of the Iowa Farmers Union, talked about health insurance for rural Americans at today’s forum:

“Rural Iowans struggle with finding affordable insurance. Even solidly middle class farmers are feeling the pinch. Nearly one in eight Iowa farmers battle outstanding health debt,” Peterson said. “I am one of them.”

Peterson, who is 53, was kicked off his private insurance plan about two years ago for what the company said was a preexisting condition. Peterson and his wife, who has no private insurance either, have accumulated $14,000 in medical debts in the past two years. “The health care system in this country is dysfunctional and burdensome,” Peterson said of the private insurance industry. “…Personally, what I’ve been through, it seems at times it’s a ponzi scheme — they’re taking your money — or (it’s) just the robber barons pulling money out of your pockets.”

On this note, I highly recommend reading this article by Steph Larsen: “For healthy food and soil, we need affordable health care for farmers.”

Getting back to today’s events, @personaltxr was at the forum and tweeted that Senator Chuck Grassley was expected but didn’t turn up. Does anybody know why? Grassley has an important role to play as the ranking Republican on the Senate Finance Committee. UPDATE: The Des Moines Register reported that Grassley stayed in Washington because of ongoing Senate business.

If you saw the health care forum, either live or on video, let us know what you thought. Everyone else can use this thread for any comments related to our health care system and prospects for reform.

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CATO reveals the GOP's dirty little secret on health care

Jed L brought something remarkable to my attention over the weekend.

Michael Cannon of the conservative CATO Institute wrote a piece called Blocking Obama’s Health Plan Is Key to the GOP’s Survival. The idea is that if Obama gets universal health care passed, he will bring “reluctant voters” into the Democratic coalition. The Republicans must at all costs provent that from happening.

David Sirota and TomP both pointed out that conservative pundit William Kristol made the same case to Congressional Republicans during Bill Clinton’s first term. At first, some were afraid to be seen as obstructing the president’s health care reform efforts. But in December 1993,

Leading conservative operative William Kristol privately circulates a strategy document to Republicans in Congress. Kristol writes that congressional Republicans should work to “kill” — not amend — the Clinton plan because it presents a real danger to the Republican future: Its passage will give the Democrats a lock on the crucial middle-class vote and revive the reputation of the party. Nearly a full year before Republicans will unite behind the “Contract With America,” Kristol has provided the rationale and the steel for them to achieve their aims of winning control of Congress and becoming America’s majority party. Killing health care will serve both ends. The timing of the memo dovetails with a growing private consensus among Republicans that all-out opposition to the Clinton plan is in their best political interest. Until the memo surfaces, most opponents prefer behind-the-scenes warfare largely shielded from public view. The boldness of Kristol’s strategy signals a new turn in the battle. Not only is it politically acceptable to criticize the Clinton plan on policy grounds, it is also politically advantageous. By the end of 1993, blocking reform poses little risk as the public becomes increasingly fearful of what it has heard about the Clinton plan.

Getting back to Cannon’s recent piece for CATO, I am struck by how conservatives don’t even believe their own propaganda about the horrors of “socialized medicine.” Yes, I know that Obama isn’t proposing socialized medicine (which would work like the Veterans Administration, where the government employs the doctors and runs the hospitals), or even single-payer health care (as in Medicare, where patients choose the doctor but the government pays the bill). But for the moment, let’s accept CATO’s frame on this issue, which is that Obama’s health plan would turn into socialized medicine.

Obama’s plan would presumably allow Americans to buy into a state-run health insurance plan as an alternative to private health insurance, and would prohibit insurers from excluding people with pre-existing conditions. These measures would force the insurance companies to compete for customers by offering better coverage, as opposed to the current system, in which they try to maximize profits by denying care whenever possible, and sometimes refusing to insure people for any price.

I have a friend with a thyroid condition. At one point her husband was between jobs and they looked into buying their own health insurance. They could not find any company that would take their family. It wasn’t a matter of excluding coverage for anything related to my friend’s thyroid condition. They simply declined to sell insurance to this family at any cost. Fortunately, my friend’s husband got a job with good benefits. Otherwise, they would be uninsured to this day.

The benefit of giving families like my friend’s the option of buying into state-run insurance program is obvious. But let’s assume that conservatives are right, and that any state-run insurance scheme is bound to be expensive and inefficient. If that’s the case, wouldn’t it fail in the marketplace?

Obama’s health care plan could evolve in the direction of single-payer health care only if the government insurance plan provided superior coverage to consumers at a lower cost. CATO shouldn’t be worried about this, right?

Let’s go a step further. Conservative pundits are trying to tell us that Democratic health care proposals would be disastrous for the country and wreck the economy. If that’s true, then why is a CATO analyst worried that enacting Obama’s health care plan would cause a political realignment in the Democrats’ favor?

Cannon’s argument is also shocking on a moral level. He appears to believe that Obama’s health care plan would improve so many Americans’ lives that the GOP’s survival would be threatened. So, he urges Republicans to put their own political interests ahead of the interests of Americans currently lacking adequate health care.

Jed L thinks

Cannon has everything backwards: the GOP’s survival depends on Republicans being part of the solution instead of being part of the problem.

I have to admit that here I agree more with Cannon. Republicans would not get much credit for helping to pass Obama’s universal health care plan. Everyone would know it was a Democratic president with a Democratic Congress who delivered on that promise.

Obstruction with the goal of making Obama look like an ineffective leader in tough economic times is probably the Republicans’ best hope of making political gains.

I am cautiously optimistic that Congress will be more open to adopting Obama’s agenda than the Democratic-controlled Congress was for Bill Clinton in 1993 and 1994. We’ve got at least two things going for us: Obama’s Health and Human Services secretary will be Tom Daschle, who knows the inner workings of Congress, and Henry Waxman (not John Dingell) will be running the House Energy and Commerce Committee.

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On Labor Day, remember why unions are good for workers

MissLaura put up this front-page post at Daily Kos today about why unions matter. She linked to Change to Win, which has all kinds of useful statistics on its website. Click the link to find charts illustrating that “Union Workers Earn More,” “Union Members Have Better Benefits,” “Union Members Pay Less for Health Coverage,” and so on.

If Barack Obama becomes president, I hope he will follow through on promises to make it easier for workers to organize in this country. Replacing some of the corporate hacks George Bush has put on the National Labor Relations Board would be a step in the right direction. The Bush administration has used the NLRB to carry out a “systematic assault on workers’ rights.”

In the good news column, Shai Sachs reported in this post at MyDD that union membership appears to be slowly inching up, reversing a long decline.

But remember, just being in a union doesn’t guarantee that a worker will receive promised benefits. As I wrote a few weeks ago, Maytag retirees are probably going to lose health benefits guaranteed in their last contract. On the other hand, if they hadn’t been in a union, it’s a good bet they never would have had those benefits to begin with.

Another failure of employer-based health insurance

If you were negotiating an employment agreement, you might consider taking an outstanding benefits package in exchange for a lower starting salary or a wage freeze. How would you feel if many years later, in retirement, some of those benefits were taken away from you?

About 3,000 former Maytag workers and family members have received letters from Whirlpool this week informing them that they are about to get cheated. Here’s the background:

Whirlpool Corp. has filed a lawsuit in federal court seeking to cut the medical benefits of thousands of retired Maytag workers.

The lawsuit, dated July 24 and filed in U.S. District Court for the Southern District of Iowa in Des Moines as a class action complaint, names the international and local chapters of the United Auto Workers union and three retired Maytag workers as representatives of the class. […]

Whirlpool bought rival Maytag in 2006 for $1.7 billion and assumed the negotiated union contracts and related benefit plans. […]

Whirlpool said in the lawsuit that a contract negotiated between the union and Maytag in 2004 expires on July 31. Whirlpool said it plans to change the retiree medical benefits on Jan. 1, 2009, to bring the benefits in line with the same plan that more than 10,000 current employees, retirees and their dependents have.

I hope that Whirlpool’s lawsuit will fail, but unfortunately, the federal bench is so full of Republican-appointed judges that I don’t expect much in the way of protection for union members.

Barack Obama released this statement today in connection with the controversy:

Des Moines, Iowa – Below is a statement from Senator Barack Obama on the letter Whirlpool sent to Maytag union retirees this week about changes in their health benefits.

“In America, we believe that if you work hard, you should be able to build a better life for yourself and your family.  But today, this American dream is slipping out of reach for too many working Americans. Whirlpool’s decision to cut the health care benefits of 2,200 Maytag retirees is the latest sign that we need to change the broken system in Washington.  

“It’s not right that Maytag’s CEO walked away with a multi-million dollar buyout while the hardworking men and women who built the company lost their jobs and are now facing health care cuts. I’ve had the privilege of meeting with Maytag workers in Newton, and I know they negotiated those benefits in good faith, giving up pay increases and other benefits.  Now it is time for Whirlpool to show good faith to their former employees.  

“As President, I will fight for our workers every day because when our workers do well, America does well.  In the Senate, I’ve fought to protect pensions, and I will continue that fight in the White House.  I will make sure our workers get the fair wages, affordable health care, and secure retirement that they deserve.  And I’ll change our tax code so it rewards companies that create jobs here in the United States instead of companies that ship jobs overseas. I’ll be a President who looks out for Main Street, not just Wall Street and who fights to put the American Dream within reach for every American.”

I certainly hope Obama will work to strengthen labor unions and workers’ rights in this country if he gets elected.

But ultimately, Whirlpool’s action is yet another indictment of our health care system. Even Americans who have good employer-based health insurance can get screwed.

To get more informed about the failures of our current health care system and the benefits of moving to a single-payer “Medicare for all” model, read nyceve’s diaries at Daily Kos or the Guaranteed Healthcare group blog.

At Guaranteed Healthcare, you can also find a list of Democratic candidates for Congress who have endorsed HR 676, which would establish a single-payer health care system.

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