# Single-payer

Defeating the Health Care Forum Bullies (getting something done)

(Thanks to iowademocrat for bringing this discussion to Bleeding Heartland. - promoted by desmoinesdem)

(crossposted from Daily Kos and iowademocrat)
Last Wednesday, I attended a health care forum in Iowa hosted by Senator Tom Harkin. Following it, I wrote a diary, “Now I understand why war happens (a health care forum story).” In it, I asked the question, how can you defeat the bullies who are overrunning most of these meetings?
The problem in dealing with the teabaggers, deathers, birthers, racists, anarchists and radical libertarians who are overrunning health care forums nationwide is simple to describe.
They. Don't. Listen. Ever.
So, you can't really talk to them. When they have stacked the room, the intimidation is palpable. That's how they win.
I couldn't for the life of me think of how to beat these people, short of overpowering them somehow – hence the title of the diary. But, even as I wrote it, I knew that overpowering them just feeds into their fear and paranoia, and realistically, it's impossible anyway.
Today, after a little sleep and some reflection, I realized that the effect of the teabaggers' aggressive intimidation made me stupid for about eight hours. Anger is an amnesic agent. It makes you forget what you know. I was angry, depressed, agitated, and clueless all at once.
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Obama health care forum and open thread

I was not able to watch President Obama’s health care forum on ABC Wednesday evening. ABC News posted a summary here. I liked that Obama defended the public option and said Republican senators who criticized it are wrong.

If you watched the program, what did you think of the questions and the president’s answers?

Consider this an open thread for any comment about health care reform, or any other political issue that’s on your mind.

At some point I’ll write about whether health care activists were right to draw a line in the sand early over a public option, or whether ragbrai08 is right that it was a mistake not to organize more strongly for single-payer (HR 676). What do other Bleeding Heartland readers think?

Progressive House Democrats won't settle for health care reform without public option

A few days ago Chris Bowers reported welcome news from the progressive wing of the Democratic delegation in the U.S. House of Representatives. He posted a letter to House Speaker Nancy Pelosi from the co-chairs of the Progressive Caucus:

Dear Madam Speaker and Majority Leader,

Regarding the upcoming health care reform debate, we believe it is important for you to know that virtually the entire 77-Member Congressional Progressive Caucus (CPC) prefers a single-payer approach to healthcare reform.  Therefore, it will come as no surprise as you work to craft comprehensive health care reform legislation, that we urge the inclusion of a public plan option, at a minimum, in the final legislation.  We have polled CPC Members and a strong majority will not support legislation that does not include a public plan option that is supported on a level playing field with private health insurance plans.

We look forward to working with you to ensure inclusion of a public plan option and the successful passage of healthcare legislation that will provide a choice of  quality healthcare for all Americans


Lynn Woolsey, Co-Chair, Congressional Progressive Caucus

Raul Grijalva, Co-Chair, Congressional Progressive Caucus

Many arguments lie ahead regarding what kind of public option would be acceptable as a compromise. Like most members of the Progressive Caucus, I would prefer an option for Americans to buy into an existing government-run program such as Medicare. Presumably corporate Democrats will be pushing for no public option or at best for allowing Americans to buy into the federal employees’ health insurance plan, which is provided by various private insurers.

I am glad to see progressive leaders warn that they will not support a Massachusetts-style health care reform, with a mandate for individuals to purchase private health insurance. There must be a public option.

Congressman Dave Loebsack is the only Iowan in the House Progressive Caucus and the only Iowan among the co-sponsors of HR 676, the single-payer health care bill. I am seeking comment from his office about whether he would reject any health care reform bill that does not include a public option.

Although Congressman Bruce Braley is not a co-sponsor of HR 676, I would think that fighting for a strong public option on health insurance would be a natural position for his Populist Caucus to take. I will seek comment from his office on this matter and write a follow-up post later this week.

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Stop letting insurance companies practice medicine

Doctors go through a lengthy period of education and training before they are certified to practice medicine.

So why are insurance company bureaucrats routinely able to second-guess or overrule doctors’ orders?

Rekha Basu’s column from the Sunday Des Moines Register provides another shameful example of this common practice. Last December, Angela Ira’s 18-year-old son Nicholas, who had a history of depression, severe anxiety and borderline agoraphobia, was suicidal.

Scared and desperate, she said she persuaded him to go with her to the hospital emergency room, though he fears leaving the house. The doctor threatened to have him involuntarily committed if he didn’t agree, said Ira. She finally talked him into it. But half an hour later, the doctor returned to say the insurance company refused to pay. […]

Magellan’s clinical director, Steve Johnson, said he couldn’t discuss individual cases. But in the letter to Nicholas mailed last Dec. 10, Magellan cited as reasons for the non-authorization:

– “You do not appear to be a danger to yourself or others, and you are capable of activities of daily living.”

– “The information provided supports that other services will meet your treatment needs.”

– “You no longer have the symptoms and/or behaviors you had on admission, and you have shown progress in meeting your treatment goals.”

How could the company determine, when Nicholas’ doctor was saying he was suicidal, that he was making progress toward goals? The letter said, “If we disagreed with your provider’s clinical decision, we consulted with a licensed psychiatrist or other qualified professional and recommended an alternate service.”

As if someone who hadn’t met or spoken to the patient could better understand his needs than the doctor treating him.

Conservatives love to demagogue about “government-run health care,” but I notice that they don’t seem bothered when insurance company employees deny access to treatment recommended by the patient’s own doctor.

Basu’s column is a reminder that even Americans who have private health insurance are often forced to go without medical care they need.

Barack Obama and the Democratic Congress need to stop insurance companies from substituting their judgment for that of doctors. This needs to be part of a broader universal health care package.

The Des Moines Register’s editorial board again called for single-payer health care reform in an unsigned editorial today:

Our view: What’s needed is a government-administered health-insurance program – similar to Medicare, which covers seniors and disabled people – available to all Americans.

A single system could reduce administrative expenses associated with facilitating thousands of different private health-insurance plans in this country. It could increase leverage for negotiating lower prices. It could facilitate the expansion of electronic medical records, which would streamline paperwork and help prevent costly medical errors. It would boost the country’s economy in the long run.

Every health care delivery system has its flaws, but on balance I agree that a Canadian-style single-payer system would serve this country well. A few days ago DCblogger chided me for my “defeatism” about the prospects for enacting single-payer. I stand by my assessment, though. Even if President Obama were fully committed to “Medicare for all,” getting HR 676 through Congress would be extremely difficult. But Obama has not endorsed single-payer and is not going to put his political weight behind it, even if 93 members of Congress have co-sponsored the bill.

This is an open thread for any comments related to health care or health care reform proposals.

UPDATE: The latest from nyceve continues to make the case for single-payer, with lots of statistics on the high cost of our for-profit health insurance industry. Naughty Max Baucus: “The only thing that’s not on the table is a single-payer system.”

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