May 19, 2009
Is public health care “off the table”?
Hickey: People need to be heard now before the “heart of health care reform” is lost
BONUS: The Healthcare Industry: Protectionism Free Traders Love (see bottom of this article)
COURTESY OF THE REAL NEWS NETWORK (TRNN)
Roger Hickey, Co-Director of the Campaign for America Future speaks to Paul Jay about President Obama and Sen. Max Baucus’ health care reform. Hickey says, “The real battle that the American people and everybody listening should weigh in on, is whether or not the American reform is going to include the option of a public insurance plan.”
PAUL JAY: Welcome to The Real News Network, coming to you from our studio in Washington, DC. The health-care debate about American health-care reform is fast and furious in Washington these days. We’re told single-payer health-care plan is off the table. I can’t quite figure what’s on the table. So to help us figure it out, I’m joined by Roger Hickey. Is the co-director of the Campaign for America’s Future, an advocacy group promoting progressive economic change. Thanks for joining us.
ROGER HICKEY: Good to be here.
JAY: So, as I said, in the last couple of weeks there’ve been hearings, Senator Baucus’s hearings, and single-payer people were not at the table. And we all saw the commotion is people tried to say, “Let us in.” Before we get into what’s on the table, what do you make of what happened at hearings? Why weren’t people who promoted single payer allowed at the table?
HICKEY: Well, it’s clear that in the United States Senate, at least, the Democrats have decided that reform is not going to take the shape of single-payer. And I thought it was a bad move to exclude testimony from advocates of single-payer. You could’ve had them on without taking them seriously. But it was quite remarkable that the single-payer advocates, in a very dignified way, pointed out with their bodies how the debate has ignored them.
JAY: It seems rather strange, especially when President Obama has said on many occasions, including just a few days ago at this town hall in New Mexico, that if we were starting from scratch, he says, single-payer is a better plan. But we know every country that has single-payer, nobody ever started from scratch; it had to be introduced within a market system and then introduced. So this “starting from scratch” argument doesn’t make much sense to me. So why not at least have it there for everyone to see?
HICKEY: Listen, I believe that the Congress and the president should be talking about single-payer as one of the options. And I’m not responsible for what they’re doing right now. It’s the limits of what everybody but Bernie Sanders, who’s the one socialist in the Senate, is willing to listen to and advocate at this point.
JAY: I mean, certainly there’s support in Congress. There’s a bill. There’s something like 40 representatives have signed on to it. And public opinion seems to be in favor of it. So the argument we’re hearing against single-payer even being discussed, really, is that it’s not politically feasible, which really comes down to the Senate, doesn’t it? It’s not about American public opinion; it’s about what can they get through the Senate. So what are we being told? A system, single-payer, might be better. But the Senate is either too wedded to what they are calling it free-market model, or bought, or too influenced by insurance companies, and that’s why we can’t go there. And so we have to go another way.
HICKEY: It’s clear that the American political system right now is not going to deal with single-payer. And it’s not just the Senate, although that’s the worst situation. There’s a group of members of the House of Representatives who are supportive of single-payer, but they’re a small minority. And everybody knows that when the deals get done and the bills get written, there is not going to be a pure single-payer bill on the table, or it will be on the table but off to the [inaudible]
JAY: Okay. So you’re in the midst of all this.
JAY: So what is on the table? I can’t figure it out. I listen to president candidate Obama, who said there’s a federal health-care plan, and you’re going to be able to join the federal health-care plan just like I do, and we’ll compete with the private insurance companies, which to my mind seems like a reasonable proposition, if everybody can join it as they choose. But is that actually still on the table? Because you start to dig into what Baucus is proposing, and it actually doesn’t seem like that is on the table [inaudible]
HICKEY: That’s the real battle that’s going on right now. The real battle that the American people and everybody listening should weigh in on is whether or not the American reform is going to include the option of a public insurance plan. It’s very popular. It’s a commonsense idea. It’s something that everybody who hates insurance companies wants, a backup. And that’s what’s being debated, especially in the Senate, right now: should the Senate Finance Committee include a public insurance plan, which was an idea that Obama campaigned on, in its bill?
JAY: Which is the whole reform. I mean, if they don’t have the public plan that anybody can join, the whole reform seems to be gone. Otherwise, they’re just into some regulation of some insurance companies.
HICKEY: The danger is that what we’ll end up doing is like what they did in Massachusetts: requiring everybody to buy insurance, throwing subsidies that the insurance companies for the very poor, and creating a system where we pretending to be covering everybody but we’re really not. And we are certainly not doing it in a way that challenges the prerogatives of the insurance companies in our system. So this is the debate right now. It’s not a hopeless battle of all in terms of a public insurance plan. The House is going to be very, very strong in terms of their bill that comes out of the various committees. And there’s 31 members of the US Senate, led by Sherrod Brown from Ohio and others, who have said we’re not going to support anything that doesn’t include a public insurance plan. So that’s the real interesting battle. It’s where—.
JAY: The insurance companies are saying, well, we can’t compete with that. We need a level playing field.
HICKEY: It’s ironic. I mean—.
JAY: And they’re actually asking the regulation. One of the representatives in the hearings actually said, “Oh, just regulate us so we know what we’re doing, and then everything will be fine.” But when President Obama spoke in New Mexico and he gave his principles—I can’t rhyme them off, perhaps you can, but I think “everyone has access” and a few other things like that. I didn’t hear him say one of the fundamental principles is there also has to be a public plan here.
HICKEY: He actually did say it. He [inaudible]
JAY: Is he going to put his—his—what’s it? All his political capital on the line here or not? ‘Cause it sounds like Baucus is going the other way.
HICKEY: Listen, as you know, politics is a question of power and influence, and occasionally public mobilization. If there was ever a time for public mobilization, this is the time. During this summer, the legislation is going to be written, the deals are going to be struck, and now is the time for the American people to weigh in. I am part of a coalition called Health Care for America Now, which has 1,000 civic organizations, big ones and little ones, all over the country, and we’re buttonholing members of Congress back in their districts and here in Washington to get them to pledge that they’re not going to cut the heart out of the Obama health care plan.
JAY: What do you make of the critique of Baucus, who’s leading this all in the Senate, that he—I think if—I can’t remember the numbers, but apparently he’s one of the people that, in terms of political campaign contributions, got more money than anyone else—of course, certainly not on his own. Is Obama ready to fight this? ‘Cause he seems like—I mean, I loved his Notre Dame speech. Just so everybody knows, we maybe play it again, but I’m sure it’s everywhere for you to see it. But he’s so, it seems, wanting to find common ground that if he finds too much common ground with the insurance companies, then he’s lost his health-care reform.
HICKEY: Well, listen, I went to the health summit that he did, and what I concluded is that Obama will do what he thinks is possible. And, therefore, I’m not sitting around waiting for Obama to weigh in heavily. I’m working with a network of organizations that is weighing in with Obama and with all the political system, including the US Senate, to tell them that there is strong public support. I think Obama would like to do a public insurance plan.
JAY: But he campaigned on it. It was his mandate. He promised it. This was the heart of the change he promised.
HICKEY: Listen, I think the job of politics is getting politicians to go with their promises, to keep their promises because the American people want them to do it. So we can sit here and talk about whether Obama’s going to weigh in or not. The important thing is that the American people, and organizations like organized labor and civic organizations and consumer organizations, and lots of other groups, women’s groups, weigh in and tell the president, “We support a public insurance option that guarantees high-quality health care for everybody and anybody can choose it.” That is the important battle that’s going on right now, and we’re saying that to every politician from the left to the right.
JAY: Well, the devil in all this is, to some extent, in the details. So in the next segment of our interview, let’s dig into the devil. Please join us for the next segment of our interview with Roger Hickey.
Please note that TRNN transcripts are typed from a recording of the program; The Real News Network cannot guarantee their complete accuracy.
Roger Hickey is co-director of the Campaign for America’s Future, an organization launched by 100 prominent Americans to expand the national debate about America’s economic future. The Campaign seeks to empower working Americans, middle-class families, and the poor to make their voices heard in support of a populist economic agenda and an expansion of democracy. Recently, Hickey organized and helped to lead a national coalition of citizen leaders known as Americans United to Protect Social Security.
Comments from Registered Members
Baucus is a closet republican. I would rather have a real republican in charge of this. Anyway, anyone that would joke about needing more police to silence Americans is a traitor and does not deserve to “serve” the American people.
BONUS FEATURE | Crosspost with truthout
Monday 18 May 2009
Free traders are not interested in promoting free trade in health care. (Photo: Steffan Hacker / USA TODAY)
Suppose that people in the United States paid twice as much for our cars as people in Canada, Germany, and every other wealthy country. Economists would no doubt be pointing out the enormous amount of waste in the US auto industry. They would insist that we both take advantage of the lower cost cars available elsewhere and take steps to make our own industry more efficient.
For some reason, economists do not have the same attitude towards health care. Most seem little bothered by the fact that we spend more than twice as much per person as people in other countries, with no obvious benefit in terms of health care outcomes. This lack of concern is especially striking since health care is a far larger share of the US economy than autos, comprising 17 percent of total output, as compared to about 3 percent for autos.
The excess health care spending comes to more than $1.2 trillion a year or the equivalent of more than $16,000 for a family of four. Paying too much for health care has the same economic impact as a health care tax. In effect, we have a health care waste tax that is about 10 percent larger than the projected federal revenue from the personal and corporate income tax combined. In short, this is real money.
However, the enormous waste in the US health care sector does not arouse anywhere near as much concern as items like the “buy America” provision in the stimulus package. This provision, which applies to a small fraction of the recently passed stimulus package, was the topic of a front-page article in The Washington Post. The article warned that this protectionist provision could lead to the unraveling of the world trade system.
While features of health care can make trade in health care services more difficult than trade in autos, it is possible for the barriers to be bridged. If the self-proclaimed “free traders,” who dominate the economics profession and policy debates, actually were free traders, they would be pushing hard to allow people in the United States to benefit from international trade in medical services in the same way that US consumers have benefited from low cost imports of cars and clothes.
There are several obvious paths through which the United States could gain by freer trade in health care. First, we could construct trade deals that simplify the process through which foreigners can train to meet US standards for becoming doctors, dentists, and other highly paid medical specialists.
The point would be to set up procedures through which students in countries like Mexico, China, and India could train to meet our standards, and then would have the same ability to practice in the United States as US trained doctors. This could be easily implemented and offer large gains to both countries, especially if the US paid a fee to compensate for the medical training offered to foreigners, so that two to three doctors could be trained for every one that practiced in the United States.
An even simpler route for gaining from trade would be to allow Medicare beneficiaries in the United States to buy into the much cheaper health care systems in other countries. The government could split the savings with the beneficiaries, allowing them to pocket thousands of dollars a year, while saving the government the same amount. The receiving country could even get a premium over its costs in order to give it an incentive to take part in the program.
Finally, the government could try to standardize rules around the rapidly growing industry of medical tourism. Every year, tens of thousands of patients travel to Thailand, India, and other countries to have major medical procedures performed at prices that are often less than one-tenth as much as those in the United States. The savings can easily offset the cost of travel for the patient and several family members. If facilities were regulated and clear rules established for legal liability, then more patients would be able to take advantage of the potential cost saving.
However, the free traders are not interested in promoting free trade in health care. They would rather just tell us that there is nothing that can be done about exploding health care costs in the United States. This might have something to do with the fact that the primary beneficiaries of protectionism in health care are doctors and dentists, not autoworkers and steel workers (and the drug and medical supply industry).
Economists and other self-proclaimed free traders are anxious to use trade to reduce the income of manufacturing workers; they are very happy to have protection for highly paid professionals. After all, their parents, siblings and children can be doctors and dentists. They are unlikely to be autoworkers and steelworkers.
So, we are stuck with a hopelessly bloated health care system that most of the economists and pundits say cannot be fixed. Insofar as this is a true statement, it is because they and their wealthy friends do not want it to be fixed. It really is that simple.