What's at stake in the U.S. health care debate?

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For obvious reasons, at Cyrano’s Journal we have given special importance to the healthcare debate.  This is the latest post in a series.

Simulpost with rabble.ca (http://www.rabble.ca)                                         July 15, 2009

The U.S. health care debate again sorts out for us the parasites and demagogues in our midst, while the despicable corporate media (how do these people get through the night?) does its best to muddy up the waters.

“I happen to be a proponent of a single payer health care program.”

Senatorial candidate, Barack Obama, speaking to the AFL-CIO in Illinois, June 30, 2003

If I were designing a system from scratch, I would probably go ahead with a single-payer system.”

Presidential candidate, Barack Obama, town hall meeting, Albuquerque, New Mexico, August 18, 2008

“The only problem is that we’re not starting from scratch.”

President Barack Obama, town hall meeting, Rio Rancho, New Mexico, May 14, 2009


AP Obama 2008THERE IS NO DOUBT THAT President Barack Obama has done some serious back-pedalling on the issue of health care reform during his journey to the White House. It’s a well-worn path trod by, among others, Hillary Clinton during the 1990s and by Ronald Reagan during the 1980s.

The wind at their backs comes from the medical, pharmaceutical, hospital and insurance industries which together have spent more than US$4.2 billion on lobbying during the last 10 years. A recent report in the Washington Post [1] says that, in the current battle against a government insurance plan, the health industry is spending $1.4 million a day lobbying key figures in the capital.

The fight over universal health care in the United States is being fought on three broad fronts reflecting three different positions: those for, those against, and those who are calling for a “private-public option” that would provide American consumers with “choice.” Canadians are probably most familiar with the divide between those on the first front who support a public, universal, national health insurance (single payer) scheme, and those on the second who are against any public involvement in the health sector.

Everybody in, nobody out

Advocates [2] of a public single payer include Dennis Kucinich and John Conyers, the latter of whom brought a bill [3] before the House of Representatives that would provide U.S. residents access to “all medically necessary care, such as primary care and prevention, prescription drugs, emergency care, and mental health services.”

The Conyers bill, taking a page out of Canada’s health care legislation, would prohibit private insurers from selling coverage for services already included in the public insurance plan. The bill, which now has 93 co-sponsors [4] (20 per cent of House members), goes significantly further than Canadian legislation in prohibiting private, for-profit facilities from participating in a national, expanded and improved Medicare scheme. The plan would be financed with existing health care funds, as well as increased taxes on the top 5 per cent of income earners, a modest tax on stock and bond transactions and payroll and self-employment taxes.

In another departure from Canada, the Conyers bill would stream Native Americans in to the national health program. Support for the single payer option outlined in the bill is coming from the United Steelworkers [5], U.S. Physicians for a National Health Plan [6], the California Nurses Association [7] and, according to polls [8] conducted between October 2003 and February 2009, between 59 per cent and 75 per cent of the American public.

Public support for single payer was also strong when Hillary Clinton attempted to introduce modest reforms to the U.S. health system. What advocates learned then is being applied now. During the past several years, advocates have raised awareness about the benefits of a national, public health program — in spite of the heavy-handed propaganda from the health industry. Between December 15 and 31, 2008, for example, more than 4200 “house parties” were held across the United States largely at the encouragement of Obama’s legion of organizers. Ironically, while Obama has jumped off the single payer bandwagon, he has inspired a groundswell of support for “everybody in/nobody out” that is not only determined but knowledgeable as well.

The second front

The people campaigning for the U.S. status quo — private, high-priced, employer-controlled health insurance — include some notable Canadians, including Brian Day [9] and David Gratzer [10], whose views we have seen reflected within the Canadian Medical Association (CMA) in recent years.

Among the significant voices opposing [11] single payer are the American Association of Retired Persons, the Business Roundtable, The Lewin Group, Families USA, PhRMA and the American Medical Association [12], which argues that services should be “provided through private markets, as they are currently.” The AMA’s Principles for Health System Reform [13] include a “robust private insurance market” and “sustainable public programs for vulnerable populations.”

That position, an echo of the one taken by the CMA nearly half a century ago, was rejected by the 1964 Royal Commission on Health Care [14]as being too costly and too short of the goal post. But the corporate media is also doing what it can to support the status quo, sweeping any discussion of single payer under the rug (a repeat performance of 1993 efforts at health care reform). A March 2009 study by Fairness & Accuracy in Reporting (FAIR) [15] found a virtual blackout in the mainstream media of any reporting about the single payer option, despite support among a large majority of Americans.

The take-forever option

The third front — those in favour of incremental progress — appears to be a tactical alliance between the health and insurance industries, on the one hand, and those with financial links to the health and insurance industries on the other. Senator Max Baucus, chair of the powerful Senate Finance Committee, is described as the Senate’s “point man” on health care reform and a leading opponent of a universal public program.

In June, the Standard [16], a leading newspaper in Baucus’ home state of Montana, reported that Baucus had received “$1,500 a day, every day, from January 2003 through 2008” from the health and insurance industries, more money than any other elected member. During the last two elections Baucus has also attracted almost $230,000 from the pharmaceutical industry, another strong opponent of a single payer system.

On June 2, Baucus announced that “everything is on the table” — everything, that is, except for single payer. “It cannot pass,” he told reporters, and could endanger any meaningful reform. During Senate Committee hearings on health care reform last month, single payer supporters showed up at a Finance Committee hearing to protest against their exclusion from hearings. They were arrested. But after hearing from angry, pro-single payer voters back home, Baucus softened his position — he has drifted to the incremental middle.

This is probably not surprising since one of the senator’s key paymasters, the insurance industry, has now decided that a pubic-private partnership might save its place in the health care pocketbook. On May 5, Karen Ignagni, head of America’s Health Insurance Plans (AHIP), announced that the lobby group had issued “a transparent call for a full-scale renovation and a complete overhaul of the existing regulatory mechanism” that governs the industry.

AHIP, representing some 1300 health insurers, has promised — not for the first time — to end its long-standing practice of claim denials, discrimination and premium-gouging. Industry observers are not holding their breath, but the “middle ground” is becoming crowded with health industry representatives, politicians on their payroll and the White House. Ironically, government funding to cover the 47 million uninsured, if channeled through subsidies to the private insurance industry, could significantly increase its revenues. What the industry does not want, however, is further government regulation. The goal of industry advocates of this so called ‘middle way’ is new public money without strings. Depending on the content of future legislation, it could be a bonanza for industry investors.

Sidelined in the entire debate is the AFL-CIO, which has remained mum on the single payer option supported by some of its affiliates. The labour movement’s key speaker on national issues, the AFL-CIO seems to have adopted the view that anything is better than nothing. Its website [17] asks “What’s Wrong with America’s Health Care?” — but clearly “everybody in/nobody out” is not one of the solutions to the myriad of problems listed.

The Federation is a member of the Health Care For America Now [18] coalition that supports a private insurance option.  At a June 25 demonstration [19] in front of the US Congress, an unidentified AFL-CIO representative argued that single payer was “a kind of thing that throws everybody off the track,” articulating fears that even modest reforms like affordable premiums and coverage for the uninsured might be sacrificed to an unobtainable goal. “We feel that health care reform is the way to go,” she said, “because something has to be done NOW!”

So what does this have to do with us who live above the 49th parallel? The answer, for better or worse is “plenty.”

The Canadian and U.S. insurance markets are almost entirely integrated, thanks in part to the North American Free Trade Agreement. A quick look at the list of members of the Canadian Life & Health Insurance Association (CLHIA) shows some important overlaps with AHIP in the United States, including Manulife (through its subsidiary, John Hancock Financial Services), Aetna, Cigna (which purchased Great-West’s US subsidiary last year for US$2B), MetLife, New York Life Insurance, Prudential, State Farm, Transamerica and Zurich.

The CLHIA’s June 2009 report contains a number of recommendations to strengthen the industry’s role in the provision of insurance, including tax and financial incentives to enable Canadians to purchase of private insurance. The industry has already secured significant subsidies for private insurance coverage amounting to $5 billion in 2004, according to health economist, Robert Evans. The industry’s submission to the post-Chaoulli consultation in Quebec cautioned the province, “It is not enough to lift the prohibition on private insurance in the sectors financed by public plans in order for private complementary insurance products to spring into existence. Privates insurance must also be allowed to provide added value.” An example of “added value” would be queue-jumping.

But more to the point, Canadian governments are staging an assault on health care at the urging and with the support of insurers, employers, private providers, the media and right wing ideologues. Since 1995, for example, when Alberta became the first province to remove outpatient physiotherapy from the pubic insurance plan, a whole section of the health sector — outpatient rehab services — was privatized and delisted, reducing patient access but boosting insurance industry profits.

That was a short 10 years, and the privatization “train” is still going full steam ahead. But, like the ever-growing number of uninsured Americans, the number of people with private benefits in Canada is also falling and, of those who are covered, high deductibles, co-pays and claim denials are the order of the day.

Whatever happens in the U.S. it will have an impact on our ability to not only protect medicare in Canada, but to expand it as well — an issue that is becoming more and more urgent.

We share a continent with Americans, and soon, if economic integration continues, we may share a health care system with them as well. It is in our interest to see Americans get what they have needed for so long: a national health system that provides universal coverage based on need, not on ability to pay.

Colleen Fuller is a health care activist with the B.C. and Canadian health coalitions. She is the author of Caring for Profit: How Corporations Are Taking Over Canada’s Health Care System (Canadian Centre for Policy Alternatives/New Star Books, 1998) and, with Diana Gibson, The Bottom Line: The Truth Behind Private Health Insurance in Canada (NuWest Press/Parkland Institute, 2006).

Source URL (retrieved on Jul 15 2009 – 7:40pm): http://www.rabble.ca/news/2009/07/whats-stake-us-health-care-debate


[1] http://www.washingtonpost.com/wp-dyn/content/article/2009/07/05/AR2009070502770.html?wprss=rss_print&sid=ST2009http://www.http://www.washingtonpost.com:80/ac2/wp-dyn?node=admin/registration/register

[2] http://www.singlepayeraction.org/blog/?p=489

[3] http://thomas.loc.gov/cgi-bin/bdquery/z?d110:HR00676:@@@D&summ2=m&

[4] http://thomas.loc.gov/cgi-bin/bdquery/z?d110:HR00676:@@@P

[5] http://therealnews.com/t/index.php?option=com_content&task=view&id=31&Itemid=74&jumival=3961

[6] http://www.pnhp.org/facts/single_payer_resources.php

[7] http://www.calnurses.org/

[8] http://www.wpasinglepayer.org/PollResults.html

[9] http://www.youtube.com/watch?v=bBzie4kq6MA

[10] http://www.youtube.com/watch?v=DII7v8yeRjs

[11] http://www.opensecrets.org/news/2009/07/health-cheat-sheet-moneyinpoli.html

[12] http://www.nytimes.com/2009/06/11/us/politics/11health.html?_r=1

[13] http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/health-system-reform/ama-hsr-principles.shtml

[14] http://www.hc-sc.gc.ca/hcs-sss/com/fed/hall-eng.php

[15] http://www.fair.org/index.php?page=3733

[16] http://www.mtstandard.com/articles/2009/06/14/state/hjjajdifjijigd.txt

[17] http://www.aflcio.org/issues/healthcare/whatswrong/

[18] http://healthcareforamericanow.org/site/content/statement_of_common_purpose

[19] http://therealnews.com/t/index.php?option=com_content&task=view&id=31&Itemid=74&jumival=3937

[20] http://www.rabble.ca/podcasts/shows/i-read-news-today-oh-boy/2009/06/will-get-fooled-again-iran-public-health-care-and-fa

[21] http://www.rabble.ca/babble/national-news/public-health-care-under-attack-bc

[22] http://www.rabble.ca/user

[23] http://www.rabble.ca/user/register



DATELINE: April 27, 2009

What’s Missing from the AFL-CIO Health Care Survey

How Corrupt is That?


The AFL-CIO recently posted a health care survey on its web site.
And in the key question (question 21) about the future of the health care system, the AFL gives you a choice.

Health care reform should let people choose to have private insurance or a public health insurance plan.


Health insurance should remain in the hands of private insurance companies.

There is no choice for single payer:

The hundreds of private health insurance companies should be replaced by a single payer.

Single payer is the choice of a majority of individual members of the AFL, a majority of Americans, a majority of doctors, nurses, health economists and small businesses.

But the AFL-CIO leaves it out.


Because the AFL doesn’t want to offend the private health insurance industry, the pharmaceutical industry, President Obama and the Democratic leadership in the House and Senate – who have taken single payer off the table.

Or as House Speaker Nancy Pelosi put it last week:

“Over and over again, we hear single payer, single payer, single payer. Well, it’s not going to be a single payer.”

Many within the AFL-CIO, including Rose Ann DeMoro, head of the California Nurses Association, and a key single payer supporter, know that the AFL is corrupt to the core.

Yet they bite their tongues.

It’s either that, or banishment.

Or if they criticize, the criticism is so mild as to go unnoticed.

Andy Coates is an MD and steward in the Public Employees Federation of the AFL.

“Everyone knows that single payer is supported by many within labor,” Coates said yesterday. “Over 500 union organizations, including 39 state AFL-CIO’s and 126 Central Labor Councils, have endorsed HR 676 (the House single payer bill) which is co-sponsored by 76 members in the House of Representatives. Recently, Vermont Senator Bernie Sanders, a friend of labor, introduced SB 703, a single payer bill, in the Senate.”

“Since a large section of unions and union members supports a single payer solution to the health care crisis, it is unfair to construct a survey that completely ignores opinions from single payer advocates,” Coates said.

It’s not only unfair, Dr. Coates.

When the majority of your membership wants single payer.

And you don’t even put it on the survey.

That’s more than unfair.

The only question remaining is:

How corrupt is that?

Russell Mokhiber is editor of Corporate Crime Reporter and founder of singlepayeraction.org

6 comments on “What's at stake in the U.S. health care debate?
  1. We should try to give Obama a chance before condemning him with the other fools. But your article on healthcare reform was indeed “right on” on everything. A single-payer system is the only fair solution but has little chance of success. Better an attack on the real problem, the monopoly held by physicians and teaching hospitals (via the AMA, et al), and the obscene charges resulting.

  2. “Giving Obama a chance” is a recipe for failure, code for doing nothing while he sells out the store from under us. If you know how and where to look it’s quite obvious that Obama is not even remotely the progressive some progressives continue to fantasize he is, and never was. Get the vaseline off of your eyes and get to work applying hard pressure on this administration FROM THE LEFT. He and the sellout Democrats do not deserve this kind of generous but in actuality bovine passivity.

  3. Hi gang! Uninformed Wingnut here, how ya doon? I hope well. Good article(s)… thanks for the simu-publish.

    The way I see it, single-payer is an attack on capitalism… right when capitalism’s reputation is very vulnerable. One of the things that will be discovered to cause hospital bills (costs) to be so high… is malpractice insurance. Single payer will/would put “plan” price-limits on things, and would cause the private insurance companies, both malpractice and consumer types… in a non-competing ballgame. They would need to cooperate. But capitalism is NOT a cooperator’s situation, its a competer’s thing (opposite?).

    In a way, the health care hassle IS one of the biggest and earliest “ramifications” of capitalism’s flaws and unworkabilities. So, it seems that the health care issue cannot be “re-solved” unless its underlying problem is addressed, and that underlying problem is capitalism. And just possibly, we’ll find that capitalism’s underlying problem is the use of economies and ownership (seeing no other living creatures on the entire planet… uses such things). And maybe there’ll come a day when we ask each other… what that pyramid scheme symbol on the back of the USA dollar… is all about.

    Maybe we’ll have to dig deep to find the root problem, and maybe health care is simply the frosting going brown… on a cake that has a completely rotten under-core…. which all started with a bad recipe, which started with a bad chef, who somehow got a bad cake idea.

  4. Wingnut is right that single-payer is a serious attack at the heart AND PRESTIGE of capitalism, the myth of its being a superior form of economic organization, hence all the resistance to its arrival. Capitalists only yield on these sensitive and highly lucrative economic areas under great pressure from the masses, and forced by a confluence of historical events. Europe in the postwar (WW2) saw its left parties (the real kind, not the social democrats like Tony Blair who later betrayed the left agenda) in the ascendancy, and the war had caused so much suffering and social unrest that the capitalists swallowed hard and granted the deep reforms in the healthcare system as a measure to keep the store alive…A similar set of circumstances is now happening right under our eyes, but there’s a critical difference in the US: there’s no left leadership or left party, or visible left media, to lead the masses out of the massive swamp of lies and confusion in which they operate. Things will have to get a lot worse before these scoundrels are finally neutralized. Incidentally, as has been said numerous times on this site, Obama himself is a mirage delaying more concrete action.

  5. Jesus Tapdancing Christ! When is somebody, ANYBODY, going to say that the federal government has ZERO — yes, you read that right — ZERO authority to legislate in this area. And anybody who would want the government to oversee health care, after seeing what they’ve done to this country already, is stupider than an ocean of s***.

  6. Tapdancing Christ, huh? hahaha! Damned dancers. It figures they’d be involved, though. The Earth is a stage… and dancers just cannot resist a stage. 🙂

    But really now, “the fed” owns all the “federal reserve notes” (money) and not a single dollar has a title of private ownership, so it cannot be owned by people. (thus no such thing as “taxpayer dollars” or “your hard-earned money”). That’s all self-foolery.

    So, the entire capitalism pyramid scheme is owned by the USA government, directly or indirectly. I’ve heard that the pyramid scheme symbol on the back of the USA dollar is actually a Columbian Freemason symbol, and thus the USA gov is located in a “District of Columbia” and not really a part of the USA. I’ve heard-of and seen the supposed Freemason owl symbol on the dollar, as well.

    So, I would think, that the USA government, being the owners/runners of the con/sham rat-racing pyramid scheme-o-servitude called the free marketeers (AmWay/AmericanWay/New World Order)… could do any damned thing they (we?) wanted to do. We could EASILY see the USA health care system turn into a monetary-discriminationless thing like the USA public library system. I think its a good idea… along with abolishing economies and ownership COMPLETELY. It might not be the BEST system, but it might be the ONLY solve… seeing the use of economies (AmWay coupons/money) is showing its inevitable ugly head.

    Wingnut – Anti-Cap/Anti-Economies

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