A healthcare reform for suckers

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Is the Obama Health Care Plan Really Better Than Nothing?

Editor’s Note: Most visible “liberal media assets” such as MoveOn.org, The Rachel Maddow Show, The Huffington Post, The Nation, etc., have circled the wagons around Obama as the hypocritical attacks by the right continue to convince people that his healthcare plan is really a populist assault on ingrained corporate power. In doing so, these liberals are adding further credence to the ludicrous notion that this is indeed a serious if not revolutionary plan, one being secured at great cost by a heroic and embattled president, standing tall for the interests of the “little guy”. Alas, if only part of this manufactured belief were true. As it is, all that’s being obtained by such loyalty to Obama is to add confusion to an already sufficiently murky debate, rendered intentionally obscure by the Obama team itself, which is advancing a veritable Rube Goldberg concoction capable of satisfying no one, but sure to meet the demands of his real political owners, the rich financial elites who chose him, promoted him through their media, and eventually made his election possible. A lot of suckers are born every minute in America, but the birth rate for this kind of infant sure shot up since Obama rode into town.

Created 07/22/2009 – 08:39

By Black Agenda Report managing editor Bruce A. Dixon

Candidate Barack Obama told us to judge his first term by whether he delivers quality affordable health care for all Americans, including nearly fifty million uninsured. So why does his proposal not cover the uninsured till 2013, after the next presidential election when Medicare took only 11 months to cover its first 40million seniors? Why are corporate media pretending that no opinions exist to Obama’s left? And why has the public option part of the Obama health care plan shrunk from covering 130 million to only 10 million, with 16 million left uninsured altogether?

The health care debate inside and outside the matrix

Like just about everything else, your take on the national health care debate depends on whether you’re inside or outside the matrix.

Within the bubble of fake reality blown by corporate media and bipartisan political establishment, the health care news is that the Obama Plan [1] is at last making its way through Congress. It’s being fought by greedy private insurance companies, by chambers of commerce, by Republican and some Democratic lawmakers.

Under the Obama plan, we’re told, employers will have to insure their employees or pay into a fund that does it for them. Individuals will be required under penalty of law to buy private insurance policies and for those that can’t afford it or prefer not to use a private insurer there will be something called a “public option.” This “public option, the story goes, is bitterly fought by the bad guys because it will make private insurers accountable by competing with them, forcing them to lower their costs. Both the president’s backers and opponents agree that the whole thing will be fantastically expensive, and the president proposes to fund it with cuts in existing programs like Medicaid which pay for the care of the poorest Americans and a tax on those making more than $300,000, later raised to $1 million a year.

The “public option” has that magic word “public” in it, and that’s reassuring to progressives and to most of the American people. Taxing the rich is a popular idea too. So if you rely on corporate media, the administration, or some of the so-called progressive blogs to identify the players and keep the score, it seems a pretty clear case of President Obama on the side of the angels, battling the greedy insurance companies, Republicans and blue dog Democrats to bring us universal, affordable health care.

That whole picture has about as much reality as the ones the same corporate media and most of the same politicians drew for us about Iraq, 9-11, weapons of mass destruction and some people over there who wanted us to free them. Iraq and the White House were and remain actual places, and there really is a problem called health care. But the places, problems and solutions are very different from the bubble of fake reality blown around them.

What sustains this fake reality is the diligent suppression from public space of any viewpoints, observations or proposals to Obama’s left. As long as the illusion that nobody has a better idea, that the only choice we have is Obama’s way or the Republicans’ way can be maintained, the crooked game can go on.

But bubbles are delicate things. Keeping this one intact requires so many vital topics to be avoided, so many inquiring eyes to be averted, so many fruitful conversations to be squelched that it’s hard to see how the president, the bipartisan establishment and the corporate media can pull it all off.

The real Obama Plan: doesn’t cover the uninsured till 2013, if then.

The first clue that something is deeply wrong with the Obama health care proposal is its timeline. According to a copyrighted July 21 AP story [2] by Ricardo Alfonso-Zaldivar,

President Lyndon Johnson signed the Medicare law on July 30, 1965, and 11 months later seniors were receiving coverage. But if President Barack Obama gets to sign a health care overhaul this fall, the uninsured won’t be covered until 2013 — after the next presidential election.

In fact, a timeline of the 1,000-page health care bill crafted by House Democrats shows it would take the better part of a decade — from 2010-2018 — to get all the components of the far-reaching proposal up and running.”

According to a peer reviewed 2009 study in the American Journal of Medicine, 62% of the nation’s 727,167 non-business bankruptcies [3] were triggered by unpayable medical bills in 2007. Most of these had health insurance when they fell ill or were injured, but with loopholes, exclusions, high deductibles and co-payments, or were simply dropped when they got sick. In 2008 that figure was 66% of 934,000 personal bankruptcies and in 2009 it could approach 70% of 1.1 million bankruptcies. And 18,000 Americans die each year because medical care is unaffordable or unavailable. Waiting till 2013 means millions of families will be financially ruined and tens of thousands will die unnecessarily.

Obama21health-600If the Johnson administration with no computers back in the sixties could implement Medicare for 45 million seniors in under a year, why does it take three and a half years in the 21st century to cover some, but not all, of America’s fifty million uninsured? And why does the Obama Plan make us wait till after the next presidential election? Politicians usually do popular things and run for election on the resulting wave of approval. Delaying what ought to be the good news of universal and affordable health care for all Americans till two elections down the road is a strong indication that they know the good news really ain’t all that good. And it’s not.

Inside the matrix of TV, the corporate media and on much of the internet, discussion of the Obama plan’s timeline, the human cost of another three years delay, and the comparison with Medicare’s 11 month rollout back in the days before computers are almost impossible to find. We can only wonder why.

The Obama plan is about health insurance, not health care.

As BAR has been reporting since January 2007 [4], the Obama plan is not a health care plan at all, it is a health insurance plan. Based largely upon the failed model in place in Massachusetts since 2006, the Obama plan will require employers to provide coverage or pay a special tax. Everybody not covered by an employer will be required to purchase insurance under penalty of law, in much the same manner as you’re currently required to buy car insurance.

In my state,” testified [5] Dr. Steffie Woolhandler of the Harvard Medical School last month before Congress, “beating your wife, communicating a terrorist threat and being uninsured all carry $1,000 fines.”

As in Massachusetts, the health insurance plans people are forced to buy will cost a lot and won’t cover much. In a July 20 National Journal [6] article Dr. David Himmelstein says,

Nearly every day that he is in the clinic, Himmelstein says, he sees a patient who has problems paying for care “despite this reform.’ Some of them had free care before the 2006 law took effect but are now expected to handle co-payments. If you’re not poor enough to get a subsidy, say you’re making $30,000 a year, you’re required to buy a policy that costs about $5,000 a year for the premium and has a $2,000 deductible before it pays for anything. For substantial numbers of people, it’s effectively not coverage,’ Himmelstein said. The policy he described is about the cheapest Massachusetts plan available, according to the Physicians for a National Health Program report, which Himmelstein co-wrote [7].”

A family of four making under $24,000 a year in Massachusetts gets its insurance premium free, but is still expected to cough up deductibles and co-payments and live with loopholes and exclusions that often deny care to those who need it. And in both the Massachusetts and Obama plans, funds to pay those premiums come out of the budgets of programs like Medicaid that already pay for care for the poorest Ameicans.

The Obama plan’s “public option” is a bait-and-switch scam

A July 21 pnhp.org article titled “Bait and Switch: How the Public Option Was Sold [8]” outlines how the public option is neither public, nor an option.

Public option” refers to a proposal… that Congress create an enormous “Medicare-like” program that would sell health insurance to the non-elderly in competition with the 1,000 to 1,500 health insurance companies that sell insurance today…

Hacker (its author) claimed the program, which he called “Medicare Plus” in 2001 and “Health Care for America Plan” in 2007, would enjoy the advantages that make Medicare so efficient – large size, low provider payment rates and low overhead…

Hacker predicted that his proposed public program would so closely resemble Medicare that it would be able to set its premiums far below those of other insurance companies and enroll at least half the non-elderly population.”

The White House is committed to twisting arms in the both houses of Congress and reconciling the two versions of Democratic bills to emerge from the House and Senate. What emerges will be the Obama plan. According to the Congressional Budget Office, the Senate version of the Democrats’ pending health care legislation leaves 33 million uninsured and omits the public option altogether. The House version includes a “public option” estimated to cover only 10-12 million people, a number far too small for it to create price pressure on private insurance companies, while leaving 16 or 17 million uninsured. Instead of setting prices for health care, it will be forced to pay whatever tthe private insurers already pay, and perhaps more.

As private insurers use their marketing muscle to recruit younger, healthier people who’ll pay for but not use their benefits, the public option will be a dumping ground for the customers they don’t want… the middle-aged, the poor, those with pre-existing conditions. And of course the Obama plan’s “public option’ will be managed by contractors from the private insurance industry.

Private insurers spend a third of every health care dollar on non-health related things like bonuses, denial machinery, advertising, lobbying and bad investments. Medicare spends 2 or 3% on administrative overhead. Bush’s “enhanced Medicare” administered by private insurance contractors, spends about 11% on overhead. That’s about what we should expect from the Obama public option. So much for change.

So far, discipline is holding. Nobody in corporate media, the administration, or among Democrats in Washington has gotten round to telling us that the public option has been eviscerated. But its powerful appeal and the awesome power of the word “public” are offered by Obama supporters as the central reasons to shut up, clap harder, and get behind the president on this.

Taxing the rich, paying for health care. How the Obama Plan stacks up against single payer [9].

Along with being funded by cuts in Medicaid, the Obama plan is supposed to be funded by taxing those who make $300,000 or more per year. That’s not a bad thing. The wealthy don’t pay nearly enough taxes. But the US already spends more on health care than anyplace else on the planet while leaving a greater portion of its population uninsured than anybody.

The “public option” has that magic word “public” in it, and that’s reassuring to progressives and to most of the American people. Taxing the rich is a popular idea too. So if you rely on corporate media, the administration, or some of the so-called progressive blogs to identify the players and keep the score, it seems a pretty clear case of President Obama on the side of the angels, battling the greedy insurance companies, Republicans and blue dog Democrats to bring us universal, affordable health care…That whole picture has about as much reality as the ones the same corporate media and most of the same politicians drew for us about Iraq, 9-11, weapons of mass destruction and some people over there who wanted us to free them. Iraq and the White House were and remain actual places, and there really is a problem called health care. But the places, problems and solutions are very different from the bubble of fake reality blown around them.

The Obama plan will not contain costs. It will subsidize the insurance vampires well into the next decade. On the other hand, single payer would eliminate the private insurance industry altogether. In many advanced industrial countries, most of the practices private insurers follow here, such as cherry picking healthy patients while dumping and denying sick ones, are illegal. Why can we do that?

Single payer, according to a study by the California Nurses Association [10] would eliminate 550,000 jobs in private insurance while creating 3.2 million new ones in actual health care. It would be responsible for $100 billion in wages annually and a source of immense tax revenues for local governments.

So is the Obama plan really better than nothing?

The Obama plan seems calculated to buy time for private insurers, to end the health care discussion for a decade or more without solving the health care problem, do so in a way that discredits the very idea of everybody in- nobody out health care. It will leave tens of millions uninsured, a hundred million or more underinsured, and the same parasitic private interests in charge of the American health care system that run it now.

The Obama plan as it now stands requires us to let another 18,000 die for each of the next three years and allow more than a million additional families to be bankrupted by medical expenses before we can judge whether or not the plan is working. It’s easy to imagine Obama partisans telling us in mid 2013 that it’s still too early to be sure.

The Kucinich amendment, which allows the few states wealthy enough to try it the liberty to fashion their own single payer regimes is intended to attract progressives and single payer votes in Congress without breaking the bubble. By itself, it should not be a reason to support this bill.. The wealthiest state in the union is probably California, and it’s handing out IOUs instead of salaries this month. It’s hard to see what would be lost if this health care bill went down in flames, and we started over again next year.

Can he get away with it?

Maybe. Maybe not. If the corporate media and the president can keep discussion of the devilish details to a minimum, if they can silence, co-opt and intimidate the forces to Obama’s left — if they can keep most of the public inside their bubble of fake reality, Barack Obama may achieve his goal of thwarting the reform that most of the American people want — an everybody in, nobody out single payer health care system on the model of Canada or Australia, or Medicare for All. It won’t be close, it won’t be easy, and with nothing to be gained, progressives shouldn’t make it any easier.

Since the president’s success depends mostly on keeping people silent [11] and in the dark, he will probably be unable to mobilize the 13 million phone numbers and email addresses collected during the recent presidential campaign, and now held by OFA, his campaign arm. If an organizing call went out to them, too many would try to read the bill and discuss the options, and such a discussion could easily get out of hand. When OFA called house meetings on health care last December, the most frequently advanced question was why we couldn’t or shouldn’t get a single payer health care system.

Single payer isn’t dead yet. It’s very much alive among Barack Obama’s own supporters. To succeed, he has to bury it alive, to keep them in the bubble, in the dark and quiet, or clapping so loudly they cannot hear themselves or each other think. It’s not over.

Bruce Dixon175-Black Agenda Report480x320Bruce Dixon is managing editor at BAR, and can be reached at bruce.dixon@blackagendareport.com [12]

ShareThis [13]

Source URL: http://www.blackagendareport.com/?q=content/obama-health-care-plan-really-better-nothing

[1] http://www.opencongress.org/bill/111-h3200/text
[2] http://www.google.com/hostednews/ap/article/ALeqM5hiiWnivT__38YVG-emF9zy6xVW_AD99ICP600
[3] http://www.uscourts.gov/bnkrpctystats/statistics.htm#june
[4] http://www.blackagendareport.com/?q=content/barack-obama-hypocrisy-health-care
[5] http://www.citizen.org/publications/release.cfm?ID=7676
[6] http://www.nationaljournal.com/njmagazine/cs_20090718_1479.php
[7] http://www.pnhp.org/states_flatline/State Health Reform Flatlines IJHS – 2008.pdf
[8] http://www.pnhp.org/blog/2009/07/20/bait-and-switch-how-the-“public-option”-was-sold/
[9] http://www.pnhp.org/facts/key_features_of_singlepayer.php
[10] http://www.calnurses.org/research/pdfs/ihsp_sp_economic_study_2009.pdf
[11] http://www.blackagendareport.com/?q=content/obama’s-single-payer-beat-down
[12] mailto:bruce.dixon@blackagendareport.com
[13] http://www.blackagendareport.com/?q=content/obama-health-care-plan-really-better-nothing

13 comments on “A healthcare reform for suckers
  1. Thank you ..just what I was afraid of…seriously.

    As an MSW, I have to say that the “plan” will bury the problems…

    Has anyone suggested to Pres. Obama (or Sens Warner and Webb, of Wise Co Virginia) that they attend the RAM/US (bacically a free, MASH unit style health care for un and under-insured) at Wise co, Va, Fairgrounds this wknd??
    It might open some eyes…


  2. Barack On Health Care

    If corporate interests are not nullified by advocates of the single payer healthcare plan, then true health reform will be a long time coming…Cornell West was on Democracy Now today, urging Obama to truly serve the interest of the working people.
    More and more people are becoming tired of Obamas half-assness when it comes to his policies. The grassroots are building momentum and more people seem to be willing to put Obama on blast (Onyx Powers puts out some serious Tweets under Barack_On_Blast).
    Hopefully Obama will come to realize that the people are singing a much different tune than he is, With the name of that tune being: “This is not the change we asked for”.

  3. Obama and his ilk of corrupt, corporate-beholden demagogic politicians cannot be “urged” to do the right thing. He’s smart enough to know what the right thing is in almost every case. Bourgeois politicians only understand FORCEFUL positions, whether in elections, after elections or in the streets, factories and other workplaces. The great problem we have in this nation is precisely a lack of general mobilization for authentic democracy…Brainwashed by the schools, the politicians themselves, and the fucking media, most people don’t have a clue what true democracy is like, nor what it implies.

    Mark Lawford, Boston

  4. I like this essay a lot,

    Submitted by micah pyre on Wed, 07/22/2009 – 11:52.
    I like this essay a lot, thanks very much Mr Dixon.

    I agree with NYCArtist.

    I also want to add a clarifier for those of us who want to see real changes in health care.

    It’s not enough to simply talk about “single-payer” because it’s possible to set up a single-payer system that continues to reward the intermediaries (insurance companies, HMOs, hospitals, other service providers) in the same manner our current system rewards those people.

    In other words, we haven’t helped anything if we switch to “single-payer” but those who are reimbursed by the Fed Govt continue to drive prices into the stratosphere. All that will do is further bankrupt America and further put more $$$ in the hands of those who haven’t actually earned it.

    Fundamental changes need to be made before we can have some economic parity on health care. I suggest these changes:

    1) No more intermediaries. MDs treat, MDs get paid.

    2) No more pass-through by MDs. Pass-through is how MDs reward intermediaries without the intermediaries being defined or shown to the patient. For example, Joe Smith goes to see Biff Blowhard MD and Dr Blowhard sends Joe’s blood out to the Vampire Laboratories for analysis. Dr Blowhard knows Vampire Labs charges astronomical sums for its bloodwork, well beyond what the blood analysis actually requires in the way of real work. But Dr Blowhard simply charges Joe whatever Vampire Labs charges him. Dr Blowhard doesn’t shop for a cheap, fair-priced lab — he just passes the cost onto Joe. This sort of thing must end.

    3) No more insurance. Insurance is the great price-inflator in America. Once a thing is funded at least partly by insurance, the cost for that thing begins to skyrocket because someone else is footing the bill. To keep people honest we must have direct responsibility and obligation between treating MD and patient. Insurance lets the MD charge ridiculous fees because the MD can say, “well it may be expensive, but insurance will cover it.” This is how medical care has gone so expensive in America.

    There are probably other changes that must be implemented, but these 3 are the ones that seem most needed, from my perspective. Abolition of insurance is a needed step for sure.

  5. Brilliant!

    3) No more insurance. Insurance is the great price-inflator in America. Once a thing is funded at least partly by insurance, the cost for that thing begins to skyrocket because someone else is footing the bill.
    I registered here just so I could tell you, I think you hit the nail right on the head. And for the proof of it, just look at how the cost of dental procedures tracks with the availability of dental insurance. It’s not the cost of insurance that’s the problem – it’s the insurance itself.

  6. Great. A couple of minor adds –

    I went thru personal bankruptcy due to illness in the last decade, before the new bankruptcy bill. I was too ill to continue to work the “outside” jobs that supported my art career (rent, food, etc). I had health insurance. It took me a long long time to get SSD (social security disability: folks, if you are self-employed, be sure to pay into social security – you never know…). I lived on plastic and then couldn’t keep up = bankruptcy. At that time, it was 50% of bankruptcy were due to illness. I don’t have a credit card.

    The consultant to Physicians for National Health Care Program, who teaches at Queens ollege (CUNY) said last Thurs. on Doug Henwood’s WBAI show “Behind the News” (2nd half of show), that the Public Option is MA plan going national. B. Dixon outlined it all well, but I want to add the small point the guest on Henwood’s show made: the poor in MA with the state plan still have $4000. to spend in medical expenses before they get coverage in the year – and I think he said $10,000. for the family, before the coverage “kicks” in. That’s on top of co-pay.

    Getting passage is more for politics: making Obama look “successful” if he passes a bill, even a rotten one – has been suggested by many.

    Thanks B. Dixon. I find the whole subject of the medical care bill confusing. The corporate media is making it about money, etc. Yesterday, I heard that the Congress changed the threshhold for tax on rich to now be people earning $1 million a year – up from the original figure of those earning $300,000. I recall hearing in the past that wages
    get taxed but a lot of the income of the rich is not wages.

  7. Obama couldn’t push a single payer health care bill through Congress if he wanted to. However, his failure to even entertain a serious discussion on single payer amounts to criminal malfeasance.

  8. SULPHURDUNN– Your take on this issue,

    “Obama couldn’t push a single payer health care bill through Congress if he wanted to…”

    is politically silly. It amounts to upfront defeatism and it ends up exonerating all the crooks involved in dooming this legislation. What you totally underestimate because under this corrupt capitalist regime it’s rarely tried is a presidential leadership that truly energizes the masses, truly educates them about what and who are the obstacles, etc. If Obama had the guts to do that, without consideration to his career, he could easily do it because the nation is truly starved for a real solution and someone to speak truth to the system.

    In that case, mobilizing the masses to go over the battalions of media, congressional and lobbyist crooks, he could get a bill approved with all the bells and whistles required. But that takes principle, courage, and true wisdom and Obamarama clearly has none of that.

  9. This is real simple. If this plan is so g**-damned bitchin’, then tell Congress to subject themselves to the same plan.

    Same with the vaccines. If they’re so safe, then they all need to line up and take them first, with stringent monitoring applied to make sure that they are actually taking the same vaccine, and that they take no already-provided antidote for it afterward.

    Yeah, that’ll happen, all right.

  10. P.S.: As I noted elsewhere, anybody who would want government to oversee health care, after seeing what they have done to this country in general, is an a**hole with no more brains than God gave a doorknob.

  11. Man, do Libertarians ever need a brain! Government is what you make of it, you jerk. When it’s manned by a plutocracy resting on runaway capitalism (which you assholes love), then it screws everyone and it’s a horror. Pretty much what we have today. But it doesn’t have to be. Your stupid logic is tantamount to saying by having a gun you’re guaranteed to shoot yourself in the head. A gun will obey its human conductor, and same with technology and government. These are not “disembodied” entities thinking for themselves. And cut it out Bruno with all this idiotic conspiracies about illuminati and so on. The problem here is the superrich screwing everyone else, and buying the whole f…g government.


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