http://datelineojorojo.blogspot.com/2009/11/we-need-health-care-not-health.html

From Carol Miller (We Need Health Care, Not Health Insurance - Albuquerque Journal North)

1) actual coverage doesn’t even begin until 2013, opportunistically after the next presidential election, in 2012. Run on having accomplished "historic reform" but before anyone actually experiences how bad it is? How cynical is that?

2) some good provisions. The best relate to improving existing programs like the Indian Health Service, community health centers, and health professionals education and training; all are important for New Mexico.

3) institutionalizes permanent inequality in health care. … this bill further divides the U.S. system into tiers based on ability to pay. It creates basic, enhanced, premium and premium-plus plans. … The bill doesn’t even mention coverage for essential services like vision and adult dental care except in the most costly premium-plus plan.

4) Out-of-pocket costs remain sky high. Everyone will be required to pay monthly insurance premiums.

5) Almost everyone will have to meet a deductible, capped in the bill at $1,500 a year, higher than most insurance-plan deductibles today. … insurance companies can charge even more under various "cost sharing" schemes.

6) The bill puts a cap on cost sharing, but the total amount is obscene. The cap for an individual is $5,000 a year and for a family it is $10,000 before the plan must cover everything [well, health care that the plans don’t refuse to cover].

7) creates a law to let these corporations increase what they charge people as they get older. In fact, they can be charged up to twice as much as younger people for identical coverage.

8) illegal to not buy health insurance. … People on the financial edge, people fighting foreclosure to stay in their homes or people who are unemployed all or part of a year will not be able to afford the insurance premiums or the penalties for not having insurance.

9) even more paperwork, which will continue to drive up administrative costs. Right now, insurance administrative waste is about 30 percent of every health care dollar— or about $1 billion a day.

10) setting up many new agencies to oversee the whole process including, at the top, the Orwellian Health Choices Administration, headed by the Health Choices Commissioner. …. The IRS will play a very large role in everything from certifying our income for subsidies to monitoring and taxing people who don’t buy insurance.

Carol Miller concludes:

The United States can do better. We can build on a strengthened and well-funded Medicare program. In Medicare, when a person reached the age of eligibility or is determined to qualify because they have a permanent disability, they are in, and there is no re-enrollment. Imagine real reform, as simple as adding people ages 55 to 65 years old to Medicare in 2010, 35-55 in 2011, and so on until everyone is included by 2013. The bills that promote this kind of reform are under 200 pages, they are simple to implement, cost effective and equitable. Choose a doctor, choose a hospital when needed and let the government pay the bills. Everyone in one system.

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http://www.counterpunch.org/nasser11162009.html

From Alan Nasser (Solidarity, Individualism and Public Goods; Obama’s Flawed Case Against Single Payer )

1) “..we’ve got all these legacy systems in place” [Obama’s words] simply means that our system is not single payer, and we’ve had it for a long time. … we haven’t got it, so we can’t have it.

2) it would be hard to “manage the transition” [Obama’s words] from a deeply flawed system to a much better one. Harder than it was to effect the transition to Social Security, Medicare, Medicaid, desegregation, etc.? …. The US’s irrationally costly system which leaves millions uninsured … We have been given no reason to think that the cost of a transition to universal coverage is so great as to outweigh the massive benefits of this tried and tested arrangement.

3). Obama clearly means to imply that “Americans” don’t support single-payer. This is factually false. It’s improbable that Obama is unaware of the results of many surveys on this issue.

4) Obama claims that a health care plan based on “a series of choices” is superior to one that leaves no choice … This is especially pernicious since, as we shall see, it is only concerted action motivated by solidarity that can bring about a health care system from which no one is excluded because they can’t afford it.

5) “I just want to make sure every American is covered…I don’t want to wait for that perfect system…” [Obama’s words] Whatever is finally settled upon, government will neither negotiate drug prices nor regulate premiums, so we know now that millions will remain uninsured. Obama has known that all along.

Nasser concludes:

Obama rigs the game by characterizing single-payer as “that perfect system”. One of the major weapons in the party-liners’ arsenal is to portray those who believe in greater possibilities as naïve utopians blind to the truism that a “perfect world” is impossible in what William F. Buckley liked to call “this veil of tears”. The logic is fine: since there are no finite limits to the greater possibilities of goodness, and perfection is conceived, as Anselm reminds us, as that greater than which none can be conceived, it follows that perfection is impossile down here. But whoever introduced mumbo-jumbo about perfection in the first place? Isn’t the elimination of a great deal of unnecessary suffering enough? Last I recall, single-payer advocates claim merely (sic) that it is way better than what we are offered. That’s pretty good.

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http://www.commondreams.org/view/2009/11/20-3

From Katie Robbins & Andy Coates (Health Care, Essential to Democracy)

1) In mid-July Rep. Kucinich passed in the Education and Labor Committee an amendment to the House bill for health insurance reform that would make single-payer easier to enact at the state level.

On July 31st Rep. Weiner and 6 other members of Energy and Commerce Committee brought to committee an amendment to that would substitute the text of HR 676, the national single-payer bill, for the House bill. Speaker Nancy Pelosi offered a floor vote on single payer — if Rep. Weiner would withdraw the amendment from committee.

Vigorous activity ensued, a fourteen week campaign involving millions of people in phone calls, petitions, forums, local protests and vigils, emails and faxes, op-eds and letters-to-the-editor and personal visits.

And then — poof! — single payer was back off the table.

Rep. Kucinich’s state-based amendment was out of the bill, “dead as a doornail.”

And Speaker Pelosi explained that the substitute amendment couldn’t possibly have a debate and vote, for if it did, amendments to restrict health care for women and undocumented immigrant workers would also get to the floor.

Yet the next day the Speaker allowed the anti-abortion amendment to the floor, where it passed and was added to the bill. In the end, the only progressive Democrats to vote against the House bill, abortion ban and all, were Reps. Kucinich and Massa, both single-payer supporters.

2) the Democratic Party traded away fundamental women’s rights for a Massachusetts-style mandate, a law to criminalize the uninsured and subsidize unaffordable private insurance premiums with tax money, something we know already will not reduce costs and will not cover everyone, will not lessen disparities and will not improve the health of the nation. … Reproductive rights cannot be bargained away for any reason. Autonomy over our bodies is essential to health care and to democracy.

3) We call upon the President and the Congress to start from scratch and ask you to join us. Senator Bernie Sanders will introduce a single payer bill in the United States Senate in the coming weeks. Demand that your Senator vote for this bill. In addition, join the National Organization for Women, strong single-payer advocates, in organizing days of action in DC and Pennsylvania to protest the Stupak-Pitts amendment.

4) The solution to the health care crisis must provide personal freedom from a dysfunctional and unsustainable system that ties health care to the employer and to the spouse. When Medicare was enacted, it reduced poverty in those over 65 by 60%. By this measure, a universal, single-payer system would also provide economic freedom, by raising over 22 million people out of poverty, while providing each of us with full and necessary access to health care. Nothing less will do.

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http://counterpunch.org/demoro11102009.html

From Rose Ann DeMoro(Another Big Bail Out — The Truth About the House Health Care Bill)

1) the principle beneficiary is not Americans’ health, but the bottom line of the insurance industry which stands to harvest tens of billions of dollars in additional profits ordered by the federal government.

2) the House bill actually reduces public protection for a substantial segment of the population, women, with its unconscionable rollback of reproductive rights in the anti-abortion amendment.

3) commendable provisions in the House bill: Expansion of Medicaid; Reduction of the "doughnut hole" in the Medicare drug coverage law; Increased federal funding for community health programs; Additional regulation of the insurance industry — include limits on insurers ability to drop sick enrollees or refuse to sell policies to people with prior health problems, extending the age that dependent children can be on their parents’ plan, and repeal of the anti-trust exemption for insurers; Extending the same health benefit tax benefits available to married couples to domestic partners; A progressive tax to help pay the bill through a surcharge on wealthy earners and required contributions from large employers, in sharp contrast with the Senate proposal to tax health benefits on misnamed "Cadillac" plans, comprehensive coverage available to many union members, for example.

4) many shortcomings of the legislation: Healthcare will remain unaffordable for many Americans. The bill does not do nearly enough to control skyrocketing insurance, pharmaceutical, and hospital costs. Indeed, by various estimates, with no effective limits on the insurance industry’s price gouging, out-of-pocket costs for premiums, deductibles and other fees by some estimates with eat up from 15 to 19 percent of family incomes by several accounts; No meaningful reform of the rampant insurance denials of medical treatment the insurers don’t want to pay for. Little assistance for individuals and families who presently have employer-sponsored health plans and face frequent erosion of their coverage and health security. No help for the healthcare cost-shifting from employers to employees. Minimal expansion of consumer choice. The much debated public plan option will be available only to about 2 percent of people under age 65, mostly those now not covered who buy insurance on their own (it may or may not be expanded in 2015). The new limits on abortion extended to poor women. Ultimately, the combination of the mandate to buy insurance, federal subsidies to low income families to purchase private plans, failure to adequately control insurance prices or crack down on the abuse of insurance denials make the House bill — and its Senate counterpart — look a lot like a massive bailout for the private insurance industry.

DeMoro concludes:

As Rep. Dennis Kucinich said on the House floor, "we cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem."

While some people will have improved access, the final accounting will be an even firmer private insurance grip on our healthcare system, with the U.S. remaining the only industrialized nation which barters our health for private profit. Months ago, the Obama administration pre-determined this outcome by ruling out the most comprehensive, most cost effective, most humane reform, single payer, or an expanded and improved Medicare for all. Single payer proponents were shut out of White House forums, blocked from most hearings in the Senate, and single payer amendments stripped from the final House bill. Yet, through grassroots pressure, single-payer advocates forced consideration by the House of an improved Medicare for all until the very end.