The End of Healthcare History? Let's Hope Not



There’s no doubt that mainstream liberals will gush over last night's speech by President Obama to the joint session of Congress.

But any progressive or socialist should find Obama’s speech, and his overall healthcare reform effort, as just another entry in a long list of political disasters (i.e. Afghanistan, Iraq, “don’t ask-don’t tell,” cap and trade, EFCA, etc.) that will screw the majority of people while handing over billions of dollars to private enterprise.

His speech offered little new insight on his ideas for healthcare, other than the usual list he’s been touting for months:

1. Individual mandates, which would place financial penalties on those who go without insurance for any reason

Only the most deluded of minds could go on about the horrors of private insurance (“One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it.”), then require everyone to sign up for their dismal policies in the same breath.

2. Employer mandates for large businesses that don’t provide insurance for their employees

Matt Taibbi of Rolling Stone puts it best:

“A good idea — except that the Blue Dogs managed to exempt employers with annual payrolls below $500,000, meaning that 87 percent of all businesses will be allowed to opt out of the best and toughest reform measure left. Thanks to Harry Reid, Nancy Pelosi and Barack Obama, we can now be assured that the 19 or 20 employers in America with payrolls above $500,000 who do not already provide insurance will be required to offer good solid health coverage. Hurray!”

3. An insurance exchange where consumers can choose from a variety of insurance “products”

According to Physicians for a National Health Program:

“There are no good examples yet of successful exchanges. California has 15 years’ experience with an exchange, and it has been a failure. A July 2009 Issue Brief by the California HealthCare Foundation details its problems and demise. It was initially intended to ‘provide an easy to navigate single point of entry where people could go to choose among several health plans, reduce the cost of coverage (using three primary mechanisms: reduce administrative costs by achieving economies of scale, command lower prices, and foster market competition), and enhance portability of coverage.’ None of those objectives were achieved.”

4. Tax credits (subsidies) for the poor

As anyone in Massachusetts will tell you, individual mandates combined with subsidies hardly provides universal coverage, or even comes close to reducing costs. In fact, they’ve proven to benefit the wealthy more than anyone else.

5. Ending “pre-existing condition” clauses in private insurance

In order to get this deal with private insurers, Obama needed to include the individual mandate. So, while ending pre-existing conditions is a good thing, insurers will not vow to end rescissions (denying care to the sick).

6. A watered-down, “not-totally-necessary,” “public option.”

There is a ton of speculation about Obama’s support for the “public option,” and whether he would drop it and concede to the right-wing lie that it would be a government take-over.

But, under Obama’s vision, it was never that great to begin with. At its best, the “public option” will cover only 10 million Americans, it doesn’t include vision, dental, or long-term care, and it doesn’t kick in until 2014, when insurance premiums will have increased by almost 50 percent.

Also, Obama clearly lies about it being a choice. If your employer offers you an acceptable plan, and you don’t like it, you’re not eligible to join the exchange and choose the public option. As Bernie Sanders put it, "If you have coverage you like, you can keep it. But if you have coverage you don't like, you gotta keep it."

Besides, what’s the point of a “public option” that isn’t financed by tax dollars, and “competes on a level playing-field with private insurance”? It’s only adding another bureaucracy into the insurance market with over 1,300 players. With 30 cents of every healthcare dollar already going to paperwork and executive salaries, another plan added to the mix doesn’t do anything to grasp the potential overhead savings.

The "public option" is not really public, nor would it even be an option for the vast majority of the population.

So instead of saving $400 billion a year, like single-payer would, we’re going to spend and additional $900 billion over ten years, and cut "wasteful spending" in Medicare and Medicaid.

And that’s the biggest problem with this reform. It relies on the undying, zombie-like dream of market competition to reduce costs. The market has failed us for over forty years. It’s left 47 million people uninsured, 30 million under-insured, and has done nothing - nothing - to reduce costs. Premiums have doubled in the past nine years, and they’re likely to outgrow household income by 2025.

Watching Obama tout the free market to reduce costs for 45 minutes was an exercise in torture. He essentially spent the better portion of the speech making Nixon’s debunked argument for private health insurance competition and lauding America's "rugged individualism." For someone running on change, this should be a major embarrassment.

Instead of embracing the left, he kicked us in the teeth, and caved to the right’s biggest fears when he proudly proclaimed that “no federal dollars will be used to fund abortions,” and that “the reforms I’m proposing would not apply to those who are here illegally.”

Apparently “that large-heartedness – that concern and regard for the plight of others” of America does not extend to women and immigrants. When Obama said, “I am not the first President to take up this cause, but I am determined to be the last,” I couldn’t believe my ears. Leaving millions of people uninsured, under-insured, and tied to a private corporation with nothing but a profit-motive is the final goal?

This is not the “end of history” for healthcare reform. We must continue to push for single-payer healthcare because it’s the only plan that would provide universal, comprehensive coverage and a reduced cost for all American residents.

For now, we can support Rep. Anthony Weiner’s (D-NY) amendment to HR 3200 that would essentially open Medicare to everyone. We can support Rep. Dennis Kucinich’s (D-OH) amendment that would allow states to pass single-payer legislation. And we can support Sen. Bernie Sanders's (I-VT) single-payer bill (S. 703) in the Senate.

Jeff Muckensturm is Web Coordinator and grant writer for Healthcare-NOW!, an organization fighting for a national, single-payer healthcare system

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