Guest editorial by Ernest A. Canning
Last week, in his address to a joint session of Congress, President Obama correctly noted:
We are the only advanced democracy on Earth...that allows such hardships for millions of its people….In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage...
But the problem that plagues the health care system is not just a problem of the uninsured. Those who do have insurance have never had less security and stability than they do today…More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care. It happens every day.
That was the easy part. Anyone who has paid attention understands that the core problem lies in the profit motives of the private insurance and pharmaceutical industries.
Thus, the President's diagnosis of the U.S. health care system was accurate, but did he prescribe "change we can believe in?"...
U.S. Health Care System: Corrupt, Dysfunctional, Deadly
As I observed previously, the U.S. health care system is not merely corrupt and dysfunctional but deadly. 47 million Americans have no health insurance; 18,000 die each year (according to the National Academy of Science's Institute of Medicine) simply because they cannot afford to pay for health care insurance. Countless more, as revealed by the sworn Congressional testimony of Dr. Linda Pino, replayed by Michael Moore in Sicko! and as now acknowledged by Obama, die unnecessary deaths when insurance companies come up with creative means to deny vital procedures.
These basic facts make an honest defense of the status quo virtually impossible, on all but the most base political grounds. Insurance company CEOs and their Wall Street investors can't very well claim that their obscene profits have a greater social value than the very lives of so many of our citizens, so they turn to lies (death panels) and scare tactics (government takeovers, socialism) delivered by uninformed wing-nuts --- lies and scare tactics that are amplified by the corporate-owned media which presents this tiny but obnoxiously vocal group as if it reflected the true concerns of the American public at large.
And as I noted in both an initial article and in a follow-up, the wing-nut assault on one of the oldest forms of American democracy --- the town hall meeting --- provided the ideal cover for the subtle, reportedly backroom-betrayal by Obama, Senator Max Baucus (D-MT) and the health insurance and pharmaceutical lobbyists they privately met and conferred with.
Right Diagnosis; Wrong Prescription
Appearing on Democracy Now (video below), Dr. Quentin Young, one time physician for Dr. Martin Luther King, Jr. and the national coordinator for Physicians for a National Health Program, gave Obama "an A-plus for his diagnosis. He gets a D-minus for his treatment."
Young, whom, as noted in my initial piece, "Single-Payer and the 'Democracy Deficit,'" said that his long-time personal friend, Barack Obama, had been "dishonest" on the topic of single-payer health care. He was especially troubled that Obama could acknowledge that private insurers are the problem yet come up with a solution that "enhances the insurer presence" by compelling everyone to buy insurance, with expensive subsidies flowing to the carriers --- at a cost of $900 billion over ten years, per the President.
Per the Congressional Budget Office, the cost would be $1 trillion, and 36 million Americans would still be uninsured at the end of those ten years.
Per Dr. Young, the single-payer system embodied in the H.R. 676 "Medicare for All Act", would not only provide full, universal coverage but would save $400 billion/year.
What 'Legitimate Service'?
America needs private carriers for health care like a local businessman needs the Mafia for protection.
The disconnect between the diagnosis and the prescription was demonstrated when Obama, during his speech, relied upon the congressional testimony of former CIGNA PR executive turned whistle blower, Wendell Potter.
The President said:
Just what "legitimate service" do private carriers provide? Or, as asked repeatedly by Rep. Anthony Weiner (D-NY) when he confronted former Republican Congressman Joe Scarborough on MSNBC's Morning Joe, "Why [do] we have a private plan?....What is the value? What are they providing?" The question, never answered, left Scarborough speechless.
Weiner's question squarely frames the true issue. As the President himself conceded during his address, the U.S. is the only advanced nation that "allows such hardships for millions of people." Is it coincidental that the U.S. is the only one of those countries which has a multi-payer system that places profits before people? Is it a coincidence that, while their systems vary from a Medicare-for-all like system in Canada and France to a VA-like system in the UK where the physicians are government employees, all provide publicly funded universal coverage?
As noted in "Single-Payer and the 'Democracy Deficit,'" per capita cost of health care in the U.S. is nearly double that of single-payer countries, yet the U.S. ranks 37th in health care delivery. Administrative costs in single-payer countries range from 1% to 2%. In the U.S., private carriers siphon off 31% of health care dollars.
Spurious Assault on Single-Payer Plan
During his Sept. 9 address, the President stated:
I have to say that there are arguments to be made for both approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn’t, rather than try to build an entirely new system from scratch.
This attack on a system --- single-payer --- that former Illinois State Senator Barack Obama once championed and which, during a July 22, 2009 news conference, the President conceded was the "only" system that could provide universal coverage, was both sly and disingenuous.
First, where Obama imposes an ideological label, suggesting that only the Left seeks a "single-payer" system, a Feb. 2009 New York Times/CBS News poll [PDF] revealed that 59% of all Americans favored a national health care system. Similarly, a Feb. 2009 Grove Insight Opinion Research poll [PDF] found that 60% of all Americans favor Medicare for All, the single-payer concept embodied in H.R. 676.
Either 60% of Americans are part of the ideological Left, or the President had dishonestly chosen to label "single-payer" as "Left" as a precursor to his claim that "single-payer" amounted to a "radical change."
More troubling is the slight-of-hand where Obama attempts to equate "single-payer" as an extreme solution at one end of the political spectrum as a counterweight to the hard-right proposal that would make a bad situation worse by eliminating employer-based coverage without any option to obtain publicly funded insurance.
An argument can be made for both? What possible argument could be made for what would amount to sacrificing the health and very lives of our citizens to the ideological Gods of market capitalism? We're already losing 18,000 lives/year to the current system with employer-funded coverage. How many more would die if this radical-right proposal were adopted?
Dr. Young described the President's suggestion that a single-payer system would be disruptive as "fallacious". "We have Medicare," he pointed out, "which is a highly prized benefit to seniors and people who are disabled. It was installed in one year without any problem at all."
The President's claim that replacing the current system with a single-payer system would be disruptive is contrary to everything "we know about health care finance," Dr. Young added.
The best rebuttal to the President's suggestion, that we should "build on" the current corrupt system because it employs some of our friends and neighbors, can be found in the "cash for clunkers" program. If you had a rusty, old, gas-guzzling jalopy, would it make sense to spend more than the cost for a fuel efficient new car to replace the engine, transmission, wheels, upholstery and a new paint job simply because you had that old clunker for so long?
The adjusters now employed by the insurance industry could go to work in a government run system. The only losers would be the CEOs and their Wall Street investors who would be separated from their blood money. And, by replacing the employer-based private insurance system with a government-funded single-payer system, American manufacturers would be in a better position to compete in the global market place.
'Single-payer is Not Politically Feasible'?
You hear it even from some of the most progressive members of Congress. We can't have single-payer. It's not politically feasible.
The topic was taken up by Noam Chomsky in Failed States (2007), addressing the corporate media's coverage of a Bush-Kerry debate in 2004:
The comment is interesting. A large majority of the population supports extensive government intervention...An NBC-Wall Street Journal poll found that "over 2/3 of all Americans thought the government should guarantee 'everyone' the best and most advanced health care that technology can supply'; a Washington Post-ABC News poll found that 80 percent regard universal health care as 'more important than holding down taxes'; polls reported in Business Week found that "67% of Americans think it's a good idea to guarantee health care for all U.S. citizens..." By the late 1980s, more than 70 percent of Americans "thought health care should be a constitutional guarantee," while 40 percent "thought it already was."...
The facts sometimes acknowledged, with an interesting twist. The rare allusions to public support for guaranteed health care describe the idea as lacking "political support," or "politically impossible" because of "tangled politics." These are polite ways of saying that the pharmaceutical and financial industries and other private powers are strongly opposed. The will of the public is banned from the political arena.
More recently, reflecting on the Goldman-Sachs-connected Wall Street tycoons placed in key positions inside the Obama administration, Chomsky observed that the President chose these economic advisers because "his constituency is basically the financial institutions."
One day after the President's speech last week, Obama's "constituency" revealed how it felt about ObamaCare as shares in UnitedHealth, WellPoint and CIGNA rose between one to four percent.
In "Nader was Right: Liberals are Going Nowhere with Obama," Chris Hedges observed at TruthDig:
With so many dying so as to enrich a privileged few, single-payer could well represent the moral imperative of our time.
So I leave all progressives with these questions: Do we quietly accept the conventional wisdom that a single-payer system is not feasible? Do we again cave in to the corporate sector of the Democratic Party and permit passage of a pseudo-reform that leaves us worse off than we are now? Or do we draw a line in the sand and say, "on this we will not budge. Our health, our very lives, are not commodities"? Should progressives find a way to unite and aggressively target corporate Democrats, looking to replace them with true progressives who will put people before profits, or fall back into the traditional choice of the lesser evil?
Progressives may not, at present, have the votes needed in the Senate to pass single-payer in this Congress, but they do have enough votes in the House to block a $900 billion give-away that was essentially drafted by the insurance lobby and their chief Congressional tool, Sen. Baucus. Does it make any sense to call a piece of crap "reform" and pretend that passage of a bill, any bill, is an accomplishment?
"Change we can believe in" will be realized only when the same super-majority of the American people who desire that change acquire the wisdom and the courage to collectively say "no" to the corporate, profit-driven agenda. The "democracy deficit" can only be closed when the American people see through the deceptions of the corporate media and the expensive political advertising that only corporate money can buy.
The 9/10/09 'Democracy Now!' interview with Dr. Quentin Young, one time physician for Dr. Martin Luther King, Jr. and the national coordinator for Physicians for a National Health Program, follows below...
UPDATE 09/15/09: Today, I received an email in which Rep. Dennis Kucnich (D-OH) makes the following predictions:
2. The White House will refer to the President's speech last week where he spoke favorably of the public option.
3. The Senate will kill the competitive public option in favor of non-competitive "co-ops". Senate leaders like Kent Conrad have said the votes to pass a public option were never there in the Senate.
4. The bill will come to a House-Senate Conference Committee without the public option.
5. House Democrats will be told to support the conference report on the legislation to support the President.
6. The bill will pass, not with a "public option" but with a private mandate requiring 30 million uninsured to buy private health insurance (if one doesn't already have it). If you are broke, you may get a subsidy. If you are not broke, you will get a fine if you do not purchase insurance.
Of course, when it comes to step #5, House Democrats, like Mr. Kucinich, will be in a position to choose between supporting the President and supporting the American people. Between now and step #5, the super-majority must come together and insist that if there is no public option, there is no bill.
Polls reveal that 76% of all Americans want a public option. What we need, and right soon, is a well-organized march of millions on the streets of Washington D.C.
Throughout the summer the wing-nuts, and their allies in the corporate media, have had their say. It is time for the 76% of the American people who support a public option to make their presence known. Otherwise, the Kucinich prediction will soon become a sad and deadly reality.
Ernest A. Canning has been an active member of the California state bar since 1977. Mr. Canning has received both undergraduate and graduate degrees in political science as well as a juris doctor. He is also a Vietnam vet (4th Infantry, Central Highlands 1968).