“Not Health, Not Care, Not Reform”

Ed. Note: The writer of this post volunteered for about a half-dozen Organizing for America phone banks to ask voters to call their senators to press for a public option.

The Senate Democrats’ over-compromised health reform legislation should be killed, and efforts should turn now to a reconciliation process by which only 51 votes would be needed. Take the best elements still remaining—the health insurance exchange idea, and funding for prevention and wellness and for community health care centers—and add in universal access to Medicare, and put it up for a vote through reconciliation. You can keep your present policy if you like it, but you’d have the option of going with Medicare whether you’re 22 or 64. (We concede that 51 votes may not be attainable, but chances are good, especially if, for a change, the president will seriously push for it.)

Dr DeanThe reconciliation route is a strategy that the good doctor and health reform leader Gov. Howard Dean has been recommending for months and is pressing for now with renewed vigor—and freaking out the Obama White House and Senate Democratic leadership. (Dean is not saying give up: see his op-ed in the Washington Post here.) The reconciliation process may sound arcane, but as a rule-abiding way of bypassing Senate filibusters it has been used almost 30 times since 1980, including for budget- and health-care related legislation such as COBRA for health-care insurance portability, expanded eligibility for Medicaid, and the state Children’s Health Insurance Program (better known as S-CHIP). It was also used by congressional Republicans to pass the 2001 and 2003 Bush tax cuts that mainly benefited the upper-income tax brackets. It is time to use it again . . . for the public good.

“To end up with a bill like this as your once in a generation liberal accomplishment is about as inspiring as a Bobby Jindal speech.”

Digby, “The Best We Can Do” in Hullabaloo

We are more than grateful for the hard work of senators Jay Rockefeller, Chuck Schumer, Ron Wyden, and others (not to omit Anthony Weiner and others in the House), and we appreciate (tho’ we don’t entirely agree with) the efforts of Senate Majority Leader Harry Reid, but the health care reform legislation in its present state is now too compromised and degraded, a giveaway to the health insurance industry. They are already drinking the victory champagne. We don’t just blame the despicable Joe Lieberman—the responsibility for the Democrats’ fix starts at the highest level of the party.

“A kind of Chicago stockyards of insurance”

But first, the faults of the present legislation are that (1) there is no public option—already a compromise from the best and simplest idea: universal coverage with a single-payer system, preferably through universal access to the already existing, popular, and fairly efficient Medicare program; (2) the expansion of Medicare eligibility to those 55 and over was dropped; and (3) there is an individual mandate that requires the purchase of insurance from the very insurance firms that have driven us into the present crisis in the first place. Senate Democrats boast that “we would be covering 30 million people now without healthcare”—but that’s compulsory enrollment in private plans that have no cost controls. The government would have no control over how much you have to pay for coverage. (As Keith Olbermann said in a special comment Dec. 16, “The bill now is little more than a legally mandated delivery of the middle class . . . into a kind of Chicago stockyards of insurance.”) If you don’t buy insurance from these corporations you’ll be subject to a fine. Ready for that? You’ve got the extra money lying around, right? This individual mandate, by the way, is a requirement that Obama campaigned against (when Hillary Clinton supported it; see video below). This element of the legislation would cause already epidemic health care–related bankruptcies to soar. Further, although Democrats say that insurance companies won’t be able to turn you down for pre-existing conditions, they will be able to jack up your rates and can charge older people 300% of the premiums charged to younger customers. This is an improvement?

The American insurance cartel is the “death panel,” and this Senate bill does nothing to destroy it, nor even to satiate it. It merely decrees that our underprivileged, our sick, our elderly, our middle class, can be fed into it as human sacrifices to the great maw of corporate voraciousness at a profit-per-victim of 10 cents on the dollar instead of the current 20. . . .

The mandate in this bill under which we are required to buy insurance must be stripped out. The bill now is little more than a legally mandated delivery of the middle class—and those whose dreams of joining it slip ever further away—into a kind of Chicago stockyards of insurance.

—Keith Olbermann, “Special Comment,” Dec. 16, 2009

The mandate, says Democracy for America, is “a ticking time bomb” that will not only hurt consumers, but will harm Democrats at the polls for years to come. “The mandate is toxic, and Democrats will own it.” Every time policyholders’ rates go up, they’ll think of Democrats. As Digby (quoted above) points out, “it actually looks like the worst caricature of liberals: taking people’s money against their will, saying it’s for their own good.” We do not want Democrats to suffer electoral defeats as a result of rushing into passing a bill that could have been less bad.

The White House and the Democratic leadership just want a bill, any bill, that they can sign in a ceremony and whose best parts they can sell to the public between now and next November’s midterm elections (rather as the Republican leadership in 2003 wanted the giveaway Medicare Modernization Act that did not allow the U.S. government to negotiate for lower drug costs, locked in overly generous payments to drug companies, and added some $1.8 billion to the federal deficit in 2004–2005 alone).

Obama’s Not Happy? Too Bad.

Although we’ve been told repeatedly that health care reform was Obama’s #1 domestic legislative priority, the president has been somewhere between intermittently involved in and AWOL from this struggle throughout the process. Maybe he was trying to keep his fingerprints off the plan so that he would not be blamed if it turned sour, but the strategy has not worked out well. (Wisconsin Sen. Russ Feingold, however, says, “This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth.”) But what a difference Obama could have made. He appeared at some town halls in the summer, he gave a fine-sounding speech in early September (which we naively hoped was the start of a vigorous presidential push). But from early on he did not push for a single-payer system, he tried to placate the medical and insurance industry (don’t be scared, we won’t do anything radical); he and his team made sweet deals with Big Pharma and Insurance and concessions to win GOP support; and when Harry Reid told him in October that he would be including a public option in the final Senate bill, the president’s response was muted.

Newsweek’s Howard Fineman tells Keith Olbermann on MSNBC that from the very beginning, the White House has been ambivalent about the public option. From early on, Rahm Emanuel and other top administration officials were telling “anybody who would listen” that the public option was not essential to the final reform bill—even though the president had campaigned on the idea. The public option was very popular among progressives and others who voted for Obama and campaigned for him, including many, many union members. Further, Organizing for America, an outgrowth of the Obama campaign, was assembling teams of phone banks all across America to call people in states whose senators were in doubt and urge them to call their senators and ask for a “strong public option.” That was the term on all the scripts. A strong public option. But if the White House was ambivalent about the idea, then who was in charge? Why were OFA volunteers told to press for something the president was ambivalent about? With the president’s commitment less and less certain, many of us began peeling away from the effort. As we wrote to Obama in November, “Many of us have this uneasy feeling that the captain is not onboard the ship.”

But wait, there’s more: Even though the late Senator Kennedy’s HELP Committee passed a health care reform bill in July, there was little White House or media attention to it. The HELP Committee’s Affordable Health Choices Act included a strong public option, expanded coverage to about 97 percent of Americans, prohibited discrimination based on “pre-existing conditions,” and was estimated by the Congressional Budget Office to cost less than $615 billion over 10 years (or about $1.3 trillion including subsidies to the poor). It was strongly endorsed by Nobel Prize–winning economist Paul Krugman. But, inexplicably, all the White House’s support and the media’s cameras were focused on Max Baucus’s conservative Finance Committee, in which a “bipartisan Gang of Six” dawdled for weeks in private meetings that excluded senators Rockefeller, Schumer, Wyden, Kerry, and Cantwell, but included three Republicans who flatly opposed any reform at all. The president supported this. Isn’t it logical that the health committee should be the primary architect? Obama didn’t see it that way. Now look what he’s got.

The president warns that if the current legislation is not passed—by Christmas Eve!—the nation will (eventually) go bankrupt. These are the same scare tactics used last fall to frighten Congress and the public into accepting the $700 billion Wall Street bailout. How well has that worked out? The president still can’t get the big banks to open up their lines of credit so that companies can borrow, rebuild, and go back to hiring—he couldn’t even get three of the top bank CEOs to show up for a meeting at the White House on Monday (they phoned in; planes were delayed by fog).

Not Giving Up

But we are not stuck here, and we haven’t given up (even though we’re tired like everyone else who’s been working and thinking hard about this issue for the past year). We’re pressing the Senate leadership and the White House to support a redirection of energies (those not yet exhausted) toward a reconciliation process that can pass with 51 votes for a bill that includes the best of the present Senate bill and add an expansion of Medicare—a simple remedy that will not involve setting up a new government program; not-for-profit Medicare has only about 1% overhead (administrative) costs, and no big CEO salaries and advertising budgets. This can be done. This is not giving up: it’s getting back to a more sensible approach that should have been pursued in the first place.