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Universal Health Care - Still Not Possible in US


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May 12, 2007
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Niagara Region
The US Senate is finally conducting hearings and meetings about how to bring together a so-called 'universal' health delivery system.

BUT, on its very first day Washington (as usual) excluded all single-payer voices from the debate. They were removed by police under direction of the Democratic committee chairperson, Max Baucus, and all the other committee members supported the move.

Video of the start of the proceedings where single-payer voices were removed:

If all they are going to include are corporate insurance voices, corporate america, and other politicians, my disdain for the Obama administration and the new, stronger Democratic majorities in both houses of Congress are not without reason: It doesn't matter whether Republicans or Democrats are in charge, Washington is bought and sold to the highest corporate bidder and all over voices are consistently shut out.

Watch it for yourselves. Obama may be helping the US's image abroad, but the Democratic party is up to the same old tricks on domestic policy that have plagued America for decades.

The US really hasn't changed... These meetings are the first serious meetings on health care since Bill Clinton's efforts in 1993 and the first since Richard Nixon's creation of the HMO-PPO-POS-network insurance systems in the early 1970's that have plagued America ever since.
^The reason why they were so upset is because all of the people allowed to debate on the panel were corporate insurance executives, private industry executives concerned only with their health care benefit costs, selected doctors from groups that don't support single payer, think tanks that don't support single payer, etc.

Max Baucus, the Democratic chairman, basically mumbled and fumbled because he knew he had excluded these voices, and basically said he respects the view despite it not being considered.

He was backed up by John Kerry and one Republican Chuck Grassley from Iowa, all of which are lame idiots regardless of party affiliation.

When the only party that would potentially include single payer voices refuses to do so, you can bet private insurance corporations will be running this new 'health care system' when this reform bill is passed.

And Obama isn't going to stand up and show leadership on this, I'm sure of it.

This is the reason I wished Hillary would have had a chance, I think she might have been able to work the Senate better than this.

Another hearing that was held includes the new HHS Secretary Kathleen Sebelius.

In the video on this c-span clip, if you fast forward to 1min 35secs and listen to Charlie Rangel speak, he quotes as saying "how we achieve near universal health care" coming from a so-called 'liberal' New York urban Democrat. He also opens earlier on by saying "access to affordable health insurance" and makes no mention of guaranteed insurance.

So urban Democrats from New York and rural Democrats from Montana agree: we won't be getting universal health insurance anytime soon. Obama is nowhere to be found to lead on this issue.

Despite the fact that Canada is lead by Stephen Harper, even Harper has no power to remove the universal health system, yet when the largest, strongest Democratic majority occurs in a generation south of the border the debate starts out THIS way.

There's still a reason to be proud to be Canadian guys. Harper, or not. ;)
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Given the huge business interest in healthcare in the United States, moving toward single payer healthcare is incredibly difficult politically right now. It'd be similar to Canada attempting to nationalize the oil industry - there's a huge business voice out there that would scream bloody murder.

The smart thing to do politically IS to look at a phased-in approach, unfortunately. Hillary made an attempt to push straight through to universal health care in the past, and it failed.
Democrats have the first fillibuster proof majority in Congress in many, many decades. I don't think now is a time to give up and do the second option. They are talking about making it more affordable, not guaranteeing coverage.

This is one of my number one domestic issues in the US, I just think its sad. I already saw this coming last year which is why I was just unmoved by the election last fall.

The exact same debate would have occurred if McCain were president right now... It literally makes no difference.
^^Btw, I am a little soap boxy on this issue, so bear with me.

But the type of plan Obama has proposed as a 'public option' that Sebelius, the Health Secretary is proposing on his behalf in Congress, is not guaranteed coverage.

The public health plan will have pay schedules with monthly premiums and co-pays just like a private plan. It does not fully insure the person buying the plan.

The Obama plan essentially means you will pay a premium to the government, based on need, and the government can pay a certain amount with more general guarantee than a private plan that tends to reject most individual claims.

US Medicare doesn't even run that way. The 'public option' Obama has proposed is essentially a public premium and public copay option instead of guaranteed full coverage, and the plan can still reject items if the government doesn't want to pay.

I just can't believe what i'm reading, I didn't even realize it was this bad last year during the campaign.

This isn't a phased approach, its a total sellout so the government doesn't become 'too competitive' and put the private insurance industry out of business.
Sick as this may sound, the only way the U.S. would adopt universal health care presently would be if the flu going around was an actual pandemic like 1918. It would be a crushing blow to the health insurers and private hospitals - both of whom would likely have to run to the government to avoid the crushing debt loads.
Regarding the removal of the protester: this is more of an order issue. When someone starts shouting at a Congressional hearing, whether he's a Dem or Rep, is the committee chair supposed to sit back and let the protester keep shouting? Or perhaps he should go ahead and invite the protester to sit down and join in the discussion? (that's a rhetorical question; if your answer is "yes", well then good for you)

The goal of these hearings, to a large extent, is to bargain with the Reps and the industry lobbies. Of course Obama and the Dems know that their most progressive base wants single-payer universal health coverage. What they need to do is to manoeuvre and bargain with the parties whose interests are most affected and who will lash back most strongly, to force them to make concessions while making the necessary compromises. It is a form of appeasement, and also a form of consensus-building, and as such, there is little point, at least on the first days of the hearings, to bring in supporters and simply preach to the choir. Which brings me to my third point.

In the US congressional system, there is little party discipline to speak of. There is very little "leadership" that Obama can really show on contentious issues like this other than trying to convince even his own party to support his plans. The two US parties are not monolithic blocks that can be whipped to unquestioningly support their "party position" if there ever is one, and the Dems are certainly not prevasively left-wing. A significant number of them are as right-wing as moderate Canadian Tories, and at the end of the day, in a weak-discipline system, the loyalty of the congresspeople are to their electorate. And the trouble is that the American people are overall a much more libertarian and right-leaning population than Canadians, and while a fraction of the truly left-wing progressives and social democrats would undoubtedly support a universal system, there is no guarantee that the ever-malleable general American populace would not be easily swayed by the smearing by the Reps and the industry lobbies. The Dems learned a very tough lesson from the Clintons' failed attempt at reforming healthcare, when their own party rebelled (less of a concern this time around because the conservative Dem faction is much smaller this time) and the electorate threw them out the window in the next election. Even in this past presidential election, nearly half the country went for the Rep ticket, so Obama still has to tread very treacherous waters. There is no indication that Hillary would have any more success than Obama might be able to do (afterall the process is just starting, who can say right now what the outcome will be?); if anything, given the Clintons' past record, the backlash and the Dem mutiny might be even more serious than otherwise.

What Obama is trying to push through right now is a compromise plan that will try not to immediately invite a complete industry backlash yet be able to bring coverage up to universality as much as possible. When I was at a lecture two months ago by Paul Krugman (who also happens to be a strong supporter of single-payer universal healthcare but is a realist who knows that will not happen right now), he outlined that the Dems/Obama's optimal plan will include a private component, a public option, a community rating system (where insurance companies will not be able to charge and cover selectively), and one other thing I can't remember off the top of my head now. The hope is that while going to be much less efficient than single-payer and still costing more than it could have been, at least it will be able to achieve the same effect and bring about universality. But even this is already causing severe backlash from the Reps and industry, so one can imagine what will happen if a single-payer system is suggested outright: half the Dem caucus will revolt and America will end up with nothing. Krugman also mentioned that an advantage that Obama may have right now over the Clintons' times is that the economy is really bad and the demand for public healthcare is strong among the grassroots; but now that "glimmers of hope" are starting to appear in the economy, this advantage may not last long and thing will be even more bleak then.

Obama is doing what he can to bring in universality to healthcare as much as possible, but if the hard left is disappointed that Obama isn't a god who can whip the entire Dem caucus into shape and miraculously make every good thing happen, well perhaps they should not have expected him to be a god in the first place.


Hydrogen: Actually I doubt even if the flu becomes really bad that universal healthcare could happen easily. Given that one of parties hit worst by a universal system are the pharmas and medical tech industry, it's not hard to imagine them working together with the insurance companies and private hospitals in the pandemic to ensure each other's survival and put off public healthcare in order to assure their mutual benefits.
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"A significant number of them are as right-wing as moderate Canadian Tories, and at the end of the day, in a weak-discipline system, the loyalty of the congresspeople are to their electorate."

Perhaps on high profile, hot-button issues. The rest of the time they are bought and paid for by campaign contributors.

The massive scale of American union and corporate contributions to political campaigns is a cancer on American democracy. Perhaps a policy like we have here in Canada would help, banning union and corporate donations and capping individual donations at $1000.
Health care is an issue I have known at length for some time, and none of the things and none of the excuses work for me anymore.

Max Baucus, Finance Committee Chair, is a Democrat. Charlie Rangel is a Democrat and chair of the House Ways and Means Committee. Both represent the wide variety from rural more conservative to urban and more liberal. None of Rangel's constituents would give him heat for bringing single payer just to the table for debate.

There is a clear difference between negotiating a balanced approach and completely selling out. Obama has shown very little leadership on this issue, he basically has delegated all the powers and will let the people below him fight it out because he's not willing to risk his political capital. Ironically Obama is very much like Bush on this issue, and how Bush handled the Medicare bill, Obama just wants to SIGN SOMETHING to look good politically, as if he's achieved something massive, something great, something visionary. But as of yet, Obama hasn't put his toe in the water and called these members of Congress up to kick them in the political teeth.

I know all the arguments put forth about this, but its time to consolidate Medicare, Medicaid, and CHIP, and etc. and just create a government option for everyone, and if you can afford private insurance keep it on the table.

Here's the problem with the lame Kerry types and Baucus types.. They say they want universal care during elections and off-seasons, but when push comes to shove they leave entire platforms out of the debate, and in their condescending tones (did anyone notice how much Baucus was laughing at them) they just get rid of them.

These are hippie protestors, they are doctors and lawyers, educated people from some of the best institutions in America. They spoke up BECAUSE they were left out after SPECIFIC requests to be included in these discussions.

Every one of those people at the table were HMO/PPO/POS execs, industry trade execs, and etc.

The Democrats cannot lead by cedeing the debate before it starts, and I have become fed up with the issue here.

The kind of 'government option' that Obama has proposed does not guarantee coverage. It will likely try and 'compete' with the private market by rejecting some coverage and still requires a hefty premium for everyone. Even worse is that the plan that Obama proposes isn't ran through Medicare. Its an entirely new program. Details yet to be decided, and I hope they change it before it becomes set in stone. There's something odd about paying a Medicare FICA tax and then having to pay the government another premium for a plan that can still reject care because they are trying to make the plan compete with the private market.

And on discipline of parties, I have long discussed about how the US is a non-responsible party system. I first had a class in college in 2002 and had a professor that specifically outlined a section of our textbook that discussed how Parliamentary systems have responsible party systems; whereas, US Congressional party members do whatever they want, and in modern day it usually means selling out to campaign donors - not supporting grassroots opinion most the time.

As far as my distrust of Obama on this issue, its simply the fact that he never invested interest or energy into promoting true universal health care. He didn't lie about it, every debate held last year he would wrap his words in the same condescending nonsense that even Republicans use: "We want everyone covered" and then he would mumble about bringing people together and creating affordable insurance accessible to all, not guaranteed access to health care.

Hillary may not have been any better, but I wanted her to have the chance to lead on this issue. Again, this was my number one domestic concern (or close to it) last year and has been for some time.

All of my disappointments of Obama have come true in regards to a lot of domestic policy.
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And Gol, I don't know what you think all single-payer advocates are, but many of us happen to be very educated and have observed over many years what it would take to create a true government option and keep private options available.

In my opinion, I think a better way toward universal coverage is to bring a consolidated single-payer option forward AND also bring the insurance industry to the table and let them know we won't be outlawing private insurance like Canada has done (at least for services provided under the public plan, obviously you have to buy private coverage if you visit Canada or for services the public plan doesn't offer).

We already have a single-payer program in the name of Medicare, but Medicare has the right to reject coverage unlike the Canadian system where the Health Canada Act forbids any public program to deny care.

This needs to be stopped, Americans need a plan that does not have the ability to deny payment for medically necessary procedures - government or otherwise - and that would be an unnegotiable change that needs to take place.

I'm not sure many people in here, since its a Canadian forum, understands that millions of Americans WITH INSURANCE get claim denials on a regular basis. ESPECIALLY for people with individual insurance plans that isn't backed by an employer or a government plan.

"Universal coverage" in the US, if the law isnt' changed so that insurers cannot discriminate and deny coverage, is meaningless if the coverage people end up purchasing won't pay up after the doctor visit.

There are too many loopholes, side issues, and too many problems to deal with from that vantage point.

This is why these professionals spoke up at the meeting, they just wanted to be included at the table.

Single payer in AMERICA does not have to exclude people from buying private insurance services, I think all of us on the single payer side concede that. Of course we need to coddle the insurance executive side because their entire industry stands to lose a lot if we don't negotiate.

I don't even agree that the US should outlaw private coverage for what the public plan offers like in Canada, every single payer advocate I know concedes this and is more than willing to negotiate on a public option plan.

BUT the true public option should at least be in the debate.

Make all the typical arguments you want to speak out for Obama, but this isn't a high point for him or his administration. Congress has excluded the people and is listening only to insurance industry executives and other industry specialists who are interested in saving corporate money... Not people's health.

So goes the debate in America... No matter the political party.
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And Gol, I don't know what you think all single-payer advocates are, but many of us happen to be very educated and have observed over many years what it would take to create a true government option and keep private options available.
Just to let you know, I am fully in support of a single-payer universal coverage if it is feasible; if anything, I am even more in support of an NHS-type fully socialized medicine program if it's at all possible (but obviously not in the US or even Canada at this stage). I am merely pointing out what I perceive to be the considerations that are in the minds of the Obama people, before resorting to conspiracy theories about how they are excluding people and putting up a show for politics' sake. I am not emotionally invested in American politics or domestic issues and I do not personally support either Obama or Clinton or anyone else.

And I certainly know the level of education of single-payer advocates. I walk and work everyday among scientists and doctors and academics who are such advocates.
Regarding the removal of the protester: this is more of an order issue. When someone starts shouting at a Congressional hearing, whether he's a Dem or Rep, is the committee chair supposed to sit back and let the protester keep shouting? Or perhaps he should go ahead and invite the protester to sit down and join in the discussion? (that's a rhetorical question; if your answer is "yes", well then good for you)

I generally agree with you, but if these doctors and professionals would not have spoken up, do you think the public would have realized that after months of planning and sending requests they were denied a seat at the table?

Do you realize these people waited to see who was seated, after their requests of being seated at the table, and came to the meeting to voice their protest for a genuine cause and purpose?

These aren't random protestors, Dr. Margaret Flowers is the state head of a group that represents 16,000 doctors for example. She is the one interviewed with Ed Schultz.

While I generally agree that mindless protest sometimes hurts the cause more than it helps, this isn't just an insignificant voice. They used Congressional procedures to apply to be at this hearing, they were denied, and these professionals went to the meeting after realizing that single payer would be entirely excluded from the debate.

Ed stated it best: she was educated at Georgetown and John's Hopkins and UofMaryland.

This is the reality. The Democratic party is denying these voices in favor of what, exactly?? To be inclusive and consider all opinions doesn't mean leaving important voices out.
Gol, my anger is at the Democratic party and not you. I just don't buy any of the arguments anymore.

I have the right to bitch all night and all day, because I wasted my vote on Obama last fall after negotiating it away from Ralph Nader (I was already upset at the system, as people on here remember).

My vote for Obama was just as much of a 'waste' as my vote for Nader could have been.