Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review has been on the web since 1995. See main page for full contents

August 15, 2009


Sam Smith, Progressive Review - The health care debate has come down to a struggle between greed and hypocrisy. The Republicans see health as a prerogative of wealth while the Democrats want just about anything they can call reform in the next election and have sold themselves to the insurance companies in the process. The public is clearly left out in this discussion.

Further, the Democrats are hurting themselves even more than usual. They don't understand, for example, that when they label as Nazis their opponents at fake town hall meetings, many other ordinary citizens with doubts about the Obama approach may take that personally. And when they stiff single payer, they are all but shoving progressives out the door.

And some of it doesn't have to do with healthcare. One of the town hall protesters, when interviewed later, seemed mainly concerned about the soaring number of "czars" in the Obama administration. There was a time when Democrats wouldn't think of calling one of their appointees a czar.

At the same time, there is the quality that Neal Cavuto nailed, namely that Obama is approaching this matter like a used car salesman - don't worry about the specifics of the deal, just get the customer to buy into it as fast as possible and don't let them leave the lot before they do.

Then there's the rationing controversy. The Obama crowd acts as though it's all nonsense, when in fact it's a major medical issue that should be openly discussed and not concealed under a cloud of spin. For example, rationing fan Peter Singer wrote in the New Times Magazine, "In the current U.S. debate over health care reform, 'rationing' has become a dirty word. Meeting last month with five governors, President Obama urged them to avoid using the term." Why did Obama have to warn five governors not to refer to an issue that the president claims doesn't even exist? Besides, when you commodify health care you are talking about rationing whether you use the term or not.

Further, hidden just behind the Democrats' current troubles is their assumption that "we can do it better than you can." It's there in all the regulations and controls slowing down the stimulus package; it's there in the extraordinary invasion of local control of public schools; and it's there in the health care effort.

When you don't trust people, they know it. There has been a growing snottiness about non-elite America among the liberal czars and czarinas that is playing a role in the kickback over healthcare.

Michael Lind recently offered an example

[][][] In a recent Washington Post column, Kathleen Parker quoted Ohio Sen. George Voinovich's assertion that the Republican Party is "being taken over by Southerners" to suggest that the GOP risks becoming a permanent minority party of the old Confederacy. In itself this is a legitimate point that I and many other critics of Republican conservatism have made for years. However, at Mother Jones, the blogger Kevin Drum used Parker's political argument as an excuse for all-too-typical liberal Southern-bashing. According to Drum: "There are, needless to say, plenty of individual Southern whites who are wholly admirable. But taken as a whole, Southern white culture is [redacted]. Jim Webb can pretty it up all he wants, but it's a [redacted]." Drum did the redacting on his own blog post, explaining he'd blacked out the offending text "on the advice of my frontal lobe." Drum's creepy bigotry becomes clear when other groups are substituted: "There are, needless to say, plenty of individual blacks who are wholly admirable. But taken as a whole, black culture is [redacted]. Barack Obama can pretty it up all he wants, but it's a [redacted]." [][][]

Finally, the public may not know the figures, but it knows it's not at the table, that something bad is going, something of the sort described by Bloomberg News:

[][][] If there is any doubt that President Obama's plan to overhaul U.S. health care is the hottest topic in Congress, just ask the 3,300 lobbyists who have lined up to work on the issue. "That's six lobbyists for each of the 535 members of the House and Senate, according to Senate records, and three times the number of people registered to lobby on defense. More than 1,500 organizations have health-care lobbyists, and about three more are signing up each day. Every one of the 10 biggest lobbying firms by revenue is involved in an effort that could affect 17 percent of the U.S. economy. [][][]

So here are. We're not going to get single payer. We may not even get a public option. Yet hidden behind all the uproar are a number of reforms that Democrats could pass on their own, or even with GOP help. And if the Republicans try to block the measure because of some of the items, they could be put in a separate bill and passed anyway.

The result would not be the historic, ground-breaking, earth shaking measure that Obama has obsessed over, but a modest measure improving the state of healthcare in America. Here are some existing proposals that might be included, taken from a list compiled by Joshua Holland for Alternet:

[][][] Insurance companies could no longer deny coverage to people because they've had health problems in the past, nor could they charge hugely different rates for different groups of people (premiums could only vary by age, geography, tobacco use and family size).

- The House bill bans the insurance industry's habitual practice of collecting premiums until someone gets sick, and then digging through their histories for an excuse to cancel coverage.

- Insurers wouldn't be allowed to cancel an individual's coverage for reasons other than failing to pay the premium.

- Insurers would no longer be permitted to impose annual or lifetime caps on benefits.

- Insurers that sell insufficient, cheapo plans that leave people vulnerable to medical crises would be required to disclose that fact to their customers.

- All insurers would be required to disclose how much of their spending is on health care and how much goes to costs like overhead, advertising, etc.

- If the House measure passes, individuals would face a maximum of $5,000 in out-of-pocket expenses a year, and families no more than $10,000. For poorer families, the limits would be much lower: $500 per year, for example, for a family making less than 1.33 times the poverty rate.

In 2007, Harvard researchers studied thousands of bankruptcy filings and found that medical causes played a role in more than 6 in 10.

- In the House bill, individuals making less than 400 percent of the poverty line -- $43k per year and families earning under $88k -- will be eligible for subsidized coverage on a sliding scale.

- Many small businesses would be eligible for tax credits for insuring their employees.

- All of the plans being considered by Congress make more of the working poor eligible for Medicaid by lifting the income limits on eligibility. [][][]

There you have it. A bill that could be passed in September filled with good things most of which you probably haven't even heard mentioned in the debate, thanks to all the bipartisan showboating. And the only thing odd about this is that it is a compromise being proposed by progressive populist and not by those who yammer all the time about their love for the middle.

It's not single payer; it's not a public option. But neither is it the present disaster.


Blogger Inspector Clouseau said...

Great title, "How to Survive...." I am sure that many are simply turned off. At this point, although the debate and spin continue, this bill is essentially dead from an emotional and mandate perspective, even if some version gets passed. Whether it ultimately proves to be of any benefit to society, or a detriment, will take years, if not decades, to appreciate.

This bill, and virtually anything that might be done to improve our healthcare system, involves too much complexity with which we are emotionally motivated to deal. In addition, there are too many factions with entrenched economic and/or financial interests to permit it to become a true health initiative.

There's been too much arguing about the details. People can not describe in 2 or 3 sentences the conceptual parameters of the effort and what it is supposed to accomplish. Unfortunately, people can describe how they feel about it in 1 or 2 words, and that's not good. And that's not to mention the elements which have whipped up hysteria by suggesting, with certainty, what will occur once the final product (which does not yet exist) emerges.

If either side of the debate has to work this hard arguing about something which theoretically should improve the lives of the masses of people, there's a big problem.

Even more so than how something is done, people are interested in results, not the details. And once again, as is frequently the case with much of human processing, the facts don't really matter. How people view the world, what they value, and what they want, matters.

And there is nothing collaborative in nature about that. Factor in the strong individualistic American DNA, and this effort is emotionally toast.

August 15, 2009 6:22 PM  
Anonymous MonkeyMuffins said...

Mr. Smith wrote:

"For example, rationing fan Peter Singer wrote in the New Times Magazine, 'In the current U.S. debate over health care reform, 'rationing' has become a dirty word.' "

A better example of sophistry you will not find!

"Rationing fan"?

Who are you kidding Mr. Smith?

Peter Singer is not a "rationing fan" but a rational man!

He's enlightened enough to realize--as his article exposes and explores in detail--that we already ration health care by means of our Dollar Democracy (the more dollars you have, the more "Democracy" you get; similarly if you have more money you have more access to healthcare options).

Singer is not a "fan" of rationing, he's merely an observer of a blatant reality hidden in plain sight.

A few years ago I would have assumed you (Mr. Smith) were smart enough to understand this.

But I now know you to be a Closet Conspiradroid--hiding behind bylines of easily-debunked, conspiracy-theory infotainment-sites such as GlobalFiction.ca (a/k/a GlobalResearch.ca) and PuerilePlanet.com (a/k/a PrisonPlanet.com).

Shame on you Mr. Smith.

August 15, 2009 8:39 PM  
Blogger jmann said...

MonkeyMuffins said:
“Peter Singer is not a "rationing fan" but a rational man!”
It is true that we have some rationing in our Health Care system as is pointed out by Peter Singer, which is why we really need health care reform.
But the rationing that takes place in the US does not even compare to the extent of rationing being delivered by Countries with single payer systems.
Just a small portion of the bill being voted on dictates rationing even well beyond these other countries:
The tax aimed at people making over $250k per year also includes small business net income.
Obama said this in his town hall at Grand Junction, CO:
“So about two-thirds of what we’re talking about is paid for through the existing health care system, money that’s already being paid by taxpayers — does not require additional taxes. But that still leaves one-third.
Now, in order to pay for that, there have been a lot of proposals out there. One of them that I proposed, I still think is the best idea. You may disagree, because I don’t know what your income bracket is. My proposal was that for people making more than $250,000 a year — people like myself — that we should, instead of getting the full itemized deduction of what our highest tax bracket is, we should just cap out our itemized deduction at 28 percent, which is what the average American gets. So — because my attitude is, I shouldn’t get a bigger tax break if I write a check to my local church than if the janitor down the street writes a check to their local church. We should get the same tax break. If we were willing to do that, just that alone would pay for what we’re talking about.”

Along with the mandate for employee Health Care provisions, this leaves us with a serious quandary.
One thing added in this bill is government subsidies for employers who cover their workers, but this negates the possibility for taxes on people making $250k per year to cover the cost of health care.
The majority of people who are in this category are small business owners. If they have an itemized income of $350k per year and, they get capped a flat 28% deduction rate ($90.1k), then their tax payout at 33% is $85.7k.
If you own a small business (Self Employed), then you know that “Itemized Income” includes all of the operating costs of your business including what you get paid at the end of the day.
Obama said this in his town hall at Grand Junction CO. It is not a secret or conspiracy. It is in the Bill.
The average business in the US today operates at a 6% profit margin and pays an average of 4.1% on total business conducted over the year, which, if using the model above, gives them a total of 21k in profit per year, after total Itemized deductions.
Using the model of the Health Care Bill passed by Congress this would put every single small business in the US automatically in the red, and paying almost 6 times the current tax rate.
The $350k business is $50,400.00 in the red automatically.
Now if you still do not understand what will happen to our economy, then I cannot reason with you.
This is not a scare tactic.
This bill should have been read before passing in congress.
This will put an end to small business.
Private Insurance companies will not be able to compete; they will be paying these taxes too.
The businesses that do stay in business will have to use Government Health Care for their employees in order to receive enough subsidies from the Government to stay alive.
The entire plan to pay for the Health Care bill by taxing income of over $250k will be null and void.
Thus leaving the Health Care plan broke, which will make rationing Impossible to avoid.
Compared to the rationing that is taking place now! This my friends’ goes way into another realm!
Therefore Peter Singer is not a rational man.

August 16, 2009 4:29 PM  
Anonymous chi original flat iron said...

death knell for substantive reform of the health industry, making it about Obama is probably the best way to do it, because what will come out of it is the successful passage of some version of the terrible legislation that is on the table.
chi Pink ceramic flat iron

August 16, 2009 11:36 PM  
Anonymous robbie said...

But the rationing that takes place in the US does not even compare to the extent of rationing being delivered by Countries with single payer systems.

Could you quantify that? I've heard that "rationing" under the Canadian system or the UK system is comparable to not being able to rush right into the emergency room for a hangnail. Everyone with any real injury is taken care of right away.

August 17, 2009 6:19 PM  
Blogger abvodvarka said...

Dear Sam, Thanks for pointing out how we might improve the quality of the crumbs that fall from the table of the insurance companies, indeed not a small thing when one considers the need. But, BLOODY HELL, when one considers the trillions of bucks that are being speedily delivered to the goddamned banking and insurance thieves that are sucking the life's blood out of our economy, no questions asked, when we are clearly in thrall to a totally corrupted political machine that practices corruption openly, in our faces, as though our bad opinion has no meaning at all, when the hell do we finally discuss politics in a way that reflects reality, i.e., that we not not have a viable political or electoral system any more? We have come to live in a proto-fascist kleptocracy, unresponsive to the needs of the vast majority of citizens. The old language of politics no longer serves in the class war our economic elites have forced upon us.
Tony Vodvarka

August 23, 2009 9:12 AM  

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