What the Great Recession has crystallized is a larger syndrome that Obama tapped into during the campaign. It’s the sinking sensation that the American game is rigged — that, as the president typically put it a month after his inauguration, the system is in hock to “the interests of powerful lobbyists or the wealthiest few” who have “run Washington far too long.” He promised to smite them.
No president can do that alone, let alone in six months. To make Obama’s goal more quixotic, the ailment that he diagnosed is far bigger than Washington and often beyond politics’ domain. What disturbs Americans of all ideological persuasions is the fear that almost everything, not just government, is fixed or manipulated by some powerful hidden hand, from commercial transactions as trivial as the sales of prime concert tickets to cultural forces as pervasive as the news media. It’s in this context that Obama can’t afford a defeat on health care. A bill will pass in a Democrat-controlled Congress. What matters is what’s in it. The final result will be a CAT scan of those powerful Washington interests he campaigned against, revealing which have been removed from the body politic (or at least reduced) and which continue to metastasize. The Wall Street regulatory reform package Obama pushes through, or doesn’t, may render even more of a verdict on his success in changing the system he sought the White House to reform.
The best political news for the president remains the Republicans. It’s a measure of how out of touch G.O.P. leaders like Mitch McConnell and John Boehner are that they keep trying to scare voters by calling Obama a socialist. They have it backward. The larger fear is that Obama might be just another corporatist, punking voters much as the Republicans do when they claim to be all for the common guy. If anything, the most unexpected — and challenging — event that could rock the White House this August would be if the opposition actually woke up. Read it all at NYTimes.com
Frome Firedoglake:
They're fringe, anti-government nihilists and they're not interested in the government reforming health care, or anything else. The media, however, continue to frame these events as a referendum on health care reform, which they are not. One side wants to reform health care, the other wants to lynch the federal government.
Not the same thing. Good point. At these town halls, we need to point out that these anti-healthcare reform protesters really want to take Social Security and Medicare away from seniors.
Republican obstructionists to Obama's agenda have developed a new tactic. Seemingly forgetful of how Republican majorties jammed through huge bills without letting Dems actually read them, they now insist that every Dem has to read every bit of every bill and more specifically the Health Care Bill. Well in reality that is not that much of a challenge. When people make the claim that no one can really understand a 1018 page bill realize that mostly you don't need to deeply engage with more than maybe seventy or eighty double spaced, highly indented pages to get a pretty solid grasp of what the bill proposes. Read it all at Angry Bear
By Timothy Noah
On July 30, single-payer advocates staged a rally on Capitol Hill to demand why Congress wasn't even considering enacting a single-payer health system. The usual answer you hear from Sen. Max Baucus, D-Mont., and others is that the United States requires a solution to its health care crisis that's "uniquely American."This smug cliché, as I have complained before, encapsulates the American political establishment's hubristic refusal to consider how other industrialized countries tackle the problem at the practical level. Health care reform, it is said, must reflect distinctly American values, and that's why Congress resolutely ignores the single-payer model favored in Canada; the Bismarckian nonprofit model favored in France, Germany, and Japan; and the socialized model favored in the U.K., Spain, and much of Scandinavia. Under a single-payer system, the government doesn't care which doctor or hospital you use because none is going to be more expensive than the others. Granted, the government may deny choice in tests and treatments, but Brett judges that reality as no more restrictive than with market-based medicine; the only difference is whether the gatekeeper is public or private.
By definition, a single-payer system would deny consumers (or, more typically, their employers) the opportunity to choose a health insurer. But choosing an insurer, Brett says, is "not an end in itself." Rather, it's a means to "efficient, cost-effective health care." And single-payer has shown itself superior to private insurance in this respect as well, "[b]ecause administrative costs are consistently lower in single-payer systems than in private-based systems." (Brett might also have pointed out that a single-payer system can set hospital and doctor fees at whatever it deems reasonable.) Why, then, is Congress so resistant not only to creating a single-payer system but even to creating a robust "public option" government health-insurance plan as one option among many? In the Aug. 3 New Yorker, Hendrik Hertzberg correctly identifies the obstacle not as culture but as the structure of U.S. government itself: Other industrialized democracies typically favor a more streamlined parliamentary approach. Hertzberg goes on to point out that in one of our legislatures (the Senate), "one member may represent as little as one-seventieth as many people as the member in the next seat," and a minority of members may block any action through the filibuster. (These are two hobbyhorses I happen to share with Hertzberg. See "Abolish the Senate!" and "Abolish the Filibuster!") Harold Pollock, faculty chair of the University of Chicago's Center for Health Administration Studies, noted last month that the small, bipartisan "coalition of the willing" writing the Senate finance committee's health-reform bill while it munched on chocolate-covered potato chips represented a combined population of fewer than 11.2 million, which was less than that of greater Los Angeles. Since Pollock wrote, Sen. Orrin Hatch, R-Utah, has dropped out, reducing the coalition's membership from seven to six and lowering its collective constituency to 8.5 million souls, or less than that of the Chicago metropolitan area. Read it all at Slate Magazine
The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket.Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.
Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.
Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.
Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.
And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.
So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays. Read it all at NYTimes.com
by: Chris Bowers:
Contrary to popular belief, the United States actually spends just as much on social programs (pensions, health care, education, etc.) as just about any other country in the world. The key difference between the United States and other wealthy democracies is where the money comes from. Specifically, in the United States, many people pay for social services straight out of their pockets, rather than having the public sector (aka, the government) provide the services. In 1960, the United States was equal to other wealthy democracies in terms of overall social spending from the public sector. During the 1960's, we continued to increase our nationa level of public sector spending through programs like Medicare and Medicaid. However, since that time, while other wealthy democracies experienced a vast increase in public sector social spending, the United States has experienced little change (PDF, page 4). What has changed in the United States is a vast increase in private spending on social programs. In 1980, the 4.4% of the United States GDP was private expenditure on things like health care and education, but by 2005 that number had increased to 9.4% (source: OECD). While other wealthy democracies increased their public sector spending on social programs, the United States increased its private sector spending on social programs. A public health care option is the first major step required to redress this inequality. There is no such thing as health care reform without a public option. Lacking a public option, our health care system will continue on its current path of skyrocketing costs and inequality of access. We already have as much health care as other wealthy democracies--ours just costs to damn much and access to it is distributed unequally. Any health care reform without a public option should be actively opposed.
The grand arc of American politics over the last forty years is about inequality. Changing that arc requires a public health care option that is available to all Americans. Anything less does change the arc at all. We have to stop increasing private social spending a as a percentage of GDP.
By Joe Conason | Salon:
The Europeans spend more money on social programs than we do -- and get great results, in everything from universal childcare to tuition-free higher education.
April 3, 2009 | If the world is no longer enthralled by the “old Washington consensus” of privatization, deregulation and weak government, as British Prime Minister Gordon Brown proclaimed at the London G-20 summit, then now it is surely time to reconsider what that consensus has meant for us over the past three decades. We could begin by looking across the Atlantic at the “social market” nations of Europe -- where support for families and children is less rhetorical and more real than here.
Most coverage of the summit failed to observe the stinging irony of the debate over stimulus spending that brought the United States into conflict with France and Germany. Today’s American demand that the French and Germans (along with the rest of wealthy Europe) should spend much more on government programs and infrastructure contrasts rather starkly with the traditional American criticism of Europeans for spending too much. So when the French and other Europeans note pointedly that their societies routinely spend much more than ours to protect workers, women, the young, the elderly, and the poor from economic trouble, they’re merely making a factual observation. (France spends as much as 1.5 percent of GDP annually on childcare and maternity benefits alone.) Different as we are in culture and history, we might even learn something from their example, now that the blinding ideology of the past has been swept away.
By now, most Americans ought to know that Europeans treat healthcare as a public good and a human right, which means that they spend billions of tax dollars annually to insure everyone (although they spend less overall on the medical sector than we do). What most Americans probably still don’t know is that those European medical systems are highly varied, with private medicine and insurance playing different roles in different countries. Expensive as universal quality care has inevitably become, as technology improves and populations age, the Europeans broadly believe in their social security systems -- because they provide competitive advantage as well as moral superiority.
From Europe’s perspective, the same can be said of the support its governments provide to families, from the entitlements available to pregnant women and new mothers and fathers, to universal child care and tuition-free higher education, to the special benefits that assist single parents. The challenges that working families face in a globalizing world where both parents work are mitigated by policies designed to encourage balance between home and workplace and adequate attention to children.
These "socialist" measures to protect families are far more effective, of course, than all of the Sunday shouting from American pulpits about the Biblical way of life. Perhaps the leadership of the religious right, still obsessed with stigmatizing gay couples, should take note. It is true that globalization, aging and immigration have imposed severe pressure on the budgets of European countries, and the trend of increasing benefits that continued until a decade ago has been reversed. But it is also undeniable that despite those pressures, public and political support for the social market economy remains strong across Europe, and that free-market fundamentalism is a thoroughly discredited alternative. The old argument that the social market is unsustainable and hinders growth was never persuasive on close inspection. And the old expectation that outmoded European systems would eventually collapse into imitating ours has been swept away, along with the rest of the Washington consensus. Now perhaps we can honestly consider what America might learn from them.
Posted by Don McCanne, MD on Thursday, Mar 5, 2009
Report of Health Care Community Discussions HealthReform.gov
March 5, 2009 In December 2008, the Presidential Transition Team invited Americans to host and participate in Health Care Community Discussions to talk about how to reform health care in America. IV. Solutions to the Problems in the U.S. Health Care System B. Roles in a Reformed U.S. Health Care System Role of Government v. Market The real debate was over the balance of government versus the market in insuring Americans. Supporters of a single-payer system submitted numerous reports, in part due to the encouragement by advocacy groups to participate in Health Care Community Discussions. Under most versions of a single-payer system, the government would replace private insurers in organizing, financing, and paying for health care. Its specifics, and arguments for and against it, are described below (see Single-Payer System box). http://www.healthreform.gov/reports/index.html
That’s it. In this long report, this is the paragraph that expresses the ubiquitous single payer presence at these meetings. (The single payer box mentioned was not posted on this web version of the report.)
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