Closing Time

A Historic Confirmation of Corporate Power

By CHRIS FLOYD

It looks like heaven but it feels like death;
It's something in between, I guess:
It's closing time.
-- Leonard Cohen

Official transcript of remarks by President Barack Obama after the March
21 vote in the House of Representatives on H.R.3590: Motion to Concur in
Senate Amendments to Patient Protection and Affordable Care Act:

My fellow Americans. As many of our more serious commentators have noted,
Democrats and progressives have sought genuine reform of our broken,
bloated, unjust health care system for almost a hundred years. Today, I am
proud to say that we have brought that century-long struggle to a close.
Together with our visionary partners in the House and the Senate, we have
finally killed genuine health care reform for many years to come --
perhaps even for another century!

The struggle is over, the deal is done, the fix is in, and corporate power
-- unbridled, unchallenged, coddled, protected, and larded with the
endless pork of government-guaranteed profit -- has triumphed at last.
This is an historic achievement. This is a mighty legacy we will bequeath
to future generations.

This, my friends, is what change looks like.

Now, you know and I know that such change never comes easily. It never
comes without opposition. It never comes without controversy. Even in this
hour of victory, we know that the doom-sayers will be out in force.

And I'm not speaking here of the Republicans, whose opposition has simply
been a lurid, baseless "Red Dawn" fantasy about "communism" coming to
America. "Communism" -- in a bill that has been written by our visionary
partners in the corporate community, by our hyper-capitalist friends and
patrons on Wall Street, by the lobbyists and bagmen of Big Money! It's
true there is a tinge of socialism in the bill, but it is, of course, the
only kind of socialism that is tolerated in America: socialism for the
rich, where the masses shoulder the risks -- and the costs -- while the
wealthy reap the profits for themselves. The health-care barons, the
bailed-out banks, the farm-devouring agriconglomerates, the war profiteers
... we've got plenty of boardroom bolsheviki out there -- but it sure
ain't "communism" like Castro used to make! So let them hoot and holler
down this false trail all they like; for as I learned back in my Senate
days, when I was considered part of the "anti-war" faction, opposition
without substance only entrenches the status quo.

No, what we must look out for are all those -- or rather, those very few
-- nattering nabobs of negativism who have opposed our historic corporate
empowerment bill out of -- get this -- principle. Like barnacles hanging
onto the butt of the Titanic, they have clung to the idea of truly
universal, equal, single-payer health care, a system that is less
expensive, more efficient, more secure, more democratic, more popular and
more effective than the heroic measure we have passed here today.

These poor wretches -- who now must face the wrath of Kos and the wroth of
Rahm for their tragic apostasy -- are simply not savvy enough to see that
our 2,000-page boondogglepalooza, riddled with fine-print exceptions,
toothless regulations (which we will 'enforce' every bit as rigorously as
Wall Street has been regulated all these years), impenetrable phase-in and
phase-out schedules, and mild benefits that won't even begin kicking in
for years -- and that even after a decade will still leave millions of
people uncovered -- is much better than a simple, streamlined system that
could be implemented by the end of this year, bringing genuine relief from
intolerable, life-degrading financial burdens and medical problems to
millions and millions of people in dire need right away.

Or as that avatar of negativity, Ralph Nader put it:

"The health insurance legislation is a major political symbol wrapped

around a shredded substance. It does not provide coverage that is

universal, comprehensive or affordable. It is a remnant even of its own

initially compromised self — bereft of any public option, any safeguard

for states desiring a single payer approach, any adequate antitrust

protections, any shift of power toward consumers to defend themselves, any

regulation of insurance prices, any authority for Uncle Sam to bargain

 with drug companies, and any reimportation of lower-priced drugs." 

Hey, Ralph, thanks for reciting my credits! All those "berefts" you cited
were the result of my own super- savvy negotiations! It's 11-dimensional
chess, man, a really heavy-duty Matrix Zen Jedi Master use-the-Force kind
of thing, where you win the game by giving away everything you have in the
opening move! But you're too much a dinosaur to understand. 'Anti-trust
protections!' Hey, Teddy Roosevelt -- your horse-and-buggy is waiting!
Just listen to this guy:

"Most of the health insurance coverage mandated by this legislation does

not come into effect until 2014, by which time 180,000 Americans will die

because they were unable to afford health insurance to cover treatment and

diagnosis, according to Harvard Medical School researchers."

Well, what can I say? 180,000 is a lot of dead people. This is a very hard
choice, but the price — we think the price is worth it.

Then there's this Chris Hedges guy. He used to be a "serious" journalist,
reporting on the imperial wars for our corporate partners in the
stovepiping community -- what old-timers and barnacles still like to call
the "news media." But he went off the rails a long time ago and joined the
carpers and cranks on the sidelines, those malcontents who, unlike so many
of our progressive partners today, have never imbibed the timeless wisdom
of Warren G. Harding: "Don't knock, boost!"

Just get a load of Hedges here, making the big-whoop observation that our
 historic bill is just a bloated version of the already-failed,
Republican-created Massachusetts plan:

"Take a look at the health care debacle in Massachusetts, a model for what

we will get nationwide. One in six people there who have the mandated

insurance say they cannot afford care, and tens of thousands of people

have been evicted from the state program because of budget cuts. The

45,000 Americans who die each year because they cannot afford coverage

will not be saved under the federal legislation. Half of all personal

bankruptcies will still be caused by an inability to pay astronomical

medical bills. The only good news is that health care stocks and bonuses

for the heads of these corporations are shooting upward. ..."

Again with the credits! Stocks going up, corporate heads filling their
pockets, pols gorging on backroom baksheesh, Big Money controlling the
debate ... Earth to Hedges: That's what we're here for! That's the whole
point! You're an old Seventies guy, aren't you, Chris? You remember ZZ
Top? "Jesus Just Left Chicago"? (If you'll pardon the immodesty.) What do
they say? "Taking care of business is his name." They got that right.

So who cares if the plan "fails"? Who cares, if, as you say,

"[the plan] will not expand coverage to 30 million uninsured, especially

since government subsidies will not take effect until 2014. Families who

cannot pay the high premiums, deductibles and co-payments, estimated to be

between 15 and 18 percent of most family incomes, will have to default,

increasing the number of uninsured. Insurance companies can unilaterally

raise prices without ceilings or caps and monopolize local markets to shut

out competitors."

Listen, Hedgie: If the plan was to reform the health care system for the
benefit of the people, then we would have, like, reformed the health care
system for the benefit of the people. You follow? The plan was, is, and
will always be to appear to be reforming the system -- to make the rubes
believe that something is being done to alleviate their pain -- precisely
to avoid really reforming the system, which is just too good and greasy
for too many of us at the top of the imperial pyramid.

And when this plan fails -- as it will, as it will -- then you rig up
another boondoggle, another "great debate" full of sound and fury,
signifying zilch, to keep the rubes at bay. Meanwhile, we can get on to
the real job our corporate colleagues and patrons want us to do --
bringing that other old dream of social amelioration for the common folk
to an end at last: Social Security. Scalpel, Nurse! The doctor is in!

Chris Floyd is an American writer and a frequent contributor to
CounterPunch. His blog, Empire Burlesque, can be found at
www.chris-floyd.com.

QUACK CARE BILL PASSES

Sam Smith
I ended up supporting the health care bill. Not because it was a historic
measure, or the most important piece of legislation in four decades or as
an icon of Obama's greatness, but for the same reason one hands over a
wallet to a robber. There are times when principle takes the back seat.
But when it's all over, the robber is not your hero, but still a thug.
Obama essentially said that if you want 16 million poor people covered,
you have to agree to heavily subsidize the insurance industry either
through your taxes or through the individual mandate. Remember that about
a third of that money will go for marketing and other superfluous industry
spending that might have been avoided under a public plan.
The Maine Owl put it well: "The health bill neither is the Armageddon that
the Republicans claim, nor the greatest social legislation since Civil
Rights and Medicare in the 1960s. Rather, it's a warmed over version of
Republican Bob Dole's individual private insurance mandate proposal from
1994. It is what Barack Obama campaigned against versus Hillary Clinton
and later John McCain in 2008."
I can't recall a major piece of Democratic legislation that was so coated
with corruption, intellectual dishonesty, cynicism and political
disloyalty by those pushing it. Obama and the Democrats have offered us a
quack cure - full of corrupt, ineffective and even unconstitutional
provisions - neatly moderated by some good provisions. And we'll be years
straightening it all out.
The liberal groupies at Move On and the like didn't notice or weren't
bothered by all this, but much of America was, and because neither side
was being honest, the public predictably floundered. The irony is that the
Tea Party that the liberals love to hate built itself in no small part on
the indefensible way in which the Democrats have behaved on health care.
Thus, we are not only getting a badly designed bill but a future in which
the right will thrive even more than it already has.
WHAT'S GOOD
Center On Budget Policy Priorities: The plan would expand Medicaid up to
133 percent of the poverty line for all children and adults younger than
65 who are lawfully residing in the United States and not eligible for
Medicare. This would mean that millions of low-income parents, as well
non-disabled low-income adults who do not have dependent children (and who
are generally ineligible for Medicaid today except in a small number of
states with waivers), would become newly eligible for health coverage
through Medicaid. Medicaid is the most cost-effective way to provide
comprehensive and affordable coverage to people with very low incomes and
thereby ensure that the low-income uninsured gain coverage.
Reuters - Within the first year of enactment Insurance companies will be
barred from dropping people from coverage when they get sick.
Lifetime coverage limits will be eliminated and annual limits are to be
restricted.
Insurers will be barred from excluding children for coverage because of
pre-existing conditions.
Young adults will be able to stay on their parents' health plans until the
age of 26. Many health plans currently drop dependents from coverage when
they turn 19 or finish college.
Uninsured adults with a pre-existing conditions will be able to obtain
health coverage through a new program that will expire once new insurance
exchanges begin operating in 2014.
A tax credit becomes available for some small businesses to help provide
coverage for workers.
In 2011, Medicare provides 10 percent bonus payments to primary care
physicians and general surgeons.
In 2011, Medicare beneficiaries will be able to get a free annual wellness
visit and personalized prevention plan service. New health plans will be
required to cover preventive services with little or no cost to patients.
In 2012, The threshold for claiming medical expenses on itemized tax
returns is raised to 10 percent from 7.5 percent of income. The threshold
remains at 7.5 percent for the elderly through 2016.
In 2012, The Medicare payroll tax is raised to 2.35 percent from 1.45
percent for individuals earning more than $200,000 and married couples
with incomes over $250,000. The tax is imposed on some investment income
for that income group.
In 2014, State health insurance exchanges for small businesses and
individuals open.
In 2014, Health plans no longer can exclude people from coverage due to
pre-existing conditions.
In 2014, Employers with 50 or more workers who do not offer coverage face
a fine of $2,000 for each employee if any worker receives subsidized
insurance on the exchange. The first 30 employees aren't counted for the
fine.
Crooks & Liars: Authorizes early funding of community health centers in
all 50 states. Community health centers provide primary, dental and vision
services to people in the community, based on a sliding scale for payment
according to ability to pay.
WHAT'S BAD
There is a huge subsidy for health insurers, paid for out of either taxes
or required purchase of health insurance.
The bill doesn't take insurance and medical cost inflation into adequate
account. For example, between 2000 and 2007, health insurance went up
100%. Under such a rise, the policy subsidies would become less valuable.
Congress tends to lag badly in correcting such situations.
Major provisions of the bill don't got into effect for four to nine years.
This is a considerable con, because it allows politicians to say they've
passed something that may not go into effect until they are either out of
office or, as with the president, safely in his second term. As a result
they don't have to take responsibility for any failure or unanticipated
cost.
The individual mandate is unconstitutional. If the Supreme Court doesn't
strike it down, it will open the door to major new intrusions by the
federal government into individual freedom of choice.
Many healthy people may prefer to pay fines than to purchase health
insurance. Others would have no choice. Just because you're making a
middle class wage doesn't mean you can afford all your expenses. What
effect this will have - including on health insurance costs - is unclear
but it's not good
Medicare will be hurt one way or another, probably most deeply by cuts
recommended by an appointed budget commission with unconstitutionally
broad powers.
Because of the delay in programs, the election of a Republican Congress or
Senate could drastically change things. As the LA Times pointed out:
"Insurance industry experts say there is no way to fully gauge the effect
because of its extended time frame. Four years from now, they say,
Congress and the White House could have new occupants who may try again to
reshape the healthcare landscape."
There will be cuts to the Medicare Advantage plans that could reduce
enrollment by as much as one third.
The bill does not deal with state actions. For example, budget cuts in
Arizona may slash $385 from the state's Medicaid program and end Kids Care
for 39,000 poor children. Writes Casey Newton in Arizona Central:
"Programs benefiting low income individuals and families, such as Medicaid
and CHIP, are politically vulnerable to the whims of conservatives
wielding budget cleavers. Gov. Jan Brewer of Arizona has just provided us
with a prime example of that. Yet popular programs benefiting everyone,
such as Medicare, are relatively impenetrable to the weapons of the
conservatives. Suppose Congress had included single payer in their
deliberations and eventually decided that the benefits were too great to
pass up ,and so enacted an improved Medicare program that covered
everyone. Gov. Brewer and her ilk on the state level would be powerless to
stop it. "
One of the big sleepers in the bill is the plan to "institute
efficiencies" in Medicare programs. In fact, Medicare is far more
efficient than any private insurance plan in the country. Consider this
snippet from CBPP: "The legislation would reduce annual payment updates to
hospitals, skilled nursing facilities, hospices, ambulatory surgical
centers, and certain other providers to account for improvements in
economy-wide productivity. It would also reduce payments to home health
agencies, skilled nursing facilities, and inpatient rehabilitation
facilities." And just what will happen to service and its availability?
Remember: one person's efficiency is another's lack of service.
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