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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Obama's Health Care Reform Plan Is Based on the Clintons' Failed 1990s Model

By Marie Cocco, Washington Post Writers Group

http://www.alternet.org/story/109844/

WASHINGTON -- Here is a number easily understood by even the math-phobic: Every 1 percent increase in the unemployment rate leads to another 1.1 million Americans becoming uninsured -- and causes still another million more children and adults to become eligible for state health insurance programs.

This means that over the past 10 months, as the hemorrhage of jobs began to push the national unemployment rate toward its October level of 6.5 percent, about 3 million Americans were thrown off the insurance rolls or had their incomes fall so much that they became eligible for Medicaid or the State Children's Health Insurance Program.

These estimates by the Kaiser Commission on Medicaid and the Uninsured do not bewilder as much as do the tallies associated with the various federal bailouts and guarantees of banks and other institutions at the core of the financial crisis. Those are in the hundreds of billions -- actually, we're into the trillions when you count up each form of taxpayer backing -- to shore up this or that part of the teetering financial system.

But before long, if unemployment climbs as predicted to 8 percent or 9 percent next year, the worsening economic crisis will deepen the health insurance crisis. And the combination of job losses and the loss of insurance that is inevitably connected to them is likely to be an awful lot like the crisis of the early 1990s -- the last time the political system tried to fix the confused, costly and crumbling health insurance system.

The recession of the early '90s led the Clinton administration to attempt universal health care. Though the Clinton plan is consistently derided as a failure, in truth, President-elect Barack Obama's campaign pledge to build a universal system based on the current, employer-based method of delivering insurance is in good measure modeled upon it. And that is the problem.

Look only to the Detroit automakers' current economic straits for the reasons why. The car companies' unionized workers still count on a model health insurance safety net -- but even this has been scaled back repeatedly in successive contracts. Last year, the United Auto Workers Union and the Big Three entered into a deal to create a separate trust fund to bear the cost of retiree health benefits. The fund is jointly financed by the union and the companies, and a substantial part of the money is coming from current workers' forgoing promised wage hikes.

Year after year, employers demand health benefit cuts in contract talks, or impose them unilaterally where there is no union. In a 2008 survey, the Kaiser Family Foundation found that 40 percent of firms that offer insurance said they are "somewhat likely" or "very likely" to increase the amount their workers contribute to insurance in the coming year, a cost shift that includes higher premiums and co-payments. Yet the average annual worker contribution toward premiums for a family policy already has more than doubled in the past nine years. During the same period, middle-class incomes have been largely stagnant.

With employers quickly shedding workers, is there any doubt that more health benefit cuts are coming for those lucky enough to keep their jobs? And when recovery comes, does anyone think American business is going to abandon its argument that health costs represent a competitive disadvantage in the global marketplace? They won't, because it's accurate. And that's largely because other countries have universal, taxpayer-funded health care systems.

These are the immutable truths of the health care conundrum. They haven't changed much in two decades. Costs are driven inexorably higher by continual advances in care as well as an aging population that needs more of it. Employers can't cope unless they scale back coverage, shift costs to workers or eliminate benefits altogether. States have become insurers of last resort -- but right now they face crippling budget shortfalls that threaten this safety net.

Using this compromised system as the basis for health insurance revision is folly -- more so now than it was in the Clinton era, when more employers still were covering their workers. Tightening regulation of the insurance industry and creating a new, government-based plan to make coverage available to those who cannot afford to buy it from private insurers -- the essence of Obama's campaign proposal -- would only add another layer of complexity and, eventually, cost. Only a single, government-financed system can eliminate the administrative waste, unfairness and economic burden of our current health insurance scheme. Timidity is no longer an option.

Marie Cocco's e-mail address is mariecocco(at)washpost.com.

(c) 2008, Washington Post Writers Group

Marie Cocco is a prize-winning syndicated columnist on political and cultural topics for The Washington Post Writers Group. She is a frequent commentator on national TV and radio shows.

Doctors, Citing Mandate for Change, Call on Obama, Congress to 'Do The Right Thing' on Health Reform

15,000 physicians urge enactment of single-payer system

November, 09 2008

By Authors Many

Authors Many's ZSpace Page

A group of over 15,000 U.S. physicians has called on President-elect Barack Obama and the new Congress to "do the right thing" and enact a single-payer national health insurance plan, a system of public health care financing frequently characterized as "an improved Medicare for all."

"Our country is hailing the remarkable and historic victory of Barack Obama and the mandate for change the electorate has awarded him," said Dr. Quentin Young, national coordinator of Physicians for a National Health Program.

"In large measure Sen. Obama's victory and the victories of his allies in the House and Senate were propelled by mounting public worries about health care," he said. "Yet the prescription offered during the campaign by the president-elect and most Democratic policy makers - a hybrid of private health insurance plans and government subsidies - will not resolve the problems of our dangerously dysfunctional system.

"We've seen such hybrids repeatedly fail in state-based experiments over the past 20 years in Oregon, Minnesota, Washington and several other states, including Massachusetts, whose second go-round at incremental reform is already faltering," Young said.

"The only effective cure for our health care woes is to establish a single, publicly financed system, one that removes the inefficient, wasteful, for-profit private health insurance industry from the picture," he said. "Single payer has a proven track record of success - Medicare being just one example - and is the only medically and fiscally responsible course of action to take."

"A solid majority of physicians endorse such an approach," Young said. "An April 2008 study in the Annals of Internal Medicine shows 59 percent of U.S. physicians support national health insurance. Opinion polls show two-thirds of the public also supports such a remedy. Now, with strong political leadership, this reform is within reach."

Young said the adoption of a single-payer health system can be a "major component of the new president's economic rescue of Main Street."

"We see no value in trying to bail out the private health insurance industry, an unsustainable system of financing care that has outlived its usefulness," he said. "By contrast, a single-payer plan would provide direct and much-needed relief to millions of American households at a time of great economic hardship."

"Only a single-payer system can achieve the goal of comprehensive and affordable care for all," he said, noting that the estimated $350 billion administrative savings realized by replacing private insurers would be enough to cover all of the country's uninsured and to end co-payments and deductibles for all Americans. "This would be the perfect way for President Obama to get the country back on track."

"Patients would be able to go to the doctors and hospitals of their choice and not have to worry about being able to afford it," he said, "and the single-payer system's ability to do bulk purchasing, planning and global budgeting would rein in costs."

Young noted that Obama has said more than once that he is a supporter of a single-payer universal health care program, and that if he were "starting from scratch," he would favor adopting one. In 2003, Young said, then Illinois state Sen. Obama remarked that "first we have to take back the White House, we have to take back the Senate, and we have to take back the House."

Young remarked: "Tuesday's election has made all of these conditions happen. In his first 100 days, President Obama has a window of opportunity to inspire the nation by championing the enactment of single-payer national health insurance under the slogan, 'Everybody in, nobody out.' Such a plan is embodied in the U.S. National Health Insurance Act, H.R. 676, introduced by Rep. John Conyers Jr. (D-Mich.) and co-sponsored by more than 90 others, more than any other health reform legislation."

Young noted that at least five additional supporters of single-payer health reform were elected to Congress yesterday, including Senator-elect Tom Udall (D-N.M.), and that pro-single-payer ballot initiatives in 10 Massachusetts legislative districts "won by a landslide, on average receiving 73 percent of the vote."

"Adopting a nationwide single-payer system will build on the great achievement of Medicare, further unify our people, strengthen our country's economic competitiveness and assure President Obama's legacy as an American hero," Young said.

*****

Physicians for a National Health Program, a membership organization of over 15,000 physicians, supports a single-payer national health insurance program. To contact a physician-spokesperson in your area, call (312) 782-6006 or visit www.pnhp.org/stateactions.

---

From:	Z Net - The Spirit Of Resistance Lives
URL:	http://www.zcommunications.org/znet/viewArticle/19407

The New New Deal

If This Is Such a Rich Country, Why Are We Getting Squeezed?

By Heather Boushey and Joshua Holland, AlterNet
Posted on July 18, 2007,
http://www.alternet.org/story/57180/

The commercial media is telling us two perfectly contradictory stories about the American economy. The first is how wonderfully rich we are in the United States. The stock market's booming -- some analysts predict the Dow will break the 15,000 this year -- the economy is expanding at a healthy clip, productivity growth is up and unemployment and inflation are relatively low.

But, at the same time, we're also told that we don't have the money to pay for a robust social safety net. When it comes to paying for universal health coverage, affording retirement security for our elderly, investing in programs for the poor or educating our children, we need to pinch pennies. According to this story line, we face a looming "entitlement crisis" -- we won't be able to afford to keep the Baby Boomers in good health and out of poverty, we're told, unless we slash their benefits and privatize the programs that their elderly parents enjoy today.

This is the line we hear from the administration when it talks about entitlement "reform": Treasury Secretary Henry Paulson says that "the biggest economic issue facing our country is the growth in spending on the major entitlement programs: Medicare, Medicaid and Social Security." The solution, according to the Heritage Foundation, is to cut entitlement spending. "Reforming Social Security, Medicare, and Medicaid is the only way to get the budget under control," it says.

How can two narratives that are so clearly at odds with each other be so pervasive? Are we seriously supposed to believe that Paris Hilton has to dig between the cushions of her sofa to buy a can of tuna?

What reconciles these two themes is absent from our mainstream economic discourse: We "can't afford" all sorts of programs that are clearly in the common good because most of the benefits of our growing economy have gone to a very small group of Americans, who have, in turn, seen their taxes slashed again and again in the past six years. It's a story that isn't told as often as it should in the commercial press, because it's a supposedly "liberal" narrative -- never mind that über-conservative former Fed Chairman Alan Greenspan told Congress that there is a "really serious problem here, as I've mentioned many times … in the consequent concentration of income that is rising."

Saying that the majority of the country's economic gains in recent years have gone to the top 1 percent of the income ladder understates the trend. You have to cut the pie into even smaller slices to get the full picture. Because, while the bottom half of the top 1 percent of the income distribution have done far better than the average wage slaves, it is a smaller slice still -- the top .01 percent -- that has grabbed most of the gains, seeing an impressive 250 percent increase in income between 1973 and 2005 from an economy that's grown by 160 percent.

An analysis by economists Thomas Piketty and Emmanuel Saez gives us the best perspective of what's going on for everyone else. They found that despite several periods of healthy growth between 1973 and 2005, the average income of all but the top 10 percent of the income ladder -- nine out of ten American families -- fell by 11 percent when adjusted for inflation. For three decades, economic growth in the United States has gone first and foremost to building today's modern Gilded Age. The recipients of those gains don't care about a fully funded Social Security system or a healthy Medicare program -- they don't need them.

Meanwhile, even as the top earners' incomes have gone through the roof, their tax burden has shriveled. At the same time, the share of federal revenues contributed by corporations has declined -- by two-thirds since 1962.

It's important to understand how that plays out in our national economic discourse. When people tell us that our economy cannot "afford" things like universal healthcare or paid sick days, it fits with the economic experience that most Americans have had in their real lives -- the benefits of our boom-boom economy have not gone to the great masses but to "someplace else."

Americans feel pinched. Polls show that they feel a time crunch -- not having enough time for family and friends -- and that they're anxious about getting into or staying in the middle class. Over the past generation, the economy has not been good to the typical, married-couple family (let alone single-parent families) and families feel, rightly, that they need to be careful about where their dollars go.

It's not that they're not working hard. The typical U.S. family puts in more time at work than ever before. The typical married couple works an additional 13.3 weeks per year -- 533 hours -- compared to a generation ago. But even though families are working more, their incomes have grown by only a third between 1973 and the present. That's much worse than the generation before; between 1947 and 1973, the typical married-couple family saw their income rise by 115 percent, and that was often just one parent's income. This was a period when most families could afford a stay-at-home mother. Of course, fewer families have that luxury today -- those with stay-at-home moms have the same inflation-adjusted median income in 2007 as they did in 1973. They haven't gained a penny from three decades of growth.

When we talk about the slow growth of family income, economists like to mention globalization, mechanization or other factors that require us to be lean and mean and more "competitive." The story line is that U.S. families have not seen their income grow because America has had to fight it out in a wide-open global economy, and these are lean times for workers.

But that's simply not true.

The economy -- as measured by gross domestic product (GDP) -- has grown by over 160 percent since 1973 (PDF). This is only slightly less than the period from 1947 to 1973 when GDP grew by 176 percent. That has come as Americans have become much more productive -- by over 80 percent since 1973 -- meaning it now takes fewer workers to produce the same number of widgets as it did in the past.

As each worker in the U.S. economy produces more "stuff" per hour, be that DVD players or clients served, those goods and services are being sold in greater numbers. In a healthy economy, that growth is shared between workers and investors, and wage growth should rise with productivity. This was the case in the decades between World War II and the early 1970s, when productivity and median wages both increased by an average of two percent to three percent every year. But since 1973, productivity has increased sharply, especially after the late 1990s, but median wage growth has been flat. So firms are getting much more output per worker, but they're not paying for it. They've pocketed the difference in executive compensation and corporate profits. The share of national income going to wages is at the lowest level ever recorded, while the piece of the pie gobbled up by corporate profits is at its highest point since 1960.

But when the masses ask for help paying for health insurance or child care, or request that everyone be given the right to paid sick days, we're told we cannot afford it. "Afford" seems to be a very special term in the current American context: Letting the wealthy take ever-bigger pieces of our national product is something we always seem able to afford.

We work hard. We -- the 99.9 percent -- and deserve a bigger piece of the pie. With a growing economy, we can afford it, and we all know just where to look for how to pay for it.

Heather Boushey is a senior economist with the Center for Economic Policy and Research. Joshua Holland is an AlterNet staff writer.

© 2007 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/57180/