Number 2) Failure of liberal democrats to get a single payer national health care system
under President Obama!
Democrats has control of the Presidency and both houses of congress when Obama
refused to even consider a Single payer system in 2009!
Please stop repressing the truth about a single payer health care system in the USA.
Killed by 2 liberals Ted Kennedy in 1978 and Barrack Hussein Obama in 2009.
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December 18, 2009
We Need Single Payer Now: Obama’s Failed Approach to Health care Reformby Steven L. Strauss, M.D.
December 18, 2009
We Need Single Payer Now: Obama’s Failed Approach to Health care Reform
by Steven L. Strauss, M.D.
When President Obama announced that health care reform would be a top priority of his presidency, there was a predictable sense of optimism among millions of people. In the course of a year, however, this mood has turned sour, and now many people are just hoping that something, anything, gets passed.
Indeed, the Obama euphoria that characterized the early days of the new administration has been steadily disintegrating. His approval rating now stands at less than fifty percent. A president who promised to get the U.S. out of Iraq now says that withdrawal means maintaining the presence of 50,000 allegedly “non-combat” U.S. troops. A president who complained that No Child Left Behind was inadequately funded now threatens to withhold federal dollars from local school districts unless they comply with the law’s draconian measures.
And in health care, the president who once said he is in favor of single payer now says that such a program is off the table, that it is “too disruptive”, even though the majority of Americans support replacing private insurance with a well-run, profit-free government program. More and more, the bait-and-switch game played by the Democrats and Republicans is becoming exposed to U.S. workers.
It is a game because the agenda they are trying to sell is not in the interests of the overwhelming majority of Americans. It is an agenda in the interests of corporate America, one that is fundamentally opposed to the needs of working people. To do this, they have to lie.
When the corporations want war, the big business parties sell it as the way to achieve peace. When corporations want public schools to be the training ground for a workforce with new set of skills to exploit, they call it education reform. And when the corporations want to unload their financial obligations to workers’ health insurance, in order to keep more for themselves and increase their profits, they call it health care reform.
Indeed, the current legislation is not the reform of health care that most Americans had in mind when Obama’s smile was still taken to be sincere. Most Americans want and expected better access to doctors, diagnostic tests, safe and effective treatment, acute care, long term care, and rehabilitation. They want cost to not stand in the way, for themselves, their parents, and their children.
But this straightforward and eminently reasonable expectation among millions of Americans is not what we’re getting. Instead, we are bombarded with swirling dust-devils of confusing rhetoric about penalties for not buying insurance, a public option not open to the public, and cutbacks in Medicare. This is hardly what working people expected.
Confusion is what fills the chasm between what was expected and what we are getting. A problem that seems so straightforward can’t get a straightforward solution from the White House and Congress. We need a surge in health care and we need it to be financially accessible. What’s so difficult about that?
Nothing really. Except that this was never what the so-called debate was about. It was never about health care. It was and is about corporate profits and the efforts of big business to unload the drag on those profits represented by the money it must contribute to employee health insurance. And the debate will stay that way as long as the two parties of big business are the only ones carrying it out.
And that’s not confusing at all. Since when did the Democrats and Republicans ever act out of the goodness of their hearts on behalf of working people? Social advances are achieved by struggle against corporate power and their agents in Washington. That’s how union workers won employer health care contributions in their contracts. That’s how the American people won Medicare.
The only confusion should be in imagining that the two parties of big business are now somehow establishing a new precedent, that they are motivated by sincere empathy for working people.
The Need
The initial optimism over health care reform was based not only on Obama’s promise to make it a top priority of his presidency; not only on Obama having a cultivated image as representing real change; not only on health care feeling like the good news we’ve all been wishing for. It was based on the real, deep need people have for real change in how to get the care they need. There is nothing abstract about getting sick and about getting unpayable bills in the mail.
Thus, the need is both medical and economic. Health care is prohibitively expensive for most working people. In fact, it is essentially unaffordable. A heart bypass operation costs as much as a BMW, about $55,000. If a BMW is a luxury car that most working people can’t afford, then the same applies to coronary bypass. From a financial standpoint, it’s a luxury operation.
Health care insurance makes it somewhat easier for people to access the medical care they need. But people are still stuck with their premiums and deductibles. And this runs so high that 60% of all personal bankruptcy cases in the United States are due to unaffordable medical bills.
Having health care insurance does not protect someone against such bankruptcy. About three-quarters of these personal bankruptcies are among people who have insurance. Obviously, the insurance that most people have is entirely inadequate.
Imagine the even graver situation for people with no insurance. We are talking about 48 million Americans. Half of the uninsured are women. Half of the uninsured are Blacks and Latinos. Half of the uninsured have not seen a medical doctor in more than a year, even though they actually do have medical conditions that need surveillance and treatment, conditions like hypertension, diabetes mellitus, heart disease, and cancer.
How often have you seen a picture of a child with leukemia pasted on a neighborhood telephone pole with a plea for money to pay for chemotherapy? Or a child who needs a major heart operation or liver transplant? Or surgery for a cleft lip and palate? How often is this the child of a CEO of a major health insurance company? Never. This is a class issue.
Women obviously have health care issues quite distinct from men. Yet women are penalized for the chronic “condition” of having a uterus. In some private plans, women are charged up to 48% percent more than men for exactly the same overall coverage. In some plans, having had a Caesarian section is considered a pre-existing condition that the insurance company uses to deny coverage. Hard as it may be to believe, there are some plans that count being a victim of domestic abuse as a pre-existing condition.
The so-called “don’t ask, don’t tell” policy in the military that allows gays and lesbians to enlist has led to some interesting health care problems. Military officials are finding that the “don’t tell” part seems to carry over to the medical clinic, so that gays and lesbians in the military are not getting the care they need.
Job injuries create disabilities. Becoming elderly creates disabilities. People need long term care.
Being young and naïve makes one a target for tobacco pushers, cholesterol pushers, and sugar pushers. Draconian classroom practices, launched into the stratosphere by No Child Left Behind, are associated with increasing rates of childhood depression, anxiety, and suicide. There are all kinds of medical and psychological problems that ensue from the commodification of plants, animals, food, and learning. We need broad health education, including sex education, for young people. We need to create healthful contexts for young people.
There is virtually no end to what needs to be done. And yet this level of need leaps exponentially if we go beyond our immediate political borders, even just to nearby countries. In Haiti, for example, some poor people live on a concoction of mud mixed with cooking oil and sugar. The oil provides a smooth texture, and the sugar a flavorful taste, to the brown substance that will provide a feeling a being full once it lands in a hungry child’s stomach. Most people would agree that this is wrong. Its solution clearly shows that health care is intimately connected to politics and poverty.
A recent New York Times study revealed that, since 2004, 49 million Americans are drinking tap water containing higher concentrations of arsenic, radioactive substances, disease-bearing organisms, and other pathogens that are legally permitted. This wasn’t from an unfortunate natural disaster. It was from federal oversight agencies looking away, over and over again. The Times reported that “fewer than 6 percent of the water systems that broke the law were ever fined or punished by state or federal officials, including those at the Environmental Protection Agency, which has ultimate responsibility for enforcing standards.” Many of these pathogens are dumped by corporate polluters, for whom the nation’s waterways are just one big toilet bowl. According to the Times, “as many as 19 million Americans may become ill each year due to just the parasites, viruses and bacteria in drinking water.” In addition, breast, prostate, and other cancers, whose rates have risen over the past three decades, are linked to drinking water pollutants.
In other words, the same system that puts obstacles in the way of adequate health care is making people sick. A comprehensive health care plan must include forcing the corporate polluters to clean up the water systems. This won’t be easy, since it will cost them money. Private profit both causes disease and stands in the way of treatment.
The Solution
There is a solution to this problem. Not an immediate one, but one that has an initial step that can be launched immediately. And that initial step is single payer.
A Business Week poll in 2005 revealed that about 62% of Americans support single payer, when it is clearly characterized and they understand what it is. Hundreds of locals of the AFL-CIO are on record as supporting single payer. In a recent poll, 48% of medical doctors supported it. A single payer bill, HR 676, has been introduced regularly into Congress by Representatives John Conyers (D-Mi.) and Dennis Kucinich (D-Oh.).
Single payer is a set-up in which there is only one agency to whom medical bills are sent. This agency reimburses the doctors, hospitals, and other health care providers. Crucially, it is not private. It is a government agency. In the Conyers-Kucinich bill, no private insurer is allowed to compete with the federal insurer. In other words, the private insurance industry is no more.
Some single payer advocates would still permit doctors and other health care providers to remain private. They all just submit their bills to the federal insurer. This may be a goal most easily attainable in the short run. But a far more manageable situation, one that would not allow the arrangement to be sabotaged from within, would be to have all physicians, nurses, and other health care providers be federal employees. This, of course, will take some convincing at the present stage of the struggle.
But doctors, for example, can be won to such an arrangement. The one obvious advantage is that being a federal employee eliminates the need for malpractice insurance. This does not in any way imply that doctors are no-longer periodically peer-reviewed, even censured if necessary for poor care. Rather, it means that if an unfortunate outcome occurs, a patient will still have his or her medical needs covered, as in any other situation. There will be no need to bring a lawsuit against doctors and hospitals.
One of the most important features of quality health care is the doctor-patient relationship. The patient must trust the doctor enough to feel comfortable revealing the most private of feelings and physical concerns. The doctor must demonstrate that trustworthiness through both a caring personality and professional expertise.
Single payer poses no inherent obstacle to choosing one’s physician. That means you can stay with whomever you choose, or move on to someone else. That’s your right and prerogative.
Under privately insured medicine, there is a profit-driven basis for insurers telling you whom you may or may not see. The insurers seek contracts with medical practices that will accept their reimbursement schedules. Private physicians may themselves reject insurers who, they feel, reimburse too little. Thus, not every physician is available for every insurance plan. This means that if your insurance plan changes, your doctors can change right along with it.
Under single payer, there are no co-pays or other out of pocket deductibles. There is only a single payer, the government agency. The patient is no longer a payer in a fee-for-service arrangement. As most working people understand, co-pays and deductibles are merely obstacles created by private insurers to discourage people from seeking medical care. They of course become unavoidable within the private system when you land in the hospital because of a heart attack, stroke, or other medical catastrophe.
Single payer has a stake in preventive care, since it is all about keeping the population healthy. Preventive care includes educating teens about the medical risks associated with tobacco use, unprotected sexual activity, and drug use. Preventive care is proactive in screening for breast cancer, cervical cancer, and colon cancer. Preventive care makes the population healthier.
But preventive care is not something private, for-profit insurers want to spend their money on. Even if they could be convinced that their profits would be increased because of reduced rates of preventable diseases, they are too myopic to reckon that far in the future. No capitalist seriously invests now for a return 30, 40, or 50 years in the future, especially when the economy is in a serious downturn and the goal is to squeeze through the present crunch.
Obama on Single Payer
In 2003, Barack Obama said “I am in favor of single payer.” He made this statement before an audience of the Illinois AFL-CIO. He was getting ready for a run for the U.S. Senate from Illinois, and clearly was courting labor support.
For the bureaucrats who run the union, words are a cheap way to buy an endorsement. The ambitious politician became the first African-American president of the United States, and immediately denied he ever made a statement in support of single payer. “I never said I supported single payer”, he stated.
What was he for now? He was for “health care reform”, of course, just like everyone else. But in whose interests?
Obama stated at the beginning of his presidency that health care reform would be a top priority. So important was it to have a reform measure pass in the Congress, he announced that he endorsed a bipartisan approach, and charged House and Senate committees to work out various portions of a comprehensive bill.
Now, what does it mean to endorse a bipartisan approach? It is important to keep in mind that the other party in power is the Republican Party. It is no secret that there is not one Republican who supports single payer, and virtually none who supports a meaningful public option.
If Obama’s bipartisan strategy were based on a sincere desire for everyone in Congress to work together to find a common solution to the problem facing all of us, then it is exceedingly naïve. But certainly such naivety would have been caught early on by all of Obama’s advisors.
No, the bipartisan approach was a signal to the insurance companies and the other private interests that they had nothing to fear. Their sacred profit ledgers would be protected. Behind a veneer of “working together”, Obama took sides.
Bipartisanship is a sign that something bad is coming down the pike. Bipartisanship is the watchword for the U.S. occupation of Afghanistan and Iraq, and for the occupation of the public school classroom via No Child Left Behind. Bipartisanship is the watchword for the USA Patriot Act. Bipartisanship is the watchword for Mumia Abu Jamal, the Cuban 5, and Lynne Stewart. It is why Obama’s “change we can live with” makes no dent in the ongoing terrorist activities of the Central Intelligence Agency. Bipartisan means the capitalist class, corporate America, big business. Two parties representing a single class.
When Obama held his famous health care summit in March, 2009, advocates of single payer were not invited. They staged an embarrassing demonstration outside the White House and were given visas. But their proposals were never taken seriously.
Obama pronounced in his speech that, at the present time, single payer would be “too disruptive”. Too disruptive to whom? Lack of health insurance is directly responsible for 48,000 deaths a year in this country. That’s disruptive too. Whose disruption counts more, the private insurers or working people?
Obama said that he has “no intention of doing away with the insurance industry” since they perform “a useful role”. He proposed instead a “public option” to “keep them honest”.
Perhaps Obama knows something we don’t. Most Americans regard the tobacco industry as more honest than the private health insurance industry.
In truth, the private health insurance industry performs no useful role in society and is inherently dishonest.
What is a health insurance company anyway? What does it sell? An automobile company sells cars. A soap manufacturer sells soap. A brewery sells beer. What does a health insurance company sell?
It sells risk reduction. If you are alive you are at risk for getting ill. Medical care is out there. Without it, you can become seriously disabled, even die. But it is extremely expensive, literally out of reach for most people. Thus, there is a financial risk associated with the medical risk of getting sick.
Working people know that the financial risk can economically disable them, or kill them. So an insurance company comes along and says, essentially: “If you pay us $500 a month, we will take on some of your risk. For $1500 a month, we will take on some of the risk of your family.” This seems like a good bet, and a deal is struck.
Of course, like any good gambling casino, the insurance company won’t let three cherries come up every time the slot machine is rung. Not every illness will be covered. Not every claim will be granted. The insurance company will do everything it can to shell out as little as it can get away with.
That’s the source of the company’s profits. It collects premiums. The less it spends on health care, the more it keeps for itself. The California Nurses Association discovered that 21% of claims in California are denied. The private insurance companies are in the business of denying health care.
That’s inherently dishonest. But the deception doesn’t stop there. The company has a medical director who signs off on the denials. This is a medical doctor, someone who graduated medical school and has an M.D. after his or her name. The insurance company can claim that its denials are based on a careful, medical review.
Except that these medical directors often haven’t seen a patient, or taken care of a clinical problem, in five, ten, or more years. I myself have encountered denials from medical directors who did not know the disease for which they were denying care, or the medicine they were not paying for. That is dishonest.
They say they are not denying care. They are just not paying for it. For most people, that amounts to the same thing.
Between 2000 and 2005, the private insurance industry increased its administrative staffing by 32%. This was not to provide health care, but to further bureaucratize the manufacture of health care denial.
What they do with their money is, of course, no surprise to anyone. The salaries of the CEOs of the ten biggest insurance companies averaged around $11 million in 2008. That’s the equivalent of about 2000 heart bypass surgeries.
Profits to shareholders have gone up 428% in the major companies. While denial of payment to patients is widespread, campaign contributions are quite healthy, about $19 million since 2007 just to federal candidates for the House and Senate. Fifty-six percent of these went to Democrats.
And for working people, premiums have gone up 131% over the last ten years.
It is a lie that this way of doing things has made the U.S. system the best health care system in the world. It certainly is the most costly, with about twice the per capital spending compared to countries like France, Germany, and the UK. It amounts to 16% of the gross domestic product (total spending) in the United States, versus 8% in other advanced capitalist countries.
Yet the World Health Organization reported that on their Disability Adjusted Life Expectancy scale, that is, how long someone lives healthy and without disability, as opposed to immobilized in a nursing home bed, the U.S. ranks 24th in the world!
We pay more and get less. Because we pay an astonishing $350 to $500 billion a year for private health insurance bureaucracies, from which the CEOs and stockholders amass their fortunes, from which Democrats and Republicans get bought off with campaign contributions and lobbying efforts. The administrative costs of actually running a health care system just to provide health care is about 3% of their revenues, as is the case, for example, with Medicare. The administrative costs of a typical for-profit insurer are about 32% -- an utter waste of society’s resources.
And if the Democrats and Republicans get their way, we will be paying even more and getting even less.
The Public Option
It is instructive to consider what Obama said about the “public option”, the plan that would be the compromise with those opposed to a truly non-profit, government run insurer. In his speech to Congress, he praised it and called for its inclusion in the health care reform legislation. He compared the health care public option to the public option in higher education, where truly outstanding public universities co-exist alongside private universities.
Of course, the public university option is shrinking day by day, as cutbacks in capital and personnel expenses are making life more difficult for faculty and students. But even so, the kind of public option that the federal legislators debated bears no resemblance whatsoever to high quality public universities.
There are public options and there are public options. In Los Angeles, if you don’t have a car, you can take the public option – the bus. Using your bicycle on the public roads is also a public option. In fact, all these are better than the health care public option, because no version of the latter discussed by the Democrats and Republicans in Congress was in fact an option open to the public.
Indeed, like welfare and social security disability, the criteria for approval are quite stringent, designed to keep out as many people as possible. The Congressional Budget Office estimated that fewer than 5% of the currently uninsured would be eligible for the various public options being debated.
It is hard to imagine that Obama was not aware of the kinds of public option plans being considered, and that he really thought a health care equivalent of UC Berkeley or the University of Michigan or the University of Texas was in the works.
What the discussion is all about
At last count, the Senate bill was 2074 pages in length. Quite a bit of work went into something that should take only three sentences to summarize: 1. All medically approved health care will be available for everyone who resides in this country. 2. It will be paid for entirely from a non-profit government fund. 3. That fund will obtain its revenues by taxing corporations and the billionaires and millionaires of this country.
But these are not the three sentences that would express, in condensed form, what the Senate and the House have in store for U.S. workers and poor people. Their summary sentences will read more like the following: 1. The government will require everyone to purchase insurance and will levy fines on those who do not. 2. Businesses will not be obligated to contribute to employee health care premiums, but the government will subsidize the costs of premiums for those who cannot afford them. 3. The government will pay for these subsidies by gutting Medicare an estimated $460 billion over ten years and increasing taxes on working people.
This is the core of health care reform from the Democrats and Republicans. It needs to be very clearly understood, because it is not at all about health care, and never was. It is about financial restructuring in the midst of a crisis of capitalism, in which capitalist markets are getting saturated, speculative investment bubbles burst, and the corporations are scrambling to find ways to both boost and safeguard their profits.
The core of health care reform is a massive transfer of money from the working class to corporate America. Instead of big business having to contribute to employee health care, this will eventually come entirely from workers. Instead of private insurers being replaced with a single, non-discriminatory public payer, they stand to gain millions in new “customers” and billions in new profits.
To entice working class support, the government will subsidize some of those who cannot afford the premiums. But this will be paid for by taxing workers and by raiding Medicare, ultimately leaving Medicare too weak to be meaningful.
Democrats and Republicans alike have praised the core content of reform as leading to a lowering of the deficit by about $130 billion over the next decade. It should be crystal clear that it is workers who will be paying off this deficit. That will make it easier for big business and the U.S. government to continue borrowing money to pay for their wars.
Taxes to pay for this, that is, taxes that will unload big business’s financial obligations, increase insurance company profits, and pay off the deficit, will start immediately. But the reform measures won’t actually begin for five years. They plan to suck workers’ limited financial resources for five years to help build up the fund they need to make this thing work.
Some estimates of the impact of the bill include a figure of 24 million as the number of Americans who will remain uninsured even by 2019. Even if a working family qualifies for federal subsidies to pay the premiums, co-pays and deductibles will remain unsubsidized and still amount to about 20% of a family’s income, that is, before the actual insurance coverage kicks in. So, for example, a family with an income of $66,000 will pay about 10% of that for co-pays and an additional 10% for deductibles.
It will be no big deal for private insurers to cover people with “pre-existing conditions”, that is, people who pose a higher financial risk to them. They will more than make up for this with the millions of new customers they gain.
None of this should be a surprise. Since when did Democrats and Republicans take the initiative in giving working people something they needed, either economically, socially, or politically? The gains of our class have come from struggle, and only from struggle. Women’s right to vote, workers right to organize, civil rights and the end of Jim Crow, Social Security, Medicare – in short, every social gain for workers and poor people – has been won through organized confrontation with the corporations and their politicians.
The politicians have known all along what this is all about. They are wined, dined, and refined by the private insurers, the private pharmaceutical companies, the planetary polluters, the military monsters. Senator Baucus got millions from the private insurance industry. According to Physicians for a National Health Program, Senator Reid’s main staff writer of the Senate bill is none other than Elizabeth Fowler, former vice-president of Wellpoint, the nation’s largest private health insurer.
Even the liberals who periodically submit a bill for single payer, but never fight for it, know the score. A telling letter was written by three liberal Congresspersons earlier this year. Here is the letter:
February 19, 2009
G. Richard Wagoner, Jr.
Chief Executive Office, General Motors
300 Renaissance Center
Mail Code 482-C39-B50
Detroit, MI 48265
Dear Mr. Wagoner:
As part of our ongoing efforts to ensure that the auto industry continues to be competitive, we write to engage you in a discussion about solutions. With a difficult economic outlook, plummeting auto sales, efforts already underway to cut costs relative to the competition, and health care costs rising faster than inflation, there has never been a more prudent time for GM to endorse H.R. 676, the United States National Health Care Act. We invite you to meet with us to discuss the matter in person.
You have convincingly articulated the effect of health care costs on GM’s competitiveness for years. Though the Voluntary Employee Beneficiary Association agreement with the United Auto Workers (UAW) has provided some short-term relief of health care costs by relinquishing financial responsibility for retiree care, the health care costs of current employees remain. Unless those costs are controlled, financial relief will be temporary.
As the nation’s largest provider of health care in the U.S., GM is likely to have captured the majority of the efficiencies that can be gained under a system with multiple, competing insurers. If true, systemic health care reform is the remedy of choice. There is a model for health care finance that has proven in several countries to control costs, provide health care to all, and increase the quality of care: national health insurance, which is embodied in H.R. 676.
One such success story can be found in Canada, where Canadian GM, Ford and Chrysler have publicly declared their support for Canada’s health care system specifically because of the competitive advantage it gives them over their American counterparts.
If H.R. 676 was implemented, the benefits to GM would not be limited to cost control. H.R. 676 would reduce liability insurance & workers compensation costs; eliminate the cost and inconvenience of running a health benefits bureaucracy; eliminate employee concerns about rising premiums and co-pays and conflicts with labor unions over benefit cuts; free up money for consumer spending; reduce absenteeism; and produce a healthier, more productive work force.
Momentum behind H.R. 676 is increasing by the day. It garnered 93 cosponsors in the 110th Congress including multiple Chairs of committees and subcommittees of jurisdiction. Fifty-nine percent of all physicians and about 60% of the American public now support a national health insurance plan like H.R. 676. The California State Assembly has twice passed such a bill in the last three years. National health insurance is supported by the deans of prominent medical schools, a former New England Journal of Medicine editor, a Nobel Laureate, a former Surgeon General, the US Conference of Mayors, the US Presbyterian Church, the League of Women Voters, Consumer’s Union, and the UAW.
Please consider meeting with us at your earliest convenience to discuss the issue further. We look forward to your response.
Sincerely,
Dennis J. Kucinich
John Conyers, Jr.
Members of Congress
Marcy Kaptur
Member of Congress
These Democratic liberals merely work for their version of how to make U.S. capitalism more competitive in the global, capitalist economy. They were hoping that one wing of the capitalist class, represented by General Motors and other non-insurance companies, would be willing to sacrifice the insurance wing of their class on the altar of the system itself. Indeed, General Motors has complained for years that it has to compete with non-U.S. automakers who don’t have the same financial obligations to workers health care costs. A mid-sized car built in Canada costs $1400 less than the same car built in the U.S. because of such costs.
The Business Roundtable, a group of about 150 CEOs of the nation’s largest corporations, has complained that “health care is sapping America’s competitiveness in the global market”. They complained that, unless there is “health care reform”, their costs to employee health insurance will increase over the next several years from $11,000 per worker per year to $29,000.
Here come the liberals to the rescue.
Except the private insurance industry here will have nothing to do with single payer, nor even with a “public option” that stands to cut into their profits. Nor will General Motors ally itself with workers against the insurance industry. Nobody ever said that liberals had any clue about how to fight for workers rights.
But progressives who work on behalf of these liberals are undermining the struggle that needs to take place. Because the liberals contain their fight within the hallowed halls of Congress. That, by the way, is the real policy of containment. They contain the debate within their venue. Liberals all too easily give up when they don’t have enough votes. They don’t say, “The majority of Americans support single payer. Let’s build a mass movement in the streets and show we are the majority and not leave until we get what we want and deserve”.
Here’s another letter from Conyers and Kucinich on giving up the fight for single payer:
Thursday, 05 November 2009
Dear Friends,
We thank you for your continued devotion to the cause of health care for All Americans. We have worked together for many years to write, promote and campaign for HR676, a single payer, not for profit health care system. Your work, in communities across America, has been instrumental in helping at least ten states create single payer movements, with many more states to come.
Tomorrow, the House of Representatives is scheduled to consider a single payer bill. As the two principal co-authors of the Conyers single payer bill, we want to offer a strong note of caution about tomorrow's vote.
The bill presented tomorrow will not be HR676. While we are happy to relinquish authorship of a single payer bill to any member who can do better, we do not want a weak bill brought forward in a hostile climate to unwittingly accomplish what would be interpreted as a defeat for single payer.
Here are the facts: There has been no debate in Congress over HR676. There has not been a single mark-up of the bill. Single payer was "taken off the table" for the entire year by the White House and by congressional leaders. There has been no reasonable period of time to gather support in the Congress for single payer. Many members accepted a "robust public option" as the alternative to single payer and now that has disappeared. The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?
While state single payer movements are already strong, the national single payer movement is still growing. Many progressives in Congress, ourselves included, feel that calling for a vote tomorrow for single payer would be tantamount to driving the movement over a cliff. The thrill of the vote would disappear quickly when the result would be characterized not as a new beginning for single payer but as an end. Such a result would be seen as proof that Congress need not pay attention to efforts to restore in Conference Committee the right of states to pursue single payer without fear of legal attacks by insurance companies.
We are always grateful for your support. We are now asking you to join us in suggesting to congressional leaders that this is not the right time to call the roll on a stand-alone single payer bill. That time will come. And when it does there will not be any doubt of the outcome. This system of health care injustice will not be able to endure forever. We are pledged to make sure of that.
Sincerely,
Congressmen John Conyers and Dennis Kucinich
Rather than risk losing in the Congress, they are willing to give up. But single payer is winnable. It is supported by the majority of Americans and by hundreds of AFL-CIO locals. The key is to organize the support that already exists. We have already won the first step of the struggle – workers support. Now we need to proceed with the next step – mass action.
Dynamics of the Struggle
The current drive for health care reform was initiated not by Democrats and Republicans. It was not even initiated by workers and poor people, though there is mass yearning for change. The hammering out of a program to restructure the way health care is financed in this country was initiated by big business as a partial solution to its financial crisis.
Once the Business Roundtable and other agents of corporate America decided to attack health care, they let their clients in the White House and Congress know what needed to be done. The job of the Democrats and Republicans is to sell a corporate agenda to American workers. They use nice-sounding words like “reform”. They feign outrage at the abuses of the private insurance industry. They want everyone to have “affordable” insurance.
But they have utterly failed to give working people what they need – single payer health care reform. And this is not a surprise. The interests of corporate America and working people are irreconcilable and diametrically opposed.
Baltimore Congressman Elijah Cummings, who has a liberal, progressive reputation, announced that what he liked about the House bill was that “It will lower healthcare costs and provide more choice for America’s working families. Right now, healthcare costs are 16 percent of our nation’s economy, and we are simply not getting the results we should be, for that amount of money. We need to lower costs and improve quality.” This is typical liberal blather. It is not an oversight that Cummings leaves unspecified whose healthcare costs will be lowered. If he made it clear that working people will be paying more and getting less, he would lose his liberal credentials. If he made it clear that it is big business whose costs will be lowered, he would jeopardize his support from labor. If he pointed out that the real plan to try to lower the 16% figure is to gut Medicare to help pay off the federal deficit, his political life would be over. So he simply announces that the Congressional reform will lower costs.
There is a simple way to cut the 16% GDP in half – single payer. But that has never been a real option in Congress. Obviously, it will require a mass movement committed to winning. Only the single payer demand brings in forces that recognize health care as a right and not a privilege, because it automatically provides health care for all people, with no first class, second class, and third class distinctions. Therefore, only the single payer demand can keep this whole struggle focused on real health care, not budgetary reform.
It will take a fight against corporate America, the architects of the proposals being most seriously considered, like mandated care, in which everyone must purchase insurance or face penalties, and making Medicare “value” based, that is, where only those aspects of care are reimbursed that prove their worth through a positive outcome, or lack of a negative outcome. The first proposal will give private insurers more customers, and more profit now paid by taxing working people. But the larger number of customers will lower the costs big business will have to contribute for its employees. The second gimmick will start the erosion process of Medicare. The less the federal government has to pay for elderly health care, the more it has available to pay off its creditors, thus keeping its credit rating at a level it needs to borrow indefinitely to fight planetary wars. Remember, the “war on terror” is “permanent”.
But corporate America is not the only adversary. While not actually initiating the debate, the right wing has entered the ring. They are pushing their misogynist anti-abortion agenda. They are pushing their racist, dark-skin hating anti-immigrant agenda. No federal funds for these. And what did Obama say in his speech to Congress? Essentially, don’t worry, no federal funds will pay for abortion and no “illegal” will get health care through the federal plan.
This is the dangerous compromise that liberal Democrats are all too willing to support, even embrace. They think compromising with the neofascists will allow them to gain some things that would otherwise be out of reach. They think appeasing the neofascists will quiet them down.
This is a strategy that must be vigorously opposed. Appeasing the neofascists will never make them go away. Quite the opposite in fact will occur. They will be more emboldened. They will take their hate messages elsewhere. They will recruit people who think they really do have clout. No, they must be energetically and uncompromisingly opposed. We need to boldly say that real health care reform means full coverage of women’s health, including reproductive health and the right to an abortion on demand. We need to boldly say that real health care reform means full coverage for everyone living in the United States, including undocumented workers and their families. Any compromise on who is covered opens the door to forces opposed to real health care reform.
We need to recognize that the Democrats, including the liberal Democrats, have no clue about the crucial significance of this aspect of health care. California Senator Barbara Boxer revealed she was not happy with the Stupak amendment in the House bill, which would have prohibited any private insurance company receiving federal subsidies from providing any abortion coverage. She was happy, however, that the Senate bill merely prohibited insurers from using federal funds to pay for abortions, while still allowing them to use the woman’s own premiums for abortion care. She said: “Senator Reid also has crafted language that will keep women from being discriminated against when it comes to their reproductive health care. The Senate bill maintains the compromise that has been in place for decades that prohibits the use of federal funds for abortion, but allows a woman to use her own private funds.” But Senator Boxer is completely misguided on this, since discrimination against women and their reproductive health care stems precisely from the fact that it is paid for out of private funds. Those who do not have the private funds to pay for an abortion are discriminated against. End of story. The only way to end this kind of discrimination is to make reproductive health available regardless of ability to pay, to take it out of the profit-driven economy.
Democrats have a funny way of turning defeat into victory. They call compromise with the neofascists a victory, since this isn’t really about health care for women and immigrants. They call maintaining an already bad status quo, in which women are discriminated against, but where the forces for even greater discrimination have been temporarily defeated, a victory. Pretty soon, jumping off the edge of the cliff will be a victory, because it is better than being shot and then kicked off.
We need to completely reject the Democrats and their failed approach to health care reform. Their strategy is a losing one for working people, women, immigrants, and poor people. We need to recognize that, from their standpoint, this whole thing was never about real health care. It was, is, and will continue to be about their budget and the profits of corporate America. The bipartisan No Child Left Behind was called “education reform”, but never had anything to do with real education, unless you think creating a police state in the classroom to test kids to death and punish children and their teachers and their schools for poor test scores is education. No, it was only about corporate America using the public schools as a ready-made factory system to manufacture workers with skills that could keep U.S. businesses competitive with their European and Asian counterparts.
The so-called health care debate, likewise, is about keeping U.S. businesses competitive with their overseas counterparts. We are the ones who need to make this a struggle for real health care reform, where the focus is on health, the health of real human beings, not corporate profit ledgers.
We can only rely on ourselves to do this. But we are the majority. And the majority of Americans want single payer. Organized U.S. labor broadly supports single payer. It needs to take the lead in educating the public and organizing outside the straightjacket called the U.S. Congress. We need to bring natural, and crucial allies, into the struggle – women’s rights groups and immigrant rights groups. We have great resources to get all the facts we need, like Physicians for a National Health Program. We need to think about building towards a national march on Washington to demonstrate to the politicians, Republican and Democrat, liberal and conservative, that we will define what health care is all about, not them, since they clearly don’t have a clue, and that we demand single payer now, free abortion on demand, and free health care for everyone living here, legally or not. Democrats and Republicans alike signed civil rights legislation only after millions of people took to the streets. And threatened to stay there. That’s the strategy we need to win.
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W.E.B. Du Bois: Solidarity can save us
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