The State of Healthcare
Michael Givel
=====================================
01/23/2007 @ 5:12pm
The State of Healthcare
by Katrina vanden Heuvel
According to the Bush administration, the new health care plan that
the President unveiled in the State of the Union address Tuesday
would cover three million people who are currently uninsured. Three
million - out of forty-seven million. After years of dangerous
inaction, this is what Bush rolls out to address a grave and
growing crisis!
And, of course, no Bush domestic proposal would be complete without a
further gutting of the social compact - this time, "cutting Medicaid
payments to public hospitals and other 'safety net' providers by $3.9
billion over the next five years." As Deborah Bachrach, a deputy
commissioner in the New York State Health Department, told the New
York Times, this cut would impact hospitals "that serve some of the
lowest-income, most vulnerable patients." This at a time when many
such facilities are already struggling to survive.
The Bush tax cuts for the wealthy survive untouched - in fact, they
receive a new deduction if they purchase their own plans. However,
the continuing War on the Middle Class is being.well, escalated.
Workers who, according to the President, "choose overly expensive,
gold-plated plans" through their employers will be taxed, while those
who buy plans on their own will receive a deduction. As Columnist
Paul Krugman suggested in a Times op-ed, who in our nation has one of
those gold-plated plans? Krugman goes on to write, "The uninsured
don't need an 'incentive' to buy insurance; they need something that
makes getting insurance possible.. Mr. Bush.is still peddling the
fantasy that the free market, with a little help from tax cuts,
solves all problems."
"The President's so-called health care proposal won't help the
uninsured, most of whom have limited incomes and are already in low
tax brackets," said Democratic Representative Pete Stark, Chairman of
the Ways and Means Health Subcommittee. "But it will hurt middle-
income Americans, whose employers will shift even more cost and risk
to their employees."
And as Gerald Shea, assistant to the president of the A.F.L.-C.I.O,
told The Times, "It would throw into turmoil the employment-based
system of health insurance, and it would impose a new tax on the
middle class."
Most experimentation (both good, not-so-good, and bad) with health
care policy is happening at the state level. The often-touted
Massachusetts plan - in the words of Doctors Steffi Woolhandler and
David Himmelstein of Cambridge Hospital and Harvard Medical School -
"offers empty promises and ignores real - and popular - solutions."
By requiring every resident of the state to have health insurance or
pay a fine while doing nothing to control costs of insurance and
care, or setting standards for coverage - Big Insurance wins, and
consumers lose. And the middle-class which doesn't qualify for
subsidies but can't afford insurance is further squeezed.
In California, Governor Arnold Schwarzenegger has proposed a similar
plan. Again, the plan mandates coverage but, according to State
Senator Sheila James Kuehl, "it doesn't ensure that coverage will be
comprehensive and affordable.. [it will] at best provide high-cost,
low benefits plans for many Californians; it limits what employers
pay but not what individuals must pay or what insurance companies
can charge."
Although Schwarzenegger has won praise for a "bipartisan approach,"
in fact both his plan and that of Massachusetts Governor Milt Romney
move in a direction Romney's staff calls "a culture of insurance" and
"personal responsibility."
State Sen. Kuehl herself has a plan for universal coverage that I
previously reported on here. Her proposal - SB 840 - would offer all
Californians comprehensive care and the right for a patient to choose
his or her doctor. It would replace insurance companies with a
statewide trust fund that collects premiums paid by employers and
individuals. The creation of a single fund reduces administration
costs from nearly 30 percent of total health care costs to under 10
percent. With 80 percent of Californians wanting a government
guarantee of affordable health care coverage, one hopes state
legislators will take another look at the Kuehl plan.
The Washington Post reports that Pennsylvania Governor Edward
Rendell has proposed a tax - on tobacco and businesses not offering
health care coverage - in order to create state-subsidized private
insurance for its 767,000 uninsured people. Vermont, Illinois, and
Maine have all enacted legislation to expand coverage of uninsured
residents as well, and at least eleven other states are
"considering" doing the same.
Meanwhile, at the federal level, any real action to improve this
unacceptable situation - worse than any other industrialized nation
in the world - will have to overcome a lot of naysayers (not to
mention powerful lobbying interests with their campaign dollars).
Consider these statements from three representatives to The
Washington Post:
"The truth of the matter is that dealing with this problem between
now and the election is not realistic," said Senator George
Voinovich.
"Congress is not going to act in a major way to deal with this access
problem in the next couple of years," said Senator Jeff Bingaman.
"That's the unfortunate reality that we're facing."
"If we tried to adopt a universal health-care plan on the federal
level, we probably wouldn't have the votes," said Representative
Frank Pallone Jr.
Nothing like negative, self-fulfilling prophecies to justify do-
nothing proposals from our elected leaders.
The fact is there are 78 co-sponsors of HR 676 - the United States
National Health Insurance Act introduced by Representatives John
Conyers and Dennis Kucinich. There are 225 labor organizations
supporting it as well. It would expand Medicare to every resident
through savings from negotiated bulk procurement of medications; a
tax on the top 5 percent of income earners; and a phased-in payroll
tax that is lower than what employers currently pay for less
comprehensive employee health coverage.
"There are only two real choices in the present healthcare debate.
commercially-based models which reinforce the insurance industry and
fail to provide genuine universal and comprehensive care, and HR 676,
a patient-based model which caregivers know is the most effective,
humane approach," said Deborah Burger, president of the California
Nurses Association/National Nurses Organizing Committee.
"Solutions to the health care crisis based on increasing our
reliance on private health insurance companies are bound to fail,"
said Dr. Oliver Fein, director of Physicians for a National Health
Program. "Insurance companies limit patients' choice of doctor and
hospital, and take money out of patient care and put it into
marketing, bill collectors and claims deniers. We need a National
Health Insurance program."
At a time when our nation is spending $8.4 billion per month in Iraq
it is clear that the resources are available where there is political
will. Just as the President proposes that we continue to follow his
course of folly in Iraq, so too will he ask us to stay a course which
causes the number of uninsured to grow year after year, and makes
access to comprehensive health care a privilege for the fortunate who
can afford it.
Tonight, when President Bush offers his flawed prescription for
improving the state of health care, respond by signing on to the only
real solution: universal health care now.
-------------------------------------------------
Progchat_action is a non-partisan and progressive political news weblog,
chat, and action discussion alternative in cyberspace:
http://groups.yahoo.com/group/progchat_action/