Health Care Reform--Single Payer Excluded?

The Senate Finance Committee, chaired by Senator Max Baucus, had its first hearing on health care reform this week. Representatives of insurance companies, pharmaceutical companies, etc. were at the table. Advocates of single payer were excluded, and in at least one case, arrested.

Single payer is government sponsored health care, essentially what Medicare is for those qualifying for that plan, extended to cover everyone. It is the most cost-effective, least expensive option of all the health care plans under consideration because (a) the expenses associated with maintaining a bureaucracy enabling insurance companies to minimize coverage of the insured would be eliminated and (b) the number of people in the plan would be so big it would enable the government to negotiate with pharmaceutical companies for much lower drug prices than would be otherwise available.

What kind of reform are we going to get if the most effective approach is off the table?

If, like me, you support single payer (or even if you just think it fair that all options be put under consideration in the deliberations leading to the crafting of a health care reform bill), please contact members of the Senate Finance Committee to insist that single payer advocates be at the table. The next hearing of the Senate Finance Committee on the subject will be next Tuesday, May 5. Senator Max Baucus’s phone number is (202) 224-2651. Other contact info can be found via the link above.

[H/T to Karla Moore for the link & to Avram for Senator Baucus's phone number]

Healthcare Reform--Death by a Thousand Cuts?

I have a recurring nightmare about Barack Obama's efforts to bring health care reform--finally--to the United States of America. 

The scenario is this: Faced with solid opposition from the GOP, Obama needs enough Democratic support in the Senate to enable use of the budget reconciliation process to get a health care reform bill passed. Via reconciliation, that means he needs 51 votes. Currently, the Democratic margin in the Senate is 58-40 (the Franken-Coleman race still being in legal limbo), the number of Democrats having increased by one last week with the addition of Arlen Spector of PA, who switched parties (as I'm sure you all remember). HOWEVAH, a number of Democrats are of the genus blue dog, which may put that necessary 51-vote total in jeopardy.

I was reminded today (again) of the potential for blue dogs to vote with the GOP by recent statements by Nebraska Senator Ben Nelson (D, allegedly) and Senator Spector (D, at least this week) in opposition to Obama's proposed health care plan, particularly its public option.

What is the public option & why is it important? Basically (and please bear in mind that no bill has yet been written, so the precise details of the plan have yet to be spelled out) the public option would provide medical coverage without private insurance to those who choose it. Instead of private insurance, the government would, in effect, be the insurer, a la Medicare. This would not eliminate current health care plans using private insurance; rather, the public plan would exist alongside medical coverage as currently constituted. However, given that the public option would operate without the private insurance middleman, it is expected to be less expensive than current privately insured coverage because it eliminates the extra layer of bureaucracy created by insurance companies for the purpose of minimizing their responsibility for paying insurance claims, and thus, maximizing their profits. 

Why the opposition to the public plan? Nelson specifically has stated outright that his opposition is due to the pressure on profits a public plan would represent to the insurance companies (if Spector has enunciated the reasons for his objections, I have not yet seen it). In other words, given a choice between the interests of the public and those of insurance companies, Senator Ben Nelson opts for the latter, unambiguously. It should be no surprise to learn, therefore, that insurance companies are the biggest single source of funding for Senator Nelson. They're certainly getting what they paid for. And who says there's corruption in Washington D.C.?

In any case, whatever the motivations of other blue dogs in re Obama's health care plan, it should be clear that if we want health care reform to occur this year--that is, if we want to finally seize the moment and remove the U.S. from that small list of industrialized countries without universal health care (leaving only South Africa), we need to organize to put the maximum amount of pressure on conservative Democrats who are caving in to the insurance lobby or thinking about doing so. And while we're at it, in states where there's a possibility of replacing someone like Spector with someone who'll actually vote in the interests of the public, we should do whatever we possibly can to make sure that such wolves in sheep's clothing are retired in the next election cycle. In PA, keep an eye on Joe Sestak--he seems to be edging in the direction of opposing Spector in the next election. If that's true, I think it incumbent on progressive voters and activists to support him.

Budget Links and Where Do We Go From Here?

By now, everyone knows we’re in midst of the worst recession since World War II, and possibly the Great Depression.

Here’s a collection of graphs providing graphic representations of where we are right now, economically speaking.

And here’s some anecdotal evidence.

In response, President Obama has put forth a budget for fiscal year 2010, projecting into the next 10 years.

The budget bill includes the following:

• $634 billion for health reform, 2009-2019
• higher taxes on the affluent to pay for healthcare reform
• ending the gradual privatization of Medicare
• eliminating overpayments to insurance companies
• $645 billion in revenues: sale of emission allowances
• deficit reduction
• cuts to Agribusiness subsidies
• cuts to large-scale weapons systems
• increases in pay and benefits to military personnel
• elimination of student loan financial intermediaries

Here’s a detailed analysis by Robert Greenstein, executive director of the Center on Budget and Policy Priorities.

And unlike the Bush budgets, Obama’s is honest:.

At TNR, Bradford Plumer explores the White House’s assumptions in the budget regarding global warming (yes, we can call it global warming now):.

Many economists have expressed varying degrees of optimism regarding the Obama budget. Paul Krugman calls it “very, very good” while expressing concern about longer-term implications about deficits, social security and taxation, all of which he thinks we can address after the economy regains its equilibrium.

Pete Davis supports Obama’s efforts as well.

Stan Collander agrees.

Jeff Frankel, who was at first skeptical, is now enthusiastic about Obama’s budget and analyzes it in terms of its elimination of the various dishonest manipulations of past budgets (especially Bush’s) and its ability to lead to long-term deficit reduction here.

Here’s a collection of links to various reactions to the tax portions of Obama’s budget plan.

As we all know, the GOP is gearing up to present massive resistance to President Obama’s budget bill. This, of course, includes the tea parties being conducted around the country and may very well include use of the filibuster in Congress.

In response to current signs of GOP hostility to the budget bill and in anticipation of more in the coming months, the big scary libruls are gearing up to lobby for President Obama's budget legislation.

Healthcare expert Merrill Goozner discusses the healthcare portions of the Obama budget plan, discusses the politics of the coming battle, and issues a call to action to all of us.

It seems to me that if we expect to get out of this mess, and if we intend to reduce the deficit afterwards, deal with global warming, our declining public education system, our deteriorating healthcare system, and many of the other disasters bequeathed to us by Bush et al, we need to get this budget passed. I really don’t think anything else on any progressive agenda will get done without it.

If you agree, the next question is what we can do to support Obama’s efforts to get the budget through Congress. Please feel free to comment.

In Case You Thought It Would Be Easy...

In case anyone was expecting the Obama healthcare plan to sail through Congress without a hitch, here's a foreshadowing of the coming opposition.

It is certainly true that the opinion of a writer at the Cato Institute is not necessarily indicative of the points of view of all who come to oppose the Obama healthcare plan; however, history has already given us multiple examples of precisely this sort of nihilistic cynicism on the part of many in the GOP. (The Democrats have not historically been immune to obstructionism either, but they've never taken it to levels anywhere near those of the GOP. And where cynicism is concerned, the GOP wins the race, hands down.)

So I propose a fairly unproblematic test: when the opposition arises, scrutinize the rationale given by each opponent of the legislation. If it's logical and fact-based, fine. People are, of course, free in a representative democracy such as ours to disagree, debate and perhaps change the legislation in question. But if the logic and evidence don't add up, remember the comments above. After all, such behavior would certainly be consistent not only with the Cato prescription, but with that of the Republican members of the current Congress, who (to give just one example) after threatening to eliminate the filibuster altogether in a flap over Bush judicial appointees, used the filibuster more in the past 2 years than any other Congress in history. On principle, of course.

The Obama website had better gear up for this--it's going to be an epic struggle, & the new administration is going to need all the help it can get.