The disorder of words. When the public option is not public at all.

Written by: T Nuspl on Nov 16, 2009 12:53 PM EST

It's a grave mistake to think the present health care bill "will move very close to what single payer can provide."  Single-payer, the concise 30-page bill for health care reform, saves the taxpaying public $400 billion per year, by cutting out private insurers, and provides truly universal coverage for all Americans, regardless of ability to pay. Meanwhile, with the mammoth bill that has actually passed in the House, HR3962 for a very weak public option, you only have a fig leaf in the place of a public option. It's very unclear how the present bill reduces costs in any way, and it only extends coverage on the margins of society.   Although I hear Rep. Weiner (D-NY) claiming very forthrightly that this bill will reduce costs, overall, to the federal government at least, and won't add to the deficit, the CBO still has not waded through the 2,100 pages of the bill, to tell us whether it saves or costs money in the end. It's a strange form of accounting into the future: spend $1 trillion to save $190 billion over a decade.  But what is known is that the present bill ADDS $50 billion of consumer cost per year (some say as much as an addition $70 billion per year), coming directly out of the taxpayers pockets, by directly underwriting corporate profits with monthly insurance payments, and adding captive customers to the big insurers' base of subscribers. The present bill treats health insurance as if it were auto insurance, and everyone as if they're able to pony up. It comes nowhere near recognizing the right to health care (as opposed to the privilege of driving a car).  It's a HUGE favor to the health corporations.

If you are not covered by an employer, you can calculate what the House bill will cost you, here:
http://healthreform.kff.org/SubsidyCalculator.aspx

The monthly premium under HR 3962 will likely be more costly than existing health premiums paid to corporate health care providers. The bill wants to garner between 10.5% and 11.5% of your annual pay. Some sources say health care insurance could eat up between 15% and 19% of family annual income! And that's only the cost presuming you are willing to pay (i.e. buy crappy insurance from a company you know is bloated, unethical, and untrustworthy, providing a defective product). If you don't pay, there will be hefty fines (there's talk of thousands of dollars per year per person or per family). You will be penalized if you refuse to play with the big boys in the health insurance industry, friends of politicians in the House. That's what a "mandate" means: punishment for disobedience.

Here's another way of putting it: To whom would you rather be forking over your dollars?  The government or the big health corporations?  At present, the weak public option that passed in the House is going to be RUN BY the insurance companies (who will drive it into the ground, on purpose, so that it fails in the near future), and you will NOT get the choice to direct your health insurance dollars to a genuine government-run public option.  At minimum, when we speak of a "public option," this should mean a government-run program, similar to Medicaid (an existing and working single-payer system, with minimal overhead, and fixed rates for services, well liked by many who bill the government for private services delivered under its aegis). 

The present bill does nothing to provide competition for the private health insurance industry because it has no government-run option (unless you count the slight extension in Medicaid coverage for the very poor).  The bill caves into the lobbying pressure of that industry, which in turn is simply trying to parley its way out of meaningful reform, hoping the Democrats go away by the next election (in 2010 already).  The $1.4 million PER DAY spent by the lobby against health care reform, in D.C., this year, won out against any grassroots activism, this summer.  The goodwill Obama had created in favor of health care reform is being squandered, and we will be yet more unfree as a result, without being in any better health, physically or financially.

Let's call a spade a spade. Let's recognize that the American people is getting virtually nothing of what it wants in this bill; meanwhile, the U.S. corporatocracy is getting a lot of what it wants, albeit with a slap on the wrists for being such bad corporate citizens for so many decades.  They are being rewarded and allowed to steal from your pocket book, yet again, with this Pelosi bill. And without any cost controls.

If you're going to demonstrate for health reform, I'd suggest at least getting clear about what the "public" means in defining a "public option."  To be "public" it should, at minimum, be an independent government-run option, wholly separate from private insurers, that competes with private insurers to provide better cost efficiency, as it would be a non-profit (cutting out the 20% or 30% overhead that most private insurers are burdened with).  We want a non-profit federal option to buy into, something like Medicaid.  At this point, we're being given instead a junk bill that forces us to buy crappy insurance products from unethical providers in private industry, who look at patients as commodities, more or less expendable for the sake of their bottom line.  This is not the reform we wanted.  This is betrayal.

And it's hard to smile about it.

On the failure to get a vote on HR 676, the bill that would create an amended and expanded Medicare for All, I take the point about not being a purist in politics (or being hopelessly loyal to a party, or political leader, when they fail you, which is another kind of dead end).  Although HR 676 is co-sponsored by veteran health care consumer advocates like Kucinich and Conyers, I would have been very happy to see an up-or-down vote on the Weiner Amendment that defined a version of single-payer, or Medicare for All, that could reform our system sensibly, albeit without touching the privately-run hospital system that we have now, leaving aside the issue of dealing with its gross inefficiencies for another day.  I understand Weiner's amendment wasn't sufficiently pure to get the support of Kucinich and/or Conyers, and I believe that they made a mistake, in not making common cause with Weiner, before the amendment was pulled.

Maybe by the next Congress, if we work hard to get progressives elected, we could get the single-payer system we deserve; however, Pelosi has to go.  The present bill that Pelosi has managed to get passed is a woeful substitute for the public option.  She is not working for UNIVERSAL health coverage. The measure’s public option, according to the Congressional Budget Office (CBO), will only attract 6 million out of the 45 million uninsured Americans (which I now estimate at 53 million Americans, due to the increased unemployment in this country, and the inability of an additional 17,000 Americans each day to pay health insurance premiums.) We expected better from the Democrats, many of us having lobbied all summer long, as private citizens or as grassroots organizations, in favor of a robust public option or, preferably, single-payer.  There will need to be future attempts at reforming the corrupt, bloated, inequitable health care system in this country.

We can start by electing better Democrats. Rather than DINOs.

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