by BAR managing editor Bruce A. Dixon
When it comes to health care, Barack Obama is a hater, and a dishonest one at that. An honest and ethical hater tells you where she or he stands, and throws down the appropriate facts. President Obama doesn't do this. He has claimed for years to be a proponent of single payer health care, the only practical and workable health care solution, but since his election to the senate in 2004 he has become accustomed to saying he would favor single payer "if we were starting from a clean slate" but of course we are not. Insurance companies are powerful interests, he seems to say, and for some reason, we have to let them keep the thrid of every health care dollar they currently take.
President Obama knows there is no blank slate and there never was. That's not even honest hating. It's hypocrisy. And it's not leadership, it's caving to the parasitical private insurers.
President Obama: Hypocrite and Hater on Single Payer Health Care
by BAR managing editor Bruce A. Dixon
"...the Obama Administration's emerging health care plan is expected to be based upon a model that has failed multiple times, most recently in Massachusetts"
Obama likes to say that the insurance industry employes tens or hundreds of thousands, and we cannot just displace them. That's hating. But his advisors know perfectly well that single payer health care insurance would create 2.6 million new jobs , after allowing for the 440,000 insurance company jobs it would do away with a fact detailed in the groundbreaking report issued earlier this year by the National Nurses Organizing Committee. Instead, in the spirit of a dishonest hater, Obama has tried to ban from public forums any discussion of the single payer health care option, despite the fact that it has massive support among the people who voted for him. That is hypocrisy.
When the Obama campaign asked for house meetings across the nation on health care, the option suggested most often was indeed single payer. So you didn't hear much of anything about the outcomes of those meetings. If that's not dishonest hating on single payer health care it's hard to imagine what is.
Instead, the Obama Administration's emerging health care plan is expected to be based upon a model that has failed multiple times, most recently in Massachusetts, which includes "individual mandates" requiring people above a certain income level to purchase private insurance or face a fine, and provides some kind of care at subsidized rates to those with the lowerst incomes. A recent study by physicians at Harvard Medical School meticulously exposes the predictable failure of the Massachusetts Plan live up to any of its promises, and explains succinctly why no "individual mandate" which subsidizes private insurance companies should be a model for any national health care plan.
It's called "Massachusetts' Plan" A Failed Model for Health Care Reform", and you can find it online here.
In it, Drs. Rachel Narden, David Himmelstein and Steffie Woolhandler, all of Harvard Medical School deliver a withering assessment of the plan's failure, and explain why it must not be a model for any national health care plan worthy of the name.
These are the key features of the Massachusetts Plan upon which Obama's health care plan is modeled.
- Subsidized private insurance is made available for the poorest at reduced or no cost through a state agency.
- Unsubsidized private insurance at controlled costs was to be made available for those who made a little more.
- As with automobile insurance, those not qualifying for subsidized insurance would be fined ($912 a year in 2008, $1,068 in 2009, collected with your state income tax) for failing to purchase insurance.
- Employers were required to pay $295 a year for each employee they didn't give health insurance to.
- To control costs, funds to pay for the program were taken from the existing pool that previously financed “safety net” care for the poor and uninsured, leaving many with fewer options and less care than was available befor the “reform.”
But the subsidized health insurance policies available to the poor in Massachusetts often covered fewer services than they were already receiving under previously existing conditions, and the greater the “income” of these poor people, the lower the subsidy and higher the deductibles. Under the Massachusetts Plan, the subsidies vanish altogether when one makes 300% of the ridiculously low Federal Poverty Level --- about $31,000 per year.
Despite the fines for persons who fail to buy health insurance under the so-called “individual mandate” plans, many remain uninsured because coverage is simply not affordable.
“...the reform law specifically exempts uninsured families from fines if no affordable private plan is available. About 79,000 Massachusetts uninsured residents received this exemption in 2007, which excused them from fines, but left
them uninsured.
“The private insurance plans available through the Commonwealth Choice program can be extremely expensive. According to the Connector website (accessed December 29, 2008 at www.mahealthconnector.org) the cheapest plan available to a middle-income 56-year-old now costs $4,872 annually in premiums alone. However, if the policy holder becomes sick, (s)he must pay an additional $2,000 deductible before insurance kicks in. Thereafter the policy holder pays 20% co-insurance (i.e. 20% of all medical bills) up to a maximum of $3,000 annually ($9,872 in total annual costs including premium, deductible and co-insurance). A need for uncovered services (e.g. physical therapy visits beyond the number covered) would drive out-of pocket costs even higher. It is not surprising that many of the state’s uninsured have declined such coverage.”
How can someone making $31,000 a year pay $90 a week in premiums alone, plus $20% of all medical bills up to $3,000 if they get sick? Is calling this "reform" even the least bit honest? Or is it hypocrisy?
The study makes the point again and again that access to health insurance is not the same as access to health care. A full third of every health care dollar is already diverted to private insurance companies. The Massachusetts Plan, and the emerging Obama Plan seem intended to preserve this cut for private insurers, even at the expense of needed care. “...(T)he new inssurance policies that replced the (previous) free care system require co-payments for office visits and prescriptions, which are difficult for many low income patients to pay...” says the study, hence patients suffering from HIV-AIDS and other chronic conditions have had to reduce doctor visits or skip their meds due to the high co-payments that the "reform" required.
The report outlines how the advocates of these private insurance industry endorsed versions of health care reform have lied in state after state where this has been tried --- in Oregon, Maine, Vermont, Tennessee and elsewhere. We encourage our readers to download and read it, at only 18 pages, as an antidote to whatever form of "individual mandate" health plan is finally proposed by the Obama Administration.
Plans of this type have not lowered overall health care costs, either. They provide no incentive to tone down the over-reliance on expensive techniques and specialists. They fail to address the acute shortage of primary care physicians, the doctors who provide day to day, person to person coverage. Obama's offer to "let's computerize medical records" as a cost-saving procedure sounds nice, but falls flat. Most of the unecessary paperwork is between care givers, hospitals and insurers with a vested interest in saying no to this or that treatment, test, or medicine.
During the presidential campaign, Barack Obama declared we should judge his first term by whether, under his leadership, the nation finally enacted national health care system that takes care of everybody and lowers the cost of health care. Now we are in the middle of a completely foreseeable economic crisis caused in part by many of the people who are advising the president. Single payer health care has come to the fore as a viable means to create 2.6 million new jobs, a proposal that Obama's advisors neither address nor discuss.
Sixty days into his presidency, the clock is ticking. Lofty rhetoric and lawyerly evasions are giving way to actual policies, many of them deeply disappointing to the people who campaigned and voted for this president. It looks like national health care for everybody is a dream, that if left up to this president and his advisors, will be deferred again. The question is, should we leave it up to them at all?
Bruce Dixon is managing editor at Black Agenda Report. He is based in Atlanta GA and can be reached at bruce.dixon(at)blackagendareport.com.
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