Obama For Universal Healthcare

This is seriously good news. Obviously having another influential Dem politician behind the idea brings it that much closer to happening, and it would be nice to see the Obama campaign settle on a signature issue or two. But to me this is interesting because Obama may have the right combination of qualities to exploit the growing tension between the American insurance industry and basically everybody else. Relative to our competitors with more sensible healthcare plans (that is, virtually every other developed nation) American industry is suffocating under the financial burdens of our employer-provided healthcare system.

It might seem insensitive to set aside the concerns of citizens who can’t afford private healthcare, employees whose coverage nickels and dimes them to death (sometimes literally) and the entire categories of Americans who cannot buy health insurance at any price, and I suppose that’s true. The problem is that outside of AARP, which has Medicare, no specific organization speaks for healthcare consumers. Every politician has to answer to the voters, sure, but come election time they answer with lobbyists’ money. To get attention on Capitol hill you need money and organization. Consumers can’t do it (though it might be wrong to write off the grassroots/netroots just yet). However, if one lumps together the American industries that would quickly come off life support when a single-payer plan is sensibly implemented (auto, airlines, service, etc) it would become seriously difficult even for the insurers’ titanic K street operation to compete.

Needless to say, tossing together American industry behind universal healthcare isn’t beginner chess. Somebody will have to overcome business leaders’ instinctive mistrust of socialist-sounding ideas and Democrats in general. Then we can even start talking about problems like institutional inertia. For that reason it seems unlikely that John Edwards, career trial lawyer, will make much headway. Fairly or unfairly Hillarycare gives me shudders. Obama, though, has a knack for making unlikely friends, a pragmatic tendency to look for common ground and little to no skeletons to get in the way. The idea of marshaling American industry against American insurance may be a fool’s errand for any pol, but I have an odd feeling that Barrack Obama may have what it takes to pull it off.

***

To add, finding one encouraging quality in a candidate does not a full endorsement make. In my view every credible candidate in the Democratic field would make an fine president. I also have no doubt that if current trends continue any one of them will slaughter whoever the GOP eventually puts forward.

***Update***

Color Kevin Drum underwhelmed. Maybe I’m guilty of projecting what I want to see. It’s hard to say, he hasn’t proposed anything yet.






33 replies
  1. 1

    Color me in agreement with Drum. Hillarycare, love it or hate it, is real single payer, fleshed out and worked out. It’s wildly unlikely that we’ll do any better.

  2. 2
    Zifnab says:

    Can someone define for me exactly what “single payer” is and what the other options were supposed to be?

  3. 3
    Dave says:

    Well at one time I was hopeful that American business, feeling the weight of health care costs, would eventually gravitate to universal/single payer health care. After all it would be good for their bottom line. That was until Bush introduced his idea of “health care reform” which effectively removes the burden of health care from employers and leave the employee with nothing but a useless tax credit.

    This is essence is a wet dream for American business: off load health care costs on to the employee and not have to suffer taxes on their own income.

  4. 4
    Dave says:

    Zif…

    Wikipedia has a pretty good summary

    The proponents of single payer need to do a lot better job explaining what it is. Until recently it was just a buzzword to me too. I actually had to do some research.

  5. 5
    Zifnab says:

    Ah. Single payer means government. I assumed they were refering to the method of paying into health care i.e. who pays the insurance premium.

    Of course, if this were implimented, it seems like it would be the death blow to the insurance industry. No way the bloated infrastructure of the insurance system could stay afloat with this in place. What would they offer?

    I just don’t see us ever weaning ourselves off private insurance. There would be literally hundreds of millions of dollars thrown against the initiative. The insurance companies would beat the system to death with their bare hands if they had to.

  6. 6
    Geek, Esq. says:

    Well, it’s pretty damn early right now to be advancing a plan to radically reform our health care system.

    And, contra Drum, such a plan would be how many thousands of pages long?

    The correct goal is to get the American people to the point where they’re ready to accept the radical proposals.

    Until that happens, any substantive plan would just get nicked and cut to death by a thousand different nitpickers.

  7. 7
    Tim F. says:

    Of course, if this were implimented, it seems like it would be the death blow to the insurance industry. No way the bloated infrastructure of the insurance system could stay afloat with this in place. What would they offer?

    Two simple answers. First, other countries usually have private plans that you can buy in addition to the state plan. These let you, for example, choose your doctors, schedule speedier surgery at participating hospitals or choose fancier drugs. Second, the insurance industry will fight it like a banshee on crack. That is the point of my post – consumers have crap for lobbyists. If we want to answer the insurance juggernaut we need a juggernaut of our own. Hence, industry.

    Hillarycare, love it or hate it, is real single payer, fleshed out and worked out.

    HRC thought that she could mollify the insurance companies by involving them in the plan, but she was wrong and the plan was worse off for it. They lined up against her and left the plan with no influential ally, guaranteeing its eventual death. I would like to think that she learned from her mistakes, but from the quote at TAP I don’t get the impression that she has.

  8. 8
    Krista says:

    Why can they not set up a dual-payer system, though?

    The government (in other words, your taxes), would pay for urgent care like hospital stays, non-elective surgery, chemo treatments, and a subsidy on prescription meds. That way, all of the stuff that people would…you know….DIE without are covered. Then, people would still have the option of purchasing private insurance to cover the co-pay on prescription meds, protheses, vision correction, hospital room upgrades, walkers, wigs, physiotherapy and chiropractic, and whatnot. The insurance companies would still make plenty of dosh (I know the ones up here aren’t suffering any!), but you wouldn’t have people dying because they don’t have any medical insurance.

  9. 9

    huh. The juxtaposition of this and John’s most recent post brought a sudden insight – a realization of another reason the GOP will resist single-payer healthcare.

    Abortions. It doesn’t matter whether they get covered or not, the decision goes to court. Or the polls. Or both.

    And for a whole bunch of reasons, the current GOP can’t afford that. Promise, but don’t deliver.

  10. 10

    Hey, Krista, you should described how those nasty socialist European countries do it. Pssh. Can’t have that! It makes too much sense!

  11. 11
    Dave says:

    huh. The juxtaposition of this and John’s most recent post brought a sudden insight – a realization of another reason the GOP will resist single-payer healthcare.

    Abortions. It doesn’t matter whether they get covered or not, the decision goes to court. Or the polls. Or both.

    And for a whole bunch of reasons, the current GOP can’t afford that. Promise, but don’t deliver.

    Well I think the GOP will resist this regardless since it stinks of “socialism”

  12. 12
    Tim F. says:

    That way, all of the stuff that people would…you know….DIE without are covered. Then, people would still have the option of purchasing private insurance to cover the co-pay on prescription meds, protheses, vision correction, hospital room upgrades, walkers, wigs, physiotherapy and chiropractic, and whatnot.

    The problem is that those little things go a long way to prevent the need for emergency care, which is the vastly more expensive way to treat an illness. So in order to keep costs under control the government will not only pay for preventative treatment and those other not-a-big-deal things, but come up with any number of programs to encourage you to use it.

    Private insurance assumes that you will skip to some other insurer sooner or later so the don’t care much about preventative treatment. It won’t save them money, so why should they care? Under single payer, every cancer prevented is a million saved. Incentives pretty much guarantee that the big and little stuff will both be covered.

  13. 13
    AkaDad says:

    Isn’t socialism where the Government provides your shelter, food, clothing, health care, and job?

    Oh wait, that’s our military. Nevermind.

  14. 14
    dreggas says:

    The government (in other words, your taxes), would pay for urgent care like hospital stays, non-elective surgery, chemo treatments, and a subsidy on prescription meds. That way, all of the stuff that people would…you know….DIE without are covered. Then, people would still have the option of purchasing private insurance to cover the co-pay on prescription meds, protheses, vision correction, hospital room upgrades, walkers, wigs, physiotherapy and chiropractic, and whatnot. The insurance companies would still make plenty of dosh (I know the ones up here aren’t suffering any!), but you wouldn’t have people dying because they don’t have any medical insurance.

    See here’s my problem with things like this, now before I start I am an advocate of single payer. My wife is disabled and has to use a wheel-chair, she also has to take 2 pain medications as well as a drug for her gastritis. I myself have to take a few medications.

    Under a scenario like this I would continue to be at the mercy of the current insurance/drug company cabal to get hers and my meds which leaves me with the situation I am in now.

    Because it is somehow cheaper the insurance company, rather than providing a sturdy wheel-chair that is customized for my wife they continually rent refurbished wheel-chairs from a specific company, the quality is piss poor and by the end of the year the chair is practically falling apart but by that time we “own” it and she gets a new one and we repeat the same cycle.

    With regards to our meds some are covered, some aren’t hell the health insurance I have now charges on a scale for meds so that where before I payed a set price for generic and another for name brand scrips I now pay on a rising scale based on the drugs meaning some of my meds cost 40 for a months supply (and yes I know the alternative is worse since said medication, without insurance is 400 a month).

    Top that off with the fact that I have to take these meds every day and recently when changing jobs had to basically figure out a way to make sure I would have my meds while I waited for the new jobs insurance to kick in and praying nothing completely disastrous happens during my month without coverage.

    I used to deride hillary care back in the 90’s but facing what I have faced in just the past year I wish we had a single payer health system so I didn’t have to worry about this crap and on top of that had someone with enough market power and negotiating power (ie the government) to tell the drug companies to quit raping me vis-a-vis my insurance company because I need X medication.

    Thank god I don’t have heart problems or diabetes like my in-laws their drugs are through the roof!

  15. 15
    Krista says:

    Oh, I’m not denying that single-payer would be fantastic, mostly for the reasons that Tim and dreggas are stating. But, it might be a good idea for legislators to start considering “happy medium”-style options like those, in case your wished-for single-payer health care just doesn’t happen (which, you have to admit, is a distinct possibility).

  16. 16
    dreggas says:

    Krista Says:

    Oh, I’m not denying that single-payer would be fantastic, mostly for the reasons that Tim and dreggas are stating. But, it might be a good idea for legislators to start considering “happy medium”-style options like those, in case your wished-for single-payer health care just doesn’t happen (which, you have to admit, is a distinct possibility).

    Oh I agree it most likely won’t happen any time soon and that kills me, just as much as the need for REAL reform when it comes to energy consumption and pollution.

    The real bitch here is these are party neutral in the grand scheme of things. Everyone should be able to get treated for whatever ails them and everyone shouldn’t have to worry about whether their home will sink into the ocean etc. but because Insurance has become a “Industry” and so has the medical profession and since, unlike back during the days of trust busting and nailing robber barons to crosses big business’ such as the oil industry are controlling energy policy we’re screwed.

  17. 17
    les says:

    I don’t think industry/employers will like Bush’s plan, and will get behind a real reform of some kind; the Bushco proposal will leave them as provider negotiators, as now, and will add the employer share of FICA to their taxes when the deduction from taxable payroll goes away. The insurance industry will of course fight reform, since that’s where the bloat is; but if, as one article I read indicated, reform can free up 5% to 8% of GDP (the difference between what we spend v. what other industrialized major nations spend on healthcare–without better results, by the by), soft landings should be manageable.

  18. 18
    Zifnab says:

    Isn’t socialism where the Government provides your shelter, food, clothing, health care, and job?

    Oh wait, that’s our military. Nevermind.

    Socialism is the one that provides you with bullet-proof vests and armored vehicles that don’t pre-date Vietnam.

  19. 19
    Adam says:

    Kevin’s full of crap on this one.

    What Obama’s doing is exactly parallel to what Bush did when proposing his Social Security “reforms.” They’re pitching proposals that will solve the problems while not getting sucked into the political black hole that prevents Social Security from moving either left OR right.

    There’s a reason they call it the “third rail,” folks.

  20. 20
    Zifnab says:

    What Obama’s doing is exactly parallel to what Bush did when proposing his Social Security “reforms.” They’re pitching proposals that will solve the problems while not getting sucked into the political black hole that prevents Social Security from moving either left OR right.

    But there was nothing inherently wrong with Social Security – except for the fact that the government kept raiding the pig-bank and leaving it full of IOUs – while there is something seriously wrong with the current medical system.

    Bush tried to violate the sacred law of “don’t fix it if it ain’t broken” by hyping SS being some sort of emergency that absolutely had to be fixed right now. But no one who’d banked on SS wanted to gamble, especially when W was rolling the dice.

    Obama is pushing a reform 47 million uninsured Americans would instantly support. Bush never had that sort of popular power base.

  21. 21
    Richard 23 says:

    Why not get rid of the age requirement for Medicare? Or at least extend it to cover those under 18?

    Don’t yell at me. I’m just brainstorming here of course.

  22. 22
    ConservativelyLiberal says:

    I do not like regulation of any industry for just the sake of the government getting its fingers into the pie and screwing it up, but there is little that the government could do that would make any replacement to the current system a total screw up. That is not easy to say, but I think it is true.

    The free market works for non-essentials in life, but healthcare is not an option if you wish to live well. Money leeches have attached themselves between the medical community and the patient, and they are sucking the system dry. Add to that the spiraling costs of visiting the doctor as healthcare is taken over by the few and bled dry by those looking to profit from people who need to get help for medical issues.

    Every single year, our healthcare provider jacks up the premiums and cuts the benefits. We are paying almost 200% more than we were five years ago, and our benefits have been limited, reimbursements have been cut and the minimum deductible has doubled, and we have rarely used our healthcare/doctors in that time. For the flu, a small cut on a finger and lancing a boil. No major emergencies or medical conditions, and with our advancing ages here at home I dread what the future holds.

    The free market is great if you have a free choice to use or not use whatever they are selling, but when it comes to medical problems you just do not have the option to say ‘Naah, I don’t need to get that tumor removed, that is just a luxury item anyway.’.

    The American healthcare system is sick, and the old line ‘Physician, heal thyself’ will not work. It needs an intervention, and damn fast.

  23. 23
    TenguPhule says:

    Why not get rid of the age requirement for Medicare? Or at least extend it to cover those under 18?

    Funding Funding Funding.

  24. 24
    ThymeZone says:

    Single Payer is a misnomer, and the reason why it’s essential is because of the relationship between the funding stream, and the payments. Without a single collection point for the funding, the insurance scheme is crippled.

    That’s why Dual Payer won’t work.

  25. 25
    ImJohnGalt says:

    Krista, I think an argument could be made for a stealth approach to the issue from the other direction. Cover doctor visits, basic drugs, and follow-up diagnoses and make people pay extra for disaster-level coverage. If you can’t afford that, chances are you can’t afford it now, but at least you’re covered for smaller illnesses, checkups and basic treatment.

    That way, as per Tim, people would stop using the Emergency Room as their family doctor, and start practicing preventative medicine which would eventually lead to less serious illnesses.

    The long-term hope, of course, is that people would respond favorably to this initial foray into single-payer and start demanding more things be covered.

  26. 26
    b-psycho says:

    Am I the only one still wondering how the hell “single-payer” wouldn’t result in more regulation of our lives via the “your habits affect my wallet” excuse?

    I have no love whatsoever for the insurance companies, having had to deal with them a lot recently for reasons I won’t detail here or anywhere else. But even so I can’t just sit idle while others move us towards a policy that’ll eventually have the feds weighing my burrito.

  27. 27
    ImJohnGalt says:

    You mean more regulation by the government as opposed to corporations? Have you ever *read* a health insurance policy? If you think the insurance you’re currently using doesn’t come with strings, you’re crazy.

  28. 28
    eSteve says:

    Tim; I, too was quite excited to see Obama’s support for universal coverage, and quickly sent enthusiastic notes to my friends about it. Then I started seeing the dubious reviews from folks like Kevin Drum and Ezra Klein and I began to doubt myself: am that much of a chump?

    But I never dreamed that a serious candidate would lay out detailed policy platform at this stage of the game, and I thing criticisms along these lines are petty. The true worth of Obama’s stance is exactly as you state it: it legitimates the topic and places it squarely in the center ring for the coming election.

    Really, after all these years, that’s a huge step forward!
    So, stick to your first reaction, Tim; sometimes it’s OK to take “yes” for an answer!

  29. 29
    b-psycho says:

    IJG: My preference is for there to be little or none by neither. Problem is, that’ll never happen, either way people will have their lives micromanaged somehow, health sinners will be punished. Why? Because the structure is made to subsidize others bad habits whether they want it to or not, and busybodies take that as excuse to interfere.

    IMO, absolutely no good will come of health “policy”, whether public or private, unless it all collapses first.

  30. 30
    b-psycho says:

    To explain further: if a “good” healthcare system, as popularly defined, whether nationalized or not, requires that any force on earth be empowered to punish people for behavior that harms no one but themselves, or allows the possibility of excuse for such later, then I don’t want it anyway. I’d rather it all goes to shit so we can start over.

  31. 31

    […] In my view the only way to make progress involves choosing an ally that can counterbalance the predictable hew and cry from insurers and their titanic lobbying arm. That’s a tall order, but as I laid out in two recent posts it’s clearly within our reach. […]

  32. 32

    […] It is about time somebody figure out that the Democrats need powerful allies to move healthcare reform forward and it won’t be the insurance biz. I have only pointed this out now in three separate posts. You can go read those to get the gist of my point so I’ll be brief. It is very, very exciting to see Stern working together with Wal-Mart on this because for one, Wal-Mart is the single largest employer in America and a heavy contributor to party politics. That’s a lot of pull. […]

  33. 33

    Once I learned how single payer works the light bulbs went off like gang-busters. I am now an activist for the cause. Check out the MySpace page for the single payer plan proposed in California. You can hear the news conference from this week and watch a short film that explains it.

    http://www.myspace.com/onecarenoworg

    Here’s to your health!~

Trackbacks & Pingbacks

  1. […] It is about time somebody figure out that the Democrats need powerful allies to move healthcare reform forward and it won’t be the insurance biz. I have only pointed this out now in three separate posts. You can go read those to get the gist of my point so I’ll be brief. It is very, very exciting to see Stern working together with Wal-Mart on this because for one, Wal-Mart is the single largest employer in America and a heavy contributor to party politics. That’s a lot of pull. […]

  2. […] In my view the only way to make progress involves choosing an ally that can counterbalance the predictable hew and cry from insurers and their titanic lobbying arm. That’s a tall order, but as I laid out in two recent posts it’s clearly within our reach. […]

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