Obamacare: "Asprin for Cancer" (PNHP)

by Dollars and Sense

It has become an annual Left Forum tradition for some D&S folks to meet up with D&S friends over dinner in the East Village, and this year one of the main topics of conversation was, of course, health care reform. No one at the table liked the bill, so the discussion was about whether it would be better or worse if the bill passed.

On the bus ride home, D&S collective member and frequent blogger Larry P. wondered out loud what Steffie Woolhandler and David Himmelstein and other single-payer advocates think about the bill and the likelihood that it would pass. So I was happy to find out about this statement from Physicians for a National Health Plan, co-signed by Woolhandler and Himmelstein:

Pro-single-payer doctors: Health bill leaves 23 million uninsured
A false promise of reform

For Immediate Release | March 22, 2010

As much as we would like to join the celebration of the House's passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem--the profit-driven, private health insurance industry--this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:

* About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
* Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
* Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.
* The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
* People with employer-based coverage will be locked into their plan's limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
* Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
* The much-vaunted insurance regulations - e.g. ending denials on the basis of pre-existing conditions - are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
* Women's reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn't have to be like this. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid - a woefully underfunded program that provides substandard care for the poor - could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers' health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill's passage reflects political considerations, not sound health policy. As physicians, we cannot accept this inversion of priorities. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That's enough to cover all the uninsured and to upgrade everyone else's coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to "wait and see" how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.
Oliver Fein, M.D.
President

Garrett Adams, M.D.
President-elect

Claudia Fegan, M.D.
Past President

Margaret Flowers, M.D.
Congressional Fellow

David Himmelstein, M.D.
Co-founder

Steffie Woolhandler, M.D.
Co-founder

Quentin Young, M.D.
National Coordinator

Don McCanne, M.D.
Senior Health Policy Fellow

******

Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

Two other tidbits on health care: First, the spin about the aftermath of the health care debate seems to be that the Republicans have overplayed their hands, what with all the hate-mongering and fear-mongering all along, with a definite crescendo at the final hour. Here's (some of) what Politico had to say:

GOP weighs costs of losing ugly
By: Glenn Thrush and Marin Cogan| March 23, 2010 05:05 AM EDT

The only thing worse than winning ugly is losing uglier.

The Democrats' ungainly march toward a victory on health care reform Sunday night provoked a graceless response from angry House Republicans, who shouted insults across the chamber, encouraged outbursts from the galleries, brandished "Kill the bill" placards from the Speaker's Balcony and, apparently, left veiled threats of electoral retribution on the benches of undecided Democrats.

And that all came before Texas Republican Rep. Randy Neugebauer shouted "baby killer!" as anti-abortion Rep. Bart Stupak (D-Mich.) spoke on the House floor.

That incident followed an even uglier series of events outside the chamber Saturday, when tea party protesters reportedly shouted the N-word at civil rights hero Rep. John Lewis (D-Ga.), spit on Rep. Emanuel Cleaver (D-Mo.) and hurled an anti-gay insult at Rep. Barney Frank (D-Mass.).

While House Minority Leader John Boehner (R-Ohio) was quick to criticize the racial and anti-gay outbursts and to distance himself from Neugebauer's shout, he made no apologies for the feisty floor debate or the overall tone of the health care opposition.

"My impression is that Rep. Boehner was satisfied with the tone of the debate, which focused on the serious factual arguments against the Democrats' job-killing government takeover bill," said Boehner spokesman Michael Steel.

Other Republicans weren't so sure.

"It was like a mob at times," lamented one House Republican, speaking on the condition of anonymity. "It wasn't good for us. ... Remember, it took years [for Democrats] to recover from the bad publicity the anti-Vietnam protests generated."

In an interview for POLITICO's "Health Care Diagnosis" video series, Rep. Paul Ryan (R-Wis.) called the "baby killer" outburst "horrible" but said the issues Democrats are pursuing are "so polarizing that they're really bringing out emotions and the darker sides of people on both sides."

Still, Ryan made it clear he would have preferred a less emotional approach over the weekend.

"In our conference [Sunday] before the vote, a lot of us said, 'Look—no screaming, no shouting, no yelling, no nyah-nyah-nyah. If they pass this thing, be somber be glum,'" Ryan said. "I said look, 'We've got to be adults about this. This is a serious situation; this isn't something that we politicize. . . . Yes, in basketball games you hear things like this. We don't do that. We're grown-ups.'"

Neugebauer's outburst, which echoed the infamous "You lie!" shout by Rep. Joe Wilson (R-S.C.), had Republicans worried about the impact on "persuadables"—independents skeptical about President Barack Obama but leery of the GOP's increasingly conservative tilt.

The incident also undermined attempts by Republicans to project the image of a sober, less combative party willing to meet Obama halfway. And it prompted a salvo of rebuke from Democrats, who spent much of their post-passage Monday accusing the other party of violating the chamber's decorum and coarsening debate.

Read the whole post.

A recent CNN poll seems to bear out the idea that the Republicans, by siding with the vituperative Tea Baggers, are not on the side of the public. According to the poll, 39% favor the bill, while 59% oppose it; but the breakdown showing why people oppose it is instructive: 39% favor; 43% oppose because it's "too liberal"; 13% oppose because it's "not liberal enough". So that means that a majority of Americans polled by CNN are in favor of health care reform at least as "socialist" as Obamacare.

So what we have is a crappy bill that is coercive and a give-away to the insurance companies, and may entrench their power. But a majority of Americans still seem to want (real) universal health care, and if you want to put an optimistic spin on it, you can take heart in the fact that the success of this bill may put the Democrats on a better footing than they have seemed to be recently. Whether we like what they do with the momentum (real financial reform, with an independent financial consumer protection agency and effective regulation? real comprehensive immigration reform, vs. some guestworker nonsense?) remains to be seen. The best-case scenario might be if this legislative victory emboldens left challengers in the 2010 congressional elections, to push incumbents to move to the left (whereas a week ago it seemed likely that the Republicans' momentum would push them all to the right).

Labels: Barack Obama, health care, health care reform, Physicians for a National Health Program, socialism, Tea Partiers

 

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3/23/2010 03:53:00 PM