Dose of Reality: HR 676 and the presidential candidates' proposals

In the August Dose of Reality column, "HR 676: The Route to Affordable Health Care," Davis discusses why the proposal is "a dream bill...that does all the right things to create an affordable single-payer health care system."

In the July Dose of Reality, Davis looks at the health care plans of John McCain and Barack Obama:

I get the feeling that both the presidential candidates are happy to see the health care issue fade a bit, because neither of them has logically defensible positions on health care, nor do their proposals have any hope of reducing health care costs.

The primary problem in both candidates' proposals is the failure to address actual health care; instead they focus on health insurance. This failure or inability to distinguish between the two is one of the central problems in the national discussions about health care reform.

However, concludes Davis, "Obama's plan is far better than McCain's....Obama at least proposes moving in the right direction." Still, both senators would do well to take a leaf or two more from John Conyers' excellent House bill.

A Good Investment

This year the Alaska legislature took a small but positive step toward helping to improve health care in the state by appropriating $3.85 million in support of the 26 federally funded Community Health Centers in the state. By taking this action Alaska has, for the first time, joined 37 other states which contribute funds to the CHC programs.

The Community Health Centers play an important role in providing comprehensive, affordable primary care and preventive services to those most in need. The centers accept Medicare, Medicaid, private insurance and also offer a sliding fee scale to those without insurance coverage. They now serve over 88,000 Alaskans, more than half of them with incomes below the Federal Poverty Level. Operating at 124 sites in Alaska, the centers provide the only source of medical care in many of the remote rural villages of the state. The centers are open to all Alaskans, and the care received there is far cheaper than from other sources.

The legislature’s action was in response to a funding request of $13 million from the Alaska Primary Care Association, the umbrella group for the CHCs which are all locally governed. Considering the effectiveness and low cost of the centers, the $3.85 million is a paltry sum. It amounts to only $40 per person for the 88,000 served, and to less than $6 per Alaskan. Compare that to the $1200 per person outlay for energy relief this year and think about the relative value of the two appropriations. The tiny one is an investment in the future, and the big one is a shotgun blast that has no lasting benefit. A significant portion of the money will go to the federal government in income taxes and to Alaskans who do not really need the money. How sad.

Nevertheless, the legislature took an important first step by appropriating funds to the Community Health Centers. The action might be the start of a new era of social responsibility, and we can hope that future legislatures will be far more generous in their appropriations for health care.

Harry and Louise Return

Today, August 24, 2008, marks the return of the old Harry and Louise ads credited with defeating the Clinton universal health care plan of fifteen years ago. They are being put on the air on the eve of the presidential conventions for the same purpose as the last time: to try to convince Americans that single-payer universal health care is not in their best interest.

The persons portraying the fictional couple Harry and Louise are the same as before, now obviously fifteen years older, but the message is a little different this time. Aware that health care reform might be coming soon, the ads’ sponsors are trying to use the ads to warp that reform in a direction that favors the health insurance industry and its allies, but which is to the detriment of the users of health care, namely the American public.

The sponsors of the new Harry and Louise ads are promoting not only less regulation of the health insurance industry, they want the government to subsidize it by paying the premiums for the high-risk persons that the industry would otherwise either not insure or charge unbearable rates. They are trying desperately to maintain their throttlehold on health care financing. As one ad sponsor, the National Federation of Independent Business, states, “To the greatest extent possible, Americans should receive their health insurance and healthcare through the private sector. Care must be taken to minimize the extent to which government safety nets crowd out private insurance and care.”

Overall, the primary purpose of the new Harry and Louise ads we are going to see a lot of from now on is to maintain the profitability of the private health insurance industry. A proven propaganda ploy; it will be interesting to see how well it works this time.

Also jumping on the bandwagon is the American Medical Association with its own Louise ad (not the same Louise as in the other ads, but obviously borrowing on the Harry and Louise concept) touting the association’s reform proposal. This is not a health care reform proposal at all; rather it deals only with health insurance, and it basically also calls for less regulation of the insurance industry plus government subsidies to the industry to help pay the premiums for high-risk persons. Not the powerhouse it once was, the AMA’s membership has declined, and it now represents less than one-third of all U.S. physicians. Increasingly, physicians are going against AMA and are coming out in favor of establishing a single-payer universal health care system.

Another co-sponsor for HR 676

The ninety-first co-sponsor of HR 676 is André Carson (D-IL). The list of endorsements of this legislation is growing, including the US Conference of Mayors and numerous unions, including the Alaska AFL-CIO.