Dose of Reality: Obamacare

April's Dose of Reality is a discussion of the 900-page Patient Protection and Affordable Care Act, which may, says Davis, actually do some good.

Anyone aware of the control that the health insurance and pharmaceutical industries exert over Congress should not be surprised that the new law does good things for these industries, and very little that may harm their profitability right away. The surprise (for me at least) is that the new law actually does do some good for the public—and in ways that might and should eventually lead to the demise of the for-profit health insurance industry and the continuing obscene profits of the pharmaceutical industry.

The act allows for self-insuring, although it does not include a public option, unfortunately. Health care cooperatives already exist, and this bill may strengthen them by providing an option that costs less. (Obamacare doesn't do much to reduce health care costs, alas--some, but not much.) Neil uses the example of the Seattle-based Group Health Cooperative. The more people who join health care cooperatives, the stronger they will become. And cooperatives, unlike insurance companies, exist to benefit their members. (Insurance companies, you recall, exist to make a profit for their investors.)

Obama's speech on health care reform

Here's a transcript of Obama's speech to Congress on health care reform, along with some videos, from Huffington Post.

Sarah Palin on Health Care

Sarah Palin’s recent Facebook statement (Associated Press, Aug. 8, 2009) in which she called President Obama’s health plan “downright evil” suggests that she did Alaska a big favor by abdicating the governorship last month. Anyone capable of intentionally publishing such a ridiculous and obviously untrue claim lacks the ethics and moral fiber to hold any public office from dogcatcher on up, never mind one as important as the governorship of Alaska.

When Palin broke her contract (sworn to on the Bible) with the Alaska voters who put her in office, I figured that she had in mind reverting back to a public communications career as in the years of yore. As an ex-governor, she now could aspire to the role of a respected journalist and commentator on world and national affairs whose clever insights, penetrating analyses and profound judgments would earn her respect far and wide. Admittedly, this aspiration could be a little bold for a logically challenged person who sometimes found it difficult to assemble words into a meaningful sentence and who even sometimes was unable to determine when the end of that sentence had come. So was this a hopeless idea? Not in America, absolutely not!

Let’s face it, Palin knew she could easily do it. Despite various psychological weaknesses, she knew she had some nice counterbalancing physiological assets, including a pretty face, a seductively crooked smile and a hell of a wink. The key to success here was merely to pick the right audience to speak to, one to which her physical assets would hold strong appeal and to which her cerebral weaknesses would not matter squat. In other words, Palin needed an audience that liked things simple—not just simple, flat out either black or white—an audience that would suck up to the kind of emotional appeals Palin enjoyed presenting. She did not need to be speaking to that portion of the public that preferred factual information over emotional arguments. Unfortunately for her, there were a lot of people in America like that, maybe even half the population. So forget them; this would not be the audience ex-governor Palin should try to cater to, but this group’s very nature gave a hint as to the direction she go. Best to plant a sharp right heel and do a quick one-eighty away from them. Of course! Now right there in front of her was a ready-made audience already shepherded together by that great Republican leader Rush Limbaugh. This was the audience to go for. Heck yes, Sarah would be a perfect Rush Limbaugh in Lipstick.

Sarah knew that her appeal to this ultraconservative audience was already proven by her recent campaign effort with John McCain to help elect Barack Obama president of the United States. She had come out of it with maybe three-quarter million supporters (more than the entire population of Alaska) and a lucrative book contract. Pondering the issue, Sarah Palin could see that although Rush Limbaugh was the acknowledged spokesman for that group he might not continue to be. “He’s OK on talk radio but he’s an ugly ole cuss, and I betcha I can do better than him on TV, and God would want me to,” Sarah must have thought as she reached her decision to shoot for the position of hostess of the Sarah Palin TV Show or whatever the network might want to call it.

Oh it was going to be so easy, ‘cause it didn’t matter what you would say as hostess of this production. All she would have to do was do as Rush does: pick a topic, any topic involving President Obama, put on a crooked knowing smile and a sneer in the voice and make fun of Obama’s action.

Rush was good. Like just the other day on his program Sarah had heard him say that Obama was going to use several million dollars of the stimulus funds to hire people to clean up and improve the toilets in the national parks. Snickering and scoffing at this huge and pernicious waste of taxpayer funds, Ole Rush made the concept resonate across the airways as another vicious government attempt to takeover our guaranteed 2nd Amendment rights to choose or own methods and manners of bodily waste disposal in the national parks. About the time Limbaugh finished his tirade, a female caller came on air to gush, “Oh thank you, Rush, for telling it to us like it is.” Now that was Sarah Palin’s kind of woman.

Shoot, even if none of the networks wanted to shell out big bucks for her to host a TV talk show, there were plenty of other ways to rally the clueless masses. Twittering was good; 140 characters was just about right to detail any idea that she could think up. They might call her tweets “Quitter’s-Twitters,” and those missives could strike to the hearts of millions who would applaud her abandonment of the Alaska governorship. And then there was Facebook and plenty of Obamamania fumbles to attack on it. Hey, just the stupid idea of reforming health care should get plenty of mileage. “It’s evil, evil, evil,” she could say repeatedly. “We’ve got to stop Obama from trying to take our doctors and guns away. You betcha, folks, now is the time to get our country back. Evil, evil, evil.”

It really would not matter how it all worked out. Sarah was now rich and famous and also free of those nasty ethical constraints some people thought should be imposed on those serving in public office. She now could say anything she wanted, and hundreds of thousands of Americans already thought anything she said was virtually the word of God. If it really went well, those thousands would turn into millions, and if so she might consider letting Rush Limbaugh serve as her running mate in the next election.

The health care reform war starts

And the first sally, according to Neil Davis, is the Medicare Prescription Drug Savings and Choice Act of 2009 (HR 684 and S 330).

I am hoping that President Obama and the Democrat-controlled Congress will get behind the serious reform proposed by HR 676… this bill calls for a total overhaul of the system by taking health care out of the marketplace.…But the early signs are that the Democrats in Congress and President Obama are not willing to make a frontal attack on health care reform.

Instead, Davis says, they are hoping to set up a government operated program that would deal with only one small part of the health care picture: negotiating drug prices for Medicare. A step in the right direction, but only one smal step--still, one that would save perhaps $40 billion annually!

More in the March Dose of Reality.

The Economics of Health Care

At the Democratic National Convention, Senator Ted Kennedy stated that health care is a human right, and in one of the presidential debates, Senator Barack Obama said the same thing. What this means, of course, is that this country needs to put in place a single-payer universal health care system.

“This is a completely understandable view and one that, I think, is utterly wrong,” wrote columnist Robert J. Samuelson in NEWSWEEK on September 15, 2008. Then he went on to say that the problem was not to improve insurance coverage, it was to contain health care costs. He said, “We need more realism on health care. The trouble with casting medical-care as a “right” is that this ignores how open-ended the “right” should be and how fulfilling it might compromise other “rights” and needs.” What he means by this is beyond me: how does saying fulfilling one right affect fulfilling other rights, whatever they may be?

Samuelson does not seem to understand that treating health care as a right—which implies instituting a program of universal health care—is the direct route to containing health care costs. Doing so has the potential to cut health care costs by 30 percent, while at the same time improving health care for Americans. Another columnist, Bernadine Healy writing in the October 13/October 20, 2008, issue of U.S. NEWS & WORLD REPORT, describes various ills of our dysfunctional multi-payer health care system and then says, “Changing our 50-50 blend of private and public spending into a single-payer system clearly is not feasible.” Why not?

Both she and Robert J. Samuelson seem to have preconceived ideas about health care, and they would do well to open their minds far enough to read and accept what another well-known economist and columnist, Paul Krugman, has to say about the economics of health are. In his January 1, 2007, column in The New York Times he said, “The truth is we can afford to cover the uninsured. What we can’t afford is to keep going without a universal health care system.

“If it were up to me, we’d have a Medicare-like system for everyone, paid for by a dedicated tax that for most people would be less than they or their employers currently pay in insurance premiums. This would, at a stroke, cover the uninsured, greatly reduce administrative costs and make it much easier to work on preventive care.”

Paul Krugman just won the Nobel prize in economics, for good reason it would seem. He is a thoughtful man who pays attention to and carefully analyzes factual information. Too bad Robert J. Samuelson and Bernadine don't do the same.

Pundits on Health Care

Right now, the crash of the financial markets is taking center stage, but the nation’s health care problems are still the subject of various press pundits’ commentaries. In the October 13, 2008 issue of NEWSWEEK, one of better known commentators, Jane Bryant Quinn, discusses John McCain’s health plan, and alludes to Barack Obama’s. These, of course, are not health care plans as such, but rather are health insurance plans, a fact that the pundits like her seem to be ignoring, or would rather not talk about. It is an easy way out, and a poor substitute for taking on the health care problem directly and discussing solutions.

Quinn notes that the McCain and Obama health insurance plans over the next decade are likely to cost the taxpayers an additional $1.3 billion and $1.6 billion, respectively. She clearly favors Obama’s plan over McCain’s, but she seems to be trapped in the philosophical box that does not allow thinking or discussion about anything but health insurance per se. She is not a dumb person, and I don’t understand why she doesn’t go outside the box and state what she surely knows is the way to reduce health care costs rather than increase them. Maybe her editors would not let her do that. If they would allow it, Quinn could have gone on to say that both the McCain and Obama plans were off the mark, and that the establishment of a single-payer health care system in this country has the only potential to reduce health care costs—not just a little bit, a lot. Instead of spending 16 percent of our gross national product on health care, we could be spending only 10 percent, while giving all Americans health care just as good as the citizens of all other modern countries get from their much cheaper and more effective universal health care systems.

Yes, Quinn and some of her fellow pundits could serve us better by talking more about health care, and less about health insurance. But at least in her column she does say that McCain’s belief in the magic of the marketplace is misplaced. She says, “Friends, there’s zero evidence that that works.”

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.

Mayors Back Universal Health Care

Yesterday, the U.S. Conference of Mayors unaninously adopted a resolution in support of the "United States National Health Insurance Act," H.R. 676. Known also as the "Improved and Expanded Medicare for All Act," H. R. 676 is sponsored by Rep. John Conyers of Michigan and 90 members of Congress.

This is an excellent bill that, unlike the proposals of Senators Obama and McCain, actually addresses health care and guarantees everyone in the country affordable health care by forcing the highly profitable private health insurance industry out of the loop. That is a necessary action if the country is to have an effective health care system like that of all other modern countries.

The backing of HR 676 by the nation's mayors is highly significant because the mayors, far more so than most elected officials, are closer to the people and more free of pressure from the pressures of health insurance industry and pharmaceutical industry lobbying efforts that hope to maintain the staus quo. The fact that the mayors are backing HR 676 indicates that the public is increasingly in favor of universal health care. We may be closer to an effective universal health care system than many have thought possible.

Clinton and Obama on Health Care

Listening to the debate of February 27, 2008, between Democratic presidential contenders Hillary Clinton and Barack Obama, I was pleased that they both paid much attention to the issue of health care. Up to this point, the Republican candidates have not said much about the health care issue, obviously wishing to ignore it. The Democrats, on the other hand, have made it clear that they want to push forward toward changing our dysfunctional health care system into something more sensible.

However, it was distressing to see both Clinton and Obama start by saying how important it was for everyone to have affordable health care and then switch the discussion over to health insurance. Perhaps intentionally, they were both failing to distinguish the difference between health care and health insurance. They each seemed to be trying to claim that having affordable health insurance was equivalent to having affordable health care.

If all health insurance was like Medicaid insurance—which pays the full costs of health care for its beneficiaries—then affordable health insurance would be equivalent to affordable health care. But we all know that most insurance policies pay only a portion of health care costs, and in extreme cases, not even a major part. It is getting worse by the day, too. Private insurers and the employers that buy insurance from them are increasingly trying to dump more of the cost of paying for health care off onto individuals. Furthermore, the insurance companies are doing their best to refuse insurance coverage to those persons needing the most health care. These are the persons who are getting hit the hardest by our current system.

It would be nice if our presidential candidates felt they could be forthright in admitting that the only way to bring affordable health care to all Americans is to establish a government-operated program of universal health care and to get the private insurance industry out of the picture altogether.

So we can only hope that once he or she gets elected, the winner of the presidential race will get down to business and push for real progress by establishing a universal health care program rather than continuing to promote a program of universal health insurance in which the insurance industry plays the major role. This industry’s high administrative costs and shareholder profits absorb a substantial share of the health care dollar. This is money that should be going to pay for health care directly, and if that money did go there, the overall cost of health care would go down.

It won’t be easy of course, because even if Clinton and Obama do, a large segment of the American public does not recognize the difference between health insurance and health care, and many are leery of increasing the government’s role in health care or any other arena. Many Americans have a hard time realizing that the best tool we have available for fixing the health care system is our federal government.