Rx and the Single Payer
By Bill Moyers
Campaign for
May 22, 2009
http://www.ourfuture.org/blog-entry/2009052122/rx-and-single-payer
In 2003, a young
Obama told a local AFL-CIO meeting, "I am a proponent
of a single-payer universal health care program."
Single payer. Universal. That's health coverage, like
Medicare, but for everyone who wants it. Single payer
eliminates insurance companies as pricey middlemen. The
government pays care providers directly. It's a system
that polls consistently have shown the American people
favoring by as much as two-to-one.
There was only one thing standing in the way, Obama
said six years ago: "All of you know we might not get
there immediately because first we have to take back
the White House, we have to take back the Senate and we
have to take back the House."
Fast forward six years. President Obama has everything
he said was needed - Democrats in control of the
executive branch and both chambers of Congress. So
what's happened to single payer?
A woman at his town hall meeting in
week asked him exactly that. "If I were starting a
system from scratch, then I think that the idea of
moving towards a single-payer system could very well
make sense," the President replied. "That's the kind of
system that you have in most industrialized countries
around the world.
"The only problem is that we're not starting from
scratch. We have historically a tradition of employer-
based health care. And although there are a lot of
people who are not satisfied with their health care,
the truth is, is that the vast majority of people
currently get health care from their employers and
you've got this system that's already in place. We
don't want a huge disruption as we go into health care
reform where suddenly we're trying to completely
reinvent one-sixth of the economy."
So the banks were too big to fail and now, apparently,
health care is too big to fix, at least the way a
majority of people indicate they would like it to be
fixed, with a single payer option. President Obama
favors a public health plan competing with the medical
cartel that he hopes will create a real market that
would bring down costs. But single payer has vanished
from his radar.
Nor is single payer getting much coverage in the
mainstream media. Barely a mention was given to the
hundreds of doctors, nurses and other health care
professionals who came to
protest the absence of official debate over single payer.
Is it the proverbial tree falling in the forest, making
a noise that journalists can't or won't hear? Could the
indifference of the press be because both the President
of the
single payer like, well, like the plague? As we see so
often, government officials set the agenda by what they
do and don't talk about.
Instead, President Obama is looking for consensus,
seeking peace among all the parties involved. Except
for single payer advocates. At that big White House
powwow in
representatives of the health care business to reason
together with him. "What's brought us all together
today is a recognition that we can't continue down the
same dangerous road we've been traveling for so many
years," he said, " that costs are out of control; and
that reform is not a luxury that can be postponed, but
a necessity that cannot wait."
They came, listened, made nice for the photo op. and
while they failed to participate in a hearty chorus of
"Kumbaya," they did promise to cut health care costs
voluntarily over the next ten years. The press ate it
up - and Mr. Obama was a happy man.
Meanwhile, some of us looking on - those of us who've
been around a long time - were scratching our heads.
Hadn't we heard this before?
Way, way back in the 1970's Americans were riled up
over the rising costs of health care. As a presidential
candidate, Jimmy Carter started talking about the
government clamping down. When he got to the White
House, drug makers, insurance companies, hospitals and
doctors - the very people who only a decade earlier had
done everything they could to strangle Medicare in the
cradle - seemed uncharacteristically humble and
cooperative. "You don't have to make us cut costs,"
they promised. "We'll do it voluntarily."
So Uncle Sam backed down, and you guessed it. Pretty
soon medical costs were soaring higher than ever.
By the early `90s, the public was once again hurting in
the pocketbook. Feeling our pain, Bill and Hillary
slightly more complicated than the schematics for an
F-18 fighter jet.
This time the health industry acted more like Tony
Soprano than Mother Teresa. It bludgeoned the
reforms with one of the most expensive and deceitful
public relations and advertising campaigns ever
conceived - paid for, of course, from the industry's
swollen profits.
As the drug and insurance companies, hospitals and
doctors dumped the mangled carcass of reform into the
Potomac, securely encased in concrete, once again they
said don't worry; they would cut costs voluntarily.
If you believed that, we've got a toll-free bridge to
the Mayo Clinic we'd like to sell you.
So anyone with any memory left could be excused for
raising their eyebrows at the health care industry's
latest promises. As if on cue, hardly had their pledge
of volunteerism rung out across the land than Jay
Gellert, chief executive of Health Net Inc. and chair
of the lobbying group
assured his pals not to worry abut the voluntary
reductions. "We believe that we can do it without
undermining the viability of companies," he said, "and
in effect enhancing the payment to physicians and
hospitals." In other words, their so-called voluntary
"reforms" will in no way interfere with maximizing profits.
Also last week, John Lechleiter, the chief executive of
drug giant Eli Lilly, blasted universal health care in
a speech before the
believe that policymakers have yet arrived at a full
and complete diagnosis of what's wrong and what's right
with
concerned that some of the proposed policies-the
treatments, to continue my metaphor-will have
unintended side-effects that make our situation worse."
So why bother with the charm offensive on
Avenue? Could it be, as some critics suggest, a Trojan
horse, getting the health industry a place at the table
so they can leap up at the right moment and again knife
to death any real reform?
Wheelers and dealers from the health sector aren't
waiting for that moment. According to the non-partisan
Center for Responsive Politics, they've spent more than
$134 million on lobbying in the first quarter of 2009
alone. And some already are shelling out big bucks for
a publicity blitz and ads attacking any health care
reform that threatens to reduce the profits from
sickness and disease.
The
Tuesday that Blue Cross Blue Shield of
has hired an outside PR firm to put together a video
campaign assaulting Obama's public plan. And this month
alone, the group Conservatives for Patients' Rights is
spending more than a million dollars for attack ads.
They've hired a public relations firm called CRC -
Creative Response Concepts. You remember them - the
same high-minded folks who brought you the Swift Boat
Veterans for Truth, the gang who savaged John Kerry's
service record in
The ads feature the chairman of Conservatives for
Patients' Rights, Rick Scott. Who's he? As a former
deputy inspector general from the Department of Health
and Human Services told The New York Times, "He hopes
people don't Google his name."
Scott's not a doctor; he just acts like one on TV. He's
an entrepreneur who took two hospitals in
built them into the largest health care chain in the
world, Columbia/HCA. In 1997, he was fired by the board
of directors after Columbia/HCA was caught in a scheme
that ripped off the Feds and state governments for
hundreds of millions of dollars in bogus Medicare and
Medicaid payments, the largest such fraud in history.
The company had to cough up $1.7 billion dollars to get
out of the mess.
Rick Scott got off, you should excuse the expression,
scot-free. Better than, in fact. According to published
reports, he waltzed away with a $10 million severance
deal and $300 million worth of stock. So much for
voluntarily lowering overhead.
With medical costs rising six percent per year, that's
who's offering himself as a spokesman for the health
care industry. Speaking up for single payer is Geri
Jenkins, a president of the
Association and National Nurses Organizing Committee -
a registered nurse with literal hands-on experience.
"We're there around the clock," she told our colleague
Jessica Wang. "So we feel a real sense of obligation to
advocate for the best interests of our patients and the
public. Now, you can talk about policy but when you're
staring at a human face it's a whole different story."
=====
Michael Winship co-wrote this article. Bill Moyers is
managing editor and Michael Winship is senior writer of
the weekly public affairs program Bill Moyers Journal,
which airs Friday night on PBS. Check local airtimes or
comment at The Moyers Blog at www.pbs.org/moyers.
Research provided by editorial producer Rebecca Wharton.
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