The State of Healthcare

According to the Bush administration, the new health care plan that the President unveiled in the State of the Union address Tuesday would cover three million people who are currently uninsured. Three million – out of forty-seven million. After years of dangerous inaction, this is what Bush rolls out to address a grave and growing crisis!

And, of course, no Bush domestic proposal would be complete without a further gutting of the social compact – this time, "cutting Medicaid payments to public hospitals and other ‘safety net' providers by $3.9 billion over the next five years." As Deborah Bachrach, a deputy commissioner in the New York State Health Department, told the New York Times, this cut would impact hospitals "that serve some of the lowest-income, most vulnerable patients." This at a time when many such facilities are already struggling to survive.

The Bush tax cuts for the wealthy survive untouched – in fact, they receive a new deduction if they purchase their own plans. However, the continuing War on the Middle Class is being…well, escalated. Workers who, according to the President, "choose overly expensive, gold-plated plans" through their employers will be taxed, while those who buy plans on their own will receive a deduction. As Columnist Paul Krugman suggested in a Times op-ed, who in our nation has one of those gold-plated plans? Krugman goes on to write, "The uninsured don't need an ‘incentive' to buy insurance; they need something that makes getting insurance possible…. Mr. Bush…is still peddling the fantasy that the free market, with a little help from tax cuts, solves all problems."

"The President's so-called health care proposal won't help the uninsured, most of whom have limited incomes and are already in low tax brackets," said Democratic Representative Pete Stark, Chairman of the Ways and Means Health Subcommittee. "But it will hurt middle-income Americans, whose employers will shift even more cost and risk to their employees."

And as Gerald Shea, assistant to the president of the A.F.L.-C.I.O, told The Times, "It would throw into turmoil the employment-based system of health insurance, and it would impose a new tax on the middle class."

Most experimentation (both good, not-so-good, and bad) with health care policy is happening at the state level. The often-touted Massachusetts plan – in the words of Doctors Steffi Woolhandler and David Himmelstein of Cambridge Hospital and Harvard Medical School – "offers empty promises and ignores real – and popular – solutions." By requiring every resident of the state to have health insurance or pay a fine while doing nothing to control costs of insurance and care, or setting standards for coverage – Big Insurance wins, and consumers lose. And the middle-class which doesn't qualify for subsidies but can't afford insurance is further squeezed.

In California, Governor Arnold Schwarzenegger has proposed a similar plan. Again, the plan mandates coverage but, according to State Senator Sheila James Kuehl, "it doesn't ensure that coverage will be comprehensive and affordable…. [it will] at best provide high-cost, low benefits plans for many Californians; it limits what employers pay but not what individuals must pay or what insurance companies can charge."

Although Schwarzenegger has won praise for a "bipartisan approach," in fact both his plan and that of Massachusetts Governor Milt Romney move in a direction Romney's staff calls "a culture of insurance" and "personal responsibility."

State Sen. Kuehl herself has a plan for universal coverage that I previously reported on here. Her proposal – SB 840 – would offer all Californians comprehensive care and the right for a patient to choose his or her doctor. It would replace insurance companies with a statewide trust fund that collects premiums paid by employers and individuals. The creation of a single fund reduces administration costs from nearly 30 percent of total health care costs to under 10 percent. With 80 percent of Californians wanting a government guarantee of affordable health care coverage, one hopes state legislators will take another look at the Kuehl plan.

The Washington Post reports that Pennsylvania Governor Edward Rendell has proposed a tax – on tobacco and businesses not offering health care coverage – in order to create state-subsidized private insurance for its 767,000 uninsured people. Vermont, Illinois, and Maine have all enacted legislation to expand coverage of uninsured residents as well, and at least eleven other states are "considering" doing the same.

Meanwhile, at the federal level, any real action to improve this unacceptable situation – worse than any other industrialized nation in the world – will have to overcome a lot of naysayers (not to mention powerful lobbying interests with their campaign dollars). Consider these statements from three representatives to The Washington Post:

"The truth of the matter is that dealing with this problem between now and the election is not realistic," said Senator George Voinovich.

"Congress is not going to act in a major way to deal with this access problem in the next couple of years," said Senator Jeff Bingaman. "That's the unfortunate reality that we're facing."

"If we tried to adopt a universal health-care plan on the federal level, we probably wouldn't have the votes," said Representative Frank Pallone Jr.

Nothing like negative, self-fulfilling prophecies to justify do-nothing proposals from our elected leaders.

The fact is there are 78 co-sponsors of HR 676 – the United States National Health Insurance Act introduced by Representatives John Conyers and Dennis Kucinich. There are 225 labor organizations supporting it as well. It would expand Medicare to every resident through savings from negotiated bulk procurement of medications; a tax on the top 5 percent of income earners; and a phased-in payroll tax that is lower than what employers currently pay for less comprehensive employee health coverage.

"There are only two real choices in the present healthcare debate… commercially-based models which reinforce the insurance industry and fail to provide genuine universal and comprehensive care, and HR 676, a patient-based model which caregivers know is the most effective, humane approach," said Deborah Burger, president of the California Nurses Association/National Nurses Organizing Committee.

"Solutions to the health care crisis based on increasing our reliance on private health insurance companies are bound to fail," said Dr. Oliver Fein, director of Physicians for a National Health Program. "Insurance companies limit patients' choice of doctor and hospital, and take money out of patient care and put it into marketing, bill collectors and claims deniers. We need a National Health Insurance program."

At a time when our nation is spending $8.4 billion per month in Iraq it is clear that the resources are available where there is political will. Just as the President proposes that we continue to follow his course of folly in Iraq, so too will he ask us to stay a course which causes the number of uninsured to grow year after year, and makes access to comprehensive health care a privilege for the fortunate who can afford it.

Tonight, when President Bush offers his flawed prescription for improving the state of health care, respond by signing on to the only real solution: universal health care now.

Comments (31)

1. When we got rich. Look at America- like someone with beautiful clothing in a starving city. Most Americans are too satiated to care about anything that doesn't harm them personally.

   Posted by fromredbird at 01/23/2007 @ 6:01pm

2. It is interesting when people comment about how anyone other than George is responsible for fixing the Iraq mess. He's going to get off scott free for it all and others will be blamed for not being able to fix this awful situation. As far as the health care issue, we insure our employees, many of whom are over 50 and I can assure you that we have no golden plan by any stretch of the imagination, yet the premiums for these employees will be taxed because of the premium on their age, not the spectacular benefits they derive from being older. I suggest that in this day and age, only government employees and our golden-parachute CEOs have such stately plans, so here we are, the workers of America, shelling out more of our money for those at the top (we pay higher taxes as a percentage of our earnings, because, after all, they don't have to earn anything) and those at the bottom who won't be able to afford health insurance even with tax deductions. Tax incentives only help those who have ample amounts of money. If the president gets this plan through, he should get a sales trophy.

   Posted by deniseahlberg at 01/23/2007 @ 6:05pm

3. Have you noticed that absolutely nothing is said about the obscene executive salaries of most of the firms involved in healthcare? My health insurance became higher than my house payments two years ago and I had to drop insurance to keep the house out of foreclosure. We were paying almost $800 for me and my three children, but we never even reached the deductibles for the last ten years. This lead me on a search to figure out why things were so out of kilter. I discovered the SAME large shareholders were involved in EVERY facet of healthcare, from malpractice insurance, to health insurance, to hospital chains, to drug companies, and to the companies that finance them. At this site [GreatRedDragon.com], I've described this in "Medical Enslavement" and other articles. NO ADS! Just hope others realize WHAT and WHO we are up against, and why these problems continue to remain unresolved. It's simply NOT in THEIR financial interest, and regular folks like you and me do not have the means to purchase our congressional representatives to represent US!

   Posted by Ed Cate at 01/23/2007 @ 6:25pm

4. It's January. Must be time to trot out the "HMOs are evil" slogans and advance socialized medicine again. Hey, while we're on the subject, let's examine just where those evil HMOs came from.

   "On March 3, 1978, Senator Edward Kennedy bragged, 'As the author of the first HMO bill ever to pass the Senate, I find this spreading support for HMOs truly gratifying. Just a few years ago, proponents of health maintenance organizations faced bitter opposition from organized medicine.' He added, 'HMOs have proven themselves again and again to be effective and efficient mechanisms for delivering health care of the highest quality. HMOs cut hospital utilization by an average of 20 to 25 percent compared to the fee-for-service sector.'

   Hmmm. Teddy hit a home run with that one, didn't he? Didn't he?

   Posted by usc1 at 01/23/2007 @ 7:15pm

5. I'm an ICCU nurse and I say don't believe everything you hear or read. Those organizations that KVH mentioned are not truely interested in the human aspect of healthcare. It's the money they're after.

   And, if I were any of you, I wouldn't bet the family farm on any subsidized healthcare offered by Congress either.

   Posted by ACook at 01/23/2007 @ 7:35pm

6. Posted by ED CATE 01/23/2007 @ 6:25pm

   Ed, a lot of what you have listed as "real owners" of many of the economic categories are mutual fund companies who own the shares fbo, for the benefit of, their shareholders- everyone who owns any mutual fund shares. That would be America's 401Ks', etc., mostly small holders. I'm not disputing that there is a political class in America which is also an economic elite, by any means, but I don't think it's rule is accurately illustrated simply by majority ownership of industries. It's influence is greater than it's economic clout primarily because the majority of society fails to exercise it's economic and social clout.

   Posted by fromredbird at 01/23/2007 @ 8:13pm

7. how many americans could have gotten good insurance for the cost of the iraq war?

   simple fact...neocons care more about enriching themselves than ensuring health care for 47 million "losers". and their love of mammon knows no bounds...if the deaths and suffering of hundreds of thousands is needed to ensure hefty profits...so what? we were all born to die anyway - denying health coverage in favor of pointless self enriching slaughter is actually kind...if you aint rich dying before the end of your natural lifespan from something that could have been prevented is actually not so bad, you know?

   ah...compasionate conservatives...

   Posted by ibbleblibble at 01/23/2007 @ 9:01pm

8. IBBLE, you can't blame everything on conservatives, they weren't the ones who introduced this disaster called HMOs in the first place. You can thank the libs for that.

   As for the estimated 47 million uninsured out there, you can blame that on failed social programs passed by Congress. It's always been about the money. Rarely does the House and Senate revisit any initiatives that fail to aid the masses. They have no intent on offering affordable health care coverage, it's another smoke screen to line their pockets.

   Posted by ACook at 01/23/2007 @ 9:21pm

9. Posted by ACOOK 01/23/2007 @ 9:21pm

   how many americans could have gotten good insurance for the cost of the iraq war?

   yeah, you are right...it aint all conservatives, but time and again we have had opportunities to improve things, only to settle for half ass fixes that profit wealthy donaters and not schmuk nation...

   and time and again conservatives have consistantly proven they side with monied interest over welfare of schmuk nation...more than the dems, even the clintonian dinos...

   but an incompetant pack of ass coverers had to get us into iraq...

   Posted by ibbleblibble at 01/23/2007 @ 9:50pm

10. Ed Cate,

    ". We were paying almost $800 for me and my three children, but we never even reached the deductibles for the last ten years."

    You have discovered your solution without even knowing it...

    $ 800.00 a month times 12 months plus your deductable....your cost for a year is aprox $11,000 WITHOUT ANYTHING COVERED, MUCHLESS THE 80-20 RULE......now, use the EXACT actuarial tables and math the insurance companies use...they are betting your $ 800 a month plus deduct that you will never come close to costing that much, and they are correct....it is cheaper to pay for drugs and pay for broken bones OUT OF POCKET,than the current system you have, or used to buy.

    Take out a medical savings account with higher deduct...acts like an IRA.. premiuns are less....what you want is catrastrophic coverage for YOU and your WIFE...the savings are real...

    I did it for 14 years...my premuims were higher than $ 800 a month deducts were over $ 3,000...in 12 years alone I saved over $144,000 in premiums and paid out, including appendiX operation and 3 broken bones..less than $ 28,000.....and you get the doctor of your choice(NOT HILLARYS) and you can negoitate evErything from DR bill to hospitals stays..THIS ADVICE IS NOT JUST MINE, BUT FROM A FRIEND OF MINE WHO RUNS $ 5 BILLION A YEAR RESEARCH HOSPITAL...

    One must think a little and not wait for govt to step in....after all I don't want to pay for YOUR health care either...

    Think about it...why do insurance companys make so much money? Because most policy holders are in an age group(kids) that NEVER uses the service, yet the familys or employers(its still your money they pay you instead of paying it to you..tax free)

    Posted by john maasch at 01/23/2007 @ 9:51pm

11. are still paying for ineffective coverages..

    Sorry hit the submit button too soon.

    Posted by john maasch at 01/23/2007 @ 9:57pm

12. Posted by JOHN MAASCH 01/23/2007 @ 9:51pm

    john...you and i may disagree about a few things, but...

    if i ever need good personal financial advice i'll go to you...lol

    Posted by ibbleblibble at 01/23/2007 @ 10:07pm

13. Ibble,

    I am not so sure ....that system worked for me but it makes many nervous...I have a cast iron stomache ,I guess...I hate insurance companys,bankers, unions, govt beurocrats and lawyers(until I need one of course)...and speed traps, which is just another tax...

    side bar,...I told a judge a fews weeks back...

    "I entertained my son with stories of how the bandit jumped out of the bushes, robbed the passengers in the stage of $ 100 with a gun, the sheriff then got a posse, rounded up the thief and hung him...today the guy coming out nof the bushes is a cop with a radar gun, who is robbing us of $ 100 for safety on the road and hanging me out to dry...if it was safety, I told the judge, the cop needs to get his butt out of the bushes and set up around the corner where we have an accident problem..

    The cop was embarassed and the judge laughed, said I was right and threw out the tickets...

    Posted by john maasch at 01/23/2007 @ 10:18pm

14. Asked this on another thread, glad Ms vH brought up health care.

    When we get "Federal universal health care" and "put the evil insurance companies out of business!!!!!".....

    what happens to all the employees of those "evil insurance companies"?

    I mean, CIGNA, Blue Cross, etc. aren't run by the CEO and "fat cats" on the Board...alone. Aren't there thousands, maybe tens of thousands, maybe a few hundred thousand people employeed by them?

    And what happens to the tax revenue that the insurance companies USED to pay into the treasury? Who will pay the pensions of the former insurance company employees?

    Now, I KNOW that we will put the insurance companies out of business...because if they stay in business and offer ONE BENEFIT MORE than the Government offers...that wouldn't be "fair" and the Govt would have to offer it too!

    And who's going to pay premiums to a insurance company...when they'll get it for "free" from the Fed???

    So ....again, what happens to the guys and gals who get laid off?

    Posted by Mask at 01/23/2007 @ 10:35pm

15. Posted by JOHN MAASCH 01/23/2007 @ 10:18pm

    i tend to suffer from lots of minor crap myself, but never been under the knife (us hypochondriacs tend to live long lives - lol)

    you got out of the ticket? good for you! years ago, the last time i worked for a dem (or any) pol i got a speeding ticket, took a gamble the traffic court judge in that part of the state was a democrat, wrote a gushing letter bemoaning the collapse of the dem party, poor mouthed a bit, and begged for mercy...

    it worked...

    then there was the time i told the cop i was about to crap in my pants...that worked too...i pulled into the next gas station "to crap" and there he was...faking a crap is not as easy as it would seem.

    and then there was the time in costa rica when i payed "a reduced fine" directly to the "fine" officer instead of showing up to court...

    Posted by ibbleblibble at 01/23/2007 @ 10:43pm

16. so let me get this straight, payroll deduction is now considered getting it for free?

    you hamsters took a bottle of stupid pills this morning didn't you?

    Posted by Will C. at 01/24/2007 @ 12:03am

17. which makes this morning just like every other morning

    Posted by Will C. at 01/24/2007 @ 12:03am

18. Dear Ms Vanden Heuvel, considering all that you said if you coulple the health care issue with the disaster in Iraq, should people not support Kucinich in its run for president? He is the only elected representative that has been against the war at 100% and has a real progressive program instead of the more or less "corporate welfare" democrats. In addition (and this is the real difference), he is the only one who is not insisting on the "strong defense" issue, on the military might to solve the problems, but he takes the advanced approach of a leadership that is not based on violence. How taboo is it to say that the horribly huge Pentagon budget should be severely slashed ? When is the US going to abandon the militarization-brainwashing that is imparted to its citizens in many various and different ways from the youngest age? It is disheartening to see how DrMartin Luther King is revered in public events, but, in a tragic betrayal, how little of his non-violent attitude is peremating the education and cultural system of the USA.

    Best, Francesco Spano'

    Posted by spano at 01/24/2007 @ 06:59am

19. Posted by PLAIN BRUCE 01/23/2007 @ 11:26pm

    Actually BRUCE (revealing the trick here)...thought I'd take a "liberal tack" on questioning a liberal issue.

    Essentially, Government universal health care will HAVE to drive out of business the insurance companies.

    Either the insurance companies will offer benefits that the Government won't provide....and liberals will demand them too so that "it's not just for the elites who can pay". But that means that the insurance companies will go out of business, since NOBODY will pay for a service they can get for "free" from the Government.

    or that will happen immediately, with Government health care covering everything from plastic surgery to Lazik. (not likely, most libs understand that wouldn't "sell" at the outset...they'll have to wait and "give" it to us later when nobody is looking).

    So....what happens to the employees of the insurance companies? Seems we're talking about putting THOUSANDS of people out of work.

    Where's the compassion?

    Posted by Mask at 01/24/2007 @ 09:09am

20. the insurance companies won't be able to offer services that single payer health care can't also provide.

    Posted by Will C. at 01/24/2007 @ 09:46am

21. So....what happens to the employees of the insurance companies? Seems we're talking about putting THOUSANDS of people out of work.

    Where's the compassion?

    Posted by MASK 01/24/2007 @ 09:09am

    I hear the government is hiring thousands of insurance professionals.

    oh wait, we're not there yet.

    Posted by Will C. at 01/24/2007 @ 09:48am

22. Give it time.

    Posted by Will C. at 01/24/2007 @ 09:48am

23. Posted by WILL C. 01/24/2007 @ 09:48am

    WILL....hehe...did you just ADMIT that when we get Government-run health care that...

    it will hire THOUSANDS of new bureaucrats to run it?!?!??

    Posted by Mask at 01/24/2007 @ 10:17am

24. the insurance companies won't be able to offer services that single payer health care can't also provide.

    Posted by WILL C. 01/24/2007 @ 09:46am

    Which is what I said. Means "Government plastic surgery" and "Government Lasik" and "Government tummy tucks", etc., etc.

    That's another good admission too, WILL!

    Posted by Mask at 01/24/2007 @ 10:18am

25. No, Katrina, the REAL solution is to get business and "managed care" systems out of it, and force the medical profession to get their money from the ones to whom they provide their goods and services-the people.

    Chip

    Posted by CHIP THORNTON at 01/24/2007 @ 10:51am

26. Posted by CHIP THORNTON 01/24/2007 @ 10:51am

    People actually paying for goods and services? Huh. What a radical idea!!!

    Posted by usc1 at 01/24/2007 @ 11:16am

27. the insurance companies won't be able to offer services that single payer health care can't also provide.

    Posted by WILL C. 01/24/2007 @ 09:46am

    Which is what I said. Means "Government plastic surgery" and "Government Lasik" and "Government tummy tucks", etc., etc.

    That's another good admission too, WILL!

    Posted by MASK 01/24/2007 @ 10:18am

    And this, among other things, is why Katrina's proposal is bad.

    Moreover, one of her fundamental premises is faulty (something that has been touched on by some other posters here). The only basis for her argument is that the status quo is bad. This is problematic because it assumes that the only alternative to the status quo is what she's proposing. Once this false dichotomy is eliminated, she no longer has any leg to stand on.

    Posted by Thrawn at 01/24/2007 @ 1:20pm

28. Posted by THRAWN 01/24/2007 @ 1:20pm

    This "employees of the insurance companies" thing just kind of came to me the other day...I suppose mixing around in my head all the discussion, by the Left ironically, of "jobs lost to outsourcing" and the Government not doing anything about it.

    Then I thought, wait a tic...if universal health care from the Fed puts the "evil, greed HMOs and insurance companies out of business" (always a crowd-pleaser to the Rive Gauche of American politics)....

    what about THOSE jobs? So far, no answers.

    My young friend WILL sort of stumbled around trying to come up with one...but basically, with his "let them all go to work for the Govt" line, he ended up admitting that the denial from the UHC supporters that "Federally-sponsered health care will NOT become a vast bureaucracy"....is a lie.

    AND he also blew up the denial that Federal UHC would cover luxury items like nose jobs and laser-eye surgery with his "the insurance companies won't be able to offer services that single payer health care can't also provide."---Posted by WILL C. 01/24/2007 @ 09:46am

    which has been a KEY retort from the proponents when asked about the INEVITABLE spiral of more and more and more benefits.

    But take the "insurance company employee" thing and run with it, next "universal health care" debate comes up....I'd truly like to see some "answer" (i.e. spin) on it.

    Posted by Mask at 01/24/2007 @ 1:39pm

29. There's only one decent argument that I've gotten in favor of universal health care, and that's a comparison with European democracies in terms of both health-care costs and health-care coverage.

    Posted by Thrawn at 01/24/2007 @ 5:19pm

30. Posted by THRAWN 01/24/2007 @ 5:19pm

    Sure, but the PSYCHOLOGICAL factor needs to figure into it.

    Americans get freebies, they want MORE freebies....Europeans SLIGHTLY less so (note except the French students last year!)

    Posted by Mask at 01/24/2007 @ 8:03pm

31. Bush is in Kansas City today in an attempt to help Governor Matt Blunt save his office in the next election (Matt Blunt kicked 90 Thousand Missourians of Medicaid in 2006). To suggest a tax break so that the average American could afford healthcare is obscene. This proposed policy is nothing more than an attempt to line the pockets of the richest providers of healthcare (Hospital Systems like HCA, Insurance Companies and Medical Product Manufacturers) all at the expense of the taxpayer. For those of you not aware of what really goes on in the Healthcare Industry, Kansas City is the epicenter for the largest Healthcare anti-trust case ($1.5 Billion) in US History, which is why Bush is here today. The roundtable discussion is being held at a Novation (GPO) member hospital St. Lukes East. Novation is a Texas company and under investigation by the justice department for it's anti competitive business practices. To learn why healthcare is not affordable for the average American visit http://www.medicalsupplychain.com/news.htm.

    Posted by splymgmt at 01/25/2007 @ 09:24am