Thursday, July 9, 2009

Take Two and Call Me In the Morning

The President went to Green Bay, Wisconsin, to conduct a town hall meeting

concerning health care. Talking to folks at a local high school, the President turned up

both the heat and rhetoric on the subject. He said the next eight weeks will be crucial

to getting health care reform written and passed. He wants to sign it into law by November.

He called on members of the audience to monitor their members of Congress, and to call

and write to them demanding wholesale change in how health care is delivered in this

country. The fear-mongering being engaged in by opponents of the President's plan didn't

escape Obama's notice. He reiterated that Americans with insurance will not have to

change and won't lose coverage.

Eight weeks to push for a dramatic change in how health care is delivered; eight

weeks to write a comprehensive plan so that 50 million Americans without insurance can

acquire it. Eight weeks to put in place a system to force the costs of health care down and,

in the process, help to get the nation's fiscal house in order, reduce deficits, and provide

better care. Eight weeks to bring American health care in line with it's European neighbors

who pay less than half for their health care, and get better care and outcomes. The question

is are you ready to "take to the mattresses" (Godfather reference) for the next eight weeks

to keep the Democrats feet to the fire and accomplish something as momentous as the

passage of Medicare or Social Security? For years people have complained to me about

griping too much without offering solutions to problems facing us. OK, here is your chance

to get in the game. If you sit this one out, you deserve a system where you cannot get the

care you need at a cost you cannot afford to pay.

The biggest debate in the next eight weeks will be over whether there will be a

public option for receiving health care. The President said in Green Bay that the public

option is vital to provide competition to the private health insurance companies; and

guarantee that they keep their word to bring down costs, make health care more available

to all Americans, and not deny health care for pre-existing conditions. If we have the

option to get coverage through a government sponsored health care plan, the health

insurance companies will have to match the cost and benefits that the government program

provides or lose customers. Without a public option, insurance companies can promise

anything and deliver nothing. Without a public option, we will still be left with no choice

if the insurance companies go back on their word. Without a public option, there is no

competition and the insurance companies can do anything they want.

New York Times columnist Paul Krugman called on the President not to believe

the promises of the health insurance industry. He called on the President not to trust them.

He says there will be no health care reform without a public option. He doesn't believe the

health care industry will follow through on any of their promises unless forced to by the

knowledge that if they don't come through, we can leave them and get coverage through a

government sponsored program.

We already know there will be almost no support for real healthcare reform from

the Republicans. The regressives of that party fought the passage of Medicare and earlier

fought the passage of Social Security. They opposed the creation of Head Start, food stamps,

and most civil rights legislation. They have no interest in fixing the health care system or

expanding access to it to more Americans. So it will come down to the Democrats. The

Democrats have majorities in both the House and the Senate. In the Senate, they are close

to being filibuster proof and might even bring over one or two moderate Republicans. In

the House, the Democrats can ensure passage no matter what the Republicans do. However,

there are Democrats who balk at a public option. They receive a lot of money from hospitals,

pharmaceutical companies, and health insurance companies. They need to be more afraid of

you than they are of them. They need to know that there will be a heavy political cost if they

oppose the President. They need to be inundated with calls and emails demanding a public

option. Remind them that this is America and competition is a good thing. In the grand

tradition of free market capitalism, they should embrace the President's idea. If the health

insurance companies cannot or choose not to offer competitive rates and services, they will

go out of business. What could be more American than that?

Opponents of a public option say it is the first step toward socialized medicine.

The question I have is what do they mean? Are they saying that any government sponsored

health care is bad or wrong or inferior? Are they saying that the standards of care will be

worse? Are they saying that government sponsored health care won't save money?

In America today, millions of Americans get their health care from the government.

First, there are the millions of Americans who are covered by Medicare coverage. (You will

notice that as the regressives yell and scream about socialized medicine, not a one has ever

proposed repealing Medicare because it would be political suicide. Not even Limbaugh,

Hannity, et al. have ever called for Medicare to be repealed.) Millions more Americans and

their families, who served in the military, are covered by the Veterans Administration. The

biggest complaint they have is not bad care, but rather not enough access to VA hospitals

and doctors. (Do the regressives claim that our returning soldiers are getting sub-standard

care because it comes from the government? Hospitals like Walter Reed Medical Center or

Bethesda Naval Hospital, are they considered inferior to Mass General or Stanford Medical

Center?) Members of Congress themselves, and their staffs, get health coverage through

the Federal Government; and you don't hear them complaining about it.

Just recently the Congress expanded the S-CHIP program providing medical care

to millions of children not previously covered. The main attack from regressives in the

Republican Party was not about standards of care, but rather that too many children would

get access to coverage at too high a cost. Oh, and speaking of cost, both Medicare and the

Veterans Administration have the best cost containment of any health care providers in

the country. The rise of health care costs is smaller in these government sponsored programs

than in any private health care company. Using it's buying power, the V.A. forced

pharmaceutical companies to sell drugs to them at prices similar to those charged in

Canada at a significant cost savings.

So, don't spend any time lobbying Republicans. Concentrate on the Democrats

and turn up the heat. This opportunity is not going to come along again for a long time;

and the health insurance industry knows that if they can kill the public option, there will

be nothing that forces them to change how they conduct business and what they charge

to do it.

I wish the President had the testicular fortitude to propose a single-payer plan.

The private health insurance companies should simply be eliminated. They provide no

health care, and act simply as middlemen between you and your doctor. In the industrialized

West, single-payer delivers better health care, at lower costs, to more people than is done

in this country. It appears the President has rejected a single-payer option; so the public

option of a government sponsored program competing with private insurers is the best

we can get. With a public option, there is competition in the market place. Without a

public option, the health care industry can ignore any promises they made and continue

business as usual.

Do not get distracted by arguments on the periphery. Don't let them throw up

a lot of smoke and mirrors about employer sponsored care, or with words like socialism

or scare tactics telling you that you won't get adequate coverage or access to your personal

doctor. Keep your eyes on the prize, and the prize is a publicly sponsored program that

you can join if your health insurance company doesn't keep it's word to you. The prize is

competition. The prize is lower costs and better health care.

The President promises that the key to getting the cost of government reduced,

deficits brought under control, and the economy revitalized is to get the cost of health care

under control. Without a public option, it will never happen. In the next eight weeks, we

have a chance to do something truly historic for ourselves and our children. It is in your

hands now. You can't claim that there is no solution. What will you do? What do you think?

I welcome your comments and rebuttals. Please send them to

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