Health Care Debate in US

How Corporate Media, Sellouts in Congress and Industry Bigs Have Hijacked the Health Care Debate

Published on AlterNet, by Joshua Holland, July 29, 2009.

If we let these powerful interests get their way, we’ll see more outlandish increases in premiums, and millions more people being denied care

… Finally, there’s a sad irony to this whole discussion – one that few commenters have bothered to note. It is true that the potential savings contained in the proposals currently on the table are limited, but it is also true that the reason for that shortcoming is that Congressional leaders have ushered through a series of bills that are far less expansive than progressive reformers have long advocated, and that’s only been done to mollify the very same Dems and Republicans – those ideologically opposed to the effort and/or especially cozy with the “disease-care” industry – who are now complaining about the limited potential for savings (It’s enough to make your head spin).

Just consider the “public insurance option.” While progressives were promised a “robust” public insurance program that would be open to all comers, what emerged from the Senate HELP Committee and from the leaders of three House committees was a pale shadow of what had been touted during last fall’s campaign season. Instead of insuring as many as 130 million Americans as candidate Obama suggested his public option would, lawmakers restricted eligibility for the program in such a way that the CBO’s preliminary estimate suggested that just 10 million Americans would be enrolled in the public insurance plan by 2019. (That’s out of about 30 million who could buy insurance – either public or private – through the publicly-run insurance exchanges.) This was a nod to the power of the insurance industry – nothing more, nothing less.

In designing a (pretty good) system, but then tightly controlling who could gain access to it, the potential for cost-containment – through greater economies of scale, more bargaining power with providers and a decrease in the shuffling of paperwork that’s estimated to account for about 30 percent of our health spending – has been greatly diminished.

So, next time you see some congressional meat-puppet on TV discussing how much a plan will cost, or lamenting its limited potential for cost-containment, keep in mind that it’s his or her ideology that is directly to blame for those shortcomings.

It’s only because of pressure from industry groups, Republicans and Blue Dog Dems that congressional leaders took single-payer off the table (and threw advocates out of the room) and gave us a limited public insurance option – a pale shadow of what reformers had been promised. Now, those same forces are bent on killing an already watered-down proposal. If they succeed, we can expect more human suffering, more outlandish increases in premiums, more people being denied care, an increase in the numbers of uninsured and a continued drag on the American economy. (full text three long pages). But even that standard doesn’t tell the whole story. Looking only at how the current proposals impact health spending over a 10-year window ignores the longer-term impact they might have. For example, contained within both the Senate and House bills are provisions that would create more incentives for preventive care. Most analysts agree that prevention costs a lot less than waiting for people to develop serious illnesses and then treating them, as we now do, but those savings can only be fully realized over the long term. If a young obese person visits a doctor whom he or she might not have seen because of a lack of insurance, and as a result of that visit makes changes that prevent him or her from developing diabetes – with all its attendant complications – it will save the health care system a small fortune, but probably not for several decades.

Finally, there’s a sad irony to this whole discussion – one that few commenters have bothered to note. It is true that the potential savings contained in the proposals currently on the table are limited, but it is also true that the reason for that shortcoming is that Congressional leaders have ushered through a series of bills that are far less expansive than progressive reformers have long advocated, and that’s only been done to mollify the very same Dems and Republicans – those ideologically opposed to the effort and/or especially cozy with the “disease-care” industry – who are now complaining about the limited potential for savings (It’s enough to make your head spin).

Just consider the “public insurance option.” While progressives were promised a “robust” public insurance program that would be open to all comers, what emerged from the Senate HELP Committee and from the leaders of three House committees was a pale shadow of what had been touted during last fall’s campaign season. Instead of insuring as many as 130 million Americans as candidate Obama suggested his public option would, lawmakers restricted eligibility for the program in such a way that the CBO’s preliminary estimate suggested that just 10 million Americans would be enrolled in the public insurance plan by 2019. (That’s out of about 30 million who could buy insurance – either public or private – through the publicly-run insurance exchanges.) This was a nod to the power of the insurance industry – nothing more, nothing less.

In designing a (pretty good) system, but then tightly controlling who could gain access to it, the potential for cost-containment – through greater economies of scale, more bargaining power with providers and a decrease in the shuffling of paperwork that’s estimated to account for about 30 percent of our health spending – has been greatly diminished.

So, next time you see some congressional meat-puppet on TV discussing how much a plan will cost, or lamenting its limited potential for cost-containment, keep in mind that it’s his or her ideology that is directly to blame for those shortcomings.

It’s only because of pressure from industry groups, Republicans and Blue Dog Dems that congressional leaders took single-payer off the table (and threw advocates out of the room) and gave us a limited public insurance option – a pale shadow of what reformers had been promised. Now, those same forces are bent on killing an already watered-down proposal. If they succeed, we can expect more human suffering, more outlandish increases in premiums, more people being denied care, an increase in the numbers of uninsured and a continued drag on the American economy. (full long 3 pages text).

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