Two For Two: Podesta Answers My Question about Single-Payer -- It's Off The Table
Thanks to all who went over to ThinkProgress.org yesterday and rec'd my question. It was ranked as 3rd. When Podesta answered it (about half-way into the first screen), the answer is clear. The Health Care proposal coming out of this administration will be insurance-based. To be fair, this is what Obama ran on. But considering his conciliation to republicans on issues which actually go against our ideals, is it too much to ask for those of us who are on his side to even be heard and considered?
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So, once again, health care dollars will be divided between health care delivery and advertising, bureaucratic paper-pushing, and profit. We lose.
Any suggestions for a grass-roots message to the Obama Administration, or should we give up?
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We need to have a national referendum on this issue, unfortunately that's not part of our nation's lexicon in governance. We obviously still need to continue with the discussion on single-payer. There are a surprising number of people who either haven't considered it seriously, have ideological reasons for rejecting it, are just plain afraid, or are drinking the kool-aid being handed out by the vested interests of the status quo. While BHO didn't run on a single-payer platform, I find it disheartening that there will be no national discussion on this.
January 29, 2009 12:39 PM | Reply | Permalink
So let's not let this go! See the duck's blog on "Dramatic New Study..." How about a Single-Payer Walk for Health?
January 29, 2009 12:49 PM | Reply | Permalink
Sign me up. That idea is worthy of a blog in and of itself CVille. We need to get some of the existing organizations, like the nurses association Duckie quotes, physicians groups, and the myriad other pro-single payer groups to sponsor such a walk. Let's make it an annual nationwide event until this issue starts getting the attention it deserves. I'm going to make some phone calls/write some letters to some of these groups.
January 29, 2009 1:05 PM | Reply | Permalink
Gosh, we could "walk for health" till we get it!
I'm hoping that the game-plan they have is to start with something more doable. And move it, keep kicking it down the field - with the goal of single payer.
It's the pits of all we get - forever - is bowing and scraping to insurance companies!
January 29, 2009 1:11 PM | Reply | Permalink
I hope that too Thera. The problem is that the financially vested interests get more and more entrenched each time the ball gets closer to the goal, and change becomes even harder to institute. So we get to look forward to a harder fight each step of the way, than what we went through the step before. I would just like to see a national debate take place that isn't stacked with insurance and pharmaceutical industry surrogates.
January 29, 2009 1:26 PM | Reply | Permalink
That's a great idea!
January 29, 2009 6:37 PM | Reply | Permalink
Just a little reminder folks: insurance companies used dump trucks full of money on Obama's campaign from the get-go. It was clear early in the primary season that he was the #1 candidate of the insurance companies. His plan was and will be nothing but subsidies for the absolutely worst element in the whole health care mess: the insurance companies. It will do little to alleviate the massive inequities of our current system, will not make anything cheaper for anyone, and will only prolong the rotten state of affairs we have now. This "plan" still keeps our busineses behind the 8 ball and keeps our expenses sky high. They will tout the number of children especially that will be covered that otherwise wouldn't be, but it's a baby step where leaps are urgently needed for moral, economic, and just as a practical matter.
Obama's health care commercials (you may recall) used language practically straight from the insurance company litany of priorities condemning "government run" health care plans and pandering to the fears of the more fortunate by assuring them they wouldn't "lose" their coverage and would still be able to choose their doctor. I love how the insurance companies emphasize choice of physicians and then refuse to pay for them. Delicious irony wot? Funny thing about that whole argument about not being "forced" into a government plan is, in this country when ya lose your job you also lose your health care. In the past few months, something like 2 million Americans who that line used to appeal to find that it no longer attracts them in the same way because they no longer have jobs and lots of em probably wouldn't mind at all if they were "forced" into a government plan right about now.
I don't think Obama is horrible for taking this incredibly bad and shortsighted approach. He's just being a typical DC Democratic politician. But it is a bad course and does not lead us closer to universal coverage and it won't help our country even marginally when all is said and done. It puts off the inevitable for an unknown period of time, but who does that help except the insurance companies who are raping us with high premiums and screwing us by not paying for the health care people need? It simply leads us to a different inequality in health care coverage that may or may not turn out to be less inequitable than our current mess. I do keep in mind that he's just a politician and on this particular domestic issue, more than any other I can think of, his plan is timid, panders to and favors corporate interest over the public interest and leaves many millions without any kind of hope for decent medical care.
Nicholas Katzenback has posted a couple of times this week in TPM Cafe and in those posts he points out how doing the right thing, albeit difficult and tricky, is not just good government, but it is good politics. You can't do the right thing when your objective is only half a loaf to begin with. After all, who would expect an athlete to win a race if he/she planned only to win the first half of it? You have to be bold, not just talk about being bold. You have to aim to do what is right now, not in an unspecified future time.
They said Medicare was socialized medicine and if it is then I say hip, hip fucking hooray for socialism! Bring it on baby! Because if that is what it takes to provide decent care for the elderly (which it has) and if it is cheaper than a) doing nothing and b) private insurance (which it is) then it is worth it. Why so many of us, but especially Democratic politicians, refuse to stand up and demonstrate any moral courage on this at all is mystifying to me particularly in light of the spectacular success of medicare.
The only way to get the Democratic political establishment to do the right thing is to insist, demand, cajole and more. If you go hat in hand with the nice, polite, "oh Mr. President do you think you could possibly consider providing medical care and treatment for all the people of the nation like they do in every civilized nation but ours?" you will get exactly what we're getting now: ignored and dismissed. The truth is they don't care a whole lot more about what our nation needs or our citizens want than the Republicans do and this sort of thing makes it very clear. They will only care if we make them care and being polite and courteous and two bucks will get you little more than a cup of coffee in DC.
January 29, 2009 11:32 PM | Reply | Permalink
co-sign! Every word of it!
January 30, 2009 12:01 AM | Reply | Permalink
Aye, Oleeb. Me Too. I have no intention of not continuing my personal letter writing campaign to legislators, friends, and anyone else on this issue regardless of the new administration's 'position' on the issue..
January 30, 2009 12:13 AM | Reply | Permalink
Personally, I like the idea of labor (SEIU and other progressive unions) organizing and leading a very vocal, single payer march on Washington. Several hundred thousand people demanding single payer and being militant about it might actually get their attention. Unless they all received about 10 million letters simultaneously, I think letters are pretty much ignored on these big issues. It's power they respond to and that most often comes in the form of the mean green. Despite the fact that little people were the reason Obama had all the cash he did in the campaign, the DC establishment (much of which now works in the Obama White House) still responds to the big boys and the big checks.
You know, even in the thirties, it was only because people took more militant action than previously that any of the progressive laws were passed. One of the factors that seriously motivated New Dealers was the fear of an uprising if something wasn't done to address the concerns of the common people after decades of Republican misrule, laissez faire capitalism, and anti-worker labor laws. I now we're not near an uprising, but we are entering a serious depression and the longer people wait to literally demonstrate their righteous anger at the state of things, the longer it will take to see any notable progress. No reason why it wouldn't work now as far as I'm concerned. All the evidence historicaly here in America and abroad indicates this sort of thing would be a powerful tool for progressives.
January 30, 2009 12:21 AM | Reply | Permalink
I'm with you on the need to get feet on the street, Oleeb. Whether through walks in every town and city, or a single large-scale march to Washington, both sound good to me. And obviously, fire up the organizational effort, the letter-writing, the media push, all of it.
And the end goal HAS to be single payer, universal. Full stop. There may be more than one way to get there, but that's the goal.
What my brain's turning over and over on, is how the months to come are going to unfold. Which is far more important than the Congressional shenanigans this week. Because already, 3 million plus individuals have lost their health insurance. And every economist out there, and even Obama, knows there's at least another 3 million more to come.
This is gonna hit people hard, and they're gonna make noise about it. And since a lot of them are going to be new to this, it's going to put a sharp edge on it. When you consider their families, what you're gonna see is 10, maybe 20 million MORE people who have to think about health care options.
Which, since there are already large numbers supporting single payer, is going to drive this issue up the charts. Meanwhile, our opponents are gonna see a sapping of the general public faith in the private sector, the insurers and banks.
Now MAYBE Obama's team is gonna propose to set up this public insurance company as a competitor. There'll be all kinds of weaknesses to doing that, as people have mentioned. The question for me is, will it be hobbled from Day One... or will it - like so many other policies - get scaled up & strengthened as the economic turns down.
While I suspect the business-as-usual reps in DC will start by aiming to hobble it, there are moments where public pressure is rising... manufacturers and other employers swing onto our side... X million new people start shouting in pain... and the pols may HAVE to strengthen it, right out of the gate. Because this is exactly what happened to Obama's energy policy, and stimulus package - both far larger than they were 12 months ago.
The thing that is common, between these two courses, is that they'll have greater potential if WE push and shout and march and talk back. I don't know enough to know 100% for sure that his plan won't work, because sometimes, to split your opponents, to compete with them but appear to leave them standing, KNOWING that events will weaken them daily, and then take them out, well... sometimes that strategy can work. So I don't rule it out 100%.
But what I do know is that the public pressure has to rise, and the creativity and ORGANIZATION of those who want single payer. People will do the stating their views bit, and the letter-writing, for a while. But sooner or later, on something as large as this, it's gonna require faces and names and feet on the pavement. Just as it did to elect him.
So I guess my mind is wanting to: a) Look at ways to organize and get people out there, publicly; and b) As a back up, look at his plan, and find out what needs to be done to make it stronger, and then to weigh out whether, even at its best, it has the potential to do the trick. But that's Plan B. Cheers.
January 30, 2009 1:02 AM | Reply | Permalink
We are singing the same tune essentially but I think I'm a bit more skeptical.
You wrote:
"The question for me is, will it be hobbled from Day One... or will it - like so many other policies - get scaled up & strengthened as the economic turns down."
For me that's not even a question. In my opinion it is a foregone conclusion. Of course they will make sure the goverment option fails. That's their poison pill! "See! The private insurers may be bad, but they aren't as bad as this!" They will act like people should have the same expectation for success and profit from a pool of the sickest who the insurance boys wouldn't touch with a ten foot pole! And many people will go along with it.
One of the biggest strategic problems is there is no official with great enough stature to counter the "it's off the table" sentiments of the creatures of DC insiderdom. The only real hope is to flank them on the left. Since there is no left in DC this is the scariest foe for them all but they clearly feel like they can ignore everyone on the spectrum from center/liberal to lefty's. That tells me the time to strike is now. Apply maximum pressure from the left a la the Nuclear Freeze and they will start to come our way. Without pressure of that magnitude they'll keep flippin us all off.
January 30, 2009 1:11 AM | Reply | Permalink
As you consider who in Washington might be willing to stand in the vanguard of such a grassroots movement pushing for single payer universal health care, keep in mind the name of Tammy Baldwin. She is a Dem Member of Congress from Wisconsin who has targeted this as her issue and has been waiting for the time to make it happen. I believe that time soon approaches, and she is one smart cookie from a VERY liberal district.
January 30, 2009 1:27 AM | Reply | Permalink
I've seen her speak and she may attain stature. I'm thinking of an already established heavyweight. For example, Ted Kennedy if he were in good health or a group of senior Senators and members of the House. But hey, I'll take anyone at this point!
January 30, 2009 3:15 AM | Reply | Permalink
Actually, maybe there is room for Caroline Kennedy in the political arena.
As morbid as it sounds, I've considered the fact that although Ted Kennedy is too frail to undertake such an effort, health care is his legacy. Caroline can put the focus on it and frame it as "honoring Uncle Ted" in a way nobody else could.
Just thinking.... Your thoughts?
January 30, 2009 1:23 PM | Reply | Permalink
The Democratic Party knows that true liberals will never vote Republican, and staying home is worse than voting in someone who is 90% on your side, even if the single-payer is off the table.
You are so right, in every single word, but the above sentence is also, unfortunately, correct too.
January 30, 2009 3:01 PM | Reply | Permalink
Well... I'm smiling, because I think we beat Krugman to the punch, at least by a few hours. Today's column on health care.
He's not THE leading light in my eyes, but he's seeing the same dynamics unfold. HEALTH CARE NOW.
January 30, 2009 3:08 AM | Reply | Permalink
Well, he's got the strategic importance of it right. Delay kills health care reform and frankly there is no crisis so big or bad that we can afford (with a clean conscience anyway) to ignore doing something about this. Democrats in DC like Rahm are constntly outfoxing themselves. The reason Democrats so often come off to the public as calculating politicians who only really care about themselves is because it's true! This is just another in the myriad of instances in DC these days where a pair of balls could sure come in handy! DC Dems love to plot how they will brilliantly recover from the setbacks and disappointments they created!
January 30, 2009 3:24 AM | Reply | Permalink
Sorry, I misspelled "Katzenbach" in my post.
January 30, 2009 12:32 AM | Reply | Permalink
Barack received no more money from PACs than any other candidate and much less than most. By the end of the campaign, just about all of his funds was coming from small donors - many of whom may or may not have worked for an insurance company.
If you base your entire argument upon a faulty foundation, how can you expect anyone to take you seriously?
January 30, 2009 10:21 AM | Reply | Permalink
Dimwit. The most cursory search reveals much but I wouldn't expect a gasbag to do any of that.
As identified by opensecrets:
Campaign contributions
$2,185,727 insurance industry $3,241,944 from hospitals and nursing homes
$1,927,159 from pharma
$1,225,402 health service/HMO’s
$11,457,850 health professionals
Convention:
$4,850,300 pharma/health
$3,696,600 insurance
$5,400,710 health
January 30, 2009 12:17 PM | Reply | Permalink
This doesn't offer proof of anything. Even a dimwit like me knows that.
Put the numbers in context. How many people are employed in those industries? How do those numbers breakdown per employee? How many contributed multiple times? How much did these industries contribute to other candidates, both past and present?
Here is one piece of perspective for you. Total money raised by Barack Obama's campaign: $650,000,000. COMBINED health care industry donations per oleeb's list: $30,743,748. Percentage of total money raised: About 4 percent.
Obama is such a tool of health care interests I don't know how he can live with himself.
January 30, 2009 12:38 PM | Reply | Permalink
Thanks for the factual numbers, JEM! I'll trot them out the next time I hear the same tired old arguments about Obama being in the insurance company's bag. I think it is more accurate to say that he doesn't want to spend all his capital on this one issue. I wish he would realize that if every American had guaranteed, affordable health care (only possible with shared risk across the board, ie: single-payer) he would have so much capital he wouldn't know where to spend it all!
That is one of the reasons the repubs are so against it. When health-care was nationalized in Britain, that sealed the tomb on the party of opposition.
January 30, 2009 3:18 PM | Reply | Permalink
I think he does see that essential truth, CD. I just think his plan to accomplish it has to be measured against all the competing "truths" that tend to confuse public opinion.
I suspect that if Medicare for All hit his desk that Barack would sign it and let the chips fall where they may. That will take an enormous grassroots effort, though, that doesn't seem to exist at this point in time. In the absence of a workable bill making it through Congress, though, he'll probably put his original plan into motion and hope the opportunity presents itself to get there quicker down the road.
The Navy SEALs have a great saying: Slow is Fast. As in, sometimes the quickest, most direct route isn't always the safest or most effective. Doing something quickly, but two or three times, takes a lot longer than doing it once, properly.
I always liked that concept and am especially susceptible to the inverse because of my numerous personality flaws.
January 30, 2009 3:28 PM | Reply | Permalink
I think "something more doable" is the key. Let's at least take a step in the direction of universal coverage and work to continue evolving it into a system that covers everyone at an affordable cost and gives good quality care. I don't much care what that system actually looks like, I just want one that works. And I'd rather have one now that works a little better than the current one than to have some perfect system stuck on the drawing board for the next five years or more.
There was a terrific article in last week's New Yorker describing the various ways in which health care systems have evolved in other Western countries out of what already existed there. I think that's what we need to do: not try to build a new system from scratch, but take what we've already got and make it better. As the article points out, this is the way that systems naturally evolve; it's called "path dependence".
Our current system of private insurance is largely the result of choices that were made to respond to events of more than 60 years ago. That's the path we're on, and it's where we've got to start from to get to something better. We can't scrap the current system and build something entirely new without considerable risk of causing a lot of pain in the process. But we can evolve something that works. I believe in the power of evolution to transfom even less that ideal initial structures into something marvellous. It will take patience, determination, and imagination, but it can be done. And I think people will be much more comfortable with it if it's not so drastically different from what they already know.
January 30, 2009 4:13 AM | Reply | Permalink
Thanks for adding some common sense to the discussion. A journey of a thousand miles starts with a single step.
January 30, 2009 10:23 AM | Reply | Permalink
Come on.
Single payer is common sense.
And sometimes those single steps are big ones. Besides. Pushing for single payer means we might actually get that something in the middle.
January 30, 2009 11:39 AM | Reply | Permalink
Those journeys are almost never taken in huge steps unless the place you are in is so catastrophic that you have no other option.
I think it will be hard to convince every American that we are in such a place, no matter how many are actually already there. I think that we can all certainly hope for single payer and even agree that it is the best ultimate option, but getting there may be a little more complex and require a bit more strategic thinking to accomplish.
As the US Navy SEALs are quick to say: Slow is Fast.
January 30, 2009 12:10 PM | Reply | Permalink
Maybe we disagree in our definition of "catastophic" and "small steps."
January 30, 2009 12:13 PM | Reply | Permalink
I think everyone disagrees in their definitions of all kinds of important things, the Achilles Heel of democracy.
January 30, 2009 12:15 PM | Reply | Permalink
LOL. Truer words never spoken. ;)
January 30, 2009 4:44 PM | Reply | Permalink
Bingo!
January 30, 2009 12:27 PM | Reply | Permalink
But TheraP, even single payer is not starting new. It's pretty widely acknowledged that the easiest, quickest and cheapest transition the nation could make would be to go directly to a Medicare for all model.
January 30, 2009 12:30 PM | Reply | Permalink
.
Thanks for refer... Jan
And this is the direct link to the blog post:
The Duck Pond
There is a link to a PDF download there that will take a person with patience to properly and fully absorb the information.
~OGD~
January 29, 2009 1:07 PM | Reply | Permalink
Thank you for this Cville. I have changed my mind over the last months and I am totally in favor of a single payer system.
Voices must be heard.
And Olden has also provided a much needed link.
January 29, 2009 1:12 PM | Reply | Permalink
I'm interested in this "public option" they keep mentioning. Is this to be a new insurance provider created by the public sector? Will it be able to offer everyone a solid health care package? Will it be set up to be a serious competitor, open to all?
There's one scenario, I suspect, in which more & more people join the public insurance option, which would enable it to gain more and more bargaining power, driving its own costs down... while the private guys, with shrinking bases, would see their costs rise.... Run that film for a few years, and I think you'd begin to see a scenario develop where the next obvious move would be to shift the funding of health insurance, and the parameters of the public program.... and something close to single payer becomes possible.
Does anybody have any info on how this new public option will work? Or how it might grow? Because if its set up right, and comes out competitive, with quality care, the grassroots push could be to get people to join it - and set the next move in the game up.
January 29, 2009 1:13 PM | Reply | Permalink
Those are encouraging thoughts Q. I suspect that as the insurers see their bases shrinking, they will begin to get more competitive/in line with whatever the public option you suggest is offering. The upshot of that is that it becomes less of an incentive to join the public option as a user, thus stagnating the growth of that pool and its ability to offer better terms. We end up with a better system than we have now, but still haven't attained the maximum efficiency of a single pool of users.
January 29, 2009 1:33 PM | Reply | Permalink
Well, it all depends on how competitive they intend (and allow) the new public insurance company to be, and how easy it is to join. As we've discussed, there's enormous fat/waste/cost in the system, and it doesn't all stem from the existence of multiple insurers. A lot of it is within those firms themselves, in the cozy deals they strike with certain pharma companies & suppliers, in advertizing, in management, etc.
And here's the thing. Yes, you'd think the insurance companies would lower their prices and aim to compete, and the whole dynamic might stagnate at a somewhat improved, but still not very good level. But there's also the fact that if a new entrant comes in with some force, and takes market share away from the others - especially if they're already in financial straits - they can kick into a downward spiral. Even just eating the GROWTH they were planning on can sometimes be enough to crush them. Their smaller revenues makes it tougher for them to negotiate... they have less cash to advertize... they have to start handling lay-offs.... etc.
Yes, I think the push for still be directly toward single payer. But if that's not won, and the new public firm is set up, why couldn't there be a "Yes we can" push to join the new firm? The groups and mailing lists and all that organization will be in place. And if X million people joined, it would not only help create financial advantage, it would help shift the public debate - because we'd have more "proof on the ground" that an alternative was possible.
January 29, 2009 1:59 PM | Reply | Permalink
Good points. Let's hope they "allow" whatever this is going to look like a LOT of competitive advantages.
January 29, 2009 2:12 PM | Reply | Permalink
My understanding is close to what you describe. That they are allowing individuals to finally come together and create a pool just like a corporation or other large entity.
Several people have also envisioned an end game where the insurance companies ultimately can't compete (I can't find the link, but I read some testimony from a couple of private carriers predicting they won't be able to compete long term).
That's why the insurance companies are now pushing for mandated coverage. That would force everyone to buy no matter what deal was created as the floor. I'm just scared that people looking for "universal" will buy their BS. If it's mandated, the private plan can't work.
January 29, 2009 2:26 PM | Reply | Permalink
Thanks KGB. Your last para confused me though. The private firms are pushing for mandated insurance... but then you say, if it's mandated, they can't compete?
January 29, 2009 2:46 PM | Reply | Permalink
The more likely scenario will be the Insurance Companies doing a harder sell to get the healthy people insured, leaving those with serious medical problems for the government program. That will allow them to cut their rates and let Congress struggle with the ever increasing costs for the government program. We all know how that ends.
Single payer can only work if it is single payer, where everyone, healthy, sick, young, and old are insured together. Any exceptions to that leave the insurance companies with the young and healthy, where profit is assured, and the government with old and unhealthy, with the cost for that rising every year.
January 29, 2009 9:43 PM | Reply | Permalink
Bingo Hoppy! You're on to the insurance industry's scam.
Just as with these other albatross' in the financial collapse, the brilliant business minds prefer to have the government take on all the mutts and they take the cream. They promise to have lower premiums of course if the sicka re taken off their hands except there's a startling catch involved: they're lying! Big surprise huh? And we taxpayers get screwed coming and going once again.
January 30, 2009 12:26 AM | Reply | Permalink
That isn't even possible because economies of scale will make the government plan cheaper by far, meaning it just isn't the sickest who take part, just the poorest. Plenty of sick rich people will drag down private insurance companies when they are no longer able to deny coverage by law.
January 30, 2009 10:28 AM | Reply | Permalink
I found this, Quinn. Haven't read it, but it seems to cover the high points at least.
January 29, 2009 5:22 PM | Reply | Permalink
Thanks for that, FDRdog. Just scanned it, looks really useful. Guaranteed eligibility... comprehensive care... cut admin costs and negotiate to capture more savings... ensure affordability and provide income-linked subsidies... all useful components.
Question is, if this public insurer can seriously compete, and takes market share from the private cos, and there's a public push to use it... then what dynamic would that put in place with the private insurers?
January 29, 2009 6:38 PM | Reply | Permalink
That occurred to me, too. I'm guessing the public will be a last resort for people who can't get it through a private carrier. Companies would be required to carry private insurance or pay all(?) or part of the employee's premium. Still, it seems like it would erode private market share eventually.
January 29, 2009 7:07 PM | Reply | Permalink
This is exactly how I saw Barack's plan all along and he pretty much explained it as such.
Make the insurance companies perform up to par or they can go out of business in a very public way while most Americans enjoy the benefits of Americare or whatever it ends up being called. They will have no more appeals once we have transitioned without them involved.
Always more than one or two or ten ways to skin a cat.
January 30, 2009 10:26 AM | Reply | Permalink
If given the option between expensive coverage that is dependent on employment and cheaper Americare that provides the same level of protection and is permanent, I know what I'd choose.
January 30, 2009 11:06 AM | Reply | Permalink
Good name, huh, Americare? Catchy. Easy to say. Sticks in the head and sounds faintly patriotic to help the Limbots get on-board.
January 30, 2009 11:19 AM | Reply | Permalink
No doubt!
January 30, 2009 12:15 PM | Reply | Permalink
I got the idea during the campaign was that the public option would be based on the insurance plan that is currently available to government employees, including Congress itself.
And yes, as I recall, one of the ideas was that if the public option was attractive enough that people signed up for it voluntarily, even if they could afford other options, it could well become the core of a single payer system.
February 1, 2009 5:15 AM | Reply | Permalink
Although I am not a complete convert yet, I have to admit that when I read the words "its off the table" my immediate reaction was "that's too bad," so I'm making strides in my conversion. I would have, at the very least, liked to have had a national debate about it so that the merits of each plan would be up for comparison and people could see in black and white the benefits and shortcomings of the two options.
My guess is that Obama knows we can get modifications to the existing plan, and not so sure about single payer...
I don't have a strong preference at this point as to how we get there, I just don't want one more family to lose their home because they can't pay their medical bills, or for one more person to be denied health care, or one more couple need to get divorced to get the attention they need, or one more child to suffer because their parents can't afford to take them to the dr.
If we can do that with changes to the existing system, I can live w/ it, but I'm not sure what the mechanics are that will ensure those goals...
I'm up for walking! And writing! Keep us posted as to what we can do, Jan.
January 29, 2009 1:40 PM | Reply | Permalink
P.S. Give up? NO way!
January 29, 2009 1:42 PM | Reply | Permalink
There's a reason for this. As far as Washington is concerned, they must protect the investors and private institutions at all costs. Which is why they are perfectly willing to pour money down the banking rat hole and why they will never do anything that might jeopardize the insurance industry.
We will not see single payer health in this country if and until private health insurance is already gone.
C
January 29, 2009 2:10 PM | Reply | Permalink
As you point out, Obama ran with a specific plan. It seems like the most effective course of action would be to START from the plan we know he is going to propose and figure out how to shape it to the desired goals.
IMO the plan he's proposing could really help IF the insurance companies can't get the little tweaks they are pressing for into it. I'm particularly concerned about the push for involuntary participation being forced on adults. That totally undercuts the competitive aspects that should work to make things better. IMO if it's not voluntary then it must be single payer.
But other than that, I just want something that brings care within my reach. Going without coverage is damn scary. I'm not married to any one path. I can see a couple of courses of action reaching this goal. And I can see the insurance industry screwing up any one of them if we aren't careful.
My concern with the press for single payer is that it places democrats who could be focusing on keeping the insurance companies from screwing up Obama's plan in a position of being flanking opposition. This sort of triangulation gives the insurance industry a serious advantage.
January 29, 2009 2:17 PM | Reply | Permalink
But how do you keep costs from skyrocketing without a mandate? That's my understanding of the need for it - need healthy people in the pool to keep costs down, and also prevents people from signing up after the get the diagnosis.
January 29, 2009 2:45 PM | Reply | Permalink
I suggest you give up and allot your energies to more productive means.
January 29, 2009 2:56 PM | Reply | Permalink
Thank you for following through on on his response. He is now on my enemies list. lol
Being that I am not a democratic party member I have no issues with tearing the Blue Dog, DLC types that are blocking single payer down.
January 29, 2009 3:26 PM | Reply | Permalink
While I believe that national single payer is the ultimate goal and we shouldn't stop advocating for it, I don't see any way that it will happen at the national level before first showing viability at the state level (VA & medicare aside - there is a reason HR 676 is expanded and IMPROVED medicare for all, not just expanded). PA is leading the way in the charge to implement The Single Payer Solution at a state level so that politicians can see a working model here in the US before publicly voting for a national single payer system. Healthcare for All Pennsylvania, led by former PA senate Candidate Chuck Pennacchio, PhD, is an 8000+ member (and growing daily) grassroots led coalition advocating for, lobbying for, and working tirelessly for the passage of PA HB 1660 and PA SB 300, which would bring single payer healthcare to PA. PA 1660 has had HHS hearings already (last year). We're working on putting together a road show and town hall meetings to educate about single payer. I was dead set against it 1 year ago. Then, I read, learned and educated myself on both sides of the argument, and the answer was clear: While it is not a silver bullet (nothing is - all answers will have their own obstacles to overcome) publicly funded privately delivered single payer healthcare is the BEST answer for this debacle, this unconscionable crisis we've walked into. Go to http://hfap.camp7.org to learn more. sign up to be a member. And consider making a contribution. Every dollar helps get us closer to having a viable state based solution, which is the first, and biggest, step towards national single payer.
http://hfap.camp7.org
January 29, 2009 3:58 PM | Reply | Permalink
Thanks for that info and links mdm. I just sent a link to a blog I wrote advocating Single-payer uhc to a bunch of friends in PA. We all need to keep pushing this. Eventually we'll make headway.
January 29, 2009 4:46 PM | Reply | Permalink
I recently moved to Colorado and applied for Blue/Cross as that is what I had where I came from. Yesterday I received their offer which states that they will sell me a policy very much similar to what I had before, but because I suffer in the presence of cats and take allergy meds when needed their quote to me carries an additional premium (penalty) of 75% of their initial quote. This more than double the cost of my previous insurance.
I am a 53 yo male with absolutely no health issues whatever other than the fact that I am single (now) and like to date women over 40 yo. Women over 40 ALL HVE CATS (especially the pretty ones who like to go dancing and listen to blues)! How the hell does me liking to date women justify an additional 75% penalty on top of the base premium.
I don't have cardiovascular, hypertension, or cancer issues or history. I have rarely ever maxed my deductible, and when I have it was because of a sports related injury or two (three - whatever).
I am at once outraged and also motivated by their behavior. It's one of the Blues for crying out loud! I thought dating and having fun is GOOD for my health.
Ladies...let's go out for dinner and dancing? Uh...would....could.....will you......pay for dinner? I'm broke.
This sucks. Health care for profit is not sustainable. Single payer is the way to go.
January 29, 2009 4:46 PM | Reply | Permalink
That the first link I've seen of dating to increased health risks mjeff. Bummer. ;-) No one gets out without payin' the man. Keep up the good fight.
January 29, 2009 4:52 PM | Reply | Permalink
Thanks. I'm also allergic to Wingnut trolls but until now, the thought of seeking a medical solution to that hadn't crossed my mind. Perhaps oxycontin would do the trick. Does it come in a generic or do you have to shop for it?
As far as "no one getting out without payin' the man" goes, I always figured that is what the cover charge was for...and dinner...and drinks.
January 29, 2009 6:42 PM | Reply | Permalink
:-)
January 30, 2009 4:03 AM | Reply | Permalink
That's absurd. Question: Do you take OTC or prescribed allergy medicine?
January 30, 2009 11:53 AM | Reply | Permalink
Hopefully the corruption scandals surrounding Andy Stern's SEIU will cause that pseudo-union to either follow the grassroots or at least get out of the way, because they aren't showing any leadership by supporting health insurance companies.
January 29, 2009 5:40 PM | Reply | Permalink
I am not certain that I agree about single-payer. I think our current health care system can work if we keep costs down, and getting us on the CongressCritter Plan would certainly do it for the vast majority of Americans.
And no, I'm not just swilling Kool-Aid (though I am partial to lemon-lime flavor). I actually started reading about it in 2000 because I was looking into Nader's history, so I have a fair amount of information. That doesn't mean I'm processing it correctly, though.
I'm rec'ing this blog because our current "wealth care" is so FUBAR'ed that all options need to be on the table.
January 29, 2009 6:38 PM | Reply | Permalink
I don't consider an objection to Single-Payer as an example of kool-aid consumption. I disagree with you because I cannot for the life of me understand how dollars spent on health care should be spent on advertising, extra office employees who have to deal with each insurance company's hurdles, and don't forget their needed profits; as opposed to delivering health care.
What I object to is the notion that Single-Payer is off the table. This is the same guy who spent time listening to republicans, and ended up putting many of their suggestions into his stimulus bill.
It is beside the point that they did what we all knew what they would do: thumbed their noses at our President.
What I have a problem with is the idea that many of us who supported this ticket care deeply about Single-Payer and we are told (by Zeke Emmanuel, Chris Dodd, and now Mr. Podesta) that what we want is OFF THE TABLE!
I would have responded to many other individual posts, but it has been an enormously busy day.
I want to thank all of you for your responses. Quinn, you have given me hope that even if we lose this one, we may ultimately prevail.
We cannot give up!
January 29, 2009 8:39 PM | Reply | Permalink
"What I object to is the notion that Single-Payer is off the table. This is the same guy who spent time listening to republicans, and ended up putting many of their suggestions into his stimulus bill."
I totally agree. It is difficult to accept the blazing hypocrisy of these politicians when they aren't even willing to discuss the one option that would serve the nation best and that Obama himself has repeatedly said he thinks would be best for the nation after having caved in to Republican demands on the stimulus the thanks for which was not one Republican vote in the house. We got these people in power, not the Republicans and not the insurance executives, yet we are the last people that are paid any heed. The only thing more outrageous than their lack of responsiveness to the people's interests is that both the media and the people let them get away with it.
January 30, 2009 12:37 AM | Reply | Permalink
But Obama never ran on single payer, so why should you be surprised that he is not putting that proposal forward now? In fact, his health care plan was slightly to the conservative side of what was proposed by Clinton and Edwards -- it's one of the reasons I wasn't really an Obama supporter until he was the only horse left in the race.
But even Clinton and Edwards weren't proposing single payer; and even Krugman, who is very much in favor of the single payer system in principle, doesn't think it's politically viable at this point.
I like single payer in principle, too, but I'm not sure the country as a whole is going to be receptive to that idea, and it will for sure mean a huge fight with the insurance companies. I wouldn't want this to turn into 1993 and have the whole effort go down in flames -- it's too important to get something will work. Granted, there's a lot more support for the idea of universal health care than there was in 1993, and Obama won't likely make the same fait accompli mistakes that the Clintons did with their plan, but a single payer plan is still something that is going to be very easy for the opposition to demagogue.
I say let's get something that will at least get more people under the health insurance umbrella, and once that is secured, then we can work on taking the next step down the path to the ideal. I just don't think you're going to be able to convince the public to go for a radical change all in one giant step; I think we're going to have to take an incremental approach to sell it.
February 1, 2009 5:00 AM | Reply | Permalink
It's just entering the legislative process as a proposal at this point, no? Is it premature to declare defeat? In other words, in answer to your question, NO!!
January 29, 2009 9:14 PM | Reply | Permalink
Thanks, Dogtail! I agree. Go up and read what Quinn said. It makes a whole lot of sense, and gives me hope, because my thought before I had considered what he said was that this is the time; it is all or nothing. Quinn made me realize that maybe all is not lost.
That said, I really don't like the blowing-off of single-payer. It is like they don't want to get the republicans all riled up. Did the republicans worry about getting US all riled up in the last 8 years? No, in fact they laughed at us, and ridiculed us, and ignored our legal subpoenas.
So why should our very own administration cow-tow to these selfish people all the while saying OUR desires are off the table? It is very discouraging, and also disheartening to be on the right side of things, and see those on the wrong side getting far more attention and respect than we are.
January 29, 2009 9:25 PM | Reply | Permalink
Well I think you have to define cow-tow versus compromise and find out what that line is for the Obama Administration. He seems to be motivated by strategy and approach perhaps more than result. While not willing to compromise on his approach, he is willing to do so on the product. This appears to be how he works so far. We all knew he was going to hand an olive leaf to the Repugnanitans if nothing else, to nail them later and the package is not what he originally proposed. Obama is a strategist and a brilliant one at that. Who was it that said tell me what you want then make them go out and do it? FDR right? This is exactly what Obama told us he would NEED us to do when he became president so
lets do it. I think he wants his 3 million folks on his email list to make him do the right thing. He needs us as a counterbalance to the INCREDIBLE forces of darkness. He will need us to play this role the next 4 years every day of his presidency.
If not single payer, what do you think about Maine and Mass's programs?
Incidentally as a side note, did Obama ever run on the single-payer platform? I don't think he did though it would be interesting to check this out if early on, this was his position (as senator).
Thank you. Time for dinner.
January 29, 2009 9:43 PM | Reply | Permalink
Your Q: Any suggestions for a grass-roots message to the Obama Administration, or should we give up?
My A: Work on Congress. They actually write bills. Get a bill outlined and submitted, and work to get sponsors for it. Congress remains at about 80% disapproval so there may be plenty of reps to work on.
It would be great to have a national debate between the Obama plan and the long-lived Single Payer notions. Congress it one place to have it.
Of course you could try to get it into the insipidly sensationalistic MSM too...
January 29, 2009 9:43 PM | Reply | Permalink
Oh My God Purples? What is this talk about giving up? I just checked my calendar and Bush is gone. I can see this feeling during Bush but NOT NOW.
Holy moly! I agree with Hoppycalif2! Tomorrow I will make some calls for singlepayer.
Re: making absolutely everyone happy with everything you do? It is absolutely IMPOSSIBLE by anyone so we have to be real. Would you want to trade places with Obama right now?
Now I am really going to get off this box and open another one to make some dinner. I mean it this time.
Good night all
January 29, 2009 10:16 PM | Reply | Permalink
I think it is safe to say that most of us reading here are progressives (liberals, with sunglasses) who support single payer health care. It isn't our place to compromise and decide how much we are willing to give up for Obama. Our job is to advocate ferociously for what we know is right - single payer health care.
I expect to continue doing that. I supported Obama, I'm ecstatic over his election, I think he is the right man in the presidency, but I am never going to agree with everything he is for. I don't agree on waging war in Afghanistan, and I sure as Hell will never agree to give up on single payer health care.
Now, what can we do? First, we get up off our knees and stop worshipping Obama! He is our president, not our all-knowing God. When he screws up, as he did by accepting GOP tax cuts on his economy rescue plan, we need to let him know, and let him know very loudly, that he screwed up and we don't like it at all. He seems to be planning to screw up on health care, too. So, I intend to speak up about that.
MoveOn voted that health care is our number one concern now. Unfortunately, MoveOn is now leading the cheers for Obama. But, one of the progressive organizations will surely lead the fight. I will join it.
January 29, 2009 9:54 PM | Reply | Permalink
While we are getting off our knees, perhaps we could climb down off our high-horse as well. It is the height of arrogance to assume that our interpretation of events is actually objective reality. There are always three or four or ten interpretations of every "fact" and sometimes none of them are right from a truly objective standpoint.
What if as a progressive I see his moves on the recovery package and health care as supporting the idea of Evolution versus Revolution? What if I actually agree with his strategy of "compromising" with current republican Congressional leadership, whether they live up to their end of the bargain or not.
I think the way this bill played out will come back to haunt incumbents in 2010 and was probably the end game Obama was seeking. What progressives need to learn from Barack is the ability to think strategically first, tactically second. If the strategic goal is single payer health care, then the tactics to achieve it may be a little more complex than ramming it down everyone's throats during this session.
Perhaps a longer view is required to achieve that goal because of systemic weaknesses and organizational inertia?
January 30, 2009 10:47 AM | Reply | Permalink
Co-sign.
January 30, 2009 11:01 AM | Reply | Permalink
Whether you are right or not doesn't change what should be our position. We want single payer health care. The only chance we have of ever getting that is to come out very strongly in favor of it, rejecting any compromise that stops short of that. You can be sure that the insurance/medical industry will fight even harder for the status quo or an even more favorable system for their profits. They will not think about strategic aims, and tone down their opposition to single payer health care. And, neither should we back down.
Obama, and Congress are the people who have the responsibility to do any necessary compromising, going for what they see as the best we can do at this time. We don't have that responsibility. Our responsibility is to make the strongest possible case for what we want, and fight as long as possible to get it.
January 30, 2009 11:43 PM | Reply | Permalink
Hear, hear!
January 30, 2009 11:58 PM | Reply | Permalink
I am not asking you to tone down your opposition. By all means, scream to high heaven. But perhaps reserve enough reserve to understand that Obama is coming at this from the idea of what can be done and what is likely to succeed. Don't be so vocal in your opposition that it becomes denunciation of your party or president.
That is biting off one's nose to spite the face.
Very few modern democracies got to single payer systems by fiat and many remain an amalgam of competing solutions, with a single dominant solution riding herd over the rest. If it takes a couple sessions of Congress and perhaps a healthy mid-term gain to get single payer, that is a win in the grand scheme of things.
Is there any reason why can't your position be tempered by temperance? That is sure to win more converts over the long run than the insurance companies and their continued scare tactics. In case you missed it, we elected Barack Obama despite the very same thing from his opponents. I suspect Americans in general are waking up to their manipulation at the hands of special interests.
Reminding them of our common interests, but being OK when it takes a little while to finally get there sounds like a simple sort of wisdom that just might win the day. It also sounds like the kind of politics Barack spoke of in his book. I figure giving the guy a real chance means giving him the room to govern the way he articulated in the campaign.
January 31, 2009 9:41 AM | Reply | Permalink
You misunderstand my position entirely. I am, as I stated, delighted that Obama was elected and that the Democrats have a majority in both houses of Congress. I will do what I can to be sure that configuration stays in effect as long as possible. That isn't the issue.
The issue is that I am a strong advocate for single payer health care, because I believe that to be in the best interest of our citizens, in our economic standing in the world, and morally. I, and those like me, need to keep Obama's feet to the fire on this issue, and we need to continually lobby Congress to try to move them to this side of the issue. I intend to do that.
Don't fall in the trap of believing that putting "Democrat" alongside your name makes you immune from pressure from others with "Democrat" alongside their names. You can be both a Democrat and an advocate for things that the majority of Democrats, or the ruling Democrats are not in favor of.
January 31, 2009 3:10 PM | Reply | Permalink
We appear to be in agreement then as all Americans finally feel the freedom to advocate loudly for their stated positions.
January 31, 2009 8:00 PM | Reply | Permalink
We need to keep hammering away in what ever way we can. I have been doing two things which I hope are useful: One, I have set a "google alert" whereby I receive a daily notice from Google about news articles which feature the term "single payer" I read and circulate these articles and add comments if I think I have anything to add. Second, as a physician, I speak with my patients regularly about this issue as it seems appropriate in a clinical context and have developed an email which I send to patients which elaborates on this issue and urges them to contact our Congresswoman to encourage her support. We each have to do what we can.
January 30, 2009 1:31 AM | Reply | Permalink
Thanks for that 'heads-up'. Didn't know about 'google alerts' heretofore.
January 30, 2009 2:44 AM | Reply | Permalink
Here's another way to move things forward: See what my patients had to say at an Obama-inspired "Health Care Discussion" held on December 31. The video along with a written summary of the discussion was sent to Obama via Change.org. I hope some one is listening: http://www.youtube.com/watch?v=_WukOIsG5dA
January 30, 2009 1:38 AM | Reply | Permalink
Thanks for taking the time and effort to conduct the meeting and produce the video. It doesn't seem like it should be this hard to convince the voters on this issue. The legislators on the other hand are gonna be an uphill battle. I hope someone is listening too. Keep up the fight Dr.A.
January 30, 2009 2:13 AM | Reply | Permalink
I mentioned this up above to Oleeb, but worth a repeat cause it made me smile. I think we beat Krugman to the punch, at least by a few hours. See his column today on health care.
He's seeing the same dynamics unfold that we were jawing about above. HEALTH CARE NOW.
January 30, 2009 3:11 AM | Reply | Permalink
I took DrA's advice and signed up for a google alert on 'single-payer' last night. This morning I got an alert of this opinion piece in a NH paper by a NH Republican state representative. The information is so woefully ignorant, misleading, and pandering to peoples fears of changes to our health care system, as to almost be laughable. I just sent in a letter to the editor refuting just about everything he states as a reason to not adopt such a system. Unfortunately, a lot of people will read his opinion and take it at face value. This is just part of what we are up against in getting the word out on this issue. I would recommend others here take the time to respond to these disinformation campaigns to the extent they're able to. I'm considering writing a 'generic' 'letter to the editor' on single payer, so I can cut and paste it into future opinion pieces I may come across.
January 30, 2009 12:02 PM | Reply | Permalink