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Fri

07

Aug

2009

Health Care Reform Sell-Out: Why Obama and the Democrats are Either Shysters or Idiots
Friday, 07 August 2009 07:55
by Dave Lindorff
As I predicted months ago in an article titled America’s Stupid Health Care Debate: Keeping Some Ideas Off the Table and several subsequent pieces on my website, President Obama and the Democrats who currently run Congress have been hoist on their own collective petard by their craven and gutless refusal to consider adopting a Canadian-style single-payer system to finance health care in the US, or simply to expand Medicare, which is a successful single- payer program, to cover everyone, instead of just people over 65 and the disabled.

Instead, because they are the recipients of hundreds of millions of dollars in legal (and probably plenty of illegal) bribes from the health care industry, they have cobbled together a “reform” in name only, which preserves not just the central role of the vampire-like health insurance industry, but also ensures the continued rapacious profitability of the other segments of the medical-industrial complex—the hospitals, the pharmaceutical industry, and the specialist doctors.

Now, like Hillary and Bill Clinton before them, these weasels and slimeballs who pose as the people’s advocates are left with nothing but a Potemkin Health Plan that looks on the outside like a reform, but that changes little or nothing, leaves vast numbers of Americans uninsured, forces tens of millions to buy crappy plans from private companies, and that will end up doing nothing to halt the continuing rise in health care costs that is bankrupting the people, employers and the country.

Nice going guys!

Let’s for a moment consider what could have happened (and what could still happen if the American people would descend on Washington with pitchforks and firebrands in hand to demand it!)..

Medicare, which is wildly popular among seniors and the disabled according to every poll I’ve seen, currently covers 45 million of the highest-cost segment of this country’s 300 million people—its elderly and its permanently disabled. It does this at a cost of $484 billion.

Now that’s a heck of a lot of money—about 13% of the federal budget—but it’s money well spent. We’re talking about our parents and grandparents here, and because they’re all covered by a government single-payer plan that pays virtually all of their doctors’ and hospital bills, we don’t have to pay those bills for them out of our own pockets. Okay, there are problems—the drug industry managed during the Bush/Cheney dark ages to get a prescription drug law passed that bars Medicare from negotiating group discounts for drugs, and that has added enormous rip-off costs to the program, but that’s just another example of corporate scamming of the system that needs to be fixed. I'm also aware that Medicare is hardly perfect. It doesn't cover important tests, it has gaps that people currently have to fill with supplemental plans, but for all that it's better than what most people get with private insurance, and the shortcomings are fixable. The important point that needs to be made is that according to Medicare analysts, 10 percent of Medicare beneficiaries account for fully two –thirds of the total annual cost of Medicare.

What that tells you is that the cost of treating that 10% of the elderly is $320 billion, while the healthier 90% of the elderly—roughly 40 billion people--only cost $160 billion a year to care for.

Now, given that the rest of the population under 65—about 255 million people—need on average far less care than the 90% of seniors who are in that lower-cost group, extending care to them all would clearly cost less than $1 trillion. Add in the cost of the 10% of high-cost elderly, and you’ve got a total bill of $1.34 trillion to care for everyone in America.


That’s a big number, but now you need to subtract out the total cost of Medicaid—the crappy program that, primarily funded by the states through income and sales taxes—pays for the crappy care of the poor. That would be about $400 billion in 2009. So now we’re down to $944 billion to care for all Americans. But from that we need to subtract the cost of Veterans health care—actually a pretty successful national health care system of public hospitals and doctors on salary much like the British National Health system--that already cares for veterans (or at least some of them—it’s grossly underfunded). If we had a single-payer system for all, we could just shut down the VA and fold veterans into the national program. That would mean another $100 billion saved (because remember, we calculated that original expanded Medicare budget for covering all 300 million of us, including vets. So now we’re down to an annual budget of $844 billion for a single-payer program to cover all Americans. Finally there is uncompensated care provided by hospitals to those 47 million Americans who have no health insurance but who don’t qualify for Medicaid. This care is funded in two ways—one by state and county revenues, which come out of state income and sales taxes and also out of local property taxes, and the other is in the form of higher hospital charges and insurance premiums and Medicare costs for the rest of us. Uncompensated care is estimated to cost about $200 billion, all of which would be eliminated if we had a single-payer plan for all.

Okay, so now we’re down to a total net cost for a national single-payer program of just $644 billion. Now remember, we’re talking about expanding a single-payer program that we already have in place, that doctors and hospitals are already familiar with, and that the people who use it already like. And expanding it to cover everybody, instead of just the old and disabled, would only cost an added $160 billion, or just 33% more than it costs now to cover only the old and disabled. In these days of multi-trillion-dollar Wall Street bailouts, $160 billion is almost chump change—heck, it’s less than the cost of a year of war in Afghanistan.

Sure it would still mean a modest tax increase for everyone (to figure out how much, just look at your check stub, find the Medicare tax deduction, and multiply it by 1.33. Then double that to account for the employer share of the added funds). But wait, all you anti-tax nuts! Before you start freaking out at a tax hike and waving those little teabags Fox TV got for you, there are more savings we haven’t yet considered.

If everyone is covered by Medicare, that means no more out of pocket payments by you for doctor bills. No more co-pays. No more deductibles that you have to pay before your health insurance kicks in. No more employee contributions to health insurance premiums, which these days more and more employers are forcing us to shoulder. That’s a lot of money. For many families, it adds up to thousands of dollars a year. But there’s more. Your employer, if the company is one of the one in three that still provides and pays at least something towards health benefits for its workers, would be off the hook. That would free up a lot of money that could go to higher wages and salaries for workers (especially if you have or get yourself a union to make sure that the managers pass the savings on to you and don’t just pocket it or pass it along to shareholders). We’re talking about big savings here. (Incidentally, we're also talking about ending the feudal relationship that has you afraid to talk union, or even to talk back, or speak up, to your employer, for fear of losing not just your job, but your and your family's health insurance. We're talking about liberating you from a major shackle. And as long as we're on the subject of shackles, remember, under Medicare, as also under Canada's single-payer plan, we all get to choose our own docs, which is not something you can say if you're shackled into some company HMO, or even in a PPO plan where there's an approved list of participating physicians to choose from. Ask a senior how Medicare works: You pick your own doctors.)

There is another savings which, while harder to quantify, would be enormous, and that is the huge reduction in health costs that would be realized if we had a good single-payer system covering everyone, so that everyone would be getting regular check-ups, would be getting treated early when they developed a medical condition or problem, and would be getting good follow-up. With the present patch-work, profit-based system, and with 47 million people simply without coverage of any kind, we have as many as 100 million people who have only limited access to timely, quality care, and who end up needing expensive emergency care.

So while yes, your taxes would go up a bit to expand Medicare to all, it wouldn’t be by much, and on the plus side, you would be saving an enormous amount of money, making the added tax bite easy to swallow (and remember, your state and local taxes could be reduced).

Why didn’t Obama and the Democrats tell you all this? Why does Obama continue to diss single-payer, as he did to the American Medical Association, and as he continues to do, claiming it is not in the American tradition, as though he never heard about Medicare?

Well, as a matter of fact, some people in Congress, notably Reps. John Conyers (D-MI), Dennis Kucinich (D-Oh), Anthony Wiener )D-NY) and 83 other members of the House are pushing a bill, HR 676, which would do exactly what I’m suggesting—expanding Medicare to cover everyone.

It is being opposed by the Congressional leadership to the point that advocates at one committee hearing were ejected and arrested for even mentioning the term single-payer. With the blessing of the White House.

Clearly, Obama and the Democrat Party and Congressional leadership are in bed with the health care profiteers.

There is no other excuse for failure to do the obvious, and have America adopt some version of the kind of health care system that has been proven to be more effective and far, far cheaper than our own in every other developed nation in the world—and in many less developed nations, too. And I've only focussed here on the dollars and sense of it. There is, of course, also the moral question: how can we continue to accept living in a society where over 100 million of us get inadequate or no health care?

My question: How long are we going to stand for this crap?

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