Archive: Opinions

In the beginning there was an idea: let’s guarantee that all Americans have access to affordable, quality healthcare. The concept was simple. The government would act as the sole insurer, processing claims and establishing reimbursement rates to providers, much the same as they have been doing under Medicare for people over 65 years old for the past 44 years. This would reduce costs by eliminating the profits that the private insurance companies now include in their premiums as well as high advertising, promotional, executive compensation and administrative expenses that are the hallmarks of the health insurance industry. With those savings in hand, the cost to the patients would be affordable. Doctors wouldn’t have to pay staff to fill out different kinds of forms from different insurers and argue with the insurance companies so still more would be saved. This efficient and effective way is called a “single-payer” system.

But, there was a problem. For most of the past 8 years, the Republicans were in power. There was a Republican president, and, for most of that time, the Republicans controlled Congress. Republicans don’t like the idea of a single payer system and the Democrats in Congress were unable to advance the plan.
 
“Just wait until we take control of Congress,” the Democrats said, “then we will be able to enact single payer healthcare reform.” And, happily, the Democrats did take control of Congress in the November 2006 election. But sadly, they did not elect enough Democrats to the Senate to defeat Republican filibusters.
 
“All we need is a filibuster-proof majority in the Senate and a decent majority in the House and we will enact true universal healthcare legislation,” said the Democrats. “Moreover, if we elect a Democratic president, we will be assured of success.”
 
Lo and behold, in 2008 the nation elected, not only a filibuster proof Democratic majority in the Senate and an increased majority in the House, it also elected a Democratic president, who, although he didn’t promise a single payer system, did vigorously promote a Medicare-like public plan as a major feature of his healthcare reform proposal. Many Democrats were disappointed because the new president didn’t support single-payer (even though he admitted that single-payer was the only system that would insure nearly universal coverage and bring costs down), but they were willing to compromise with him and develop a plan that included an option that would allow people not covered through work or otherwise to be government insured.
 
But then some House Democrats got cold feet. They were being called socialists and other terrible things. They convinced the Democratic Speaker to weaken the public option. When other, more progressive Democrats, got wind of that, they managed to reverse some, but not all, of the weakening amendments. Another compromise.
 
About then we learned that the president had made a deal with the pharmaceutical industry that any new legislation regarding healthcare reform would not let the government negotiate lower drug prices with the companies. It was seen as a compromise, --an exchange for the industry’s promise to stop passing on unnecessary costs to consumers.
 
 Over in the Senate, important Democratic senators insisted on trying to negotiate a bill with the Republicans. While these negotiations were going on, some of those Republicans were lying about the healthcare proposals. They claimed (as did a former Republican governor of a very cold state) that the Democrats wanted the government to take over healthcare and set up “death panels” to determine which elderly citizens should live and which should die. These claims were ridiculous, but many people believed them, so the Senate Democrats again gave in and eliminated both the public option and end of life voluntary counseling provisions.
 
Instead of providing an option for uninsured people to join a public plan, the Senate Democrats are now working on a (surprise, surprise) compromise to substitute “consumer cooperatives.” There is no reason to believe that these cooperatives will have nearly the same economic clout as the federal government, clout that is needed to really compete with the insurance companies, to establish a backup for those without employer based insurance, and to provide a benchmark for cost and quality standards in the healthcare realm.
 
It is one compromise too many.
 
On May 7, 2007, The New Yorker reported that then Sen. Obama said:” If you're starting from scratch, then a single-payer system would probably make sense.”
 
He was right.  Let’s can the compromises and start from scratch.
 
Marty Luster
Trumansburg, NY

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