Sam Uretsky

No Compromise On Health Reform

The validity of Sen. Hillary Clinton’s claim of having more experience than her rival for the presidential nomination is open to debate, but there’s one area where she has more experience than absolutely anybody: getting whomped by medical insurance companies. The plan for universal health care that she developed in 1993 has been described as cumbersome, which is true enough, but only because it attempted to compromise with the insurers. It was obvious decades ago that the US had gone down the wrong path in terms of health care, but Mrs. Clinton tried to forge a compromise that would satisfy both social needs and corporate greed. Her synthesis was unwieldy, but to a large extent no worse than the Japanese system, which has produced the longest-lived population on the planet. Given the limitations of political reality, Hillarycare was a good idea for its time.

But the Health Insurance Association of America wasn’t satisfied. They rolled out the Harry and Louise ads featuring two normal, everyday Americans who were completely satisfied with their health care insurance, and didn’t want anything changed. This was enough to convince lots of other normal Americans that there was nothing wrong with their health insurance and that nothing needed changing. The ads were wonderfully successful, we the people were conned, and the most important advance in health care financing was killed. We know where that got us.

What we haven’t gotten is an apology. The people who got us into this mess, or collection of messes, haven’t written letters to the Washington Post explaining that they really believed they were working for the betterment of mankind, and intend to spend the rest of their lives trying to gain absolution for their sins. The bankers who created the sub-prime mortgage mess, the toy companies that sold pretty toys with very unpretty paints, the airline executives who think it’s more important to have planes take off on time than to land safely—it has been very quiet. We’ve had seven years of a social philosophy that deregulates corporations but does regulate individual behavior, and what do we have? Toxic toys, toxic toothpaste, adulterated injections, contaminated meat, airplanes allowed to flout safety inspection requirements so as not to inconvenience the airline—and Texas housewives being prosecuted for holding parties to sell sex toys were. 

The situation isn’t going to get better any time soon. The fight over health-care financing isn’t about political philosophy any more; it’s about facts and figures. There is a world of experience showing that a single-payer health financing system costs far less, covers more people and produces better results (measured by lifespan, healthy lifespan and infant mortality) than the mess we have now. That doesn’t mean that the CEOs and COBs are going to accept reality and volunteer to help with the conversion to single-payer for $1 a year. The Republicans are still opposed to any change in health financing and the budgets for both political contributions and advertising are larger than ever. When former Sen. John Edwards proposed his plan for health financing reforms, Jonathan Cohn at The New Republic, wrote, “grafting universal coverage onto an already complicated system inevitably means drawing up a complicated plan. That’s not particularly helpful in the current media environment.” The Edwards proposal is the one now being advocated by Sen. Clinton. Mayor Giuliani described it as Hillarycare 2.0, which is blatantly unfair to Sen. Edwards. The Cato Institute, Wall Street Journal and the Weekly Standard have blasted the proposal as if it were spawned by the creeping socialist menace. Sen. Obama’s healthcare proposal is similar in many respects, but is a little bit weaker, a bit further from single-payer, and so far hasn’t gotten a nickname or even inspired much in the way of right wing outrage. Grafting universal coverage onto an already complicated system inevitably means drawing up a complicated plan. That’s not particularly helpful in the current media environment, but it will if he gets the nomination. Fact: there is no way to compromise with the current system without coming up with something that’s bulky and unwieldy—and the defenders of the status quo use the attempts to compromise as an excuse to refuse to compromise. When both parties are willing to compromise, it’s compromise; when one party is and the other isn’t, it’s appeasement.

HR 676, proposed by Rep. John Conyers, D-Mich., has been around since 2003, and is currently in subcommittee. One of the names for this bill is “Expanded and Improved Medicare for All” and it comes very close to the sort of system that has proved itself in every other developed nation. It would cover everybody, cut costs, simplify the system and let General Motors stop complaining that they’re at a competitive disadvantage of $1,500 per car because Japanese and German auto manufacturers don’t have to pay their workers’ health insurance. 

Okay, the candidates have their campaign songs and those songs symbolize hope and promise and sweetness and light—all good. But when they talk about health care financing, it would be nice to hear, playing in the background, the Dixie Chicks singing “Not Ready to Make Nice.”

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

From The Progressive Populist, April 15, 2008

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