Reset for Single Payer

Senate Finance Chairman Max Baucus (D-Mont.) said May 5 that he deeply respects the views of those who want a single-payer health plan. He just doesn’t want to hear from them. He had eight advocates arrested May 5 when they disrupted his “health care roundtable discussion” to protest the exclusion of single-payer advocates from the discussion. Another five single-payer protesters were arrested at a May 12 hearing.

One of the few references to single payer during a hearing ocurred May 12 during a discussion of the Republican proposal to eliminate the tax deductibility of employer-sponsored health plans. Baucus said he was not in favor of such a radical change. In response, Gerald Shea of the AFL-CIO said “If we’re going to do a radical change, I think that single payer is really the way to go.” At least Shea was not arrested.

Baucus’ attitude toward single payer doesn’t do much for our confidence in his good faith, but reform is highly unlikely without his imprimatur.

At least the chairman has indicated he is open to a public health insurance option as part of the health reform bill. One approach would be to allow the public to buy into a plan similar to Medicare offered through an exchange and administered by the Department of Health and Human Services. Another approach would be to administer a Medicare-like plan through multiple regional third-party administrators. A third approach would be to allow states to set up and administer their own insurance plans—which is scant comfort for residents of skinflint states, such as Texas or most of the South.

But Baucus also apparently is open to the Republican plan, which excludes a public insurance option but instead relies on “private options in a reformed and well regulated private market.” Sen. Charles Grassley (R-Iowa), the ranking Republican, reportedly is pushing hard for this plan. When he talks about a “bipartisan approach,” that is what he means. Sen. Ben Nelson (D-Neb.) also has said he would oppose legislation that sets up a public plan to compete with private insurance companies.

Sen. Charles Schumer (D-N.Y.) is working on a public option compromise that would give consumers a public insurance plan in the mix with private insurers. Schumer would require the public plan to comply with the same rules as private plans. The public plan would not be supported by tax revenues; premiums would pay the way. It would have to maintain reserves and provide the same minimum benefits as private insurers in the exchange.

Don McCanne of the Physicians for a National Health Program calls Schumer’s plan “public option light.”

One of the advantages of a single-payer program is that it will allow a more efficient health care system by doing away with insurance company bureaucracy whose job is to figure out ways to deny care and allowing doctors and hospitals to do away with clerical staff whose job largely consists of arguing with insurance bureaucrats and tracking billing. As long as you leave private insurers in the game, those layers of bureaucracy remain.

In fact, expansion of Medicare to cover all Americans may be the best way to fix funding for the medical plan for seniors. Since we already are covering the most expensive patients—the elderly—expanding Medicare into a full-scale single-payer plan would yield administrative savings estimated at $400 billion annually, which would cover the current Medicare deficit and go a long way toward covering the 75 million uninsured and underinsured Americans.

Sen. Bernie Sanders (I-Vt.) says enacting single payer is possible, but only if grassroots organizers can get Democratic senators to overlook the huge amounts of money spent by insurance companies, drug companies and health care providers.

The health industry spend $163.8 million buying influence in Congress in the 2008 election cycle, with 54% going to Dems, reflecting the party’s consolidation of power in Washington. Insurance interests spent $46.37 million buying influence in Congress in the 2008 election cycle, with 55% going to Republicans.

Ultimately, Obama will be judged by the health care reform he signs into law. If Obama signs a bill that includes a strong public insurance plan that allows individuals and small businesses to get benefits similar to those that are available to members of Congress, for example, it will count as a victory.

If he doesn’t get a bill, or if he signs one that maintains the cash cow for insurance companies and HMOs, that would be a defeat not only for Obama, but for every small business that struggles to come up with increasing premiums every year. And a bill that does not guarantee universal coverage would be a defeat for workers whose employers are unwilling or unable to offer health benefits.

Dirty Dozen Dems

An April 30 Senate vote showed that the biggest obstacle to getting President Obama’s agenda through Congress is not the Republican minority. It is the dirty dozen Senate Democrats who are willing to sell out their constituencies to block progressive legislation.

In this case Sen. Dick Durbin (D-Ill.) was trying to pass an amendment to allow bankruptcy judges to modify mortgage terms for troubled homeowners on their primary residences. Judges already have the authority to renegotiate mortgage terms on vacation homes, cars, yachts and other investment properties.

Durbin’s measure, called a “cramdown amendment,” would simply give regular people the same opportunity to renegotiate their mortgages as the investor class already enjoys. But support for the “cramdown” evaporated in the face of intense lobbying by the banking industry, which would rather keep the hammer of foreclosure.

Ironically, three of the big banks that resisted the amendment were recipients of federal bailout funds under the Troubled Asset Relief Program—Bank of America ($45 bln), JPMorgan Chase ($25 bln) and Wells Fargo ($25 bln). But they refused to allow any relief for homebuyers, according to Congress Daily. Republican senators put pressure on the big banks not to agree to Durbin’s compromise, as Citigroup had earlier.

The US Chamber of Commerce also threatened that those who voted for the “cramdown” would pay a financial price from the Chamber and the banking industry.

The financial industry spent nearly a half billion dollars in the 2008 election cycle buying influence in Congress and enough senators stayed bought to stop the “cramdown” amendment.

Durbin’s cramdown amendment was rejected 45-51, as 12 Dems voted with the bankers and the GOP against drowning homeowners. The senators and the amounts they received from the finance, insurance and real estate industries during their careers, according to the Center for Responsive Policy (OpenSecrets.org), are Baucus ($4.63 mln), Michael Bennet (Colo., at least $25,000 in his first few months as senator), Robert Byrd (W.V., $420,830), Tom Carper (Del., $2.16 mln), Byron Dorgan (N.D., $1.1 mln.), Tim Johnson (S.D., $3.02 mln), Mary Landrieu (La., $2.38 mln), Blanche Lincoln (Ark., $977,290), Ben Nelson (Neb., $2.66 mln), Mark Pryor (Ark., $1.32 mln), Arlen Specter (Pa., $5.57 mln) and Jon Tester (Mont., $473,226).

Durbin, who before the vote complained that the bankers owned Congress, told HuffingtonPost.com after the vote that he had expected more support than 45 votes. “If we fail on mortgage foreclosure and we fail on credit card reform,” he said, “I hope that people in this country will stand up and say to Congress, ‘You’ve got the wrong friends.’”

If you live in any of the states represented by the Dirty Dozen, let them know they have the wrong friends. Because, with a few variations, they’re the ones most likely to flake on health care reform and clean energy legislation. — JMC

From The Progressive Populist, June 1, 2009

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