We Need Fighters!

Health reformers were put on the defensive in August, as critics of reform ambushed congressional Democrats at town meetings with jeers, chants and wild accusations of what a socialized government health plan would do to their beloved insurance plans.

Never mind that neither President Obama nor congressional leaders have proposed a socialized medical plan. Nor that many of the protesting “teabaggers” are seniors who are covered by Medicare, which actually is a socialized insurance plan. Nor that far from creating government “death panels” to determine who would get treatment and who would die, the reforms Obama supports would set standards for coverage that would stop private insurance company bureaucrats from arbitrarily denying expensive medical treatments in order to fatten corporate profits.

But the insurance companies, which desperately want to prevent the government from setting up anything like a viable public option to compete with them, have managed to sow doubts about reform with the general public. And as the White House and Senate Finance Chairman Max Baucus (D-Mont.) continue to seek a compromise that would attract at least some Republican support in the Senate, progressives feel disillusioned about reported backroom deals with insurance and pharmaceutical lobbyists that protect their corporate profits but don’t seem to advance universal health coverage.

This went to press before Obama’s speech to the joint session of Congress. UPDATE: He gave a good speech where he said a public option would be a good thing to put in the bill but he didn't threaten to veto the bill if it didn’t contain that feature. But we’ve heard his speeches before; it’s time for action.

At a Labor Day picnic in Cincinnati, Obama told a cheering union crowd “it’s time to act” for health reform. He said, “I continue to believe that a public option within that basket of insurance choices would help improve quality and bring down costs,” even as his aides left room for further compromise.

Unions helped carry the day for Obama last November and it’s time for him to return the favor. Organized labor’s top priority, the Employee Free Choice Act, would make it easier for workers to organize a union and to force management to negotiate with them once they form a bargaining unit, but it has been put on the back burner. Obama hasn’t ruled out proceeding with free trade agreements that would enable multinational corporations to export more manufacturing jobs to low-wage countries. Now we’re hearing how flexible Obama’s White House is on healthcare reform with some of the same Blue Dog Dems who have been missing in action on card-check and fair trade.

Four of the five congressional committees with authority over health care produced bills in July. Despite his own failing health, Sen. Ted Kennedy, from his home at Cape Cod, helped draft a solid bill with Sen. Chris Dodd (D-Conn.), who shepherded it through the Health, Education, Labor and Pensions Committee in Kennedy’s absence. Meanwhile, Baucus has been negotiating with two other Democrats and three Republicans on the Finance Committee in an attempt to produce a compromise, but two of the Republicans — Sens. Charles Grassley (Iowa) and Mike Enzi (Wyo.) have indicated they would not support any reform and the third, Sen. Olympia Snowe (Maine) would only support watered-down reform — possibly a public option, but only if private insurance fails to meet specified goals after several years.

Baucus has sent other senators on the “Gang of 6” a framework for a bill, which has a number of good points: It would ban insurance exclusions for pre-existing health conditions. It would prohibit health insurance companies from rescinding health coverage. It would subsidize insurance premiums for low-income families. It would set standards for coverage and limit the out-of-pocket charges families would pay and it would go a long way to protect millions of Americans from medical bankruptcy. But it does not include a “public option” to help keep costs down or make sure people have a choice in areas dominated by one private insurer. It would allow non-profit regional co-ops to provide insurance, but they probably would lack the resources to compete with national health insurance corporations.

The Baucus plan would tax insurance companies on their most expensive policies to help cover the cost of providing insurance for the working poor but it also would encourage employers to buy cheaper, less generous coverage for their employees, thereby reducing the “overuse” of medical services. Baucus also would require employers to reimburse the government cost of insurance subsidies for their employees, which the Center on Budget and Policy Priorities noted could discourage the hiring of lower-income people.

In addition to taxes on high-cost insurance, it would extract $400 billion in cost savings from Medicare, which could generate a backlash among senior citizens who already have been warned by Republicans that any improvements for working people would have to come from their benefits. But it would provide a 50% discount on prescription drugs for seniors in Medicare Part D’s “donut hole.” Baucus’ proposal subsidizes premiums for people who are forced to buy insurance up to 300% of the poverty level, or $66,000 for a family of four.

For all this, Baucus’ bill would still cost up to $900 billion over 10 years, rather than the $1 trillion that the Kennedy bill would cost with a strong public option. Kennedy’s bill would subsidize premiums for families making up to 400% of the poverty level, or $88,000 for a family of four.

The Senate majority should pick out the best features of Baucus’ plan and merge them with Ted Kennedy’s bill. The Dems should give Snowe and other “moderate” Republicans the opportunity to stand for sane healthcare reform, but they shouldn’t give them a veto. If the Republicans try to block reform, the Dems should get Massachusetts to send them an interim senator to cast Ted Kennedy’s vote — which should be the 60th vote to shut down a filibuster — and roll over the obstructionist GOP. At that point, any ConservaDems who vote to support a Republican filibuster of healthcare should be stripped of any leadership position and get a primary opponent at the next electoral opportunity.

If necessary, Democrats should pass the financing and public option sections of the bill as part of the budget reconciliation process, which only requires a simple majority, and leave the rest of the bill, with the parts the insurance and pharmaceutical companies want, to be passed in the regular order. Republicans will squeal like stuck pigs, but what else is new?

The House Progressive Caucus has sent a letter to Obama stating that its 80-plus members will not vote for a bill that lacks a public option. House Speaker Nancy Pelosi backs them up. Encourage your House member to insist on a public option. Tell your representative that a bill that forces us to buy overpriced private insurance without a more affordable public option is unacceptable and will get their butts kicked out of Congress next year.

Washington wags are convinced the progressives will back down and accept whatever minimal reforms the Republicans allow. But the AFL-CIO Secretary-Treasurer Richard Trumka said a public option is necessary, along with a requirement that employers provide insurance. “Our members have said they want it.”

So does the public. Survey USA in August found support for a public option at 77%, as long as it is presented as a choice between a government-run health insurance plan and private coverage. Conservative Democrats need to get over the Reagan-era mantra that government programs are bad and the free market is good. Fair competition is best.

Health reform took some body blows in August. It isn’t dead, but it will need strong leadership from President Obama, House Speaker Pelosi and Senate Majority Leader Harry Reid to get a bill worth naming after Ted Kennedy to Obama’s desk and, more importantly, your doctor’s office. — JMC

From The Progressive Populist, October 1, 2009


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