We can win the battle over the public healthcare option of October/November

Posted on September 26th, 2009 in Health,Medicine by Robert Miller

The latest NYTimes/CBS News Poll should warm the hearts of those intent on making the public option component part of our healthcare reform package. After being distracted by the Republican goons of August, whose mission was to distort and destroy healthcare reform, no matter what the plan, the latest poll provides us with some glimpse of how successful they were in derailing a serious reform effort. The NYT/CBS Poll asked a very straightforward and general question: “Would you favor or oppose the government offering everyone a government-administered health insurance plan–something like Medicare coverage that people 65 and older get–that would compete with private insurance plans?” The beauty of this poll question is that it was phrased generally, without reference to a specific bill. The results indicate that, despite what the press wanted to portray as a mounting healthcare reform failure, the respondents to that question overwhelmingly endorsed the public option plan with 65% in favor of the public option–one like medicare–26% opposed and 9% without an opinion. In short, the support of the public option has grown and must be viewed as a plan favored by most Americans. And, with that level of support, derived from a question that wasn’t linked in some devious way to a confusing healthcare plan subtlety, the NYT/CBS Pollsters will apparently use that same question to follow the debate in the coming months of what is  shaping up to be a modern political food fight.

The Baucus bill that was in the Senate finance committee emerged without any Republican support, turning Obama’s  position of insisting on bipartisan support, into a non-entity: this will be a Democratic bill and we can win the public support option in two ways. First, floor amendments to the Baucus bill will bring up the public option plan, though it is currently unclear whether the Senate will vote their version of the healthcare plan with that component in it. But, this is up to the Democrats and the pressure on conservative Democrats who do not favor the public option plan, will be to face the prospects of not getting a decent bill passed at a time when the Democratic Party controls all three branches of government. Though the planned healthcare bill will not go into force until 2014, a failure to achieve a decent healthcare bill could doom the prospects for Democrats’ re-election bids on any one of a number of legislative failures. Passing a bill in which the public becomes increasingly aware that it favors the for-profit insurance companies, as analysis trickles in over the next few years,  could be the single greatest element of destruction for the Democratic Party in the election of 2010. All Democratic Senators are aware of this dilemma and we should continue to remind those conservative Democrats that the NYT/CBS polling data favors a solution with the public option plan as a major component.

The second pathway to insure the public option is through the House, where several bills have already come out of committees that have a public option plan. Nancy Pelosi insists that a healthcare reform bill that lacks the public plan cannot pass the House because of pressure by progressive democrats and union support.  By increasing our pressure on Democrats who are wavering on this issue (again, we are unlikely to see any Republican votes in the House, unless we apply pressure and keep the poll numbers pointing in the direction of the public plan as an essential element to healthcare reform), a strongly endorsed healthcare plan coming out of the House with the public option intact, will force acceptance of that component in the House/Senate conference meeting–the Senate will not be able to avoid it. So the margin of victory in the House now becomes an important component of our reform prospects.  Now is the time to write to your Senators and House legislators, to keep the pressure and drive the issue into a state of redundant acceptance. I believe that the public option plan is more achievable now than at any other time in the last few months. We may have passed through the dimly lit tunnel of the goons into a brighter light of new hope for decent healthcare reform. The lobbying against the public option is running out of gas and it’s time to energize our legislators and force our news media to talk about the new polling data and explore the ethical failure of our current healthcare system. For the past two months, opponents of healthcare overhaul have outspent those supporting the bill, but that tide has now shifted, with more advertising money spent on support of the legislation, even though we don’t yet have a specific bill to fight over. One can almost predict that the Senate/House conference committee  will be the site at which the public option succeeds or fails and, if so, no conference in history will be in the public spotlight more than that one. Energize yourself–the battle for healthcare supremacy is about to begin!

RFM

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The Healthcare debates in August

Posted on September 17th, 2009 in Health,Politics by Robert Miller

It is easy to summarize the healthcare debates that took place during the August Congressional recess this year: there weren’t any. The filtration process of the mainstream media helped to amplify the role of the goons who appeared at town hall meetings to disrupt, confuse and intimidate, with the bogus claims of “death panels,” “socialized medicine,” “free abortions” and “medical care for immigrants.” The political fight over healthcare has nothing to do with our healthcare system, but everything to do with political power. The right-wing Republicans, the only Republicans with any voice, view the healthcare issue as the single greatest threat to their power future as well as their ability to control the public agenda and the national dialogue. They know that once a public system is implemented, such as Social Security, Medicare, Medicaid or Veterans healthcare programs, the public becomes enamored and devoted to them. Medicare has a huge popular mandate among those that receive healthcare service from that system.

The Republicans have worked hard to earn their way into the status of a minority party, but they hope to start their political recovery in the fall elections of 2010, by defeating any and all healthcare bills, painting Obama as a black man who shouldn’t be president and infusing fear into the public about the excessive costs of dealing with a healthcare system, a system that is so corrupt,  that it should be viewed by all Americans as an antidote against forming a civilized society.

The mainstream media seem content to let the flap over healthcare remain at the shouting level, while they avoid any attempt to shed insight into the problems with our dismembered healthcare system. How many charts or graphs did you see in the publicized healthcare debates that served to illustrate the train wreck were are headed for with our current healthcare system, or the lack thereof? I didn’t see one. No one in the mainstream media has been willing to discuss the ethics of huge corporate profits generated off the backs of the sick and elderly. No reporter with any national news visibility has undertaken the task of exposing how public funds are used by the for-profit health care system to support their huge profit margins. For every individual eliminated from private insurance plans as a patient with too much risk or unreported preconditions, their arrival at the doorstep of our emergency rooms generates a public expense for their care that all of us must share. Of course, it’s far worse when they don’t show up at all and become victims of our healthcare system by choosing to die rather than seek aid, either from ignorance or fear of facing an insurmountable financial disaster. The Institute of Medicine of the National Academy of Sciences has estimated that 18,000 people die each year because of a lack of access to healthcare; many consider this estimate to be too low. The partial conversion  of Medicare to a privatized system has generated additional costs that fall on all of us, but wind up in the profit margins of privatized health care companies. Republicans acknowledge that we need healthcare reform, but refuse to advance a serious plan that can achieve that objective. In choosing the option of offering nothing of substance, it should be transparent to all of us that their function is to destroy all the current bills, rather than build a serious consensus on healthcare reform principles.
The one element of healthcare reform that could generate serious savings if properly implemented is the government-controlled public healthcare option. Despite the fact that we don’t know much about the details of such a plan, because there are too many different House bills at the moment that include this option, if implemented effectively,  it could potentially force for-profit insurance companies out of business and that’s the “secret hoped-for” outcome.  The public option is likely to remain in the final version of the House bill on healthcare, but it is not in the first iteration of the Senate bill that came out of Max Baucus’ committee yesterday (that bill includes public cooperatives, which Howard Dean claims have been tried before without success). So can the public option emerge from a House-Senate conference if these very different bills get passed by each legislative body? Stay tuned–there is a food fight brewing here. But Obama shouldn’t fool himself into believing that his past record as a consensus-builder is going to work in bringing a significant number of Republicans to live under his healthcare tent. This fight for healthcare is a fight over political power–current and future, and to win it, we have to run over the opposition and grind them into the political dustbin of history. LBJ would have known how to fight and win this war and he wouldn’t mind bragging about those he had to run over. But, give Obama credit, he was at his best last week when he showed the anger of an aroused campaigner who finally awakened to the challenge. In his speech to the auto workers, he talked about being jerked around by the healthcare industry. That’s the face he needs, coupled with a few simple charts to repetitively and redundantly remind Americans what a disaster they have for their own healthcare system. Our healthcare system leads the world in only one category–its cost! In far too many areas, such as our infant mortality rate, we rank among third-world countries, an achievement that bothers too few Americans for the comfort zone of a progressive in judging the character and ethics of his own country. So many other countries do it so much better than we do and commit themselves to universal healthcare out of a moral obligation for the whole-cloth of their national identity. Obama has talked about a moral and ethical obligation to provide healthcare for all of our citizens and his framing the issue in those terms and the lack of any serious public response,  reminds us of the fracture lines that once threw us into a bloody civil war. Too many Americans refuse to acknowledge these moral fault lines that underlie the essence of our healthcare debate.
RFM

Two weeks away

Posted on September 4th, 2009 in Biography,Politics by Robert Miller

I will be out of the country for two weeks, on a sort of modified vacation, combining attendance at a scientific meeting with a celebration of Rosemary’s 65th birthday. Naturally, we will be staying on the Left Bank while in Paris. In the absence of millercircle postings, I invite you to look at a few things I found of interest in the last week or so. First, Amy Goodman hosted a special show on Edward Kennedy, the day after his death. She played audio excerpts from some of Kennedy’s most famous speeches and interviewed Adam Clymer, Kennedy Biographer, on his life and impact on the country. Very touching if you haven’t heard it. Clymer also gives a quick review of Kennedy’s major legislative achievements. There was really no one like him, even though he gave the opposition plenty of ammunition. But, when you are a public figure and someone challenges your ethics and moral behavior, you know there are very few Republicans who haven’t done something far worse.

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