The End of Healthcare History? Let’s Hope Not
Posted by ydsblog on 9/10/09 • Categorized as Domestic,Lead Story
JEFF MUCKENSTURM

There’s no doubt that mainstream liberals will gush over last night’s speech by President Obama to the joint session of Congress.
But any progressive or socialist should find Obama’s speech, and his overall healthcare reform effort, as just another entry in a long list of political disasters (i.e. Afghanistan, Iraq, “don’t ask-don’t tell,” cap and trade, EFCA, etc.) that will screw the majority of people while handing over billions of dollars to private enterprise.
His speech offered little new insight on his ideas for healthcare, other than the usual list he’s been touting for months:
1. Individual mandates, which would place financial penalties on those who go without insurance for any reason
Only the most deluded of minds could go on about the horrors of private insurance (“One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it.”), then require everyone to sign up for their dismal policies in the same breath.
2. Employer mandates for large businesses that don’t provide insurance for their employees
Matt Taibbi of Rolling Stone puts it best:
“A good idea — except that the Blue Dogs managed to exempt employers with annual payrolls below $500,000, meaning that 87 percent of all businesses will be allowed to opt out of the best and toughest reform measure left. Thanks to Harry Reid, Nancy Pelosi and Barack Obama, we can now be assured that the 19 or 20 employers in America with payrolls above $500,000 who do not already provide insurance will be required to offer good solid health coverage. Hurray!”
3. An insurance exchange where consumers can choose from a variety of insurance “products”
According to Physicians for a National Health Program:
“There are no good examples yet of successful exchanges. California has 15 years’ experience with an exchange, and it has been a failure. A July 2009 Issue Brief by the California HealthCare Foundation details its problems and demise. It was initially intended to ‘provide an easy to navigate single point of entry where people could go to choose among several health plans, reduce the cost of coverage (using three primary mechanisms: reduce administrative costs by achieving economies of scale, command lower prices, and foster market competition), and enhance portability of coverage.’ None of those objectives were achieved.”
4. Tax credits (subsidies) for the poor
As anyone in Massachusetts will tell you, individual mandates combined with subsidies hardly provides universal coverage, or even comes close to reducing costs. In fact, they’ve proven to benefit the wealthy more than anyone else.
5. Ending “pre-existing condition” clauses in private insurance
In order to get this deal with private insurers, Obama needed to include the individual mandate. So, while ending pre-existing conditions is a good thing, insurers will not vow to end rescissions (denying care to the sick).
6. A watered-down, “not-totally-necessary,” “public option.”
There is a ton of speculation about Obama’s support for the “public option,” and whether he would drop it and concede to the right-wing lie that it would be a government take-over.
But, under Obama’s vision, it was never that great to begin with. At its best, the “public option” will cover only 10 million Americans, it doesn’t include vision, dental, or long-term care, and it doesn’t kick in until 2014, when insurance premiums will have increased by almost 50 percent.
Also, Obama clearly lies about it being a choice. If your employer offers you an acceptable plan, and you don’t like it, you’re not eligible to join the exchange and choose the public option. As Bernie Sanders put it, “If you have coverage you like, you can keep it. But if you have coverage you don’t like, you gotta keep it.”
Besides, what’s the point of a “public option” that isn’t financed by tax dollars, and “competes on a level playing-field with private insurance”? It’s only adding another bureaucracy into the insurance market with over 1,300 players. With 30 cents of every healthcare dollar already going to paperwork and executive salaries, another plan added to the mix doesn’t do anything to grasp the potential overhead savings.
The “public option” is not really public, nor would it even be an option for the vast majority of the population.
So instead of saving $400 billion a year, like single-payer would, we’re going to spend and additional $900 billion over ten years, and cut “wasteful spending” in Medicare and Medicaid.
And that’s the biggest problem with this reform. It relies on the undying, zombie-like dream of market competition to reduce costs. The market has failed us for over forty years. It’s left 47 million people uninsured, 30 million under-insured, and has done nothing – nothing – to reduce costs. Premiums have doubled in the past nine years, and they’re likely to outgrow household income by 2025.
Watching Obama tout the free market to reduce costs for 45 minutes was an exercise in torture. He essentially spent the better portion of the speech making Nixon’s debunked argument for private health insurance competition and lauding America’s “rugged individualism.” For someone running on change, this should be a major embarrassment.
Instead of embracing the left, he kicked us in the teeth, and caved to the right’s biggest fears when he proudly proclaimed that “no federal dollars will be used to fund abortions,” and that “the reforms I’m proposing would not apply to those who are here illegally.”
Apparently “that large-heartedness – that concern and regard for the plight of others” of America does not extend to women and immigrants.
When Obama said, “I am not the first President to take up this cause, but I am determined to be the last,” I couldn’t believe my ears. Leaving millions of people uninsured, under-insured, and tied to a private corporation with nothing but a profit-motive is the final goal?
This is not the “end of history” for healthcare reform. We must continue to push for single-payer healthcare because it’s the only plan that would provide universal, comprehensive coverage and a reduced cost for all American residents.
For now, we can support Rep. Anthony Weiner’s (D-NY) amendment to HR 3200 that would essentially open Medicare to everyone. We can support Rep. Dennis Kucinich’s (D-OH) amendment that would allow states to pass single-payer legislation. And we can support Sen. Bernie Sanders’s (I-VT) single-payer bill (S. 703) in the Senate.
Jeff Muckensturm is Web Coordinator and grant writer for Healthcare-NOW!, an organization fighting for a national, single-payer healthcare system




An excellent post. At least a portion of the left is finding some sort of voice in this debate. Someone who has been around for longer can tell me how this compares to the response to Clinton’s gutting of welfare.
Great article, but I hope you don’t mind a small rebuttal from someone who, by and large, agrees with you and wants the same things. Mostly I believe that progress is always going to be more gradual than we’d like or hope. If this is a step in the right direction, which I think for the most part it is, then it’s progress. It’s not perfect, certainly, but then there’s a political element in this country that elected officials have to contend with.
With the mandates, obviously this is something the insurance companies will push for. It means more payers and more money for them. But with a cheap (or free, based on income) public option, mandates could effectively lower the cost of healthcare as a whole by making sure everyone is covered. It’s a tightrope they have to walk, though, to make sure no one ends up getting screwed by being forced into healthcare they can’t afford.
As for the employer mandates, I think it’s nothing more than a shot straight at Walmart. And good on them. Maybe in a decade or so, we can lower that $500,000 limit (or let inflation catch up).
But the public option really is key and, honestly, I was surprised he still put it on the table at all. From everything I’d heard before the speech, it was expected to be removed. So that it’s out there at all shows some sack on Obama’s part. I just wish he could get those traitorous blue dogs on his side to force the issue. Cause without a public option, there can be no mandates. And without mandates, there’s no end to pre-existing condition clauses, as you said. And without that… well… what’s the point?
I don’t think the battle’s lost quite yet, though. There is still a chance for progress.
Did anyone really expect Obama to push for single-payer? If you think things are ugly now, think about the shitstorm the Right would’ve kicked up over THAT. I’m just counting my lucky stars he didn’t pussy out on the public option like we all thought he would. With so many ill-informed, brainwashed assholes driving this country into the ground, you kinda gotta take what you can get. Small victories, folks.
Sorry, Hutch. Didn’t mean to reply directly to you.
I don’t think any single-payer advocates expected Obama to come out for Medicare for all. It’s been years since he publicly endorsed the idea of a single-payer system. What’s more frustrating is the fact that so many people who actually want a single-payer system, or at least a real public option, aren’t fighting for it and are accepting a terrible “reform” that will basically boil down to this: buy bad private health insurance or be fined upward of $4000 (and you’d be forced to accept whatever health plan your employer offers you, even if it’s terrible). That’s not even a small victory in my book.
There’s a very good chance there’s not going to be any public option in any final legislation either. Pelosi, Reid, and other leadership Democrats are backing away from it: http://politicalticker.blogs.cnn.com/2009/09/10/democratic-leaders-in-congress-soften-on-public-option/. There could be “trigger option,” but if this is the case the bill would probably be structured in such a way that this public option trigger will never be pulled.
This might not be happening if people like you (I don’t mean this in a negative way, I just mean people on the center-left who generally support what the Obama administration is doing) were out there fighting for better reform rather than just “taking what you can get.”
The reason why Obama keeps talking (increasingly weakly) about the public option is to protect his left flank and prevent liberals from rebelling against him. That’s it. The “public option” would not to what its supporters think it’s going to do – expand coverage and lower costs – because it will not be tax-funded, and it will not be big enough to allow it to effectively compete with the private insurance industry (as Obama himself said in the speech, it would only be available to about 5% of the population). Besides, there’s a very good chance it won’t even be in the final bill because the votes are probably not there in the Senate. As for mandates, people will most certainly be forced to buy bad health insurance coverage that they cannot afford. The experience in Massachusetts proves it: http://www.pnhp.org/news/2006/april/massachusetts_health.php.
My biggest fear is that this doomed legislative boondoggle is going to discredit the entire concept of government funded/guaranteed insurance coverage in many people’s eyes. We could very well have a system that’s even worse than the one we have now by the time all this is over. That wouldn’t be progress at all.
Doug Henwood made basically the same point as Chris in the latest Left Business Observer. I tend to be an optimist, but I agree with both of them.
I see a shred of hope in the Kucinich amendment that would allow states to pilot program a single-payer system.