For anyone fazed by healthcare reform histrionics, take heart. We’ve been here many times before. The real question is, for all the political, capitalistic, and social angst, what’s changed? According to medical economist J.D. Kleinke, who first arrived on the scene in 1989, only one big thing: now everybody gets to whine about the status quo on Facebook. He goes so far as to call the healthcare bills moving forward today “a violent endorsement of the status quo.” I can’t say I disagree with his logic, but two women just gave me hope for this go-round.
Kleinke points out that in 1989 we had a dysfunctional third-party payer insurance system based on fee-for-service. Some insurers, hospitals, doctors, drug companies, and even employers figured out how to game the system and make out like bandits. Medicare was forecasted to become insolvent, Medicaid programs were underfunded, and malpractice costs were supposedly bankrupting healthcare. Costs were skyrocketing along with the number of uninsured. Does all this sound familiar?
Yet in 20 years, he says, all we can come up with is to fit more insured patients into our current mess and make it harder for insurers to kick them out. Each time the smallest of reforms is proposed (like adding prescription benefits to Medicare) entrenched US stakeholders rally mass hysteria, and the result is government funding of more corporate services. That’s true, J.D., but times have changed; about that Facebook phenomenon …
In 1999, Rick Scott of Columbia HCA was finally exposed for defrauding the public throughout the decade. Total damage, $1.7 billion for Medicaid and Medicare overcharges. Today, Scott is exposed far more rapidly for defrauding the public in his “patients’ rights” campaign and the news speeds around social networks. Turns out he relies on insurance lobbyist Brian McManus, well known for his Astroturf front groups that promote efforts to increase insurer profits while defeating consumer protections. Apparently Scott supports robbing patients of their rights. As Christopher Hayes at The Nation says, “Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation.”
But on to those two women who give me hope. First, there’s Sarah Palin. On her Facebook page this weekend, she posted her “solution” to our healthcare mess, including taking away Medicare and forcing seniors to buy private insurance with vouchers. So after all that Republican rhetoric about Democratic reform taking away seniors’ Medicare, Palin promotes it? Oops. Throw them to the wolves, Sarah, that’s sure to enhance your anti-reform credibility. I guess she didn’t know that $0.86 of every $1.00 spent on private Medicare Advantage plans don’t benefit plan members? We know she 'reads all the papers' so apparently they didn't cover that.
Because of this private insurer-promoted idiocy, including the deceptive AHIP and BCBSA premium studies, public support for a public option increased this month. Yes, the majority of Americans (57%) now support it, according to a Washington Post/ABC News poll conducted last week, and 51% favor it over a bipartisan bill. Perhaps because of the insurance studies, 56% also now support an individual mandate.
Thankfully someone in Washington is listening to the majority. While all Harry Reid can say is "“We’re leaning towards talking about a public option," Nancy Pelosi has a plan to pass a public option, and it’s alarmingly straightforward. She’s asking the CBO to score the updated House bill (currently $871 billion and counting), which covers more people than its Senate sibling without any public option. So she can show a bill containing a public option costs less than one without it, and offers more coverage. In other words, it’s sound policy. Brilliant! We’ll see if it works in the city that defies logic. But spread the word – perhaps we’ll see a non-violent endorsement of actual progressive healthcare change.
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