Universal Health Care Run by Psychotics

I'm glad there's widespread liberal discussion about the health care system and the need to fix it.  Paul Krugman made a forceful argument about it today in his Op-Ed, but it's really the same argument that heroic blogger nyceve makes on a regular basis on Dailykos - the policy questions aren't the problem, the insurance companies themselves are the issue at hand.   There are two pieces of the puzzle in health care - the policy and the politics.  Clinton's failures in 1993-1994 were the result of a lack of willingness to handle the politics appropriately - read this timeline from Digby and you'll see that we could have won the fight - public support for a different health care system was extremely high, even after Clinton's plan had been defeated.  

From what I can see, what happened in 1993 is that a wonky Clinton team tried to preemptively compromise with the insurance companies, and did zero organizing to deal with a backlash they didn't foresee.  The right-wing innovated to the defeat his plan, using a new combination of genuinely poisonous Congressional politics, direct mail, and cable news punditry.  Instead of understanding that they had been outmaneuvered, Clinton Democrats took the lesson that any policy challenging corporate power had low public support, whereas the business community took the lesson from this fight that bad faith poisonous aggression can pass any policy they want.  It was a nice little partnership that worked through the 1990s, though it fell apart with George Bush as corporate elites used the opportunity Bush presented to rape America, and Democrats sat helpless on the sidelines.  The K-Street project and the cronyism we are dealing with today are a direct legacy of this fight, but so is the new and pugnacious generation of Democratic politicians who grew up watching us get bloodied with corporate money.

Now I've done a fair amount of blogging onChamber of Commerce and its President Thomas Donahue, who has built the Chamber into the $100 million a year institutional manifestation of this sickness.  Donahue has been on the board of both Union Pacific and Sunrise Senior Living when they were found to have serious safety concerns that end up killing or hurting people, and Donahue never loses an opportunity to lobby for relaxed regulations to allow his companies to kill more efficiently.  He's going to fight tooth and nail to kill any attempt to change the system for the worse, and he has $100 million to do it.  And with the new Democratic Congress undominated by Dixiecrats for the first time in a hundred years, the fight for universal health care is going to mirror a whole series of clashes with corporate power that include the Employee Free Choice Act, negotiations with Medicare, net neutrality, media consolidation, war profiteering, corruption in the food industry, shareholder abuses, etc.  It's that bad.  And these are not problems that can be solved this cycle - they are going to require big fights and then one or multiple elections during which the public must ratify our anti-corporate populist message.

The problem with health care in other words is not passing technically interesting policy, which is why the Wyden plan should be seen only as a somewhat besides-the-point rhetoric gambit.  The problem is convincing the public that the Republicans and their corporate backers are bent on attacking the American way of life, and that Republicans simply need to be voted out of office.  Only then, when Republicans are sufficiently convinced that they cannot survive in office by bucking the public, can we reign in corporate power and implement good health care for all and other nice economic goodies that reduce risk for most of us.  To get to this place, we need to present a series of obviously good proposals and let the Mitch McConnell-led Republican Congress filibuster them, and then make 2008 about the national question of who controls the economy.  that creates the space for 2008 contenders to be progressive and build a movement around them.  Let's not be afraid to take this to the voters, as they are with us.

As part of this, ">Atrios thinks, and rightly so, that getting politicians behind universal health care needs to happen.  That's true.  I'd like to think a little bit about framing, though.  It's been clear for some time that America already has a universal health care system, it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more.  Once we accept the framework that American taxpayers already pay for health care coverage for everyone, we just do it in the worst way possible, the argument changes from 'should the government pay for health care' to 'who's ripping us off'.  And the answer is the health insurance industry.

These companies render our health care system bloated and inefficient, but let's be honest, that's somewhat dry language to describe what they are really doing.  Through their immoral decisions to deny care and coverage based on excessive bureaucracy, the executives of these companies are simply killers.  Their wealth is literally built with blood money.  And their chief lobbyist, Tom Donahue, probably believes that there should be a special tax exemption for equipment to clean the blood off their hands.  You might think I'm being rhetorically hot or irresponsible, but dealing with horrible customer service designed to deny you care when you have, say, cancer, demands a certain level of honest outrage.  It isn't wrong to disdain these people, though I suppose that Very Serious People like to pretend that decisions made by a corporate elite denying millions medical care isn't actually murder by spreadsheet.  But it is.

As progressives, we are going to be fighting these terrible people who use poisonous political tactics for a long time.  They are well-funded, they are smart, and they have a lot of institutional allies.  I don't know what it's going to take to convince Democratic wonks that this is a very aggressive time in politics, and we ought to change our strategies to emphasize public persuasion.  But we ought to.

So anyway, to recap, we already have universal health care, it's just run by psychos.  These psychos happen to wear nice suits and drive fancy cars and have titles like 'CEO' and credentials like 'Harvard Business School' graduate.  These psychos will resist any attempt to take away their power.  Taking away their power is a necessary part of any solution.

You do the math.

Tags: Chamber of Commerce, Health care, Paul Krugman, Thomas Donahue (all tags)



Re: Universal Health Care Run by Psychotics

As someone pointed out- Americans are paying a heavy tax now because of the insurance companies, and our healthcare system. I think the frame that this is a heavy tax has its plus and minus, but its definitely true that at double digit increases in insurance per year, it's a heavier and heavier financial burden. Why aren't people talking about it in those terms- demonize the insurance companies?

by bruh21 2007-01-01 08:19AM | 0 recs
tax or ripoff?

I don't think the "taxes are inherently evil" meme should be reinforced if at all possible. But perhaps the point can be made that this is an unneccesary financial burden. It's basically a ripoff. By paying more in taxes, we could get a more efficient system and have the overall financial burden reduced.

And as for demonizing the insurance companies, that shouldn't be hard. Who hasn't been personally fucked by them? It would be like demonizing demons.

by miasmo 2007-01-02 12:20PM | 0 recs
by gragrapa 2007-04-14 11:16PM | 0 recs
Could the gov't buy up the health ins. industry?

I'm dead serious - what are the health insurers (or the health insurance components of more borad-based insurance companies) worth, as an industry?  What's their market cap?  

If the government just buys it up, then there's no one to complain that they've been done out of their profits.

by RT 2007-01-01 08:31AM | 0 recs
Re: Could the gov't buy up the health ins. ind

What of value would we taxpayers be buying? Just a bunch of planned obselesence - red tape and incompetence intentionally built into a system designed to fuck people - "murder by spreadsheet" as Matt so aptly put it. Why would we want to spend one dime on such an evil pile of crap. We could with the stroke of a pen make eveyone eligible for medicare, and the health insurance industry would simply die. Why should we pay those bastards one cent more? Don't we have enough costs just paying for the healthcare itself?

by miasmo 2007-01-02 12:13PM | 0 recs
Re: Universal Health Care Run by Psychotics

I think it's going to take presidential leadership, a candidate who says we need to change to universal single payer health care, runs on that platform and can put together Congressional political support to do it.

We just haven't had a candidate willing to tell the truth about health care and stake out that position.

"The problem is convincing the public that the Republicans and their corporate backers are bent on attacking the American way of life, and that Republicans simply need to be voted out of office."

Actually the real problem is convincing US industry that it is their best interests to get US health care costs off their balance sheets.

The real need is a very articulate president to lay out to the American public the guts of the issue.

1. US health care costs 16% of GDP vs. 8% for Europe/Japan. This costs the US close to $1T per year.

2. US health care system covers 70% of population vs. 100% for European systems.

3. European systems produce better results measured by lower infant mortality and longer life span.

4. US people, jobs and economy are all dying under the weight of US health care costs.

by BrionLutz 2007-01-01 08:36AM | 0 recs
You've Got the Frame

We have the worst health care system in the world.  We are spending twice as much as in France, Germany, and Japan, have shorter life expectation, and higher child and infant mortality rates than Costa Rica.

Medicare does better than the private sector.  So does the Veteran's Administration.  We need to organize small business and manufacturers against the insurance industry.

If the insurance industry resists then we have to blame them for dead babies.  It happens to be true.

Therefore I am not concerned about the frame.  The real problem is that the insurance industry is organized by definition.  The victims of the state of affairs are not.

by Hellmut 2007-01-01 10:13AM | 0 recs
Re: You've Got the Frame

Correction, the VA before Bush. Now it takes nine months just to get an appointment.

by antiHyde 2007-01-01 03:20PM | 0 recs
Re: Universal Health Care Run by Psychotics

The issue I have with the "universal health care" debate is that we keep looking to places like Canada as the model.  However, this is a case of "the grass is always greener."  Canada's health care system may cover everyone for little things, but people who suffer catastrophic healthcare emergencies may be put on waiting lists.

Moreover, I've seen and heard some on our side villify doctors as greedy and wanting to keep the status quo.  

I think the root problem is the approach we take to solving the crisis.  EVERYONE has been approaching healthcare from a cost perspective, Left and Right alike.  Instead, we should approach from a quality perspective.  

Germany has an excellent healthcare system that is run like a co-op.  We could bypass the insurance industry all together and form various co-operatives based on a tiered healthcare system.  The tiers will be quality-based and graded by patients and peers with government oversight.  

People can opt to pay more for a Grade A healthcare system or pay slightly less for a B.  This incentivizes the healthcare professionals to strive for excellence, which they undoubtedly should do already.  However, a little carrot will go a long way.  

While some may argue it creates a class-structure for healthcare it is  our choice to join whichever network we choose and every year we have the option of moving to another grade network.  

Moreover, the government will cover catastrophic healthcare costs so that everyone gets the same treatment for life-threatening emergencies such as cancer.  

It is basically insurance without the insurance companies.  The people of each grade network vote for a board who oversees the quality all of which is subject to strict governmental oversight.
We'll just be cutting out the middle-men, a.k.a. insurance companies.

This is by no means a magic-bullet.  Great structural changes have to be made to how health-care is managed.  Newt Gingrich is right on the money when he calls for a 21st century, computerized infrastructure.  

Moreover, malpractice reform is another element.  My Dad is a very prominent and highly respected physician who is constantly dealing with malpractice suits.  (Before y'all say anything, Dad is a socialist and this is pretty much his idea)  His line of work usually involves getting people when nothing much can be done for them except alleviate their suffering.  The families spend all their money on their loved one until the end.  In which case, they really have no recourse but to sue to try to recoup some costs.  Malpractice insurance usually settles for some amount.  Also, there are people who get medical degrees who make a career out of testifying in malpractice cases.  These individuals usually do not practice hands-on medicine.  

Yes, there's a lot of wonky nuanced policy stuff, but the end result is a system that COULD work.  We wont know until we try something and the states would make a perfect laboratory.  If it doesnt work, isolate what's wrong and correct the problem.  

Just like the practice of medicine...

by dayspring 2007-01-01 08:40AM | 0 recs
Health of Nations

Ezra Klein did a great job summarizing each of the very different universal coverage approaches of Canada, Japan, France, England, and Germany.

http://ezraklein.typepad.com/blog/health _of_nations/index.html

I think France had the model that is best adaptable to the US. There are some disparities in the quality of care but everybody is covered and it's paid for with a employee/employer contributions just like Social Security in the US.

by joejoejoe 2007-01-01 08:58AM | 0 recs
Malpractice/Other Countries

Malpractice is a real problem - not malpractice insurance or payouts, which are down in the white noise of our health system's costs, but the actual malpractice.  A number of recent studies have shown that substantive mistakes in hospitals happen much more often than anyone would have figured.

The resulting costs are human costs - lives lost, permanent health conditions, etc.

Other countries' systems: the only people I see comparing our system with just one other system are the anti-reform forces.  They can raise the worst cases under another country's system, be it England's, Canada's, or whoever's, and say, "See - this is why you don't want universal health care."

The reformers know that every advanced country except us has universal health coverage, so there are lots of models to consider, to compare and contrast and discuss which system would be most acceptable to Americans.

Cost/Quality: Everyone talks about cost because until you demonstrate the affordability of universal health care, there's no further discussion.  But Ezra, K-Drum, and others have in fact been discussing quality too.

by RT 2007-01-01 10:24AM | 0 recs
On the wrong side of progress

So if people want to organize themselves into a government backed co-operative that provides better care more cheaply for more people it's still wrong because it hurts the insurance industries profits?

Screw 'em.

No phalanx of Congressmen defended trolley manufacturers or harness makers when the automobile was invented. The modern US insurance industry exists  like water exists on the wrong side of a levee after a flood. You don't just live with the consequences - you dynamite holes in the levee so the water flows back into the river. Substitute money for water and health for the river and you have the plan.

The plan should be to tell health insurance shareholders and employees to expect massive erosion of their market. What health insurance market that is left standing should be highly regulated like old school public utilities. Same goes for Big Phrma and medicine.

It's still a free country and the wealthy are free to get care for pay outside the system. But like our public schools, you don't get a voucher. You pay into the public system through taxation AND pay for your Rolls Royce healthcare out of pocket.

The National Academies have said our dysfunctional system isn't just failing to provide care for 40+ million Americans - it's a huge drag on our economy. Those 40+ million people would be far more productive if didn't have all the concerns asssociated with the lack of healthcare.

http://www8.nationalacademies.org/onpine ws/newsitem.aspx?RecordID=10719

Some kind of universal coverage (see Ezra Klein's Health of Nations - pick any form) would be win-win-win for the sick, taxpayers, and the US economy. The only losers would be people making a literal killing in speculating on health risk.

by joejoejoe 2007-01-01 08:51AM | 0 recs
Love the concept

So if people want to organize themselves into a government backed co-operative that provides better care more cheaply for more people

How, triplejoe? Any ideas? Does it have to be government backed? The car makers that replaced the harness horse had no government backing.

Can we re-invent the HMO to be a Health Maintence Organization? It was invented as a non-profit by Henry J Kaiser for his steelworkers in Fontana,Ca my hometown where my dad and his brothers worked. Henry J never considered it anything other than a breakeven organization at best.

His real idea was to take care of his workers so he could be more productivity at the Kaiser Steel.

Great idea. Changed everything until some company decided an HMO should be a PROFIT organization.

I've always thought it was an oxymoron. A Health
Maintence Organization can only make a profit by finding ways to deny services to it's members.

Membership Revenues have to exceed costs. Period.

How do we get back to the original concept?

by BigDog 2007-01-01 10:02AM | 0 recs
Safeway self-insured health plan touted?

SF Chron touts Safeway self-insured health care http://www.sfgate.com/cgi-bin/article.cg i?f=/c/a/2006/12/29/MNGUBN9SG91.DTL& hw=safeway+health+care&sn=001&sc 1000

The plan limits employee contributions to $3000, but pays in extra if the employee uses $1000 or less -- and covers ALL 'wellness' and prenatal care.

A second Chron story explains the accident of 'employer-based health coverage' -- when post-WW II policy made it impossible for companies to have 'excess profits' unless the 'profits' were spent on benefits for employees.

Another Chron story praises States' efforts (most recently Mass. and maybe even Calif): http://www.sfgate.com/cgi-bin/article.cg i?f/c/a/2006/12/29/MNGUBN9SG91.DTL& hw=health+care&sn=001&sc=1000

And John Edwards focuses on universal health care:
http://www.sfgate.com/cgi-bin/article.cg i?f=/n/a/2006/12/31/politics/p154925S42. DTL&hw=health+care&sn=008&sc =483

by MS 2007-01-01 08:56AM | 0 recs
Re: Universal Health Care Run by Psychotics

This is just dead wrong:

Canada's health care system may cover everyone for little things, but people who suffer catastrophic healthcare emergencies may be put on waiting lists.

I have Canadian two relatives who suffered major health emergencies last year and both received immediate care with no paperwork. The only time there are waiting lists are for elective procedures. The only cost one of them incurred for a series of radiation treatments was the parking fee for the car in a nearby lot.

As for changing the insurance industry. It's not likely. The only time we ever restrained a powerful industrial sector was during Prohibition. Fifty years after cigarettes were shown to be deadly they are still on the market. Such is the power of vested interests.

Any "single payer" system that keeps a useless middle tier of insurance companies in the loop will fail to lower costs significantly. The best that can be hoped for with the current political climate is the extend coverage to the uninsured and under-insured. The head of United Health Care has a retirement package worth over $1 billion. Look up how much Bill Frist's family is worth. What's the chance that these powerful people will lose the source of the continuing wealth? Zero.

by rdf 2007-01-01 09:04AM | 0 recs
Re: Universal Health Care Run by Psychotics
To take on the insurance and Business industries we will have to over come the Myth of Capitalism vs Governmentism. Ever since the fall of Communism there has been an unquestion assumption that Capitalism is the winner and supreme source of all the is effective and good. We have been led to believe by embracing Capitalism Communist China and other Dictators would eventually succumb to power of Democratic ideals. I see little concern about the failure of Democracy to take hold and the myth of Capitalisem still lives.
 As long as Liberal politicians use their Business accumen and experience as positive qualities for elective office we have an up hill battle. As long as we liberals don't reject those who see Capitalism as the route to solve our problems we will never succeed. On the other hand those of us who "attack" Capitalism as NOT the answer, will of course suffer the wrath of Capitalists and being branded with the scarlet Star of lenin and unbridles rabid condemnation for becoming just a bunch of Communists or socialists pretending to be progressives.  
by eddieb 2007-01-01 09:21AM | 0 recs
Re: Universal Health Care Run by Psychotics

Never gonna happen.

The Republicans and their corporate allies are not the only roadblock here. There is a significant cadre of Democrats, DLC or otherwise who will oppose any universal system. Despite the crisis, and it IS a crisis, there is no outrage out there--no sense of urgency among the population. Plus the propaganda machine has done it's job since '93.

I have friends who have terrible insurance, and havebad experiences with the HMOs but balk at the talk of "socialized universal healthcare". I do the best I can to explain that it is not socialized...doesn't work. They don't want government involvement and think that their crappy healthcare is 10 better than anything the gov't can give them.

It's a sad state of affairs and we will never get single payer because of some inmense roadblocks, which includes lack of support in the population, spineless Democrats who have a tendency to capitulate to the right wing machine and a corporate behemoth that will never go down.

It will never happen.

by need some wood 2007-01-01 09:38AM | 0 recs

If we don't make it happen, it will be the end of the middle class.  The middle class cannot sustain price increases three, four, and five times the rate of inflation every year.  That's why people are getting more and more concerned every year.

There is enough energy.  The challenge is to harness it and organize people.

Before you give up, remember that when we surrender the health care problem, we surrendering the middle class itself.  That would be the end of democracy as we know it.

May be, you are willing to settle for that.  I'm not.

by Hellmut 2007-01-01 10:18AM | 0 recs
Re: Universal Health Care Run by Psychotics

They said slavery would never be ended too because of the immense economic obstacles. It took a long time and a civil war, but it was ended.

Just because battles are big and hard doesn't mean we shouldn't undertake them. They are worth fighting.

by RandomNonviolence 2007-01-01 11:15AM | 0 recs
Re: Universal Health Care Run by Psychotics

I'm not saying they aren't worth fighting for, I am just putting out there what I think the odds are of making it happen with the current crop of Democrats we currently have, the corporate obstacles we face, and the fact that this crisis has not become a CRISIS in the minds of the populance.

That's just the way I see it right now...in order for single payer to happen the only way I can envision it being enacted is with a president who actively campaigns for it, a Democratic Congress with at least 57 Democratic senators, and a House majority in the 250s or 260s to give breathing room for DLC opposition.

But the most important thing that needs to happen is for the people to be fed up and push for single payer. The fact that I know way too many people--liberal otherwise, but not pol junkies, who are dead set opposed to "socialized medicine" and that they prefer their crappy coverage over it  tells me the fight to change people's minds about it has not even begun. There is a healthcare crisis, but people don't seem to realize how big it is--the disconnect is huge.

Polls show healthcare as a top issue, yet they don't seem to demand answers from the politicians who run. A simple "I am in favor of making health care more affordable for working families" seems to sufice despite the absurd platitude it is. At this pace we are 30 years away from achieving anything remotely close to being able to pass such a plan.

by need some wood 2007-01-01 12:44PM | 0 recs
Re: Universal Health Care Run by Psychotics

"They don't want government involvement and think that their crappy healthcare is 10 better than anything the gov't can give them."

I've never understood why people think the government can't do anything right because it is the government, and simultaneously think the government can run the finest military in the world. Obviously, the government can do SOMETHING right. The same people also praise the police and FBI, apparently thinking that these are corporate organizations.

by antiHyde 2007-01-01 03:33PM | 0 recs
Re: Universal Health Care Run by Psychotics

Hellmut has got it.

It will happen.

Because we, the folks who need healthcare, will soon be unable to afford it.

And if we can't afford it...

Those who sell it will go out of business.


It's time to throw the insurance companies, who contribute nothing, under the bus and implement single-payer, government funded health-care...

For every one in the nation.

Past time.

By the way this is the number one issue of concern when folks are polled...

It beats Iraq, or did until recently, quite handily.

As progressives we need to get out in front of this and sound the trumpets.

For a fight to the death with the insurance industry.

by Pericles 2007-01-01 05:53PM | 0 recs
Since I was in the ER 10 days ago...

I was in the ER 10 days ago. And the last ER visit was a false alarm. Thanks, God!

(I had two heart attacks in the 2003 Primary and General Election. I can proudly say I kept my fulltime volunteer work on the Executive Commitee in LA and Orange County on behalf of Wes Clark without missing a beat. That was a damn dumb thing to do that has had it's consequences but I'm still proud of what we tried.)

Now, even though I am by no means a senior citizen, I can't get insurance for less than $800 or more a month. Probably around $1000.

As I am also self employed there is no 'company' insurance.

So there's the part of Matt's VERY GOOD POST that hits home in terms of reality...and very good framing:

It's been clear for some time that America already has a universal health care system, it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more.  Once we accept the framework that American taxpayers already pay for health care coverage for everyone, we just do it in the worst way possible, the argument changes from 'should the government pay for health care' to 'who's ripping us off'.  And the answer is the health insurance industry.

While I have some coverage, the medical issues, combined some candidates that never paid their accounts receivable last year for staff and consulting work, have broken the bank. And this happens to millions every year when hit with some huge expense. (I built an entire wing on my hospital in 2003.)

Get this into the hands of your Congressman! It is so much more important than you can imagine.

Very, very  good work, Matt!

by BigDog 2007-01-01 09:50AM | 0 recs
Re: Since I was in the ER 10 days ago.../PS:

PS: My cardiologist actually told me this about the cardio program of Orange County:

"Orange County has a very efficient program for heart patients, Stuart. They wait for them to die.'

No crap. His actual words. There has to be a better way.

by BigDog 2007-01-01 09:54AM | 0 recs
Re: Universal Health Care Run by Psychotics

Nice post.  Interesting to read your take on the Clinton attempt.

by catherineD 2007-01-01 09:52AM | 0 recs
The Murderous Corporations Act of 2007

Seriously, this post lists a number of murderous corporations. Since they are legal persons, why is there no death penalty for them?

That would certainly be one way to deal with the insurance companies...

by lambert 2007-01-01 10:11AM | 0 recs
Re: Universal Health Care Run by Psychotics

Even with a Democratic majority, universal healthcare will be an enormous lift in Congress.  But it's a significantly less daunting (if still formidable) challenge at the state level, especially in places like California in which ballot initiatives are available as a lever to force compromise in the legislature and counterbalance the threat of a veto.  With Democrats now controlling the majority of state houses, we shouldn't lose sight of the fact that what we can't (or if we can't) win at the federal level we can achieve state by state.  And this year, that fight will begin in California.

by Woodhouse 2007-01-01 10:17AM | 0 recs
Re: Universal Health Care Run by Psychotics

You can't really do universal health care at the state level alone. It has to be national because so much of the health care spending is Federal or tied to Federal rules (state Medicaid, Medicare spending for example).

It has to national policy.

If you look at Kitzhaber's Archimedes's Project website, http://www.archimedes.org, he has an interesting stat that if you totaled, private, state, federal and local health care spending, and applied that money to providing health care using Medicare costs and guidelines, you could get the job done, cut costs by half, increase coverage to 100% and start to see the better results that Europe and Japan see from health care.

by BrionLutz 2007-01-01 10:51AM | 0 recs
Re: Universal Health Care Run by Psychotics

Whoops...typo in link.


by BrionLutz 2007-01-01 11:08AM | 0 recs
Re: Universal Health Care Run by Psychotics
Given the burden that health insurance has been for business, small business and mega-business, for employees, and for retirees, it seems to me that a lot of the business community (absent present HMOs and others invested in ripping us off) should be behind universal health care -- and health care reform big-time.  Why can't we see the collaboration of business leaders to support universal health care from this perspective?
I have been thinking about this for a long time.
While those in the insurance business are keeping our system from improving, they are killing the rest of business and manufacturing in this country.
Can we get some action in making this pro-business argument, and in getting some business people to work on this issue.  Why haven't they up to now?
by syolles 2007-01-01 10:56AM | 0 recs
Re: Universal Health Care Run by Psychotics

This is a question many of us have asked. I see several possibilities:

* Corporate leaders are so ideologically anti-government that they are willing to watch their companies go down the tubes (like GM) before they are willing to embrace universal healthcare.

* Corporations see the present health system as a great threat to wield against workers: any worker with a pre-existing health problem is scared to death of losing her/his job since that also means losing healthcare so workers are more willing to give in to corporate demands.

* Corporations are tied into the insurance industry and so see them as their friends/allies/funders/whatever. Undercutting these insurance companies is thus unthinkable.

by RandomNonviolence 2007-01-01 11:22AM | 0 recs
Re: Universal Health Care Run by Psychotics

The health insurance problem is a big drag on big business and a big drag on entrepreneurs, too. As a self-employed person, I'm on e-lists for such people, and health insurance is the number one complaint.

People are paying $1,200 a month for a family policy that's full of holes, and they're delighted they could buy any insurance. People with preexisting conditions, say, diabetes, can't buy it at any price. On these lists, small businesses often fold because the owner is taking a crappy job that offers minimal health insurance.

From my perspective, enterprise would boom in this country if health insurance wasn't employer-based and predicated on holding onto some tedious job for dear life.

But the only organized entrepreneurs and small businesses are the phony outfits set up by Republicans, of which the Chamber of Commerce referenced here is far from the worst.

And also, most doctors are owners or employees of small businesses and no doubt see the same problems. My doctors tell me that for their own sakes as well as for their patients' sakes, they'd prefer single-payer universal health insurance.

by joyful alternative 2007-01-01 06:09PM | 0 recs
Re: Universal Health Care Run by Psychotics

Matt -- check out Former Governor of Oregon John Kitzhaber and his Archimedes Movement.  

There is no one in public life that understands the issue better.   John was an emergency room doctor who became Governor of Oregon.  

Go to  http://wecandobetter.org/learn_more/watc h

I would really like to work with others in the blogoshpere to get Kitzhaber, Atrios, you and any one else who is interested and do a rootscamp of sorts around this issue.

I really believe that John Kitzhaber is to health care reform what Al Gore has become to global warming.  The right leader with the right knowledge to help empower the rest of us to make a difference.

by JoeTrippi 2007-01-01 11:05AM | 0 recs
Re: Universal Health Care Run by Psychotics

full disclosure.  I was one of Kitzhaber's consultants in both his Gubernatorial campaigns -- and help on the Archimedes Movement.  I think he is a true transformational leader -- but alas I have failed in all attempts to get him to run for national office.

by JoeTrippi 2007-01-01 11:14AM | 0 recs
Re: Universal Health Care Run by Psychotics

Kitzhaber is a real visionary on health care issues.  I lived in Oregon for a few years while he was Gov and he did great things with the Oregon Health Plan.

by John Mills 2007-01-01 05:45PM | 0 recs
When the time is right... you have to fight.

I actually don't blame Hillary & Bill for pulling the plug on healthcare 10 or 12 years ago. In retrospect we can all see that they were going to lose, so it was better to punt, and come back at another time. It wasn't just the power and money of the insurance industry, the Republicans were ascendant, and now we know that they would remain ascendent until 2006. The right-wing framing of anti-government, anti-tax and anti-abortion sucked away from us a whole segment of the populace that we will need to win this one. I think that pushing harder for UHC back then would have lost more than it would have won.

But, times change.

Health insurance costs have sky-rocketed. Businesses are dropping insurance benefits or jacking up the price. Businesses themselves suffer. Union contracts are cutback. The uninsured increasingly includes a lot of middle-class people. Someone should plot the costs and number of people impacted over the past 10 years; I'll bet the picture would be pretty stunning.

And, who doesn't hate the insurance industry?

Universal health care is a universal political issue because everybody needs health care, and almost everybody is feeling the pinch. I don't underestimate the insurance industry, nor the anti-government Republicans, but this time around I welcome the fight because the political terrain is so much more favorable for us. The insurance companies are viewed so negatively, that they will have no choice but to hide behind front organizations.

It's like FDR and the great depression. If they were smart, they would propose a 50% solution to coopt the opposition, because otherwise they're gonna lose the whole banana.

What do you bet that McCain calls for some kind of health-care reform lite?

WRT the Democratic primaries.

I don't know about the Dems in your part of the woods, but here in Colorado, the Party activists are strongly in favor of Universal Health Care. The politicos and more establishment voices in the Party may try to moderate or ignore the issue, but I don't think they can hold back the dam this time around. Or else they support it verbally, but don't actually do anything.

Watch for insurgent candidates to do well running on anti-Iraq and UHC.

by MetaData 2007-01-01 11:12AM | 0 recs
Grassroots healthcare co-ops

Here's an example of a healthcare co-op that exists right now (including free clinic to members). But these "up-by-your-own-bootstraps-only" efforts won't be enough, But it's still taking money out of the hands of the insurance companies.


Ithaca Health Alliance
The Ithaca Health Alliance is a cooperative which helps members pool their resources in order to reduce health care costs, support each other, ...

by johnalive 2007-01-01 11:18AM | 0 recs
Re: Universal Health Care Run by Psychotics

Democrats need to take a page out of Huey Long's book when it comes to dealing with corrupt corporations that control the policy process.  Huey took down Standard Oil with a relentless assault on the greed and corruption embodied in that company.  In short, attack, attack, attack.  Call out insurance company CEO's by name as being greedy, selfish, etc.  Obviously this strategy is problematic given the Dems reliance on insurance company money.  But they should be able to find new sources of money now that they are in the majority in Congress.    

This is an easy argument that every American understands - healthcare is expensive because insurance companies are greedy.  It also happens to be true.  By all means do not get bogged down in policy details as Stoller urges.  

by Calikid 2007-01-01 11:26AM | 0 recs
UHC is a legislative D-Day

Organizationally speaking, that is.

It's probably, in context, the most difficult-to-pass Federal legislation ever attempted (if it is!).

Leave aside the substantive complexities of such a bill: the bull point was mentioned upthread - the lack of perceived crisis.

There is no equivalent of the Great Depression, with Hoovervilles of patients dying in the mud; no medical equivalent of Bull Connor committing mayhem in front of the news cameras of the nation.

There's no equivalent of Pearl Harbor.

With healthcare, it's a case of our old friend, the boiling frog.

My impression: to the extent that the lefty sphere has interested itself in the issue lately, there's been a fair amount of recounting the iniquities of the system (no shortage there!) and drutherful contemplation of single payer, and very little thought given to the magnitude of the task, and the means necessary to attempt it.

For instance, the need for goodly numbers of first class staff to be assigned to the job in the Congress and WH (in priority to other policy areas), the cash needed for paid media to counter the insurance onslaught, the management time of senior and leadership Dems in the Congress and the WH. Not to mention a Dem prez in office for whom UHC is his overriding domestic priority.

Our putative Dem prez (let's suppose, elected in an 08 trifecta), in his (or her?) first session, will have the immense task of pushing through a budget to deal with the mountain of crap bequeathed by Bush (unified government? think of Clinton's first budget!); he'll also know he has to closed the deal on UHC before his capital has been dissipated on other matters.

And who knows what distractions will turn up meanwhile?

The null hypothesis - that no such effort happens - is looking a pretty sure-fire winner right now.

I'd be delighted to see any work modelling the practicalities of such a venture which comes to a more positive conclusion.

Just so long as it's druther-free.

by skeptic06 2007-01-01 11:30AM | 0 recs
Brilliant Post, Matt

Maybe you could follow up by taking a look at Obama's semi-defense of the status quo. I understand he's telling us we would put millions of insurance company workers out on the street.

I don't mean to bash Obama here.  I'd like to see him get his position in line with reality ASAP.  I want that for all Dems.

by Paul Rosenberg 2007-01-01 11:49AM | 0 recs
Re: Brilliant Post, Matt

That's a good idea, Paul.  Do you have a link to his statements on that?

by Matt Stoller 2007-01-01 01:21PM | 0 recs
In Sirota's Interview With Him


Obama has a remarkable ability to convince you that his positions are motivated purely by principles, not tactical considerations. This skill is so subtle and impressive, it resembles Luke Skywalker's mastery of the Force. It's a powerful tool for a Democratic Party that often emanates calculation rather than conviction. "I don't think in ideological terms. I never have," Obama said, continuing on the healthcare theme. "Everybody who supports single-payer healthcare says, `Look at all this money we would be saving from insurance and paperwork.' That represents 1 million, 2 million, 3 million jobs of people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?"
Obama: Public waste, bad. Private waste good.

What a leader!

by Paul Rosenberg 2007-01-01 03:08PM | 0 recs
Re: In Sirota's Interview With Him

I agree.  That's a bogus reason.

Besides, some of those people could become Medicare staff.  Other jobs will emerge as Americans spent their money for better value.

Obama is right that there will be some dislocation but that's the price of any progress.

by Hellmut 2007-01-01 06:10PM | 0 recs
Universal Health Designed by Psychotics

The problem with the Clinton healthcare program was it was designed by Ira Magaziner who has a history of making complex, unworkable master plans that no one can understand.  For some reason his stupidities appeal to people in power, sort of like the neocons had all the answers.  It was a sitting duck.  

What was and is needed is a simple plan, which by its nature will not be perfect, but which will be workable and serve 90% of the need.

by Eli Rabett 2007-01-01 12:21PM | 0 recs
Re: Universal Health Designed by Psychotics

Well said.  What Matt doesn't understand is that the Clinton folk, especially Ira, created this plan in a vacuum without talking with anyone from key players on Capitol Hill to the medical community to many in business who were desparate to get costs under control.  What you ended up with was a plan that only a management consultant could like and anyone who has dealt with management consultants understands what I mean.  No one liked the plan and it was way too complicated.

I have recommended this book numerous times in the past but if you want to really understand the mistakes of the Clinton health effort, read the System by Haynes Johnson and David Broder.  You don't have to like the authors but they nailed the disaster that the Clinton health reform program became and I say this as someone who was and still is a true believer in universal coverage and left government as a living in part due to the disaster 1993-94 health reform became.

I believe that a single payer system is the best way to provide universal coverage but I don't believe we will ever succeed in getting it in the US.  I am jaded from my health reform experience.  Maybe I'll be proven wrong.

by John Mills 2007-01-01 05:42PM | 0 recs
Re: Universal Health Designed by Psychotics

One other thing.  We are likely to have a stalemate on health issues until Bush leaves office which is unfortunate as we really need to do something in this area.

by John Mills 2007-01-01 05:47PM | 0 recs
Re: Universal Health Designed by Psychotics

Oh I know that the Clinton plan was crap.  But the politics is why it didn't happen.

by Matt Stoller 2007-01-02 04:04AM | 0 recs
Re: Universal Health Designed by Psychotics

It was both policy and politics.  The plan was mediocre and complicated public policy created in a vacuum combined with the tin ear politics/arrogance of Ira Magaziner.  While the insurers did finance the Harry and Louise ads, that alone did not kill it and wouldn't have if there hadn't been a larger coalition including NFIB, Chamber of Commerce, major pharmaceutical companies, American Medical Association, and most hospitals.  It became a perfect storm with the supporters of the plan being lukewarm to it at best.  If we are ever to enact universal coverage, we must learn from these mistakes when we take the next crack at it.

by John Mills 2007-01-02 05:19AM | 0 recs
Re: Universal Health Care Run by Psychotics

Thanks, Matt.  The only way we can fix this mess is to require our elected government officials to actually govern.

by USAagain 2007-01-01 12:32PM | 0 recs
Obama proposal for universal health care.

Obama actually sponsored a plan while in Illinois legislature.  Interesting to look at the plan Obama sponsored in comparison to similar plan put forward by Kitzhaber in Oregon.

Kitzhaber Archimedes Movement

"Maybe you could follow up by taking a look at Obama's semi-defense of the status quo."

Whoops you didn't provide a link to what you characterize as Obama's "defense of the status quo".

Here's a real link to Obama's actual Illinois universal health care plan.  Very "progressive" dontcha think?

House Bill 2268 would create a bipartisan Health Care Reform Commission (HCRC) to oversee the gathering of comments from the public and recommendations for a universal-access health care plan."I don't think this issue is going to go away," said Senator Barack Obama (D-Chicago), the senate bill's chief sponsor.

The bill was agnostic about what tools might be used to achieve universal care," Obama said. "The commission would determine how to do it. We could adopt a Canadian single-payer option. Or we could adopt a plan like [Congressman Richard] Gephardt's, a mix of expanding Medicaid and providing tax credits to employers. Or it could be something else."

"I understand he's telling us we would put millions of insurance company workers out on the street."

Whoops...no quote or link again. Is "I understand" the MyDD version of Fox's "People are saying" line when they want get around the facts? Gets a bit tiresome.

"I don't mean to bash Obama here."

But you'll do it anyway.

Far more productive (does require a bit of work though) would be to look at the universal health   care bill Obama sponsored in Illinois.

That might provide a bit more devilish detail, more than Edwards or Hillary have provided to date.

by BrionLutz 2007-01-01 02:35PM | 0 recs
Re: Obama proposal for universal health care.

If you'd actually bothered to look down the page, you would have seen a link. Don't get huffy just because your horse is the one being criticised.

However, it doesn't seem clear to me that Obama opposes reform of healthcare because it'll cost insurance company jobs, so much as he's saying that that's something that might need to be accounted for. Which is not to say that his statement was anything but a triumph of appalling framing.

by Englishlefty 2007-01-02 07:47AM | 0 recs
Re: Universal Health Care Run by Psychotics

LexisNexis search (newspapers, transcripts and magazines all available dates) for obama and exact phrase "insurance company workers" turns up nothing.

Not following Brion either. A bill to gather comments from the public is not a plan. Obama's quote commits to nothing.

by johnalive 2007-01-01 03:12PM | 0 recs
Re: Universal Health Care Run by Psychotics

"Obama's quote commits to nothing."

The House/Senate bill for which Obama was the Senate sponsor would have committed Illinois to having a universal health care proposal to the public by 2007.

The exact final form was to be determined (same with Kitzhaber's plan in Oregon) but the bill committed to definite benefit (universal health care) in a definite time period (2007).

by BrionLutz 2007-01-01 06:27PM | 0 recs
Re: META: How good an article do you think this i

System already exists, users can rate this discussion with tools provided but, like any self rating system, it's essentially meaningless. Just like online "polls" you see on MSN etc. They aren't real polls are not much use for anything other than entertainment value.

A more interesting number would be the actual stat of how many people read (page viewed) the story and how many responded to it.

Those are at least real numbers. Some of the blog software uses those technologies to give some measure of a discussion's weight.

by BrionLutz 2007-01-01 06:24PM | 0 recs
Re: Universal Health Care Run by Psychotics

Universal health care is the key to American success in the 21st Century. Not only will it focus our attention back onto ourselves as a nation and a people, it will help reorganize and revitalize our society and our economy.

This will be the fight of the century. I'm all in!

by jmderosa 2007-01-01 06:35PM | 0 recs
Re: Universal Health Care Run by Psychotics

It isn't wrong to disdain these people


by eRobin 2007-01-02 04:53AM | 0 recs
Re: META: How good an article do you think this i

"Besides the simple rating system within a blog, there are sites like digg where people can rate an article based on its popularity."

Uh...isn't that a bit of a tautology?  If it's popular (measured by pages views?) how could users rate it again?

"However, popularity isn't a good measure of quality."

But quality is so subjective as to be meaningless in this case.  What you call quality others might not plus most people would rate it to be of high "quality" if they agreed with it vs. if it was well written, sourced etc.

by BrionLutz 2007-01-02 10:14PM | 0 recs
by jgalagger 2007-06-26 07:56AM | 0 recs
Re: Universal Health Care Run by Psychotics

We will never have universal healthcare in the states. In order for it to be financially feasible, there has to be a formulary for what is covered and what is not. There has to be a cost benefit analysis that ultimately devolves into what is the value of a human life. meba

by Traviolla 2007-10-07 12:23PM | 0 recs


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