During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is a good time to look at just what kind of seats special interest groups will have at Obama’s table and what they’re doing to bring the public around to their ways of thinking. This is the eighth of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.
Single-payer advocates are definitely not at the table, and health care reform is getting nasty. This week, Sen. Max Baucus, whose Finance Committee holds the keys to health care reform, called the Capitol police to eject single-payer advocates from his roundtable discussion. The advocates were protesting their exclusion from the committee’s witness list. The event was one of several discussions the Senator has been holding to let stakeholders talk about which route reform should take.
The fifteen witnesses read like a Who’s Who of health reform bigwigs—representatives from the Business Roundtable, the Heritage Foundation, the National Federation of Independent Business, Families USA, AARP, America’s Health Insurance Plans, the U.S. Chamber of Commerce, the New America Foundation, the National Association of Insurance Commissioners, Blue Cross and Blue Shield Association, the SEIU, the National Governors Association, and a law professor from George Washington University. The Kaiser Family Foundation got two spots on the witness list. It’s fair to say that this cast of characters has been seen many times before—at committee hearings and in the backrooms of the Capitol, where the deal-making has begun.
Single-payer reps have been marginalized since the beginning of this round of reform, and they’re mad about it. At first, the President did not invite them to his summit. Only when they threatened a protest in front of the White House did they get a last-minute invite. Tuesday they got their chance to protest, and eight single-payer supporters stood up, one by one, to say their piece. “We need to have single payer at the table,” one said. As they stood, police removed them from the room.
“It made me physically ill to see Maryland pediatrician Margaret Flowers cuffed like a criminal and pushed out the door as the Senators waited to begin their staged roundtable discussion,” wrote Donna Smith of the California Nurses Association on the Web site of the Physicians for a National Health Program. Smith observed that not one senator defended the protestors, or asked that they be given a chance to speak.
A YouTube video showed Baucus trying to maintain order, calling the protestors’ comments inappropriate and urging others not to stand up. Finally, the chairman said that he “deeply, deeply respects the views of members of the audience.” He added that single-payer is an option supported by many, and that people in Montana also share that position. He also said there were other approaches he respected, and he was trying to determine “the best option.”
The protest didn’t get much MSM pick up—the AP moved a short story on its wires, reporting that “when one protestor shouted ‘we want a seat at the table,’ Baucus responded ‘We want police.’” But the news traveled quickly on the Internet.
If the pols aren’t keen on seating single-payer folks at the table, neither are some of the Third Way health care reformists named on the Finance Committee’s witness list—those who favor a pragmatic, centrist position that neither qualifies as single-payer nor the conventional Republican nostrums of tax credits and personal responsibility.
This has long been evident to us at CJR and to Newsday columnist Saul Friedman, who for months has been questioning the single-payer embargo. A prominent health care blogger wrote to CJR, saying that single-payer should be excluded from the discussion because “single-payer advocates don’t understand (or don’t want to understand) the economics of health care.”
“I think we should avoid giving single-payer too much ink,” she said. “Single-payer won’t happen—not now. Their refusal to accept that fact is muddying the waters.”
- 1
- 2
The silliest part of this is using censorship to attempt to kill a stupid idea. If they really wanted to kill single payer, all they need to do is publicise how single payer works in Canada. As in, abysmally.
#1 Posted by s. keeling, CJR on Fri 8 May 2009 at 07:12 PM
In response to s. keeling's remark about Canada's humane and equitable health care system, I share a blog post I submitted to a web site dealing with women's issues recently. it's a unisex message:
After my preferred candidates narrowly lost the election in 2000 and 2004, I decided to become more politically active at the grassroots level. I had been visiting my aging mother in Canada, and I was impressed with the ease of navigating the health care system there. My mother and other relatives (some with serious illnesses) received timely, innovative and high quality care. No worrisome bill ever arrived. There were no distressing arguments with insurers. Young mothers knew their children would be treated without undergoing the humiliating interrogation about ability to pay. Persons in same sex relationships did not have to beg for coverage for a partner. A low-income relative was housed free-of-charge at the Daffodil Lodge during her radiation treatments for breast cancer. The municipal government was not going broke because of the cost of insuring their employees.
Under Canada's Medicare-for-all system, everyone is covered in one giant pool--sharing risk and costs. Taxes are levied according to income, but there are no premiums, no deductibles, no co-pays. And Canadians pay 1/3 less than we do for presecription drugs.
I decided to get active in my home state. I have heard the most heartwrenching stories, but I have met wonderful people who share my mission, and are working for change. I now give presentations on the economic and social benefits of a national universal nonprofit single payer health care system.
I invite CJR readers to become active in their own communities--or with the national group Healthcare-NOW.org
As for S. Keeling, some research at the pnhp.org web site might be in order. See peer-reviewed articles from eminent scholars and Nobel prizewinning economits. There's a reason all other free-market democracies have opted for one-payer, publicly-funded plans--They've done the math!
(Louisville, KY)
#2 Posted by H. Seiler, CJR on Sun 10 May 2009 at 03:05 PM
I have worked both in a national health, single payer system (U.K) and in the US (a for profit system) and I will say that I am amazed at the 38% Of Americans who still dont support Single Payer Universal health care.
What are you waiting for!.
As American Physicians we have lost everything that the for profit or fee for service system gave us over the single payer model. Physicinas have lost autonomy, patient loyalty and are steeped in beuraucracy with myriad health insurance companies.
As for people like S Keeling you and the rest of us have lost the front place in healthiness in general, a JAMA study in 2007 showed that in the 45 to 65 age group, compared to Europeans (nearly all in not for profit national Health care systems) live longer and enjoy healthier lives. The AHDI (American Human Development Index, developed in The US) rates Americans as no 15 in health with most Western European nations ahead of us. Europeans are generally now taller than Americans, live longer, and have less gaps between people economically classed as rich vs poor, These are all from published studies. So what gives except that the suits wont let us be heard.
#3 Posted by Dr Wilbur larch, CJR on Mon 11 May 2009 at 09:21 PM
@Dr. Larch, most Americans have fallen under the spell of marketing spin from insurers, healthcare providers and lobbyists. The mantra is typically that a premium cost implies premium care and further that the government is incapable of operating an efficient and effective healthcare operation (despite the long and well-regarded tenure of Medicare/Medicaid).
It's already quite clear that Congress is unwilling to overhaul a broken system with the highest per capita *cost* of any country in the world with nearly 15% of our GDP going toward healthcare.
#4 Posted by Xavier, CJR on Mon 11 May 2009 at 09:45 PM
Um, Trudy won't discuss this, but I will. Americans pay more for health care because they demand more services and are willing to pay for more sophisticated technology. Malcolm Gladwell once cited a case in his own experience which would have been an open-and-shut case of medical malpractice in the U.S., but which was tolerated in Canada, when he almost lost an eye. In the world I live in, there are trade-offs, but for single-payer advocates, it's all beer and skittles. I don't have to have undergone brainwashing by some of the above writers' plastic villain (the motive, as usual, is the supposed great intentions of leftist politics rather than actual outcomes) to know that the countries often cited as examples for the U.S. happen to get most of their innovations in medical technology and miracle pharmaceuticals from the barbaric American capitalists. Nobody asks why the Canadians, not an unintelligent population of people, do not have their own research and development sector in these areas; instead, that issue is chastely avoided in favor of an idealized view of how the Canadians pay for those U.S.-generated medications. People die on queue waiting for treatments in state-controlled medical systems, too. In France, 15,000 older folks dropped dead during the 2003 heat wave, as I recall, because French dirigiste doesn't do capitalist gadgets like air conditioning very well. I'm sure if those folks had gotten to hospital, things would have been better. But medical systems are not separable from larger cultural issues of how people live; give me a population of Swedes, and I'll give you Swedish-level health statistics no matter how the system is financed.
If I write with some frustration, it is because, as I say, in the real world there are trade-offs, and advocates of putting medical systems under more direct political control (as if we don't have the examples of Medicare cost-controlling and VA system maintenance quality as cautionary examples) refuse to acknowledge any down side to their policy proposals. We have 'universal, free' public schooling, too. Anyone want to argue for the glories of that system?
#5 Posted by Mark Richard, CJR on Thu 14 May 2009 at 03:31 PM
Um--I simply have to respond to Mark Richard's post. He says "Americans pay more for health care because they demand more services and are willing to pay for more sophisticated technology." Americans are now passing 20 to 30 cents of every health care dollar to the administrative costs of the unnecessary insurance companies (CEO salaries, marketing, lobbying, paperwork, denial deciders, rescission reseachers, legal defense teams, and shareholder profits). Moreover, they add to the billing costs in physician offices and hospitals.
In every country, there are anecdotal stories about an incompetent surgeon, or a physician who missed a diagnosis, but overall, the French and Canadians get timely and quality care.
The French deaths during the heat wave had to do with elderly people left in unair-conditioned appartments (as you said). It had nothing to do with their health care system.
In Canada, there is no wait for urgent treatment. One queues up according to medical urgency. In the US, we queue up according to ability to pay. I trust Mr. Richard is at the head of the line. An estimated 20,000 Americans (age 19-64) die each year because they lack insurance. They never make it into the queue. By the way, that's six times the death toll of 9/11 per year!
I'll check the source of the drug research being done in this country. The last I heard, much of it was being done in our universities--and would Mr. Richard admit that such research is going on in Canadian and French universities as well?
I fear I can't convince Mr. Richard, but perhaps an open-minded reader will go to pnhp.org and do some research.
By the way, the last time I heard Malcolm Gladwell interviewed, he said we could learn a lot from the Canadians.
#6 Posted by H. Seiler, CJR on Sat 16 May 2009 at 12:15 PM
JOHN SUTER
P.O. Box 670144
Chugiak, AK 99567
(907) 688-3103
suter@gci.net
5-22-09
Dear Senator Lisa Murkowski
I would ask that you introduced the number “1” proven medical model in the world, the Taiwan medical model as a bill to congress. If you have any up grades that you can put into it, to make it better than the number one standing that it has now in the world, then that would be even better for America. But, you could use it as a base to proceed with for a bill. Every one knows by now that congress is going to put in national health care. What I am concerned with is that congress will put in a medical model that is an inferior medical model that does not provide A-1 health care and reduce America’s health care cost like the Taiwan medical model does. That means we will be paying more and getting less when we could have had the Taiwan medical model and we would be getting more A-1 medical care that would cost %55 less than what America pays now for heath care.
What I am saying is, beat them at their own game and you put in the best medical model and let them run for second place or less. I bet that there would be a lot of national press on your bill being the best congress has put forward compared to what every one else has put forth. In this manner you have a shot at stopping congress from putting in a bad bill. Your good bill can and should over ride their bad bill will do the trick. Don’t let us be stuck with bad health care when we could have the number one health care medical model in the world.
Thank you for your prompt and courteous attention.
Sincerely, John Suter
#7 Posted by John Suter, CJR on Mon 25 May 2009 at 05:32 PM