Last fall, soon after Barack Obama was elected president, Sheila Burke was waiting to discuss Obama’s campaign promises, via Webcast, with students specializing in health reporting at the City University of New York’s Graduate School of Journalism. Burke, a health-policy expert who now teaches at Harvard’s Kennedy School, laid a spreadsheet on the table and whispered to another guest. “See,” she said, “we had all these provisions before,” and ticked off the similarities between the current effort to pass health-care reform and those in the past. Burke declined to show me the document, saying that it was proprietary and belonged to former Senator George Mitchell, the Senate majority leader during the Clinton-era reform effort.
But whether Mitchell, Burke (who was Senator Bob Dole’s chief of staff during the 1993 debate), or any of the other health-care heavies from the old days want the déjà vu reality of reform, circa 2009, made public, it has become dismayingly clear that that is exactly what is happening, despite abundant rhetoric to the contrary. “The idea that we’ve made a great breakthrough just isn’t so,” says Jonathan Oberlander, a health-policy expert at the University of North Carolina. “Most of the plans today are direct descendants of what was proposed for the ’93-’94 debate. The debate reminds me of one of my favorite movies, Groundhog Day.
With few exceptions, like the fine series last summer by NPR that explained how a number of other countries handle health care, the press has done little to challenge this reality or help to broaden the health-care debate. Rather, it has mostly passed along the pronouncements of politicians and the major stakeholders who have the most to lose from wholesale reform. By not challenging the status quo, the press has so far foreclosed a vibrant discussion of...
Complete access to this article will soon be available for purchase. Subscribers will be able to access this article, and the rest of CJR’s magazine archive, for free. Select articles from the last 6 months will remain free for all visitors to CJR.org.
Trudy, what you have to say is very much to the point, All that is missing is the part of the equation that says "What is happening to those parts of the population that are currently being covered by Medicare and Medicaid, and those who can't afford any health coverage now (and still won't be able with manditory enrollment). The conservatives talk like any national coverage is socialism, but there is little evidence that either private insurance or the present public plans are giving us adequate healthcare. The one solid point that the rightwing has got is that Medicare is a bureaucratic nightmare for the sick, who do not get the care they should anyway. We do need to fix THAT. Better public health coverage already exists within our system. The VA also likes lots of red tape, but it more or less works. The Congressional Plan offers
excellent coverage to the very few at taxpayer expense.
We can do a version of Single Payer that does the same. We have to, if we and those we love are not going to suffer needlessly. We have the Americans with Disabilities Act, not because George senior wasn't getting the rights he needed, but because he had a mother. We need protection for the people, not
guarantees of ever increasing insurance company profits.
Posted by darrel armstrong on Mon 6 Jul 2009 at 07:15 PM
The insurance industry, I think, has a unique exemption to anti-trust law. Pretty sure that exemption allows insurance companies to pool actuarial data while shielding actuarial methods from all outsiders. Does anyone else think that this might have something to do with our world's most expensive health insurance system?
If I'm wrong about this, Trudy, please correct me.
Posted by edward ericson jr. on Mon 6 Jul 2009 at 07:48 PM
Great reporting on the non-reporting as usual. I would just add two items:
1. The power of lobbyist/money/insider culture to both the politics and reporting, per today's WaPo on the millions per day being spent by insurance, pharma, etc, with all the ex-aides who are now lobbyists. Also DePerle, who went from aide, to corporate hack and back to aide. And alas the press who reports on them as if they were sources and not the problem.
2. The Dutch situation is even worse then you mention: they had a more pure public system until recently. They changed (or added) more privatied managed competition because their own right wingers believed ours that this would save them money and increase quality. And now their situation is getting worse. Remember all those articles 1-2 years ago touting the Dutch system. Not so much anymore.
Posted by drsteveb on Mon 6 Jul 2009 at 10:09 PM
links for WaPo's reporting on health "reform" lobbying:
http://www.washingtonpost.com/wp-dyn/content/article/2009/07/05/AR2009070502770.html?hpid=topnews
Ezra not not understanding that money and relationships are the same thing (one buys the other):
http://voices.washingtonpost.com/ezra-klein/2009/07/its_not_the_money_its_the_rela.html
http://www.dailykos.com/storyonly/2009/7/6/750495/-Advocacy-Groups-Shut-Up.-Lobbyists-Have-A-Seat.
Posted by drsteveb on Mon 6 Jul 2009 at 10:20 PM
It is a shame that you made no mention of Mental Health within this superbly excellent article.
Posted by SAMUEL W VELSOR IV on Wed 8 Jul 2009 at 07:41 AM
Great job, Trudy! I worked with you on that TV journalism project back in 1993. As I watched Obama in his prime-time news conference last night, I too was struck by how similar all of this is to '93, and why anyone actually believes the outcome is going to be substantially different this time around. I have been especially astonished that car insurance is being used as the model for an individual mandate. Having worked more recently on auto safety issues, I learned just how many millions of motorists are driving without auto insurance (as many as 50 percent in some communities). This is why when we go to purchase an auto insurance policy, we are offered (and in some states required to buy) uninsured motorist coverage -- to cover ourselves in the event of a crash involving an uninsured motorist. Auto insurance for most drivers is a mere fraction of the cost of health insurance. So if the government can't get people to comply with that mandate, even with subsidies it's unlikely they will get people to comply with a health insurance mandate. Massachusetts was never a good model for what would happen with an individual mandate for health insurance because they already had a much lower rate of uninsured than most of the rest of the nation to begin with. The whole thing is really a disaster -- one that could surely have been avoided if reporters had just done their job.
Posted by Lisa Sheikh on Thu 23 Jul 2009 at 02:16 PM