Since the beginning of the presidential campaign, I have found scant coverage of how real people would fare under the kind of reform envisioned by the health-care cognoscenti. In fairness, until June there was no bill to measure. But we have known enough about what was coming that it should have prompted some reporting along these lines. What will happen, for instance, to the owner of a South Bronx taco restaurant who finds he must pay thousands of dollars for insurance or face severe penalties for not being insured? Or to the factory worker who must pay taxes on her health insurance, just as her employer makes her pay more for fewer benefits?
In the fall of 1993, I wrote in CJR: “So far, neither the press nor the Clintons have built a consensus among the people who have to use whatever system Washington rebuilds.” The same is true today. Neither Obama nor the press have built a consensus for reform. It’s hard to assemble one when the public doesn’t know what reform actually means. An engineering doctoral student from the University of California at Berkeley and a Manhattan hairdresser recently asked me the same question: What is single-payer? And last spring, my journalism students at CUNY asked people on the streets of New York what they knew about the differences between a public-plan option and private insurance. “I didn’t know there is a difference,” one said. Another added: “Public, everybody knows about it; private, nobody does.”
President Obama says he wants a bill by October, so the press still has a chance to help the rest of us make sense of these crucial policy decisions. But they will have to do it quickly. It really is Groundhog Day for health-care reform.
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.
#1 Posted by darrel armstrong, CJR 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.
#2 Posted by edward ericson jr., CJR 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.
#3 Posted by drsteveb, CJR 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.
#4 Posted by drsteveb, CJR 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.
#5 Posted by SAMUEL W VELSOR IV, CJR 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.
#6 Posted by Lisa Sheikh, CJR on Thu 23 Jul 2009 at 02:16 PM