More critiques of the health care bill acknowledging the good as well as the ugly (several articles)
March 25, 2010 by PaulA cause for celebration?
(Socialist Worker) examines the claims made about the Democrats' health care legislation.
March 24, 2010
LAST SUNDAY night around 10 p.m., I was finishing up the next day's edition of SocialistWorker.org when my e-mail inbox started filling up like a casino slot machine finally paying off.
The subject lines all had the same theme: "Historic legislation..." "Monumental effort..." "Accomplishment on a scale with Social Security..." "Salute this landmark achievement..."
The House had finally voted in favor of health care legislation, passed by the Senate and supported by the White House, and now liberal organizations were celebrating a long-delayed triumph on the issue that dominated the first year of the Obama presidency. Every pro-Democratic and progressive list-serve I'm on came alive.
Barack Obama e-mailed to thank me for my tireless efforts and for not listening to the people who said it couldn't be done. His adviser David Plouffe even invited me to co-sign "this historic legislation." On the BarackObama.com Web site, though--not actually in the East Room of the White House.
The enthusiasm extended beyond elected officials. "The health care reform bill passed by Congress and signed into law today by President Barack Obama is progressive reform at its finest--conceptually farsighted in design and pragmatically far reaching in scope," wrote John Podesta of the liberal Center for American Progress.
Also weighing in were groups and figures who previously had criticized the legislation--people who protested the exclusion of voices advocating single-payer health care from the discussion; who warned that a bill without at least a strong "public option" for the uninsured was a disaster in the making; who opposed the so-called "Cadillac tax" on employer-provided insurance plans with halfway decent coverage.
One surprise came from Michael Moore, director of the excellent documentary Sicko about the health care crisis in the U.S. and a bitter opponent of both Republican smears of reform and Democratic concessions to the health care industry.
Moore's initial statement was couched as an "open letter to Republicans," which allowed him to make fun of the fanatical right-wingers who opposed every proposal for health care reform as a communist plot.
Moore did say that he was "going to get busy trying to improve upon this bill so that all Americans are covered." But mostly, he emphasized all the good the legislation would do. Instead of focusing on the Democrats' concessions, he called on "my Republican friends" to "be happy for your country. We're doing better."
On Wednesday, though, Moore delivered a much tougher assessment of the legislation in an interview with Democracy Now!:
This bill was never about universal health care. It did a couple of good things that could have been done any time, I guess--like ending the pre-existing condition rule for children. It doesn't end it for adults for four years, so you can rack up another 20,000 to 40,000 deaths in the meantime from people who otherwise would have received help had we truly gotten rid of pre-existing conditions for all citizens...
The larger picture here is that the private insurance companies are still the ones in charge. They're still going to call the shots. And if anything, they've just been given another big handout by the government by guaranteeing customers.
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The Democracy Now! Moore got it right. As leading members of Physicians for a National Health Program wrote in a damning indictment of the legislation:
Instead of eliminating the root of the problem--the profit-driven, private health insurance industry--this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money.
The hype surrounding the new health bill is belied by the facts:
-- About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
-- Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income, but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
-- Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it, their ability to block future reform.
-- The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
-- People with employer-based coverage will be locked into their plan's limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
-- Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
-- The much-vaunted insurance regulations--e.g., ending denials on the basis of pre-existing conditions--are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
-- Women's reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.
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IT'S UNDERSTANDABLE why many people would look for reasons to celebrate the passage of health care legislation.
For one thing, the Republicans finally didn't get their way on something in Congress. That's become a rare event, especially on the health care issue, even though the Democrats have the biggest majority for either party in both houses in a generation.
The gathering of tea party fanatics outside the Capitol that spewed racial and anti-gay slurs at Democrats like former civil rights leader John Lewis and openly gay congressman Barney Frank exposed the ugly reason that the right wing opposed the health care legislation: racism and bigotry.
So the Republicans lost. But the problem is that the Democrats won--and in this case, that means the passage of a piece of legislation that will do more harm than good for most people in the U.S.
If you followed the media coverage about health care in the last few days, you've heard one person after another point out that some 30 million people will be covered by health insurance as a result of this law. That sounds like a step forward, but the real question is how much they'll have to pay, and what they'll get for their money. There's nothing to guarantee that the insurance they'll have to obtain will be affordable or adequate.
America's health care crisis isn't limited to the fact that 50 million people have no insurance in the U.S.--as appalling as that is in the richest country in the world. The other side of the crisis is that tens of millions more people are covered by insurance that does them little good if they actually get sick or suffer an injury.
If you saw Michael Moore's Sicko, you'll remember the startling fact about the health care horror stories portrayed in the film: Every one of the victims had insurance, at least when they got sick or injured.
Now, under the law signed by Barack Obama, millions more people will be forced--under the threat of an annual penalty of $750--to buy what PNHP leaders rightly call the "private insurers' defective products."
The legislation does provide for subsidies to help the poor get insurance. But to pay for the subsidies, the legislation requires cuts in spending and benefits in the Medicare program for the elderly--and a new tax on employer-based health insurance plans that provide decent benefits.
The bill will do nothing to reverse the downward pressure on whatever decent health insurance plans people still have today, as employers continue to shift costs to workers. The shoddy policies that insurance companies will peddle to the uninsured will lower the standards for everyone.
In short, while it may take some years to become clear, Obama's "reform" law signals a new era of rationing for health care.
What a twisted outcome to the opportunity that greeted Barack Obama and the Democrats a year ago--massive public sentiment in favor of transforming the dysfunctional health care system.
Another effect that will play out in the years to come is the discrediting of proposals for reform. Just in the past few months, Republicans were able to portray the health care legislation as "big government" run amok by exploiting legitimate disgust with the backroom deals used to bribe Democratic holdouts. Imagine what the GOP will do when ordinary people are forced by the federal government to spend hard-earned money on insurance policies that are worse than useless.
People will continue to hate the insurance company parasites--but they'll also despise even more a political system where the interests of corporations come before everything else.
Even the small steps forward in the health care legislation are mixed--the new regulations on the insurance company practices are outweighed by provisions that give the medical-pharmaceutical-insurance complex more power than ever over the fate of ordinary people.
These facts have to be stated outright. On Democracy Now! Michael Moore said that progressives were "too afraid of going too far. But frankly, if not us, who? If we don't stand up against this, if we don't say this is wrong, if we don't speak out against it--then who's going to do it?"
The need for real health care reform--to remove the drive for profit at the heart of the crisis--will only grow more urgent as the Democrats' legislation takes effect over the coming years. The job of organizing for an alternative will be best served by being clear about Barack Obama's "historic achievement"--it's not a cause for celebration.
Chomsky: Health bill sustains the system’s core ills
by Sahil Kapur (rawstory.com)
espite its flaws, 'I'd hold my nose and vote for' reform, intellectual tells Raw Story
He’s a hero of many progressives, but his enthusiasm for the passage of health care reform legislation this weekend was fairly muted.
In an interview with Raw Story, world-renowned scholar and political critic Noam Chomsky reluctantly called the bill a mildly positive step, but cautioned that it wouldn’t fix the fundamental problems with the nation's troubled system.
"The United States’ health care system is so dysfunctional it has about twice the costs of comparable countries and some of the worst outcomes," Chomsky told Raw Story. "This bill continues with that."
The decades-long critic of corporate power alleged that premiums won't stop rising as the package is designed in no small part to funnel money into the pockets of the health care industry. "The bill gives away a lot to insurance companies and big pharmaceutical corporations," he said.
The legislation forbids government from negotiating prices with pharmaceutical companies or permitting the importation of drugs. Nor does it provide competition to private insurers, an oligopolistic industry that will maintain its impunity from antitrust laws. But despite this, Chomsky, an advocate for a single-payer system, said killing the bill wasn't a better solution.
"If I were in Congress," he said, "I’d probably hold my nose and vote for it, because the alternative of not passing it is worse, bad as this bill is. Unfortunately, that’s the reality."
"If it fails, it wouldn’t put even limited constraints on insurance companies," he explained, noting that the bill "at least has some steps towards barring the withholding of policies from people with prior disabilities." The consumer protections from dodgy insurance practices are among the bill's most popular components.
The mandate to purchase insurance has been a central qualm of progressives and conservatives opposed to the effort. Chomsky, while admitting it’s a boon to insurance companies, called it a "step toward universality," asserting that "without some kind of mandatory coverage, nothing is going to work at all."
The Massachusetts Institute of Technology professor added that it’s a damning referendum on American democracy that one of the most highly supported components of the effort nationally, the public insurance option, was jettisoned. He partly blamed the media for refusing to stress how favorably it’s viewed by the populace.
"It didn't have 'political support,' just the support of the majority of the population," Chomsky quipped, "which apparently is not political support in our dysfunctional democracy."
The provision has consistently polled well, garnering the support of sixty percent of Americans across the nation in a CBS/New York Times poll released in December, days after it was eliminated from the reform package. Democratic leaders deemed it politically untenable.
"There should be headlines explaining why, for decades, what's been called politically impossible is what most of the public has wanted," Chomsky said. "There should be headlines explaining what that means about the political system and the media."
By Street, Paul at Mar 24, 2010 19:35 PM
Statement of NOW President Terry O'Neill
March 21, 2010
As a longtime proponent of health care reform, I truly wish that the National Organization for Women could join in celebrating the historic passage of the Patient Protection and Affordable Care Act. It pains me to have to stand against what many see as a major achievement. But feminist, progressive principles are in direct conflict with many of the compromises built into and tacked onto this legislation.
The health care reform bill passed by Congress today offers a number of good solutions to our nation's critical health care problems, but it also fails in many important respects. After a full year of controversy and compromise, the result is a highly flawed, diminished piece of legislation that continues reliance on a failing, profit-driven private insurance system and rewards those who have been abusive of their customers. With more than 45,000 unnecessary deaths annually and hundreds of thousands of bankruptcies each year due to medical bills, this bill is only a timid first step toward meaningful reform.
Fact: The bill contains a sweeping anti-abortion provision. Contrary to the talking points circulated by congressional leaders, the bill passed today ultimately achieves the same outcome as the infamous Stupak-Pitts Amendment, namely the likely elimination of all private as well as public insurance coverage for abortion. It imposes a bizarre requirement on insurance plan enrollees who buy coverage through the health insurance exchanges to write two monthly checks (one for an abortion care rider and one for all other health care). Even employers will have to write two separate checks for each of their employees requesting the abortion rider.
This burdensome, elaborate system must be eliminated. It is there because the Catholic bishops and extremist abortion rights opponents know that it will result in greatly restricting access to abortion care, currently one of the most common medical procedures for women.
Fact: President Obama made an eleventh-hour agreement to issue an executive order lending the weight of his office to the anti-abortion measures included in the bill. This move was designed to appease a handful of anti-choice Democrats who have held up health care reform in an effort to restrict women's access to abortion. This executive order helps to cement the misconception that the Hyde Amendment is settled law rather than what it really is -- an illegitimate tack-on to an annual must-pass appropriations bill. It also sends the outrageous message that it is acceptable to negotiate health care reform on the backs of women.
Fact: The bill permits age-rating, the practice of imposing higher premiums on older people. This practice has a disproportionate impact on women, whose incomes and savings are lower due to a lifetime of systematic wage discrimination.
Fact: The bill also permits gender-rating, the practice of charging women higher premiums simply because they are women. Some are under the mistaken impression that gender-rating has been prohibited, but that is only true in the individual and small-group markets. Larger group plans (more than 100 employees) sold through the exchanges will be permitted to discriminate against women -- having an especially harmful impact in workplaces where women predominate.
We know why those gender- and age-rating provisions are in the bill: because insurers insisted on them, as they will generate billions of dollars in profits for the companies. Such discriminatory rating must be completely eliminated.
Fact: The bill imposes harsh restrictions on the ability of immigrants to access health care, imposing a 5-year waiting period on permanent, legal residents before they are eligible for assistance such as Medicaid, and prohibiting undocumented workers even to use their own money to purchase health insurance through an exchange. These provisions are counterproductive in terms of controlling health care costs; they are there because of ugly anti-immigrant sentiment, and must be eliminated.
Fact: The bill covers only 32 million of the 47 million uninsured in this country, does not contain a meaningful public option and provides no pathway to a single payer system like Medicare for all. Democratic negotiators crumpled before powerful business interests and right-wing extremists, and until they get a spine there will be no true competition to help rein in costs.
.The bottom line is that everyone -- citizen and non-citizen, undocumented immigrant and visitor -- has a fundamental human right to health care. This right has been denied in the U.S. for far too long, while the rest of the industrialized world moved ahead to assure universal and affordable care for their people.....