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Two Key Health-Care Numbers

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Many rank-and-file Democrats are already rankled over the refusal of the Obama administration and the Democratic-controlled Congress to even consider a government-run single-payer program along the lines of what most Western industrialized nations offer. To those Democrats, a vibrant public option has become a minimum requirement for any health reform bill.

However, the fear of the insurance industry and parts of the medical establishment, such as the American Medical Association, is that so many Americans are so dissatisfied with how they've been treated by insurers and hospitals that they would flee to almost any public plan, voting with their pocketbooks and their health in a way that might lead to a de facto single-payer system eventually.

Stopping the Defectors

As Grassley--the top Republican on the Senate Finance Committee--noted in his column, "As many as 119 million Americans would shift from private coverage to the government plan,"- putting "America on the path toward a completely government-run health care system. "- Eventually, the government plan would overtake the entire market."

While many Americans might say private industry brought that prospect on itself with its high-handed treatment of so many patients when they are most in need--when they are beset with serious illnesses--Grassley and other industry defenders see the solution as simply to exclude the public option.

Yet, as these industry defenders in Congress would strip out the public option, they appear to favor including a government mandate that would compel Americans--under some penalty of law==to obtain private insurance coverage either individually or through their employers (with the help of government subsidies if necessary).



That, of course, would be the ideal course for the industry, killing the public option--thus keeping the 119 million potential defectors --and forcing another 50 million Americans to sign up whether they want to or not. A win-win.

Rarely has a political debate more starkly highlighted the philosophical question of whether in a democracy, the government should represent the people's interests or an industry's.

It goes without saying that many members of Congress--both Republican and Democrat--have accepted hefty campaign contributions from the medical industry.

For instance, since 2005, Grassley's various political action committees have collected nearly $1.3 million in donations from the industries related to the health insurance debate, according to OpenSecrets.org. Grassley's top four donor groups were Health ($411,956); Insurance ($307,348); Pharmaceuticals ($233,850); and Hospitals ($197,137). Eighth on Grassley's donor list were HMOs at $130,684.

In hitting the road on behalf of his health-reform initiative, President Obama is counting on the enthusiasm--and desperation--of many Americans to serve as a counterweight to the influence of industry lobbyists in Washington, who want to get the 50 million but don't want to lose the 119 million.

The big question now is: how far will Obama and the Democrats go in demanding that the final legislation have in it what tens of millions of Americans want--a public option and a chance to escape the clutches of the private medical insurance industry--when that same powerful industry is deathly afraid of just that possibility.

Robert Parry broke many of the Iran-Contra stories in the 1980s for the Associated Press and Newsweek. His latest book, Neck Deep: The Disastrous Presidency of George W. Bush, was written with two of his sons, Sam and Nat, and can be ordered at neckdeepbook.com. His two previous books, Secrecy & Privilege: The Rise of the Bush Dynasty from Watergate to Iraq and Lost History: Contras, Cocaine, the Press & 'Project Truth' are also available there. Or go to Amazon.com.

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Robert Parry broke many of the Iran-Contra stories in the 1980s for the Associated Press and Newsweek. His latest book, Secrecy & Privilege: Rise of the Bush Dynasty from Watergate to Iraq, can be ordered at more...)
 

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