is the relentless drive to marginalize us, not only by conservatives
but also by members of our own party.
Case in point: the accounting arm of Congress, the Congressional Budget
Office, has yet to perform a financial analysis of the cost of
implementing single payer, a system whereby taxpayers-businesses and
individuals--pay into a single general fund which covers everyone's
health care for the rest of their lives, regardless of job or health
status. Studies in California and Colorado have shown that a single
payer system would save money for businesses, families, and government
by eliminating private insurance overhead and creating enormous
purchasing power that would drive down the costs of care.
I wanted to know why we don't have federal government cost projections
for single payer, so I called the Congressional Budget Office - and
reached an answering machine.
Two days later, Melissa Merson, the Communications Director with the
CBO, called me back and left a polite message, explaining that the CBO
takes its orders from Congress, specifically the leadership, (House
Speaker and Senate Majority Leader), as well as the chairs of various
committees:
Health, Education, and Labor (S-Ted Kennedy, D. Massachusetts)
Budget (H-John Spratt, D. South Carolina; S-Kent Conrad, D. North
Dakota) Appropriations (H-David Obey, D. Wisconsin; S-Daniel Inouye, D. Hawaii) Ways and Means (H-Charles Rangel, D. New York)
Energy and Commerce (H-Waxman, D. Los Angeles)
"We are fully aware there are members of the public who would like us to provide a cost estimate of single-payer," said Merson, "but we are inundated with requests from committees of jurisdiction. The priorities are set for us by the Congress."
Now, single-payer activists, rallying behind Progressive Democrats of
America and the California Nurses Association, are demanding the
congressional leadership request a CBO analysis of single-payer. Not
projecting the costs is another way to marginalize the growing
single-payer movement.
On the other hand, we do know the cost projections for the current
proposal, the Affordable Choices Act, a hybrid concoction of private
insurance and the so-called "public option" which funnels billions into
private for-profit insurance companies. In a June 15th letter to
Senator Kennedy, the primary sponsor of this legislative effort,
Douglas Elmendorf, the Director of the Congressional Budget Office,
estimated the proposal would result in a trillion-dollar federal deficit over a ten year period. And that amount could only be offset by increased taxes, payment penalties for the uninsured, and cuts in Medicaid-hardly the way toward health care for all.
Instead of taxpayer money paying for actual health care under the
public option, most of it, according to the CBO letter, would pay
insurance companies to pay for health care. To make matters worse, this
subsidy to the insurance industry requires dramatic cuts in Medicare, a
program that should be expanded, not curtailed.
But here's the real kicker. At the end of the decade, in 2019, under a
private insurance/public option proposal, 36,000,000 Americans, as
opposed to the current 45,000,000, would still be uninsured, according
to the CBO. Because the draft legislation includes an "individual
responsibility" clause, anyone who couldn't afford to pay for coverage
could face steep fines. Much like mandated drivers' insurance, this
system would be a boon to private insurers reaping the benefits of the
new law requiring everyone to get health coverage.
On top of that there would be more marginalization. Cancer patients who
couldn't get private insurance coverage on their own would be pushed
onto the public rolls, thereby saddling taxpayers with having to subsidize insurance policies for the seriously ill. In time, the public option, weighed down by this tax burden and unable to fully exercise20bulk purchasing power, would collapse amidst a fierycongressional storm over the cost of the public option, thus legitimizing arguments that publicly-funded health care is a failed idea.
Which begs the question, why is the health insurance industry pushing
back if the public option would be such a bonanza? Is it because the
insurance industry is scared of the unknown or is it because the industry would prefer to narrow the debate to two choices: the public option or business as usual? I would argue the industry's biggest fear is a frank and open discussion about the merits of single payer - a system that would put health insurers out of business. Hence, the insurance industry, in Academy-award winning style, paints the public option as the false boogie man and bores in for the kill - the death of anything public.
HCAN (Health Care for America Now) television commercials pitching the
public option urge Americans to embrace this hybrid solution--a
moderate, reasoned approach--because others "would like the government
to take over health care." We know who those marginalized "others" are
- the single payer advocates who can tell a snow job when they see one.
For those hoping the "public option" will be a vehicle for getting
single payer, Health and Human Services Secretary Kathleen Sebelius
recently set us straight.
From National Public Radio:
"Asked if the administration's program will be drafted specifically to prevent it from evolving into a single-payer plan, Sebelius says, "I think that's very much the caseand again if you want anybody to convince people of that, talk to thesingle-payer proponents who are furious that the single-payer idea isnot part of the discussion."Fox News, the Republican Party, and the insurance industry charge thepublic option is an attempt to "socialize" health care.
Please.
Last time I checked we had publicly funded the fire department, police
department, national parks, libraries, universities and the highways of
America. Though the government pays the bills for these services, fire
departments are still free to purchase equipment made by private
vendors; libraries purchase books from for-profit publishing houses.
The same would be true under a single-payer system, which though funded
by taxpayers would allow for individual choice: choose any doctor,
hospital, lab, or clinic you wish. Ironically, a free market approach
in the delivery of health care.
So, let us not adopt the Republican Party's talking points to
marginalize the oracles; instead, we must marginalize those who make a
killing off of health care.
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