This is the introduction on the official Barack Obama website, to the Democratic candidate's summary of his healthcare initiative. What does it tell us about the way the debate about healthcare reform is moving in this country? Are Americans being offered two extremes? Is either of these two views necessarily wrong?
We certainly have knowledge of the second of these two propositions. The health insurance industry is one of the most powerful special interest groups in the country. Every year they spend tens of millions of dollars to lobby lawmakers to maintain the status quo in our healthcare system. In the past, they have been tremendously successful at scuttling any significant reforms. In comparison to the rest of the industrialized world, it can be said that they operate without rules.
The list of criticisms of this status quo is extensive and damning. Forty-two percent of adults in this country are either uninsured or underinsured. We rank at or near the bottom of every measure of health among industrialized nations. The price of healthcare rises at about 10% a year, doubling every seven and a half years. We spend 16% of our GDP on health costs, generally twice as much as other developed nations. Eighteen thousand people die every year because of the lack of health insurance. Fifty to a hundred thousand die each year because of medical errors. Yet, $2.1 trillion is wasted each year on unnecessary tests, treatments, hospitalizations, over-priced drugs, or end of life care with no discernable purpose.
This is certainly one extreme. But what of the other extreme? Have we, too, often been offered government-run health care with higher taxes? Probably not that you've heard much about. In fact, something similar to this idea has been offered in a bill before Congress by Representative John Conyers of Michigan--though it hasn't received much attention from the mainstream media. It's called HR 676 and it has the backing of 91 members of the House including former presidential candidate Dennis Kucinich and current candidates Ralph Nader and Cynthia McKinney. It can be characterized as an expanded Medicare for all. The delivery of health care would remain under the private control of doctors, hospitals and other professionals, but the financing of that healthcare would be paid by a single government-run insurance fund, or single-payer.
It is also a direct confrontation of the entrenched power of the health insurance industry. By putting the function of these private entities into public hands, it would create significant savings in a system where at present nearly a third of each healthcare dollar goes to administrative costs, advertising, promotions, lobbying, CEO salaries and profits. By comparison traditional Medicare spends about 3% on administrative costs. The savings of a single payer system would be more than $350 billion annually.
Barack Obama and Joe Biden believe that this is wrong.
Here's where the confusion comes in. The promotional group that is pushing for HR 676, Conyers' single-payer plan, is called Healthcare Now. This might ring a bell in some people's minds but maybe not for the reasons that it should. Healthcare Now has been around since 2004. They have limited funds which they have received from individuals, unions and faith-based organizations and they are up against the multi-million dollar annual lobbying budget of the healthcare industry.
Over this past summer, a new group has emerged with half a million dollars in seed money, an impressive list of backers and plenty of press that is pushing a very different plan. They have called themselves Health Care for America Now. So far HCAN, as it is known for short, has not returned repeated phone calls to explain who is funding them and why they decided on a name that was bound to cloud the truth about their intentions. Thousands, if not millions, of people have now jumped on board the highly visible HCAN campaign, confusing it with Healthcare Now, believing that it is an effort to bring about a single payer system.
Instead of advocating a specific solution for healthcare reform, such as HR 676, HCAN is pushing for a general policy goal--"quality, affordable health care we all can count on." It would appear, from its backers in the mainstream of the Democratic Party, that its purpose is to lay the groundwork for Barack Obama's push for healthcare reform early in his administration. What, then, is this middle way and how does it affect the progressive agenda on health care?
The Obama plan has many laudable goals and there is no reason to think that there would be a lack of sincerity in its implementation. It would offer a tax credit for individuals to pay for health insurance as well as one for small businesses. Government would relieve business of part of the burden of catastrophic health costs. Health coverage would continue to be at the discretion of employers but there would be a tax on companies that did not offer it. There would be a National Health Insurance Exchange that would offer different plans and encourage competition. All plans would be required to cover pre-existing conditions.