Taibbi then breaks down the five steps Congress took to be sure no bill would pass -- aiming low, gutting the public option, packing it with loopholes, providing no leadership and blowing the math. In a series of video interviews at RollingStone.com, Taibbi tells how the Democrats (and some progressive groups) sold out their constituents in exchange for financial contributions from the relevant industries. He also explains how the biggest flaw in the American health care system is that almost a third of its costs are associated with administration and paperwork. Further, he examines the easiest way to eliminate this red tape and explains how the Democrats wound up on the defensive -- then alleges that Obama struck a sideline deal with the pharmaceutical industry to use a $150 million advertising budget to back "Obamacare" (rather than oppose it) -- provided he lets go of the "public option" that so many Americans are counting on, thereby selling these good folks (including all his campaign workers) down the river. Finally, Taibbi looks inside the "individual mandate" that would force people to buy crappy insurance policies and how the bill might make conditions worse than before.
America has not only the worst but the dumbest health care system in the developed world. It's become a leprosy eating away at the American experiment -- a bureaucracy so insipid and mean and illogical that even our darkest criminal minds wouldn't be equal to dreaming it up on purpose.
The truth is that the existing health care system doesn't work for the vast majority of us. It cheats patients and leaves them to die, denies insurance to 47 million Americans, forces hospitals to spend billions haggling over claims, and systematically bleeds and harasses doctors with the specter of catastrophic litigation. Even as a mechanism for delivering bonuses to insurance-company fat cats, it's often a miserable failure: Greedy insurance bosses who spent a generation denying preventive care to patients now see their profits sapped by millions of customers who enter the system only when they're sick with incurably expensive illnesses.
The cost of all of this to society, in illness and death and lost productivity and a soaring federal deficit and plain old anxiety and anger, is incalculable -- and that's the good news. The bad news is our failed health care system won't get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.
Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.
We have an urgent national emergency on the one hand, and on the other, a comfortable majority of ostensibly simpatico Democrats who were elected by an angry population, in large part, specifically to reform health care. When they all sat down in Washington to tackle the problem, it amounted to a referendum on whether or not we actually have a functioning government.
Programmed for failure
Before Congress recessed in August, four of the five committees working to reform health care had produced draft bills. However, the only committee that didn't finish a bill is the one that's likely to matter most: the Senate Finance Committee, chaired by the infamous obfuscating Max Baucus, a right-leaning Democrat from Montana who has received $2,880,631 in campaign contributions from the health care industry.
The game in health care reform has mostly come down to whether or not the final bill that is hammered out from the work of these five committees will contain a public option -- i.e., an option for citizens to buy into a government-run health care plan. Because the plan wouldn't have any profit motive -- and wouldn't have to waste money on executive bonuses and corporate marketing -- it would automatically cost less than private insurance. Once such a public plan is on the market, it would also drive down prices offered by for-profit insurers -- a move essential to offset the added cost of covering millions of uninsured Americans. Without a public option, any effort at health care reform will be as meaningful as a manicure for a gunshot victim
So whether or not there will be a public option in the end will likely come down to Baucus, one of the biggest whores for insurance-company money in the history of the United States. The early indications are, not surprisingly, that there is no public option in the Baucus version; the chairman hinted he favors the creation of nonprofit insurance cooperatives, a lame-ass alternative that even a total hack like Sen. Chuck Schumer has called a "fig leaf." (A more accurate term would be "sham.")
This setup senselessly submarines the committee's Democratic majority, effectively preventing members who advocate a public option, like Jay Rockefeller of West Virginia and Robert Menendez of New Jersey, from seriously influencing the bill. Getting movement on a public option -- or any other meaningful reform -- will now require the support of one of the three Republicans in the group: Grassley (who has received $2,034,000 from the health sector), Snowe ($756,000) or Enzi ($627,000).
STEP ONE: AIM LOW
Heading into the health care debate, there was only ever one genuinely 'dangerous' idea out there, and that was a single-payer system. Used by every single developed country outside the United States (with the partial exceptions of Holland and Switzerland, which offer limited and highly regulated private-insurance options), single-payer allows doctors and hospitals to bill and be reimbursed by a single government entity. In America, the system would eliminate private insurance, while allowing doctors to continue operating privately.
In the real world, nothing except a single-payer system makes any sense. There are currently more than 1,300 private insurers in this country, forcing doctors to fill out different forms and follow different reimbursement procedures for each and every one. This drowns medical facilities in idiotic paperwork and jacks up prices: Nearly a third of all health care costs in America are associated with wasteful administration. Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system -- more than enough to pay for the whole thing, if anyone had the courage to stand up and say so.