Category Archives: Health Care

Bought and Sold

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From Derrick Jackson’s column in today’s Boston Globe:

The hold of the healthcare industry on the top candidates is already apparent. According to the Center for Responsive Politics, the top recipient of campaign contributions so far from the pharmaceutical and health products industry is Republican Mitt Romney ($228,260). But the next two are Democrats Barack Obama ($161,124) and Hillary Clinton ($146,000). The top recipient of contributions from health professionals is Clinton ($990,611). Romney is second at $806,837, and Obama third at $748,637.

The top recipient of cash from the insurance industry, which includes health insurers, is another Democrat, Connecticut’s Christopher Dodd, at $605,950. Romney and Republican Rudolph Giuliani are second and third, with Clinton and Obama fourth and fifth. Even though Obama is in fifth place, he still has collected $269,750 from insurance companies.

In a category that is relatively small in money thus far, but huge in terms of healthcare morality, Democratic presidential candidates occupy four of the top six spots in receiving money from death-dealing tobacco companies. After Giuliani’s $69,500 from tobacco companies, Dodd has received $45,400, Clinton $32,300, Romney $31,400, Obama $7,885, and Democrat Joe Biden, $4,000.

No surprise:

The top recipient from lobbyists by far is Clinton at $406,300. She is still so badly smoldering from the torching of her healthcare efforts as first lady that she recently asserted to the National Association of Black Journalists, “I have never advocated socialized medicine. That has been a right-wing attack on me for 15 years.”

One of the several reasons I don’t want Senator Clinton to be the nominee is that she is in a uniquely weak position to work for real healthcare reform.

Jackson’s column focuses on Dennis Kucinich, who is the only candidate advocating a universal, single-payer, not-for-profit healthcare system. And, of course, Kucinich will not be the nominee. John Edwards, who has a shot at the ticket and who has proposed a healthcare plan I don’t like, at least doesn’t seem to be in the health insurance industry’s pocket.

See also this editorial in today’s New York Times.

Send CARE Packages

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Via Kevin Drum — L.J. Williamson writes in the Los Angeles Times says the local school districts have to make a choice:

The Los Angeles Unified School District receives about $2.85 a child a day from the state and federal governments to provide breakfast and lunch to students. Of that amount, according to the nonprofit group California Food Policy Advocates, or CFPA, about $2 must be spent on milk, supplies, salaries and benefits, leaving about 85 cents for the food on your child’s Styrofoam tray. Given this paltry budget, it seems astounding that our children are fed at all, yet L.A. Unified’s food service manages to serve nearly half a million meals each school day, and it does so within or exceeding U.S. Agriculture Department nutrition guidelines.

If this feat seems miraculous — and I defy anyone else to make an even moderately healthy meal for that amount — try doing it with even less.

That’s the kind of loaves-and-fishes territory that the food service might soon find itself in if the school board passes an initiative today expanding healthcare for cafeteria workers.

Part-time food service employees are seeking the same health benefits — including coverage for their families — that their full-time counterparts enjoy. Extending these benefits to cafeteria staff who currently work only three hours a day would cost an estimated $40 million a year, according to school board calculations.

Nowhere in the private sector do three-hour-a-day employees expect to be eligible for full family benefits; nowhere but in the surreal world of L.A. Unified would anyone have the nerve to ask for them.

Williamson concludes that the school districts should just say no to the cafeteria workers. But as Kevin, Ezra, and Melissa gently suggest, perhaps Williamson is not seeing the bigger picture.

Here we are, the Richest Nation in the World, and children in a major city are being fed a breakfast and lunch for $2.85 a day (what do those children eat, I wonder? Stuff rejected by the dog food factory?), and the cafeteria workers don’t have health benefits. And all this motherbleeper concludes is that the cafeteria workers have some nerve.

Exactly what is wrong with us?

Notice, Ezra says, “that every single time a group of individuals seeks health coverage, they’re forced into direct warfare with their immediate colleagues, place of employment, etc. So in this case, cafeteria workers who need coverage are set in opposition to children who need food.” The notion that we ought to be doing better than this for both the children and the cafeteria workers doesn’t even flicker through Williamson’s head.

To paraphrase the Ronald Reagan quote in the last post, someday we will tell our children and our children’s children what it once was like when America wasn’t a third-world shithole.

“We Are All Uninsured Now”

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Laurence J. Kotlikoff writes in the Boston Globe:

BIG NUMBERS, like 45 million uninsured Americans, are hard to grasp. But that number came home to me at a recent conference. The keynote speaker was former Supreme Court justice Sandra Day O’Connor. Her topic was our healthcare system, and her message was personal and anguished.

The gist was that even she lives in constant fear of major uninsured health bills. Not her own — those of her son. He can’t afford insurance because his son — her grandchild — has a preexisting condition.

As I listened, a light dawned: O’Connor and the rest of us with health coverage are also uninsured. We too face terrible, albeit more remote, healthcare risks — the risk that our employer will drop our plan, that Medicare will go bust, that our plan won’t cover our needs, that premiums will eat us alive, that our doctor will stop taking our insurance, that long-term care will wipe us out, and that our uninsured friends and family members will need major financial help.

These risks are entirely avoidable. We can have an efficient, transparent system that includes everyone; treats everyone fairly; covers all the basics, including prescription drugs, home healthcare, and nursing home care; and costs little more than what we now spend. But we can’t get there via the piecemeal reforms that President Bush, most of his would-be successors, and our state governors are advocating.

To clarify, state governors are not necessarily “advocating” piecemeal state-by-state solutions. It’s more correct to say that the states are stepping into the leadership void and crafting whatever solutions they can. Currently on the Right, “let the states do it” is a favorite health care talking point. On the other hand, righties love to point to the failures of several state programs to argue that the same programs would fail at the national level, also.

As Ezra Klein explains here in detail, “providing health care for all citizens is one of those tasks, like national defense, that the states are simply unequipped to manage on their own.” States cannot tackle the underlying cause of the problem, which is that the private health insurance industry and other moneyed interests are setting the rules and calling the shots. Any solutions the states come up with will be no better than work-arounds.

Kotlikoff writes that we seem to be heading “toward a balkanized healthcare system with the old in Medicare, the poor in Medicaid, most workers in employer plans, and the losers — the otherwise uninsured — in highly subsidized, limited-coverage plans. Loser plans.” But as we’ve seen with the S-chip controversy, right wingers don’t even want to pay for the “loser plans.”

Although he seems to understand the problem, Kotlikoff’s “solution” is for Washington to hand out vouchers that people can use to purchase health insurance. The private health insurance industry and other moneyed interests would still setting the rules and calling the shots. Not a solution, I say.

But his larger point is one politicians, particularly those in Washington, need to wake up to. The health insurance crisis is no longer just a matter of poor people, or the unemployed, being left uninsured. The health insurance crisis has spread to the middle class. If even a former Supreme Court justice is worried, it is spreading to higher-income citizens as well.

Righties are still pretending that people without health insurance are somehow all poor and undeserving. The uninsured are supposed to be content that, at least, if they get really sick, and treatment can no longer be postponed, they can show up at an emergency room and wait most of a day to see a doctor so they can be “stabilized” and sent home. I don’t expect the hard core Right to see the problem until they’re the ones dumped out of the system, leaving them one aneurysm away from death or financial ruin.

According to a recent CNN/Opinion Research Corporation Poll, 64 percent of Americans think government should provide a national health insurance program for all Americans, even if this would require higher taxes, and 73 percent think that government should provide health insurance for all children under the age of 18.

In 1988, Michael Dukakis made health care reform an important part of his platform. Back then, most middle class Americans were still paying only a small deduction from their paychecks for insurance plans that let them see any doctor they wished without worrying about networks. I remember that when George H.W. Bush was asked about healthcare reform, he looked somewhat baffled and said (all together now) “America has the best health care system in the world,” and he didn’t understand why Dukakis wanted to fix something that wasn’t broken. I think, back then, most middle class Americans bought that argument.

And in 1993, when the Clintons brought out their health care plan, the insurance industry’s “Harry and Louise” ads effectively frightened people to stick by the status quo. I had problems with the Clinton’s approach, but it’s interesting to me that the Right still speaks of it as a failure. It didn’t fail, because it was never tried. What is failing is the status quo.

I have thought for years that, some day, we’d reach a tipping point at which enough Americans were personally impacted by the failures and inequities of The Best Health Care System in the World that they would be desperate to change it. I think we’ve reached that tipping point. Even corporations are now calling for reform, although they are still talking about a “market-led” system. They can’t yet see that sticking to a “market-led” system is what brought us to this crisis, and all the “market-led” solutions amount to using tax dollars to keep the “private” health insurance beast alive. People are so invested in “government is not the solution” ideology that they make government the solution for maintaining a failed “private” system.

And even the states, the “laboratories” of new policy, are hamstrung by right-wing ideology. In today’s Los Angeles Times, the speaker of the California Assembly, Fabian Nuñez, describes the fight within the Golden State:

In the next 15 to 18 days before the Legislature adjourns, the narrow window of opportunity we have to achieve healthcare reform in California — reform that expands access for those who don’t have health coverage and keeps costs down for those who do — will start to close. If history is a guide, we can expect an anything-goes campaign in the next few weeks to delay, derail and demonize healthcare reform. We need to focus on some basic truths to keep that campaign from succeeding.

First, for nearly 10 months now, the reform proposals I put forward with Senate President Pro Tem Don Perata have been vetted in the legislative process, fiscally analyzed by academics and scrutinized by the media. Yet you can count on opponents saying, “We’re moving too fast; let’s slow down.” Practically speaking, what they are really trying to do is kill any reform — delay means death to controversial big-issue legislation. Given more time, the forces against healthcare reform will find ways to take more potshots at the proposals. We don’t need a special session of the Legislature later this year. We don’t need to punt to the 2008 election year.

After a discussion of various proposals, he continues,

Those who want to see more complete coverage also will object to our plan because they’d rather see a single-payer system — in which a government-run entity contracts with doctors and hospitals and handles all claims.

I embrace the idea; it is a noble goal and may one day prove to be the ultimate answer. It’s overwhelmingly supported by legislative Democrats and has growing support from Californians. But in 2007, a single-payer plan would be vetoed by the Republican governor just as he did the version the Legislature sent him in 2006. Sacrificing the good for the perfect doesn’t make sense in the world of public policy.

That’s the tune we’re all singing. Most Americans know what the solution to our problem is. What’s standing in the way is the Right. And the Right has so dominated politics in recent years that even progressive politicians are inhibited from bringing the the solution they really want to the table. Instead, they patch together something less comprehensive and less workable and hope it won’t be completely eviscerated by the Right before it comes to a vote.

And then, when the state program fails, the Right will point to it and say, see? Government doesn’t work.

Regarding S-chip, Bob Herbert writes in today’s New York Times:

The program is popular because it works. It’s cost effective and there is wide bipartisan support for its expansion. But President Bush, locked in an ideological straitjacket, is adamant in his opposition.

In addition to the new rules drastically curtailing the ability of governors to expand local coverage by obtaining waivers from the federal government, the president has threatened a veto of Congressional efforts to fund a more robust version of the overall program.

“It’s stunning,” said New York’s Gov. Eliot Spitzer. “He says he’s going to veto health care for kids because it’s too expensive at the same time that these continuing resolutions for the war, where we don’t even know what the cost is, are going through unabated. This is insanity.

“Everybody agrees this is the right thing to do except the Bush administration.”

States want to expand S-chip to middle class children not to undermine health insurance industry profits, but because more and more middle-class children are uninsured.

Wherever there are large numbers of families without coverage, you will find children who are suffering needlessly and, in extreme cases, dying. They don’t get the preventive care or the attention to chronic illness that they should.

“That has not only an immediate effect on their development,” said Mr. Spitzer, “but a long-term cost to society that is incalculable.” …

… Administration officials have argued that the CHIP program should adhere closely to its original intent of limiting coverage to families only slightly above the official poverty line. They said there is a danger that families with higher incomes would begin substituting CHIP for private insurance coverage.

The reality is that under the administration’s approach enormous numbers of children in families without a lot of money will be left with no coverage at all, private or otherwise. The expansion of CHIP is the most efficient, cost-effective way of reaching those youngsters.

And here we come to the plain truth:

What’s happening is cruel. Children who should be eligible for CHIP are being held hostage to policies driven by a desire to protect the big insurance companies and an ideology that views CHIP, correctly, as yet another important step on the road to universal health care.

Ronald Reagan, one of the tribunes in the fight against Medicare and Medicaid back in the ’60s, pumped up the warnings against “socialized medicine” by saying that if Medicare becomes a reality “you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”

I wonder what crazy things the ideologues think would happen if CHIP is expanded to cover the children who have no health insurance today.

The whole bleeping nation is being held hostage by right-wing insanity. When’s it going to stop?

Why Is the Right Afraid of Universal Health Care?

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Today’s Paul Krugman column connects the S-chip controversy and public school education, and wonders why one is bad but the other acceptable.

The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care. It’s just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children’s medical bills “welfare,” with all the negative connotations that go with that term.

And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.

Here’s what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that. For example, N. Gregory Mankiw, the former chairman of the Bush Council of Economic Advisers, contrasts the position of liberals, who he says believe in equality of outcomes, with that of conservatives, who he says believe that the goal of policy should be “to give everyone the same shot and not be surprised or concerned when outcomes differ wildly.”

But a child who doesn’t receive adequate health care, like a child who doesn’t receive an adequate education, doesn’t have the same shot – he or she doesn’t have the same chances in life as children who get both these things.

Actually, much of the Right wants to dismantle public education also — for our own good, of course. But let’s stick to health care.

Krugman may have a point about a “historical accident.” People are comfortable with the familiar, “the way we’ve always one things.” It’s like the “reefer madness” phenomenon. Liquor is legal and marijuana is not, even though liquor is the more dangerous of the two substances — people do become physiologically addicted to alcohol, and it is possible to die of an overdose of alcohol, which is not true of marijuana. But we’re used to liquor, so it’s OK. And we’re used to universal public school education, but not universal health care for children (or the rest of us), so the first is acceptable but the second is scary.

This blogger argues for the status quo:

Where in the Constitution does it say that every one has the right to health care?

Where in the Constitution does it say that every one has the right to an education? Or the right to call the fire department if your house catches fire? What’s the big bleeping deal with allowing We, the People, to use the federal government to solve national problems that aren’t being solved any other way? Isn’t that what bleeping government is for?

Besides, I bet you most people think that everyone should have access to affordable health care, but that is not the same as making it the responsibility of the federal government to provide it.

Well, yes, and if the U.S. health care system were providing at least basic health care to everyone who needs it, at an affordable cost, then we wouldn’t have a “health care crisis,” would we?

Certain conservatives may, for instance, think that it is unconstitutional to get the government (too much) involved or they may think that private companies can deal with the problem… or (shocker to people like Krugman who seem to believe that States in the US are not much different that provinces in the Netherlands) that States could and should deal with it.

Certain conservatives think that universal health care is unconstitutional, but that suspending habeas corpus or warrantless surveillance of U.S. citizens isn’t. This is why I don’t give a bleep about what certain conservatives think.

And states are not going to come up with anything but band-aid solutions; Ezra Klein explains why.

The blogger continues,

This issue is not between conservatives who do not want children to have a health care insurance on the one hand, and progressives who do want that on the other, it is about what solutions / plans actually work and the power of the federal government. Krugman, then, does not approach this subject from the perspective of someone who tries to bring people together to join forces on an issue, he approaches this subject from the perspective of a partisan liberal.

Krugman has written a ton of columns about possible solutions to the health care crisis. Here’s just one of them. But today’s column was not about solutions. This column is about why we haven’t been able to have a sensible national discussion about these solutions, much less put any of these solutions into practice.

Part of the reason is that politicians — and I’m not just talking about Republicans — are in the pockets of the health insurance industry. But the larger reason is that the American Right is in deep denial about the true dimensions of the crisis and what it will take to correct it. In fact, I have yet to see a substantive discussion about health care in mass media. What I’ve seen by way of “discussion” are right-wingers screeching about waiting lines in Canada. Thus, the United States remains the only industrialized democracy on the planet without universal health care for its citizens, and the only thing most Americans know about health care in other countries is that there are waiting lines in Canada.

Are there any conservatives out there who say that children should, quite simply, never see a doctor? Of course not. This is not what the debate is about.

I’m sorry, but that is what the debate is about. Children are being denied medical care. This is really happening. It is not imaginary. It does those children no good to say that, in principle, we’re fine with all children seeing a doctor. We’re just not going to do anything to make it possible.

I write about health care a lot, and I’ve written several posts that look at various solutions. And I don’t much care which party or which politician comes up with a workable solution. In fact, so far none of the Democratic presidential candidates has come up with a plan that I’m all that excited about.

But the Right is coming up with nothing. Less than nothing. For example, I’m certain that Health Savings Accounts would make the problem worse, for reasons Kevin Drum explains. As he says, “solutions” coming from the Right don’t even rise to the level of band-aids; they’re more of a papering-over.

If by some miracle someone comes up with a workable plan that does not involve a federal program, I’d be thrilled. I am not advocating or a federal solution just for the sake of a federal solution. I’m advocating for a federal solution because I haven’t seen any other plans that would come even close to solving the problem.

The first step in finding a solution is understanding the problem. I see no indication that anyone on the Right has made that step.

We’re back to “lead, follow, or get out of the way.” On health care, the Right won’t lead, they won’t follow, and they won’t get out of the way. They just obstruct and deny.

Taking Care of Our Own

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As you know, the Bush Administration has moved boldly to protect the insurance industry from the State Children’s Health Insurance Program, or “S-chip.” The Bushies have attached tough new strings to the program to prevent states from expanding coverage to children of middle-income families. Many of these strings are designed to prevent families already covered by private insurance from dropping it and moving to the subsidized programs.

However, most of the middle-income children the Administration wants to keep out of the program are not covered by private insurance, either.

This Associated Press story from Texas explains the problem:

… The Houston teaching assistant’s 18-year-old twins were bumped in May from the state Children’s Health Insurance Program, known as CHIP in Texas. The overtime she worked pushed the household income above the program’s limit. The boys relied for six years on the program, which covers kids to age 19.

The Pacheco twins are among thousands of children whose families’ incomes are too high to qualify for CHIP but still can’t afford private insurance. While some in Texas are hoping to raise the limits to allow more coverage, President Bush and some in Congress want to keep the income ceilings intact.

This week, the administration directed states to make children wait a year before enrolling in the program, a guideline aimed at preventing families from dropping private insurance to enroll in CHIP.

About half of the estimated 1.4 million uninsured children in Texas don’t qualify for CHIP. Some are undocumented, some have pre-existing conditions that keep them from getting private coverage, and others are like the Pachecos whose incomes prevent them from enrolling in CHIP.

Children’s advocates in Texas had hoped that one day the state would raise the income limits, which in the state is 200 percent of poverty level, or $41,300 for a family of four.

“The largest growth of uninsured has been in the middle class,” said Barbara Best, executive director of Texas Children’s Defense Fund. “Families earning $50,000 to $60,000 a year can’t afford private health insurance. Why can’t they benefit through the system as well?“

In 2005, the average cost of life insurance in Texas was was $9,100 per family, about $760 a month. I assume it’s higher now.

Officials also said states can’t enroll children in families who earn more than the CHIP income limit until 95 percent of children who qualify for CHIP or Medicaid are enrolled in those programs.

Last year, 41,523 children covered by CHIP left because their family income exceeded CHIP income limits, according to the Texas Health and Human Services Department.

A department study found 1 percent of the 2003 average monthly new enrollees, 21,295 kids, had dropped private insurance to get CHIP coverage.

But, that 1 percent is taking bread out of the mouths of health insurance executives. BTW, via a quickie google search I learned that health insurance profits are booming.

The dwindling number of Americans still covered by employee-subsidized health care are sheltered from the realities of health insurance cost. Texas is one of the states without those nasty “regulations” righties sneer at that prevent health insurance companies from refusing to cover sick people, yet it also has the highest percentage of uninsured citizens — 27.1 percent — of any state. The high percentage of uninsured has an unfortunate impact on Texas.

Regarding S-chip, this op ed from today’s Orange County Register expresses the Bushie POV:

A Bush administration policy that would make it less easy for states to expand a children’s health insurance program well beyond the low-income children it was designed to cover has been greeted with outrage.

The most logical explanation is that some legislators really want the government to “crowd out” private insurance as a prelude to replacing it with an all-inclusive government program that covers everybody. …

… The government has already allowed states to offer the program to families above the official poverty level of $20,650 for a family of four. Most states now offer it to those at double that level, or $41,300 a year. Some states are at 250 percent ($51,625), and New York wants to offer it to families at quadruple the poverty level, up to $82,600.

At such levels, however, a subsidized government program starts to look better to people who already have private health insurance. Thus the “free” (i.e., taxpayer-paid) insurance starts to “crowd out” private insurance.

The Bush administration would make states that want to offer the program to families at more than 200 percent of the poverty level wait until 95 percent of those at or below the 200 percent figure are covered before they expand it.

That has states eager to expand a program — with “free” federal money — howling on behalf of “the children.” Enough already.

Spoken like a man who’s never had to buy private insurance for a child with a pre-existing condition. Attempt to buy, I should say.

See also: “Stiff-Arming Children’s Health“

Big Government Will Save Us From Big Government

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Nothing the Bush Administration does surprises me any more, including this:

The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.

Of course they did this. What else did you expect? “Big government” is bad, so big government must reach out to save the states from falling into the error of big government.

David Sirota highlights two points of the Bush Administration’s argument:

The first is this passage:

    “If a state wants to set its income limit above 250 percent of the poverty level ($51,625 for a family of four), Mr. Smith said, ‘the state must establish a minimum of a one-year period of uninsurance for individuals’ before they can receive public coverage.”

So basically, the pro-devolution and pro-“states rights” Republican Party is now on record saying that if a state legislature wants to extend coverage to a family of four making over $51,625, the legislature must insist that the family go without health insurance for a year. Wonderful.

The other nugget is this:

    “In his letter, Mr. Smith said the new standards would apply to states that previously received federal approval to cover children with family incomes exceeding 250 percent of the poverty level. Such states should amend their state plans to meet federal expectations within 12 months, or the Bush administration ‘may pursue corrective action,’ Mr. Smith said.

This is threatening, deliberately intimidating Big Brother-style language. The federal government “may pursue corrective action?” Against who? In states that expand their CHIP programs, are federal agents going to swarm in and revoke publicly subsidized health insurance from working-class families and force those families to retroactively pay back the aid they received? Is that “corrective action?” If not, what is? I’m not even joking around here – these are very legitimate questions that we have to ask.

The most legitimate question that we have to ask, seems to me, is why is there government? In particular, what is representative, republican government good for? Do people really elect representatives to Congress so that their needs can be ignored in favor of special interests? Is the Constitution really all about limiting the power of people to establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity? If that’s really what government is all about, then I’d be tempted to throw in with the libertarians and do away with most of it.

However, I don’t think that is what government is all about. Call me a hopeless romantic or a loony liberal, but I still hold up government of the people, by the people, and for the people as the ideal.

What exactly do people reasonably expect from their government? Franklin Roosevelt explained,

The basic things expected by our people of their political and economic systems are simple. They are:

Equality of opportunity for youth and for others.

Jobs for those who can work.

Security for those who need it.

The ending of special privilege for the few.

The preservation of civil liberties for all.

The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.

He was talking about “political and economic systems,” which may or may not mean government. He isn’t saying that government and government alone should provide those things, in other words. If private enterprise is providing “jobs for those who can work,” that’s fine. But if private enterprise is sending too many jobs overseas, what then? Does government have any role in seeing to it that enterprises incorporated in the United States are not using slave labor in the third world or importing toys covered in lead paint?

In fact, Kevin Hall of McClatchy Newspapers reports that

The Bush administration and China have both undermined efforts to tighten rules designed to ensure that lead paint isn’t used in toys, bibs, jewelry and other children’s products.

To which one might rightfully say, WTF?

The Bush administration has hindered regulation on two fronts, consumer advocates say. It stalled efforts to press for greater inspections of imported children’s products, and it altered the focus of the Consumer Product Safety Commission (CPSC), moving it from aggressive protection of consumers to a more manufacturer-friendly approach.

“The overall philosophy is regulations are bad and they are too large a cost for industry, and the market will take care of it,” said Rick Melberth, director of regulatory policy at OMBWatch, a government watchdog group formed in 1983. “That’s been the philosophy of the Bush administration.”

I’m sure all of America’s mothers and fathers who vote send their elected representatives to Congress to protect the profits of manufacturers over the lives of their children.

But let’s go back to what Roosevelt said back in 1941 about “The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.” I would say “the fruits of scientific progress” include health care. One of the reasons health care is so expensive now is that science has opened many doors to new treatments that didn’t exist in 1941. So much of the high-priced stuff, like open heart surgery, chemotherapy, and MRIs, hadn’t yet been accomplished or invented in 1941.

So how will our political and economic systems provide these benefits of scientific progress to all citizens who need them? If private enterprise would do it, I’d be happy, but I think it’s apparent that private enterprise either cannot or will not do it, else it would be done already.

Essentially, the position of the Right is that it’s just wrong for government to use tax dollars to pay for citizens’ health care. I’m going to set aside why it’s wrong for the moment. Let’s just pretend, for arguments’ sake, that it is. Health care “solutions” coming from the Right these days mostly amount to using government programs to prop up the existing “private” system. Apparently government involvement in health care is OK as long as the involvement is indirect and the profit motive is not entirely eliminated.

Arguments against universal, taxpayer-paid health care coming from the Right vary. This one argues a single payer plan is not the same thing as risk pooling —

I think it’s a little misleading to talk about insurance pooling here. This isn’t really insurance we’re arguing about; insurance is voluntary. Single payer advocates are looking for the most politically palatable way to tax the young and healthy in order to pay for the health care of the old and sick.

And don’t you dare think of taxing the old to pay for children’s health care, either. This is not fair. It is not fair for healthy people to have to pay for the health care of sick people. (Exactly how this is different from risk pooling eludes me, unless the author thinks that healthy people never, ever turn into sick people.)

As for insurance being “voluntary” — the fact is that huge numbers of people in this country who want insurance cannot have it, either because insurance companies refuse to cover them or that insurance simply costs more than they can afford to pay. For many, health insurance isn’t something one can or cannot “volunteer” to have. It’s becoming more like a lottery, as Jane Bryant Quinn wrote last year:

America’s health-care “system” looks more like a lottery every year. The winners: the healthy and well insured, with good corporate coverage or Medicare. When they’re ill, they get—as the cliche goes—”the best health care in the world.” The losers: those who rely on shrinking public insurance, such as Medicaid (nearly 45 million of us), or go uninsured (46 million and rising).

To slip from the winners’ circle into the losers’ ranks is a cultural, emotional and financial shock. You discover a world of patchy, minimal health care that feels almost Third World. The uninsured get less primary or preventive care, find it hard to see cardiologists, surgeons and other specialists (waiting times can run up to a year), receive treatment in emergencies, but are more apt to die from chronic or other illnesses than people who pay. That’s your lot if you lose your corporate job and can’t afford a health policy of your own.

As I understand it, one of the reasons my ancestors (with some other folks, of course) fought the Revolution and established a republic was to allow ordinary folks to have a bigger say in their own lives and in their own government. But the Right seems to think this is not so. While it’s acceptable for corporations to get special favors and sweetheart deals from government, if ordinary citizens ask their representatives to make it possible for their children to receive good health care, the Right gets all worked up into a froth about it.

Others on the Right are complaining that the expansion of the Children’s Health Insurance Program would extend welfare benefits to middle-class families. But as Quinn writes, the shock of losing health insurance is rapidly becoming a middle class problem. Insurance has become so expensive — if you have to pay for it privately, you’ll probably find it costs a lot more than your mortgage — that even middle income families lose health insurance if they lose their benefits.

It is true that, as Gene Sperling explains here, some of the children who would be brought into the program already are covered by private health insurance.

But the White House well knows that every coverage-expansion plan — conservative or progressive — benefits some people who already have insurance.

In fact, the proposed S-CHIP expansions are highly efficient compared with the White House’s proposals. About 77 percent of the benefits of Bush’s plan to expand health savings accounts and 80 percent of his most recent proposal to subsidize purchases of premiums go to those who are already insured.

MIT economist Jonathan Gruber wrote to House Energy and Commerce Committee Chairman John Dingell, explaining that the House S-CHIP expansion was among the “most cost-effective means of expanding health insurance coverage.”

And as the Center on Budget and Policy Priorities points out, the disappointing rhetoric and name-calling about government-run health care is just a ruse. Seventy-four percent of children covered by Medicaid and more than three-quarters of children covered by S-CHIP are enrolled in private managed-care plans. And virtually all states contract with private providers to deliver health-care services. …

… This is the administration that was willing to finance a half-trillion-dollar prescription-drug benefit completely with borrowing and deficit spending. It is off the chutzpah charts for the White House to cry fiscal responsibility in regard to S-CHIP-expansion bills when the Democrat-controlled Congress is paying for its entire proposal with spending cuts and tobacco revenue.

What is most inexcusable about the White House stance is what they don’t say. They offer nothing — no better idea, no alternative, no plan — that has been shown to keep even a chunk of these 5 million to 6 million children from going to sleep every night without health insurance.

They are content to keep the status quo even with heartbreaking reports that uninsured infants with congenital heart problems are 10 times more likely to die because of delayed treatment than those with coverage.

I’ve got this crazy idea that when our “economic systems” are withholding fruits of scientific progress, especially fruits that might save the lives of our children, government is a tool that We, the People, may use to remedy the situation. But the Right says no; the Right says We, the People, have nothing to say about what government will or will not do for us. It’s up to government to decide what it will do for whom. Thus, we’ve got big government saving us from big government.

This Is a Test

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Paul Krugman:

… All of which raises the question Mr. Moore asks at the beginning of “Sicko”: who are we?

“We have always known that heedless self-interest was bad morals; we know now that it is bad economics.” So declared F.D.R. in 1937, in words that apply perfectly to health care today. This isn’t one of those cases where we face painful tradeoffs — here, doing the right thing is also cost-efficient. Universal health care would save thousands of American lives each year, while actually saving money.

So this is a test. The only things standing in the way of universal health care are the fear-mongering and influence-buying of interest groups. If we can’t overcome those forces here, there’s not much hope for America’s future.

See also “Sicko: Commenting on Commentaries.”

See Sicko Again

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Gateway Pundit writes,

Yahoo defines “Sicko” as a documentary in the Politics/Religion genre. Truly, the socialism pushed in the movie is nothing short of a religion to many.

First, one of the things I hope to bring out in the ongoing Wisdom of Doubt series is to establish that religion is something other than “fanatical belief in things that demonstrably are not true.” But let’s put that aside for now. The real fantasy is, of course, that the United States has The Best Health Care in the World. It does not. It does not by any empirical measure. The only way one could possibly still believe that the United States has The Best Health Care in the World is if one is utterly ignorant of the health care systems here and abroad.

I’ve said this before, but I’ll repeat it. There’s an old joke that a “conservative” is a liberal who got mugged. The new joke is that a “liberal” is a conservative who lost his health insurance.

A brainwashed twit named Sheila commented to the last post, saying that

First of all, 4 out of 5 Americans are satisfied with the health care system, so it is really a non-issue (this will likely be the reason the movie flops).

Take a look at the latest polls on health care at pollingreport.com. It’s very encouraging. A CNN/Opinion Research Corporation Poll of May 4-6, 2007, asked the question “Do you think the government should provide a national health insurance program for all Americans, even if this would require higher taxes?” 64 percent said yes; 35 percent said no. Interestingly, a smaller percentage of people in the same poll said yes to “Do you think all employers, including small businesses which employ few workers, should be required to provide health insurance to every employee, or don’t you think so?” Here the spread was 56 percent yes to 43 percent no. I think people are starting to catch on that the cost of employee health insurance is terribly burdensome to business, large and small. Well, except to the health insurance industry, of course.

Anyway, Gateway Pundit’s post is fairly typical of the “Best Health Care in the World” genre. It consists mostly of photographs of filth and cockroaches alleged to have been taken in Cuban hospitals and not at Walter Reed. And they may very well have been taken in Cuban hospitals; I wouldn’t know. But then there’s France, whose health care system is generally considered to be the crème de la crème of health care systems on the planet. And Canada. and Britain. And about 30 other nations with nationalized health care and better life expectancy and lower infant mortality rates than ours.

But after reading Gateway Pundit’s post I decided that I’d like to amend something I wrote in the last post, which is:

But most of the bad reviews I’ve read amount to sputtering defenses of the status quo and personal attacks on Michael Moore. What the critics never ever do is honestly address the problem of people who can’t get insurance, or our crumbling emergency rooms, or our dismal health data. They just make excuses.

To “sputtering defenses of the status quo and personal attacks on Michael Moore” I’d like to add “photographs of roaches in Cuban hospitals” and, of course, the old stand by: waiting lines in Canada. Still, not a peep about the problem of people who can’t get insurance, or our crumbling emergency rooms, or our dismal health data.

See also: “Bush to Uninsured Kids: Drop Dead” and The Mahablog health care archives.