Healthcare reform is back in the news, as Legislators and interest groups spar over the promised public component of Obama's healthcare plan. In very simple terms, this is a fight between groups with a vested interest in expensive healthcare and everyone else. This week, the American Medical Association warned Obama that a public plan could restrict patient choice. But for millions of Americans, getting a choice between healthcare and no healthcare wold represent a 100% increase in their healthcare options. Obama's public plan would also give people the choice of keeping their private health insurance. So, the public plan is an additional option, not a diminution of options.
The AMA is a powerful interest group, but it doesn't speak for all physicians. Several prominent groups representing doctors and medical students, including the American Association of Family Physicians, co-signed a declaration supporting Obama's push for a public plan this week.
Expect the health insurance lobby to fight the public option tooth and nail, says economist Dean Baker in AlterNet. It's smart business from their perspective. Platitudes about the free market aside, no real capitalist welcomes competition. As Baker points out, a public plan represents competition to health insurance companies. For every dollar Medicare pays to providers, it spends two cents on administration. Whereas private insurers spend about fifteen cents on the dollar in administrative costs. Baker estimates that if a public plan were available, insurance profits would drop by 20-30%, all things being equal.
Former president Bill Clinton invited about 20 progressive bloggers to his Harlem office on Monday for a seminar-style discussion about the work of the Clinton Foundation. Several staff from Media Consortium member organizations were in attendance, including yours truly. Healthcare was a major topic of conversation. Emily Douglas of RH Reality Check, who also attended the meeting, writes:
"The former President observed that the country, emerging from a "post-9/11 emotional straitjacket" has become "more communitarian" -- and that President Obama has fewer budget issues, and less Republican opposition, to content with when attempting reform. But, most importantly, "everything is worse now" -- health care spending has doubled, more are uninsured, and disposable income, adjusted for inflation, is down."
Clinton said that he's optimistic about the prospects for healthcare reform this year, but he encouraged Obama to drive a hard bargain with congressional Republicans. All things considered, the former president said, it would be better to pass healthcare with 60 votes for the sake of the Obama administration's long-term relations with Congress. The alternative would be to pass healthcare through budget reconciliation, which would require only 51 votes, but which would incur a lot of ill-will among Republicans. However, Clinton cautioned against writing a weak bill to avoid reconciliation. In Clinton's opinion, if we don't contain healthcare costs by moving to outcomes-based medicine and making our healthcare delivery systems more efficient, the system will be unsustainably expensive.
James Ridgeway of Mother Jones has also been mulling the challenge of writing a bill that's acceptable to enough Republicans to avoid a budget reconciliation fight. Ridgeway fears that sweeping structural reform will take a back seat to political expediency. He fears that by trying to please everyone, Obama could end up pleasing no one:
"One disturbing possibility is that health care could become a replay of the credit card legislation. The pattern goes something like this: First, we get a propaganda blitz heralding sweeping changes. But although the final legislation corrects some of the most egregious abuses, it doesn't change the system's underlying flaws. So, for example, insurance companies may be required to cover people with preexisting conditions—a need Obama illustrated vividly in his AMA speech with moving references to his mother's battle with cancer. We might see what the president called "more efficient purchasing of prescription drugs," which presumably means faster approval of generics and giving the government greater power to haggle with Big Pharma over drug costs. We will likely see incentives for health care providers to offer more cost-effective—and, hopefully, better—treatment. These things are not meaningless, and they will provide a modicum of relief to some struggling Americans. But they do virtually nothing to strike at the deeper problems of the for-profit health care system. And they offer only a fraction of the savings that a single-payer system would provide."
If the healthcare debate sounds vague and abstract, that's because it is. There are several competing bills coalescing, but at this point, there's no overall vision for reform. Everything is up for grabs. Never afraid to think big, Sen. Bernie Sanders (I-VT) is circulating a petition for single-payer healthcare, with an assist from Chelsea Green.
Surely the weirdest healthcare story of the week comes from Tracy Clark-Flory of Salon: An anti-choice blogger who claimed to be carrying a non-viable pregnancy to term out of pro-life principle was exposed as a hoaxster when an alert reader identified her "dead baby" as a doll. It's not clear why the 26-year-old social worker perpetrated the hoax. Jessica Valenti of Feministing injects a note of compassion for the perpetrator, "Though as angry as this makes me, I'm with Sadie at Jezebel on this: 'It's tempting of course to use this as a chance to take an easy bash at anti-choice, and revel in anything that makes them look foolish, but frankly, I'm just sad for this woman.' As am I."
By Lindsay Beyerstein, TMC MediaWire Blogger. This post features links to the best independent, progressive reporting about health care.
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