Barack Obama promised to put fixing America's broken health care system at the top of his agenda as president. But supporters of the one solution that could actually work were at the bottom of his White House invitation list.
As Obama's White House health care summit approached on March 5, advocates of a so-called "single-payer" system, under which the government would cover everyone, eliminating the role of private insurers, were stunned to learn they weren't invited. It was an insult to organizations that have been warning for years about the health care crisis-in-the-making and putting forward the single-payer alterative — Physicians for a National Health Program (PNHP), the California Nurses Association (CNA) and Healthcare-NOW!
Rep. John Conyers, the sponsor of a bill, known by its official designation HR 676, that would establish single-payer, personally asked Obama for an invitation when the two met at a Congressional Black Caucus meeting. The answer was no.
Only because people flooded the White House with angry phone calls, faxes and e-mails, and PNHP threatened to protest, the administration relented and reluctantly invited Conyers and Oliver Fein, the president of PNHP.
At the summit, Obama stated: "In this effort, every voice must be heard. Every idea must be considered. Every option must be on the table. There will be no sacred cows in this discussion."
This simply isn't true. Obama and his advisers have stated openly and unequivocally that as far as they are concerned, single-payer isn't on the table — and the White House guest list for the summit proves the point.
Summit invitations went out to more than 120 "stakeholders," every one of them opposed to single-payer, save for Conyers and Fein. It was a rogue's gallery of profit-seeking, price-gouging, highly compensated corporate criminals from the insurance and pharmaceutical industries.
Among them were Karen Ignagni, president and CEO of America's Health Insurance Plans (AHIP), annual compensation $1,236,422; Scott Serota, CEO of Blue Cross Blue Shield, annual compensation $1,498,018; Jeff Kindler, CEO of Pfizer, annual compensation $12.6 million; and Ken Powell, member of the Business Roundtable and CEO of General Mills, annual compensation $6,515,047.
Another invitation went to Billy Tauzin, a former Republican member of Congress notorious for his sleazy deals, and now, as president and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), the top lobbyist for the drug company giants.
There were representatives from patient organizations and unions at the table, too: the American Cancer Society, AARP, Families USA, the Service Employees International Union, the United Auto Workers, and the AFL-CIO. Unfortunately, the leaders of these organizations still accept that there is a role for the private insurance industry, even while many of their members do not.
Watching the breakout sessions streaming live over the Internet was both infuriating and surreal. The "stakeholders" sat side by side at the same table, laughing and smiling — among them, CEOs responsible for a health care crisis that has left 50 million Americans uninsured and that causes the needless deaths of 18,000 and 100,000 people every year, depending on who is doing the estimating.
Meanwhile, not one union leader or patient advocate or political leader was willing to point out the responsibility of the insurance and pharmaceutical industry for the crisis. Not one dared to speak truth to power, not even Conyers.
Obama set the tone for the meeting by asserting, "Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect. While everyone has a right to take part in this discussion, no one has the right to take it over." Yet in each of the five breakout sessions, the insurance industry did dominate the discussion. Moreover, the moderators of each session were all foes of single-payer, including Zeke Emanuel, a physician and brother of White House Chief of Staff Rahm Emanuel.
At the end of the forum, Obama handed the microphone to Ignagni, the voice of the insurance industry, who declared, "We hear the American people about what's not working. We've taken that seriously. You have our commitment to play, to contribute, and to help pass health care reform this year."
Really? Is this the same Ignagni whose AHIP bankrolled the infamous Harry and Louise television commercials 15 years ago in a successful attempt to smear the Clinton administration's health care reform effort (though the Clintons certainly helped by putting forward a compromised proposal).
Does anyone seriously believe the AHIP would be willing to play fair if it didn't think the Obama administration was preparing to deliver "reform" on terms that preserve its interests and profits?
Single-payer advocates never even got in the door in Sen. Ted Kennedy's secret meetings on health care. According to the New York Times, Kennedy has been holding behind-closed-doors gatherings since last fall with lobbyists from AHIP, PhRMA, the Business Roundtable and others.
These clandestine, invitation-only sessions were designed to whittle down options for health care reform under the Obama presidency, with the health care industry setting the parameters of what would be acceptable. Reportedly, the insurance industry got a guarantee from Kennedy that single-payer wouldn't be on the table.
According to the Times, the consensus in the Kennedy meetings embraced so-called "mandates"–a legal requirement that every American have health insurance. As a memo written by a Kennedy staffer and leaked to the Times put it:
[T]he sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable…There seems to be a sense of the room that some form of tax penalty is an effective means to enforce such an obligation, though only on those for whom affordable coverage is available.
According to the Times, the industry lobbyists at Ted's table said they would accept stricter regulation, including a requirement to offer coverage to people with pre-existing medical conditions, but only if the federal government requires everyone to buy coverage.
This is essentially the same scheme for insurance mandates that was passed in Massachusetts in 2006, under then-Gov. Mitt Romney, a right-wing Republican.
Under the Massachusetts law, for those who don't have employer-provided coverage, the state subsidizes sub-standard insurance coverage for the poor, and requires those in other income brackets to buy policies or pay a tax penalty — this year, it will be over $1,000.
In other words, the insurance companies make money coming and going, and ordinary people pay the price. A recent study by doctors at Harvard Medical School, titled "Massachusetts' Plan: A Failed Model for Health Care Reform," shows the Massachusetts mandate model isn't financially sustainable or truly affordable for those required to buy private insurance.
The plan hasn't even attained its stated goal of "universal" coverage: over 200,000 people in Massachusetts are still uninsured, and that number will increase as a result of rising unemployment. That is the other major flaw in the model — it continues to link health insurance to employment.
The cost of an individual plan in Massachusetts averages around $3,500 for an individual and $10,000 for a family. The Commonwealth Choice program classifies commercial plans into four levels: Gold, Silver, Bronze and Young Adult. The lower-priced Bronze plans have a $2,000 per person deductible, co-pays and restrictions on where care is provided. The message: We won't all be Michael Phelps.
As for the federal "reform" effort, insurance executives have made it clear they will oppose the creation of a new public Medicare-like option, with the government providing health care benefits. The insurers complain this would be unfair competition — Ignagni has called such proposals "a 'stalking horse' to drive the nation toward a single-payer government system."
The insurance companies want "reform" that delivers the entire nation to their doorstep and forces us to buy private insurance from them at prices they set. They definitely don't want any option that lets people opt out of their system and choose a public plan, as no doubt millions would, if given a choice.
In a distortion of the single-payer slogan "Everybody in, nobody out," the insurers want everybody in and nobody out . . . of their private, for-profit system.
The health care summit was a reality check for anyone who may have had illusions that Obama would advocate for a single-payer system once he got into office. Despite saying that he would favor such a system if he was "starting from scratch," Obama is clearly opposed to single-payer under the current circumstances. On the contrary, he has invited the parasitical insurance industry to continue to play a central role in health care.
The administration is holding health care forums in five states, and activists are planning to hold protests and pickets to make sure the message of the single-payer movement is heard. The hope for winning health care justice for all doesn't lie with political leaders, but with organizing and protest at the grassroots.
WHAT YOU CAN DO
Activists for single-payer plan to make their voices heard at demonstrations outside the White House forums on health care reform taking place around the country. See the home page of the California Nurses Association Web site for more details as they become available. The group Healthcare-NOW! also has information about the protests.
Physicians for a National Health Program has a Web site that makes the case for a government-administered single-payer program and has information on single-payer legislation sponsored by Rep. John Conyers.
Nancy's Welch's article, “National Health Care: A Dream Deferred,” in the International Socialist Review, examines what it will take to win health care for all. Also in the ISR, Helen Redmond uncovers the crooked practices of the pharmaceutical industry in “Bitter Medicine.”
Check out Helen Redmond's blog at HelenRedmond.wordpress.com, or e-mail her at redmondmadrid AT yahoo DOT com.