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3 posts from October 2009

October 28, 2009

The Health Care Ghetto

Even worse than Joe Lieberman's threat to veto the health care bill, the Connecticut senator's ego may well have distracted Americans from the real issue in the debate over the public option: Will Americans actually be able to choose it or will it just be a health care ghetto for those of us who have been tossed out like unprofitable trash by the insurance industry?

Speaking on The Rachel Maddow Show less than twenty-four hours before Lieberman announced that he would join a Republican filibuster against a public option, Sen. Ron Wyden (D-OR) said the following about Harry Reid's proposal :

The public option will be a great tool, if people can get it. It seems to me that Harry Reid deserves a lot of credit tonight. He`s made it clear there ought to be options. But I continue to be concerned that the way this proposal is written, more than 90 percent of Americans, seven years after the bill becomes law, won`t be able to hold insurance companies accountable. They won`t be able to get the public option at the exchange, the marketplace, nor will they get additional private choices. You can`t get an accountable insurance industry with just a small fraction of the population. You`ve got to have the whole customer base of the industry on the line...If folks at the grassroots level, the folks who are carrying those signs about the public option now, say, "Look, it`s not good enough that only 10 percent of the population can hold insurance companies accountable, it`s not good enough at a crucial time in American history to have choice available only to a handful of people who are poor and sick and unemployed," that`s almost like a health care ghetto." Let`s hold insurance companies accountable the right way by making them put their whole customer base on the line.(Sen. Ron Wyden (D-OR), The Rachel Maddow Show, Oct 26, 2009)

Wyden's point was clear and straight forward:  the public option will fail to bring down the costs of health care if it is designed such that it cannot possibly compete with the massive customer base forced to stay with private insurance.  "We`ve got to make sure that it`s possible for Americans," Wyden emphasized, "who feel their insurance company is abusing them, to have choices like members of Congress."

Wyden offered praise top Harry Reid for bringing the public option to the floor, but a warning that the current state of the public option in the Senate bill does not match the rhetoric about "competition" and "choice" used by the Democratic Party to explain the public option to American voters.  The solution?  Americans need to demand that their senators add amendments to the current bill that make the public option available for everyone to choose.

Enter Joe Lieberman.

The minute Joe Lieberman threatened to veto a "government run" public option--which is itself a complete fabrication as to what the public option would be--Wyden's key point that Reid's version of the public option would create a health care ghetto was trampled over by a media hypnotized like a crazed throng of Conrad Birdie fans.

Honestly.  Nora the piano playing cat could figure out what Lieberman is doing, ignore it, and focus back on the real issue at stake in the debate over the public option.  What is Lieberman doing?

Lieberman is inserting himself into the debate not because he gives one iota about health care or the public option or what the voters of Connecticut want (68% want a public option), but in order to get for himself--to get for Joe Lieberman.

Over the course of his career, Joe Lieberman has taken $2,395,369 in donations from the health sector and  $1,033,402 in donations from the insurance industry (link).   So, he is threatening to veto a public option in order to guarantee those taps stay open and the cash keeps flowing. Joe will filibustering health care reform so that Joe can keep getting for Joe.  It is exactly what one should expect from a man who is the founding and only member of a party that bears his own name: self-aggrandizement.

If you are like me, however, and you care little about Joe Lieberman, but a great deal about making a public option available for all Americans to choose, then you should consider taking five minutes to watch this clip of Wyden explaining what we should be talking about instead of focusing our attention on a narcissistic Nutmegger:

(Thanks to Firedoglake for recording the clip and posting it to YouTube)

After you watch that video, send the link to your friends on Facebook and Twitter so they can watch it, too.

What is at stake in the next phase of the health care debate is not whether a self-centered senator is able to hold the Senate hostage so that he can get rewarded by his health insurance industry donors--but whether or not the public option will be available to everyone ever abused by that industry or merely cordoned off as an undesirable, built-to-fail, health care ghetto. 

Leave Lieberman to Lieberman.  Let's talk about what matters for a change--particularly when it matters so much to so many.

October 17, 2009

Caution: Health Insurance May Be Hazardous To Your Health

Lately, I am starting to wonder if Congress should put forward an amendment requiring every health insurance policy sold in America to come with a warning label: "Caution: Health Insurance May Be Hazardous To Your Health." 

This idea may seem strange at first, but when you think about it the struggle against the health insurance industry is looking more and more like the forty-year struggle against the tobacco industry that began in the early 1960s and is just now ending.

In 1964, the U.S. Surgeon General published a report linking cigarette smoking to cancer, which resulted in the 1965 Cigarette Labeling and Advertising act. Starting in 1966, every pack of cigarettes sold in the U.S. carried the warning label: "CAUTION: Cigarette Smoking May be Hazardous to Your Health."   They knew back then that cigarettes killed, but the problem was that most Americans did not know it.  We still thought cigarettes were good for you because the tobacco industry told us they were good for us.

Likewise with health care, as tough as the debate has been so far, America has only just begun to disentangle itself from the health insurance industry.

Part of the problem with the health care reform debate is the whole idea that health insurance is good for our health.  It should come as no surprise that Americans think this way.  The health insurance industry does not make obscenely huge profits by selling health insurance that keeps us healthy, but by selling us the idea that health insurance keeps us healthy--such that we keep paying for it right up to the point that our coverage is being denied.

Now we all know better.  Certainly it helps to have health insurance to cover the costs of going to the doctor when we are healthy, but the moment we get sick--we now know--the health insurance industry gets busy finding a way to deny our claims, cancel our policies, and otherwise endanger our lives.  In the long run, health insurance is not so healthy after all.

By 1970, a half decade of public education had resulted in stronger warning labels on cigarettes, "The Surgeon General Has Determined that Cigarette Smoking is Dangerous to Your Health."   By the mid 1980s, after two decades of education, Congress passed a new law called the Comprehensive Smoking Education Act, requiring even stronger warning labels.  Boxes now read,"Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy," and a host of other bone chilling predictions.  Cigarettes from that point forward all but said, "Listen, pal. No matter what these jokers at big tobacco say, if you smoke these: death."

It could well be that in order to break the grip of the insurance industry on America, we need a twenty year long process of education.

Imagine if the next time you went to the doctor for a physical, at the end of the exam he turned to you and said, "You're in good shape now, but I need to warn you that your health insurance policy could endanger your life in the next ten to fifteen years."  The doctor would then give you three or for pamphlets explaining the various ways that health insurance companies deny claims, cancel policies, and refuse coverage. "There is no cure for health insurance at this time, but for now we wanted to make sure that you were informed."  What an eye opener that would be.

Imagine kids in schools giving book reports on the ways health insurance companies endanger American lives.  Imagine goofy, "School House Rock" style cartoons where a walking, talking health insurance policy with a folksy accent explained how private insurers process reimbursement denials, how they blacklist children with leukemia, or how they cancel policies when people receiving care from brain injuries hit their coverage limits.  Imagine public service posters in schools warning kids not to talk to health insurance salesman. 

It took all of these approaches, plus millions of people dying from lung cancer, to break the grip of big tobacco on the American public.  Government standing up to big tobacco in 1964 was just the beginning. What finally brought that industry to its knees after thirty years of public education was a combined legal and legislative strategy by the Clinton administration, resulting in historic wrongful death settlements.  But even then, cigarette smoking still remained deeply entrenched in American society.

Only in the past few years have most major cities finally passed laws banning smoking in government buildings, the workplace, bars and restaurants.  Forty years after the first "Caution" labels appeared on boxes, a set of state and federal policies finally took shape that once and for good curtailed the dangerous impact of cigarettes in our lives.

How many of us are prepared for a forty-year struggle against the health insurance industry? Not very many, I suspect. But we better prepare ourselves.

It may be hard to believe, but we are not much further along than the very beginning of breaking the grip of the health insurance industry on our country.  Sure, the current debate has shown how the unregulated health insurance industry went awry over many decades.  And yet, only now are we as a nation waking up to the horrific problems this has caused to--and will continue to cause--until we fundamentally change our understanding of it.

Of course, all of this requires the emergence of a viable, long-term alternative to health insurance in its current form--something along the lines of Medicare-for-all, but not hampered by the population formulas currently causing financial problems with the existing program.  Maybe it will not take a full forty years to develop a workable solution, maybe it will take less.  But even as President Obama gives speeches about the problems with health insurance and Congress sketches out the solution, we are only now completing "step one" of the battle--the step where we begin to realize a product is hazardous to our health.

October 10, 2009

The Outrage Pandemic

Forget the Swine Flu.  America is suffering from an outrage pandemic.

Like everybody else in America, I was surprised when the Nobel committee awarded the 2009 Peace Prize to Barack Obama.  I was pleased, but surprised.  Apparently, just about the only living creature not surprised was Bo the First Dog.  But the outrage that flowed from every corner of the political conversation was far more depressing than the surprise I felt when after learning about the award. 

When did American optimism succumb to this constant outrage?

A year ago, tens of millions of Americans descended on Washington, DC, just so they could say "I was there," on the day Barack Obama became President.  Nine months later, a majority of Americans seem convinced that this same man--who once inspired them so deeply--has personally slighted them.  

The right-wing is certainly responsible in part for the spread of the outrage pandemic.

The right has reached a level of outrage at Barack Obama that already exceeds what the left mustered after eight years of George W. Bush.  The result is that right-wing politics in America now follows one general argument: If Obama wants it, then it is so bad it must be stopped or it will destroy America. 

The insanity in this approach became  clear in the healthcare reform debate where we have heard Republicans on Medicare say crazy things like, "I'd rather die than see this country adopt government-run health insurance"  (e.g., I would rather die than have the kind of government health insurance that I currently have, which keeps me from dying). 

When people shake their fists in protest at the very things they say they will die to defend, the result is far worse than a nation divided along political lines. It is a form of national schizophrenia.

While the outrage pandemic may have reached critical levels on the right, the left has done its part in the past nine months, too.

Try talking to anyone in the left-wing, nowadays, and it seems everyone has a bone to pick with Barack Obama.  Whatever Barack Obama does, more and more people on the left are outraged by him.  First it was the bank bailout program, then the auto-industry rescue, then the health care bill.  Then it was not moving fast enough on closing Gitmo, then the Israeli-Palestinian conflict, then withdrawal from Iraq.  Now the left is outraged at Obama's Afghan policy and his view on cap and trade and home mortgage relief and marriage equality and the prosecution of past administration officials.

Is there anyone left on the left who is not outraged at Barack Obama for something? If they're out there, I never come across them.  

Some outrage is good for politics, but only if the outrage can be translated into action.  The Democrats needed more outrage to advance their healthcare initiative, for example, so an online whip count effort to rally votes for healthcare reform was created, inspiring tens of thousands of ordinary Americans to participate in the healthcare debate in a constructive way.   That was outrage put to useful ends. But for the most part, the ordinary people I talk to say that they are turned off by the 24/7 general, non-productive outrage they see from their friends on the left and the right. 

What Americans see, lately, from this outrage pandemic is a daily drama of name-calling hurled at President Obama from both sides of the political spectrum.  The right now routinely says Obama is no different than "Hitler" and "Carter" and "Arafat," while the left compares him to "Kissinger" and "Reagan" and "Bush."   None of it is true, of course.   I could argue that the schnauzer across the hall is like Hitler and that the Pekingese is like Kissinger--but it doesn't make it true.  All this historical name calling is just shorthand for both sides saying: Obama is the worst there could be, and that's all I'm going to contribute to this debate. Outrage, thy name is Hitler (and Carter, and Arafat, and Kissinger...).

Curiously, while the outrage pandemic has spread to every corner of the American political system, reducing it to the point where it seems near death, the Europeans are not suffering as we are.

From the perspective of the Nobel Committee in Copenhagen, American politics is not a patient laying comatose on a table, but a shining beacon of hope shining anew after the darkness of the last eight years.

For the Europeans, Barack Obama ended nearly a decade of outrage in response to Bush's and Cheney's  military policies. The election of Barack Obama was greeted by Europeans (and Asians, and Africans, and Latin Americans) not just as a turning point in history, but as step in the direction of survival.

Over the course of nearly a decade, the rest of the world watched the policies of the Bush administration and worried about the rising specter of nuclear annihilation--a fear that had not gripped the world so strongly since the end of the Cold War.

Awarding the Nobel Peace Prize to Barack Obama seemed to carry with it a collective sigh of relief from Europe, if not the world.  If the Nobel medal could speak, this year it would say, "Thank you, for stopping that crazy march to military madness that worried us all so much!"

America is still in Iraq and considering sending more troops to Afghanistan.  Yet, we these military actions are not being driven through by propaganda campaigns and bellicose brinkmanship.  We no longer turn on our televisions to be greeted by constant White House speeches warning that terrorists will destroy our shopping malls with nuclear bombs tomorrow if we fail to invade Iraq and Iran and Afghanistan, today.  The world still has problems, but the biggest kid on the global stage is no longer picking fights everyday with everyone else.

In response to the logic behind this year's Nobel, it is not surprising that the left and the right vented their outrage at Obama. Our outrage pandemic is far from over.  And yet, as someone who stood in the cold to watch Barack Obama's inauguration, and who felt that optimism for Democracy in a way that I cannot recall feeling before or since, I understand why the Europeans might still feel it strong enough to give Obama the Nobel Prize.

Perhaps we should take this Nobel Peace Prize as an invitation to remember that feeling of optimism we felt less than one year ago--a chance to recall that feeling with the help of an old friend who still believes in its potential.

So, amidst the latest outbreak of outrage springing up across America, take a few moments to enjoy Barack Obama's Nobel Prize.  The way our outrage pandemic is growing, it could be a long time before we feel good again--about Barack Obama or anything else for that matter.