Health Care: It's Time for a Major Overhaul

By Alexander Zaitchik, AlterNet. Posted December 1, 2008.

Sen. Jim DeMint, R-S.C., recently summed up the dilemma in an interview with Politico, saying, "The big thing for Republicans is to communicate that it is not acceptable for 40 million people in America not to have health insurance. But it's also unacceptable to turn our whole health care system over to the same people who ran Katrina and ran the Iraq war and [are] running the bailout."

Those "same people" are, of course, Republicans. Such are the obstacles the GOP faces in the looming health care battle.

Which isn't to say that anybody is predicting a cakewalk. Uniting progressive and fiscally conservative Democrats will require applying sustained heat and effort. And, as they did 16 years ago, the billion-dollar industries can be expected to defend their bottom lines with ferocity and guile. Indeed, the message war is already begun. The Pharmaceutical Research & Manufacturers of America (PhRMA) in mid-November unleashed the first ad in a multistaged campaign designed to frighten Americans away from the idea that the government should negotiate drug prices on behalf of Medicare, as president-elect Obama has pledged to do.

"There's no question that next year will be a challenging year," Ken Johnson, senior vice president of PhRMA, recently told the Washington Times. "We've been moving the pieces on the chessboard around for some time now, and we've got a great game plan in place. We've earned a right at the table, and we're optimistic that the majority of members of Congress will recognize the importance of the pharmaceutical industry to health care." Among those "pieces on the chessboard" are the millions of dollars the pharmaceutical and biotech industries gave to Democrats over the last two cycles.

The insurance industry has likewise begun positioning itself in anticipation of the coming showdown. Two weeks ago, American Health Insurance Plans unveiled its own reform proposal in an attempt to shape the debate before it is shaped by it. At the heart of the AHIP proposal is a deal whereby insurers would accept all comers regardless of prior conditions, but only if there is a federal mandate for universal coverage. Crucially, the plan does not mention "community pricing" (standard rates), meaning millions of sick or high-risk Americans would still be priced out of coverage. Along with helping to influence the shape of a final bill through its legislative outreach team, which has been working on the Hill since summer, HCAN plans to expose and kill such sham industry-reform proposals in the crib.

In its first post-election ad buy, HCAN recently launched a spot in the Washington-area aimed at Congress. The 30-second ad features footage from an Oct. 4 speech Barack Obama gave in Newport News, Va., in which the then-candidate described health care as central to the broader project of rescuing the economy and rebuilding the middle class.

"We are reminding Congress and the incoming administration of the commitment to health care that won the White House and increased majorities," says HCAN Director Richard Kirsch.

HCAN intends to turn up the pressure on Congress after the inauguration and focus resources on stiffening the spines of centrist Democrats as the debate intensifies, which a mounting number of signals indicate will happen earlier in 2009 than many expected. Along with the funds for strategic media buys, HCAN's not-so-secret weapon is an intimidating, indeed historic, activist base.

"The vision from the beginning was to bring together the largest membership groups in the country to form a coalition that combines impact in Washington with a massive field presence across the country," says Kirsch.

Once the health care battle is won, could the HCAN coalition stay together to fight for other planks on a progressive agenda? Kirsch says the coalition does not anticipate outlasting the current mission, but believes the new relationships developed among its members "should provide new openings for progressive organizing in the future." But first things first.

"HCAN was formed to win health care for all," says Kirsch. "Right now we are very focused on doing just that."

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Alexander Zaitchik is a freelance journalist.

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