It's Now or Never for a Public Option: Why We Need to Take a Stand Against the Insurance Industry's Greed
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A Red Line
Although the proposals put forth during the primaries by presidential candidates Obama and Hillary Rodham Clinton differed in the specifics, both had a public-insurance option at their hearts; it was one of the promises that helped get Democrats elected.
But big insurance has flexed its muscles, and they are some impressive guns. Over the past 10 years, the insurance industry has ranked second in dollars spent lobbying Congress and the White House. The top spot is held by the pharmaceutical-and-health-
As a consequence of the industry's influence, the health care debate began in the center, and now, with the power of the corporate right coming to bear, it's moving toward the industry's preferred policies.
The discussion about health care in America was narrow when it began. Truly socialized medicine -- with a U.K.-like system of state-run clinics and hospitals that provide care directly to everyone who needs it -- has never seriously been "on the table."
Although right-wing commenters love to invoke the specter of "government-run health care," virtually all of the progressive voices in the debate believe that truly socialized medicine is a political non-starter in the U.S.
That's a sad irony: A 2004 Rand Corp. study ( PDF) published in the Annals of Internal Medicine found that the relatively small group of Americans who do have socialized health care -- military veterans -- receive significantly better care than the rest of us in terms of overall quality, treatment of chronic diseases and preventive care.
In fact, it scored better than the rest of the system on every measure but emergency care (which is a like a single-payer system in that it's available to everyone whether or not they have coverage or the means to pay).
A 2007 study found that 6 in 10 American physicians favored the establishment of a single-payer system. Also spun -- dishonestly -- as "socialized medicine," a single-payer system just means that the government would pay the bills, not provide the treatment.
A study ( PDF) by researchers at Harvard and the Canadian Institute for Health Information concluded that 30 percent of our health dollars go toward administrative overhead rather than actual care, and a good chunk of that is insurance companies fighting over who will pay various bills.
Yet early on in the process, single-payer advocates were removed from a Senate hearing and arrested for disrupting the proceedings. Montana Democrat Max Baucus, chairing the hearing that was supposed to "kick off" the health care debate, set the tone when he invited 15 witnesses to share their views. Ralph Nader noted at the time:
The insurance industry was at the table. The Business Roundtable was at the table. The U.S. Chamber of Commerce was at the table. Blue Cross Blue Shield was at the table. The [corporate-funded] Heritage Foundation was at the table. … But not one person who stood for what the majority of Americans, doctors, nurses and health economists want -- single-payer -- was at the table.
What remains "on the table" today is the public exchange approach. While flawed -- and far from the "robust public option" promised during the 2008 presidential campaign -- legislation working its way through the more progressive congressional committees would go a long way toward fixing some very severe problems in American health care -- it's imperfect but would still serve the greater good.