Readers Write: John Edwards' Plan to Get Serious About Healthcare

AlterNet readers had an animated discussion following a recent piece looking at Democratic presidential hopeful John Edwards' new campaign ads, airing in Iowa, that promise to take away the health insurance members of Congress enjoy unless they enact his proposal for universal healthcare ("Edwards: If Members of Congress Won't Give Americans a Healthcare Plan, I'll Take Away Theirs.")

Vox Persona, while approving of Edwards' strategy for bringing about universal coverage, also had some words of caution: "Being from N.C., I can give you the heads up on our former illustrious senator. Serving in his one term, he spent most of his time running for president. How would you feel? The word opportunism comes to mind. He seems to say some of the right things, and I want to give him the benefit of the doubt, but his kind of raw ambition makes me uneasy."

Jefferson's Guardian, disagreeing, replied: "It has to start with someone, Vox Persona, doesn't it?

"Quite possibly what you view as "raw ambition" in John Edwards might also be interpreted as someone who sees that time is running out for the American people.

"Someone has to take the bull by the horns. Aside Kucinich, who else is out there speaking for the American people?

"None."

Oregoncharles, a Green Party organizer, expressed concern that the candidate might be someone other than Hillary Clinton. "Uh-oh," he wrote, "if Edwards is the nominee, I'm in trouble. I'm counting on Hillary to make the Greens players in the election … Edwards is the only one of the Big Three who could hold progressives in the party." But Scheherezade disagreed with Oregoncharles' appraisal: "Hillary knows if she gets the nomination, Greens will come on board" s/he wrote. "Nobody's going to risk a repeat of the 2000 election. However, the presence of Edwards as a running mate would certainly sweeten the pot."

There was quite a bit of debate over the fact that Edwards' plan leaves the for-profit system and insurance companies in place for the moment, but puts the private sector in direct competition with a publicly financed system, the idea being that if people are given the choice, the benefits of the public system would eventually lead to its adoption by everyone. The article's author had argued that it was a politically pragmatic way to get to a public, single-payer system, but many readers disagreed.

Oregonscribbler wrote: "There is a fatal flaw in the Edwards plan. He says the ultimate aim of his plan is single-payer -- that private care will just wither away because it won't be able to compete with the public system. This is just nonsense. It is legislators and administrators who will determine just how good the public plan is, and for years they have been in the deep pockets of the medical insurance industry." After endorsing Dennis Kucinich's healthcare proposal, s/he continued:

"We need a bold plan, to really revolutionize our healthcare system. Make it single-payer and decentralized, like in Canada, with people going to the doctor of their choice. Make it labor-intensive, and include alternative health practitioners, because simple attention and touch are often as healing as pharmaceuticals, only without negative side effects.

"We ALREADY PAY for a fabulous healthcare system, we're just not getting. It's time we forced the bureaucrats and plutocrats and industrialists to stand out of the way and let the rest of us make it happen."

Peacelf disagreed: "Edwards' plan makes smart political sense. I think a public healthcare program in competition with private health insurance is a smart move toward a single-payer system …

"Like social security, once in service, the people will not let public healthcare coverage die. It will become a political hot button that voters will defeat anyone who touches it. And, it could solve once or for all the conservative's argument that the private sector can do it better."

TZ offered an example of why private healthcare systems are, generally speaking, so much costlier than public ones:

"About 25 years ago here in Cleveland, Blue Cross, Blue Shield held sway. Then one of the crafty bosses decided to take this company private into what is now called Medical Mutual. By so doing he needed the board to approve it, and thus they paid each board member an average of $500,000 for their vote. The crap hit the fan when it was made public, but it still went through.

"The total administrative costs of the old plan were often touted as about 3 percent for each dollar spent. Now our friends at Medical Mutual have an average administrative cost of about 40 percent. I wish to hell I was one of the bosses at Medical Mutual.

"Now you wonder why our costs are so high and care so low. The insurance industry will not admit this and Medical Mutual in Cleveland (Ohio) claim they cannot break out these costs. They do not want us to know this, but we do know it since some clients have "third-party administrators" working for them, and since these folks review each claim, they only pay what are really medical bills. Maybe the candidates ought to push for a mandate to force the insurance industry to use real, independent third-party administrators.

"These administrators could not be part of the medical providers in any manner, shape or form.

"By the way, Medical Mutual just purchased one of the largest third-party administrators in Ohio. By so doing they will keep the cash cow producing milk. It is disgusting.

"Think of it folks, we could save about 15 percent to 20 percent of our total bill, and the private insurance boys would still make one hell of a living. It would not be as huge, but still very nice."

There was quite a bit of discussion of the feasibility and potential effectiveness of the proposal, with pdxstudent asking: "How Many in Congress Couldn't Afford Health Insurance?":

"Not many, if any, I imagine. So, in a nation where money equals access to a quality life, why would taking this free service away be that threatening of a charge? What's more is the health insurance industry would not have to "invest" much to make sure that, even if Edwards were to be good with his threat, Congress would get health insurance, and therefore not experience Edwards' threat as much of a threat. Boning up the money to actually provide healthcare for a thousand people is much less of a profit drag than doing the same for hundreds of thousands, if not millions.

"For all these reasons, I don't think Edwards threat means anything. So f**king what if we make the empty gesture of not paying for Congress' healthcare if they won't pay for ours. It's rhetorical bread and circus more than anything, because it isn't really a lever of influence."

Several readers suggested that pdxstudent was missing the point, including Suzon, who pointed out that "there is such a thing as "gesture politics" and sometimes gestures (and images) can change ways of thinking." Wm Greybeard added: "The point is not just to take away their free insurance … but to lobby their constituents to take away their seat in Congress."

There were some readers with relevant experiences to relate. Dr. Rick Lippin, a regular AlterNet commenter who also writes on the Critical Condition blog, said that while it was a bold plan, he'd like to see it focus more on prevention rather than treatment. And Westomoon, expressing doubt that members of Congress would simply opt out of their coverage and buy private plans, spoke of his or her experience in the federal system:

"I get my healthcare from the program Edwards is threatening to shut down -- the Federal Employees Health Benefits Program. It's not a great insurance program -- co-pay for most things is around 25 percent of strange low-ball numbers set by the insurers plus the substantial balance of the actual market cost of care, and it contains nothing that isn't approved by Sen. Foghorn Leghorn and his snake-handling fundie constituents -- forget about coverage of chiropractic, acupuncture, naturopathy, or any other foreign and satanic practice.

"Reading the article, I also went into a swoon of despair at the "same old, same old" approach -- until I processed the fact that Edwards is also building in a Medicare option. Trust me, I would opt for medicare this instant if I could, and so would you, if you'd seen it in action. It's a relic of the days when health insurance actually covered what you needed to get well, unlike any of the insurance plans in the market these days. It won't take long for the rest of the country to make the same choice, once they're given the option. And, voila, you then have national health with no discernable bad guy who made us shift to the Communist way of life.

"Back to the federal plan. The one good quality it does have is that nobody gets turned down, and pre-existing conditions are covered, after a waiting period. For Congress (and their staffs) to dodge Edwards' ploy by opting for individual plans, nobody in their family could have a pre-existing condition, and they'd have to be ready to cover mental health, maternity costs and a lot of other categories out-of-pocket. Simply having money to spend (and congressional salaries these days put them in the middle class, not the ranks of the wealthy) is not enough to get you insured.

"We have already split into concierge care and gerbil care -- but Congress isn't in the concierge-care plan. For us regular gerbils, a Medicare-based plan is much closer to concierge than anything offered by a private insurer today. I'm not convinced yet that Edwards is the progressives' best hope (my vote is still with Seabiscuit), but this is a damn smart approach to letting the country bring about a single-payer system by "voting with its feet," and thus depriving the right-wing noise machine of its next 30-year grievance."