Why not air all the health-care reform options?

In a sort of follow-up to yesterday’s post about how the supposedly moribund GOP still manages to shape the debate on certain issues, here’s Congressional Black Caucus chairwoman Barbara Lee, D-Oakland, on the House floor last night talking about health-care reform:

You’ll notice she speaks of her own advocacy of a single-payer universal health care plan, but then she focuses in on ensuring whatever plan comes forth this year has a robust public insurance component so that every American is guaranteed accessible, quality health care. That’s in keeping with a statement issued jointly a few weeks ago by Lee’s CBC along with the Congressional Progressive Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus.

The chairs of all those caucuses – Lee for the CBC; Lynn Woolsey, D-Petaluma, and Raul Grijalva, D-Ariz., for the progressives; Nydia Velasquez, D-N.Y., for the Hispanic Caucus; and Mike Honda, D-San Jose, for the CAPAC – all are among the 75 cosponsors of H.R. 676, which would expand Medicare into a national, single-payer system covering all Americans.

But as the U.S. Senate Finance Committee held hearings last week to lay groundwork for a health care reform plan, chairman Max Baucus, D-Mont., invited nobody to talk about single-payer options. Protestors decrying this omission disrupted the hearings; more than a dozen were arrested.

“We’ve got to reform our system fairly quickly, and to be candid with you, very few members of the House and Senate advocate single-pay. The vast, vast majority do not,” Baucus told the Great Falls Tribune last week. “It tells me that if I go down that road, it’s not going to be successful — it’s not going to pass the Congress.”

So the votes might not be there right now, but how do we know they wouldn’t be there if all the options were aired, if Congress and the American public could consider a single-payer option side-by-side with other options? Perhaps it would still be a non-starter, perhaps not; if opponents are so sure it’s nonsense, why not follow Woodrow Wilson’s axiom that “nothing chills nonsense like exposure to the air.” Isn’t that what open debate is all about?

Republican leaders not only don’t want to hear about single-payer, they don’t even want to talk about any public component at all lest we end up with “socialized medicine” that they insist would be inferior to the patchwork of private insurance America has now.

And yet a recent CBS News/New York Times poll found Americans are more likely today to embrace the idea of the government providing health insurance than they were 30 years ago: 59 percent say the government should provide national health insurance, including 49 percent who say such insurance should cover all medical problems. Go figure.

Josh Richman

Josh Richman covers state and national politics for the Bay Area News Group. A New York City native, he earned a bachelor’s degree in journalism from the University of Missouri and reported for the Express-Times of Easton, Pa. for five years before coming to the Oakland Tribune and ANG Newspapers in 1997. He is a frequent guest on KQED Channel 9’s “This Week in Northern California;” a proud father; an Eagle Scout; a somewhat skilled player of low-stakes poker; a rather good cook; a firm believer in the use of semicolons; and an unabashed political junkie who will never, EVER seek elected office.

  • ulno

    I have a relative in Europe that is denied health care because they are too old (77 years). The doctors tell them that it’s a waste of money spending on them for routine procedures since there are others. We are trying to fly them to the US as the surgical procedure is quite straightforward.

    I have friends in France who must take medical tests in order to be permitted to live in certain regions of Paris. This is part of the state plan to control and regulate each persons health.

    Members of my wife’s family in England are denied treatment since they smoke. One is denied access to surgery because they are obese. These individuals are not indigent, they have advanced college degrees and work at good paying jobs. One of my cousins was classified by government officials as obese at age 5 because he was 1 pound overweight, and this rating was done by the yearly public exams.

    My aunt died while waiting for availability for surgery. After 10 months of waiting for a visit, the doctor told her that her cancer would easily have been curable only 4 months earlier.

    Socialized medicine will ensure equally low and bad treatment for all. Once individuals submit to handing over their freedom to a central agency, they also turn over their rights to choose how they want to live.

  • RR

    Single-payer insurance is splendid for younger and healthier individuals. It is no help to the aged or sickly.

  • John W

    I’m in no position to question somebody’s anecdotes. However, even from Canada and U.K., I don’t hear clamoring to junk their system and replace it with ours. An occasional story about crossing the border to get elective surgery more quickly or to visit a “Center of Excellence” facility like Cleveland Clinc or Mayo, yes; but envy for our system, no. The highly rated French system is not like the U.K. Providers are private. Insurance is a hybrid of public and private. However, unlike the U.S., the role of private insurance, which 90% of people purchase, is to backstop the public plan. Private insurance is not the gateway to health care the way it is here. Contrary to another comment posted here, my understanding is that the French system is even better for the very sick, compared with the young and healthy. That said, it’s this year, now or never, for health care reform. Next year, with midterm elections, no way. After that, we get into the run-up to 2012. Second terms sputter. Focusing on single payer as if it is, politically, even a remotely viable option would put the whole works at risk. People who have employer-sponsored coverage — that’s 60% of us — don’t want to lose that. The insurance industry would fight to the death. I think Baucus is wise with his approach of pushing forward with what is likely to get through Congress and not get sidetracked by something than ain’t gonna happen.

  • ulno

    If you don’t hear clamoring, that’s because you have only been listening to the American media.

    Claude Castonguay, the founder of Canada’s socialized health care system in the 1960’s said in the Canadian IBD paper in June 2008 that the Canadian system is in “crisis”. The reason he has abandoned his program is that the services provided to citizens is “ruinous”.

    “We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

    “What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor.”

    Both Canada and the UK trail the U.S. in five-year cancer survival rates, transplantation outcomes and other typical measures.

    The American media is extremely effective at only providing one side of the story, John. Please spend some time with elderly Canadians or Brits or Scots who have tried to get health care services. Americans used to get facts from two sides of the issues, but now the media only provides one side of the issue.

    And if you haven’t heard, those 60% of Americans that get employer sponsored health care: the Obama folks want to tax you for those benefits. Valued at $5-$10k a year, we are talking $300/month each. Those are people making a lot less than $250k a year. Add on top of this taxes on foods out of political favor. And, to quote Mr. Altman from last weeks Senate Finance Committee hearings: “but we do need take account of the cost — you know, I hate to say it, the cost-benefit of some of the things we do.”

    “Remember, our population is aging. And with the very, very elderly, the costs go down, so that percentage should be falling, and it’s not. Second, the cost of care is growing by so much, so at the same percentage, it’s worth a lot more. So let’s go back to the issue of comparative effectiveness, which we’re supporting. That’s where that can have a big impact. It’s not only there, but that’s where the waste is. That’s where people are using technologies that keep people alive for a limited [time] and [at] a high cost.”

    In California as of Dec 2008, 31% of those who were uninsured made over $50k a year. 44.7% of the uninsured were not US citizens and illegally here. This is according to revised US Census Bureau numbers.

    I’m sure the Senate hearings were properly covered by the media. Reducing health care to those over 65 to fund health care for illegal aliens must be the lead story in every paper.

  • ulno

    Oh, by the way, the premise that Republicans are preventing debate on socialized health care has little basis in fact.

    Consider that 45 _Democrats_ last week wrote a letter of protest that even the NYT published, but this newspaper did not:


    “WASHINGTON — Forty-five House Democrats [..] have protested the secretive process by which party leaders in their chamber are developing legislation to remake the health care system.”

  • Josh Richman

    I’m not sure how that article undercuts the idea that the GOP is playing a role in shaping the debate. From that story:

    Centrist Democrats said they fully endorsed President Obama’s goal of guaranteeing access to health insurance and health care for all. But, they said, they are concerned about the cost of the legislation, which could easily top $1 trillion over 10 years. And they want to be sure that the role of any new government-sponsored insurance program, expected to be a centerpiece of the bill, is carefully delineated.

    Many Blue Dogs come from usually Republican districts or swing districts and see their stance on health care as vital to their political survival. By contrast, the committee chairmen writing the House bill have safe Democratic seats.

    The Blue Dogs said the policy-making process in the House compared unfavorably with the approach in the Senate, where two committees have held open forums and the chairman of the Finance Committee, a Democrat, is working with the panel’s senior Republican.

  • John W

    Ulno, it is my understanding that Castonguay and the commission he chaired proposed changes to the Canadian system, including greater cost-sharing by patients and a greater private sector role. However, he did not advocate abandoning the universal health care system or adopting anything like the current U.S. system, if you can call it a “system.” As for the idea of taxing employer-sponsored insurance, this idea was originally proposed by President Bush and then advocated by John McCain during the campaign. Obama opposed the idea during the campaign and is still reluctant to “go there” but has not rejected the idea outright. It is members of Congress, not the administration, that have been advocating this as one way to fund universal health care. As somebody who pays for my own insurance outside the employer-sponsored system, I have mixed feelings on the subject.

  • John W

    Ulno, regarding a couple of statistics. It is true that the U.S. is a leader when it comes to cancer survival rates. Credit government investment, starting with President Nixon’s “war on cancer.” There are a bunch of other “outcomes” statistics where we don’t look so good. Regarding the uninsured, you mentioned that 31% of them make $50k or more. If you have a family and have to shell out $12k (25% of gross income) for coverage, it’s a problem. Some don’t get it because they have preexisting conditions and are unisurable. The uninsured numbers would be much higher if it weren’t for expansion of coverage in recent years through SCHIPS and Medicaid. The percentage of employed people with access to employer-sponsored insurance has been falling. And, if we didn’t have Medicare, imagine being 65 and trying to convince Blue Cross to sell you a policy. I love it when I go to a health care forum and see some elderly person railing against “socialized medicine,” even though they get their coverage via Medicare, the VA or insurance provided as a retiree benefit by their former government employer.

  • Ulno

    I think the name for the US system is “freedom”. At least it used to be. Once the government starts to offer alternatives that undercut private industry, private industry is unable to compete.

    Consider a simple example: Hayward used to have many video stores until the public library removed many aisles of books and replaced them with hundreds of DVDs and videotapes that are free to check out. Within 12 months of this move, 6 video stores shut their doors in the area of the library.

    Similarly, Union City offers a subsidized health club whose price is a third of the local health clubs. As a result, there are no health clubs open within miles of the public gym.

    This translates to alternatives to Medicare and public insurance. The government intrusion prevents the growth of private competition, which would offer the growth of improved services and lower prices. Instead, the government run version costs more and improves less.

    Consider the overhead cost of public schools versus private schools. Private schools have less than half the overhead costs of public schools, and vastly better results. This despite a vast disadvantage in pricing.

    So you “love it” when you see elderly people trying to protect their life savings and health and being unable to do so because of socialist government coercion?

    It’s a sad day when people are happy to support the unlimited power of state government over individuals who are helpless to say no.

  • John W


    I think NetFlix, Amazon and pay-per-view may have had something to do with the demise of DVD stores in Hayward.

    Anyway, we’re a bit off topic now.

    Three cheers for free markets!

    Over and out.