Worse than nothing at all

March 19, 2010

Helen Redmond examines the health care proposals that Barack Obama and the Democratic Party want to push through Congress in the name of "reform."

THE DEMOCRATS' mad rush to pass health care legislation--any health care legislation, no matter how awful--is center stage in Washington politics.

And they got a step closer to their goal this week with the capitulation of Rep. Dennis Kucinich, the last of two House Democrats who previously voted against health care "reform" legislation because it doesn't do enough to actually reform the system.

Now, Kucinich--who still claims to support a single-payer system that would cover everyone under a government-run program and cut out private insurers--is championing a proposal that not only isn't single payer, but doesn't even include the "public option" half-measure that liberals once insisted was non-negotiable.

Kucinich had continued to criticize the measure backed by the Obama White House and congressional Democratic leaders--until last Monday, when he was invited to fly with the president on Air Force One. By Tuesday, he had called a press conference to announce his support for Barack Obama's version of health care reform, and by Wednesday, he was marching around the House floor, trying to convince fellow Democrats to get on board.

President Obama confers with House Speaker Nancy Pelosi outside the Capitol building
President Obama confers with House Speaker Nancy Pelosi outside the Capitol building (Monique Cala)

Former Democratic National Committee Chair Howard Dean was another vociferous critic of the Senate bill last year. In an op-ed article, he presaged how the health care endgame would play out.

In Washington, when major bills near final passage, an inside-the-beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health care reform is done. The result is legislation that has been crafted to get votes, not reform health care.

That's exactly what's happened--but Dean is now a supporter of the Senate bill.

These surrenders are only the latest steps backward--away from the promises during the 2008 campaign of a reformed health care system, where the abuses of the insurance industry would be stopped, and toward the dismal reality of legislation that will do the opposite.

IN SPITE of the hysterical complaints of Republicans, the truth is that the health care measure House Democratic leaders hope to ram through this weekend is a disaster in the making for working people and a massive giveaway to the medical-pharmaceutical-insurance complex.

It will "mandate" people to buy policies from private insurers, without any guarantees of affordable premiums or adequate coverage. It won't have a "public option." It will slash spending and benefits for the federal government's Medicare program by $500 billion. It will impose a tax in some form on employer-provided insurance--supposedly aimed at expensive "Cadillac" plans, but in reality affecting any insurance that has decent benefits.

The list goes on and on. But the conventional wisdom is that the fate of the Obama presidency hangs on passing this legislation, so the White House and Democratic leaders like House Speaker Nancy Pelosi are bullying and bribing the holdouts in their party--mostly conservative "Blue Dog" Democrats who want even more concessions to the right.

A lot of the media's attention has been focused not on the content of the legislation but the bizarre maneuvering of the Democrats now that a united Republican Party has 41 votes in the Senate--enough to block a final version of the legislation negotiated between the House and Senate from coming to a vote.

Instead, House Democrats plan to approve the health care bill passed by the Senate late last year, but with a number of revisions that would be included in a separate measure called a budget reconciliation bill. The reconciliation measure could bypass a Republican filibuster in the Senate.

The possibility remains, however, that the Senate could ignore the House Democrats' revisions--there's no guarantee that it would take up the budget reconciliation bill.

In any case, the convoluted parliamentary maneuvers were an excuse for still more retreats. For example, in compiling the revisions that the House wants in the Senate bill, Democratic leaders dropped a measure supported by Obama that would give the federal government the authority to regulate health insurance premiums.

THE ADMINISTRATION'S push for health care legislation has been in trouble since January, when Republican Scott Brown won the special Senate election in Massachusetts. The Democrats still have the biggest majority in both houses of Congress than either party has had for years--but the fact that they don't have the super-majority necessary to overcome Republican filibusters under the undemocratic rules of the Senate has become the all-purpose excuse for Democrats to act like a panicked minority.

Nevertheless, the administration got a new boost of momentum--ironically, from something that shows the need for much more radical measures to fix the health care crisis.

In February, Anthem Blue Cross, a division of WellPoint, raised premiums by a whopping 39 percent on 700,000 individual plans in California. The increase caused an uproar that the Obama White House exploited to renew pressure on Congress to take up health care legislation.

Summoned to a congressional hearing, a well-coached Angela Braly, CEO of WellPoint--which netted $4.7 billion in profits last year--was unapologetic. "Raising our premiums was not something we wanted to do," Braly declared, "but we believe this was the most prudent choice given the rising cost of care and the problems caused by many younger and healthier policyholders dropping or reducing their coverage during tough economic times."

Braly went on to criticize the Democrats' health care proposals for having a weak "personal coverage requirement"--read: mandate. In fact, the legislation will force tens of millions of people into the arms of private insurers, but that's not good enough for Braly and Co.--they want no one exempted from the mandate and higher financial penalties for anyone who doesn't get coverage.

The next stop for Braly--along with Stephen Hemsley, CEO of UnitedHealth, the country's largest health insurer--was a private meeting at the White House with Obama and Health and Human Services Secretary Kathleen Sebelius. The meeting was described in the New York Times as "surprisingly cordial," but there were no concessions from the insurers on the premium increases.

The farce continued when Sebelius was dispatched to a meeting of America's Health Insurance Plans (AHIP), the insurance industry's association--not to demand anything, but to politely ask insurers to disclose requests for increases in premiums, along with data showing costs and other factors that justify the hikes. Insurance companies in 27 states have to do this already.

"It's not too late to work on this issue together--for insurance companies to come to the table and work with us," Sebelius told the meeting. But the truth is that the insurance bosses have been at the table from day one, shaping the Obama administration's proposals to be more in their favor.

The health care industry has used a two-pronged strategy with Washington. Its representatives participated as "stakeholders" in discussions with the Obama administration--and even more centrally with members of Congress, like Sen. Max Baucus, who actually wrote the legislation.

But the health care bosses have also kept up a steady stream of criticism of the Democrats' proposals, and provided financial and political support for the Republicans' opposition to all reform. This is meant to box in the Democrats from considering more radical proposals. For the health care giants, it's a win-win situation.

MEANWHILE, THE administration's push to get health care legislation passed at all costs is being aided and abetted by liberal commentators and some progressive Democratic-aligned organizations.

Economist and New York Times columnist Paul Krugman claims that the Senate version of "reform" is "a seriously flawed bill we'll spend years, if not decades, fixing." Nevertheless, he writes, "For a real piece of passable legislation, however, it looks very good. This is a reasonable, responsible plan. Don't let anyone tell you otherwise."

Wendell Potter--the former director of corporate communications for insurance giant Cigna-turned-whistleblower and trenchant critic of the insurance industry--now supports the Senate bill. In an interview with PBS's Bill Moyers, Potter declared, "Yes, it'll be a win for the insurance companies, but I don't think we're going to wind up with the insurance companies walking away and winning the whole ball game. If we don't do anything right now, that's what will happen."

Krugman, Potter and other liberal voices--some of them previously passionate defenders of single payer--who claim that "something is better than nothing" are wrong. The health care legislation that the White House and Congressional leaders want to pass is worse than nothing at all.

As Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and a sharp critic of the Democrats' proposals, explained:

What this bill does is not only permit the commercial insurance industry to remain in place, but it actually expands and cements their position as the linchpin of health care reform...Not only does it keep them in place, it pours about $500 billion of public money into these companies over 10 years...and it mandates that people buy these companies' products for whatever they charge.

One argument in favor of the Senate version of health care legislation made by Democrats and groups like Health Care for America Now, the labor-backed organization that has been for the Democrats' highly restricted "reform" proposals all along, is the claim that 30 million people without insurance today would gain coverage under the bill.

What they don't say is that it will take 10 years for that number to gain coverage. Fully half will be covered by Medicaid, a program that is in fiscal crisis in every state, where officials have made drastic cuts to balance budgets. More and more doctors are refusing to take Medicaid patients because reimbursements rates have been slashed.

And on top of that, more than one-third of the uninsured today, or around 20 million people, will still be uninsured 10 years into the reform--among them, millions of undocumented immigrants who won't be eligible for federal subsidies.

The other measures that can be painted as reform--like forbidding insurers from denying coverage to patients with pre-existing conditions--are long overdue, but are offset by concessions to insurers, like provisions allowing them to charge older patients more than younger ones.

On one point, according to liberals, the Senate bill is superior to the health care bill passed by the House last year: women's reproductive rights. The House version contained an amendment proposed by Democrat Bart Stupak that would have barred any insurer participating in the government insurance exchange for the uninsured from covering abortion as a medical procedure.

The Senate language on abortion, written by anti-choice Democrat Ben Nelson, isn't as all-encompassing--but it still represents an outrageous attack on women's rights. Women could buy a policy through the government insurance exchange that covers abortion, but they would have to write two checks each month, and insurers will have to keep the income in separate accounts. The incentive will be for insurers to drop abortion coverage.

Republicans and some Democrats still claim this isn't tough enough--but it was good enough for the organization that represents 90 percent of the 59,000 Catholic nuns in the U.S. to put its support behind the Democrats' health care measure.

If Obama and Pelosi get their way and the Senate bill is rammed through the House this weekend, we'll hear that the vote was historic. And it will be--a historic failure to mobilize the massive popular sentiment to get profit out of health care and truly reform a broken system.

Alan Maass contributed to this article.

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