By BAR executive editor Glen Ford  [print_link]

President Obama attempts to depict proponents of Medicare for all as lefty health care “extremists.” But that’s precisely the kind of “robust” public plan favored by two-thirds of Americans, according to a recent poll. Obama is to the Right of the people, and the GOP is off the map.

“Most people favor a public option that is a lot more “robust” than anything the Congress is offering.”

Despite the infamous Max Baucus Senate committee’s long-anticipated rejection of even a fig leaf of a public health care “option,” public opinion remains remarkably firm in support of allowing everyone access to a comprehensive government health plan. A New York Times/CBS News survey last week provided the best polling evidence in recent months that most people favor a public option that is a lot more “robust” than anything the Congress is offering, aside from straight-up single payer.

The poll once again confirms that something very much like single payer remains an idea whose time has come. After all these month’s of the Obama Administration’s attempts to shrivel into near nothingness the very concept of health care “reform,” and despite the mad howlings of Republicans about the evils of “socialized medicine,” two-thirds of the American people still support a Medicare-like government health care plan. Unlike some recent surveys, the language of the pollsters’ question was straightforward and unambiguous:

“Would you favor or oppose the government offering everyone a government-administered health insurance plan like Medicare that would compete with private health insurance plans?”

That is the definition of a very “robust” public health care option. Sixty-five percent of respondents said they were in favor.

“Americans overwhelmingly endorse expanding Medicare to all who want it.”

It’s a pity that the New York Times and CBS News neglected to ask how the public feels about a full-blown single payer plan, which has for years commanded strong majorities. But the poll does show conclusively that Americans overwhelmingly endorse expanding Medicare to all who want it – and let the private insurers sink or swim on their own.

Still, it is a wonderment that, with all the disinformation from the Hard Right, and almost a year of backroom dealing, backstabbing and dissembling from President Obama and other corporate Democrats, who have mangled reform into a giant subsidy for the privateers, the people still know what they want: Medicare for all, at the very least.

HR 676, the Enhanced Medicare For All single payer bill – but the measure is anathema to President Obama, who spent most of his energies marginalizing Conyers and his allies in the early months of the administration. Obama has consistently (and viciously) tried to depict single payers and their “robust” fellow travelers as the “extremist” lefty mirror images of rightwing “tea-baggers.” Yet at the end of the day, the public center of gravity on health care remains situated in the political realm of the Congressional Progressive and Black Caucuses. Obama is way off to the Right somewhere, in the general vicinity of his soul mate Sen. Baucus, whom the president early on empowered as his health care torchbearer (more like fire-quencher).

“The ‘robust’ public option does not exist in any practical sense.”

The NYT/CBS poll shows the public is not in the least confused about what it wants from the president and the congress on the health care front. Rather, they are befuddled about what Obama wants (55 percent say he has not clearly explained himself), and near-totally up in the air about what the Republicans want (76 percent don’t understand the GOP’s position). The more the people learn about both, the less they’ll like either of them.

Which brings me to the most uplifting aspect of the poll: It is the best recent evidence that Obama has not succeeded in narrowing public perceptions of the scope of health care “reform” to fit his own puny, corporate-vetted positions. The real reform genie is permanently out of the bottle, and he is quite “robust.”

Black Agenda Report executive editor Glen Ford can be contacted at Glen.Ford@BlackAgendaReport.com .

Dateline: September 14, 2009

By PAUL CRAIG ROBERTS

The current health care “debate” shows how far gone representative government is in the United States.  Members of Congress represent the powerful interest groups that fill their campaign coffers, not the people who vote for them.

The health care bill is not about health care.  It is about protecting and increasing the profits of the insurance companies.  The main feature of the health care bill is the “individual mandate,” which requires everyone in America to buy health insurance.  Senate Finance Committee chairman Max Baucus (D-Mont), a recipient of millions in contributions over his career from the insurance industry, proposes to impose up to a $3,800 fine on Americans who fail to purchase health insurance.

The determination of “our” elected representatives to serve the insurance industry is so compelling that Congress is incapable of recognizing the absurdity of these proposals.

The reason there is a health care crisis in the US is that the cumulative loss of jobs and benefits has swollen the uninsured to approximately 50 million Americans.  They cannot afford health insurance any more than employers can afford to provide it.

It is absurd to mandate that people purchase what they cannot afford and to fine them for failing to do so.  A person who cannot pay a health insurance premium cannot pay the fine. These proposals are like solving the homeless problem by requiring the homeless to purchase a house.

In his speech Obama said “we’ll provide tax credits” for “those individuals and small businesses who still can’t afford the lower-priced insurance available in the exchange” and he said low-cost coverage will be offered to those with preexisting medical conditions.  A tax credit is useless to those without income unless the credit is refundable, and subsidized coverage doesn’t do much for those millions of Americans with no jobs.

Baucus masquerades as a defender of the health impaired with his proposal to require insurers to provide coverage to all comers as if the problem of health care can be reduced to preexisting conditions and cancelled policies.  It was left to Rep. Dennis Kucinich to point out that the health care bill ponies up 30 million more customers for the private insurance companies.

The private sector is no longer the answer, because the income levels of the vast majority of Americans are insufficient to bear the cost of health insurance today.  To provide some perspective, the monthly premium for a 60-year old female for a group policy (employer-provided) with Blue Cross Blue Shield in Florida is about $1,200.  That comes to $14,400 per year.  Only employees in high productivity jobs that can provide both a livable salary and health care can expect to have employer-provided coverage. If a 60-year old female has to buy a non-group policy as an individual, the premium would be even higher. How, for example, is a Wal-Mart shelf stocker or check out clerk going to be able to pay a private insurance premium?

Even the present public option–Medicare–is very expensive to those covered.  Basic Medicare is insufficient coverage.  Part B has been added, for which about $100 per month is deducted from the covered person’s Social Security check.  If the person is still earning or has other retirement income, an “income-related monthly adjustment” is also deducted as part of the Part B premium.  And if the person is still working, his earnings are subject to the 2.9 percent Medicare tax.

Even with Part B, Medicare coverage is still insufficient except for the healthy.  For many people, additional coverage from private supplementary policies, such as the ones sold by AARP, is necessary.  These premiums can be as much as $277 per month.  Deductibles remain and prescriptions are only 50% covered.  If the drug prescription policy is chosen, the premium is higher.

This leaves a retired person on Medicare who has no other retirement income of significance paying as much as $4,500 per year in premiums in order to create coverage under Medicare that still leaves half of his prescription medicines out-of-pocket.  Considering the cost of some prescription medicines, a Medicare-covered person with Part B and a supplementary policy can still face bankruptcy.

Therefore, everyone should take note that a “public option” can leave people with large out-of-pocket costs. I know a professional who has chosen to continue working beyond retirement age.  His Medicare coverage with supplemental coverage, Medicare tax, and income-related monthly adjustment comes to $16,400 per year.  Those people who want to deny Medicare to the rich will cost the system a lot of money.

What the US needs is a single-payer not-for-profit health system that pays doctors and nurses sufficiently that they will undertake the arduous training and accept the stress and risks of dealing with illness and diseases.

A private health care system worked in the days before expensive medical technology, malpractice suits, high costs of bureaucracy associated with third-party payers and heavy investment in combating fraud, and pressure on insurance companies from Wall Street to improve “shareholder returns.”

Despite the rise in premiums, payments to health care providers, such as doctors, appear to be falling along with coverage to policy holders.  The system is no longer functional and no longer makes sense.  Health care has become an incidental rather than primary purpose of the health care system.  Health care plays second fiddle to insurance company profits and salaries to bureaucrats engaged in fraud prevention and discovery.  There is no point in denying coverage to one-sixth of the population in the name of saving a nonexistent private free market health care system.

The only way to reduce the cost of health care is to take the profit and paperwork out of health care.

Nothing humans design will be perfect. However, Congress is making it clear to the public that the wrong issues are front and center, such as the belief of Rep. Joe Wilson (R-SC) and others that illegal aliens and abortions will be covered if government pays the bill.

Debate focuses on subsidiary issues, because Congress no longer writes the bills it passes.  As Theodore Lowi made clear in his book, The End of Liberalism, the New Deal transferred law-making from the legislative to the executive branch. Executive branch agencies and departments write bills that they want and hand them off to sponsors in the House and Senate.  Powerful interest groups took up the same practice.

The interest groups that finance political campaigns expect their bills to be sponsored and passed.

Thus: a health care reform bill based on forcing people to purchase private health insurance and fining them if they do not.

When bills become mired in ideological conflict, as has happened to the health care bill, something usually passes nevertheless.  The president, his PR team, and members of Congress want a health care bill on their resume and to be able to claim that they passed a health care bill, regardless of whether it provides any health care.

The cost of adding public expenditures for health care to a budget drowning in red ink from wars, bank bailouts, and stimulus packages means that the most likely outcome of a health care bill will benefit insurance companies and use mandated private coverage to save public money by curtailing Medicare and Medicaid.

The public’s interest is not considered to be the important determinant.  The politicians have to please the insurance companies and reduce health care expenditures in order to save money for another decade or two of war in the Middle East.

The telltale part of Obama’s speech was the applause in response to his pledge that “I will not sign a plan that adds one dime to our deficits.”  Yet, Obama and his fellow politicians have no hesitation to add trillions of dollars to the deficit in order to fund wars.

The profits of military/security companies are partly recycled into campaign contributions. To cut war spending in order to finance a public health care system would cost politicians campaign contributions from both the insurance industry and the military/security industry.

Politicians are not going to allow that to happen.

It was the war in Afghanistan, not health care, that President Obama declared to be a “necessity.”

Paul Craig Roberts was (incredibly!) Assistant Secretary of the Treasury in the Reagan administration. He is coauthor of The Tyranny of Good Intentions. His new book, War of the Worlds: How the Economy Was Lost, will be published next month by AK Press/CounterPunch. He can be reached at: PaulCraigRoberts@yahoo.com