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Categories: Action Alerts, Affordable Healthcare, Economic Fairness and Security, Higher Education, Honest and Ethical Government, National Security, Social Justice, Property Rights, News, Opinion, Front Page
Categories: Action Alerts, Affordable Healthcare, Economic Fairness and Security, Higher Education, Honest and Ethical Government, National Security, Social Justice, Property Rights, News, Opinion, Front Page
Our drive for single-payer–lost in the Obama movement?Healthcare, Ohio, The Democrats
A Weekly Column by Bill Onasch
July 13, 2008
Debilitating Deference
A chronic malady afflicting the labor and progressive movements in the USA erupts in to acute flare-ups every four years. Delusional symptoms of class subservience syndrome include the offer of sacrifices to one of two contending rivals to serve the gods of capital.
Not only treasure is involved in these offerings-though there's plenty of mammon spread around. Principles are tossed on ritual fires as well. We have recounted in past columns the deference shown to our masters on questions of war and environment. This past week fealty was expressed in an area even more basic to our day to day functioning, affecting every contract negotiation, sometimes posing literally life and death questions.
That issue is, of course, healthcare. It is by far the most contentious factor in collective bargaining in the United States. Unlike the rest of the industrialized world, healthcare in America is a commodity, just like food and fuel. Like their class cousins in Agribusiness and Big Oil, the healthcare robber barons are squeezing us to the last drop. As long as the working class remains dependent on private health insurance tied to their employer both the effectiveness of our actual healthcare and our overall standard of living will continue to sink. The system must be replaced.
Over the past couple of years, we saw a promising revival of the movement for at least a Canadian-style system, known as single-payer. Michael Moore's excellent film, SiCKO, demonstrated what is possible to a wider audience than ever. HR676, single-payer legislation introduced by Rep John Conyers, got an impressive number of sponsors in the House. Many government bodies and associations, such as the U.S. Conference of Mayors, have passed resolutions supporting HR676, as have groups such as the NAACP. The All Unions Committee For Single Payer Health Care has lined up endorsement of the bill by over 400 union bodies, including the majority of state labor feds and a number of "international" unions.
Leading the charge has been the California Nurses Association/National Nurses Organizing Committee (CNA). Single-payer is also the signature campaign of the Labor Party, working for it both in the unions, and in important coalitions in states such as Ohio and Florida. And even 15,000 doctors, organized in Physicians for a National Health Program, are on board for HR676.
But such an uppity movement by workers, healthcare professionals, and community allies is a mortal threat to a powerful section of the ruling class-and thus does not fit in to the electoral plans of our current savior's "run to the middle." So enter the new Health Care for America Now! (HCAN), a section 501(c)(4) issue advocacy organization. Its 100+ organizations include ACORN, AFL-CIO, AFSCME, Campaign for America's Future, Citizen Action, Jobs with Justice, Missouri Progressive Vote Coalition, MoveOn, National Council of La Raza, National Education Association, National Women's Law Center, Planned Parenthood Federation of America, the United Food and Commercial Workers and USAction. They started with a financial commitment of 500,000 dollars from each of the 13 organizations on their steering committee and a 10 million dollar grant from Atlantic Philanthropies. Their treasurer in charge of this slush fund, and their main "public face,"is Elizabeth Edwards, wife of former presidential candidate John Edwards-who was the first choice of many labor statesmen.
Being tax-exempt, Health Care for America Now! cannot endorse candidates. But it is a most fortunate coincidence that the healthcare they propose for us jibes with the wind of change in Senator Obama's sails. It is filled with vacuous platitudes-and it guarantees a continuing role for the robber barons.
In an aptly titled response, Why is Health Care for America Now giving up on real reform?, CNA's Rose Ann DeMoro writes,
"The groups behind the new coalition are working in concert with the Obama campaign and Democratic leaders in Congress to build 'consensus' around a plan that would presumably be introduced in the first days of the next administration, and pushed through to a quick vote before opponents can mount a 'Harry and Louse'-style counter attack.
"But, in search of a supposedly politically viable plan, the advocates of this approach have surrendered in advance on the only overhaul that will actually cure the disease, a single-payer, expanded and improved Medicare for all reform.
"…They've also missed one of the most important lessons of the failure of the Clinton plan of 1993-94 which collapsed in part due to the absence of a broad, grassroots, activist movement needed to counter the insurance industry. Only single payer engenders such a movement, the very reason the single payer bill now in Congress, HR 676, has more co-sponsors than any other reform bill with tens of thousands around the country already working to enact it."
Jenny Brown, co-chair of the Alachua County Labor Party in Gainesville, Florida, also takes on HCAN in an excellent article,
"In fact, the plan espoused by the HCAN coalition seems to be very close to what Barack Obama and Hillary Clinton advocated all through the primary -- regulate private insurance companies more, provide a mind-boggling patchwork of income-based subsidies (creating another layer of paperwork, tests and qualifications), and provide a public insurance alternative as a last resort. Worse, it continues to waste the money that could cover everyone. 'The HCAN proposal forgoes most of the $350 billion annually in administrative savings possible under single payer national health insurance,' writes David Himmelstein of Physicians for a National Health Program (PNHP).
"…The HCAN approach toys with, but then discards, the best leverage we have in the health care fight: the popular demand that insurance companies be kicked out of our health care system entirely. Eventually they will be, but it will be despite, not because of, the anemic plans of 'Health Care for America Now.'"
As with the war and environment, the struggle for genuine healthcare reform will not be won in the November election. We need to carry on the fight now-and be prepared for more of the same no matter who sits in the White House next January. We will not obtain fundamental reforms such as single-payer until we overcome class subservience syndrome. Labor should be the lead-not the tail pinned to the Democrat donkey. The only known treatment for our debilitation is a party of our own. It's time to revive the project-shamefully neglected by our union leadership-of building the one party that has stayed on message on healthcare and every other vital issue of the day-the Labor Party.
####
As you can see, Bill's article (though it fails to meniton PDA's unwavering position in support of single-payer) is spot in its assessment of what is transpiring. We PDAers have to be alert to the dynamics and must be ready to present our solid stance as one in opposition to the incrementalists, the back-sliders, and those who would capitulate to the main prolbem with our gaining real universal health care-the insurance industry.
In Solidarity,
Mike Carano
From Single Payer Health Care Supporters Press Conference.
----------
This next article by Jenny Brown, co-chair of the Alachua County Labor Party in Gainesville, sheds light on how the HCAN intentions, and it should be noted that their name slyly has coopted the title of our friend, Marylin Clement's "Healthcare-Now" organization in order to diffuse the great work she has done for pushing single-payer by confusing the public on just what real refrom is all about. One following the health care issue in America, also might note that the national leadership of SEIU (the Andy Stern camp) is also all about the incremental approach, regardless of their recent vote in San Juan to support single-payer, It might be noted that single-payer was presented froom the floor at their convention and subsequently bundled with other health care proposals that gives them the wiggle room to say they voted for single-payer while simultaneously allowing them to put their weight (as they have in the past with what they call "stakeholders," in other words "the insurance industry" ) behind an incremental approach that leaves the problem in the solution.
By the way, Bill Onasch's article can be found at this site, a site recommended by me since PDAers can keep informed of the Labor movement's take on many of the issues we support:
http://www.kclabor.org/
Here is Jenny Brown's article:
"Health Care for America Now":
Which Side Are They On?
by Jenny Brown
On June 19th, twenty of us from Gainesville, Florida traveled to Jacksonville to protest Blue Cross Blue Shield, my health insurance company. The effort was part of a nationwide protest of insurance companies, led by the coalition Healthcare NOW: Cigna in Philadelphia, Aetna in Hartford, Humana in Louisville, and many more. The biggest demonstration occurred in San Francisco, outside the meeting of "America's Health Insurance Plans," the insurance lobbying group dedicated to blocking health care reform. Malinda Markowitz, a leader in the National Nurses Organizing Committee, explained the protest: "These insurance companies . . . profit by denying care to our patients -- not by providing it. The American people are ready for guaranteed healthcare, through great bills like Rep. John Conyers' HR 676, and we will no longer let insurers and politicians block progress."
In Jacksonville, passing drivers honked vigorously when they saw our signs, "Health Care YES, Insurance Companies NO" and "Honk if you're mad at your insurance company." We met lots of new friends, union members in Jacksonville who are supporting national health insurance. Bunny Baker, a Machinist, said that a Blue Cross representative called the union hall to say he understood why we might protest other insurance companies, but "We're the good guys, we're nonprofit." She told him that Blue Cross was denying vital care to a friend of hers, making it hard to tell the difference. For my part, my Blue Cross premiums have gone up 57% in the last 3 years, so it's clear that even a "nonprofit" health insurance company is incapable of providing coverage affordably. We need national health insurance!
So I was interested when on July 8th I received emails from four separate national groups promoting a new campaign for health care reform. One was titled "An historic day for health care," and indeed it did seem to be. The new coalition is called "Health Care for America Now" (HCAN) and according to the New York Times it will spend $40 million on ads and organizing leading up to the election.
MoveOn.org Political Action wrote: "Today, for the first time ever, all the major grassroots groups in America that work on health care are coming together to take on the HMOs and private insurance companies." The linked HCAN website declared "Which side are you on?" -- "for a guarantee of quality affordable health care for all" or "for leaving us on our own to buy private health insurance."
It sounded promising. We certainly need to "take on" the insurance industry. Our private insurance system is the reason U.S. health care is the most expensive in the world, not to mention inaccessible and stingy. The most comprehensive bill in Congress, HR 676, authored by Rep. John Conyers (D-Michigan), would kick out the insurance company middlemen. It would redirect towards care the money currently wasted on insurance company profits and paperwork. It would follow the lead of countries around the world which provide healthcare as a right.
But it turns out that for HCAN "taking on" the insurance companies doesn't mean taking them out of our health care. Indeed, under HCAN's plan, we would still be buying private health insurance. A brief inspection of the Health Care for America Now website reveals just the kind of tiresome incrementalism that hobbles U.S. struggles for national health care.
In fact, the plan espoused by the HCAN coalition seems to be very close to what Barack Obama and Hillary Clinton advocated all through the primary -- regulate private insurance companies more, provide a mind-boggling patchwork of income-based subsidies (creating another layer of paperwork, tests and qualifications), and provide a public insurance alternative as a last resort. Worse, it continues to waste the money that could cover everyone. "The HCAN proposal forgoes most of the $350 billion annually in administrative savings possible under single payer national health insurance," writes David Himmelstein of Physicians for a National Health Program (PNHP).
"The private insurance industry, as it functions today, clearly must be replaced with a system that works" says Don McCann, Senior Health Policy Fellow with PNHP. "So what is the solution proposed by the HCAN coalition? Let's replace the private insurance industry with . . . the private insurance industry."
There were other warning signs. In a press conference launching HCAN, Arlene Holt Baker of the AFL-CIO stated, "If we fail to enact comprehensive reform in the next Congress, employment-based health benefits -- the backbone of our health system -- will disappear in short order." Most trade unionists have figured out by now: Job-based health benefits are precisely the problem. They burn up our power at the bargaining table, undermine our ability to speak out at work, make strikes even more risky and miserable, and lock us into jobs long past the date we might have been able to retire. Furthermore, if we're too sick to work, we'll lose our insurance, at just the moment we need it the most. Feminists chime in that job and marriage-based insurance makes a woman unnecessarily dependent on her husband -- and his employer -- for her health care. This is especially true if she is working part-time or raising children full-time. With true national health insurance, your health care doesn't depend on what job you have, whether you have a job, or your marital status. This should be the goal. Instead, this campaign seems to be rallying us to salvage the current rotten arrangement.
It's worth asking how we got to the point where groups that want to continue our private insurance system describe themselves as "taking on" the health insurance industry and advocating "guaranteed" health care. The movement to get private insurance out of our health care system has gained momentum as insurance costs have risen. Michael Moore's film SiCKO introduced a whole new audience to the reality of well-functioning national health care systems in other countries. Unions all over the country have been signing onto HR 676 -- called a "single-payer" bill because the government (the 'single-payer') pays all healthcare costs. HR 676 has been endorsed by 33 state AFL-CIOs and 397 union organizations in 48 states. The U.S. Conference of Mayors signed on June 23. The funding mechanism, similar to that of Medicare, turns out to cost nearly everyone much less than they're paying now, but allows for full coverage for the whole U.S. population. Around 90 members of Congress are signed on. Meanwhile, insurance company rate hikes and denials hit more and more people.
As a result, "taking on" insurance companies is suddenly popular. Groups like MoveOn, which a few years ago would only talk about extending coverage to children, have changed their tune. But they still don't get it. It's not about extending our expensive and unreliable private insurance system to 47 million uninsured, it's about abolishing a system that requires you to have "insurance" to get care. Private insurance companies make money by avoiding sick people. If you want everyone to get the care they need, you don't regulate such entities, you eradicate them.
Traditional Medicare did just that for a market that the insurance companies didn't want anyway: people 65 and over. The problems with Medicare were introduced by private insurers and HMOs, which have tried to entice away more profitable subsets of the elderly (only to dump them when they get expensive). As a practical matter, the Medicare experience teaches us that coverage and costs only get worse when private insurers are involved. HR 676 would essentially extend traditional Medicare to everyone, starting at age zero -- and entirely eliminate the role of private insurance companies.
Contrast that to HCAN, which would leave insurance companies in place. "We need coverage that meets our families' health care needs and is affordable, based on a sliding scale" their website states. "We need government to be an advocate for us and set and enforce the rules so insurance companies put our health care before their profits." But a sliding scale means we have to prove our income -- usually every year. And insurance companies are simply machines for making profit. Faced with new regulations, they just break the law until such time as they get caught, or can rewrite the law.
No wonder most people prefer Michael Moore's admirably brief health care proposal: "1. Every resident of the United States must have free, universal health care for life. 2. All health insurance companies must be abolished. 3. Pharmaceutical companies must be strictly regulated like a public utility."
Perhaps, you might say, well, it takes all kinds: There will always be the radical groups and then the more liberal groups. At least they're doing something. What's the objection?
My first objection is that the liberal groups in this case are cloaking themselves in radical language ('taking on the insurance companies,' 'guaranteed affordable quality healthcare for all') concealing their goals and suggesting they have more fight in them than they really do. They're even using a confusingly similar name. The main coalition that's been fighting for HR 676 is called "Healthcare NOW." The new coalition is called "Health Care for America Now." This trickery cuts off people who want fundamental change from those who are organizing for it, and diverts donations to what PNHP's David Himmelstein calls "a placebo."
My second objection is that HCAN is compromising away what people in the U.S. truly want, instead of joining the already existing fight to get it. For example, in a 2003 ABC News/Washington Post poll, 62 percent said they'd prefer a plan "in which everyone is covered under a program, like Medicare, that's run by the government and funded by taxpayers." Those who compromise the public's interests always sell their watered-down programs by saying the public finds them more palatable. In reality, these compromises are more palatable to the nonprofit foundation complex many of these organizations represent. The majority in the U.S. want the insurance companies out -- anything less is less than inspiring, and will lose support rather than gaining it.
My third objection is that their approach won't work, even to get the measly reforms they seek. To win any kind of progress, there needs to be some threat. The gathering of organizations under the HCAN banner serves to reassure the insurance industry, not threaten it. And so reassured, the industry will continue to purchase politicians and conduct its murderous business as usual. It certainly won't be put on the defensive.
The HCAN approach toys with, but then discards, the best leverage we have in the health care fight: The popular demand that insurance companies be kicked out of our health care system entirely. Eventually they will be, but it will be despite, not because of, the anemic plans of "Health Care for America Now."
Go to for the real deal.
Go to Physicians for a National Health Program for great explanations and analysis: .
Go to for the nurses' take on the situation.
-----------------------------------------------------
Jenny Brown is co-chair of the Alachua County Labor Party in Gainesville, Florida and co-editor, with Kathie Sarachild and Amy Coenen, of the Redstockings organizing packet, Women's Liberation and National Health Care: Confronting the Myth of America (available through http://www.redstockings.org).
Introduction by Michael Carano
It seems that our drive for single-payer is being diffused by those pushing to get voters out for the Democratic candidate, Obama. Now electing Obama is a good thing, so don’t get me wrong, but my fear is that the Dems will be using the health care card in 2008 as they did the Irag Occupation card in 2006 in order to get votes.
In the process, as you will see by the two articles I post, one from a Labor Party writer whom I know and respect, and the other from a woman in Florida who has insight into what is going on and how it will confuse voters about what is the best solution for real health care reform (single-payer, specifically Rep, John Conyers H.R. 676) and the fuzzy incremental approaches as put forth by Obama and the new coalition mentioned in the articles.
Let us not be confused as to what the new coalition is proposing, and let us be clear as to why we support single-payer over these wishy-washy plans proposed under the guise of “Universal Health Care” and their real shortcomings, they being bandaids to the real problem that a true universal, single-payer health care plan will cure.
A Weekly Column by Bill Onasch
July 13, 2008
Debilitating Deference
A chronic malady afflicting the labor and progressive movements in the USA erupts in to acute flare-ups every four years. Delusional symptoms of class subservience syndrome include the offer of sacrifices to one of two contending rivals to serve the gods of capital.
Not only treasure is involved in these offerings-though there's plenty of mammon spread around. Principles are tossed on ritual fires as well. We have recounted in past columns the deference shown to our masters on questions of war and environment. This past week fealty was expressed in an area even more basic to our day to day functioning, affecting every contract negotiation, sometimes posing literally life and death questions.
That issue is, of course, healthcare. It is by far the most contentious factor in collective bargaining in the United States. Unlike the rest of the industrialized world, healthcare in America is a commodity, just like food and fuel. Like their class cousins in Agribusiness and Big Oil, the healthcare robber barons are squeezing us to the last drop. As long as the working class remains dependent on private health insurance tied to their employer both the effectiveness of our actual healthcare and our overall standard of living will continue to sink. The system must be replaced.
Over the past couple of years, we saw a promising revival of the movement for at least a Canadian-style system, known as single-payer. Michael Moore's excellent film, SiCKO, demonstrated what is possible to a wider audience than ever. HR676, single-payer legislation introduced by Rep John Conyers, got an impressive number of sponsors in the House. Many government bodies and associations, such as the U.S. Conference of Mayors, have passed resolutions supporting HR676, as have groups such as the NAACP. The All Unions Committee For Single Payer Health Care has lined up endorsement of the bill by over 400 union bodies, including the majority of state labor feds and a number of "international" unions.
Leading the charge has been the California Nurses Association/National Nurses Organizing Committee (CNA). Single-payer is also the signature campaign of the Labor Party, working for it both in the unions, and in important coalitions in states such as Ohio and Florida. And even 15,000 doctors, organized in Physicians for a National Health Program, are on board for HR676.
But such an uppity movement by workers, healthcare professionals, and community allies is a mortal threat to a powerful section of the ruling class-and thus does not fit in to the electoral plans of our current savior's "run to the middle." So enter the new Health Care for America Now! (HCAN), a section 501(c)(4) issue advocacy organization. Its 100+ organizations include ACORN, AFL-CIO, AFSCME, Campaign for America's Future, Citizen Action, Jobs with Justice, Missouri Progressive Vote Coalition, MoveOn, National Council of La Raza, National Education Association, National Women's Law Center, Planned Parenthood Federation of America, the United Food and Commercial Workers and USAction. They started with a financial commitment of 500,000 dollars from each of the 13 organizations on their steering committee and a 10 million dollar grant from Atlantic Philanthropies. Their treasurer in charge of this slush fund, and their main "public face,"is Elizabeth Edwards, wife of former presidential candidate John Edwards-who was the first choice of many labor statesmen.
Being tax-exempt, Health Care for America Now! cannot endorse candidates. But it is a most fortunate coincidence that the healthcare they propose for us jibes with the wind of change in Senator Obama's sails. It is filled with vacuous platitudes-and it guarantees a continuing role for the robber barons.
In an aptly titled response, Why is Health Care for America Now giving up on real reform?, CNA's Rose Ann DeMoro writes,
"The groups behind the new coalition are working in concert with the Obama campaign and Democratic leaders in Congress to build 'consensus' around a plan that would presumably be introduced in the first days of the next administration, and pushed through to a quick vote before opponents can mount a 'Harry and Louse'-style counter attack.
"But, in search of a supposedly politically viable plan, the advocates of this approach have surrendered in advance on the only overhaul that will actually cure the disease, a single-payer, expanded and improved Medicare for all reform.
"…They've also missed one of the most important lessons of the failure of the Clinton plan of 1993-94 which collapsed in part due to the absence of a broad, grassroots, activist movement needed to counter the insurance industry. Only single payer engenders such a movement, the very reason the single payer bill now in Congress, HR 676, has more co-sponsors than any other reform bill with tens of thousands around the country already working to enact it."
Jenny Brown, co-chair of the Alachua County Labor Party in Gainesville, Florida, also takes on HCAN in an excellent article,
"In fact, the plan espoused by the HCAN coalition seems to be very close to what Barack Obama and Hillary Clinton advocated all through the primary -- regulate private insurance companies more, provide a mind-boggling patchwork of income-based subsidies (creating another layer of paperwork, tests and qualifications), and provide a public insurance alternative as a last resort. Worse, it continues to waste the money that could cover everyone. 'The HCAN proposal forgoes most of the $350 billion annually in administrative savings possible under single payer national health insurance,' writes David Himmelstein of Physicians for a National Health Program (PNHP).
"…The HCAN approach toys with, but then discards, the best leverage we have in the health care fight: the popular demand that insurance companies be kicked out of our health care system entirely. Eventually they will be, but it will be despite, not because of, the anemic plans of 'Health Care for America Now.'"
As with the war and environment, the struggle for genuine healthcare reform will not be won in the November election. We need to carry on the fight now-and be prepared for more of the same no matter who sits in the White House next January. We will not obtain fundamental reforms such as single-payer until we overcome class subservience syndrome. Labor should be the lead-not the tail pinned to the Democrat donkey. The only known treatment for our debilitation is a party of our own. It's time to revive the project-shamefully neglected by our union leadership-of building the one party that has stayed on message on healthcare and every other vital issue of the day-the Labor Party.
####
As you can see, Bill's article (though it fails to meniton PDA's unwavering position in support of single-payer) is spot in its assessment of what is transpiring. We PDAers have to be alert to the dynamics and must be ready to present our solid stance as one in opposition to the incrementalists, the back-sliders, and those who would capitulate to the main prolbem with our gaining real universal health care-the insurance industry.
In Solidarity,
Mike Carano
From Single Payer Health Care Supporters Press Conference.
----------
This next article by Jenny Brown, co-chair of the Alachua County Labor Party in Gainesville, sheds light on how the HCAN intentions, and it should be noted that their name slyly has coopted the title of our friend, Marylin Clement's "Healthcare-Now" organization in order to diffuse the great work she has done for pushing single-payer by confusing the public on just what real refrom is all about. One following the health care issue in America, also might note that the national leadership of SEIU (the Andy Stern camp) is also all about the incremental approach, regardless of their recent vote in San Juan to support single-payer, It might be noted that single-payer was presented froom the floor at their convention and subsequently bundled with other health care proposals that gives them the wiggle room to say they voted for single-payer while simultaneously allowing them to put their weight (as they have in the past with what they call "stakeholders," in other words "the insurance industry" ) behind an incremental approach that leaves the problem in the solution.
By the way, Bill Onasch's article can be found at this site, a site recommended by me since PDAers can keep informed of the Labor movement's take on many of the issues we support:
http://www.kclabor.org/
Here is Jenny Brown's article:
"Health Care for America Now":
Which Side Are They On?
by Jenny Brown
On June 19th, twenty of us from Gainesville, Florida traveled to Jacksonville to protest Blue Cross Blue Shield, my health insurance company. The effort was part of a nationwide protest of insurance companies, led by the coalition Healthcare NOW: Cigna in Philadelphia, Aetna in Hartford, Humana in Louisville, and many more. The biggest demonstration occurred in San Francisco, outside the meeting of "America's Health Insurance Plans," the insurance lobbying group dedicated to blocking health care reform. Malinda Markowitz, a leader in the National Nurses Organizing Committee, explained the protest: "These insurance companies . . . profit by denying care to our patients -- not by providing it. The American people are ready for guaranteed healthcare, through great bills like Rep. John Conyers' HR 676, and we will no longer let insurers and politicians block progress."
In Jacksonville, passing drivers honked vigorously when they saw our signs, "Health Care YES, Insurance Companies NO" and "Honk if you're mad at your insurance company." We met lots of new friends, union members in Jacksonville who are supporting national health insurance. Bunny Baker, a Machinist, said that a Blue Cross representative called the union hall to say he understood why we might protest other insurance companies, but "We're the good guys, we're nonprofit." She told him that Blue Cross was denying vital care to a friend of hers, making it hard to tell the difference. For my part, my Blue Cross premiums have gone up 57% in the last 3 years, so it's clear that even a "nonprofit" health insurance company is incapable of providing coverage affordably. We need national health insurance!
So I was interested when on July 8th I received emails from four separate national groups promoting a new campaign for health care reform. One was titled "An historic day for health care," and indeed it did seem to be. The new coalition is called "Health Care for America Now" (HCAN) and according to the New York Times it will spend $40 million on ads and organizing leading up to the election.
MoveOn.org Political Action wrote: "Today, for the first time ever, all the major grassroots groups in America that work on health care are coming together to take on the HMOs and private insurance companies." The linked HCAN website declared "Which side are you on?" -- "for a guarantee of quality affordable health care for all" or "for leaving us on our own to buy private health insurance."
It sounded promising. We certainly need to "take on" the insurance industry. Our private insurance system is the reason U.S. health care is the most expensive in the world, not to mention inaccessible and stingy. The most comprehensive bill in Congress, HR 676, authored by Rep. John Conyers (D-Michigan), would kick out the insurance company middlemen. It would redirect towards care the money currently wasted on insurance company profits and paperwork. It would follow the lead of countries around the world which provide healthcare as a right.
But it turns out that for HCAN "taking on" the insurance companies doesn't mean taking them out of our health care. Indeed, under HCAN's plan, we would still be buying private health insurance. A brief inspection of the Health Care for America Now website reveals just the kind of tiresome incrementalism that hobbles U.S. struggles for national health care.
In fact, the plan espoused by the HCAN coalition seems to be very close to what Barack Obama and Hillary Clinton advocated all through the primary -- regulate private insurance companies more, provide a mind-boggling patchwork of income-based subsidies (creating another layer of paperwork, tests and qualifications), and provide a public insurance alternative as a last resort. Worse, it continues to waste the money that could cover everyone. "The HCAN proposal forgoes most of the $350 billion annually in administrative savings possible under single payer national health insurance," writes David Himmelstein of Physicians for a National Health Program (PNHP).
"The private insurance industry, as it functions today, clearly must be replaced with a system that works" says Don McCann, Senior Health Policy Fellow with PNHP. "So what is the solution proposed by the HCAN coalition? Let's replace the private insurance industry with . . . the private insurance industry."
There were other warning signs. In a press conference launching HCAN, Arlene Holt Baker of the AFL-CIO stated, "If we fail to enact comprehensive reform in the next Congress, employment-based health benefits -- the backbone of our health system -- will disappear in short order." Most trade unionists have figured out by now: Job-based health benefits are precisely the problem. They burn up our power at the bargaining table, undermine our ability to speak out at work, make strikes even more risky and miserable, and lock us into jobs long past the date we might have been able to retire. Furthermore, if we're too sick to work, we'll lose our insurance, at just the moment we need it the most. Feminists chime in that job and marriage-based insurance makes a woman unnecessarily dependent on her husband -- and his employer -- for her health care. This is especially true if she is working part-time or raising children full-time. With true national health insurance, your health care doesn't depend on what job you have, whether you have a job, or your marital status. This should be the goal. Instead, this campaign seems to be rallying us to salvage the current rotten arrangement.
It's worth asking how we got to the point where groups that want to continue our private insurance system describe themselves as "taking on" the health insurance industry and advocating "guaranteed" health care. The movement to get private insurance out of our health care system has gained momentum as insurance costs have risen. Michael Moore's film SiCKO introduced a whole new audience to the reality of well-functioning national health care systems in other countries. Unions all over the country have been signing onto HR 676 -- called a "single-payer" bill because the government (the 'single-payer') pays all healthcare costs. HR 676 has been endorsed by 33 state AFL-CIOs and 397 union organizations in 48 states. The U.S. Conference of Mayors signed on June 23. The funding mechanism, similar to that of Medicare, turns out to cost nearly everyone much less than they're paying now, but allows for full coverage for the whole U.S. population. Around 90 members of Congress are signed on. Meanwhile, insurance company rate hikes and denials hit more and more people.
As a result, "taking on" insurance companies is suddenly popular. Groups like MoveOn, which a few years ago would only talk about extending coverage to children, have changed their tune. But they still don't get it. It's not about extending our expensive and unreliable private insurance system to 47 million uninsured, it's about abolishing a system that requires you to have "insurance" to get care. Private insurance companies make money by avoiding sick people. If you want everyone to get the care they need, you don't regulate such entities, you eradicate them.
Traditional Medicare did just that for a market that the insurance companies didn't want anyway: people 65 and over. The problems with Medicare were introduced by private insurers and HMOs, which have tried to entice away more profitable subsets of the elderly (only to dump them when they get expensive). As a practical matter, the Medicare experience teaches us that coverage and costs only get worse when private insurers are involved. HR 676 would essentially extend traditional Medicare to everyone, starting at age zero -- and entirely eliminate the role of private insurance companies.
Contrast that to HCAN, which would leave insurance companies in place. "We need coverage that meets our families' health care needs and is affordable, based on a sliding scale" their website states. "We need government to be an advocate for us and set and enforce the rules so insurance companies put our health care before their profits." But a sliding scale means we have to prove our income -- usually every year. And insurance companies are simply machines for making profit. Faced with new regulations, they just break the law until such time as they get caught, or can rewrite the law.
No wonder most people prefer Michael Moore's admirably brief health care proposal: "1. Every resident of the United States must have free, universal health care for life. 2. All health insurance companies must be abolished. 3. Pharmaceutical companies must be strictly regulated like a public utility."
Perhaps, you might say, well, it takes all kinds: There will always be the radical groups and then the more liberal groups. At least they're doing something. What's the objection?
My first objection is that the liberal groups in this case are cloaking themselves in radical language ('taking on the insurance companies,' 'guaranteed affordable quality healthcare for all') concealing their goals and suggesting they have more fight in them than they really do. They're even using a confusingly similar name. The main coalition that's been fighting for HR 676 is called "Healthcare NOW." The new coalition is called "Health Care for America Now." This trickery cuts off people who want fundamental change from those who are organizing for it, and diverts donations to what PNHP's David Himmelstein calls "a placebo."
My second objection is that HCAN is compromising away what people in the U.S. truly want, instead of joining the already existing fight to get it. For example, in a 2003 ABC News/Washington Post poll, 62 percent said they'd prefer a plan "in which everyone is covered under a program, like Medicare, that's run by the government and funded by taxpayers." Those who compromise the public's interests always sell their watered-down programs by saying the public finds them more palatable. In reality, these compromises are more palatable to the nonprofit foundation complex many of these organizations represent. The majority in the U.S. want the insurance companies out -- anything less is less than inspiring, and will lose support rather than gaining it.
My third objection is that their approach won't work, even to get the measly reforms they seek. To win any kind of progress, there needs to be some threat. The gathering of organizations under the HCAN banner serves to reassure the insurance industry, not threaten it. And so reassured, the industry will continue to purchase politicians and conduct its murderous business as usual. It certainly won't be put on the defensive.
The HCAN approach toys with, but then discards, the best leverage we have in the health care fight: The popular demand that insurance companies be kicked out of our health care system entirely. Eventually they will be, but it will be despite, not because of, the anemic plans of "Health Care for America Now."
Go to for the real deal.
Go to Physicians for a National Health Program for great explanations and analysis: .
Go to for the nurses' take on the situation.
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Jenny Brown is co-chair of the Alachua County Labor Party in Gainesville, Florida and co-editor, with Kathie Sarachild and Amy Coenen, of the Redstockings organizing packet, Women's Liberation and National Health Care: Confronting the Myth of America (available through http://www.redstockings.org).
