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Why the Dems Won't Fix Health Care

As the Democratic presidential candidates’ positions on health care policy reform have solidified, the issue of mandates has become increasingly important as it is one of the few differences between the various plans. While the right has towed the free market company line on health care, and while the Democrats’ paths differ from the Republicans’, the destination is the same: a huge payday for insurance companies. According to Shum Preston of the California Nurses Association (CNA), “Individual mandates are a step backward…Insurance companies support individual mandate plans because they guarantee them more customers, revenues, and influence over medical decision making. What’s not for them to like?” Any health care proposal that includes mandates without addressing the problems that corporate health care and insurance companies pose maintains the status quo. Barack Obama's and Hillary Clinton’s plans differ in that Obama's plan doesn't include mandates, while Clinton's does. What remains identical between the two candidates’ plans is the desire for universal health insurance, which is not to be mistaken for universal health care. John Edwards’ populist message includes a mandate and an option between public and private care, which detractors say will compromise the public option in the end.

Mandates, say Preston, “Force patients to sign up for expensive, wasteful, for-profit insurance products without guaranteeing care or protecting them from cost increases.” The CNA and its national wing, the National Nurses Organizing Committee, are a major lobbying force in the health care debate, one of the only organizations pushing for a universal single-payer model.

In a whirlwind past couple of weeks, CNA and NNOC placed advertisements in 10 Iowa newspapers that made national news, went on a two day strike in Northern California, and organized a national protest against the health insurance company Cigna HealthCare, which let a young woman die by refusing to cover her liver transplant. The message they are trying to convey in all of these actions is that the problem with the health care system isn’t just that not everyone is covered; it is that the companies that run it succeed financially by denying access and care. Mandated care doesn’t solve this problem.

The advertisement shocked many media outlets around the country as it declared that were he not on the government’s health care plan, Vice President Cheney “would probably be dead by now.” According to the union, his past medical history—which includes four heart attacks, quadruple bypass surgery, angioplasty, an implanted defibrillator—would disqualify him from signing up for any insurance plan other than the government’s. A Cheney spokeswoman responded to the ad by calling it “outrageous.”

Much of CNA’s lobbying for single-payer care falls in line with its actions as a union. The recent strike at Sutter Hospitals in Northern California was in response to nurses at those hospitals working without a contract for several months, and to press Sutter to meet statewide safety standards. The company is also attempting to close three Bay Area hospitals that have traditionally served the underserved.

The tragic death of 17-year-old Natalie Sarkisyan on December 21st illustrates many of these issues and the immediate need for reform. Sarkisyan’s liver had shut down after chemotherapy treatments for two bouts of cancer at the UCLA Medical Center. On December 11th Cigna denied her treatment while she was in critical condition. Four doctors wrote to Cigna that same day saying that she was ready for the transplant and that there was a good chance that her other organs would recover on their own if she had a new liver. On December 14th Cigna replied that a healthy liver was available, but insurance wouldn’t cover it and the family would have to make a $75,000 down payment on the liver, which they could not afford. The CNA and the NNOC organized a massive protest and put enough pressure on Cigna to force it to capitulate on December 20th. It was too late, however, and Sarkisyan died soon after. Rose Ann DeMoro, president of CNA, called it “a horrific tragedy that demonstrates what is so fundamentally wrong with our health care system today. Insurance companies have a stranglehold on our health. Their first priority is to make profits for their shareholders—and the way they do that is by denying care.”

While CNA will only actively support a single-payer model, “any plan without mandates is better than any with mandates,” says Preston. Obama has taken heat from the Clinton camp for not mandating health care for adults, but in lieu of a single-payer plan, Obama’s is the only plan that doesn’t bow completely to the insurance companies. Edwards suggests that people have the option of choosing public or private plans, yet according to Preston, “if we allow [insurance companies] to compete with public health programs, they’ll cherry pick the best customers and shuffle high risk patients on to the public dime. The idea that we can hope and regulate them to become good people isn’t going to work.” It seems as though while health care is supposedly a major issue in this upcoming election, there won’t be significant reform, no matter who comes out on top.

—Andre Sternberg

Comments

The only thing that is broken in health care is the cost of health care and no one is addressing this problem. The government caused the problem with health care cost crises in America by over socializing (with mandates) medicine to the extent it is not completive.
http://www.InteliOrg.com/

Posted by: Dr Coles on 12/26/07 at 3:24 PM Respond

Cheney's office is correct; it is outrageous. It's outrageous that he can get the health care that he does on the public dime, while standing in the way of the public at large getting merely decent health care. It's outrageous that Bush continues to demand more and more money for his wars (I just saw an article this am when Sen. Stevens puts the cost of Bush's wars at $15BILLION per month) while vetoing extended health care for children (because we can't *afford* $20Billion over 5 years).

Bush has often stated that our medical decisions should be between us and our doctors; and not involve some government bureaucrat. I guess that attitude comes from having government provided health care. He doesn't realize that our medical decisions haven't been between us and our doctors for a number of years now. I for one would rather have a government bureaucrat (who is being paid by my tax dollars) involved than the insurance company bureaucrat who is now involved (who is paid by the insurance company, and whose bonuses, promotions, and possibly continues employment depend on saving the insurance company money).

Posted by: DaveD on 12/27/07 at 5:29 AM Respond

While I'm all for single payer, it's just fantasy to think that it would end the rationing of care. It is unquestionable that the British and probably Canadians would not have covered Natalie Sarkisyan's transplant.

The big issue in health care is cost. Whether it's the gov't or private insurance, the hardest thing is saying "no" to wasting money on expensive procedures to briefly prolong the lives of people who are going to die anyway.

As a post on Daily Kos said:
"I am a supporter of single payer health care, primarily because I believe it will rein in both the cost of providing care and the cost of paying claims. I have no illusions, however, that implementation will eliminate all problems in our health care system. It would be ironic if the Nataline Sarkisyan case was the impetus for a national single payer plan, when it appears that such a plan might well not have approved her transplant."

Posted by: Phil K on 12/27/07 at 9:11 AM Respond

Why can't we just say "Taxpayer Funded", when that's what we're really talking about?

That "Single Payer" is actually hundreds of millions of taxpayers, and we owe it to ourselves to exhibit some intellectual honesty about what we're promoting, rather than obscuring the truth with catchy phrases.

"Single Payer" is taxpayer funded and government controlled, so just say it out loud.
If the thought of having the same people who run the War on Drugs and the War in Iraq in charge of running our medical system is not a comforting one, that makes it all that much more imperative that we take a long, hard look at the reality of the concept before we make such a massive and irreversable change.

Posted by: REALITY CHECK on 12/27/07 at 12:12 PM Respond

Let's do a "Hugo Chavez" on Healthcare. Nationalize the Pharma Industry and all Hospitals and Clinics. Conscript all Health Care delivery people into a Medical Army. Have the Gov't run Medical schools and decide how many and what kind of doctors to produce. Require them to serve 10 years for their education. Ban any private delivery of health services under criminal penalty. Pay for it all with a tax on the top 5% of income earners and a 1% annual Net Wealth Tax. Finally, the ultimate liberal health care fantasy!

Posted by: Isopluvial on 12/27/07 at 12:35 PM Respond

"The big issue in health care is cost. Whether it's the gov't or private insurance, the hardest thing is saying "no" to wasting money on expensive procedures to briefly prolong the lives of people who are going to die anyway." Part of Phil K's post.
In response to Phil K, if you are ever in the position of the young woman that needed the transplant or her family, will you say no to it to avoid wasting money?

Posted by: zqahtt on 12/27/07 at 12:43 PM Respond

Is no one aware that Dennis Kucinich and John Conyers have a bill in the House at the present time the will give us Universal Health Care Ins. now and not wait until Kucinich is elected? People need to sort out the difference between the providing of health care, providing access to care and paying for it. We have excellent health care in this country, the worst access in the industrialized world and an even worse method of paying for it. Our health care delivery system is so bad that the nations who have had real Universal Health Care for the last 30 or so years are now growing taller citizens than we are!

Posted by: Barbara Ashman on 12/27/07 at 1:46 PM Respond

It's time to take the profit incentive out of our health care. Only Kucinich has plans to do so.

As examples of the results of profit incentive, consider that the U.S. is 5% of the world's population but consumes 56% of the world's medication. We are overmedicated fools.

Further, cesarian sections are so popular in the U.S. (because the docs make more money) that we are actually breeding a race of humans where many are already physically unable to give birth vaginally. Without the selective force for smaller head size at birth, babies' heads are getting too big to fit through the birth canal.

This sounds good to a misanthrope like me with no plans to have children, but should scare those planning to breed.

Posted by: Misanthropic Scott on 12/28/07 at 5:26 AM Respond

Candidates proposing universal health care are inspiring. However, we need
to fix the health care system as well.
As a patient and a former employee (I used to work at a famous hospital on
Long Island) of the health care system - I have first-hand knowledge on how
the care system works in America.
Close to 100,000 people die each year in hospitals due to medical errors.
The hospital I worked at had too much administrative waste. There was
endless paperwork in processing patient information.
Many of the positions, especially in the non-medical areas, were filled
through nepotism. Many of the supervisors and mid-level managers at this
hospital were concerned about how they looked to top administrators, rather
then perform thier jobs effectively. (CYA was the major activity).
A question I would like to ask the general public, particularly doctors -
How come doctors never challenge other doctors?
Right after I graduated college I was “confused,” doing drugs, and getting into trouble; so my parents sent me to psychiatrist. The psychiatrist said I was “mentally ill” and he sent me to neurologist for my tests. (Our family doctor stated at first I did not need any tests, and then he changed his mind.) The neurologist examined my brain and said I was fine. I just needed to “grow up.”

Posted by: Larry Nelson on 12/31/07 at 5:22 PM Respond