Sunday, September 23, 2007

Healthcare for Dummies

A few days ago, the AARP hosted a Democratic presidential debate in Iowa. One of the main topics of discussion was healthcare, a cause once championed by Senator Hillary Rodham Clinton. The debate itself was the usual mishmash of meaningless campaign slogans and promises to ensure a "better healthcare system" for all Americans. But there were a couple of things conspicuously absent - content and candidates.

Senator Barack Obama was invited, but declined to participate. Also absent was Congressman Dennis Kucinich, but not for lack of interest. In fact, Kucinich wasn't even invited to the debate. An odd decision, given that Kucinich is in favour of a truly universal healthcare system for all Americans, and would have added some much needed spark to an otherwise predictable evening. Why would the AARP exclude someone like Kucinich?

Turn out the AARP is one of the largest lobby groups in the USA. It has drawn critics from both sides of the political spectrum, at once accused of being too socialist and too cozy with big Pharma. The association was however a major supporter of Medicare Part D, a stance which angered many Democrats. Part D is an addendum to the original Medicare Plan, which ostensibly permits subsidies for prescription drug costs for Medicare beneficiaries. The program is seen by critics as a boon to the Pharmaceutical industry, as it forbids the federal government from negotiating drug prices (this practice is allowed by the Veteran's Association).
Medicare pays $1,485 for Zocor, while the VA pays $127. Former Congressman Billy Tauzin, R-La., who steered the bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully, who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress.

The two frontrunning candidates present at the debate (Edwards and Clinton) both support some form of plan which would require all Americans to buy healthcare coverage - provided by a private insurer, and possibly subsidized by the federal government. In an open letter, Kucinich asks:
Is it appropriate for AARP to be sponsoring a Democratic Presidential debate on health care while excluding the one candidate who wants to dramatically change the system from which AARP profits mightily?

Kucinich was a co-sponsor of Bill H.R. 676, legislation that proposed the creation of a National Health Program that would provide comprehensive coverage for all Americans and prohibit private insurers from selling duplicate coverage. In today's political climate, it is of course unlikely that such legislation could get off the floor. The phrase "single-payer healthcare" has become the modern day equivalent of "communism", thanks to the concerted efforts of Republicans, private insurers, and big pharma. Even Senator Clinton was quick to reassure the Iowa debate audience that her plan was "NOT a single-payer system". Kucinich has little chance of becoming President, but his exclusion from the "debate" on healthcare is a sad example of the way in which progressive thought has become marginalized in the race for 2008.


knb said...

Kucinich has little chance of becoming President, but his exclusion from the "debate" on healthcare is a sad example of the way in which progressive thought has become marginalized in the race for 2008.

Indeed RC. It's frightening really, to see how lobby groups have taken over policy.

I wonder how aware the average American is of this? The term, "lobby group" is bantered around quite a bit, but I really wonder if it's known what sway they hold.

It's sad really, especially when you consider the prosperity gap. The liklihood of the populace becoming more educated on such matters is slim.

Of course, the same could be said here. How many know who has Harper's ear?

I suppose the good news in the States, is that they are actually talking about Health Care. I don't know much about Clinton's plan, but I thought it took courage to present one.

Oddly, no matter how Kucinich is portrayed, he's the bravest candidate out there.

Red Canuck said...

Hi KNB, nice to "see" you again!

Yes, the whole debate was a bit distressing for me to watch. True, they were making a point of discussing their plans for healthcare, but it was hard to tell one from the other, quite frankly.

You can read about Hillary's plan here.
And John Edwards' plan is here.

Edwards released his plan several months before Hillary. Nonetheless, their plans seem quite similar. Basically, they would mandate coverage for every American, and the gov't would pitch in to subsidize plans for the poor. Critics argue that this would mean even more money for private insurers.

People like Kucinich (who advocates for a truly universal one-payer system) and Mike Gravel (who wants some kind of a healthcare voucher system) weren't even invited to the AARP debate, and this is a real shame. Heck, Gravel is even a senior citizen! You'd think the AARP would invite him just out of courtesy!

It really makes you wonder about the power large groups like the AARP have to shape public opinion. It's easy to make fun of Kucinich for his elfin looks and his incongruously attractive wife, but he has valuable ideas that deserve a place in the Presidential debates.

knb said...

Agreed RC. His ideas and you are right, Gravel's, deserve attention.

For the record, I've been a Kucinich fan, from day one.

The AARP deserve to be exposed on this issue. How do we make that happen?

Most Canadians will not follow this issue, but they should. So I am glad you wrote about it.

It's important here. How do we make noise about it here?

I can't think of the Lib candidate's name running against Diane Finley, but he's a doc. Oh, he started a Save the Children foundation.

My point is this. Canadians need to know what is at risk. We need the example, in the US, though I wish them better than what they have, to steer us to an even better system.

MD said...

knd makes a valid point...there are more health care lobbyists in Washington than congressmen. America's best chance for meaningful universal health care came with Bill Clinton's election in 1992. Between the 1992 and 1994 midterm elections, health care was at the top of the public agenda, and the democrats had strong representation in both houses. But Hillary Clinton got destroyed by the health insurance lobby, and since then she has been more or less subservient to them.

Actually, I think many Democrats in general took the same lesson from the failed Clinton plan. All of the plans to "expand" coverage by both dems and republicans have since essentially been offers to throw more public money to the private health insurance industry. Big Pharma and insurance companies are laughing all the way to the bank. Kucinich is the only one proposing true universal health care, but the US media seems to equate a single-payer system with inviting the KGB to run the health care system. I don't really think that any of the three leading dems (H Clinton, Obama, Edwards) plan to achieve anything meaningful in health care.

MD said...

of course I meant knb, not knd. sorry about the typo!

Red Canuck said...

I can't think of the Lib candidate's name running against Diane Finley, but he's a doc.

I think perhaps you're referring to Dr. Eric Hoskins?

For the record, I've been a Kucinich fan, from day one.

I too am a big fan of Dennis Kucinich (as he is the most liberal of the candidates), but I realize that he has no real hope of winning.

How do we make noise about it here?

I think in general, healthcare is a bigger political issue here than in the States. Iraq and terrorism are the issues that will likely dominate the 2008 election. Up here, the Conservatives will likely do their best to keep healthcare off the map, and instead try to get mileage out of the economy and getting "tough on crime". You'll recall that one of Harper's election promises was a wait-time guarantee, but there's been hardly a whisper about it since. Progressive politicians like Dr. Hoskins need to campaign loudly on issues like universal accessible healthcare, and hopefully engage the public in real discourse about the direction we want our system to take.

Red Canuck said...

MD - Big Pharma and insurance companies are laughing all the way to the bank.

They certainly are. If the gov't mandates health insurance coverage for all Americans, the 40 or so million uninsured Americans will suddenly become the paying clients of private insurance companies like Kaiser-Permanante etc. And if any of those people can't afford coverage, the fed will simply step in and pay subsidies to those same private insurers.

Of course, they can still go on denying claims as they see fit (as Michael Moore exposed in SiCKO), which would leave a lot of indigent people up the proverbial creek.

Either way, the premiums are paid, and the insurers turn a profit.

Aurelia said...

Health care is an enormous issue in the States to go by the bloggers I communicate with.

Their bills, even with full insurance coverage are utterly outrageous. Especially considering the amount they are charged by hospitals and doctors.

My friend S's insurance was charged $330,000 for her to stay 9 days in the hospital. That did not include the delivery of her son, or her pregnancy care, or the few hours he spent in the NICU.

There was a 20% co-pay. So they owed 66,000 and were only exempted from paying because she and her husband are still considered full-time PhD students as well as lecturers.

Absolutely nightmarishly unreasonable costs. Here, a L&D is approx. 11,000 and hospital costs are about $900 a day for high risk patients. NICU stays are anywhere from 600/day to 900/day depending on the level of care.

We can afford universal coverage because we keep costs reasonable.

With costs like the US, there is absolutely no possibility that they will ever be able to insure everyone.

Every American I know thinks the system is a disaster and would gladly vote for a Canadian system, but no candidate will ever propose it...

Whole thing is stupid. At some point, why bother to vote?

Red Canuck said...

Aurelia - Thanks for your comments! Those are certainly some sobering numbers.

I concur that if you add together the uninsured and the underinsured in the States, you would probably have a significant number of people who would gladly support a single-payer system. And yet no frontrunning candidate has the guts to propose it. To me, this is a stark example of the entrenched power of the private healthcare lobby, and the tacit acceptance of it by politicians of all stripes.

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