On one side, conservative Republicans allied with the health insurance industry are doing their best — including disrupting the democratic town hall meetings across the country, — to maintain the status quo.
On the other side, the Democratic Party, bullish from two back-to-back election victories and a clear public mandate, is determined to change the health care system once for all.
In round one, Republicans, with help from the so-called Blue Dog Democrats, were able to throw a few punches by stalling the debate until after the congressional recess in September.
Despite scoring a few points, conservatives are poised to lose this battle, as the health care issue has not only brought loyal liberals to the battleground, it has also brought consumer groups and the business community in on the Democrats’ side.
While at the end of the day Democrats will likely have their way, it’s important to know what that means.
At best, Democrats will be able to pass a health care reform bill with a limited public option. However, the insurance industry will continue to maintain an immeasurable ability to influence the cost of health care. Is this what health care reform is all about?
The current health care reform idea is a part of President Obama’s campaign promise to help provide health care insurance to all Americans, as well as to bring down the health care inflation from its current 10 percent annual rate.
According to the Congressional Budget Office, the health care proposals, as presented in congressional committees, will be able to cover 95 percent of the 47 million uninsured Americans. However, it will do nothing to control the cost of health care, which is bankrupting the country.
This makes the current health care reform proposal a single-part solution to a two-part problem.
Obama, gun shy from the Clinton experience in 1993, crafted the health care reform idea during his 2008 campaign without a single-payer option. Then, the candidate Obama and his advisors wrongly believed that health care reform without a single-payer option would easier to pass than the universal-care options proposed by President Bill Clinton.
The Obama team seems to have forgotten the fact that, as the biggest stakeholder of a more than $2.5 trillion industry, health insurance companies are not going take any chance of reform and risk billions of dollars of profit. Not when they have their friend, the Republican Party, helping fight their battle.
The insurance industry, which is in between doctor and patient, is only there to squeeze profit out of both without offering a tangible value to either.
A significant portion of the trillions of health care dollars spent on brokers, advertising, lobbying, paperwork, record-keeping and executive bonuses by the health care industry contribute no value to better people’s health. Yet, they make up of a sizable percentage of double-digit health care inflation.
Therefore, as long as the insurance companies are in the forefront of the business, no amount of tinkering — without a single-payer system, controlled by either government or a government-regulated agency — is going to bring down health care costs.
The White House and the Democratic leadership in Congress have made a strategic mistake by taking the single-payer system out of the health care debate. Not only has it deprived the country of a real health care reform opportunity, it has also weakened the Democrats’ bargaining position. Had they started the debate with a single-payer threshold, they would have at least come up with a public insurance option with bipartisan support. Instead, they are fighting with the members of their own party.
It’s still not too late for Democrats to act. They should introduce a new bill when they reconvene the House of Representatives after summer recess and pass a single-payer, comprehensive health care reform bill with or without Republican support. That will end the health care debate, once for all.
• Roger Adhikari has been a Tracy resident for more than 17 years and works as a finance and management consultant in the Silicon Valley.
I don't have health care insurance and really don't want to pay for YOUR "plan". It seems like a way to squeeze some additional monies out of us. And I don't have a lot more to give. I wonder if you could tell us, why should I have to pay for someone else's healthcare? Yes, please stop for a minute to explain. And why are Democrats suddenly interested in listening to businesses? When did Democrats listen to businesses. Democrats always claimed they we were the party for the American People.
Things have changed with the Democrats. Recently the Democrats, along with yourself, appear to be sidelining the American people in favor listening to business and other special interest groups. It's very sad to see this happen to the American people.
Democrat appear all to eager to push Nancy's agendas through and seem to be making the mistake of taking on far too many issues at one time. The current "Career Congress" is costing us a staggering multiple trillions, of trillions, of trillions of dollars. If not multiple trillions more. Why don't we pause for a moment and see if that makes sense? Why is it Congress won't go to work on the economy first?
Let's humanize this. My neighbor can't go to work becuse of the economy and has been unemployed for over eight months. Why can't Congres understand people like my neighbor want a strong economy first? Let's get back to the idea of making America a place where we all have a job to do and clearly understand what that job is.
While we're at it. Let's not focus on too many issues at a single time. When you do that we lose focus. It doesn't seem clear that Democrats like yourself, are being inclusive of the public's input on some issues of importance to the American people.
Honestly, I feel democrats are making the same mistake the Clinton administration did by not including everyone in a healthcare debate. A good example is your "phoney town-hall meeting".
I also don't see businesses as being the right venue to USE to push health care reform on voters who are getting little or no say in the issue. Bring the issue to the people (not businesses and special interests) and let the people who have health insurance be the judge.
The people are the stakeholders that Congressmen and Congresswomen should be listening to. Democrats appear to be ONLY interested in listening to businesses and special interests. That seems to be a sad repeat of history. And that will ultimately turn the voters away from Democrats agenda. It's already happening.
Sorry, Jerry. It sure seems wrong to count people out in favor of business and special interests. Is that what you promsed the American voters, back in November? Let's get our priorities back in order. Why not tell Congress to give us jobs and slow down on the 23 trillion dollars before we have no money left. I really doubt the American voters wanted Democrats to put the cart before the horse. (or the special interest before the voters).
We'll have to look at the ballot boxes in November.
Just hope somebody's listening.
Shikha Dalmia, 07.01.09, 12:01 AM ET
President Barack Obama walked into the Oval Office with a veritable halo over his head. In the eyes of his backers, he could say or do no wrong because he had evidently descended directly from heaven to return celestial order to our fallen world. Oprah declared his tongue to be "dipped in the unvarnished truth." Newsweek editor Evan Thomas averred that Obama "stands above the country and above the world as a sort of a God."
But when it comes to health care reform, with every passing day, Obama seems less God and more demagogue, uttering not transcendental truths, but bald-faced lies. Here are the top five lies that His Awesomeness has told--the first two for no reason other than to get elected and the next three to sell socialized medicine to a wary nation.
Lie One: No one will be compelled to buy coverage.
During the campaign, Obama insisted that he would not resort to an individual mandate to achieve universal coverage. In fact, he repeatedly ripped Hillary Clinton's plan for proposing one. "To force people to buy coverage," he insisted, "you've got to have a very harsh penalty." What will this penalty be, he demanded? "Are you going to garnish their wages?" he asked Hillary in one debate.
Yet now, Obama is behaving as if he said never a hostile word about the mandate. Earlier this month, in a letter to Sens. Max Baucus, D-Mont., and Ted Kennedy, D-Mass., he blithely declared that he was all for "making every American responsible for having health insurance coverage, and making employers share in the cost."
But just like Hillary, he is refusing to say precisely what he will do to those who want to forgo insurance. There is a name for such a health care approach: It is called TonySopranoCare.
Lie Two: No new taxes on employer benefits.
Obama took his Republican rival, Sen. John McCain, to the mat for suggesting that it might be better to remove the existing health care tax break that individuals get on their employer-sponsored coverage, but return the vast bulk--if not all--of the resulting revenues in the form of health care tax credits. This would theoretically have made coverage both more affordable and portable for everyone. Obama, however, would have none of it, portraying this idea simply as the removal of a tax break. "For the first time in history, he wants to tax your health benefits," he thundered. "Apparently, Sen. McCain doesn't think it's enough that your health premiums have doubled. He thinks you should have to pay taxes on them too."
Yet now Obama is signaling his willingness to go along with a far worse scheme to tax employer-sponsored benefits to fund the $1.6 trillion or so it will cost to provide universal coverage. Contrary to Obama's allegations, McCain's plan did not ultimately entail a net tax increase because he intended to return to individuals whatever money was raised by scrapping the tax deduction. Not so with Obama. He apparently told Sen. Baucus that he would consider the senator's plan for rolling back the tax exclusion that expensive, Cadillac-style employer-sponsored plans enjoy, in order to pay for universal coverage. But, unlike McCain, he has said nothing about putting offsetting deductions or credits in the hands of individuals.
In other words, Obama might well end up doing what McCain never set out to do: Impose a net tax increase on health benefits for the first time in history.
Lie Three: Government can control rising health care costs better than the private sector.
Ignoring the reality that Medicare--the government-funded program for the elderly--has put the country on the path to fiscal ruin, Obama wants to model a government insurance plan--the so-called "public option"--after Medicare in order to control the country's rising health care costs. Why? Because, he repeatedly claims, Medicare has far lower administrative costs and overhead than private plans--to wit, 3% for Medicare compared to 10% to 20% for private plans. Hence, he says, subjecting private plans to competition against an entity delivering such superior efficiency will release health care dollars for universal coverage.
But lower administrative costs do not necessarily mean greater efficiency. Indeed, the Congressional Budget Office analysis last year chastised Medicare's lax attitude on this front. "The traditional fee-for-service Medicare program does relatively little to manage benefits, which tends to reduce its administrative costs but may raise its overall spending relative to a more tightly managed approach," it noted on page 93.
In short, extending the Medicare model will further ruin--not improve--even the functioning aspects of private plans.
Lie Four: A public plan won't be a Trojan horse for a single-payer monopoly.
Obama has repeatedly claimed that forcing private plans to compete with a public plan will simply "keep them honest" and give patients more options--not lead to a full-blown, Canadian-style, single-payer monopoly. As I argued in my previous column, this is wishful thinking given that government programs such as Medicare have a history of controlling costs by underpaying providers, who make up the losses by charging private plans more. Any public plan modeled after Medicare will greatly increase this forced subsidy, eventually driving private plans out of business, even if that weren't Obama's intention.
But, as it turns out, it very much is his intention. Before he decided to run for office--and even during the initial days of his campaign--Obama repeatedly said that he was in favor of a single-payer system. What's more, University of California, Berkeley Professor Jacob Hacker, who is a key influence on the Obama administration, is on tape explicitly boasting that a public plan is a means for creating a single-payer system. "It's not a Trojan horse," he quips, "it's just right there."
But even if Obama wanted to, it is simply impossible to design a public plan that could compete with private insurers on a level playing field and without "feeding off the public trough" as Obama claims.
At the very least, such a plan would always carry an implicit government guarantee that, should it go bust, no one in the plan would lose coverage. This guarantee would artificially lower the plan's capital reserve requirements, giving it an unfair edge over private plans. What's more, it is simply not plausible to expect that the plan wouldn't receive any start-up subsidies or use the government's muscle to negotiate lower rates with providers. If it eschewed all these things, there would be no reason for it to exist--because it would be just like any other private plan.
Lie Five: Patients don't have to fear rationing.
Obama has been insisting, including during his ABC Town Hall event last week, that the rationing patients would face under a government-run system wouldn't be any more draconian than what they currently confront under private plans. This is complete nonsense.
The left has been trying to address fears of rationing by trotting out an old and tired trope, namely, that rationing is an inescapable fact of life because every system rations whether by price or fiat. But there is a big difference between the two. If I can't afford caviar and champagne every night, any rationing involved is metaphoric, not real. Genuine rationing occurs when someone else controls access--how much of a particular good I can consume.
By that token, Obama's stimulus bill has set in motion rationing on a scale unimaginable in the land of the free. Indeed, the bill commits over $1 billion to conduct comparative effectiveness research that will evaluate the relative merits of various treatments. That in itself wouldn't be so objectionable--if it weren't for the fact that a board will then "direct financing" toward approved, standardized treatments. In short, doctors will find it much harder to prescribe newer or non-standard treatments not yet deemed effective by health care bureaucrats. This is exactly along the lines of the British system, where breast cancer patients were denied Herceptin, a new miracle drug, until enraged women fought back. Even the much-vilified managed care plans would appear to be a paragon of generosity in comparison with this.
Obama has repeatedly asked for honesty in the health care debate. It is high time he started showing some.
Shikha Dalmia is a senior analyst at Reason Foundation and writes a biweekly column for Forbes.
Hey Roger. Did you happen to notice this guy makes the last guy look good?
I guess all Liberals have a one trak mind?
Cash for Clunkers, which of course is a government backed bribe to get people to buy cars, had an original budget of $1,000,000,000. Now the program needs another $2,000,000,000, man that's a lot of zero's, to keep going. They only missed that projection by 66.3%.
At his recent town hall meeting, he mentioned how between Fed Ex, UPS, and the Postal Service, the government entity is the one in trouble. Guess what will keep the Post Office afloat, our tax dollars, and our pocket books. Apparently he's not all that smart, because by pointing out the failure of the Post Office, he's giving a great example of why we should not trust government run health care.
This man and his minions are a bunch of amateurs. Obama is the least presidential President I can remember in my lifetime. Disagree with his very questionable programs, and you're either a Nazi, a rascist, a dummy, un-American, or a member of an unruly mob. This man has an obvious disdain for any American who is not one of his obsequious followers.
Don't you find it strange that the president let some companies go under and then turns around and decides to bailout "INSURANCE COMPANIES" to the tune of one trillion dollars, with money he finally admited we don't have?
You can't turn this country into a socialist experiment and tell us it will improve America?
If you don't trust pharmaceutical companies wait till they are owned by a socialist government.
Pass me that vodka. NO more for you.
Here is a local story about one of thus evil pharmaceutical companies.
Genitope was a research drug company locate in Fremont ca.
For years Genitore spent millions and millions of dollars on research for a cancer vaccine, all private money.
In 2007 along Genitope out go was 65.9 million dollars. At the end of 2007 their vaccine did not pass the gov. phase three test. Genitope went bankrupt in 2008
If this vaccine was successful just think how many lives would have been saved.
So after all this private money don’t you feel they should be able to make a profit if this vaccine would have been successful?
Sure the vaccine would have been expensive, but how much is a life worth. I believe we will be finding out what a life is worth under the uhbama health care plan.
Let’s see here 80 billion dollars of tax payer money and counting for a pay off to automobile unions. But if a pharmaceutical company tries to make a profit after spending millions of private money they are evil, and I’m sure un American according to nacny and jerry.
You can attempt to margainalize it if you want. We both know that statistics alone don't meet the definition of scare tactics.
Let's not pretend that we have a plan to keep health care costs from rising. Yes, I'm calling that a Scare Tactic. And will back up my claim by pointing out that the Democrats have not put forth anything more than a piss-poor, case for healt care, reform (Problem with that: we've ALL known this for years. Remember Billary?)
Now, let's look at the facts. The problem with Democrats is they created a mountain outta a mole hill and have no clue what to do with the mountain.
That's why I can label it a scare tactic and get away with it.
Prove I'm wrong. Show us where the Democrats have facts and statistics to move this half-baked plan forward without bankrupting America.
So far it hasn't been done.
You may have inside scoop with Nancy. I'm listening. Please share?!
If hard facts and substantiated statistics meet your definition of scare tactics....that alone speaks volumes.
May I make a few suggestions?:
-Realize those who are blindly pushing socialism have made a great case for reform, but ultimately have NO clue how to create jobs out of this proposed, socialist, sinkhole, which we've already tried and proven that it failed. Please don't let them sell you (and us) a bigger version of something that is already broken. That's like buying a Prius that's a lemon and letting the sales person shift you outta more money to buy a 4-Runner SUV that's also a lemon. The bigger lemon is not always the better lemon.
-Reprioritize and focus on jobs (real jobs) not PHONE-Y, made up, jobs we heard about. Ask Dems to support sustainable, American jobs. Not outsourced, data-processing jobs. I laughed when you said we are going to create "IT" jobs. What you didn't say is that we are also giving those same IT jobs away. Let's first focus on not giving jobs away and then revisit health care reform.
-Deal with immigration and other issues before you open the pandora's box of healthcare for North and South America.
-Deal with Tort reform, which you've already lost control of AND deal with out-of-control, problems created by an over abundance of special interest lawsuits.
-Incentive and encourage employers to provide better health coverage.
-Create a market place (like Travelocity or E-Flights) where I can purchase my insurance. Maybe from a company in another state that can provide lower cost than I'm currently paying.
...
Well, apparently you seem to be the one using scare tactics now.
That money has to come from somewhere and with the complet socialist package your argument pales in comparison to the spiraling costs to come.
Jerry McNerney told us they "hope" to keep it at one trillion dollars.
That's a joke and we all know it.
If you don't believe me about the delays and spiraling costs associated with frivilous special interest lawsuits. Just ask Roger and his pal(s) ? Right Roger?
But the problem with Democrats (like Jerry) is that they have simply ignored facts that are staring them in the face (except for the ironic fact they Jerry refused his once-constituents a Town Hall meeting) that there are more problems here than they have prepared for. Nothing to prevent lawsuits. They have to overhaul the legal system first.
Then there is COBRA which is being added and rising unemployment rates.
They are moving medicare money around like a shell game and saying the cost is only going to be "one trillion for a ten year period".
We lose, if they won't listen.
Do you trust politicians like Jerry, when he won't have a face to face meeting and his operator tells you to 'hurry up with your questions' because we need to take at least ten [scripted] calls tonight.
I don't disagree, but tell me how come these same drugs from these companies cost us WAY more than they do in other countries?? Why are we paying more?
Pharma has given us the therapies that have saved our children, parents and us from deadly diseases-not just in the last 20 years, but the last 100 years, and are the only ones the world can call upon to produce emergency pandemic vaccines - like for H1N1. Pharma are innovators, taking multi-million dollar risks on every new discovery and deserve the profit they make from ~ 10 years of patent exclusivity before generics flood the market and eliminate their brand.
Sorry!