COMMENTARY:

Single-Payer Or Else...

Can the Democrats Avoid a Populist Health Care Rebellion?

The leadership of the Democratic Party is on the verge of passing health insurance reform. The centerpiece of the “reform” is requiring Americans to buy overpriced insurance from private corporations. But, it is evident that many in the Democratic voting base see the insurance industry as the problem—not the solution—and are getting angry about a new law that will force people to buy from corporations they don’t trust.

Just a few weeks ago the Mobilization for Health Care for All was announced (www.MobilizeForHealthCare.org). The Mobilization focuses on the denial of doctor-recommended care by the insurance industry. Sit-ins were planned at health insurance companies with demands that insurance corporations stop the denials. The Mobilization sought 100 people willing to sit-in at insurance corporations and risk arrest as people sat in at lunch counters two generations ago.

The response has been explosive; nearly 800 have signed up to risk arrest and thousands have signed up to join the protests. In the last 20 days 78 people have been arrested protesting the real death panels—the private insurance industry—who, according to a California study, deny doctor recommended care 20% of the time.

The Mobilization hoped to have “patients not profits sit-ins” in three cities last week, and instead it had them in nine cities. On the next Mobilization day, October 28, twice as many cities are likely to be protesting the insurance industry—just as Congress considers forcing Americans to buy insurance. This may be developing into the largest campaign of non-violent civil resistance since the Civil Rights era.

Many of the protesters supported Obama and were active in Democratic campaigns. Does the Democratic Party think that people willing to risk arrest against the corruption of the insurance industry will support, with time, money and votes, Democratic candidates who force them to buy insurance from these corporations?

These are protests the Democratic Party should not ignore. At the Washington, DC mobilization, one woman, Linda from Annapolis, said that she had helped Obama get elected in part because he promised real change in health care. She since spoke to him following his election. She still wants him to come through but reminded him, “We elected you, we can un-elect you.” Linda reflects the view of many Democratic Party activists who are angry at the pro-insurance bill being pushed by Congressional leaders.

As people come to understand the reform bill, which began as health “care” reform but devolved into health “insurance” reform, the anger will grow—not just from the right, but from the Democratic voting base who voted for the hope of real reform, not what they view as more of the corporate-dominated Washington, DC non-solutions to problems Americans face every day.

Indeed, it is predictable that Americans of all stripes will be angry. At the Washington, DC mobilization, police allowed the sit-in to occur, despite its being illegal, and refused to arrest the participants. We participants later learned that the police had to make wage concessions to keep their health care. And, when I was arrested protesting the Senate Finance Committee hearing dominated by the insurance industry, one officer told me about his mother who had lost her job, was too young for Medicare and could not afford COBRA payments. The abuse of insurance affects all Americans and they will not be happy being forced to feed corporate gluttonous greed.

Why will Americans hate this “reform?”

First, this unnecessarily complex plan will not achieve any of the goals originally set. It will not cover all Americans; indeed tens of millions will be left without insurance ten years after it is enacted. And, it will not control costs, as the insurance industry has said that their already too expensive premiums will increase by 111%—more than double—in the next decade under “reform.”

Second, few Americans will benefit from the plan. In fact, the greatest beneficiary will be the insurance industry and other health care profiteers. Every ten million people forced to buy insurance by the government will give the industry $100 billion in new revenue—at current insurance rates. With 50 million uninsured, that is potentially hundreds of billions in new revenue. In other words, the corporations that are the root of the problem will get rich off of the income of working Americans. This, at a time when American salaries are stagnating, debts are high, costs are going up and there is constant fear of unemployment and bankruptcy. Further, those who have insurance but do not like their insurance plans will not be given any choice under the “reform.” ,They will be stuck with their current, overpriced insurance with rising premiums, co-pays and out of pocket expenses. This is a recipe for populist rebellion, but it does not stop there.

The plan does not create affordable health care. Families earning $90,000 will find themselves paying 20% of their income on health insurance. And the subsidies for poor and working Americans will be insufficient. The leading source of increased poverty for America’s working poor is health care costs. How can these working families afford to buy insurance—even if they are forced to by the government—when they cannot even put food on the table? Americans will ask—why are struggling workers being forced to pay the $10 million salaries of insurance executives?

By the time most of this plan takes effect in 2013, the year after the next presidential election, insurance premiums will have increased by 20% to 25%. During the election year, Americans will be looking toward 2013 and seeing increased insurance costs and realizing they will be forced, at the threat of increased taxes, to buy overpriced insurance. Because of the lack of cost controls and the increased insurance requirements, e.g. such as requiring acceptance of people with pre-existing conditions and putting no limits on lifetime benefits, the insurance industry will be increasing rates even more quickly. The failure of “reform” will become evident before it takes effect.

The increased costs of health insurance will affect all businesses, small and large. In a “recovery” that is already not producing jobs, these costs will ensure a jobless recovery. The failure to create jobs will be a rallying cry against the Obama economic and health care plans. Democrats should be concerned because Americans traditionally vote based on their wallet more than any other issue.

In fact, the U.S. spends twice as much per person than dozens of better-rated health care systems in Europe and Asia. If the U.S. merely adopted any of these plans (almost all variations on single payer), we would save $4,000 per person EVERY YEAR. That would represent a savings of $1.2 trillion every year—a huge recurring economic stimulus, with savings flowing to businesses and others who pay some or all of their health insurance. Quickly thereafter, goods made domestically would be competitive again, companies would have faith in a better future and hire employees again, and America would break the stranglehold of corporate-government. None of this will happen under the Democratic “reform” because the current pattern of waste, fraud and abuse of the health insurance industry will continue.

During the next four years the Republicans will use the Democratic “reform” as a political punching bag. The plans to cut Medicare by hundreds of billions of dollars based on increased efficiency will frighten senior citizens. The bureaucracy being put in place by the “reform” will be evident to all. The complexity of the law will include federal rules on what employer-based insurance plans are "qualified." All Americans will see new income tax forms for the individual mandate and to determine income eligibility for insurance subsidies. The new federal insurance bureaucracy will be ridiculed by the Republicans.

Labor unions will see the good health insurance coverage they fought years to get for their members disappearing as taxes on their plans go into effect. These taxes are likely to cause employers to cut back on the derisively labeled “Cadillac” plans, which are really the kinds of health coverage all Americans should have. The result—more people will be uninsured by employers and forced to buy health insurance on their own, or more working Americans will find themselves joining the large pool of tens of millions of Americans who are under-insured. Reform will make the problems worse for these Americans.

The problem of insurance companies' denying care recommended by a doctor is likely to get worse under “reform.” A recent study in California found that insurance company denials can occur in up to 40% of cases with some insurance companies. Congress could fix the problem by giving consumers the power to sue insurance companies for denial of care. But, despite lobbying by consumer advocates, Congress has refused to do so. The industry has few ways to control costs, so experts predict that there will be increases in denial of care. "There are going to be a lot of denials," insurance industry analyst Robert Laszewski, a former health insurance executive, told the Los Angeles Times. Denial of care is the issue the Mobilization for Health Care is protesting.

During the four years it will take to put the proposed “reform” into place, more than 100,000 Americans will die each year from preventable illness. That is the current rate of annual preventable deaths—the U.S. has the shame of having the highest such rate among all developed nations—and it will not slow when Obama signs the pro-insurance reform bill. Will the Congress close its eyes and watch 400,000 Americans die during Obama’s first term? Or, will it do the obvious and open up Medicare to all during this period of transition? The Democrats' paymasters in the insurance industry will urge them to quietly let Americans die so people do not experience that Medicare, America’s single-payer system, works.

Those who were shut out of the process of developing real health care reform—the majority of Americans who favor a single-payer, improved “Medicare for All,” a national health system—will keep organizing. Mobilization for Health Care for All will be one of example of many. Those shut out will fight back and keep pointing out how simple and efficient the reform could have been. How the Democrats could have reduced bureaucracy instead of increased it, helped the economy rather than hurt it, and how they could have made sure every dollar went to health care rather than 31% of spending going to insurance industry profits and the bureaucracy the insurance industry creates. The already popular single-payer system, which Obama himself used to support, will become even more popular. The control of the Democratic Party by big business interests will become ever-more evident, and "reform" will be understood as a multi-hundred billon dollar corporate giveaway.

The Democrats, like generals so often do, are fighting the 'last war'. The Clinton experience taught them that failure to pass health care reform cost them elections. The Obama administration experience will teach them that passing legislation that is only good for the insurance industry will also cost them elections, and could cost Obama a second term. A bad bill will be worse than no bill: that will be the new lesson.

Americans prefer the Obama of the presidential campaign, who promised health care for all and opposed insurance mandates. They want the Obama they supported to return and put their interests ahead of insurance company profits.

Expanding and improving Medicare so it covers all Americans will be the only way to avert this populist revolt. Will the Democratic leadership recognize this and change course, or will they steer themselves into a disaster in order to satisfy their big donors in the insurance industry?

There is a single payer bill, HR 676, in the House that will be voted on when Rep. Weiner introduces it on the House floor. Let’s hope, for the sake of all Americans, that the Democratic Party leadership wakes up and puts the necessities of the American people before the profits of their donors. They still have time.

Kevin Zeese is executive director of Prosperity Agenda (www.ProsperityAgenda.US), which, along with Health Care NOW! and the Center for the Working Poor, initiated Mobilization for Health Care for All. For more information, contact the author at KZeese@earthlink.net.