BANKABLE HEALTH CARE REFORM
Over the past year, it has become evident that the U.S. bank and financial sector has a huge influence over both parties in Congress and the top financial advisers in the Obama Administration. The same has held true even longer for large manufacturers involved in weapons and defense spending. We will soon see the same heavy influence over Congress by the insurance companies, the AMA, pharmaceutical companies, and various healthcare providers.
For those who dream of comprehensive healthcare reform and some sort of universal coverage – you should live so long. 2009 Reality Check: “It’s not gonna happen.” The out-of-pocket costs for businesses and families have to be much higher, the number of uninsured and underinsured must be much larger, and the governmental deficits to maintain the current system must be simply untenable. Essentially things have to be much worse in order for Congress to pass any meaningful changes.
The wealthiest Americans and largest corporations control the business of this country. The U.S. has been, is, and will be an oligarchy or plutocracy (essentially the same), and our “meritocracy” simply exists to buttress this near complete control of the U.S. economic and political system. All members of Congress are so dependent upon campaign contributions for their continuing existences, that only those with enough money or the ability to raise significant amounts of money have access and effective control over the actions of Congress.
It is naive and simplistic for many advocates of various policies and programs to waste years, valuable time, too many brain cells, and far too much paper, internet storage space, and air time on the various Media, making laudable arguments that explain the “fairness, rationality, reasonableness, rightness, merits, efficiencies, ethics, cost-savings, and long-term benefits” for the majority of citizens of their proposals. These compelling arguments may be effective in some other country or political system but they have been completely useless and unpersuasive within our particular system of government.
No policy or program has been, or will be enacted or pursued if it does not benefit the wealthiest of Americans and large corporate interests that essentially control Congress and the U.S. political process. It would be better for advocates of any particular policy or program (regardless of the actual merits) to spend their time and efforts exclusively convincing this small group of people that it is in their best financial, economic, social and political interests to support a particular program or policy that happens to benefit the rest of the country. The simple reason why so many admirable programs and policies have languished in Congressional committees year after year has been that they do not resonate whatsoever with that elite group of people and their particular interests and needs.
Once 95% of Americans realize the fact that they exist principally to please and faun over that group of the wealthiest 5% of Americans (to which most members of Congress belong and upon whom they depend for re-election), then life will become much clearer and easier, and some of the things we secretly wish for might actually come true.
The American healthcare system does not exist to provide the best and most efficient healthcare to all Americans. It exists – as most everything else in the U.S. – to make money generally for the wealthiest of Americans and their controlled enterprises. The huge per capital costs of our healthcare system that far exceed the costs found in other developed countries are principally devoted to ensuring the system’s overall profitability to hospitals, physicians, healthcare providers, medical equipment manufacturers, medical technology providers, pharmaceutical companies, and health insurance companies. To ensure the maximum profitability for most of these participants, (1) we have to accept a large number of uninsured, (2) the reality that many claims and procedures are denied even if the sick people have insurance, and (3) higher infant mortality and lower life expectancies than all other advanced countries. Those other nations view healthcare as a right and a public good so profitability is not the central purpose of their national healthcare systems.
There are many other major wealthy players in the country that might be in favor of serious healthcare reform. They consist of many small, medium and large businesses not part of the financial services and banking sectors, and not part of the healthcare field. However, these stake-holders are historically not well financed, they are often inundated with many other pressing issues, and they are not well organized for effective Congressional lobbying. Therefore, healthcare reform advocates must look elsewhere for secondary support.
Advocates for serious and comprehensive healthcare reform designed to benefit the vast majority of Americans, must come up with arguments for their favorite policies and programs that will improve the wealth and influence of the richest Americans and those entities that control the healthcare industry. Of course, for the past 50 years, those winning arguments have not made and thus most healthcare reforms that have been suggested have been routinely killed Administration after Administration. Medicare/Medicaid and the recent Prescription Drug Program succeeded because they did not challenge the basic system – only provided another payer (the Government) for healthcare costs for those who were previously unable to pay directly and therefore ultimately enrich the many providers of healthcare services within the existing for-profit system.
Sadly, this author has no immediate ideas on how to convince those in power to give a damn about the other 95% of Americans on many areas of public policy, healthcare being just one of many issues. It may be likely that the current system will remain in place and our only hope is to increase the number of employers providing some sort of healthcare benefits to their employees, instead of hiring part-time independent contractors domestically or sending the work overseas. However, hope springs eternal. Now that everyone knows the real playing field, these winning arguments might be found and tailored to those who have the actual final say on any healthcare reforms.
One possible line of arguments should center on the benefits of greater investments in our transportation, energy and educational infrastructures. In fact, they now hold the most immediate and long-term promise for our country. It is very likely that most of the funds spend in these programs will ultimately trickle up to the wealthiest Americans and corporations, particularly those with heavy construction investments. It is well documented that most jobs in transportation, energy and education pay well and come with many extra benefits, including healthcare.
For example, new spending on Amtrak, rail mass transit, and high speed rail has garnered broad bi-partisan support in Congress, simply because the wealthiest Americans and many large corporations now see a direct future benefit to their own bank accounts by way of ostensibly doing something good for the American public. (It also helps that the housing bubble and other investment options are pretty well discredited.) If they did not see these public investments ultimately benefitting themselves, they would not now be playing such a large role in the current and future budget plans of this Congress and this Administration.
This post is meant to focus advocates of various meritorious ideas geared to help the majority of Americans to take the realistic view that for those proposals to ultimately become enacted, they must principally get the approval of the wealthiest Americans, investors and businesses. The author has focused other earlier postings on related topics: Americans must understand the real system of government we have and work within those overall parameters for reasonable change.
We have to make the best of an imperfect system. This is not advocating compromise since “something” is better than nothing. Instead, comprehensive policies and programs can be implemented if they are corrected argued and packaged to favor those who ultimately decide whether they are enacted or not. Comments from TMV Readers are always welcome.
5/24/09 by Marc Pascal in Phoenix, AZ
25 Responses to “BANKABLE HEALTH CARE REFORM”
BANKABLE HEALTH CARE REFORM | The Moderate Voice…
BANKABLE HEALTH CARE REFORM. May 24th, 2009. By MARC PASCAL. Print. Over the past year, it has become evident that the U.S. bank and financial sector has a huge influence over both parties in Congress and the top financial advisers in ……
You are probably so right. I notice the Google ads right next to your piece are all for the health care industry. You (we) can't escape!
At which point we will have a replay of 1789…
I'd leave a longer comment for Marc, but I suspect there's already been a knock at his door and he is now “unavailable” to read them. You're not supposed to talk about that sort of thing in public, buddy.
“Sadly, this author has no immediate ideas on how to convince those in power to give a damn about the other 95% of Americans on many areas of public policy, healthcare being just one of many issues.”
Marc, you're exactly right. I've suggested many times and always get blasted for doing so, that we level the playing field by getting corporate money out of politics. Please, get ahold of Thom Hartmann's Unequal Protection, which details with lawerly thoroughness and exhaustive footnoting, exactly how corporate personhood is the single keystone that has created the very oligarchy you so well describe. How to fix it? Congress won't. And we the people could, but we're too easily tricked by the very patriotic swill with which my comment will be met as sure as it's Sunday.
“For all purposes under the Constitution of <each state>, the term 'person' shall mean a natural person.”
That's what it takes to kill corporate personhood in your state, kick corporate money out of politics and make your congress critter give a damn about the public good.
I'm not sure I buy the notion that the top 5% make all the decisions, but they do have some influence. It can't hurt to have them on your side.
The top 5% of households are those with an income of $157K or more. They're typically working for the money, with two people bringing in paychecks, and collectively they pay more in taxes than the other 95% combined.
You might be among them. If you're not, Marc frames the problem well: why should they pay even more of your bills, medical or otherwise?
[...] BANKABLE HEALTH CARE REFORM | The Moderate Voice [...]
Like all Americans, you keep confusing income & wealth, the odds that 157k a year household does not have a pot to piss in are pretty damn good. The right or wrong disease (which ever way you care to look at it) will wipe out the finances of that 200k a year household almost as fast as it will wipe out those of the 80k a year household.
Dr J, you are arguing on behalf of an oligarchy. The assumption is that the top 5% (yes, I'm in it) deserve to rule the others because we pay more. That's right in line with feudal principles and the idea that the ignorant masses should be ruled by an educated and moneyed elite. You're entitled to that belief, but this is a representative democracy. As Jim Hightower is fond of saying “everyone does better when everyone does better.” That's been denounced as socialism, but obviously, policies that benefit the few at the expense of the many are not indicative of a functioning democracy.
Now, to the question of why I (among the top 1%) should contribute to the medical care or education of the other 99% of my fellow citizens: First, I love this country and believe it has given me the opportunity to prosper like nowhere else on earth. I don't want to pull the ladder up after me. Second, the health of the citizenry and a good education is essential to my ability to hire healthy and educated employees. Third, I have a moral and ethical code that says that here in the world's wealthiest nation NO ONE should freeze or starve. Ever! And, I believe that no one should go without a baseline of medical care, preferably at a better price than going to the ER.
I have written a letter to my congressman and would like to deliver the message as many times as I can. I invite any readers to copy and paste, modify, personalize, and pass it around. It may be naive to think that individuals have a voice, but our numbers are our strength:
Honorable Senators and Congressmen;
The time has come for reform. Abuses of power and money are destroying the very effectiveness of the people to create harmonious and constructive society. Our legal system favors corruption by enabling the greedy side of humanity to hide from responsibility amid the anonymity of megalithic corporations. From the excessive salaries of CEO’s to the person who answers the phone for the credit card company, people have become desensitized to the effects of participating in what they must know in their hearts to be immoral behavior.
This week’s passage of credit card reform is a step in the direction of cleaning up the legal robbery that has become the norm, but taking a small step when a giant leap is appropriate only condones the practices that are allowed to continue. It gives the message that, if one is a big enough bully, he can steal, abuse and victimize with minimal recrimination.
Please do not make a similar half step with health care reform. Allowing the insurance industry to maintain the power over health is the equivalent allowing the thug to stand in front of the doctor’s door to take advantage of your vulnerability when needing medical attention.
It is time to go to the heart of the problem. It is wrong to sustain those institutions that practice criminal behavior that even a child could innately perceive as wrong. The hatred of American Capitalism around the world is justified because of what companies like Monsanto do in order to strong-arm profits. This kind of enterprise, which has consequences that are the very contradiction of freedom, undermines American integrity throughout the world.
It creates hardship for our own citizens; it is demoralizing, it causes despair and depression to feel powerless in the face of inaccessibly powerful structures that provide a wall of anonymity behind which truly criminal behavior finds protection. It encourages people to participate in similar acts of depravity and insensitivity. Legalized corporate greed undermines faith, hope, and trust we must have in our fellows to create together a society that is justly for the betterment of us all.
I encourage you to watch Bill Moyers (aired May 22 on PBS) on the subject of single payer health care.
Please, as a public servant in a position of power, use that power to stand up for a creative and constructive future rather than one that is enslaved to channeling the resources of our collective productivity into the hands of squandering intention. The house of cards is falling because the immorality of wealth based on unrestrained and unconscionable abuse of the many by the few is unsustainable. Be a hero of the people. Exercise your innate ability to know right from wrong in favor of those you serve and all of our progeny. We have the ability to create a world that is free and just and prosperous for all. We only have to stop giving in to guy with the horns and the pitchfork sitting on one shoulder and telling us that one more act of greed would be insignificant enough to go unnoticed. Please stand up.
Sincerely,
As always when looking at a problem from the left, there is considerable whining and no answers. When we look to the right, the problem melts away to leave a wonderful rainbow in it’s place.
If we continue down the socialist path Obama is laying out, we will end up with a three tiered healthcare delivery system most closely resembling Argentina.
The first tier is the private, cash for service system used by the upper 5% that so infuriates Marc. This system has the best of everything – doctors, clinics, labs, hospitals, etc. When you go in, you’re treated like an important customer, mainly because you are. Waiting is unheard of, no procedure is denied and every concern is addressed.
The second tier is the union or guild clinics. These facilities and personnel are not up to the standards you would expect from a facility here in the States, but they are passable and honestly try to provide quality care for their members. Each individual union maintains their own clinics to service their membership, financed through dues and government contributions.
The third tier is the public facilities. Large, overcrowded, understaffed, aging facilities, the dregs of equipment and the remnants of the medical personnel who couldn’t find work at the other two tiers. The poor and those in the middle class without a union connection get shafted, as always.
Hillary, in her famous bid to bring universal healthcare, recognized the disparity and tried to outlaw private medical care in her plan. This approach failed, as will any plan that favors the left wing philosophy of lowering everyone to one common denominator.
By moving to a system of direct patient-doctor fee for service using instant payment via medical savings accounts, the problem of assuring all people get the best healthcare is solved by making them all valued customers.
As was put forth in previous threads, think about how you want the system to look and work when it is done, then work backwards to achieve the goal.
GD, that sounds like a bunch of high-sounding talk built on some dubious ideas.
First, our system redistributes a lot. You're already subsidizing medical care and education substantially, and we've got endless programs to keep people from freezing or starving, so portraying the current system as “pulling the ladder up” is simply unhelpful. If you think it should be more redistributive, then make the case: How much more? To what end? How will we know when it's redistributive enough?
Second, “not benefiting the few at the expense of the many” is as vague and useless a guide to policy as “everyone does better when everyone does better.” *Any* system will benefit the few at the expense of the many, because there are always a few who are better at working the system. We really do give everyone one vote (and corporations zero). But the rich still end up with more influence than the poor simply because they're better at influencing things. That's how they got rich. Even communist systems end up being ruled by elites. We could swap rule-by-the-elite for rule-by-people-who-don't-understand-interest-rates, but it doesn't seem a recipe for success.
Bill Moyers Journal had a great expose on Single Payer Healthcare Insurance. I did some video clips on it at iReports at http://www.ireport.com/docs/DOC-262091. It is very informative.
http://SinglePayerHealthcareNow.com
Dr J, I think we should be less redistributive of wealth upward to my bracket. You're right that our tax policy has always been a redistribution, but it's been upward. As this post notes, the rich have enough influence to get the rules written their way. “Privatize, deregulate, cut social spending.” That's been the conservative mantra and as I've noted before, it always leads to an unsustainable wealth gap and massive public debt. Ultimately it hurts us all.
Our economy is crumbling because people can't afford to buy what we make. That's a failure of the greedy creation of a huge wealth gap. I'll do better if Joe and Jane public have money in their pockets. It does me zero good for their wealth to be in the pockets of insurance tycoons. It does me zero good for my company to be under crushing insurance rates, a third of which is profit, marketing and sales expense.
Dr J, I want to thank you for the articulate, intelligent and civil way you discuss. It's sometimes rare here.
Jwest, your characterization does not match with Canada, England, Germany, France, Switzerland, Japan, Austria, etc. Weave your distortions if it pleases you. We pay more money for worse outcomes than anyone on earth.
GD, thank you for the kind words. I appreciate your thoughtful contribution to the discussion too.
How do you figure we redistribute upward? If you're in the top few percent of earners, you're paying dramatically more in taxes than you're getting in services. The poor, by contrast, are getting out much more than they put in. That's a big redistribution downward, no?
If I may guess waht GD is talking about, he's talking about combined fiscal/monetary policies that go far beyond direct government services. If you look at the way that monetary policy is designed over the last 30 years, it is mathematically impossible from keeping the upper 1% from accumulating money at such a rapid rate that its gains quickly make up many times more than the commensurate growth in GDP. What has happened in this country the last 30 years is stagnant real wages for the vast majority of the populace, while the top tiers get all the gains from our country's growth.
That is the prime cause for massive debt loads and enormous wealth inequality.
I personally am skeptical that tax law can do much to alleviate this, especially because taxes are so obvious and emotional, while the structural nature of the economy works in the background. Taxes and services can arrest the speed at which such accumulation occurs though…maybe buying some time to reorient our economy.
Look at what the GOP wanted, but didn't get, because of the Dems. Elimination of taxes on capital gains would make it so those who make their income by investing would pay nothing as long as they never work for a living. Elimination of estate taxes means they pass it on to their progeny tax free. That would create a permanent aristocracy in America that devalues work. OK, that didn't pass. But still, I pay into Social Security on only a small part of what I make. For middle income and lower, they pay on all of their salaries. The FICA cap favors the rich.
And I get a much lower rate on investment income than earned income, again devaluing work and redistributing wealth upward. Corporations get incentives from the taxes of workers to exploit the public wealth for their private gain (from lumber to oil and minerals to ranching on public lands). There are lots of other details, which I'll expound further if you want, but as Warren Buffet said, it's wrong that he pays a lower percentage of his income in taxes than his secretary.
GD,
As always, your liberal thinking got in the way of your reading my comment.
Obama has already told you that there is not going to be a single payer system like the countries you mention (and I did not). Ed Shultz is about to be committed over this very point.
Let me run this by you one more time.
There is not going to be a government run, single payer healthcare system in the U.S.
Now that I’ve beaten that into your head, you can go back to my comment and read what the most logical system is that is going to put in place by a community organizer with heavy socialist tendencies.
One system will handle the poor and middle class who do not have any government pull.
One system will handle the middle class who belong to a union who donates to the democrats.
One system will handle the rich.
To the dismay of the envious and class warriors, there is nothing Obama can do that will stop a private healthcare system that will treat those that can afford it. This includes all of the liberal elite who want universal healthcare. Just like schools, the public facilities are good for the masses, but if you think they are going there you’re out of your mind.
Certainly there are opportunities to tax the rich more heavily. But if you look at the averages across the top 5% or the top 1%, it seems clear that despite those missed opportunities, the rich pay a lot more tax than the poor. In other words, if the few Warren Buffetts of the world really pay less tax than their secretaries (which sounds pretty suspect to me), there aren't enough of them to affect the top 1% average.
What I imagined you might say is the rich do indeed pay disproportionately more tax, but the benefits from those supposedly egalitarian government programs favor them even more disproportionately. Subsidies intended to help humble farmers end up lining the pockets of big agribusiness, etc. Of course, their susceptibility to hijack would be a case against such programs.
jwest, you're right that Obama seems to have caved to the insurance and pharma industries and will likely maintain their larceny, which doesn't please me. But I doubt that there will be a system of substandard care for the poor. If that's true, they'll continue to go to the ER and we gain nothing. Were it my passion to take this on to the exclusion of my current work, I'd establish a nonprofit insurance company and beat the crap out of for-profit insurance companies, with lower cost and better care. That's what the government could do, and what Obama promised–Medicare for all.
The people were offered a universal healthcare system were everyone would have the same ability to utilize any service they wanted.
However, the people never got the opportunity to discuss it because the democrats would not come to the table if it was an option.
Once again, liberals intervene to make the lives of the poor and middle class a living hell.
What must it be like to be an African American in the inner city?
First, the democrats block you from getting an education through vouchers, even though they send their own kids to private schools.
Then the democrats institute affirmative action, so that even though you graduate at the top of your class, everyone thinks you got special treatment and don’t belong in the position that you’re in.
Then the democrats lock you into a Social Security system instead of private retirement accounts, so that you pay in to the system your entire life, but since you die younger than any other group, you don’t get to collect and your family doesn’t inherit your hard-earned money.
Then the democrats look to place you in a healthcare system where either the government or an insurance company makes the decisions, because they believe you are too stupid to make the decisions yourself.
You know, if I were black, I might just start thinking there is a better way.
Egberto, I don't know if it was just your edit, but that was one softball interview. No one was questioning the single-payer advocates' more optimistic assumptions. If half of personal bankruptcies are caused by medical bills, our aggregate medical deficit must be huge–hundreds of billions? Yet the only cost savings they hypothesized from a single payer system was from simplified billing. What might that amount to, tens of billions? They didn't present any numbers, but it seems to be those two must be an order of magnitude off.
Actually, the Argentine system doesn't sound that far off from what we've got here in the US now. But consumer driven patient-doctor fee for service sounds like a pipe dream to me. Medical savings accounts? Get real. How much does one need to squirrel away to ensure there will be enough in the case of catastrophic illness? Medical Savings accounts and Catastrophic insurance? And who except the top 5% can afford to do that when we have an economic system that's built on undervaluing work and a regressive tax system that transfers all wealth upward? One of the real crimes in our present health system are the number of people who are wiped out even though they have extensive insurance coverage. Give me a single payer system and I'll accept the wait times.
If you are uninsured and does not have insurance, you should check out the website http://UninsuredAmerica.blogspot.com – John Mayer, California
If you are uninsured and does not have insurance, you should check out the website http://UninsuredAmerica.blogspot.com – John Mayer, California