Is this better than what we have now? Yes, certainly. Most significantly it prohibits insurance companies from denying coverage based on preexisting conditions, which is a large part of how they screw people now (although I'm not at all convinced that the insurance companies won't find new ways of screwing people). It is also a hell of a lot better than McCain's plan, which isn't really a plan at all, it is just a continuation of the status quo, but it is actually worse because he takes the burden for benefits from employers, and dumps it on individuals, leaving them to the mercy of the private insurance companies. Read the AFL-CIO's analysis for more details.
But just because it is better than really bad, doesn't make it good. The root of the multitude of problems in our health care system is the insurance companies. They, like all corporations, have one concern, one legal responsibility, and that is to their shareholders, and profit. They look out for the bottom line, period. If it isn't good for business, if it doesn't give them more profit, they don't do it. And nothing makes more profit than cutting corners and screwing customers. Do you notice something missing? I'll give you a hint: It's HEALTH CARE! Simply put, GREED is at the core of our health care system, and it will continue to make private insurance companies look for new, more inventive ways to screw over customers. The preexisting conditions exception is one of the many ways they screw people over, but even if that is closed, they still have many more ways to screw you, and they will never stop finding new loopholes.
The private insurance industry is a cancer in our health care system. It is malignant. The HCAN plan is to try to stunt the cancer's growth, responding to new growths with targeted chemotherapy and radiation, but never actually trying to attack the main tumor. They leave it there to spread and continue to kill the system. What we need is to cut it out, completely, for the health of everyone.
The funny thing is, a completely public universal system is so much simpler than trying to tape together and regulate a private-public hybrid. Remember all that "mandates vs no mandates" debate during the Democratic primary? All the crap about enforcement and fears of people cheating the system? If the plans were public and truly universal, none of that would have been an issue, because that system would cover EVERYONE, period. Those debates and regulations and clauses to try to eliminate all of these problems, and the anticipation of future problems, all those issues were symptoms of trying to piece together a broken, bleeding system with spare body parts and duct tape. Our health care system is dead, and HCAN's plan is to give it life, by turning it into Frankenstein. What we need is a rebirth, from scratch, WITHOUT the tumor of greed. The government needs to take the lead in making sure everyone has access to health care. The government's job is to look out for its citizens, and it is accountable to those citizens. The government could administer health care just like it administers Social Security and Medicare, with a goal of helping people, not screwing them over for a profit. The role of corporations is to look out for their shareholders, to make them rich. Corporate America is incompatible with public health--the goal of corporations is not the same goal as the health care system, in fact it is directly opposed. Greed is incompatible with public health. We will never have a good system of health care with the insurance companies in the middle, exacting their pound of flesh.
I'm not alone in seeing HCAN's plan as a complete cop-out. Take it from experts, like Rose Ann DeMoro, executive director of the California Nurses Association (CNA):
Why is Health Care for America Now giving up on real reform?Or Dr. David Himmelstein with his response "A Policy Response to Health Care for America Now" (worth the read), as well as Dr. Don McCanne's "What is 'Health Care for America Now' Doing?". They all point out what should be obvious to everyone, HCAN is missing the point, and totally fails to cure (remove) the root cause of the health care crisis.
The big splash of news and internet coverage for the new Health Care for America Now coalition of labor, progressive and liberal groups is a reminder of the critical importance of health care reform. And a reminder that partial solutions, such as those proposed by the coalition, will only perpetuate, not end the health care crisis.
The groups behind the new coalition are working in concert with the Obama campaign and Democratic leaders in Congress to build "consensus" around a plan that would presumably be introduced in the first days of the next administration, and pushed through to a quick vote before opponents can mount a "Harry and Louse"-style counter attack.
But, in search of a supposedly politically viable plan, the advocates of this approach have surrendered in advance on the only overhaul that will actually cure the disease, a single-payer, expanded and improved Medicare for all reform.
Their good intentions will leave the same failed system in place, and will not even blunt the political opposition from those on the right and corporate interests who will continue to challenge anything that looks like even modest reform.
They create a false hope of systemic change that won't be, squandering the opportunity to achieve the fundamental reform so desperately needed with so many lives in the balance.
They've also missed one of the most important lessons of the failure of the Clinton plan of 1993-94 which collapsed in part due to the absence of a broad, grassroots, activist movement needed to counter the insurance industry. Only single payer engenders such a movement, the very reason the single payer bill now in Congress, HR 676, has more co-sponsors than any other reform bill with tens of thousands around the country already working to enact it.
Health Care for America Now has identified the main culprit and obstacle to genuine reform. As their inaugural ad proclaims, "Will health insurance companies ever put your health ahead of their profits? We can't trust insurance companies to fix the healthcare mess."
There's just one problem -- the coalition's proposal does nothing to end the actual practice of insurance companies putting their profits ahead of your health. Nor does it fix the two central components of the health care morass -- insurance company denials of care and the financial squeeze facing American families due to ever skyrocketing healthcare costs which is exacerbated by the escalating credit crisis.
Consider the four healthcare questions posed by families in the first 30-second ad: "Will they pay for his inhaler? Is my surgery covered? Can I choose my child's doctor? Will they cover the chemo?"
All are the direct result of care denials and price gouging by the insurers -- and none would be solved by the HCAN "statement of common purpose."
How does the HCAN coalition propose to crack down on the insurance pirates? With a "watchdog role" on the plans "to assure that risk is fairly spread" and that "insurers do not turn people away, raise rates or drop coverage based on a person's health history or wrongly delay or deny care."
You can watch someone rob your bank, but unless you stop them, the vaults are still going to be stripped bare. If you're looking for the hammer or any enforcement mechanism in the HCAN proposal, don't bother, it's not there.
The insurers don't care if we know they are thieves, they will continue to deny and delay care because it's in their DNA. It's how they are set up to operate, it's how they make money for their shareholders, it's how they generate plush pay packages for their executives, and it's how they compete with the other insurance giants.
Nor does the HCAN proposal contain any effective cost controls on the insurers. Their commitment to basing pricing on "ability to pay" is a recipe for merely getting the healthcare you can afford, not what you need. It also fails to assure real choice of providers beyond the limited network established by all private insurance plans.
The bone the coalition sponsors throw to single payer advocates is the false promise of a public plan side by side with private insurance. The public plan, they contend, will be so much more attractive that the private plans will just wither away. Don't count on it.
The insurance companies will always be able to lower their prices with cut rate plans with lower standards that they can aggressively market through massive advertising, tele-marketing, even door to door salesmen (as some do now) with a marketing campaign that the public plans will not have the funding to be able to match.
The private plans can then continue to cherry pick the younger and healthier patients while the sicker and older patients are dumped in the public plan, wrecking the whole idea of a risk pool and driving up the costs for the public plan to operate. The competition won't starve the private plans and cause them to wither away, they'll starve the public plan.
There's only one way to stop the insurance industry abuses -- it's to actually stop them. The rest of the world has figured this one out -- see the study in Britain earlier this year that found that the U.S. ranks last in preventable deaths among 19 industrialized nations even though we spend twice as much on healthcare as anyone else. Isn't it time we figured it out here as well?
Like I said before, I believe these groups know that single payer universal coverage is the best solution, but they just don't think it is politically possible, so they are starting out by conceding meaningful reform. That isn't how you negotiate. You start with what you really want, and if it is impossible, you make concessions. You don't concede reform before you even try. There is a movement for single payer health care. People want real solutions and they want the government to lead the way. We just have to put pressure on our representatives so they realize truly universal health care is popular, and should be pursued. We are going to be in a perfect position to push meaningful reform next year, with Democrats controlling the White House and having large majorities in both houses of Congress. Who knows how long this position will last, or when we'll be in this position again? We can't squander this historic moment of great opportunity on bandaid solutions and piecemeal change. We must FIGHT for REAL health care reform. I intend to focus on this quite a bit going forward, especially after the election, because the debate can't be allowed to end with pseudo-reform, if it does the Republicans and private insurance companies have already won.
With that I have nothing left to say, except that I am really disappointed that so many progressive organizations have essentially given up on meaningful reform, and abandoned their mission to push the progressive agenda forward. They have left us hanging, and now it is our job to pick up the slack and pressure those who usually do the pressuring. It won't be easy, but it isn't impossible. So please, do everything you can to push single payer universal health care. And check out the Physicians for a National Health Program website to stay informed and get involved.
And even if you are cynical and pessimistic and don't think we can win this fight for truly universal health care, remember the Overton Window, and help us push it in the right direction, because that will ensure we'll get there eventually, even if we lose the battle (which hopefully we won't).
