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Health Care: Final Appraisal

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I haven’t posted to heavily on the miserable bit of political theater we call the “health-care debate” because after Obama’s cowardly about-face on the public option it became clear this was reform designed solely in the interests of corporations. And it is interesting to examine how closely the final product (which is to be passed later today) hews to their original demands, how they slowly set the parameters for debate, killing proposal after proposal, until now the majority of our so-called “left” warmly cheers its passage.

Now, there can be no doubt that HCR will have a few benefits for the public. The bill vastly expands coverage (albeit at the barrel of a mandate), outlaws discrimination against pre-existing conditions, claims to lower costs, and supposedly provides generous subsidies for those who can’t afford insurance (still unclear on how that’s supposed to work). But I want to stress that these public benefits are incidental to the bill’s primary purpose, which was to preserve the employer-based model of health insurance, and particularly to enrich the pharmaceutical and insurance industries. As I mentioned earlier, health stocks have shot upward on news of the bill’s passage.

A short history of health-care reform, detailing its spiral into in oblivion:

First, President Obama announced that a single-payer system would be completely off the table. Britain, Canada, France, Australia, New Zealand, Sweden, Denmark and Finland, Norway, Germany, and many other “developed” countries, all use single-payer – and while one can hotly debate the efficacy from a user-standpoint, those countries all get universal coverage for a fraction of the cost – which was supposed to be the goal of this bill.

Single-Payer means the government automatically covers every citizen and negotiates directly with doctor and pharmaceutical agencies. This, naturally, gives it greater bargaining power, which is one reason Canada pays 40% less for its medicine.  President Obama even admitted that the US cannot insure all Americans – and thus, cannot claim “universal healthcare” – without single-payer. However, such a plan would have demolished the massive profits and control our health care providers enjoy, so it wasn’t even discussed.

Defeated, progressives consoled themselves with the knowledge that President Obama favors a  “public option”. This would have entailed setting up a government-run nonprofit health care provider to compete with private insurers, much in the way public universities compete with private universities or the USPS competes with Fed Ex. President Obama  campaigned strongly for a public option,  but then vacillated once in office, and finally came out against it. The bill, finally, does not contain a public option, and it should be easy to see why private insurers would be pleased with that exclusion.

Okay, a necessary loss – but can we at least buy into Medicare? Nope. Import drugs from counties where they’re cheaper? Hell no. Remove the anti-trust exemption, wherein price-fixing is legal for insurance companies? Not yet. So what, then, does the bill do?

It forces 35 million uninsured Americans to either qualify for a subsidy or reach into their pockets and fork over a few thousand dollars per year to the existing insurance monopolies, significantly increasing their power with an absence of any independent regulation.  The insurance industry got literally everything they wanted – not a single new regulation, not one control on their frankly ludicrous system of pricing – and the so-called “liberals” got precisely nothing.

A few conclusions flow:

a) Insurance companies are essentially giant regional monopolies, each sovereign over all the health-insurance sold within a swath of land. They are exempt from anti-trust law, and are free to collaborate on their prices or arbitrarily set them as high as they wish.

b) The US Government is now authorized to use state power to compel its citizens to purchase this overpriced and frankly worthless product.

c) The companies, in return, promise not to callously deny coverage to the previously-afflicted and otherwise act with some modicum of humanity.

Michael Tomasky in The New York Review of Books gives an excellent rundown on “The Money Fighting Health Care Reform”, which is an odd title since his article ends up detailing the money fighting for the bill that just passed. Anyone who still thinks that the health insurance industry considers this bill a loss would do well to read it.

Some final notes:

  1. The Health insurance sector spent over half a billion dollars lobbying to shape the final HCR bill, by June ’09, more than a million dollars per day.
  2. The biggest pharmaceutical lobbying group, PhRMA, spent $6 million in the past few weeks advertising for the final HCR bill, and this is after they already spent $150 million earlier on the same thing.
  3. Major insurance providers WellPoint, Atena, Anthem Blue and many others also support the bill.
  4. The so-called “Baucus Plan”, which formed the basis for the final bill, was authored by his aide Liz Fowler, a former VP at WellPoint.
  5. Obama’s “health czar”, Nancy-Ann Deparle, who was also instrumental in arriving at the current bill, received $5.8 million dollars in 2009 from health insurance firms.

Written by pavanvan

March 23, 2010 at 2:57 pm