Americans support a public option

A New York Times/CBS News poll shows overwhelming support for a public option - 72 percent of all those polled were in favor, with 20 percent opposed and 7 percent clueless.
Half of Republicans were in favor (39 percent opposed).
87 percent of Dems were in favor! (9 percent opposed).
73 percent of Independents were in favor (22 percent opposed).

And yet Senate Dems are not on board.

What is wrong with this picture?

Contact your senators! Here's an Howard Dean petition - there are others as well.

Public Option Good Politics

Robert Creamer has an article at Huffington Post on Four Reasons Why Giving Consumers Is Great Politics.http://www.blogger.com/img/blank.gif
He cites the popularity of such a program:

In a poll taken earlier this year by Lake Research, 73% of respondents favored a health plan that gives them the choice between a private plan or a public health insurance plan. Only 15% preferred to have only the choice of a private plan. And the preference for a choice between public and private health insurance plans extends across all demographic and partisan groups, including Democrats (77%), Independents (79%) and Republicans (63%).

According to an NPR report, "Republicans argue that upward of 100 million Americans would opt out of private insurance in favor of a public plan if such a plan were available."

And yet the story is being spun that Congress would never pass such a thing. Haven't we gotten to the point where nearly everyone understands that our healthcare system sucks, that other countries do it better, and that they do it better because there's a government guarantee of healthcare?

Lincoln was for govt-financed health care

James Nowlan, a Republican at the University of Chicago, has a column in today's Chicago Tribune. It's notable both for what it says and what it doesn't say.

"Abraham Lincoln declared that government should do only that which the people cannot do so well for themselves -- defense, highways, public safety, education. And government has done a good job of fulfilling this compact with the public. In recent decades, we have been adding health care to the compact, in increments: first the elderly with Medicare, then the poor, and more recently, children, both through Medicaid. If you're not in one of these categories, you scramble for health care. Everyone in my rural area hustles to find the shelter of health-care coverage. Farmers' wives take jobs at the school in town -- for health coverage for the family. Whenever a job change is contemplated, the biggest question is: 'Will there be benefits [health coverage]?'"

Nowlan addresses the irreconcilable tension between Americans believing that their taxes are too high and at the same time believing that the government should make sure everyone has health care.

Then, as if he can't quite help himself, he points out that Medicaid and Medicare are the biggest chunk of government expenditures on health care - something that is misleading because it doesn't note the other government expenditures on health care, such as the tax breaks for companies that provide health insurance and the cost of paying for private insurance for all municipal, county, state, and federal workers, including the military.

He notes that the cost of Medicare and Medicaid have gone up 7 percent a year, "far outstripping inflation," without noting that the rate of increase of private insurance puts Medicare and Medicaid increases in the dust.

Even so, the quote from Lincoln was nice. The experience of other industrialized democracies fairly proves that government does a better job of managing health care financing than does the private sector. (If, of course, you factor in health of the population as being at all important. If you're willing to write off a substantial portion of your work force - the Darwinian cost of doing business - then our system clearly is more profitable and therefore better, capitalistically speaking.)

Then again the right has so vilified the competence of the American government that it's possible that people think that whereas the Swedish or German or Taiwanese government can competently manage health care financing, our own government cannot.

The question then becomes "Why does the right wing hate America?"

Baucus says he shouda listened

Well yeah. Politico reports that "Senate Finance Committee Chairman Max Baucus (D-Mont.) told leading advocates of a government-financed health care system that he made a mistake by not giving their proposals more consideration in the reform debate, according to participants in a meeting Wednesday."

Bernie Sanders (I-VT), a single-payer supporter, arranged the meeting with David Himmelstein, MD, and others.

Those involved in the health care negotiations say single payers have been elevated precisely because Baucus excluded them. Baucus has been able keep almost every interest group involved in the process from speaking out against the ideas under consideration. But because they are not involved, single payers have been one of the only vocal constituencies hammering away at Baucus.

The virtual shut-out has emboldened the movement.

After being left off the invite list for the White House health care forum in March, single payer advocates alerted the media and won a seat at the table. They disrupted each of the Finance Committee’s three roundtables on health care in April and May.

How many are underinsured?

Commonwealth Fund has just released a stunning report on underinsurance in the United States. "Insured But Poorly Protected: Number Up 60 Percent in 4 Years", finds that, "Rate of Underinsured Triples for Middle and Higher Income Families; Underinsured Go Without Needed Care and Face Medical Debt."

It's great to have these figures - even though they understate the problem. The report found that there are 25.2 million underinsured Americans - "based on their out-of-pocket health care costs relative to their incomes." That leaves a lot of underinsured people uncounted.

Here's the full text of the Health Affairs article, and here's an interview that the report's lead author, Cathy Schoen of the Commonwealth Fund, did with PBS. There's both a video and transcript there - and links to resources like this - U.S. vs. other nations.

Podemos con Obama

Hike the gas tax

Wednesday midday I was at National Airport drinking a coffee that tasted like boiled shoe leather at the end of a bar. An outlet lured me there. National strikes me as the worst airport in America for keeping your laptop charged before you get onto the plane and can't recharge. Why so few outlets?

So there I am, answering emails and trying not to listen to the bartender talk up a couple who were slurring a bit before they even sat down. They plowed right into slugging back beers and mixed drinks. The Metro's not so bad, the bartender says to them. That's a recent discovery for her, forced by the fact that she's got an SUV. She's going to buy something smaller when she can afford it. Yep, her customers agree. They may need a few more before flying, but they're no fools. "Those SUVs," the guy says, "we all just bought 'em because they looked so cool."

Charles Krauthammer, one of the Washington Post conservatives, has a great column on how Americans have shot ourselves in the foot - or the bicycle tire, or something - with our refusal to tax gas. He doesn't mention the fact that big business and the Republican Party have engineered that situation by instilling fear and distrust of the very government that we're supposedly so proud of. Democracy or republic or whatever.

We've crippled ourselves regarding healthcare and transportation alike - both of which are essential for a vigorous economy.

If, however, you're wedded to the YoYo ideology - you're on your own - that cowboy mythology of individualism over community, then it's hard to get behind any kind of scheme that would benefit everyone - including future generations. Like, for instance, universal healthcare or a gas tax. That's despite solid data from elsewhere that it strengthens the middle class and makes children's lives better. Not a problem in America, where we're all on the verge of winning the Powerball, and will no longer be part of that middle class anyway. And our kids? YoYo.

Enough ranting. Here's Krauthammer:

Unfortunately, instead of hiking the price ourselves by means of a gasoline tax that could be instantly refunded to the American people in the form of lower payroll taxes, we let the Saudis, Venezuelans, Russians and Iranians do the taxing for us -- and pocket the money that the tax would have recycled back to the American worker...

Want to wean us off oil? Be open and honest. The British are paying $8 a gallon for petrol. Goldman Sachs is predicting we will be paying $6 by next year. Why have the extra $2 (above the current $4) go abroad? Have it go to the U.S. Treasury as a gasoline tax and be recycled back into lower payroll taxes.

Announce a schedule of gas tax hikes of 50 cents every six months for the next two years. And put a tax floor under $4 gasoline, so that as high gas prices transform the U.S. auto fleet, change driving habits and thus hugely reduce U.S. demand -- and bring down world crude oil prices -- the American consumer and the American economy reap all of the benefit.

Medicare Meets Mephistopheles

That's the title of a 2006 Cato Institute rip on Medicare. Here's the spin, via Amazon: "Let's say you're the devil, and you want to corrupt the American republic. How would you go about it? According to David Hyman, you might create something like Medicare, the federal health care program for the elderly. Hyman submits that Medicare may be the greatest trick the devil ever played. Medicare feeds on the avarice of doctors and other providers, turns seniors into health care gluttons, and makes regions of the United States green with envy over the dollars showered on other regions... With epic political battles over Medicare and the future of limited government looming just over the horizon, Hyman uses satire to cast a critical eye on this mediocre government program."

You can pick upMedicare Meets Mephistopheles, for $1.40 from Amazon or $14.95 from Cato. Your choice as a consumer in a market that actually works - unlike the free-market healthcare biz. The New England Journal of Medicine had a January 2007 review:

Hyman is surely correct that current financial trends in Medicare funding are unsustainable and will eventually erode public support. But in focusing on Medicare's inadequacies and mocking the system as an intergenerational scam (my word, not his), Hyman overlooks the reason why Medicare was enacted in the first place and why it retains considerable public support. At its inception, Medicare addressed the palpable medical needs of the elderly and the failure of the private insurance market to meet those needs. The program reflected a set of values and social commitments that included universalism, government responsibility for social welfare, and public accountability.

More important, Hyman ignores the reality that many of Medicare's flaws are at least rivaled, and perhaps exceeded, in the private sector. It is doubtful that the private sector would match Medicare's considerable strengths in providing access to health care that was unavailable before the program was introduced. Whatever its failures, there is evidence that the program has clearly improved the lives of its intended beneficiaries. As J. Lubitz and colleagues wrote in Health Affairs ("Three Decades of Health Care Use by the Elderly, 1965–1998") in 2001, "Our findings are consistent with the idea that Medicare-funded services have improved the health of the elderly." Is there any legitimate nonideological reason to believe that consumer-driven health care will better serve the elderly than Medicare? I am dubious.

Still, Hyman's bracing critique reflects the fact that neither Medicare's problems nor the ascendancy of market-based approaches to solving them can be ignored any longer. In an era of rampant individualism, the attempt to defend Medicare's collective ethos has the aura of a reactionary battle waged to save an old order in the midst of its last throes. Those who support the social obligations underlying Medicare must demonstrate anew why market-based solutions are unappealing and why governmental investment in health care is morally justified.

Here's hoping that Obama means new hope for social obligations.

Military benefits from desperation

The Wall Street Journal blog shares a NYT article on how healthcare reform could hurt military recruiting goals. Turns out that when an illegitimate war drags on, when troops are abused, and when people realize that a war is illegitimate and troops are being abused, young people don't sign up to fight.

The NYT piece is accompanied by a chart showing that in the late '80s, 25 percent of young people figured they'd sign up for military service during the next few years. Now only 13 percent think that's a reasonable choice.

Young people signing on to military service evidently say they're partly motivated by medical need for their young families. Tricare for their spouses and children is a trade-off for signing up for Bush's war. "It seems a bit perverse that the incentives for a young person with children to join are greater than the incentives for his childless friend," writes Floyd Norris in the Times. "But that is the way it is. All that could change if the push for some kind of national health insurance program were to be successful."

Donna Smith's new blog

The indomitable Donna Smith has a new blog at guaranteedhealthcare.org that I'll begin checking regularly. It's got 11 contributors, and so is almost certain to have new news and comments several times a day. Most, if not all the commentators are with the California Nurses Association and the National Nurses Organizing Committee.

Nurses, whether they're aligned with the American Nurses Association or the NNOC or SEIU are foot soldiers, sergeants and include a few generals the the battle for universal health care. It's doubtful we can get there without their help. All their help. So it's sad to see the division between the unions. Shades of Hilary and Barack.