From Salon:
Obama, the healthcare Riddler
Why is the president suddenly so afraid of a single-payer solution to America's healthcare crisis?By David Sirota
President Barack Obama meets with healthcare stakeholders at the White House May 11. At right is Health and Human Services Secretary Kathleen Sebelius.
May 16, 2009 | The most stunning and least reported news about President Barack Obama's press conference with health industry executives this week wasn't those executives' willingness to negotiate with a Democrat. It was that Democrat's eagerness to involve those executives in a discussion about healthcare reform even as they revealed their previous plans to pilfer $2 trillion from Americans.
That was the little-noticed message from the made-for-TV spectacle that administration officials called a healthcare "game changer": In saying they can voluntarily slash $200 billion a year off the country's medical bills over the next decade and still preserve their profits, healthcare companies implicitly acknowledged they were plotting to fleece consumers and have been fleecing them for years. With that acknowledgment came the tacit admission that the industry's business is based not on respectable returns, but on grotesque profiteering and waste -- the kind that can give up $2 trillion and still guarantee huge margins.
Chief among the profiteers at the White House event were insurance companies, which have raised premiums by 119 percent since 1999, and one obvious question is why -- why would Obama engage those particular thieves?
It's a difficult query to answer, because Obama is a healthcare mystery, struggling to muster consistent positions on the issue.
Listening to a 2003 Obama speech, it's hard to believe he has become such an enigma. Back then, he declared himself "a proponent of a single-payer universal healthcare program" -- that is, one eliminating private insurers and their overhead costs by having government finance healthcare. Obama’s position was as controversial then as it is today -- which is to say, controversial among political elites, but not among the general public. ABC's 2003 poll showed almost two-thirds of Americans desiring a single-payer system "run by the government and financed by taxpayers," just as CBS's 2009 poll shows roughly the same percentage today.
In that speech six years ago, Obama said the only reason single-payer proponents should tolerate delay is "because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
That might explain why, when Illinois contemplated a 2004 healthcare proposal raising insurance lobbyists' "fears that it would result in a single-payer system," those lobbyists "found a sympathetic ear in Obama, who amended (read: gutted) the bill more to their liking," according to the Boston Globe. Maybe Obama didn't think single-payer healthcare was achievable without a Democratic Washington. And when in a 2006 interview he told me he was "not convinced that [single-payer healthcare] is the best way to achieve universal healthcare," perhaps he was following the same rationale, considering his insistence that he must "take into account what is possible."
Of course, even as a senator aiming for the "possible" in a Republican Congress, Obama promised to never "shy away from a debate about single payer." And after the 2008 election fulfilled his precondition of Democratic dominance, it was only logical to expect him to initiate that debate.
That's why the White House's current posture is so puzzling. As the Associated Press reports, Obama aides are trying to squelch any single-payer discussion, deploying their healthcare point-person, Sen. Max Baucus, D-Mont., to announce that "everything is on the table with the single exception of single-payer."
So it's back to why -- why Obama's insurance-industry-coddling inconsistency? Is it a pol's payback for campaign cash? Is it an overly cautious lawmaker's paralysis? Is it a conciliator's desire to appease powerful interests? Or is it something else?
For a president who spends so much time on camera answering questions, those have become the biggest unanswered questions of all.
10 comments:
I'm afraid I have to respectfully disagree with you (and the Salon writer), for the first time since I started reading your blog. Not that I'm not in favor of single payer; I am, absolutely. But, I think Obama's got a solid reason not to be pushing it: because it'd make Bill & Hilary's healthcare failure look like a home run. If "we" means real progressives, then "we" haven't had the House or Senate in a long time, and "we" certainly don't have them now. Not only is the notion of a progressive filibuster-proof 60 votes in the Senate ludicrous (Specter? Lieberman? Nelson?), but it's highly questionable whether Obama's going to be able to get a bare majority to support a proposal (even one that's far less than single payer) that will actually guarantee coverage to all Americans. My hope is that he'll be able to create a national health plan of some kind, however watered down in needs to be to pass. Then, perhaps, Republicans' fears will prove true in the years to come, and it will gradually expand and private health insurance will become obsolete. No doubt my feelings on this have something to do with the fact that I'm currently without health insurance, myself, so don't want to see this attempt fail and have to wait another fifteen years for the next. Something is better than nothing.
Yoga - I agree that something is better than nothing. But what we will be getting here is nothing different than what we have now. Oh some costs for some services may lower, but you will still have the same insurance companies deciding which things they will cover and what services we will be allowed to receive. Until that changes nothing will have changed.
Single-payer will come, but it will be incremental over many years. It's too bad, but that's the way it is. Profit is still king.
Gordon - I know it will take years to accomplish. In the mean time, the insurance companies will get richer and more and more people will go without the services they need because it won't be "cost effective."
Even if he has to male compromises, as YogaforCynics says, he should be pushing his original ideas with as much conviction now as he had before. Anything less looks wishy-washy at best, and flip-floppy-betrayal of campaign promises at worst. We can't afford to give the wingnuts anymore ammunition against the left.
I agree that it won't be really good until there's single payer. On the other hand, at no time while Obama was running for president did I ever hear him say that's what he was going to go for - and I was certainly paying attention to that. He said that if he was starting from scratch that's what he'd have but he never intimated that he was going to try to directly implement a single payer system if elected. If anything, he said he wasn't. So, I do think that Sirota, Ed Schultz and the others who are saying he did are being a bit disingenuous on this one. I do think that that's what the public option is intended to become eventually.
Amen! My dad assures me that ONE DAY we'll have national health care because his generation (boomers) will demand it. I sure as hell hope so.
Shea - This really shouldn't surprise any of us. He has backed off on several campaign promises that were made. I do agree, though, the right doesn't need any more ammunition.
ZenYenta - I guess maybe I didn't pay as close attention as I thought I did during the campaign.
The thing is, until we do get a single payer plan the insurance companies will continue to tell patients who they can see, what services they can have, and what conditions they will pick and choose to cover.
Riot Kitty - I'm a boomer and have been pushing for this for years.
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