Progress Now Action

Failed U.S. health care is a major contributor to our systemic economic crisis. Indeed, the excesses of Wall St. and the subprime mortgage catastrophe mirror U.S. health care policy – both are typified by privatized profit (for investors and insurers), and socialized risk (for taxpayers and consumers). Inflated U.S. health care costs – 16% of GDP and rising – are major contributors to an inflationary economy. Redress of this single aspect of an out-of-control U.S. economy would lift all boats. Comprehensive health care reform would improve the economic status of all, relieving health access concerns of families, individuals and businesses, large and small.

So-called "legacy costs" alone, comprised largely of retiree health and pension benefits, have contributed significantly to General Motor’s negative cash flow, prompting yet another request for government bailout. In 2005, costs of health care coverage to GM amounted to $5.6 billion for 1.1 million employees, retirees and their dependents. In 2005 BusinessWeek reported that legacy costs added $1,600 to the cost of each GM vehicle.

It’s time to confront the crippling economic effects of employment-linked health coverage that reduces competitiveness of businesses in the world marketplace, reduces effective employee take-home pay, and adds to the costs paid by all for goods and services (note above cost added to each U.S. -made car). State and city budgets, too, are depleted by escalating health costs for employees and retirees.

Progressives leaders must do a better job of promoting civic discourse while clearly defining issues, like health care reform. Democrats shoud cease parroting right-wing framing and code words intended to distort the issue, e.g., "government health care" or "socialized medicine," as a couple of recent Colorado candidates have done. We need to refute Republican "free-market" advocacy that treats health care as a commodity to be exploited for maximum profit, with top-skimming of over 25% of health care dollars for private insurance shareholder profits, CEO salaries, excessive administrative costs, marketing, lobbying, etc. "Free-market" health care is as perverse an incentive as free-market police and fire protection would be, leaving everyone vulnerable, at the mercy of the marketplace.

Barack Obama showed promise broaching issues during the campaign. He made a start at explaining the high cost of privatizing Medicare (13% higher than traditional Medicare), and the failure of Medicare prescription drug reform that prohibits negotiation of bulk drug rates, as the VA does to save money. The 2003 reform was a giveaway to insurance and pharmaceutical lobbies, with billions of dollars of taxpayer subsidies and inflated costs to benefit their bottom lines. Now is the time to make the case for an improved Medicare for All - a public insurance with true free choice of providers and hospitals. By contrast, for-profit insurance choices are narrowly limited to "in-plan" providers, necessitating change of providers with change of insurance.

Comprehensive health care reform shoud be part of a broad economic remedy. U.S. health costs are almost double those of all other industrialized nations, and growing; yet we still experience worse overall health outcomes. Increasing numbers of underinsured pay escalating costs for decreasing coverage. Taxpayers currently pay for over 60% of health care costs, including 70% of legislators’ health coverage. By many accounts, that is enough to provide single-risk-pool coverage for all.

In fact, single-payer health care is the only model of reform that has demonstrated in over 20 federal and state studies the capacity to save money and provide comprehensive coverage for all.

It is time for reform that benefits the worker as well as the CEO.

First posted on Huffington Post 11-13-08

The "right-to-life" movement that elevates embryonic life above women's lives is more accurately termed "right-to-prenatal-life." One of the most extreme 2008 anti-abortion, anti-contraceptive ballot measures is the so-called Colorado "Personhood" amendment - number 48 - defining fertilized eggs as "persons" with Fourteenth Amendment rights to "life, liberty and due process of law." Simultaneously, rightists have opposed the same rights for women as "reading feminism into the Constitution."

Both Amendment 48 and a rule change proposed by the Bush administration Department of Health and Human Services would re-define pregnancy as the point of conception, disregarding the medical definition of pregnancy - "the implantation of a fertilized egg." They would effectively categorize as abortion any contraception (e.g., the pill, IUD, emergency contraception, contraceptive patch) that interferes with the implantation of a fertilized egg, thus outlawing most contraception - the primary means to reduce the need for abortion.

In a slippery slope to 19th century status for women, rightists have promoted "conscience clauses" permitting pharmacists' and others' refusal to fill prescriptions or provide health care for women. The HHS proposal states, "[T]he conscience of the individual or institution should be paramount in determining what constitutes abortion..." - holding women's health hostage to anyone's professed religious/ideological beliefs.

It is time to recognize that abortion serves as surrogate for a spectrum of unspoken issues related to female personhood and male entitlement. The anti-abortion political litmus test was introduced by Paul Weyrich, who dictated that women step aside and "make way for new life." It serves dual purposes - the marginalization of women and the lightning rod around which to mobilize political coalitions, notably, Evangelicals and Catholics. The elevation of fetal life over women's lives, coupled with conservative strategist Howard Phillips' euphemistically described goal of return to "one-family-one-vote," is calculated to marginalize and disenfranchise women, consistent with the ultraright tenet that ultimately, only select white Christian males should retain the right to vote or hold office.

Rickie Solinger concluded from her historical research of women's health care that women's rights have often been held hostage by politicians and others with "political agendas hostile to female autonomy and racial equality" (Wake Up Little Susie: Single Pregnancy and Race Before Roe v. Wade, 1992). The criminalization of contraception and abortion, and the widespread U.S. adoption black market that assigned value to babies and punishment to women based on race, were some effects of pre-Roe efforts to control women's reproduction.

At core, Weyrich's anti-abortion, anti-contraceptive and abstinence-only ideology serves as cornerstone of an anticipated male supremacist theocracy. It is the platform upon which the majority of Republican candidates continue to run in 2008. The greatest conceit - that pregnancy is not a health issue and women's lives are expendable - underlies the dual standards of Republican Party pronatalist policy demanding female submission to males who presume the right to hold women hostage to personal beliefs.

On August 29, the Friday before the Republican Convention, members of the Council for National Policy convened in Minneapolis to grant their imprimatur to the vice presidential candidacy of Sarah Palin. Focus on the Family's Tom Minnery described the group's reaction in a Focus on the Family Action video, which has since been removed from their website: "There could not be more excitement based on the little we know about Palin so far," enthused Minnery. Given general longstanding opposition to women in positions of power among CNP members, Minnery was asked whether James Dobson could possibly support a woman for the office. He quoted Dobson: "If it's the right woman, we are ready to vote for her." Dobson has been hoping for some time to find a "Margaret Thatcher" type, noted Minnery.

Outside the obvious, i.e., her anti-gun control and anti-abortion positions, Minnery recited Palin's positives as a conservative candidate: a hocky mom in an intact marriage who "has not rejected her feminine side"; because she and her husband are union members, it was speculated that blue collar voters in important swing states would be attracted; and (improbably) because she is a woman, that she would appeal to Hillary Clinton supporters.

The Council for National Policy (CNP) has remained largely below the radar since its 1981 founding as an umbrella group uniting a network of over 500 members from Congress, the business community and hard-right evangelicals. The press are excluded from their secretive invitation-only strategy meetings, held three times annually.

The group is strongly influenced by the teachings of the late Rousas Rushdoony, a CNP member and patriarch of the reactionary Christian Reconstructionist (Dominionist) movement that has infused the doctrine of conservative churches since the '60s, and seeks Christian dominion over all aspects of society and the world.

When Democrat Mark Udall debated Republican Bob Schaffer in July, he made no effort to refute Schaffer’s distortions surrounding health care reform. In fact, he essentially short-circuited meaningful debate by adopting the nebulous right-wing description of single-payer health care as “government health care,” thus capitulating to Republican framing of the issue.

Just what is government health care? Is it the more than 60 percent of all health care costs that are paid by taxpayers, including subsidies for inflated costs of private insurances? Private insurers skim the cream and game the system for profit, and count on government (taxpayers) to pick up the health care costs of all whose coverage they reject. Does government health care include the 70 percent of our legislators’ health coverage that is funded by taxpayers?

Democrats who facilely echo GOP talking points grossly misrepresent single-payer health care. In fact, contrary to assertions by the right-wing “free market” chorus, only single-risk-pool insurance provides true free choice of private providers, the same as traditional Medicare before Republicans moved to privatize Medicare (at 12 percent higher cost). Private insurance plans limit choice to “in plan” doctors, often requiring change of providers when plans are changed. Only single payer is capable of providing comprehensive, continuous health care benefits and protection against medical bankruptcy.

Our leaders should vigorously protest the abomination of Medicare prescription drug reform that was written by insurance and pharmaceutical lobbies with billions of dollars of taxpayer subsidies and inflated profits to benefit their bottom lines, while prohibiting negotiation of bulk drug prices.

Instead of privatizing Medicare-for-profit, why not improve and expand its coverage for everyone? Traditional Medicare has lower overhead costs – less than 4 percent – whereas private insurances divert 25 percent or more to profits, lobbying, marketing, exhorbitant CEO salaries and wasteful administrative costs. Profit is a perverse incentive for health insurance, which protects its bottom line by reducing benefits and shifting ever-greater costs to consumers.

The insulated political class in Washington, dependent upon corporate money and privy to 70 percent taxpayer-subsidized health coverage, seem out of touch with the U.S. people. Polls by Pew and others have revealed that increasing numbers – 54 to 65 percent – support a national single-payer health care plan. A recent study reported in the Annals of Internal Medicine (3-31-08) that 59 percent of U.S. physicians “support government legislation to establish national health insurance,” an increase of 10 percent since 2002.

Notably, more than 20 federal and state studies since 1990, including the 2007 Lewin Group evaluation in Colorado, have demonstrated that single-payer health insurance is the only reform model that can both save money and provide comprehensive health care benefits for all. The Colorado single-payer proposal and Rep. John Conyers’ national health care bill, HR 676, both deserve serious further study.

We have everything to gain from an honest dialogue about quality-, saftey-centered universal single payer health care, in place of profiteering health insurance gatekeepers.

A study published in Health Affairs (6-10-08) documents a sharp (60%) increase in numbers of underinsured between 2003-2007. Underinsurance rates nearly tripled among those with incomes above 200% of poverty. Consequently, 42 percent of U.S. adults were under- or uninsured in 2007, reporting high levels of access problems and financial stress.

Even among those with incomes over 400% of poverty, 15% are underinsured. The study indicates that the move toward greater consumer cost-sharing for minimum benefit insurance policies in recent years is pushing millions of insured non-elderly adults toward spending large shares of their incomes on health care. The clear impact is to increase the share of families at risk for medical debt and loss of savings for retirement, college, or other long-term needs.

Our current insurance system is working well only for the wealthy, who can afford high costs. Politicians' promises that "you can keep the insurance you have" also apply to the wealthy.  Read the Report

Following is a 650-word piece I wrote about the failure of profit-centered health care that has been picked up by several newspapers around the state.

                              Failure of U.S. profit-centered health insurance

Spending almost twice as much, the U.S. has worse health outcomes than other industrialized nations. Uniquely, U.S. health care is dependent on over 1200 for-profit health insurances, functioning as gatekeepers. Underwriting – the art of risk evaluation and avoidance – insures profits by covering the healthy and rejecting everyone else as a "pre-existing condition."

Profit is a perverse incentive for quality health care: imagine for-profit fire or police protection. "Market-driven" health care treats health as a commodity, to be negotiated like a car or a house. The free market has also spawned "designer hospitals," offering only the most profitable specialties, e.g., cardiac procedures, and eliminating less profitable services, e.g., emergency and mental health.

No reform proposal by current presidential candidates addresses the failure of the private health insurance industry, characterized principally by decreasing benefits and greater costs and risks shifted to consumers. In turn, more are subjected to underinsurance and unpaid medical bills – now the leading cause of personal bankruptcies. Premium increases of 87 percent over 6 years have outpaced both cost-of-living and median family income increases.

Incremental reform proposals demonstrate lack of political will – the same failure to confront corporate profit-taking by insurance and pharmaceutical industries that wrote Medicare prescription drug reform with billions of dollars of taxpayer subsidies and inflated profits to benefit their bottom lines.

Commercial health insurance is the 800-pound gorilla, responsible for over 25% of health care dollars siphoned to excessive administrative costs, lobbying, marketing, CEO salaries and profit-taking: $30 billion annual health insurance profits; $32 billion insurance underwriting and marketing costs (McKinsey Group, 2007).

Gaming the system for profit has given rise to the annual $20 billion business of "denial managment" – health insurance middlemen who search claims for excuses to delay, deny or renege on reimbursements.

Responding to double-digit premium increases, more employers are opting to move employees into underinsurance – high-deductible catastrophic plans. Simultaneously, the American Hospital Association reports that both family out-of-pocket health expenses and unpaid medical bills have risen approximately 60% over a decade – still more costs ultimately shifted to taxpayers and consumers.

Notably, more than 20 federal and state studies since 1990, including the 2007 Lewin Group evaluation in Colorado, have demonstrated that single-payer health insurance is the only reform model that can both save money and provide comprehensive health care benefits for all. Indeed, the single payer model is the only truly efficient, equitable, and sustainable financing system, enabling universal coverage by spreading risk across the entire population.

Contrary to assertions by the "free market" choir, only single payer insurance permits true choice of pubic and private providers; private insurance is limited to "in plan" doctors. Only single payer provides comprehensive benefits and protection against medical bankruptcy.

Rather than comprehensive health care reform, most current proposals revert to a Massachusetts-style nostrum, preserving insurance profits and requiring an individual mandate to purchase minimum-benefit insurance, subsidized by taxpayers as needed. It is a formula for continued inflationary consumer health costs and decreasing benefits.

National single payer bill, HR676, calls for a progressive 3 to 4 percent employer and employee payroll tax to replace all health deductibles and premiums. Full-coverage costs for a family of four earning $40,000 annually would drop to $110 a month, from recent levels of $273/month for employer-sponsored coverage, or $489/month for an individually-insured family (Kaiser Family Foundation, 2007).

A political class dependent on corporate money (and privy to 70 percent-taxpayer-subsidized health coverage) sidesteps meaningful reform. Nevertheless, polls by Pew and others have revealed increasing numbers – 54 to 65 percent of people – support a national single-payer health care plan. A recent survey reports that 59 percent of U.S. physicians now support national health care, up 10 percent from 2002.

A grassroots movement and political reforms, including publicly-financed campaigns, may be necessary to instill the political will for meaningful reform. We have everything to gain from quality-, saftey-centered universal single payer health care to replace U.S. dependence on profiteering health care gatekeepers.

CheneyCare -- We taxpayers pay 70% of guaranteed coverage for VP Dick Cheney and 2 million federal legislators and employees. 
Link: Bill Moyers' Journal 5/9/08 -- California Nurses' campaign for "CheneyCare" for all.  Read transcript or view program: http://www.pbs.org/moyers/journal/05092008/transcript1.html


Video "Who the Health Cares?" gets straight to the point: Presidential candidates will not determine health care reform -- the ball is in the court of Congress. http://www.moblogic.tv/video/2008/04/30/who-the-health-cares/


For-Profit Health Insurance and Pharmaceutical Industries -- scary statistics

1) Melody Peterson's book "Our Daily Meds" reveals that the benefit of medicines marketed by pharmaceutical companies "has become secondary to how much it will bring shareholders in profit"...due to constant pressure by Wall Street for drug companies to exceed profits made the year before; Big Pharma employs 2 lobbyists for every Congress member.

2) Tests show that placebos often work as well as the drugs being marketed to the public.

3) 100,000 Americans die annually from taking prescribed drugs as prescribed (FDA reports).

4) U.S. experiences 75,000-100,000 preventable deaths annually, ranking 19 out of 19 nations. (Recent study, Ellen Nolte & Martin McKee, London School of Hygiene & Tropical Medicine) 

Please join Be the Change-USA & Health Care for All Colorado
for an exciting, engaging and fun event May 31

Are We All Really Covered? Closing the Gaps in Health Care
12 noon - 7:30 PM, Sat., May 31, 2008

First Plymouth Congregational Church
3501 S. Colorado Blvd. (Hampden and Colorado Blvd)
Englewood, CO

Registration: Full program: $35; Dinner & evening speakers: $25; Evening speakers only: $10. Discount for Seniors, students, veterans, BTC and HCAC members: $5

Special program features:
1-3 PM Providers and Patients Panel: "How did we get into this mess, and how can we get out?"

3-5 PM Presentations by CO elected officials and candidates: "Will Colorado begin to close the gap?"

5 PM Dinner "Legislative Grill" -- Members of Congress and candidates and representatives of Presidential campaigns: "Will Congress or our next President begin to close the gap?"

6 PM Evening Keynote speaker: Elizabeth Kucinich

More info: www.BTC-USA.org or www.healthcareforallcolorado.org or call Dick Barkey, 303-808-8504, or Eliza Carney, 970-416-0636
To register online: www.BTC-USA.org  

The U.S. spends on average twice as much on health care as other industrialized nations, and has overall worse outcomes. Paul Krugman’s