by Phil E. Benjamin
The top health issues voters faced in 2007 will be similar to those in 2008. But, the raging health care crisis is being eclipsed by the all consuming growing economic crisis. That 2008 is an election year, which makes the stakes extremely high. But, people have learned that it is not enough to elect pro-health to run the House and Senate; the White House must be captured.
This will be the second consecutive year that health care is considered to be a top domestic issue. The prestigious Commonwealth Fund in its yearly forecast made that prediction. Now, the growing economic crisis, starting with the mortgage sub prime disaster, with its racist edge, has placed all other issues in a secondary role.
This will required health care activists to adjust their strategies to couple health issues with broader economic issues, not the last of which is a place to live. Housing is a major public health issue. The human face to the sub-prime mortgage crisis must be brought forward. All you see on TV now, with the Bush economic solution, is for investors to buy up the foreclosures. How carnivorous and disgusting is that? No discussion how the victims of the banking and mortgage company criminal mortgage activities are surviving.
This will put pressure on all candidates to provide policy initiatives that will significantly help home and condo owners and also support a progressive domestic agenda. The Republicans will put their typical Darwinian solutions under the failed market system. The question is what will the remaining two candidates for President, Hillary Clinton and Barak Obama have their solutions. Then, of course, the positions of incumbents and candidates for the Senate and House must be confronted.
The two remaining Democrats running for the White House and even some of the Republicans are framing their health proposals in the terms that have become the coin of the realm to the hearts of voters: universal and comprehensive.
The phony fig leaf of "everyone must have health insurance" as put forward by the Republicans is quickly torn away by the remaining candidates labeling any involvement of the federal government as being socialized medicine and bad for the country. Senator McCain's position is hard to find; he hasn't come forward. But, it will be a very backward proposal.
Former Governor Mitt Romney places his proposals within the Mass Health Plan, passed under his regime and endorsed by Senator Ted Kennedy. But, Romney bowing to right wing Republican necessity has backed away from that proposal as being a federal solution. He says all states should decide for themselves. The failure of a similar plan to pass in California showed its weaknesses. Exposing the weaknesses of the Mass Plan, especially the requirement for individuals to pay out of their pockets has sent that proposal into a tailspin.
The grim reality is that neither the Clinton or Obama proposals are remotely close to the actual definition of universality and comprehensive.
The Clinton Plan is actually a reiteration of the Mass Health Plan on a federal level. Obama in most of his statements does not support a national universal plan. In one interview, he said that people couldn't afford the individual payments proposed by the Clinton Plan [Mass Plan on a state level.] In another statement he said that he favors covering all kids and then moving forward. That would similar to what we have now with the State Children's Health Plan [SCHIP].
Costs are Profits
Both Clinton and Obama will have to answer the ever-present attack from center right and some liberal forces that the cost of health care is too great to have a universal plan. And, in fact, if they accept the role of insurance carriers and other profiteers in the system, it is too expensive.
Almost all health and general economists and almost all politicians cite costs as a major issue to be addressed in the next Congress and White House. The NY Times [Jan 8, 08] reported that healthcare spending is costing $2 trillion a year. They cited Health and Human Service Adm. figures.
The problem is that when most elected officials hear the word costs they follow the direction of corporate America and never blame the major culprit of costs in the US system: Profits. They blame patients for the high costs.
In our country, health policy for those who run the system starts and stops with the demands of Wall Street, i.e., insurance and drug companies; medical supply and equipment companies.
Voters, either consciously or subconsciously, are calling for a radical change in that equation.
A hidden, major winner in the USA health system is the banks and other lending companies which "help" struggling hospitals, maintain their bottom lines. Another NY Times [31 Dec, '07] front-page article provides a good example, that documents that crisis in public hospitals. They site huge debt that these public hospitals have to go to the banks to bail themselves out. City and state budgets are completely strapped which forces the borrowing. Non Profit hospitals are also deeply in debt to the banks.
Yes, Wall Street and the its banks are directly responsible for both the sub prime mortgage and health crises.
Cutting back and cutting out profits from health care must be major goal of this new Congress.
The first major peoples' demand is for our government to purchase prescription drugs, which are now part of the Medicare system. This would require removing the Bush Administration's prohibition against this logical cost saving step. This would save billions. Both Clinton and Obama support that measure and voted that way when in the Senate.
The costs of running a for profit health system is most apparent in the area of 47 to 50 million without any health insurance. Well over 100 million people have little or very poor coverage with large deductibles, cut offs of coverage, etc. These later poorly covered people often do without health services fearing that if they use their coverage, the insurance carriers would cut them off. This is the same as fear of auto insurance carriers who cut or radically increase their prices when their policies are used.
The ever-increasing number of people who do not have any health insurance or don't have health insurance during the year has driven local actions. This pressure resulted in the half-baked Mass Health Plan.
The uninsured have been increasing in numbers each year during the Bush Administration. The U.S. Census Bureau recently announced that the number of uninsured Americans rose by 2.2 million in 2006, to 47 million. This increase of 2.2 million – a jump of 5 percent – is the largest one-year increase in the number of uninsured since 2002. The ranks of the uninsured have grown 9 million since 2000 – an increase of over 22 percent.
If the official numbers are these, the actual numbers are well above 50 million. The 50 million would include workers without official working papers and others who don't answer surveys.
To make these figures real to voters, activists will have to do what we've been doing for year after year, decade after decade, i.e., showing the human face of not having health insurance.
Coalitions of health, housing, education and other on-the-ground local and national coalitions, where they don't exist, need to be formed to promote an economic program that actually helps those in need and not the corporations that caused the problem to begin with.
There are examples of health policies actions that will reduce the costs of health services and at the same increase coverage. The San Francisco Health Plan is a bold effort to move in that direction. Legal actions to stop that plan have been thrown out of court.
The Veteran Hospitals systems are the best example. Here salaried physicians in VA Hospitals are offering quality health care at a very minimum cost. Many articles have been written about this system.
Health Action Coalitions should pressure candidates for the White House; and, the Senate and House with the VA example. The hundreds of local, central body and international unions who are pushing HR 676, the Single Payer proposal, need to break down that effort into understandable terms as asserted above.
The two streams; one being the proposals by Clinton and Obama; and, the other being the HR 676 advocates, must be brought together. This, of course, cannot be done by the HR 676 hurling insults at the candidates, but by methodically showing the value of a government run system that encourages full time physicians and public hospitals, each of which would answer the costs issues. Much of HR 676 literature states these facts, but clearly more has to be done.
The National Health Service Proposals initiated by former Congressman Ron Dellums and now promoted by his successor, Barbara Lee, is also a reasonable direction.
The combination of HR 676 and the National Health Service legislation is what takes place in all of Europe, industrialized Asia. Cuba obviously has a full national health service that works to everyone's demands.
What To Do?
So, as we prepare to move beyond February 5th major party primaries, clearly, pressure must be applied for the Democratic Party to fulfill its promises of a national health program that is universal and comprehensive. This will have to be done both inside the Democratic Party apparatus and as pressuring from independent, coalitions.
A crucial, strategic part of any national effort, at this time, is to make it possible for unions to keep their negotiated plans under any proposal. There is legitimate fear that they stand to lose in Congressional action. This method was used in Canada when its system was organized. Then, if a union wishes to join a national system, it can do voluntarily. Adopted this strategy should make it possible for unions to feel comfortable keeping their benefits while demanding a national system for everyone else.