Reform or The Full Package?
Will "Public Option Plan" Health Reform Stop Future, Comprehensive Health Legislation; Or, Make it More Possible?
It is time-honored response to reforms that they will head off, detour or destroy more radical and far-reaching policy changes? It is the old "foot in the door" argument. That is, it is important to get that "foot in the door" to be able to get more down the road. Another version of the same theme is working "in the system" rather than staying on the outside being unencumbered.
In the current struggle for a national health program, this debate is hot and heavy. In this debate there is the Single Payer HR 676 side; and, on the other, has become the Public Option Plan advocates. Just a few months ago most were on the same side. It is all in the timing. We have moved from what we want to want is possible.
The debate is clear. HR 676 Single Payer advocates, at least many of them, are urging a no compromise position. They either state that only Single Payer HR 676 should be supported and further argue that the Public Option Plan is a divergence. Or, they just state their repeated support for Single Payer HR 676 without responding to the Public Plan Option. In either case they and their supporters will not be directly involved in this phase of national health policy making. Unfortunately, in some places the angrier HR 676 advocates have attempted to destroy meetings called by Public Option Plan advocates. The actions at Senate and House Committee hearings on behalf of Single Payer legislation, not withstanding.
We are now left with a mild reform direction, which is referred to as a "Public Option Plan." Public Plan Option advocates are putting forward a strong, comprehensive public health plan for House and Senate Committees to consider. They claim to HR 676 advocates that, if most of their points are won, it will be similar to a Medicare option. In this debate over the public option, the center, right and moderate politicians in the Congress are being pressured by the Medical Industrial Complex to have the most private/profit friendly approach. These right wing forces, their recent press conference with the President not withstanding, are opposed to any Public Option Plan. In that world, the breadth between a strong Public Option Program and no such Option is ver wide.
Staying out of this fray, according to the Public Option Plan people is not an option. Pressure must be placed both within the House and Senate Committees dealing with health policies by pressuring elected officials, especially over the Memorial Day recess. At the same, public demonstrations such as the mass mobilization for June 25th in Washington D. C. is crucial.
We didn't come to this point in health policy in a straight line. The Public Option Plan didn't enter the field until the House/Senate/White House combination made it clear that Single Payer or any other comprehensive health plan would not be in the cards in 2009.
There was apparent hope, early on, during the Presidential campaign and in the period just following November 4th that the President would in fact support Single Payer legislation. He never said he would. This did not happen; and, it deeply disappointed many Single Payer advocates. We are now in May/June 2009 and the word "On the Hill" is that a markup of some kind of health legislation would take place. This fits the legislative strategy that will honor the President's commitment to passing health legislation in his first term. This conforms to the 2010 Congressional election; an election that mirrors in time the 1994 election, but, hopefully a far different result.
{Note: Check out the UE statement on HR 676 and the Public Option Plan.]
Most Public Option Plan advocates make the argument that this struggle for a robust Public Option Plan will not end with the signing of the health legislation in the Fall of 2009. It will continue well beyond. Why? The economic and financial crisis will dictate our future. This objective reality will keep the fires of reform at fever pitch and not allow elected politicians off the hook.
Democratic Party leaders will have to continue to respond to their constituents and more reforms will be needed to respond to the crisis. This will require more steps toward the more progressive end of the public option plan. Health industry profiteering will e ron and center gain. Demanding no profits in health care will be upon us again.
This is a good debate; and, one which cannot be avoided. Let's do it in a civil way.
Of course, the future is our hands. Not achieving Single Payer HR 676 or Barbara Lee's National Health Service in 2009 doesn't mean the fight is over. On the contrary, this current round has all the seeds of a continuing struggle of an immediate not a long term set.
THE GENERAL HEALTH CARE SERVICES CRISIS CONTINUES
Concomitantly to this DC Beltway debate is a rising need for reform the health system itself. What is being discussed so far has been primarily financing mechanism with some promises beyond.
Check these out:
Expanding the Primary Care system of health care delivery by:
Offering at least 24,000 medical students full tuition forgiveness programs as promoted the U.S. Senator Bernie Sanders, as long as they commit themselves to training for Primary Care medical status; [Demands to fill these slots will be far beyond the 24,000.]
Significantly expanding the existing Federal Qualified Community Health Centers System; [Also a Sen. Sanders proposal.]
Continuing federal support for paying 2/3rd of COBRA costs for unemployed workers. This is short term reform is must be expanded beyond its 11 month timetable, unless the Public Option Plan takes over;
Allowing and encouraging all workers on unemployment insurance to seek and gain health care through Medicaid; [The feds are now picking up the costs of UI in most states. The feds can make this happen];
Bailout PUBLIC AND NOT-FOR-PROFIT HOSPITALS [not profit making hospitals] to guarantee in-patient health services for those in need; But, with that bailout strict controls over hospital CEOs and other administrators salaries, expenses and other remunerations. A $500,000 salary ceiling would make sense; and forbidding these same Hospital executives from serving on the board or receiving any money from the insurance, drug and medical device industries.
THERE IS NO DEBATE FOR MEDICAL AND PUBLIC HEALTH PROFESSIONALS AND WORKERS IN THIS CONGRESSIONAL PERIOD; WE MUST FIGHT FOR THE HERE AND NOW. WE MUST THEN KEEP OUR VISION FOR A NATIONAL HEALTH PROGRAM THAT MIRRORS AND NOT OPPOSES THOSE THAT EXIST, THRIVE AND SERVE IN EVERY OTHER COUNTRY IN THE WORLD. NOT DOING THAT WOULD BE AKIN TO ABANDONING PATIENTS IN THE MINDSET OF CRISIS.
"NO PROFITS IN HEALTH CARE"
