Why is Health Care for America Now giving up on real reform?

By Rose Ann DeMoro
Daily Kos Blog
July 9, 2008

The big splash of news and internet coverage for the new Health Care for America Now  coalition of labor, progressive and liberal groups is a reminder of the critical importance of health care reform. And a reminder that partial solutions, such as those proposed by the coalition, will only perpetuate, not end the health care crisis.

The groups behind the new coalition are working in concert with the Obama campaign and Democratic leaders in Congress to build "consensus" around a plan that would presumably be introduced in the first days of the next administration, and pushed through to a quick vote before opponents can mount a "Harry and Louse"-style counter attack.

But, in search of a supposedly politically viable plan, the advocates of this approach have surrendered in advance on the only overhaul that will actually cure the disease, a single-payer, expanded and improved Medicare for all reform.

Their good intentions will leave the same failed system in place, and will not even blunt the political opposition from those on the right and corporate interests who will continue to challenge anything that looks like even modest reform.

They create a false hope of systemic change that won't be, squandering the opportunity to achieve the fundamental reform so desperately needed with so many lives in the balance.

They've also missed one of the most important lessons of the failure of the Clinton plan of 1993-94 which collapsed in part due to the absence of a broad, grassroots, activist movement needed to counter the insurance industry. Only single payer engenders such a movement, the very reason the single payer bill now in Congress, HR 676, has more co-sponsors than any other reform bill with tens of thousands around the country already working to enact it.

Health Care for America Now has identified the main culprit and obstacle to genuine reform. As their inaugural ad proclaims,  "Will health insurance companies ever put your health ahead of their profits? We can't trust insurance companies to fix the healthcare mess."

There's just one problem -- the coalition's proposal does nothing to end the actual practice of insurance companies putting their profits ahead of your health. Nor does it fix  the two central components of the health care morass -- insurance company denials of care and the financial squeeze facing American families due to ever skyrocketing healthcare costs which is exacerbated by the escalating credit crisis.

Consider the four healthcare questions posed by families in the first 30-second ad: "Will they pay for his inhaler? Is my surgery covered? Can I choose my child's doctor? Will they cover the chemo?"

All are the direct result of care denials and price gouging by the insurers --  and none would be solved by the HCFAN "statement of common purpose."

How does the HCFAN coalition propose to crack down on the insurance pirates? With  a "watchdog role" on the plans "to assure that risk is fairly spread" and that "insurers do not turn people away, raise rates or drop coverage based on a person's health history or wrongly delay or deny care." 

You can watch someone rob your bank, but unless you stop them, the vaults are still going to be stripped bare. If you're looking for the hammer or any enforcement mechanism in the HCFAN proposal, don't bother, it's not there.

The insurers don't care if we know they are thieves, they will continue to deny and delay care because it's in their DNA. It's how they are set up to operate, it's how they make money for their shareholders, it's how they generate plush pay packages for their executives, and it's how they compete with the other insurance giants.

Nor does the HCFAN proposal contain any effective cost controls on the insurers. Their commitment to basing pricing on "ability to pay" is a recipe for merely getting the healthcare you can afford, not what you need. It also fails to assure real choice of providers beyond the limited network established by all private insurance plans.

The bone the coalition sponsors throw to single payer advocates is the false promise of a public plan side by side with private insurance. The public plan, they contend, will be so much more attractive that the private plans will just wither away. Don't count on it. 

The insurance companies will always be able to lower their prices with cut rate plans with lower standards that they can aggressively market through massive advertising, tele-marketing, even door to door salesmen (as some do now) with a marketing campaign that the public plans will not have the funding to be able to match.

The private plans can then continue to  cherry pick the younger and healthier patients while the sicker and older patients are dumped  in the public plan, wrecking the whole idea of a risk pool and driving up the costs for the public plan to operate. The competition won't starve the private plans and cause them to wither away, they'll starve the public plan.

There's only one way to stop the insurance industry abuses -- it's to actually stop them. The rest of the world has figured this one out --  see the study in Britain earlier this year that found that the U.S. ranks last in preventable deaths among 19 industrialized nations even though we spend twice as much on healthcare as anyone else. Isn't it time we figured it out here as well?