John Conyers

The Best Health 'Reform' Money Can Buy

dlindorff — Thu, 24 Sep 2009 14:29:29 -0400

By Dave Lindorff

When the White House or Democrats in Congress talk about health
care reform, and about wanting to preserve the central role of the
private insurance industry in health care, it pays to look at just what
it is that they they’re so anxious to preserve.

According to the Health and Human Service’s department’s National
Health Expenditures report, private insurers will pay out $854 billion
in medical claims for health insurance policyholders this year. That
represents about one-third of the nation’s estimated $2.5-trillion
medical care bill for this year. But that’s not the whole story. The
premiums paid for those claims payments will total $1.2 trillion, which
includes $179 billion in “administrative” costs (21% or over $1 out of
every $5 dollars spent on health care) and another 150 billion in
profits (a tidy 15% return). That is money that was paid out in
premiums by individuals and by employers (who every year are shifting
more of the cost of health coverage onto employees).

A big part of that $179 billion you and your employer pay for
insurance company “administrative expenses” goes to fund private “death
panels” whose job, as insurance company whistleblower Wendell Potter
has testified in Congress, to deny coverage to sick policyholders.

And that $179 billion wasted on administration (Medicare, a
federally-run program, only devotes 4% of costs to administration by
way of comparison), isn’t all. Doctors, hospitals and pharmacies also
spend a similar sum on administrative expenses, much of it devoted to
fighting to get paid by those same insurance companies. How many of us
have spent hours struggling over claims forms, and getting signatures
from physicians in order to get reimbursed for care, or on the phone
arguing with insurance company “customer service” people on the phone?
Doctors, hospital administrators and pharmacists do the same thing.
That’s why your doctor’s office has such a large staff of people who
aren’t there to take your pulse or blood pressure—just to work with
paper.

Insurance companies, in their discussions with investment analysts,
actually refer to their payouts for patient care vs. their premium take
as their “medical loss ratio,” a figure which they vow to improve by
clamping down on “losses” (meaning benefits paid).

I took a look at the latest 10-Q financial statement filed by
Aetna, one of the nation’s largest private health insurers. Through
June 30, Aetna took in $14 billion in premiums, $10.7 billion of that
amount from employers and employees, $2.9 billion more from Medicare
recipients who bought a supplemental insurance plan to cover the gap in
what Medicare covers, and another $400 million for handling Medicaid
claims. Aetna reports that it paid out $11.9 billion in health care
reimbursements, and $2.3 billion in administrative expenses (20%).

By the way, this same Aetna is headed by CEO Ronald A. Williams,
who earned 24.3 million in 2008 according to Forbes magazine (about the
norm for insurance CEOs), as well as another $296,639 as a board member
of American Express. Williams also has unexercised options on Aetna
stock worth $194.5 million, according to Forbes. He owns a palatial
home in Farmington, CT assessed at $1.7 million. According to
Opensecrets.org, Williams has spent close to $10 million on lobbying
activity for his company and the insurance industry since 2005.

Somebody tell me why this is a system we not only want to keep, but
that, under proposals working their way through House and Senate, would
force another 40-50 million currently uninsured people, most of them
low-income, to pay into under threat of being assessed a $3800 tax
penalty by the IRS.

Common sense says that if this insurance intermediary were removed
from the process, besides Williams and the other industry CEOs and
other executives losing their fat paychecks and bloated homes, planes
and portfolios, the whole American healthcare system would run a lot
more smoothly and cheaply.

I remember back in 1990, when I was working on my book Marketplace Medicine
(Bantam 1992) about the for-profit hospital industry, talking to the
administrator of a Canadian hospital in Ontario. He told me he had
formerly worked as a hospital administrator in the US. He reported that
back then, when new less-invasive technologies, as well as reforms
introduced to Medicare, had begun reducing the amount of time people
were spending in hospital beds, his hospital had been able to shut an
entire wing because of a declining patient census. “But one year later,
we had to reopen it to accommodate all the staff needed to deal with
paperwork from the insurance industry,” he said. That problem has only
gotten worse over the ensuing two decades. Meanwhile, this same
administrator told me, “In Canada, I have only three people doing
paperwork for the whole hospital: one for Canadians, and two to deal
with paperwork for the occasional American tourist who gets sick or
injured.”

Let’s be clear. The only reason Congress and the White House are
pushing a plan that relies on the private insurance industry is that
the private insurance industry is flooding the capital with money. It’s
a great investment for them. If health insurers are collectively
earning $150 billion in profits in a year, and it only costs them
perhaps $50 million in legal bribes to keep their scam operating,
they’re earning a 3000% return on investment!
We would all be far
better off if Congress just passed Rep. John Conyers’ bill, HR 676, to
expand Medicare to cover everyone. As I have explained in an earlier article,
expanding Medicare would result in no net increase in taxes, and
because it would eliminate insurance premiums, workers’ comp and public
employee health expenses while also lowering car insurance rates, not
to mention lowering the prices charged by doctors, hospitals and
pharmaceutical companies, also a substantial savings for all Americans.

Some people worry that if we were all on Medicare, medical research
would suffer. But this is a spurious fear. Much of the most important
research in medical care and treatment is funded by the federal
government through the National Institutes of Health. In fact,
arguably, the profit motive leads industry to focus research on highly
profitable, but much less urgent things, so we get research on cosmetic
uses for Botox, but little or no research on finding a cure for Malaria
or drug-resistant TB.

There may be a valid argument for competitive markets, say for cars
or food production and distribution. But it should be abundantly clear
by this point that when it comes to health care, the market doesn’t
work. In fact, it is perverse. The end user—your and me—will never have
the information needed to make a wise decision regarding either cost or
quality. Furthermore, unless we were all buying our own insurance and
selecting our own doctors unimpeded by “preferred provider” or HMO
lists, we are being forced to chose, if we get any choice at all, from
a limited selection made available by our employers, who are motivated
only by bottom-line concerns. In fact, in countries like Canada or
France, which have Medicare-like single-payer systems, people have
vastly more choice as to physician and hospital than any American
patient.

Some people also worry that a government-run single-payer insurance
system, by pushing down the reimbursements to doctors and hospitals
through its monopoly position as sole paymaster, would lead to a
defunding of hospitals and would drive away the “best” students from
choosing the medical profession. But really, if you look at what
hospitals in the current “competitive” market spend much of their money
on, it turns out to be cosmetic things like fancy building exteriors,
pretty rooms, etc.—things that help lure patients, but that do nothing
to improve patient care. As for future doctors, does anyone really
think that having people go into medicine because of the prospect of
earning millions of dollars and driving fancy sports cars results in
better doctors than having people choose a medical career because of a
passion to serve humanity, or a passion for research into curing
disease? What changes is not the quality of the medical students, but
their motivation.

All the sturm and drang in Washington and in the media over the
course of health care “reform” in Washington is really much ado about
nothing. We are not getting real reform.

In a replay of last year’s to-do over mess in the banking industry,
we are watching our dysfunctional and corrupt government simply, to
quote President Obama, “kick the can” down the road, leaving the next
Congress and the next President to deal with the same disaster.
Meanwhile, tens of thousands of Americans will continue to die
needlessly every year because the care they need will be denied to them
by insurance companies that are focused on making as much money as
possible, and by a government that has sold its soul to the lobbyists.
_______________
DAVE LINDORFF is a Philadelphia-based journalist. He is author of
“Marketplace Medicine: The Rise of the For-Profit Hospital Chains”
(Bantam Books, 1992) and more recently of “The Case for Impeachment”
(St. Martin’s Press, 2006). His work is available at www.thiscantbehappening.net

The New York Times Trashes Single-Payer Health Reform

dlindorff — Mon, 21 Sep 2009 16:54:50 -0400

By Dave Lindorff

In an article in the Sunday New York Times, headlined
“Medicare for All? ‘Crazy,’ ‘Socialized’ and Unlikely,”reporter
Katherine Q. Seelye did her best to damn the idea of government
insurance for all with faint praise.

To begin her article, Seelye quoted from a 2005 episode of the NBC
drama “West Wing,” in which two presidential candidates, a Democrat
played by Jimmy Smits and a Republican played by the always loveable
Alan Alda, are discussing health care reform. The Smits character says
his “ideal plan” would be Medicare for all. “That’s crazy” counters the
Alda Republican. Then Seelye sequed to an opinion piece recently penned
by real-life one-time Democratic presidential candidate George McGovern
(a noble figure who nonetheless has long-since been type-cast as an
out-of-touch extreme liberal loser), who favors expansion of Medicare
into a national single-payer system.

Turning to the real world, Seelye then trotted out several
economists, ostensibly to give a broad spectrum of arguments about the
idea of single-payer, but in fact carefully avoiding including anyone
who actually supports the idea of expanding Medicare.

As her representative liberal, she quoted Brandeis economist Stuart
Altman, an Obama adviser during the presidential campaign, who said
that while he is not “ideologically uncomfortable” with expanding
Medicare, such a move would be “disruptive.” Going then to what she
described as “the other end of the political spectrum,” Seeley quoted
Robert E Moffit, of the right-wing Heritage Foundation, who claimed
Medicare would mean too much government power over heatlh care.”
Finally, seeking what she could call middle ground, Seelye turned to
Dartmouth economist Jonathan Skinner, who claimed that expanding
Medicare would be good because it would cover everyone, but bad because
it would mean tripling the Medicare tax, currently 2.9% of paychecks.
If we were looking at a political yardstick here, Seelye started at the
16” mark (Altman), then went to the 36” mark (Moffit), and finally went
to the 24” mark (Skinner).

But where was an economist from the real left end of the political
spectrum, over in the single digits of that yardstick? Altaman,
representing the private insurance-based Obama approach, was hardly it!

Seelye might have gone to her colleague, columnist Paul Krugman, a
Nobel Prize-winning economist at Princeton, who has on a number of
occasions written and stated that a single-payer system such as
Medicare for all would be “far cheaper” than any private
insurance-based system. Krugman, at least, would be over by the 10” or
12” line on a political yardstick.

Never has the Times really analyzed the true costs and
benefits of the plan espoused in a bill, HR 676, authored by House
Judiciary Chair John Conyers (D-MI), which would expand Medicare to
cover every American. Seelye mentions Rep. Conyers’ bill, but says
innocently that it is “going nowhere” in the House. In fact, his bill,
despite having been co-sponsored by 86 members of the House, has been
blocked from getting a public hearing in committee by Nancy Pelosi and
the House leadership, at the behest of the Obama White House, which is
dead-set against a single-payer reform of health care.

The reason the Times and the insurance industry-besotted
White House and Congressional leadership don’t want that analysis is
that it would show clearly that a single-payer system would mean vast
savings for all Americans.

Seelye quotes economist Skinner as claiming that Medicare expansion
to cover every American would mean a tripling of the Medicare payroll
tax—currently set at 2.9% of wages. But even if we accepted Skinner’s
math, it is meaningless without looking at the savings side.

Sure expanding Medicare would mean higher Medicare taxes, but what about the following:

Medicaid, the program that pays for medical care for the poor, and
is funded by federal and state taxes, would be eliminated, saving $400
billion a year.

Veterans’ care, currently running at $100 billion a year, would be eliminated.

Perhaps two-thirds of the $300 billion a year spent by federal,
state and local governments to reimburse hospitals for so-called
“charity care” for treatment of people who have no insurance but don’t
qualify for Medicaid, would be eliminated.

Individuals and employers would no longer have to pay for private insurance.

Several hundred billion dollars currently spent on paperwork by private insurers would be eliminated.

Car insurance would be cheaper as there would no longer have to be coverage for medical bills.

Federal, state and local governments would no longer have to pay to insure public employees.

In short, if every person were on Medicare, the overall savings
would overwhelm the small increase in the Medicare payroll tax of 5.8%.

The bottom line is that Canadians, who have Medicare for all,
devote 10% of GDP to health care. Americans, who have
private-insurance-based health care except for the elderly, devote 17%
of GDP to health care.

Seelye and the Times have never mentioned any of this. Neither does President Obama or the Democratic Congress.
______________

DAVE LINDORFF is a Philadelphia-based journalist. His latest
book is “The Case for Impeachment” (St. Martin’s Press, 2006). His work
is available at www.thiscantbehappening.net

In Praise of 'Joe' Wilson: What's Wrong with Calling Out Lies in Congress?

dlindorff — Sat, 12 Sep 2009 08:55:28 -0400

By Dave Lindorff

Liberals are acting all righteous and offended that a member of the Republican opposition, Rep. “Joe” Wilson of South Carolina, would deign to besmirch the “dignity of the presidency” by calling out “Liar!” in the middle of President Obama’s address to a joint session of Congress on Wednesday evening.

But what’s wrong with that? Whatever the veracity of Obama’s claim that his proposed health care “reform” would not pay for the health care of illegal immigrants residing in the US (and one can only hope that statement was fatuous, because at a minimum we would certainly want the government to pay for the care of an illegal immigrant in childbirth, or of an illegal immigrant who came down with a contagious disease), and even if Rep. Wilson is a racist bozo who wrongly thinks or wants to imply that Obama's plan would be out there enrolling undocumented workers in the millions at taxpayer expense, why shouldn’t members of Congress call out a president if they think he’s lying to them from the podium?

One of the big problems with American democracy is that the presidency has over the years been elevated to the level of a monarchy, with all the imperial trappings and pomposity formerly associated with royalty. Presidents surely should get no more respect than a prime minister, and look at the hoots and catcalls PMs have to endure when they address Parliament in the UK. That’s a good thing.

Anyhow, it would have been far better if, instead of clapping wildly, liberal Democrats in Congress had hooted down some of the other whoppers and stretchers told by the president in his health care address.

Among them:

1. First and foremost, Obama’s claim that he was “determined to be the last” president to have to deal with health care reform and that he didn’t want to “kick the can” down the street for a future administration to deal with. In fact, that is just what he did with his proposal, which has left the basic untenable system of employee-financed healthcare in place, and which has left the private insurance industry in control of who gets treatment and how much they will have to pay for it. It’s a sure bet that before very long—perhaps in just four more years—another president will face the same crisis. A boisterous cat-call of “Can Kicker!” here would have been in order.

2. Obama said that “nothing else even comes close” to health care expenditures in terms of causing the federal deficit. In fact, something does---the military budget—but that topic is off limits for both Republicans and Democrats. Why couldn’t Wisconsin Sen. Russ Feingold have yelled out, “What about military spending!”

3. Perhaps one of the biggest lies of the night was the president’s claim that while there are “arguments to be made” for single-payer systems like Canada’s, switching to single-payer in the US would require building “an entirely new system from scratch.” The truth: Medicare is already a successful single-payer system and in fact, it is bigger and older than Canada’s own nation-wide system. Expanding it to cover every American would not be starting from scratch at all. It would be expanding something already time-tested. Where were the shouts of “What about Medicare!” from Rep. John Conyers (and his dozens of cosponsors), whose bill, HR 676, to expand Medicare to all has been barred from getting even a hearing by the House leadership with encouragement from the White House?

4. The president insisted that insurance executives don’t “cherry-pick” profitable customers and push out those who are sickest, because they are “bad people.” He said they are just doing it because it’s profitable. It would have been nice if at least someone in the assembled throng of lobbiest-enthralled House and Senate members had shouted out something like “Just like bank robbers and drug dealers!” because the truth is that health insurance executives are bad people. They know that they are killing people every day through their ruthless policies, and they go right ahead and do it. Pursuit of profit does not, or at least should not, constitute a license to kill. (Just imagine a hit man, at his sentencing hearing, telling the judge, “I’m not a bad person, Your Honor. I just knock people off because it’s profitable.”)

5. The president said he was “not trying to put the insurance industry out of business,” and added, “They provide a legitimate service.” This line, not surprisingly, given the amount of money that industry has lavished on members of Congress and on the president himself, got what was probably the loudest bi-partisan applause of the night. But it surely led to a lot of groans and of coffee, tea or beer being spewed out involuntarily across carpets and upholstery in homes across America. Legitimate service? Insurance firms are nothing but vampires, or better, leeches on the health care system. They provide no service. Ask doctors, who have to fight to get permission to treat patients, and then fight to get reimbursed. Ask patients, who spend hours on the phone arguing with faceless drones, some probably in Bangalor or Manila, who are denying them coverage for needed medicines or procedures that are supposed to be covered. Listen to the testimony of whistle-blowers who have confirmed that those drones actually get paid bonuses based upon the number of claims they manage to deny. How satisfying it would have been if someone in Congress had yelled out, “Legitimate service my ass!”

6. Turning to the pathetically circumscribed and downsized “public option” in his “reform” plan, Obama declared that “a strong majority of Americans still favor a public insurance option.” Well that may be true, but it's not the whole truth. It would have been a great moment for Kucinich or Conyers or some other progressive member of Congress to shout out: “A majority also favors a single-payer plan!”

7. And where the defenders of women’s rights, when Obama vowed that under his plan, “no federal funds would be used to fund abortions?” Couldn’t someone have shouted out, “Women have rights too!” Is the president really saying that if a woman is raped, or a child gets pregnant through incest, or if a woman’s life is at risk because of a pregnancy, that his public plan will not pay for her to obtain an abortion? Cries of “For shame!” should have been ringing through the hall!

8. Finally the president said that one reason the nation has such record deficits is that during the prior administration, so many initiatives, “including the Iraq War,” were set in motion but “not paid for,” and he vowed, “I will not make that same mistake with health care.” But he is doing the same thing with supplemental war funding requests for his war in Afghanistan, and with the continued war and occupation in Iraq, and someone should have called him on that. Besides, there’s no way that the program he is proposing will be paid for by current funding. It will add to the deficit and he should have the courage to admit it, or to call for more taxes on the wealthy to pay for it. A lusty “Tax the rich!” cry in unison from the progressive caucus would have been appreciated by viewers.

Whack-job or not, Rep. Wilson did the cause of democracy and honest discourse a favor when, faced with a statement he felt was clearly false, he found he couldn’t repress the urge to call the president a “liar.” In doing so, he put a much-needed ding in the wholly inappropriate and dangerous imperial aura of “respect” that has grown like lichens around the office of President. No more than anyone else in this nation, a president should have to earn the respect not just of the members of Congress, but of the broader public. He or she is another citizen, no more and no less, and when a president, like President Obama in this instance, dissembles, exaggerates or attempts to deceive or mislead, it is healthy for democracy if he is called out on it immediately and publicly.

We need more honesty in Washington, not more civility.
_________________

DAVE LINDORFF is a Philadelphia-based journalist. His latest book is “The Case for Impeachment” (St. Martin’s Press, 2006). His work is available at www.thiscantbehappening.net

'My Fellow Americans...': The Speech President Obama Should Give to Congress Next Week

dlindorff — Thu, 03 Sep 2009 14:20:48 -0400

As imagined by Dave Lindorff

My Fellow Americans.

I stand before you a chastened president. I made a mistake. Two mistakes really. (wild applause from Republican side)

I thought that Congress could do its job and through the
deliberative process, produce a health care reform plan that would win
broad support across the aisle and among all of you. But I’m afraid
that I was wrong. Health care is an enormous industry—maybe the biggest
and most powerful industry in the country—and it has far too much power
in Washington. Literally thousands of lobbyists, carrying tens of
billions of dollars in campaign contributions—have invaded these halls (and my house!) (relieved laughter)
and distorted the process, and in the end have stymied reform. (some hissing)

Meanwhile, I have realized that the answer has been staring us in the face all along.

And that was my second mistake. I told the American Medical
Association that while single-payer medical plans, where the government
is the insurer, might work well in other countries, the idea of
government running health care was not part of our American tradition.
In fact, it is, and has been since 1965, when President Lyndon Johnson
signed into law the Medicare program. Medicare is a single-payer
program, and polls and surveys show it is enormously popular with older
and disabled Americans. Medicare has relieved our parents and
grandparents from the fear that they will not get medical care when
they stop working, and it has lifted the enormous burden and worry off
of younger Americans over how to pay for the care of their elders, and
it has done this with enormous efficiency, all while allowing
recipients to choose their own doctors and hospitals. (applause)

So we really don’t need to re-invent the wheel here. There is no
point in members of Congress having to hold endless hearings, and to
sit and listen to the pitches of lobbyists from the medical
establishment. We can just expand Medicare to cover everyone. (applause)

How much would that cost? Well, we know that 10% of the elderly—the
oldest and sickest among us--account for 50% of total Medicare costs,
so that means the other 90% only cost some $200 billion a year. Even if
we assumed that the rest of the population’s medical bills were as high
as those 90% or older Americans, it would mean that expanding Medicare
to cover them would cost less than $1 trillion a year, and probably
closer to $750 billion. So roughly speaking, we’re talking about adding
$750 billion a year to the cost of Medicare.

Now that’s a big number, and I know that some of you—a lot of
you—worry about higher taxes. But let me assure you, expanding Medicare
to cover everyone is going to save you money—virtually
everyone. Let’s look at why that is, and why you cannot just look at
the federal tax when you consider those savings.

Today, the United States spends nearly 20 percent of GDP on health
care. That is more than double what any other country in the world
spends on health care. And you know what? We don’t get our moneys’
worth for all that dough. Canadians, who spend half that percentage of
their GDP on health care, and who have what amounts to Medicare for all
with their single-payer system (they call it Medicare too), have longer
lifespans and better infant mortality statistics than we do. In fact,
Cuba and Mexico have better child health statistics than we do!

By the way, I want to introduce, in the gallery, Shirley Jean
Douglass, whose father, Tommy Douglass, was the founder of Canada’s
Medicare program. We will be consulting closely with experts and
administrators of Canada’s Medicare program as we move forward with our
own reform. (applause)

Now I've been accused of lecturing (laughs and applause),
and I don’t want to sound like a college professor here, but let me
just highlight a few reasons why simply expanding Medicare to cover all
of us makes not just moral, but also economic sense. If we were to make
that change, we could immediately eliminate the Medicaid program, which
as you know is funded by the states, and costs them (and you) about
$400 billion a year, mostly to cover low-income families and
individuals. Now that money would not be totally eliminated, because
Medicare currently doesn’t cover all health care costs—just 80%. And
Medicaid covers the remaining 20% for those elderly and disabled people
who cannot afford to pay for Medi-Gap private plans--something the government would continue to do with an expanded plan. Even so,
eliminating Medicaid for the poor, who would be switched to Medicare,
would save at least $300 billion. We could also eliminate the Veterans
Administration—which incidentally is an excellent example of true
government healthcare, with publicly owned hospitals and doctors on
salary, and it runs very well and very efficiently.

Something those folks at last month’s town meetings who were saying government can’t do anything right should think about. (wild applause from Democratic side)

Sorry. I just had to say that. (more applause)

Anyhow, eliminating the VA would save another $100 billion so we’ve
already saved more than half the amount that was added to the cost of
Medicare in order to cover everyone. (applause)

But there are far more savings.

One of the biggest would be the elimination of about $300 billion
that is spent each year by hospitals and doctors to provide care to
people with no insurance who end up in hospital emergency rooms. The
cost of this “charity care” is factored into higher hospital and
physician bills, and ultimately into higher insurance premiums paid by
the rest of us. Since all those people would now be covered by
Medicare, that expense would vanish.

American companies currently pay about $25 billion a year in workers
compensation insurance—money that ultimately comes out of workers’
paychecks. That would no longer be necessary, because people injured on
the job would be covered by Medicare. (smattering of applause, mostly from Republican side)

Car insurance rates would be dramatically lower, because car
insurance would no longer have to pay for medical costs following an
accident. The same is true for homeowners insurance, which would no
longer have to cover the costs of someone being injured on your
property. (applause from Pennsylvania delegation, with among highest car insurance rates in the nation)

And of course, the biggest savings of all—about $3000 per person or
$12,000 per family every year—namely the cost of private insurance
premiums paid by you and/or your employer, would be gone. Think about
that a minute: no more co-pays, no more annual deductibles, no more
employee share of insurance premiums for yourself or your family. And
for businesses that provide health care coverage, a huge savings that
will make them more competitive in the global marketplace, and that
will also allow them to pay higher wages to their employees. (prolonged applause)

Oh, and there is one other huge, if unquantifiable savings to
consider. If everyone has Medicare, the total cost of health care will
go down dramatically, because everyone will be getting timely
treatment, instead of having to put of exams and early treatment of
illness or injury. And no one will suffer the terrible anxiety or
worrying about whether they can pay for health care for themselves and
their families.

So yes, your Medicare withholding will be perhaps 25% higher if we
expand Medicare to cover everyone. That tax is currently set at 2.9%
for you and 2.9% for your employer, so it would go up to about 0.75% of
your paycheck. For someone earning $600 a week, that would represent an
increased deduction of about $4.50 a week. For someone earning $1200 a
week, it would be an increased deduction of $9. That is a pretty good
deal for not having to pay for insurance coverage any more, wouldn’t
you agree? (applause, plus some boos from largely silent Republican side)

Now for you folks already receiving Medicare, there have been a lot
of scare stories out there, some of them being promoted by some
irresponsible people right in this chamber (pause for applause and nervous laughter), suggesting that if we expand health care coverage, it will come off of your benefits. Don’t you believe it! (applause)

We live in a democracy, and when a lot of people want something, or
benefit from something, they collectively defend that particular thing.
In the case of Medicare, if everyone is receiving it, and receiving it
in the same manner as everyone else, that creates a huge voting bloc in
favor of defending that benefit, so by expanding Medicare to all, we
would be creating a powerful political force that will defend Medicare
from attack, just as the universality of Social Security has made that
program bullet-proof (something my predecessor learned when he tried to
promote the idea of privatizing it). (wild applause from Democratic side)

So here’s the deal.

I’m admitting it was the wrong move to try to lay it on your poor
folks in Congress come up with some completely new, complicated reform
our existing health care system—if you can even call it that. My good
friend and former colleague in this building, Chairman John Conyers,
had it right all along: We have a great system that we just need to
expand to cover everyone.

So to get it started, I’m going to send Congress a couple of bills.
One would immediately shift everyone eligible for Medicaid over to
Medicare. I’m calling this the States' Medical Cost Relief and Medicare
Expansion Act. It will not only begin the process of expanding
Medicare, but will provide badly needed financial relief to states that
are suffering from declining tax revenues and rising health care costs
because of the recession. (applause)

I will also send Congress a bill that will expand Medicare coverage to all Americans and to legal residents. (applause, some boos from Republicans)

I am sure that as financially sound as this change is, there will
be opposition from the medical industry, so let me add that this is,
for me, a moral imperative too. For too long, this great country has
allowed health care to be a matter of whether or not you had a job with
health benefits, or enough money to pay for insurance yourself. That is
unacceptable. We are our brothers’ and sisters’ keepers, and just as we
believe that every child needs an education, we believe that everyone
deserves to have access to quality medical care. (loud applause)

So let me add this: If Congress does not pass these two bills by
the end of the current session, in time for the holiday recess in
December, I will declare a national emergency because of the recession
and the huge rise in the uninsured that it has caused, and will issue
executive orders implementing both these measures. It’s not the way I
would prefer to see things done, but if Congress cannot act, I promise
you and the American people, I will. (applause and boos)

Let me also say that this program is a priority for me and for all
Americans, and anyone—Republican or Democrat—who gets in the way can
expect to hear from me, and from the American people, in this coming
election year. (applause)

Thank you and good night. (applause)
_______________
DAVE LINDORFF is not a speechwriter for the president. He is,
however, the author of “Marketplace Medicine: The Rise of the
For-Profit Hospital Chains” (Bantam Books, 1992). His work is available
at www.thiscantbehappening.net

A Few More Thoughts About Single-Payer and Medicare

dlindorff — Thu, 13 Aug 2009 10:31:57 -0400

By Dave Lindorff

Some critics have written, in response to my article
calling for extension of the single-payer plan called Medicare to all
Americans, that actually Medicare is a badly flawed program that leaves
America's elderly without coverage for many important health services,
and which requires them to pay for supplemental insurance, or to go on
Medicaid, too.

These critics are correct. Medicare is great as far as it goes. It
is simple for people to use, allows them to go to the doctors of their
choice, covers 80 percent of their care, and is liked by nearly all who
use it. But it doesn't pay for needed tests, only lets seniors buy
mediocre medical devices like hearing aids, and most importantly, it
has been requiring more and more contributions by the elderly year
after year. Today, Americans over 65 and the permanently disabled pay a
greater percentage of their income for medical care than they did in
1964 before Medicare was established!

But having said that, I have to say that it has nothing to do with
whether or not it makes sense to expand Medicare to all Americans as a
way to solve our health care crisis--as Rep. John Conyers' bill, HR
676, would do.

The reason Medicare is inadequate is because the Republicans and the
conservative Democrats--the very "Blue Dog" vermin who, engorged on
health insurance, hospital and pharmacy bribes and campaign donations,
are undermining and destroying the already lousy health care "reform"
plan of President Barack Obama--have been underfunding it, and
performing a slow "privatization" of the program, chipping away at its
benefits, adding increased self-pay requirements, and raising the
Medicare tax on all workers.

They get away with this treachery because their actions only affect the minority of Americans served by Medicare.

If Medicare were expanded to include all Americans, suddenly this
kind of political backsliding would be opposed by everyone who was in
the program. It simply couldn't happen. Rather, the public would, as
one, demand better coverage, fewer self-pay requirements, and an end to
supplemental insurance.

The right knows this, and the health care industry knows this, and
that is why they are all bitterly opposing the expansion of
Medicare--and yet it is so obvious that Medicare is the answer to
America's health crisis--and it's staring us all in the face. It works,
it's cheap, and it could be implemented immediately.

We are being betrayed by President Obama and by the Democratic leadership in Congress, who will not talk about single-payer.

Not one of the committees working on the health reform bill in
Congress allowed any discussion of Rep. Conyers' HR 676. Under pressure
from the public, and groups like Physicians for a National Health
Program (PNHP.org) and Progressive Democrats of America (PDA), House
Speaker Nancy Pelosi has agreed to allow a floor vote next month on
Conyers' bill, but that is a sop. Floor votes are heavily manipulated
by the leadership and never go anywhere unless a committee has already
held hearings and voted to approve a bill, which was not allowed to
happen in the case of HR 676.

The so-called "reform" bill that is going to emerge from the current
process is going to be the legislative equivalent of road kill, barely
recognizeable either as health care or as a "reform." It will be a
Christmas present for the insurance industry, the hospital industry and
the phramaceutical industry, all three of which struck secret deals
behind closed doors with the White House.

It will set back health reform in America a generation, will require
everyone to buy inadequate and overpriced insurance, overpriced drugs
and to go to overpriced hospitals. And the cost of healthcare to
individuals, businesses, and the nation as a whole (already the highest
in the modern industrial world), will continue to soar.

This is not a case where the right thing to do is push for any bill,
and then try to move on. This is a case where Obama and the Democrats
have whored themselves out to the greedy industry that is causing all
the problems, and are pushing a plan that is worse than nothing.

We should all be working to kill this whole thing and start over, with HR 676.

If Congress won't do it, we need to start working for a new Congress in 2010 that will.

No Democrat running for House or Senate in 2010 who isn't solidly for expanding Medicare to all should get a single vote.
_____________
DAVE LINDORFF is a Philadelphia-based journalist. He is author of
“Marketplace Medicine” (Bantam Books, 1992) and more recently, “The
Case for Impeachment” (St. Martin’s Press, 2006). His work is available
at www.thiscantbehappening.net

Progressives Should be Shutting Down These So-Called 'Town Meetings' Too!

dlindorff — Mon, 10 Aug 2009 17:09:13 -0400

By Dave Lindorff

Many progressives are getting all bent out of shape over the "brown
shirt" rabble organized by health industry PR firms to disrupt the
so-called "town meetings" being organized all over the country by
Democratic members of Congress.

What they are conveniently forgetting is that these are not really
"town meetings" at all, at least in the sense of the town meetings I
grew up with, and started out covering as a young journalist in
Connecticut--that is, meetings called and run democratically, with
leaders elected from the floor, open to all residents of a community.

These "town meetings" are really nothing but propaganda sessions run
by members of Congress who are trying to burnish their fraudulent
credentials as public servants, and trying to perpetrate a huge fraud
of a health care bill that purports to be a progressive "reform" of the
US health care system, but that actually further entrenches the control
of that system by the insurance industry, and to a lesser extent, the
hospital and drug industry.

ObamaCare is to health reform what bank bailouts are to financial
system reform, which is to say it is the opposite of what its name
implies.

The right-wing nuts who cry that ObamaCare is introducing euthanasia
for the elderly and infirm, or that it is socialism, are ignorant
wackos, to be sure, but they are right about one thing: Americans are
about to be royally screwed on health care reform by the president and
the Democratic Congress, just as they've been screwed by them on
financial system "reform."

The appropriate response to this screw-job is the one the right has
adopted: shut these sham "town meetings" down, and run the sell-out
politicians out of town on a rail, preferably coated in tar and
feathers they way the snake-oil salesmen of old used to be handled!

This is not about civil discourse. This is about propaganda. The
Obama administration and the Democratic Congressional leadership have
sold out health care reform for the tainted coin of the
medical-industrial industry, and are holding, or trying to hold, these
meetings around the country to promote legislation that has essentially
been written for them by that industry--legislation that will force
everyone to pay for insurance as offered, and priced, by the private
insurance industry. What a deal for those companies--a captive market
of 300 million people! There will be little or no effort to control
prices, and the higher costs will be financed through higher taxes, and
through cuts in Medicare benefits.

This isn't "reform." It's corruption, pure and simple.

Any mention of a system that works--single payer--the system we
already have in the form of Medicare for the elderly and disabled, and
the system that has proved successful for almost four decades in
Canada-- has been systematically blocked and censored out of the
discussion. Every effort has been made to bury an excellent bill, HR
676, offered up by Rep. John Conyers (D-MI), which would cover every
American by simply expanding Medicare to cover everyone.

The only proper response at this point is obstruction, and the more militant and boisterous that obstruction, the better.

Instead of opposing the right-wing hecklers at these events,
progressives should be making common cause with them. Instead of
calling them fascists, we should be working to turn them, by showing
them that the enemy is not the left; it is the corporations that own
both Democrats and Republicans alike.

The only proper approach to the wretched health care legislation
currently working its way through Congress at this point is to kill it
and start over. At these "town meeting" staged events, Obama and the
Democrats need to hear, in no uncertain terms, that we don't want no
stinkin' ObamaCare. We want Medicare for all.
_________________

DAVE LINDORFF is a Philadelphia-based journalist. He is author of
“Marketplace Medicine: The Rise of the For-Profit Hospital Chains”
(Bantam Books, 1992), and more recently of “The Case for Impeachment”
(St. Martin’s Press, 2006). His work is available at www.thiscantbehappening.net

Health Care Reform Sell-Out: Why Obama and the Democrats are Either Shysters or Idiots

dlindorff — Wed, 05 Aug 2009 13:30:36 -0400

By Dave LIndorff

As I wrote months ago in an article titled America’s Stupid Health Care Debate: Keeping Some Ideas Off the Table and several subsequent pieces on my website,
President Obama and the Democrats who currently run Congress have been
hoist on their own collective petard by their craven and gutless
refusal to consider adopting a Canadian-style single-payer system to
finance health care in the US, or simply to expand Medicare, which is a
successful single- payer program, to cover everyone, instead of just
people over 65 and the disabled.

Instead, because they are the recipients of hundreds of millions of
dollars in legal (and probably plenty of illegal) bribes from the
health care industry, they have cobbled together a “reform” in name
only, which preserves not just the central role of the vampire-like
health insurance industry, but also ensures the continued rapacious
profitability of the other segments of the medical-industrial
complex—the hospitals, the pharmaceutical industry, and the specialist
doctors.

Now, like Hillary and Bill Clinton before them, these weasels and
slimeballs who pose as the people’s advocates are left with nothing but
a Potemkin Health Plan that looks on the outside lie a reform, but that
changes little or nothing, leaves vast numbers of Americans uninsured,
forces tens of millions to buy crappy plans from private companies, and
that will end up doing nothing to halt the continuing rise in health
care costs that is bankrupting the people, employers and the country.

Nice going guys!

Let’s for a moment consider what could have happened.

Medicare, which is wildly popular among seniors and the disabled
according to every poll I’ve seen, currently covers 45 million of the
highest-cost segment of this country’s 300 million people—its elderly
and its permanently disabled. It does this at a cost of $484 billion.

Now that’s a heck of a lot of money—about 13% of the federal
budget—but it’s money well spent. We’re talking about our parents and
grandparents here, and because they’re all covered by a government
single-payer plan that pays virtually all of their doctors’ and
hospital bills, we don’t have to pay those bills for them out of our
own pockets. Okay, there are problems—the drug industry managed during
the Bush/Cheney dark ages to get a prescription drug law passed that
bars Medicare from negotiating group discounts for drugs, and that has
added enormous rip-off costs to the program, but that’s just another
example of corporate scamming of the system that needs to be fixed. The
important point that needs to be made is that according to Medicare
analysts, 10 percent of Medicare beneficiaries account for fully two
–thirds of the total annual cost of Medicare.

What that tells you is that the cost of treating that 10% of the
elderly is $320 billion, while the healthier 90% of the elderly—roughly
40 billion people--only cost $160 billion a year to care for.

Now, given that the rest of the population under 65—about 255
million people—need on average far less care than the 90% of seniors
who are in that lower-cost group, extending care to them all would
clearly cost less than $1 trillion. Add in the cost of the 10% of
high-cost elderly, and you’ve got a total bill of $1.34 trillion to
care for everyone in America.

That’s a big number, but now you need to subtract out the total
cost of Medicaid—the crappy program that, primarily funded by the
states through income and sales taxes—pays for the crappy care of the
poor. That would be about $400 billion in 2009. So now we’re down to
$944 billion to care for all Americans. But from that we need to
subtract the cost of Veterans health care—another successful
single-payer program that already cares for veterans (or at least some
of them—it’s grossly underfunded). If we had a single-payer system for
all, we could just fold the Veterans Hospital system into the national
program. That would mean eliminating another $100 billion that would be
saved (because remember, we calculated that original expanded Medicare
budget for covering all 300 million of us. So now we’re down to an
annual budget of $844 billion for a single-payer program to cover all
Americans. Finally there is uncompensated care provided by hospitals to
those 47 million Americans who have no health insurance but who don’t
qualify for Medicaid. This care is funded in two ways—one by state and
county revenues, which come out of state income and sales taxes and
also out of local property taxes, and the other is in the form of
higher hospital charges and insurance premiums and Medicare costs for
the rest of us. Uncompensated care is estimated to cost about $200
billion, all of which would be eliminated if we had a single-payer plan
for all.

Okay, so now we’re down to a total net cost for a national
single-payer program of just $644 billion. Now remember, we’re talking
about expanding a single-payer program that we already have in place,
that doctors and hospitals are already familiar with, and that the
people who use it already like. And expanding it to cover everybody,
instead of just the old and disabled would only cost an added $160
billion, or just 33% more than it costs now to cover only the old and
disabled. In these days of trillion-dollar Wall Street bailouts, $160
billion is almost chump change—heck, it’s less than the cost of a year
of war in Afghanistan.

Sure it would still mean a modest tax increase for everyone (to
figure out how much, just look at your check stub, find the Medicare
tax deduction, and multiply it by 1.33. Then double that to account for
the employer share of the added funds). But wait, all you tax freaks!
Before you start freaking out at a tax hike and waving those little
teabags Fox TV got for you, there are more savings we haven’t
considered.

If everyone is covered by Medicare, that means no more out of
pocket payments by you for doctor bills. No more co-pays. No more
deductibles that you have to pay out of pocket before your health
insurance kicks in. No more employee contributions to health insurance
premiums, which these days more and more employers are forcing us to
pay. That’s a lot of money. For many families, it adds up to thousands
of dollars a year. But there’s more. Your employer, if the company is
one of the one in three that still provides and pays at least something
towards health benefits for its workers, would be off the hook. That
would free up a lot of money that could go to higher wages and salaries
for workers (especially if you have or get yourself a union to make
sure that the managers pass the savings on to you and don’t just pocket
it or pass it along to shareholders). We’re talking about big savings
here.

So while yes, your taxes would go up a bit to expand Medicare to
all, it wouldn’t be by much, and on the plus side, you would be saving
an enormous amount of money, making the added tax bite easy to swallow
(and remember, your state and local taxes could be reduced).

Why didn’t Obama and the Democrats tell you all this? Why does
Obama continue to diss single-payer, as he did to the American Medical
Association, and as he continues to do, claiming it is not in the
American addition, as though he never heard about Medicare?

Well, as a matter of fact, some people in Congress, notably Reps.
John Conyers (D-MI), Dennis Kucinich (D-Oh), Anthony Wiener )D-NY) and
83 other members of the House are pushing a bill, HR 676, which would
do exactly what I’m suggesting—expanding Medicare to cover everyone.

It is being opposed by the Congressional leadership to the point
that advocates at one House committee hearing were ejected and arrested
for even mentioning the term single-payer. With the blessing of the
White House.

Clearly, Obama and the Democrat Party and Congressional leadership are in bed with the health care profiteers.

There is no other excuse for failure to do the obvious, and have
America adopt some version of the kind of health care system that has
been proven to be more effective and far, far cheaper than our own in
every other developed nation in the world—and in many less developed
nations, too.

My question: How long are we going to stand for this crap?
____________________

DAVE LINDORFF is a Philadelphia-based journalist. He is the
author of “Marketplace Medicine: The Rise of the For-Profit Hospital
Chains” (Bantam, 1992) and more recently of “The Case for Impeachment”
(St. Martin’s Press, 2006). His work is available at www.thiscantbehappening.net

Of Blue Dogs and Pink Jellyfish

dlindorff — Fri, 31 Jul 2009 11:51:45 -0400

By Dave Lindorff

What’s the difference between a Blue Dog Democrat and a progressive
Democrat? One is a vertebrate with a spine and a willingness to bite.
The other is a jellyfish with no spine and no teeth.

This difference has been glaringly apparent in the current fight over health care reform.

The Blue Dogs in House and Senate have been giving the progressive
Democrats an object lesson in how a small group in Congress can get its
way. They have threatened to withhold their support for the Obama
Administration’s key policy objective of a health reform package, and
have managed, with just a handful of votes between them, to remove
almost all progressive content from that legislation by threatening to
walk if they don’t get their way.

Compare that to the progressives—a much larger faction within the
Democratic Party majority in both houses. There are plenty of articles
currently circulating in the media talking about progressive rage and
dissatisfaction, both among progressives at large, and among
progressives in Congress, over the bills that are emerging in
committees in both the House and Senate—bills that are gutting any
reference to a genuine so-called “public option” government insurance
plan that would actually compete with and challenge private insurance
companies, and that have studiously avoided having anything to do with
a single-payer approach, bills that call for actually cutting back on
Medicare, the wildly successful single-payer program that since 1965
has been providing health care for the elderly and the disabled. But
none of the dissatisfied progressive Democrats in Congress, and only a
few of the progressive political organizations operating outside of
Congress, have threatened to bolt and oppose the sell-out legislation
that is being produced in Congress, or to stop supporting those
Democrats in Congress who are caving in to the pressure from the health
industry lobbies. And certainly none of those progressive groups have
told the president that he will no longer have their support if he
doesn’t insist on a much bolder and progressive health reform bill.

Given the power that the small Blue Dog Democratic Caucus has
demonstrated by threatening to rebel and vote against a health reform
bill, just imagine the power that Progressive Caucus would have if it
were to collectively threaten a “No” vote. Just imagine the different
path that health reform legislation would be taking in Congress today
if progressive organizations like trade unions, netroots organizations,
and others were to tell President Obama that they would withhold their
backing in 2010 from any member of Congress who didn’t vote for a
single-payer plan, or that he could no longer count on their support in
2012 if he failed to push for single-payer today.

This is the lesson of the current disaster of health reform in
Congress, and it is just the latest chapter in the failed history of
progressive Democratic politics.

It’s fine to work to elect progressives to Congress, and to send a
Democrat, progressive or not, to the White House, given that there is
no chance for progressive change while Republicans are in charge, and
given the institutional obstacles and the fratricidal internal
conflicts that prevent the rise of a viable Third Party alternative,
but progressive voters and progressive organizations have forgotten the
lesson of the Civil Rights and Anti-Indochina War movements. That
lesson is that elections are only a small first step, and that only
mass movements operating outside of Washington and outside of electoral
politics—mass movements that threaten the Democrats who are currently
in power—can produce progressive change.

The power of the Blue Dogs in Congress is derived from the fact
that despite their small number, they are numerous enough that, if they
stick together, they can derail a progressive reform bill.

But imagine how much more powerful the progressive caucus in House and Senate would be if it took the same tack.

Progressives in Congress, if they developed spines and teeth and
ceased being jellyfish, could threaten to vote against every bill
offered by those same Blue Dogs, unless they supported real health
reform—that is, a single-payer plan such as the one being put forward
today by Rep. John Conyers (D-MI). If they were backed up by
progressive grass roots organizations that let it be known that support
would end for any Democrat not backing single-payer reform, we could
have that reform.

Instead, we have jellyfish on the left, and both the president and
the Democrats in Congress, know that they can ignore the left, because
it will support them no matter what they do.

That is not to say that allthe Democrats in Congress are jellyfish--just most of them. Conyers, who showed jellyfish-like characteristics on the impeachment issue during the Bush/Cheney era, has been outspoken in his criticism of the Obama administration, and has offered a real single-payer alternative. And last week, at a gathering of Progressive Democrats of America in Washington, Conyers warned that Obama risks being a one-term president, saying to him, "Buddy, you are wrong on healthcare and it's going to cost you big time."

Still for the most part, progressives in Congress and at large across the country were quiet as Obama slimed single-payer and moved the debate to the right, only taking a stand at all on the already minimalist issue of whether there will be any kind of "public option" in the resulting legislation, however weak. And even there, few progressive members of Congress have actually vowed to vote down such a lame measure if there's no public option, or just a weak one.

Note: Today is the day that Congress will vote on Rep. Conyers’ single-payer bill (HR 676). For information on how to join in the fight for Single Payer, go to AfterDowningStreet.org or PNHP.org
_____________________

DAVE LINDORFF is a Philadelphia-based journalist. His latest
book is “The Case for Impeachment” (St. Martin’s Press, 2009). His work
is available at www.thiscantbehappening.net

Obama, Like Clinton Before Him, is Blowing the Chance for Real Health Care Reform

dlindorff — Mon, 15 Jun 2009 09:48:01 -0400

By Dave Lindorff

If you want to fix the disaster that is called the American
healthcare system, the first thing to do is to clearly point out what
its major failings are, and there are two of these.

The first is cost. America is one of the or possibly the most
expensive places in the world to get sick or injured. The corollary of
that is that it is one of the best places to make a killing if you are
in the medical business, whether as a doctor, a hospital company, a
pharmaceutical firm or a nursing home owner.

The second is access. One in six Americans—a total of 50 million
people at latest count—have no way to pay for that care. Too young for
Medicare, too “well off” for Medicaid, but too poor to buy private
health insurance or too sick to be admitted into a plan, or employed by
a company that doesn’t provide health benefits, these people get no
medical care until they get so sick that they are brought into a
hospital emergency room where they get treated (often too late) at
public expense, or at the hospital’s expense, with the cost shifted
onto taxpayers or onto insured patients’ premiums.

Any reform of this atrocious “system” must address these two major failings or it is no reform at all.

And that’s where all the various versions of Obamacare fall flat.

Simply put, you cannot solve either of these problems by leaving
the payment system for medical care in the hands of the private
insurance industry, since the whole paradigm of insurance is to make
money by keeping high-risk people out of the insured pool, and by
keeping reimbursements and coverage for premium payers as low as
possible.

Having a so-called “public option” plan working in competition with
private insurance plans will not solve this problem. Either the public
option will become like the private options—trimming benefits and
rejecting some applicants—or it will become a dumping ground for all
the high-cost, high-risk people that the private sector insurance
industry doesn’t want. At that point, the public plan will become a
huge cost burden on the taxpayer, who will begin demanding that it cut
back in the benefits it provides, taking us right back to where we
started.

The fact that the Obama administration and the Democratic Congress
are both raising the issue of the high cost of health care “reform,”
and are talking about ways to raise revenues to pay for it
tells us all we need to know about the alleged “reform” schemes they
are contemplating. They are doomed and, even if implemented, will not
work.

Real reform of the American health care system would not cost money. It would save money.

There is a level of dishonesty in what passes for the debate over
health care “reform” in both Congress and the media that is stunning in
its brazenness and/or venality.
Of course real reform would cost more in government spending. But that
is because real reform would remove the cost of medical care from both
employers and from workers (who over the last 20 years have been
shouldering an increasing share of their own medical care). And that
shift would mean more profits for US companies, which would free up
more money for wages, and it would mean less money deducted from
paychecks, meaning higher incomes for workers.

If President Obama had any political courage at all, he’d simply
get on TV and say this: I will create a plan that will cover everyone,
lift the burden of paying for healthcare from individuals and
employers, and have the government pay for it all. You the taxpayer
will pay for this plan with higher taxes, but you will no longer have
any significant medical bills, you will no longer have health insurance
premiums deducted from your paycheck, your employer will no longer be
paying for employee medical coverage, and you will never have to worry
about losing health benefits again, even if you are laid off.
(Incidentally, eliminating employer-funded health insurance would go a
long way towards allowing workers to fight to unions, and to strike for
contracts, by ending the threat that they would lose their benefits.)

Of course, to do that the president would have to be talking about
what is variously known as national health care or a single-payer plan,
in which the government is the insurer of health care for all.

This option isn’t even being discussed in this so-called debate. As
I’ve written earlier, even though there is an excellent single-payer
system in place that has been running for a third of a century just to
the north in Canada—a system where patients have absolute freedom to
choose their doctor, get instant access to a hospital and to expert
specialist care in emergencies, and have a healthier society by every
statistical measure—all at a fraction of the staggering cost of
healthcare in the US, not one Canadian expert working in that system
has been invited down to discuss its workings with the White House or
with members of Congress.

There has been a lot of negative propaganda spread about Canada’s
single-payer system, by right wing, business-funded “no-think” tanks,
and by medical industry lobbies from the American Medical Assn. to the
pharmaceutical industry, but no government committee or agency has
bothered, or dared, to bring in Canadian experts to respond to and
debunk that propaganda. The corporate liars talk about waiting lists
and lack of access to CAT-scan or MRI machines. But all we really need
to know about the Canadian, and other similar single-payer systems, is
that nowhere that they have been instituted have they been later
terminated, even when, as in Canada, right-wing governments have been
elected to power. The public, whether in Canada, or France, or England,
or Taiwan or elsewhere, loves their public health insurance system,
whatever flaws or problems with underfunding those systems may have at
certain times. Trying ot eliminate such systems would be political
suicide for a conservative government, as even arch-free-marketer
British Prime Minister Margaret Thatcher, who never me a government
activity that she didn’t want to privatize, learned.

Right now, with half of all Americans reportedly fearing that they
could lose their jobs, and with one in five Americans reportedly either
unemployed, or involuntarily working part-time, we have a situation
where a majority of Americans either have no health insurance, have
lost their health insurance, or are in danger of losing their
employer-funded health insurance. It is a unique moment when a bold
president and Congress could act to end private health insurance and
establish a public single-payer insurance plan to insure and provide
access to affordable medical care to all Americans.

Instead of this, we are being offered half measures or no measures
at all by leaders who are shamelessly in hock to the health care
industry or who are afraid of its power.

17 years ago, the Clintons had a similar opportunity to grab the
health care industry by the neck, strangle it, and produce a
single-payer alternative. They blew that chance by trying to keep the
health care greed-heads happy. Now, almost a generation later, we have
another shot at it, and Obama and his Democratic Congress are doing the
same thing again. There is a strong likelihood that they will fail,
like the Clintons before them. If they succeed in coming up with some
kind of hybrid public-private Frankenstein of a system that includes a
public insurance option, it will simply delay the inevitable disaster,
as medical costs, already 20 percent of GDP—the highest share of any
economy in the world—continue to soar, and as the cost of the public
plan, which will inevitably become a dumping ground for high-cost
patients, becomes politically untenable. In the end, we will have even
more expensive and inaccessible healthcare than we have today.

It doesn’t have to be this way, but only if Americans rip their
eyes away from their crisp new digital-image TV screens and start
demanding real health care reform will we get honest reform. A good
place to begin would be to start writing and phoning your local media
outlets to ask why they are not reporting on single-payer, and in
particular on the single-payer bill sponsored by Rep. John Conyers
(D-MI), which is being silently blocked and killed by his colleagues in
the Democratic congressional leadership and by the White House. A good
place to begin would also be to start calling your elected
representatives to demand that they support Rep. Conyers’ single-payer
bill.

___________________
DAVE LINDORFF is a Philadelphia-based journalist. His is author of
the critically acclaimed book “Marketplace Medicine: The Rise of the
For-Profit Hospital Companies” (Bantam Books, 1992). His latest book is
“The Case for Impeachment” (St. Martin’s Press, 2006). His work can be
found at www.thiscantbehappening.net

Victory! House Judiciary Democrats Want Special Prosecutor for Torture

Bob Fertik — Tue, 28 Apr 2009 17:11:00 -0400

We won a huge victory today! Thanks to your emails and calls, 15 House Judiciary Democrats joined chair John Conyers in urging Attorney General Holder to appoint a Special Counsel on Torture. Their letter says,

The attorney general acknowledged in his confirmation hearings that waterboarding is torture. Moreover, the International Committee of the Red Cross and the top Bush Administration official in charge of military commissions have also concluded that the United States engaged in torture of detainees. The Geneva Convention and the Convention Against Torture both require the United States to investigate, and if necessary prosecute, alleged violations. Justice Department regulations provide for the appointment of a special counsel when a criminal investigation is both warranted and in the public interest, and when an investigation may pose a conflict of interest within the Department. Since these conditions are present, the signatories below conclude that a special counsel should be appointed.

It was signed by 16 of 23 HJC Democrats (see below).

So will Holder agree? Josh Gerstein says no:

Holder is likely to reject that request – his boss, the president, has indicated he doesn’t see the need for such a prosecutor.

But Gerstein is just making s**t up:

The president restated his opposition to prosecuting C.I.A. operatives who followed the Bush administration’s legal guidelines in conducting interrogations. But as for lawyers or others who drew up the policies allowing techniques he has banned, Mr. Obama said it would be up to his attorney general, Eric H. Holder Jr., to decide what to do.

Jason Leopold says Holder's DoJ may give Special Prosecutor John Durham authority to prosecute waterboarding as a crime, not just the destruction of the waterboarding tapes:

the agency has been looking into a proposal contained in a final draft of Conyers’s voluminous report that called on Holder to extend the scope of a special prosecutor’s probe into the destruction of 92 interrogation videotapes to include whether the "enhanced interrogation" of detainees broke federal laws against torture, legal sources said.

U.S. Attorney John Durham, who was appointed by former Attorney General Michael Mukasey last year to investigate the destruction of the CIA’s torture tapes had only been given the authority to probe whether the destruction of the tapes amounted to criminal violations.

And Holder made a glowing promise to David Swanson last week:

"And you will be proud of your country."

Stay tuned...

Signers
John Conyers, Jr., Chairman
Jerrold Nadler, Chairman, Subcommittee on the Constitution, Civil Rights and Civil Liberties
Robert Scott, Chairman, Subcommittee on Crime, Terrorism and Homeland Security
Steve Cohen, Chairman, Subcommittee on Commercial and Administrative Law
Hank Johnson, Chairman, Subcommittee on Courts and Competition Policy
Mel Watt
Sheila Jackson Lee
Maxine Waters
Robert Wexler
Pedro Pierluisi
Luis Gutierrez
Tammy Baldwin
Anthony Weiner
Linda Sánchez
Debbie Wasserman Schultz
Daniel Maffei

Our deepest thanks to all 16! By contrast, the seven pro-torture HJC Democrats have some serious explaining to do - or Howie Klein will do it for them and it won't be pretty.

Howard Berman (CA)
Rick Boucher (VA)
William Delahunt (MA)
Charlie Gonzalez (TX)
Zoe Lofgren (CA)
Adam Schiff (CA)
Brad Sherman (CA)

Full letter:

April 28, 2009

The Honorable Eric Holder
Attorney General of the United States
U.S. Department of Justice
950 Pennsylvania Avenue, NW
Washington, DC 20530

Dear Mr. Attorney General:

We write to request that you appoint a special counsel for the investigation and possible prosecution of any violations of federal criminal laws related to the interrogation of detainees in the effective custody or control of the United States in connection with counter-terrorism operations or armed conflicts in the aftermath of the September 11, 2001 terrorist attacks on the United States. Many of us previously asked your predecessor, Attorney General Mukasey, to do so, expressing our desire to ensure an independent investigation into serious allegations that high-ranking officials, including lawyers and others from the Department of Justice itself, approved the use of enhanced interrogation techniques that amounted to torture.

Recent events highlight the need for such an appointment. The OLC memos formally released last week provide additional details regarding the purported legal justifications provided by DOJ lawyers for various interrogation techniques, including the slamming of detainees into walls, the use of stress positions, confinement in boxes, sleep deprivation, and waterboarding. The Senate Armed Services Inquiry into the Treatment of Detainees in U.S. Custody, declassified and released on April 21, confirms that these interrogation practices were developed at the request of and authorized by high-ranking administration officials, and that the abuse of detainees at Abu Ghraib and elsewhere can be linked to these policy decisions. Top Bush Administration officials previously testified that at least three detainees were subjected to waterboarding, and the recently released OLC memos reveal that one detainee was subjected to waterboarding 183 times in a one month period while another was subjected to waterboarding 83 times in one month.

During your confirmation hearings, you testified that waterboarding is torture, and the International Committee of the Red Cross, which had been denied access to detainees held at CIA secret prisons for several years, has concluded that the treatment alleged by fourteen of these detainees constituted torture. Earlier this year, the Bush Administration's top official in charge of military commissions concluded that the U.S. military's treatment of Mohammed al-Qahtani "met the legal definition of torture."

As you are aware, Justice Department regulations provide for the Attorney General to appoint an outside special counsel when: 1) a "criminal investigation of a person or matter is warranted," (2) the "investigation or prosecution of that person or matter by a United States Attorney's Office or litigating Division of the Department of Justice would present a conflict of interest for the Department," and 3) "it would be in the public interest to appoint an outside Special Counsel to assume responsibility for the matter." Such counsel is to be appointed from outside the government and should have the authority to secure resources for the investigation and prosecution and have full investigatory and prosecutorial powers.

We believe that these three criteria have been met and warrant the appointment of a special counsel to investigate whether federal criminal laws were violated by individuals who authorized or participated in the interrogation of detainees. First, as noted above, there is abundant, credible evidence of torture and the cruel, inhuman, and degrading treatment of detainees, and criminal investigation is not only warranted, it is also required. The Geneva Conventions obligate High Contracting Parties like the United States to investigate and bring before our courts those individuals "alleged to have committed, or to have ordered to be committed" grave breaches of those Conventions. The war crimes act, 18 U.S.C. § 2441, creates jurisdiction in the U.S. courts whenever the victim or alleged offender is a U.S. national or member of the Armed Forces, and specifically identifies torture and cruel or inhuman treatment, as well as the conspiracy to commit those acts, as punishable war crimes. The Convention Against Torture (CAT) -- signed by President Reagan in 1988 and ratified by the U.S. Senate in 1994 -- also obligates the U.S. to conduct a "prompt and impartial investigation" and "submit the case to [our] competent authorities for the purpose of prosecution" whenever there are reasonable grounds to believe that torture has been committed in a territory under our jurisdiction or by U.S. nationals. The federal anti-torture statute, 18 USC § 2340A, criminalizes torture and the conspiracy to commit torture and creates jurisdiction in the U.S. courts whenever the "alleged offender is a national of the United States" or "is present in the United States."

Second, a conflict of interest would be presented in having the Department investigate allegations that high-ranking Justice Department officials and lawyers provided legal guidance on and may have been involved in developing interrogation policy. For example, the Department of Justice's Office of Legal Counsel and former Attorney General and White House Counsel Alberto Gonzales advised the Administration and President to deny detainees the legal protection of the Geneva Conventions, and OLC lawyers wrote extensive legal memos that authorized specific interrogation techniques that likely amounted to torture. While some key individuals are no longer with the Department or Executive Branch, it is impossible to determine at this stage and before conclusion of the necessary investigation whether additional conflicts of interest might exist or arise. When Department lawyers are alleged to have been involved, we believe the Attorney General should turn to a special counsel.

Finally, there can be little doubt that the public interest will be served by appointment of a special counsel. The authorization and use of interrogation techniques that likely amounted to torture has generated tremendous concern and outrage in this country, and has harmed our legal and moral standing in the world. As a country committed to the rule of law, we must investigate and demand accountability for acts of torture committed by or on our behalf. Appointing a special counsel to undertake this task would serve the interests of the Department and of the public in ensuring that the necessary investigation is thorough and impartial, and that the United States fairly investigates serious and credible accusations of misconduct, even where high-ranking government officials may be involved.

We applaud President Obama's efforts to assure America and the rest of the world that this Department's investigative and prosecutorial decisions will be free from political considerations. We are confident that you and the President will uphold this critical guarantee, and will restore the Department's independence and integrity. Yet, as you undoubtedly are aware, Americans on both sides of the political aisle worry that this issue already is mired in politics, with those who oppose investigation characterizing that possibility as a political witch hunt and those who, like us, support accountability expressing concern that the rule of law must be upheld. Given these factors, any decisions that you make regarding prosecutions will be perceived by some as political. Appointment of a special counsel insulates you and the Department from such claims, and instills confidence that the outcome of the investigation could not possibly have been predetermined or otherwise improperly influenced.

The special counsel rules provide for both accountability and transparency. An appointed special counsel would be subject to Department ethics rules and to oversight by you to prevent undue expansion of the investigation. The special counsel would report to you about any decision to prosecute or not to prosecute; you could provide that report to Congress and the public, and would have to report to Congress if the special counsel is fired or the investigation halted. Appointing a special counsel balances the need, recognized after Watergate, to ensure independent investigation of high-ranking officials with the need to avoid prosecutors with unchecked power.

Given the importance of this issue, we look forward to a response to our request at your earliest convenience.