Monday, August 17, 2009

Necessary footnote to the preceding

Let's be absolutely clear about something: The "public option" was no panacea. Hell, it wasn't even a pan, never mind an acea. According to a preliminary analysis done by the Congressional Budget Office in July, the main House bill, the America’s Affordable Health Choices Act, would leave 16 to 17 million people still uninsured ten years from now. Earlier in the month, the CBO's preliminary analysis of the bill passing through the Senate Committee on Health, Education, Labor, and Pensions found it would leave 33 million still uninsured after the program was fully instituted.

Nope, not a panacea.

What it was, was what I called it: "the minimum requirement for making the proposals moving through Congress worth passing."

But that is not to say there aren't other, far superior, alternatives out there. But they were dissed where they were not dismissed by the Dimcrats and the Kewl Kids as too far out there to get any support (which is why, in that previous post, I very deliberately referred to the public option as the only thing "generally discussed") - even though some variety of national health insurance, defined as a government-run insurance program that would cover all or most all Americans, has been consistently supported by about 60-65% of respondents in a number of polls over the past five years. In addition, two of those polls specifically mentioned single-payer: one in December 2007 had 54% supporting it; one in July 2009 showed a plurality of 49% in favor.

DemConWatch suggests that latter number may be lower than it should be because the uninsured were under-represented in the survey sample while those with higher education (and therefore possibly higher-paying jobs with better insurance coverage) and older people (who tend to be more conservative) were over-represented. Even if none of that affected the total, it still means 49% support, which is hardly an "out there" position except among cowardly Democrats and their faux progressive enablers.

So, at the very least, single-payer has significant public support - far more than the screeching tea-baggers who have been driven to such levels of paranoia in their insular world bounded by Rush Limbaugh et. al., Fox News, and right-wing PR hacks that fantasies about black helicopters and faked Moon landings seem reasonable by comparison.

But that doesn't matter, having a plurality or even a majority doesn't matter, because it's the Blue Dogs and other assorted buffoons who must be pleased and appeased because - and I have said this so many times my jaw aches and I hesitate to do it again because of the fights it has started in the past - they know they can take us for granted. They trust that no matter what they do, we'll still vote for them because, y'know, god forbid the other one should win, right?

Anyway, all that said, there is a bill in the House for a single-payer system. It's HR 676 and it's been languishing in House subcommittees since it was introduced in 2007 and re-introduced in the new Congress that began in January. Sponsored by John Conyers, it has 86 co-sponsors. Nancy Pelosi, after having declared single-payer was "off the table," has now promised a vote on HR 676 before the end of the year. Considering the timing (well after the "health care reform" bills are supposed to have passed) and the fact that the deal seems to have arisen because the Dem leadership got wrong-footed by a proposed amendment by a single-payer supporter, it appears to be little more than a sop - but it still means that single-payer advocates have at least forced the misleadership to acknowledge them, which is a small step but it's still a step. And the possibility of seeing perhaps 100+ members of the House vote for a single-payer plan could be a building block (even though it would undoubtedly be described by the media -all of it - as having been "overwhelmingly rejected").

For information on single-payer and updates on the legislative side, two sources are Physicians for a National Health Program and Health Care - NOW!

On the other hand, if you want something that's really off the radar, try finding advocates for my preference: a National Health Care System, which, as I've said twice before but will say again because it bears repeating, would be
layered from neighborhood-level clinics through community hospitals and regional health centers up to a small number of national district hospitals for special, rare, or unusually complex treatments. The workers in all those facilities are federal employees. Ethical and financial oversight is exercised by committees of the public and health care workers at each level. The system is primarily financed through taxes with payment, if any, for services based strictly on ability to pay.

If alongside that a private system persists for those who can afford the luxury, fine. In fact, good, because those people will still be paying their full share of taxes to support the system (no tax deductions for private insurance) while reducing the demands on it.

My wife is a registered nurse who often laments the idea that the health care industry is becoming ever-more "industry" and ever-less "health care." She continues to cling to the ideal that the needs of the patient, not the needs of accountants or investors, should be the focus of health care workers. Ultimately, a not-for-profit national health care system is the only way to get there.
You want quality, affordable, health care for all? You have to take the profit out of it. Oh, and if the effect would be the collapse of the private health insurance industry? I truly don't think it would - there are, again, always those ready and able to pay for some special treatment - but if it did, I really don't give a crap. Some things are just more important than others.

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