IEET > Rights > HealthLongevity > Economic > Fellows > Douglas Rushkoff
Health Care Reform Without Public Option is Just Corporatism, Not Socialism
Doug Rushkoff   Aug 20, 2009   Douglas Rushkoff  

The healthcare debate has gotten so weird, I think it’s time someone (I guess me) says what’s actually going on. I do not presume to have the answers to all of these problems (well, actually I think I have most of it figured out) but all I mean to do is share what appears to be happening. It is bizarre. Let’s start simple.

Obama said he wanted national healthcare, and presented Congress with a bill that would create a public health insurance option for people who can’t or won’t afford the ones offered by the private sector. It’s like having public school for people who can’t/won’t afford private, or even public libraries for people who don’t want to buy and own books. The idea was that it would save so much money by preventing poor people from showing up at the emergency room in crisis (or just being sick at all), it would pay for itself. The insurance companies got really upset, and got Republicans to argue that this would hurt competition, and upset the free market.

Obama understands this perspective: that the sanctity of the free market is in some ways more important than the health of the nation’s people, and has begun to back down. What is being ignored is that health insurance is not a free market. It is part of a monopoly of corporations currently controlling what we call healthcare in America – a healthcare system that promotes the use of costly patented pharmaceuticals over preventative care, nutrition, and basic health education. If we had a truly free healthcare market… well, don’t get me started.

But all that aside, when Obama suggests he is open to removing the national healthcare part of the national healthcare act, he is turning it from social spending to straight corporatism. Now, instead of requiring everyone have insurance, and then subsidizing a person’s participation in a government health plan, the act will still require everyone have insurance, and then subsidize a person’s participation in a private health plan. So the net effect of the law is to use public funds to subsidize a private, highly inefficient healthcare insurance industry which has been documented to care much more about profit than anyone’s health.

This is corporatism.

And it is not even a step in the right direction, not a step towards getting America healthier or more people properly insured. It promises only to exacerbate the very features of private-sector healthcare that already puts America fiftieth in the list for life expectancy and general health (Canada is 8th, UK is 36th).

But the weird part is that Republicans – in the thrall of the insurance companies – are now still making a show of arguing against the bill on grounds that it’s socialism, when in fact it’s really just corporatism or corporate welfare. This is the bill they actually want passed. But in addition to making sure it passes (all they need is enough Democrats to stupidly vote for it) they want to earn political points by arguing against the steamroller of socialism that Obama is supposedly driving over us all. Get it?  It’s all backwards.

Douglas Rushkoff is a fellow of the IEET, author of a dozen books and comic books, producer of two award-winning Frontline documentaries, and his essays have been published widely.



COMMENTS

NO CO-OP’S! A Little History Lesson

Young People. America needs your help.

More than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 76% of all Americans want a strong government-run public option on day one (85% of democrats, 71% of independents, and 60% republicans). Basically everyone.

Our last great economic catastrophe was called the Great Depression. Then as now it was caused by a reckless, and corrupt Republican administration and republican congress. FDR a Democrat, was then elected to save the nation and the American people from the unbridled GREED and profiteering, of the unregulated predatory self-interest of the banking industry and Wallstreet. Just like now.

FDR proposed a Government-run health insurance plan to go with Social Security. To assure all Americans high quality, easily accessible, affordable, National Healthcare security. Regardless of where you lived, worked, or your ability to pay. But the AMA riled against it. Using all manor of scare tactics, like Calling it SOCIALIZED MEDICINE!! :-0

So FDR established thousands of co-op’s around the country in rural America. And all of them failed. The biggest of these co-op organizations would become the grandfather of the predatory monster that all of you know today as the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry. And the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry.

This former co-op would grow so powerful that it would corrupt every aspect of healthcare delivery in America. Even corrupting the Government of the United States.

This former co-op’s name is BLUE CROSS/BLUE SHIELD.

Do you see now why even the suggestion of co-op’s is ridiculous. It makes me so ANGRY! Co-op’s are not a substitute for a government-run public option.

They are trying to pull the wool over our eye’s again. Senator Conrad, if you don’t have the votes now, GET THEM! Or turn them over to us. WE WILL! DEAL WITH THEM. Why do you think we gave your party Control of the House, Control of the Senate, Control of the Whitehouse. The only option on the table that has any chance of fixing our healthcare crisis is a STRONG GOVERNMENT-RUN PUBLIC OPTION.

An insurance mandate and subsidies without a strong government-run public option choice available on day one would be worse than the healthcare catastrophe we have now. The insurance, and healthcare industry have been very successful at exploiting the good hearts of the American people. But Congress and the president must not let that happen this time. House Progressives and members of the Tri-caucus must continue to hold firm on their demand for a strong Government-run public option.

A healthcare reform bill with mandates and subsidies but without a STRONG government-run public option choice on day one, would be much worse than NO healthcare reform at all. So you must be strong and KILL IT! if you have too. And let the chips fall where they may. You can do insurance reform without mandates, subsidies, or taxpayer expense.

Actually, no tax payer funds should be use to subsidize any private for profit insurance plans. Tax payer funds should only be used to subsidize the public plans. Healthcare reform should be 100% for the American people. Not another taxpayer bailout of the private for profit insurance industry, disguised as healthcare reform for the people.

God Bless You

Jacksmith : Working Class

Twitter search #welovetheNHS #NHS Check it out

(http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/)

(http://www.youtube.com/watch?v=IbWw23XwO5o) CYBER WARRIORS!! - TAKE THIS VIRAL

Time to get the Republicans out of the way and get it done. The Republicans don’t want anything but to make sure no plan is passed. They have been lying and misleading the American public for months now. There is a related post at http://iamsoannoyed.com/?page_id=588

I’m not even sure if President Obama /wants/ single payer health care. The following two (short) videos of Obama talking tell different stories:
http://www.youtube.com/watch?v=bd-F8Z6sSpA
http://www.youtube.com/watch?v=fpAyan1fXCE
It’s frustrating.

Well, then I have a question: What do you think about the Democratic Party saying that they’re going to basically pass the bill themselves, with or without Republican support?

“Well, then I have a question: What do you think about the Democratic Party saying that they’re going to basically pass the bill themselves, with or without Republican support?”

I’m not a fan of bi-partisanship, and even if I was the Republicans tore up and burned every offer of bipartisanship with their campaign of lies and hate speech this last two months.

The problem is that any reform has been conceptualized as a part of an health insurance exchange.  In Massachusetts they call it “the connector.”  The connector has failed to provide coverage to all those who need it.  The exchange will also fail.  It will strengthen those who can claim the most national market share and adjust their pricing.  See this article which connected the insurance exchange with the Heritage Foundation:
http://socialistwebzine.blogspot.com/2009/08/obamas-health-insurance-plan.html

Theme : The public health is a fundamental human right.

1.  When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion :  As to for-profit business, the more ill patients get, the more profits they make. 

Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the expansive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.

Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal. 

Please be ‘sure’ to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Today, another innovative, fundamental change in payment system, or patient’s outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

2.  The savings via removing wastes turn into limit to medical access, rationing, tax raise, and deficit etc via the irresponsible lies.

Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class,  the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these painful corruptions & wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.

In contrast, not to mention a wide range of consumer protection, this promising reform takes initiatives in more primary care docs and improved long-term care. Unnecessarily, hope should not be replaced with fear, just like people don’t have to fear quitting drug.


3.  Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options.  Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.

4.  When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too.

5. Unlike the original financial concern over recovery from Catrina catastrophe, the recovery work is going smooth with no big problem, to my knowledge. The last thing to want would be for this health Catrina to be left untreated. And there is enough room for savings from the unsustainable wastes.

6.  Equation (By decade)  &  the flower of this reform !

$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).

$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine)  + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).

Additionally, the last thing to expect, no e-medial record(under a fee for each and every service payment, hospitals are resistant to introduce IT system) , is happening now in the sector requiring the best accuracy in terms of dealing with human lives, which leads to a shocking portion of risk-carrying duplicate tests, fatal errors and deaths, as a consequence, these cause a vicious circle, about $100bn worth of litigations and even more profits via unnecessary procedures for hospitals .

Clearly, the American style innovation, outcome-based payment reform, could speed up the adoption of IT system, under this package, docs’ pay is dependant upon patient’s outcome, no intervention, wastes, frequent readmissions, low-quality are allowed later on.

It is firmly believed with the preventive care program in operation, this innovation could make a big difference just like GM has surprised the world with the adoption of EV-conversion technology from pioneers and outpaced the excellent hybrid cars (the release of BYD’s earlier appearance in America and the ambitious plan of Germany for 1million of EVs by 2020 etc might support it).


7. Over the duration of time-consuming discussion surrounding this common sense, a fundamental human right, and slow down to shout and disrupt, and lie irresponsibly, America has been loosing market share in a futuristic sustainable energy arena. But just like if a country attempts to steal cash from wall street, America can’t wait and see, so the opposite is the same. Taking the invaluable lives and gigantic war spending into account, it can be cited as one more extended reckless disaster, regardless of the result, as this great recession says.

Please note that time does not fix the endless greed, energy depletion, only science and innovation can meet the challenge.

Thank You !

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