Transcript #152

Answering The Right's Deadly Lies In The Health Care Debate

 

Partially hyperlinked to sources.  For all sources, see the data resources page.

 

 

Your sources today include: the New York Times, mediamatters.org, Reuters, commondreams.org, mckinsey.com, Business Week magazine, oecd.org, cnn.com, the website of Physicians for a National Health Program, the Associated Press, newsmax.com, and The Nation magazine.

 

To me, the health care reform debate isn't primarily ideological.  It's about life and death, as you'll see.

 

Probably the most important right-wing lie to counter -- because so much else flows from it -- is that the U.S. has the best health care system in the world.

 

Listen to George W. Bush and Sean Hannity:

 

audio: George W. Bush

I mean, people have access to health care in America.  After all, you just go to an emergency room.

 
audio: Sean Hannity

There's not a person in America that doesn't get the best health care…We have the best care.

If that's true, then all we need is some trim around the edges.

 

But if in fact, we have one of the worst-performing health care systems in the developed world, then major major structural reform is called for.

 

Which is it?

 

Let me say at the outset, there's no doubt we have one of, if not the most technologically advanced systems.  But that ultra-high-tech care level is not where the bulk of the health care system functions.  And that ultra-high tech care is meaningless if you can't afford it.

 

Let's look at the facts.

 

About 47 million Americans lack any health care insurance at all.  Tens of millions more are underinsured.

 

That's why 60% of bankruptcies in our country are due to medical costs, and the vast majority of those people actually had insurance.

 

As many as one-third of Americans are not taking their prescription medicine as often as they should, because they can't afford to.

 

And as far as George W. Bush's emergency rooms, you can't get preventive care in an emergency room.  Go there and ask for a colonoscopy or a breast cancer exam and see what happens.

 

The American Cancer Society found that cancer killed more often when someone didn't have adequate health insurance.

 

And kill our current health care system definitely does.  Here are three numbers for you: 12,000, 18,000 and 100,000.

 

If our shamefully high infant mortality rate were as low as, say Japan's or Sweden's, 12,000 American children would live, not die, every year.

 

The national Institute of Medicine says 18,000 Americans die every year because of lack of health insurance.

 

These people don’t receive such necessities as preventive care, timely diagnosis, or appropriate treatment.

 

And 100,000 Americans would live, not die every year, if our health care system did as good on preventable deaths due to treatable conditions, as the health care systems in countries like Japan, France and Australia.  The US is dead last in this category.

 

I've been speaking only of death, but imagine the incalculable amount of additional pain and suffering that's caused by our failed health care system, even when the result isn't fatal.

 

All this, and we spend over twice as much per capita on health care as many of the other countries which outperform us.

 

No wonder health care reform is on the top of the public's agenda and consuming Congress.  No wonder a majority of the public supports a federal guarantee of health care for all Americans.

 

So, where is the process at in Congress right now?

 

I've said many times I'm not ideological, I consider myself a humanitarian pragmatist.  Whatever works is what I'm for.

 

Whatever gets first class health care to everyone at the least cost.

 

It seems to me that what's called a single payer system has the best track record.  Every other industrialized nation in the world guarantees health care to all its citizens.  And with an exception or two, they are all single payer.

 

Single payer means, you pick the private doctors and private hospitals you want to use, and the government picks up the bill.

 

If that sounds familiar, that's because we already have a much-beloved and successful single payer health care system, called Medicare.  Medicaid would also fall into the single -- or technically dual, federal and state -- payer category.

 

Unfortunately, because of years of relentless ideological propagandizing by the right, the vast war chest of the medical industry publicity machine, and the cowardice of too many Democrats, single payer does not appear to be a politically feasible goal for the immediate future.

 

Instead, what's likely to pass in Congress is some sort of health insurance exchange, where individuals, perhaps small businesses, and maybe even large corporations could buy insurance from private insurance companies.  There would be heavy regulations here to supposedly make the insurance available and affordable to everyone.

 

What progressives are pushing now, is to add what's called a "public option" to that insurance exchange.

 

Essentially, you'd be able to buy into a Medicare-type system, one administered by the government.

 

What are the benefits of that?  Stay tuned.

 

 

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The benefits of a public option. 

 

Many experts believe that

 

A public plan would have lower administrative expenses than private plans, no need to generate big profits, and stronger bargaining power to obtain discounts from providers. That should enable it to charge lower premiums than many private plans.

For example, the public plan could bargain over drug prices to get bulk discounts, unlike Medicare, which the Republicans made sure was forbidden from doing so.

 

Unlike the private insurance companies, the public option wouldn't have to pay multi-million dollar CEO salaries, advertise, pay dividends, or employ a vast bureaucracy to deny claims.

 

In short, listen to this summary of a report published in the peer-reviewed New England Journal of Medicine:

 

After analyzing the costs of insurers, employers, doctors, hospitals, nursing homes and home-care agencies in both the U.S. and Canada, they found that administration consumes 31.0 percent of U.S. health spending, double the proportion of Canada…Streamlined to Canadian levels, enough administrative waste could be saved to provide comprehensive health insurance to all Americans.

So, as a die-hard New Yorker would say, "So what's not to like?"

 

Well, if you're a right-winger, plenty.

 

Let's get into some right-wing attack lines and debunk them.

   

Right off the bat, Fox News and even some other mainstream media outlets are mislabeling the health care reform plan before Congress.

 

Some are calling it single payer, which it's not.  Single payer is when the government pays for everything through tax revenue.

 

Others, even more egregiously, are calling it socialized medicine.  Socialized medicine is when the government owns the hospitals and employs the doctors.  That's what Great Britain has.  Our own Veterans Administration is socialized medicine.  But the Congressional plan is not so at all.

 

So when speaking with any right-winger, make sure they don't get away with that mislabeling.

 

The biggest right-wing scare tactic involves painting horror stories of the health care systems in other countries, and warning us, we don't want to be like that. 

 

Listen to Dick Morris with Bill O'Reilly recently:

 

audio: Dick Morris and Bill O'Reilly

Morris:  And what's going to happen is the same thing that goes on in Canada.  Because of the long wait for colonoscopies, the incidence of colon cancer in Canada is 25 percent higher than in the US.

And because the two top drugs we use for chemotherapy for advanced stage colon cancer are not available in Canada because of costs, the death rate is 2 % higher.  41 percent of Canadians die of colon cancer compared to 32 in the US.

O'Reilly:  That is one of the most compelling things about your book, is that you deliver statistics that say Americans are a lot healthier than Canadians are in the vital disease category—heart disease, cancer, things like that. 

Morris:  Let's quantify it.  6 percent lower death rate from heart disease and a 16 percent lower death rate from cancer in the US.  And Canada has more poor people.  

Even if what Morris said was correct, Canada spends only half as much as we do per capita on health care.   Not paying for needed treatments is not an inherent characteristic of single payer, but an inevitable result of  under-financing, no matter the system.

 

And that being said, as far as the facts Dick Morris offers, I don't know where he gets them from, but they fly in the face of the data I've seen.

 

As you heard earlier, there are those three numbers: 12,000, 18,000 and 100,000, the number of American infants, uninsured, and those with treatable diseases, who would live, not die, if our health care system performed as well as those of other advanced nations.

 

Would you like to hear more facts about how the health care systems of other countries produce far better results than ours?

 

How about this: a large study found that the five-year survival rates

 

for many diseases in this country are no better than they are in countries that spend far less on health care. People here are less likely to have long-term survival after colorectal cancer, childhood leukemia or a kidney transplant than they are in Canada — that bastion of rationing.

The accompanying chart in the New York Times is succinctly and perfectly entitled "More Money, Worse Results."

 

Indeed.  According the Organization for Economic Cooperation and Development, an organization which we belong to along with dozens of other developed, and a few developing nations, we spend $412 per person on health care administrative costs, vs. an average of $72 for peer OECD countries.  Almost six times as much!

 

If you're talking with a right-winger, he or she will also undoubtedly bring up waiting times: If we change our system, you'll have to wait forever to see a doctor.  And then you'll be regaled with an anecdote or two to prove the point.

 

It was Business Week magazine, hardly a liberal source, that recently admitted after studying the issue,

 

In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.

Anecdotes used to support hard data are useful.  Anecdotes used in a dishonest attempt to refute, or deny the existence of hard data, are a deplorable right-wing tactic.

 

And I really want to stress to you again.

 

We spend far more, often twice as much, on health care per capita than other developed nations.

 

So if Canada, France, Great Britain and all the rest spent as much as we did per capita -- if they doubled the amount of money they were spending on health care  -- you can rest assured that not only would there be no waits there, they'd be making house calls with gold-plated MRI machines.

 

Put another way, if we cut our medical expenditures in half, how long would our waits be?  How bad would the rest of our health care system be?

 

So always be sure to ask your friendly local right-winger: if our health care system is so great, the model so good, that it only needs to be tinkered with, then how come, in terms of health care outcomes -- infant mortality, life expectancy, preventable deaths -- we're so far behind most everyone else, even though we spend as much as twice what they spend per person for health care.  Why?

 

Might it have something to do with their single payer systems?

 

Up next: Might this very costliness of our present system have something to do with the ferocious attack on the public option being mounted by the for-profit health care industry and its right-wing ideological and political allies?

 

Stick around.

 

 

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The right wing and its health industry patrons are frantically and at ear-splitting volume doing all they can to kill the public option.

 

Chances are, you've already heard some of it.

 

As the New York Times put it:

 

The prospect of competing with a government plan terrifies the private insurers. But in our judgment, if that many Americans were to decide that such a plan is a better deal for them and their families, that would be a good thing. Innovative private plans that already deliver better services at lower costs would survive. Inefficient private plans would wither.

The right considers the public option a Trojan Horse, that will cause the private insurance industry to wither and die.

 

Will it?

 

On the one hand, some analysts point to the fact that more than two dozen states already offer state employees the option to buy into a public plan, as opposed to private health insurance company products.  That hasn't destroyed the private health insurance companies at all.

 

On the other hand, different observers maintain that the state coverage model is not applicable to the Congressional nationwide public option proposal.

 

Many progressives actually hope the state model is not a good guide, and that the public option will prove private insurance-destroying.

 

For example, John Edwards has said:

 

Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan.

I've heard Senator Bernie Sanders say the same thing.

 

Myself, again, if the public option provides universal affordable coverage at a lower cost, and everyone prefers it, I say, more power to it!

 

Not because of ideology, but because of the life-saving results.

 

 

Despite the right-wing ranting and raving, the public is very strongly behind a public option.  A couple of polls showed this.

 

The New York Times' poll asked:

 

Would you favor or oppose the government's offering everyone a government administered health insurance plan like Medicare that would compete with private health insurance plans?

A whopping 72% favored this public option, even including half of all Republicans.

 

But there are still dangers ahead.

 

Some in Congress are promoting the trigger idea: the public option wouldn't be instituted unless at some specified number of years down the line, private health insurance companies haven't met certain standards.

 

Obviously bs, and a way to kill the public option.

 

Local insurance-buying cooperatives, which would not have much market power compared to a national-level plan, are another alternative being floated to avoid a public option.  You shouldn't buy into them either.

 

Another potential pitfall involves this line of reasoning, offered by some progressives: the public option will have far too few of the advantages of single payer, and too many liabilities.  For example, the public option will not have anywhere near the purchasing power and economy of scale advantages of a true national single payer set up. 

 

And instead of insuring everyone, with a wide variety of health situations in the insured population, a public option will tend to attract those who can't get insurance elsewhere, and since only the sickest will flock to it, its costs will be high.

 

So if this analysis is correct, and the public option fails, instead of being a bridge to true single payer, it could be used as a knife to kill a move to single payer.

 

Another big danger is the apparent openness now of President Obama and other Democrats to taxing people's employer-supplied health insurance in order to pay for health care reform.

 

Obama had pledged during the campaign not to do so, and severely criticized McCain for suggesting it.

 

Having to tax people for health care reform would not be necessary in a true single payer system, since it would pay for itself through administrative and other savings, as I told you earlier.

 

So what a tragedy that because of Democratic cowardice, they're being forced to consider a tax increase, undoubtedly giving the Republicans yet more ammunition.  What better way to ensure the public won't want it?

 

Could it be deliberate sabotage by Democrats really ultimately beholden to and doing the bidding of the same health industry lobbyists as the Republicans?

 

Just asking…

 

Back in a minute with a rebuttal to some more right-wing lies.

 

 

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All that being said about the potential pitfalls of the public option, it seems to be all we've got right now.

 

So let's go over a grab bag of some remaining right-wing talking points designed to destroy the public option element in health care reform.

 

First is the most absurd.  Here's Louisiana Republican Governor Bobby Jindal:

 

audio: Bobby Jindal

Republicans believe in a simple principle:  no Americans should have to worry about losing their health care coverage.  Period.  We stand for universal access to affordable health care coverage. 

What we oppose is universal government-run health care.  Health care decisions should be made by doctors and patients, not by government bureaucrats. 

We believe Americans can do anything.   And if we put aside partisan politics and work together, we can make our system of private medicine affordable and accessible for every one of our citizens.

What a joke.  The right has been opposing efforts to provide health care for all Americans ever since FDR first considered it and Truman formally proposed national health insurance in 1945.  The right called it socialism back then also.

 

The right never offers anything but phony plans, like George W. Bush's, which the White House was forced to admit would have helped only 1 in 10 Americans without health insurance.

 

There's also the right-wing line you just heard: Do you want a government bureaucrat between you and your doctor?

 

Yes, compared to what I have right now, a corporate bureaucrat between me and my doctor: the health insurance company employee whose job it is to figure out how to deny coverage for claims.  The heath insurance company employee whose job it is to find reasons to cancel your coverage when you make a claim.  That's called rescission.  The corporate bureaucrat whose company makes more profit by denying your claims.

 

The right will also say, look, the American Medical Association, the doctors are against the public option.

 

But the AMA has only one of three doctors as members, and the AMA has always opposed progressive health care measures, like Medicare itself!

 

Here's Dick Morris with another idiotic argument:

 

audio: Dick Morris

O'Reilly: Now, you say that if national health care passes and 45 million Americans come into the system, there aren't enough doctors and nurses to care for the 300 million plus Americans that exist.  So that therefore, the medical system will be overwhelmed. 

All right.  Now that sounds like a compelling argument—but I say to myself, those 45 million uninsured people have access to hospital emergency rooms right now.  They get care if they want it and the system isn't overwhelmed right now.

Morris:  Well, the care they get in the emergency room is a tiny portion of what they get or would be entitled to if national health insurance passes.  The whole point of Obama's talking about this 47 million is that they have unmet medical needs.  Otherwise, why would he be talking about them?

O'Reilly:  Well, I don't know about that, but they don't have insurance.  So they walk in and they say where's your insurance card and they say I don't have it. 

Morris:  But his case is that they have unmet medical needs, and he's correct about that.  You don't get a colonoscopy in the emergency room.  And you don't get a lung X-ray.

O'Reilly:  So the preventive stuff that you believe some of the 45 million would go for would overwhelm the system so that all other Americans would have to get on line.

First of all, we have rationing now.  It's called one-fourth of all Americans uninsured or underinsured.  It's called "Claim denied."  It's called rescission.

 

Second, we have far fewer doctors per capita than many other developed nations.   At least in part, because the AMA actually works to limit the supply of doctors.

 

We can very easily increase the size of medical school classes and in a few years, have the proper number of doctors for a country of our size.

 

Finally, there's the mainstream media sin of painting the public option as the left position, not as the compromise it already is, as a fallback from true single payer.  So then they -- and the right -- can promote coops and other dead ends as the compromise.  Don't let them.

 

 

Ok, real quick, a couple of points you should make that appeal to right-wing sensibilities.

 

Guaranteeing everyone health care without being tied to an employer, will encourage capitalistic entrepreneurism, because people won't be afraid to quit their jobs and start businesses for fear of losing health care coverage.

 

Also - -and this goes more towards true single payer -- right now our corporations are at a competitive disadvantage with foreign companies, which don't have to provide health coverage to their workers, so their costs are lower.  Removing that burden from US companies would level the playing field.

 

 

The bottom line is, you should go on the offensive against right-wingers.

 

Challenge them to show how the insurance industry is anything more than a middleman that performs no useful function and merely drains resources -- skims profits from -- the system.

 

If you're presented with an alleged right-wing alternative to the public option, or to single payer, be sure to demand specifics.   Reject as inadequate vague platitudes about the free market.

 

Market-based insurance is what has gotten us into the mess we're in.

 

And -- if you start hearing babble -- as likely from the Obama administration and certain other Democrats as from the GOP -- about the need for bipartisanship, ask yourself:

 

Do we want a watered-down bipartisan plan that won't work, that's doomed to failure?  Or instead, do you want to see a truly progressive, if need be "partisan" plan that will work, that'll be a success?

 

Listen to FDR:

 

audio: FDR

We had to struggle with the old enemies of peace--business and financial monopoly, speculation, reckless banking, class antagonism, sectionalism, war profiteering.

They had begun to consider the Government of the United States as a mere appendage to their own affairs. We know now that Government by organized money is just as dangerous as Government by organized mob.

Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me--and I welcome their hatred.

We should welcome the hatred of our current day right-wingers.  We're trying to reduce human misery, suffering, pain and death by ensuring all Americans have comprehensive and affordable health care.

 

The right doesn't support that goal.  They'll give it lip service, but their ultimate goal is the one they always have: to enrich their ideological and financial patrons in whatever branch of industry is under discussion.

 

Let's show the right who's in charge now.

 

A group of 120 House Democrats has pledged to oppose any insurance reform plan that does not include a public option.

 

Let's put some wind in their sails.

 

Here's your closing call to action:

 

Call your member of the House, your two Senators, and the White House, and tell them that you prefer single payer, but if not that, you demand a public option that's comprehensive and affordable, and that you don't need to buy an add-on policy to make work.

 

You can go to callcongress.org for toll-free numbers, or, you can reach the Congressional switchboard at 202-224-3121 and the White House comment line at 202-456-1111.

 

How about getting those digits moving right now?

 

 

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