Between the Lines Q&A

A weekly column featuring progressive viewpoints
on national and international issues
under-reported in mainstream media
for release March 6, 2010

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Endgame: Democrats' Health Care 'Reform'
a Windfall for Insurance Industry

RealAudio MP3

Interview with Dr. Andrew Coates,
national board member
of Physicians for a National Health Program,
conducted by Scott Harris

healthcare

The results of President Obama's Feb. 25 health care summit were predictable. Democrats and especially Republicans robotically stuck to scripted talking points aimed at the television audience. Although the meeting of congressional leaders, President Obama and members of his Cabinet was billed as a last ditch effort to negotiate a bipartisan formula for passing health care reform legislation, the meeting broadcast live on CSPAN only served to provide a platform for posturing in the lead up to the November, 2010 mid-term congressional election. When supporters of single-payer health reform, or "Medicare for all," were excluded from the summit, protesters staged their own "sidewalk summit" outside the official meeting.

In advance of the meeting, President Obama presented an 11-page document outlining a proposal to find common ground between the different health reform bills passed by Democrats in the House and Senate. Among the new planks in the president's plan was the establishment of a panel that will assess insurance company rate increases. Rate hikes became the focus of public anger after Anthem Blue Cross announced premium increases of 39 percent in California and similar amounts in other states.

Overall the president's plan would cost an estimated $950 billion over 10 years and would extend health insurance to 31 million out of an estimated 47 million people currently without coverage.

With the Democrats' defeat in the Massachusetts special election and the loss of their supermajority in the Senate, congressional leaders are prepared to use the budget reconciliation process to avoid a Republican filibuster in the Senate. Between The Lines' Scott Harris spoke with Dr. Andrew Coates, an instructor at Albany Medical College and a national board member of the single-payer advocacy group Physicians for a National Health Program. Dr. Coates assesses the results of the White House Health Care Summit and takes a critical look at legislation Democrats hope to pass in the coming weeks.

ANDREW COATES: The proposal stayed well within the bounds of the Senate bill. There are minor sops to the House bill, in terms of allowing more low-income people to benefit. The major portion of the expansion of coverage, because this is sold by its supporters as an expansion of coverage, the major portion is in Medicaid expansion. And that would be what we know as a poor program for poor people, patients who have difficulty getting access to care in spite of having coverage because they have Medicaid, (funded by) taxes upon the states, and of course, the proposal would fund the care of these patients through federal dollars. But, administration of the program would fall on the state governments, and so it wouldn't be completely and totally paid for by the state.

And then the second portion would be an expansion of private health insurance, but with a subsidy so that if you were making more than 150 percent of the federal poverty level up to 400 percent -- and this was the reconciliation between the Senate and the House bills -- then you would be eligible to have a subsidy of taxpayer dollars going to your private insurance premiums in order to make it affordable.

So it doesn't make it affordable. It just means that it's like robbing the poor to pay for the poor, I mean, it just means that the taxpayers would help you pay your premiums because they can't be made affordable by private health insurance. And we have to be frank; the health insurance industry wrote this bill. It has been what they've been after for a very long time, the individual mandate. They have a product that is very unappealing: It's not affordable, it doesn't work, people think they're covered up until the time they're sick, and then it's a devastating blow to go through all those hassles of trying to get care when you really need it. And so, if the government would coerce people to buy that product, that would save the industry. So that's what the industry put forward, and that's what the Democrats and Republicans are trying to figure out if they can agree on.

BETWEEN THE LINES:Many advocates of passing in Congress this compromise healthcare reform bill will say the political reality dictates we have to take half a loaf, or nothing at all. And they maintain that even a flawed bill at this point is better than passing no bill at all given the urgency -- 45,000 Americans die every year due to not having adequate health insurance, and 62 percent of all personal bankruptcies are linked to medical debt. So people say we've gotta do something even if it's not perfect--the old saying that we shouldn't let the perfect be the enemy of the good. How do you respond to that?

ANDREW COATES: The question is whether this bill is a half or even a quarter of a loaf or whether it's even progressive. I'm a little on the extreme side of the single-payer movement, and that I know that many of my friends and coworkers within the single-payer movement are sympathetic to the idea that anything is better than nothing. I don't see this as better than nothing, I see this as actually more harm than good. This proposal would strengthen the insurance industry in a way that is unimaginable.

Taxpayers over the decade would give the private health insurance industry -- one of the most profitable industries in the history of the world, would give over $400 billion in taxpayer dollars to this industry, to subsidize their unaffordable, unworkable product that has failed this nation since World War II. And so why would we put the industry in that position of incredible power and place? Why would we enhance its place when it has failed our nation? I don't think that a Medicaid expansion will really help improve the health of the nation.

I think that we need a dramatic and radical reform. And I think that single-payer is the very least, the very most minimum reform, that will improve quality, improve equity in health care, guarantee access, and guarantee choice, and finally, protect privacy between doctors and patients. Because when private health insurance companies stand to make money by getting between myself and my patient, or any nurse practitioner and their patient, any provider and patient, that is when privacy is eroded. It's when the money interest gets between the doctor and the patient -- and we can't tolerate that any more. And the way to remove that is through a single-payer alternative.

BETWEEN THE LINES:Given the fact that President Obama and congressional leaders have really taken single-payer off the table, the Medicare for-all option really is not among the pragmatic choices at this moment on Capitol Hill. What's next for single payer? What's your group going to be doing in terms of pushing forward with this as an option for the country?

ANDREW COATES: If you look at the history of 2009, we've had amazing amount of grassroots activity, from civil disobedience, nearly 200 people in fact arrested from civil disobedience for single-payer, and just thousands of local activities, literally thousands, millions and millions of calls to congress, so we have a movement for single-payer its not going to go away, its going to continue to grow, and I have great confidence that we will actually win.

Dr. Andrew Coates is a shop steward with the Public Employees Federation AFL-CIO. Visit Physicians for a National Health Program website at www.pnhp.org

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Scott Harris is an executive producer of Between The Lines, which can be heard on more than 45 radio stations and in RealAudio and MP3 on our website at http://www.btlonline.org. This interview excerpt was featured on the award-winning, syndicated weekly radio newsmagazine, Between The Lines for the week ending March 12, 2010. This Between The Lines Q&A was compiled by Melanie Muller and Anna Manzo.

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