Christina and Me: A Public Option Primer

I had this delightful exchange with a Facebook friend today:

As you may have noticed, I am young, but I have become increasingly interested in the Health Care Crisis. I have a ton of questions, but I will only bother you for a few. Is the public option that you are for, the same thing as the Free Choice-Health Care for Individuals thing that I keep hearing about? I am getting some information from my Rep's web site, as well as Rep. John Shadegg's web site. Are these the same ideas, or are they different? I hate to say this, but I am utterly confused! Your help is much appreciated, Mary.
-Christina

Here is my reply:

Hey Christina. No apologies needed for your age. Your interest and questions are very welcome.

The free choice thingy you've read about is very different from a public health insurance option that many people support (both Democrats and Republicans). Republican politicians want free choice for corporations, not for individuals. I would call what they advocate "Wall-Street-run health care" (that leads to neither health nor care). They want to maintain the status quo (keep things the way they are), which is working only for the health insurance industry and the very wealthy.

Of course, their descriptions of their positions would differ dramatically from mine. They would call what I advocate "government-run" health care, because in spite of the fact that they themselves are part of the government, they think anything the government does is bad. So they are unapologetic when government fails, even when they're responsible for that failure, because it confirms their belief that government is always a problem and never a solution.

I believe that government should do what it can to help people, because I believe we're stronger collectively than we are individually. Of course, we won't always get everything exactly right. But we can always work toward improving things so that more and more people are helped rather than hurt by the system.

I hope this helps. Keep reading as much as you can from all sides, and determine to make up your own mind and not let anyone from any side tell you what to think. Listen to your heart. It will not lead you astray.

Many blessings,

Mary

P.S. I love your question. Would you mind very much if I posted it (and my answer) on my blog? If you don't mind, do you want me to use your name (I'd use only your first name) or would you prefer that it be anonymous? If you'd rather I didn't post it, no worries.

Christina's reply:

All that would be fine. My first name would be ok. One more quick one. One guy I listened to, Whyden, I think, did say that he wanted individual choice. He even emphasized it. What about that?

And my reply:

Do you mean Senator Ron Wyden?

The idea of giving people more choices is a good one. But I also think it's really important that one of the choices available to anyone who wants it be a public insurance option. If all the choices you are given are lousy, it's hardly much of an improvement.

The trouble with the private health insurance industry is that it is profit-driven. Health care shouldn't be about profits. Human beings are not commodities.

Health care should be about health and care. A public insurance option would not have the high overhead costs of private profit-driven health insurance companies. A public insurance option would not be beholden to stockholders. It would be beholden to the public.

Does this help?

Peace,

Mary

Christina's reply:

Ah yes, very helpful. I think I am more of the public insurance gal. Can you feed me more information on this? Thanks for all your help, Mary. I really appreciate it.

I pointed Christina toward Robert Reich's good explanation of the public insurance option:



I also pointed her toward the excellent cartoon guide to health care reform:

"The Insurance Industry Profit Protection and Enhancement Act"

Today Senator Max Baucus (D-MT), chair of the Senate Finance Committee, and his "Gang of Six" have released their version of health care "reform," which some say is the version that has the "best chance of passing." Bob Cesca points out that the bill is "bipartisan" only in that "members of both parties hate it."

According to the Associated Press, Baucus has received "some $3.9 million in contributions from the health care industry since 1989" and "all six of the Finance Committee members most intimately involved in drafting the measure have received above-average donations from the health care world."

Wendell Potter, senior fellow on health care at the Center for Media and Democracy and former CIGNA executive turned whistle-blower, who spoke at last weekend's Fighting Bob Fest (which I was privileged to attend) says the Baucus bill may as well be called the "Insurance Industry Profit Protection and Enhancement Act" and would be "an absolute gift to the industry."

Wendell Potter speaking at the Fighting Bob Fest,
Baraboo, Wisconsin, September 12, 2009

Potter says that, rather than representing a "government takeover," as some mistakenly fear, the bill represents a "Wall-Street takeover" of health insurance, requiring that the already severely squeezed middle class sign over its life savings to the health insurance cartel.

Rather than a robust public option, the bill promotes insurance co-ops, which according to Potter, "would be unable to compete in today’s concentrated health insurance markets" and therefore would be completely ineffectual at reducing health care costs.

David Dayen of Brave New Films says the bill attempts to bring costs down by allowing insurance companies to offer lousy coverage. According to the New York Times,

To compare health plans, experts often focus on the percentage of medical expenses paid by insurance, on average, for a given population. This figure ranges from 70 percent to 95 percent under the House bill’s options, but it would be less than 70 percent under Mr. Baucus’s proposal.

Not only would the coverage be lousy, but we would be forced to buy it or pay a stiff penalty. According to the New York Times, the bill "would require nearly all Americans to obtain coverage or face a penalty of up to $3,800 a year for families."

Appearing yesterday in a forum held by the House Democratic Steering and Policy Committee, Potter testified:

The insurance industry is insistent on being able to retain what it calls "benefit design flexibility." Those three words seem innocuous and reasonable, but if legislation that reaches the president grants insurers the flexibility they claim they must have and requires all of us to buy coverage from them, millions more of us will have little alternative but to buy policies that appear to be affordable but which will prove to be anything but affordable if we become seriously ill or injured. . . .

The Baucus plan . . . would create a government-subsidized monopoly for the purchase of bare-bones high-deductible policies that would truly benefit big insurance. In other words, insurers would win, your constituents would lose.

It's hard to imagine how insurance companies could write legislation that would benefit them more.

In other words, rather than being regulated, the health insurance industry would be free to maximize its profits, while it's large pool of captive customers would be the ones being regulated. Charming. This is what I meant when I said that "this legislation . . . could be very good. Or it could be very, very bad." Uh, this would be the "very, very bad" option. Unless, of course, you are a stockholder in the insurance industry cartel, in which case it is a veritable wet dream.

~ ~ ~

So, please call your representative—again—and demand real health care reform with a robust public option. No co-ops, no triggers. Ask if you can count on your representative to vote only for a strong public option and to vote against any bill that doesn't have a strong public option. Here's the number:

(202) 224-3121

Then report your call here. Thank you.

What's at Stake, What We're Up Against, and What to Do

To some of my Facebook friends and relations, I must seem like I've gone 'round the twist. I can almost hear you thinking: "You're completely obsessed. Do you think you're going to single-handedly get a public option passed? We're going to have to find you something to do with your time. Every other post on my newsfeed is from you. And they're all about the public option."

Well, you may be right, but this is the political fight of my life. And it should be the political fight of yours too.

There are two reasons why I'm pushing so hard: First, this is not your average legislative fight. Health care reform has the potential to profoundly affect every single person in the United States—that's right, everybody: your neighbors, your coworkers, your kids, the person who rings up your groceries.

Not only that, but it will have a huge impact on some of the most important decisions of your life: whether to change jobs or start your own business, whether to get married or divorced, whether to retire. This legislation will affect each and every one of us every day of our lives—and it could be very good. Or it could be very, very bad.

Not only will this legislation affect our personal lives. It will also affect our life as a nation. It will affect our moral character—are we a people who take care of each other? Or are we content to let our neighbors fall through the cracks of a greedy, rapacious wealth care system?

This legislation will have an enormous effect—for good or ill—on our economy, on our health and well-being, on our everyday lives, on national security, on our viability as a nation. In other words,

This is a life-and-death issue, people!

This isn't something that should be left up to the politicians. This is our fight. It has to be our fight. The question about the politicians is, Do they work for us, or do they work for the health insurance industry? They can't answer that question. Politicians are like trees blowing in the wind, and whichever way the wind blows hardest, that's the way they'll bend.

Which leads me to the second reason I'm pushing so hard: $1.4 million per day. According to the an article in the July 9, 2009, Washington Post,

A record-breaking influence campaign [is being waged] by the health-care industry, which is spending more than $1.4 million a day on lobbying in the current fight, according to disclosure records. And even in a city where lobbying is a part of life, the scale of the effort has drawn attention. For example, the Pharmaceutical Research and Manufacturers of America (PhRMA) doubled its spending to nearly $7 million in the first quarter of 2009, followed by Pfizer, with more than $6 million. [emphasis added]

You may have heard how the health care industry is behind health care reform. Yes, indeed, they are "behind" it in more ways than one, according to the New York Times:

The top lobbyists for every major sector of the health care industry publicly insist they are squarely behind the Obama administration’s health care reform. But as the debate gets down to the details, the lines dividing friend from foe are getting blurry.

Each industry group is also working quietly to scuttle or reshape some element of the administration’s proposals that might hurt profits — usually some measure aimed at cost control.

The industry is very much involved in both shaping and undermining health care reform. And believe me, it's not your best interests they have in mind.

The only way to create a force that will counter that kind of gale force wind is for every single one of us to get involved. Nobody is off the hook on this one. In spite of what you may have heard about the public option fading from the debate, it's still very much alive. And it's still the very best way to bring down the skyrocketing costs of health care.

On Saturday, President Obama had this to say about this presumably fading possibility:

Now, I've also said that one of the options in the insurance exchange, one of the options—most of the folks who are going to be offering insurance through the exchange are going to be private insurers—Blue Cross Blue Shield, Aetna, all these. Well, I think one of the options should be a public insurance option. (Applause.) Now let me be clear. Let me be clear. Let me be clear: It would only be an option. Nobody would be forced to choose it. No one with insurance would be affected by it. But what it would do is, it would provide more choice and more competition. (Applause.) It would keep pressure on private insurers to keep their policies affordable, to treat their customers better.

I mean, think about it. It's the same way that public colleges and universities provide additional choice and competition to students. That doesn't inhibit private colleges and universities from thriving out there. The same should be true on the health care front. (Applause.)

Now, Minnesota, I have said that I'm open to different ideas on how to set this up. But I'm not going to back down from the basic principle that if Americans can't find affordable coverage, we're going to provide you a choice. (Applause.) And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the coverage that you need. That's a promise I will make. (Applause.)

To me it sounds like Obama is for the public option. Or something else. He wants this, but he's open to other ideas. He doesn't know yet which way the wind is blowing. First he gets blown one way and then the other. The health insurance industry lobbyists are trying to blow the public option right off the table.

That's your American dream they're trying to make disappear. The only thing standing in their way is:

You.

It's not too late. They haven't succeeded yet. But the clock is ticking.

Jane Hamsher at Firedoglake.com presents our best hope for health care reform with a robust public option. Instead of trying to push Blue Dogs or Republican obstructionists, push members of the House of Representatives who are known progressives from solidly progressive districts (i.e., their political fortunes are not at stake) to vote only for a health care reform bill that contains a robust public option. That way, they are essentially aggregating progressive power and preventing the passage of a watered-down bill:

We need at least 40 members of the House to pledge to vote for only a strong public option. By our count, we can rely on at least 17 members to say "No" to triggers, co-ops, and other faux public options.

You can help us find the remaining 23 members of Congress by calling your representative now. Can you help us whip the vote for a strong public option?

Call the House switchboard now at (202) 224-3121 and ask to be connected to your representative in the House. Clicking here will let us know you called.

It comes down to this: will progressives stand up against a health care bill written by insurance industry lobbyists? Or will they follow the lead of Rep. Raul Grijalva, who slammed the insurance industry bill as "not legitimate," and fight for what the President says we need to keep costs down?

Here's what we need you to say when you reach your representative's office:

1. State your name, city, and state, and that you're calling because you strongly support only a true public option in health care reform.
2. Say that you expect your Representative to support nothing less than a strong public option - that means no co-ops, no triggers.
3. Ask if you can count on your Representative to vote only for a strong public option and vote against any bill that doesn't have a strong public option. Again, that means no co-ops, no triggers.

Can you call your member of Congress now? Dial (202) 224-3121 and ask to be connected to your representative in the House.

When you're done, click here to let us know you called. and then report the office's response.

Thanks for your help in whipping the House to pass the public option.

Best,

Jane Hamsher
Firedoglake.com

Now Let's Get It Done!

I am guardedly hopeful. Obama's speech was better than I expected. He said he supports the public option, but he's open to triggers and co-ops. The last part of his speech was really great.

I especially liked his reference to the letter he received from Ted Kennedy:

I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death....

He expressed confidence that this would be the year that health care reform – "that great unfinished business of our society," he called it – would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that "it concerns more than material things." "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country." [emphasis added]

It was truly a great speech. Given the opportunity to edit it, I would have tweaked it:

But an additional step we can must take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option only for those who want it. don't have insurance.

Even so, the president demonstrated more support for a public option than I expected. His stated goals are good.

So now the question is, Can he deliver?

Even more importantly, can we?

I believe that the stance Barack Obama took tonight was altered by our activism and our persistence. In spite of his chastisement of Progressives for imbuing the public option with so much importance, I think his support of it was stronger because of indications Americans demand it. I think we did that.

During the election last year, we were just dipping our toes into this online organizing thingy. But clearly our work on health care reform proves that we're getting better at this. We're learning more, we're teaching each other, we're making more and more important connections. We are aggregating our power. How awesome is that?

Tonight I feel guardedly hopeful, not so much because of Obama's speech but because we are mobilizing for real change. I knew when Obama was elected that the really hard work lay ahead of us, and I was worried about whether we'd have the heart and the wherewithal to do it. Tonight, I'm less worried.

Barbara Boxer reported on Rachel Maddow that after the speech, Obama said to her, "Now let's get it done." That was my favorite thing he said all night. Enough talk. Let's have some action.

If you haven't already, tell each of your representatives to support real health care reform. Tell them you insist on a robust public option.

Write letters to local and national newspapers in support of real health care reform with a robust public option.

Particularly if your representative is a member of the Progressive Caucus, ask her or him to publicly commit to voting against any health care that does not contain a robust public option.

If you have other ideas of how to push for meaningful health care reform, please let me know.

Now let's get it done!

Whose Side Are You On, Mr. President?

Yesterday in his speech at the AFL-CIO's annual Labor Day picnic, President Obama gave us a little down payment on Wednesday night's speech:

I want a health insurance system that works as well for the American people as it does for the insurance industry. They should be free to make a profit. But they also have to be fair. Security and stability for folks who have health insurance, help for those that don't, the coverage they need at a price they can afford.

Is it just me, or did the last bit sound like an advertisement for health insurance?

Two statements keep running around in my mind: "I want a health insurance system that works as well for the American people as it does for the insurance industry.... They should be free to make a profit."

Now hold on just a cotton-pickin' minute. President Obama is holding up the concerns of the health insurance industry in one hand and the concerns of the American people in the other like there's some kind of parity there, like the two are somehow comparable. Uh, hello?

Could we focus on what will work well for the people of this country, the people who are losing their homes because they can't pay their medical bills, the people stuck in crappy jobs because they're afraid to lose their health insurance, the people being denied care even when they're insured, the people who are dying because their insurance companies won't cover the care they need?

How can these direst of life-and-death circumstances be mentioned in the same breath as the lust of the health insurance industry to make ever-increasing profits? Are we so beholden to the great capitalist machine that profit-making is always our priority?

The pit in my stomach is telling me that I know the answer to that question, but I just can't accept it.

Can you really look us in the eye, Mr. President, and hold the concerns of the health care industry alongside ours? Really? Have you not heard anything we've been saying? Are you not paying attention? What if it was your daughter whose care was denied by one of these modern-day pirates? How would you like her health and well-being held up alongside the concerns of industry stockholders to make a profit?

What I keep hearing is the politicians' deep concern for the health insurance industry. Enough already! Will you quit worrying about them? Quit acting as though their concerns are every bit as legitimate as ours! I don't care how much money they've sunk into your reelection coffers. You can't serve their needs and ours. Are you theirs? Or are you ours? You can't be both.

I don't understand why our health should be treated like it's just another commodity in America's capitalist soup. We keep hearing about how the bogeyman of socialism will rear its ugly head if the American people transform their "wealth care system" into a system that is designed to actually care for the health of the American people. Does every single aspect of our lives have to involve some corporate behemoth making a filthy profit? How many more of us have to die or have our lives ruined because of oblations poured out on the altar of rampant, unchecked capitalism?

Here's my question for you, Mr. President, members of Congress: Whose side are you on? Really? Because you can't be on the side of the health insurance industry and on the side of the American people at the same time. Our interests are diametrically opposed to theirs. You can't be for both. So which is it?

The Choice (video)

Terrific effort by Lee Stranahan calling on President Obama to do the right thing.

Ninth Inning Fail

White House senior advisor David Axelrod told ABC News today that this is the "9th inning" for the health care reform debate and that "President Obama is getting in the game [uh, about time?] and is 'at the point where he can close this' debate."

Oh really? Axelrod continued:

As to the fate of a government option plan to compete with private insurance, Axelrod suggested the controversial concept is gone but not forgotten: "The spirit that led him to support a public option is still very much at play here and so you know he wants competition. He wants choice.'

Russ Feingold has this to say about this "controversial concept":



The public option is the only way to bring down the skyrocketing costs of American health care. As Feingold says, "Real reform needs a strong public option." So if the public option is dead, so is real health care reform.

But how the hell can it be dead when 77 percent of the American people support it and even 65 percent of Republicans support it (according to an AARP poll)? That's as close as this country will ever come to a consensus. And it's dead????

Nevertheless, indications are that the administration is ready to bail (read: fail) on the public option and thus has declared it "dead" so that no one will pay attention to the fact that they are the ones who are murdering it.

This is change we can believe in only in the most profoundly cynical sense.

There's something much, much worse at work here than our rapacious health care system, and that would be our rapacious political system.

If Obama and the Dems undermine real health care reform, like it sounds like they're going to, then I suggest we encourage progressives like Kucinich and Feingold to organize themselves into a new party, one that is beholden to the people and not corporations.

Because I'm not voting for those damned Republicans any more than I'm voting for those damned Democrats. And I'm not not voting either....

So if the Dems screw this up, it's party time. NEW party time.

Oh, and in case you're wondering, I still won't back down.

Ted Kennedy on Health Care Reform (video)

Ted Kennnedy's astoundingly passionate and eloquent plea for health care reform:

The Kennedy Plan: The Dream Shall Never Die

Senator Edward Kennedy
February 22, 1932 – August 25, 2009

For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.
--Senator Ted Kennedy
1980 Democratic National Convention

Our country has lost a great leader, who picked up the torch of his fallen brothers and became the greatest United States Senator of our time....

For five decades, virtually every major piece of legislation to advance the civil rights, health and economic well being of the American people bore his name and resulted from his efforts.
--President Barack Obama, on the passing of Ted Kennedy

Quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to.

This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver—to support Barack Obama, but also to make sure, as I said, "that we will break the old gridlock and guarantee that every American…will have decent, quality health care as a fundamental right and not just a privilege." For four decades I have carried this cause—from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society. Now the issue has more meaning for me—and more urgency—than ever before. But it's always been deeply personal, because the importance of health care has been a recurrent lesson throughout most of my 77 years....

We have to cut the costs of health care. For families who've seen health-insurance premiums more than double—from an average of less than $6,000 a year to nearly $13,000 since 1999—one of the most controversial features of reform is one of the most vital. It's been called the "public plan." Despite what its detractors allege, it's not "socialism." It could take a number of different forms. Our bill favors a "community health-insurance option." In short, this means that the federal government would negotiate rates—in keeping with local economic conditions—for a plan that would be offered alongside private insurance options. This will foster competition in pricing and services. It will be a safety net, giving Americans a place to go when they can't find or afford private insurance, and it's critical to holding costs down for everyone....

I believe the bill will pass, and we will end the disgrace of America as the only major industrialized nation in the world that doesn't guarantee health care for all of its people.
--Senator Edward Kennedy, Newsweek, July 18, 2009

For so many years, Ted Kennedy has been a politician we could count on not only to do the right thing but to inspire right action. He was a passionate advocate for justice and equity. He was a great leader, and he will remain an inspiration to many.

Senator Kennedy called health care reform the cause of his life, and he considered the public option to be one of "several elements that are essential to any health-reform plan worthy of the name."

I agree with Senator Robert Byrd: Let's honor Teddy Kennedy's great legacy and name the health care reform bill, replete with the public option, after him. Let's call it the Kennedy Plan. And better still, let's get this thing through Congress and enacted into law.

Predatory Government

Chuck Grassley (R-IA) is quoted today in the Wall Street Journal:

"Government is not a competitor, it's a predator," he said of the public option that has been embraced by key congressional Democrats."

And what do you call the health insurance companies that routinely deny people needed care and refuse to cover those with preexisting conditions?

And you're calling the government a predator?

This comes from Obama's great bipartisan hope, no less, one of the Senate's Gang of Six who are holding health care reform hostage while thumbing their noses at the 77 percent of the American people who are in favor of the American option.

Oh crap, maybe Grassley's right, at least in part.

The predator is the U.S. government in the death grip of the health insurance industry.

Bamboozlers

Great word of the day: bamboozle.

So who's bamboozling you? The health insurance industry wants to put health care "reform" dollars in its own pocket, not yours.

These are the same people who deny coverage on the basis of preexisting conditions and deny care on the basis of their bottom line.



The bamboozlers don't care about you, and they don't care about America. They spend millions of dollars a day lobbying Washington to maintain the status quo, or even better, "reform" health care so they can increase their profits. Their one and only passion is their own bottom line.

Do you really want the bamboozlers in charge of your health care?

Foil the bamboozlers and insist on the American option.

Contact your representative--especially if she or he is a member of the Progressive Caucus--and urge her or him to take the pledge to vote against any health care bill that doesn't have a public plan.

Stand Up for the American Plan

I love George Lakoff. He understands how I think. Really. I love it when someone understands how I think. Don't you? It's one of the best feelings in the world, to be understood.

Not only that, George Lakoff understands how people who don't think like I do think. And that's something really special. Because, really, how people who don't think like I do think has been a great mystery to me. George Lakoff is a cognitive scientist. He studies thinking and communication.

In the HuffingtonPost today George weighs in on health care reform. He has a keen-sighted take on what has been happening (and not happening) and some excellent suggestions on where we go from here. I know it's long, but it's worth reading. If you just don't have time, bookmark it and make sure you read it later. And for now, read the following two paragraphs. There's much, much more, but these two paragraphs are sparkly gems of dynamic communication:

Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.

The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.

Read it a few times. Take it in. Ah, clarity.

George suggests the term "American Plan" instead of "public option," which is boring and uninspiring. I'm for it. I'm for the American Plan. It is the answer to our health care emergency.

Thank you, George, for your insight and clarity. I hope progressives get the message. I hope Americans get the message. I hope we get our American Plan.