Democracy for Vancouver

Hillary Clinton has finally unveiled the heart of her universal health coverage plan, and, fortunately for the health insurance industry which has filled her campaign warchest, there is no way that it would ever make it through Congress with anything like universality; or, if it has universality, it will cost the federal government billions while continuing to plow profits into the health insurance industry’s coffers.

Why? Let me count the ways:

1. “This is not government-run,” the party’s front-runner said of her plan to extend coverage to an estimated 47 million Americans who now go without.

According to a 2003 article in the New England Journal of Medicine by two of the founders of Physicians for a National Health Program:

[A]dministration consumes 31.0 percent of U.S. health spending, double the proportion of Canada (16.7 percent). Average overhead among private U.S. insurers was 11.7 percent, compared with 1.3 percent for Canada’s single-payer system and 3.6 percent for Medicare. Streamlined to Canadian levels, enough administrative waste could be saved to provide compressive health insurance to all Americans.

Those savings would amount to about $350 billion/year, covering everyone without withholding funds that could be used for care to pay for administration and provide shareholders with profits. Without a government-run plan, health care coverage will still be driven by profits, which is insanity.

2. “In unveiling her plan, [Clinton] called for a requirement for businesses to obtain insurance for employees, and said the wealthy should pay higher taxes to help defray the cost for those less able to pay for it. She put the government’s cost at $110 billion a year.”

This makes no sense in so many ways.

Though widespread health insurance may have first come about as an employee benefit, forcing all employers to provide health care will put some employers out of business, force others to cut back on their workforce, and, like the no-negotiation-for-lower-prices Medicare Part D plan, put billions of dollars into the health insurance industries pockets in pure profit.

U.S. manufacturing and high-skill jobs are being driven offshore by, among other things, the stratospheric cost of providing health care to both employees and retirees. Just look at the currently stalled GM/UAW contract talks. If part of the aim of healthcare reform is to put everyone on an even playing field and make U.S. companies competitive in the world markets again, Clinton’s plan won’t help.

3. “The New York senator said her plan would require every American to purchase insurance, either through their jobs or through a program modeled on Medicare or the federal employee health plan. Businesses would be required to offer insurance or contribute to a pool that would expand coverage. Individuals and small businesses would be offered tax credits to make insurance more affordable.”

Again, this just makes the government a stalking horse for the health insurance industry, with tax credits funding insurance industry profits.

4. “…[T]he senator’s proposal would require insurance companies to accept all applicants for coverage and would limit insurers’ ability to charge higher premiums because of preexisting conditions.”

These provisions would never make it through the Congress alive. One of the reasons that it’s often cheaper to buy an individual plan, say, through Blue Cross/Blue Shield, than for your employer to buy it for you, is that on an individual basis the insurance company is free to reject you. If they accept the contract for providing healthcare to your company, they are required to cover everyone in that company.

Unless the insurance companies gets big incentives to cover everyone - incentives large enough to cover their costs and provide for a healthy profit - you can be assured that either the care will suck and denials will go through the roof, or the premiums will be sky high.

5. Hillary Clinton’s plan is too complicated to raise the groundswell of popular support that will be needed to get any universal healthcare plan through Congress.

The surge of support that will be needed to pass any kind of meaningful healthcare reform will have to be enormous. It will probably have to poll upwards of 65% if Senators and Representatives are ever going to be forced to turn their backs on the wads of cash being thrown at them by the health care lobby. This is not an insignificant challenge: the health care industry has more lobbyists on the Hill than all the members of the Senate and the House put together.

Clarity, simplicity and fairness are key. The only plan that will make sense to the electorate will be a single-payer system run by the government, if the plan clearly shows that the system will:

• reduce the current cost of healthcare in this country, while providing truly universal coverage;

• allow every person to see the doctor of his/her choice;

• give doctors more time to spend with their patients, because they will spend less time and money sorting out the individual insurance benefits for each patient;

• vastly increase the competitiveness and productivity of American industry by keeping employees healthy and on the job, while cutting out a primary impediment to company profitability;

• stop the financial hardships that force thousands un- and under-insured Americans each year into divorce, bankruptcy and even homelessness;

• keep hospitals and urgent care centers in rural and poor communities financially viable, and therefore open and available to serve their communities;

• reduce overall, maternal and infant mortality rates; and,

• help control the increased incidents of diabetes, heart disease and other diseases that disproprtionately affect the uninsured.

These are just some of the dozens of benefits to a universal, single-payer health plan; there are far too many to mention here.

But first and most important among them is the simplicity of selling it to the public, which is ready for and even demanding comprehensive, straighforward universal healthcare.

Clinton et al always try to find the Third Way: appease the donors and business community (and rake in the campaign donations) while giving the voters part of what they want. It won’t work this time. There is too much at stake, and too much has already been lost. And they will lose the business community with a plan that puts the burden back on employers.

It’s time for a New Deal solution to this 21st century economic crisis.

Illustration courtesy of Mr. Fish.