Wanted: Self Starters

I want to encourage you to go looking for events Organizing for America happening related to the health care reform push at http://www.broward4obama.com/myboevents

Just remember, if you do not see something going on in your area, there is no reason you can’t make something happen. You can organize your own event and post it to their calendar (and I encourage you to also cross-post to BlueBroward). You can find many of the informational resources you need to set up a canvass or petition drive right on the O for A website. Or you can contact the regional organizers to set up something a little more organized.

That contact information, if you need it, is:

Robyn C. Donaldson (Robby)

Regional Field Director- Broward & Palm Beach County
708-915-9385 / ofadonaldson@gmail.com
Organizing for America (OFA)
Democratic National Committee

If you lead a busy life and find it hard to make the time, I sympathize, and the truth is I’m not doing as much as my conscience would like, either. But if we all find a way to do something for the cause, we’re more likely to achieve it.

Opportunity Squandered: health reform which is not change I can believe in. Lose/lose for the Democrats.

As a solid single payer advocate and Obama supporter who contributed and worked hard for his election, I am disgusted with the health reform proposals coming out of Congress. No serious cost control, no limit on what can be charged for policies, no limit on copays or deductibles, subsidies would be needed for 100 million Americans in addition to those on Medicare and subsidies are inadequate. Would surely increase the deficit as all entitlements do. Very likely to fail, as all individual mandate programs at the state level have done : Washington, Oregon, Tennessee, Mass. twice, Illinois, Maine, Vermont, usually within 3 years due to cost overruns. These proposals were written with only industry lobbyists at the table and are a gift to industry. Millions of policies and pills to be sold and insurance industry licking its chops as long as public option not included. Industry spending 150 million in August alone for TV spots to promote. Dems are in lose/lose state here. If this passes, it will cost a bundle and go over budget and likely fail since there is no cost control (some elements like preexisting conditions and lifetime caps are good but will cause insurers to raise rates) then Dems will lose “tax and spend” and “gov’t can’t do anything right” etc. True reform which this is not, would be set back a decade. Horrible. Best to kill this gift to industry written by industry lobbyists ASAP then go back to the drawing table without lobbyists. Proposal is patterned after the Mass plan written by Blue Cross and now failing due to cost overruns. Sick.

“I Don’t Want Forced Insurance”: A Letter You Can Fax In Your Name Via The Health Justice Website

You can send a fax in three simple steps via the website of Health Justice. There are several subject lines to choose from in regards to health care reform, each taking a different angle and priority. In regards to David Carr’s latest post on the subject here on BlueBroward.org, here’s one of the letters on the Health Justice website at www.1payer.net that pretty succinctly addresses a counter argument to what David wrote:

Mr. President and Legislators,

You have enunciated two principles of health reform. Both are based on a flawed understanding of what Americans need and want. Clearly you have been sheltered for too long in Washington.

The first flawed principle is the mistaken belief that Americans want to “keep the plan they have.” Nothing could be farther from the truth. I have been insured and I most decidedly DO NOT WANT to keep the plan I have. The health insurance companies are middlemen that tack a 15% “handling fee” on top of everything. The insurance company tells my doctor how she can (and cannot) treat me. The insurance company haggles with my doctor and me over payment of bills. The insurance company denies care with even the flimsiest excuse. How can you possibly believe that Americans have any desire to keep any health insurance company in business?

Allied to this ludicrous notion that any American “likes” health insurance that makes every effort to fleece us is the equally ridiculous notion that the Massachusetts forced insurance model is working or can ever work. Open your eyes, Mr. Legislator. Forced insurance is failing the people of Massachusetts. They face the choice of $800/month premiums for completely inadequate health insurance or being criminalized for not paying this outrageous premium. What kind of choice is that? Are you prepared to criminalize the choice of 50 million people who cannot afford or don’t want to boost the profits of health insurance companies by buying egregiously expensive and totally inadequate insurance policies?

The only real solution is the one that you and everyone else knows is the real solution; you are apparently too afraid of the insurance industry to recognize it. The only real solution is Expanded and Improved Medicare For All, similar to what is proposed by HR 676. Have some courage. Become a leader. Vote for what is right, not for what is wrong.

Health Care Reform and the Right Compromise

The emotional state of grassroots advocates for health care reform is precarious right now, something like the period in which Obama was on his way to winning the nomination but looked like he might get there too wounded to win the general election, thanks to the Rev. Wright controversy and intramural fighting with the Clinton campaign. Obama sometimes dithered or suffered from self-inflicted wounds. Democrats were split and we wondered if they could be united in time to win the presidency.

Currently, some activists are afflicted with doubt about how much effort to put into working for the President’s agenda when we’re not sure quite what that is. Is the public option an “essential element,” or is it something he is willing to compromise away in search of Republican votes that will never materialize?

Those who think a single payer plan is the right choice, and this public option stuff is already too much of a compromise, are particularly incensed. They see the emergence of some bastard co-op plan that will really be a way of funneling money to the insurance companies.

But just this last week, there have been several news analysis stories saying that the Democrats are now ready to push through a plan on a party-line vote, given that the Republicans seem united in opposing any semi-serious plan, compromise or no compromise. This does open up the possibility of Democrats solidifying their own positions – provided, of course, that we can round up enough Democratic votes for the same plan.

The best spin I can put on all this is that Obama has merely been trying to avoid sounding dogmatic when he says he is open to compromise on the public option. In principle, there might be many ways of structuring a plan to compete with traditional health insurance companies. He articulated it that way in a conference call with bloggers a few weeks ago, as reported in the Daily Kos:

With the topic the public option, and the fact that the Senate Finance committee is still considering the coop model as an alternative, I asked whether there was a coop model that would be an acceptable substitute to his vision of a robust public plan. He [Obama] gave the well-informed, wonky answer I’d been hoping for. His advisers have been looking at the details the coop approach, and have yet to find a model that answers the problems that co-ops have in getting off the ground and growing quickly enough to compete at the level that will be necessary in a public option. His team is looking for the evidence that exists to show that a co-op could provide that competition, and if they can find it, it might be an option. He then reiterated his commitment to having a robust public option.

Since then, however, it’s true that he has made several statements about the public option being “only a small part” of the overall plan.

If he really does fold like a cheap map, expect serious consequences. To quote from another Daily Kos post:

If the White House does end up letting the public option disappear without a major fight, many of President Obama’s most ardent supporters, inspired by his “Yes we can” attitude, will withdraw from politics, their previous cynicism once again affirmed by a broken system.

I think it’s important for the grass roots to send a clear message that he was right the first time, and that the public option really is essential, that it’s the right compromise, a necessary compromise – but also the farthest we should go in search of compromise.

Why Reaching for Single Payer Would Be Over-Reaching

I highly recommend reading Atul Gawande’s essay in the New Yorker, “Getting There from Here: How should Obama reform health care?” A key passage from the introduction talks about the single payer idealists and their contempt for those who portray themselves as pragmatists and compromisers:

The country has this one chance, the idealist maintains, to sweep away our inhumane, wasteful patchwork system and replace it with something new and more rational. So we should prepare for a bold overhaul, just as every other Western democracy has. True reform requires transformation at a stroke. But is this really the way it has occurred in other countries? The answer is no. And the reality of how health reform has come about elsewhere is both surprising and instructive.

He goes on to describe how the more universal plans that exist in other industrialized nations are all different in their particulars, and all arose evolutionarily rather than revolutionarily. One important difference is that nations like the U.K. made the transition at the end of World War II, building on institutions that had been established during wartime. That was the road not taken in the U.S., which instead built employer-sponsored healthcare into a powerful institution.

Perhaps we could have made a different choice in the 1940s and been the better for it. But today health insurance is something like a $400 billion industry (combined revenues, according to a 2007 survey). UnitedHealth Group alone had revenue of $81 billion and employs more than 70,000 people. You say the profits are criminal, and the employees are all uncaring jerks? Hey, I’ve had to fight to get them to pay claims, and I have no love lost for them or any other health insurer I’ve had the misfortune to deal with. But the corporations who profit from the current system and the employees who work in it aren’t just going to fall on their swords for the good of the nation. The stockholders are pension funds and grandmothers, not just robber barons. Some of those employees are good people, trying to do their best within the system, who are also Moms and Dads and friends whom we would hate to see lose their jobs, if we only knew them.

So the revolutionary overhaul that would sweep all that away and replace it with a supersized incarnation of Medicare seems to me to be a fantasy. I’m not even convinced it would be an improvement. The people who think the government can never do anything right (and therefore we can never trust it with anything important) are wrong, but so is anyone who thinks the government can never screw anything up. Good intentions can and do go horribly wrong. There is also a substantial body of management theory on how to achieve systemic change that suggests “big bang” overhauls that try to change everything at once run a much higher risk of failure than processes built around incremental change.

So when Obama talked in one of his recent Town Hall meetings about believing that a shift from our current system to single payer would be “too disruptive,” he had me nodding along with him.

So what’s the right balance between a change that is too incremental and timid and one that’s too radical? The plan for a “public option” seems to me to strike about the right balance, particularly if combined with tighter regulation to prevent health insurers from cherry-picking the people they insure and inflating profits with non-payment of claims. If we can establish a publicly-sponsored plan that sets a baseline of acceptable coverage, and make insurers compete to show that what they offer is superior, then we ought to achieve a better result. I’m not expecting a perfect result, but I do want to see a significant improvement, with room for further improvements to follow.

As Paul Krugman recently pointed out in the New York Times, those who decry this as a step toward something like the U.K. health system are way off base. The most ambitious of the current plans would leave us with a hybrid system of public incentives and regulation over private insurance, more similar to what they wound up with in Switzerland:

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

We need a system that works and that is a significant advance over what we have now. There are necessary compromises required to achieve it. But we can’t compromise away the whole goal.

Surrender Reform Foes, or Be Destroyed!

I never thought I would compare Obama to Luke Skywalker, but after today’s Town Hall meeting I can’t resist.

“Return the Jedi” is my least favorite of the original Star Wars movies (though no worse than the more recent sequels). There’s a very silly sequence at the beginning where Luke and his friends seem to be loosing every fight and every attempt to escape from Jabba the Hutt. Our heroes are about to walk the plank and tumble into the maw of desert monster when Luke tells his captor, “This is your last chance Jabba…surrender…OR BE DESTROYED!” Jabba laughs, of course, but then it turns out R2-D2 is carrying Luke’s spare light sabre, and within minutes Luke has snatched victory from the maw of defeat.

Substitute Senate Minority Mitch McConnell for the alien mobster, and frothing-at-the-mouth wingnuts for Jabba’s sycophants. They may look like they’re winning, but they just don’t know what they are up against. Turns out Obama, our hero, has just been spotting them a few points to make the game more interesting.

I hope I’m right. Like a lot of people, I’ve been worrying that Obama and his administration are letting the chance of winning real reform slip away. But then I think about all the times over the year leading up to his election to the presidency when I thought he was losing. Times when Obama and Hillary Clinton were beating each other up and potentially creating openings for the Republicans in the process. Those dark days of the Jeremiah Wright controversy. Days when a few too many people interviewed on the news were expressing the belief that Obama was a Muslim, leading me to think he would be sunk by sheer stupidity. The aftermath of polls that showed the race very tight, tighter than it ever should have been, and pundits saying the support for Obama was actually weaker because of racist attitudes not necessarily captured by the polls.

Obama always showed an ability to make a comeback then. The Wright controversy was followed by a brilliant speech on race in America. Obama made peace with Hillary, and the supporters of the two weren’t as determined to tear their party apart as many Democrats feared at the time. The stupid people made the news, but the American electorate as a whole turned out not to be quite that stupid.

Ominous music swells in the background, all seems lost, and then comes hope and redemption.

I hope that’s what we’re seeing now, as Obama goes head on against absurd right wing talking points like “death panels” that are out to kill Grandma. I want to believe that all those dishonest tactics from the opposition will wind up making them look foolish, not make us feel foolish for ever believing in hope and change.

I found the Town Hall tremendously encouraging. Now, if Obama can just stay on message and keep making the case, without getting distracted by any more self-inflicted wounds that require a “beer summit” to put to rest.

That Luke Skywalker strategy is a little too stupid to work outside of a movie, and even that dunderhead Jedi probably wouldn’t try to pull it off twice.