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By Robert Kuttner
Co-Founder and Co-Editor of The American Prospect

I’m sure I’m not the only reader who noticed the juxtaposition of two front page stories in Sunday’s New York Times dealing with health care. The first article cited a new Times-CBS poll showing that 72 percent of Americans favored a government run health plan comparable to Medicare, which would be available to everyone.

The second reported on a rogue radiologist at a Philadelphia VA hospital who botched 92 prostate procedures.

The right will doubtless go to town on that one, as what we can expect of government-sponsored medicine. I’ll have more to say about the VA in a moment, but first let’s consider the poll findings.

The poll is relevant because Congress will soon decide whether to include the so-called “public option” in the Obama health reform bill. As drafted by three House leaders and unveiled last Wednesday, the 852-page bill would include a government-sponsored, Medicare-like public plan.

Republicans and the health industry have been kicking and screaming that this is socialistic. But the poll suggests that defenders of the public plan have nothing to fear politically, and that Republicans are in danger of getting on the wrong side of a popular issue.

However, that’s only the beginning of the story. The reform package, as drafted by the Obama administration and the House leadership, is dubious legislation even with the inclusion of a public option. Basically, it leaves the two worst aspects of the system intact. First, private insurers will continue to dominate. Second, most people will continue to get their insurance through their employers. Given these two bedrock realities, there is no way that the bill can make serious inroads on cost without cutting back on care. The high cost of the approach is already causing key legislators to back off. The current system wastes huge sums, but because it is so fragmented the money flows to profit opportunities and not to the most cost-effective forms of health care.

Also, as my American Prospect colleague Paul Starr warns, a mixed system with a public option effectively invites the most expensive and hard-to-treat people to opt for the public plan, while private insurers will seek to insure the young and the healthy. This is a familiar problem known as adverse selection. The private insurers will then smugly point out that the public plan is less “efficient,” when in fact it simply will have a more costly population. The only way to avoid this problem is to have everyone in the same universal plan–what’s otherwise known as a single-payer plan.

The public option is a not-very-good second best–because our leading liberal politicians lack the nerve to embrace the one reform that simultaneously solves the problem of cost, quality, and universal inclusion. The policy that dare not speak its name is of course comprehensive national health insurance, or Medicare-for-All. I try to avoid using the term “single payer,” because a technical, policy-wonk phrase not understood by most civilians has become insider shorthand for national health insurance. Let’s call the thing by its rightful name. Medicare-for-All is something regular people understand.

The Times-CBS poll is evidence that this is what more than two Americans in three really want. Most voters have not followed the nuances of how the public option in the Obama plan would compete with private insurance. The poll simply indicates that voters want access to a straight-up, Medicare-style plan to be available to one and all. In past polls, when Times-CBS pollsters ask whether people favor national health insurance, responses generally favor Medicare-for-All by margins of about two-to-one.

In the current debate, liberals find themselves fighting to keep the public option alive, so that some form of efficient, publicly-run health insurance will stay in the mix–but knowing that it is embedded in a reform package that is far more costly and inefficient than it should have been. Instead of validating the common sense and reformist demands of ordinary Americans and identifying the insurance, drug, and corporate elites as the obstacles to real reform, too many of our liberal leaders from President Obama on down hope to co-opt business elites with a convoluted scheme that undermines the efficiencies of a comprehensive and universal system. And just wait until it gets watered down further in order to retain the support of these same elites. A plan that all of these groups would endorse would not be worth having.

So what’s the matter with our politicians? Why are the people so far ahead of their elected leaders on this one? One reason, as usual, is money. The combination of the insurance industry, the drug industry, the American Medical Association, the hospital lobby–all of whom oppose Medicare-for-All–represents a huge amount of political spending. It takes a brave politician to face down all of these industries, even though the people are on the side of real reform. The AMA’s position is especially shameful, since the professional societies that represent most actual physicians favor national health insurance.

The second reason that liberal politicians wimp out on single payer is that the self-styled realists in this debate have decided that Medicare-for-All, even if it’s the first-best system, is too hard politically. But think about it. Has the administration picked up one Republican vote by supporting the present system plus a public option? Hardly. The current House leadership bill, offering a mixed system, with a robust public option, a requirement that employers provide good insurance or pay a tax, and that insurers not discriminate against pre-existing conditions, is just as heavy a political lift as national health insurance–and far inferior policy. So why not just go for the first-best?

The advocates of Medicare-for-All have become something of an embarrassment to the liberals. The White House forum on health reform on March 5th, which boasted a diverse range of viewpoints, including representatives of the Business Roundtable, the health insurance industry, the drug lobby, as well as a broad spectrum of business, labor and Congressional leaders, left advocates of Medicare-for-All banging on the door. None were included, despite requests for invitations.

When Sen. Bernie Sanders recently arranged for five prominent advocates of national health insurance to have a courtesy meeting with Senate Finance Committee Chair Max Baucus, the story was newsworthy because the political elite usually pretends that this viewpoint doesn’t exist, much less that it represents the desires of two Americans in three. The mainstream media have also colluded in the general effort to keep the single-payer option out of the limelight. The organization FAIR recently published an important study in its heroic magazine, “Extra”, titled “Media Blackout on Single-Payer Healthcare.”

Indeed, the Sunday New York Times-CBS poll didn’t even offer Medicare-for-All as a free-standing option. It took the Obama position as the left edge of the debate.

As for that rogue doctor at the Philadelphia veterans’ hospital, quality control is not what it should be throughout our fragmented system. And the oases of public medicine are particularly starved for resources. Yet studies consistently find that on average, the VA does more with less than its private sector competitors. Phil Longman has written the definitive book on the subject, “Best Care Anywhere.” Here is a summary.

In this case, the offending radiologist, Dr. Gary D. Kao, was actually a contract employee and not a VA physician.

Only by having a comprehensive system can we marry quality, cost-effective care, and universal access. One of these days, a national leader will have the nerve to embrace national health insurance and fight for it. Until then, we will keep paying more money for less care, and liberals will defend reforms they themselves scarcely believe in.

***

Robert Kuttner is co-editor of The American Prospect, and senior fellow at Demos. His recent book is “Obama’s Challenge“.

By Robert L. Borosage
Co-Director of the Campaign for America’s Future

The administration has rolled out its financial reform plan, which the president accurately calls the “the boldest set of reforms in financial regulation in 75 years.”

Rep. Barney Frank, the chair of the House Banking Committee, promises to act rapidly, hoping to pass reforms by the end of the year. Best to move now while the banks are weak, goes the argument, than try to take them on when they are back on their feet.

The banking lobby has reacted like wasps whose hive has been hit by a stick, swarming out to fend off the threat. First target of their sting is the proposed Consumer Financial Protection Agency, designed to defend consumers from the serial abuses of credit card companies, payday lenders, mortgage brokers and the like. Ed Yingling, president of the American Bankers Association, decries even the idea of the agency, saying banks are “dumbfounded” by its scope, suggesting that it would “blow up the system”

This assault on the consumer agency reveals how much the banking lobby has already won. Most notable about the administration’s plan is what was left out. Nothing real is done about compensation schemes. Exotic derivatives and credit default swaps are not banned. Rating agencies are still paid by the financial houses they are supposed to rate. Banks too big to fail are to be monitored, not broken up. Oversight of the system is entrusted to the Federal Reserve, which was designed to insulate money center banks from the democracy. No mention is made of a tax on securities transactions that would both put a damper on excessive speculation and raise a ton of money to help repay some of the staggering costs of the crisis the speculators caused.

Sadly, the whole notion of urgency is based on the false assumption that the banks are weak since they are on the public dole. But, as we’ve seen over the past months, the banks, even on life support, have big time clout in Washington. They blocked the effort to give bankruptcy judges the right to renegotiate mortgages of distressed families. They torpedoed legislation to put a lid on credit card interest rates. “It’s hard to believe,” Senator Dick Durbin said in frustration, but the banks are “still the most powerful lobby on Capitol Hill. And they frankly own the place.”

So what can alter the balance of forces in Washington?

We have one lesson from history: the Pecora Commission in the New Deal. Ferdinand Pecora, the fearless chief counsel of the Senate Banking Committee, led hearings that dragged the barons of Wall Street before a riveted public, exposing their insider dealings, their ponzi schemes, and their excesses. By the time he was done, Time Magazine was calling them banksters, the public was demanding reform, and Congress located its backbone and enacted the Securities Exchange Act, the Glass Steagall Act and much more. (For a good summary see Kate Phillips piece here).

These real reforms helped the US escape the cycle of financial crises that previously had convulsed the economy about every ten years. It was only when these protections were dismantled from Reagan on that the bankers once more became “masters of the universe,” and replayed the sorry saga of casino and crash.

Modern day Pecora hearings are waiting to happen. Led by Speaker Nancy Pelosi, the Congress passed legislation setting up a Financial Crisis Commission with subpoena power and the mandate to probe and exposed the roots of the current crisis. Senate leader Harry Reid and Pelosi each have the power to name three commissioners, with the Republican leaders of the House and Senate naming two each. Pelosi and Reid name the chair.

With strong and independent leadership — say if it were chaired by Elizabeth Warren, the brilliant Harvard Law Professor who has chaired the Congressional Accountability Panel that helped expose the follies of the bank bailout — the Commission could transform the debate in Washington.

It could hold hearings in the epicenters of the housing crisis, exposing the systematic fraud practiced by lenders like Countrywide and fostered by the banks that bought up the mortgages. It could expose how the banks and rating agencies colluded to transform garbage NINJA (no income, no job, no assets) mortgages into triple A securities. It could subpoena the barons to show how they profited personally and turned their eyes as the banks took ever greater risks, gambling with ever higher levels of borrowed money. It could make the case for adult supervision.

Americans are eager for this. Pollster Celinda Lake found that 71 percent of voters want Congress to hold investigations into the “events leading up to the Wall Street financial crisis.” We want to know who caused this mess, who made out like bandits, who brought down the house. Public hearings would gain national attention. Leads winnowed out by the Commission would be pursued by muckrakers and bloggers. Congressional committees would be stirred from their lethargy. Time magazine would start talking about banksters again. Then real reform might be possible.

It is now up to Pelosi and Reid. The law was passed weeks ago. They have the power. They can choose to name aggressive and independent commissioners or to turn the commission into a pro forma review that creates a report for the shelves a year from now.

The banking lobby is no doubt pushing hard to neuter the commission. And here we see another cost of the Geithner decision to subsidize the banks rather than reorganize them. If his plan fails, we’ll be like Japan with the recovery burdened by zombie plans. If the plan works, we’ll end up with the banks “too big to fail.” And while we’re deciding whether it works or not – as we are now — there’s immense pressure not to “undermine confidence.” The banks are given stress tests and allowed to pass by cooking their books (not marking their toxic assets to market). The Treasury Secretary announces that they are “healing.” They trumpet independence by repaying billions to the Treasury, even while they are still mainlining a range of subsidies from Federal Reserve. That same pressure makes Geithner and Summers unlikely allies of a strong, independent and public investigation (to say nothing of Summers’ involvement in the deregulatory follies of the 1990s).

But Reid and Pelosi have a significant stake in creating a hard-hitting commission. Politically, Democrats need to hold the Wall Street barons accountable, not just bail them out. Americans are furious at the hundreds of billions that are going to save the richest people in America while workers lose their jobs. As the party of “no,” Republicans are being taught by Newt Gingrich on how to disingenuously disavow any responsibility and posture as fake populists. Democrats need to show that they are not in the pocket of the Wall Street.

Moreover, this isn’t just about politics. Fundamental financial reform is essential to the future of the economy and the country. President Obama is correct when he says we can’t go back to an economy where finance captures 40% of the profits of the country. He’s right when he condemns a culture of “arrogance and greed” that can’t be tolerated.

If we don’t get comprehensive reforms now, we’ll have created an even greater peril — banks and hedge funds officially recognized as too big to fail, assuming that they can pocket their winnings and the public will cover their losses. That is a recipe for another crackup a few years from now, as avarice once more clouds memory.

Will we get a modern day Pecora? Harry Reid and Nancy Pelosi have the power. They could appoint truly independent commissioners, give them the budget to gear up, and the mandate to tell the people. It’s time for them to step up.

QUESTION:  “The U.S. House and Senate are completing drafts of health care reform legislation. President Barack Obama has said he wants Congress to pass the legislation so he can sign it this fall. What do you believe must be included in that legislation to resolve the health insurance crisis in the U.S.?”

Real Public Option; Choice

The most attractive and beneficial, for the society as a whole, would be the single-pay system that is standard in most of the industrial nations of Europe. The reality, of course, is that Obama himself has already ruled this out as undoable given the historical and political conditions that prevail in the US today.

Having passed on that, the irreducible minimum the American people should insist upon is a public option alternative to the current system that will, in a short time, implode like the so-called free-enterprise system did beginning in 2008. The current system excludes some 45 million who have no health insurance at all. The cost of the current system runs about $2 trillion a year and provides less health care and protection than any of the health systems in Western Europe, Australia and New Zealand, for example. We can only expect the costs to rise and the service in general to deteriorate over the next 5 years.

Obama must see that the public option is on the table and that he holds the feet of the Democrats in Congress to the fire—they either support a public option or they can expect nothing from his office by way of support down the line. The opposition to a public option is entrenched and powerful—Big Pharma, the insurance industry, Rightwing bloggers like Rush, Hannity, O’Reilly, the GOP and the newpaper czar Rupert Murdoch, and people of his ilk.

Obama and the Americam people must see to the creation of an authentic public option. One that allows for a real choice in medical programs.

Dr. Gerald D. McKnight
Frederick, Md.

Disconnect Insurance from Employment

1) Health Insurance should not be tied to employment.

In our society, we expect employees to be fungible. They have to be able to go from job to job as needed. We do not expect employers to be loyal to their employees. If a company has to cut costs, employees are the first to go. Older employees that can be replaced with younger, cheaper employees are a common target for termination.

Having health insurance tied to employment results in people being uninsured when they least can afford insurance. It also creates a problem for older people and people with pre-existing conditions who are terminated. Employers don’t want to hire older individuals or individuals with pre-existing conditions and insurance companies don’t want to insure them.

Having health insurance tied to employment also gives US companies a disadvantage against foreign companies who don’t have to pay for health insurance.

2) Insurers can’t be allowed to avoid individuals with medical conditions and must pay all health costs.

Two-thirds of health care costs in the U.S. are paid for through Medicare and Medicaid. Private insurers are making their money by insuring individuals who need health care the least.

Sixty-one percent of bankruptcies are a result of medical bills. Three-quarters of that 61% of bankruptcies had health insurance. No one should have to pay for health insurance that doesn’t pay all the costs and won’t keep you out of bankruptcy.

3) We need universal health care to avoid the costs of sales commissions and exorbitant executive pay.

James K. McCabe
McCabe & McCabe, Ltd.
Brookfield, Ill.

Health is in the Nation’s Interest

The most important item to include in any health reform legislation is single payer.  For too long private insurers have controlled individual access to health care, which I see as a right, not a privilege; that should not be controlled by corporations.  Millions have no health coverage at all, and thousands lose theirs every day by losing their jobs in this recession.  Does anyone ever ask why health care should be tied to employment?  Consider that a healthy society is also in the nation’s interests, not only the individual’s.

Private insurers routinely deny care for so-called “pre-existing conditions,” even those only marginally related to a current illness, and they too often deny life-saving procedures.  They raise premiums unconscionably when their insured become sick and try to use the medical benefits for which they have been paying all along.  And they do it in the name of profit!  Why does profit control an individual’s health care?

Further, why don’t private insurers cover more preventive care?  Money would be saved in the long run, not to mention how much improved patient outcomes would be.  But CEOs get credit for short-term profits earned during their tenure, not long-term profits, regardless of the impact on patients.

As an employee, I was covered by private insurance and have witnessed such problems all too often.  Government programs don’t require profit, and I’m hoping we won’t be “Harry and Louise’d” out of single payer.  I have also been covered by military medical care and Medicare, both government-run programs, and have never had a bureaucrat get between me and my doctors.  But private insurers intervene in a doctor’s care every day of the week to control their costs and ensure a profit.  In a word, it’s sickening!  Private insurers need some competition to keep them in check.

Americans are unhealthy, live shorter lives and have a higher rate of infant mortality, and we pay far more for our health care than Europeans, who suffer no loss of the individual liberties we have.  In fact, their freedom is enhanced by the “portability” of their single-payer health care, independent of their employment.

The insurance companies are, shall I say, “deathly” afraid of single payer, and they will fight it.  We must fight back by holding our elected representatives accountable.  Senator Durbin said the banks own the Senate, but we should be suspicious of the insurance and pharmaceutical companies also owning it twice over.

Gloria Aukland,
Mesa, Ariz.

Appalling to Exclude Single-payer

My opinion is that we in this country desperately need a health plan like the single-payer plan which has been working for years in most of Europe and Canada. It is outrageous that this plan is not ”on the table” with the 15 other plans in Congress.

The “consumer co-op compromise” that the Senate is discussing at present only serves to kill the full public health insurance option.

For so long, the nation has been strongly influenced by both the insurance companies and the pharmaceutical companies. They have lied to us about what can happen under a single-payer plan, claiming it will mean we can’t choose our own doctors and will have to wait for long periods of time to get any medical help. This seems to be nonsense.  I have talked with many people in England and in Canada who say it is not true. They are very grateful for their socialized health plans and feel very sorry for us in the U.S. with the situation we are in.

If people are frightened by “socialized” programs, they might think again about our socialized libraries, socialized schools for our children, socialized parks across the country, our socialized Medicare program for those with disabilities and the elderly,  etc., etc. We need a plan, such as single-payer, which will cover the millions who have nothing and live in dread of being ill.  Those who can afford to pay and are happy with paying insurance companies, can continue on that road.

We also need to change the use of money that special interests and lobbyists use to “pay off” our Congress people. This is disgraceful.

Dallas Cline
St. Johnsbury, Vt.

Let Us Care for Each Other

Our way of seeking health care as a system should be the same as our conception of firefighting.  Although the days of bucket brigades (in which everyone in the community carried water to put out a fire) are gone, and firefighting is now done by professionals hired for the job, the responsibility for providing a system to fight fires still must be shouldered by every able member of the community.  And the benefits of the system are shared by everyone equally, regardless of taxpaying status.

So should it be with our medical needs.  We should provide for each other, through our representative government, everything we need in the way of health care.  Nothing should be left out except elective procedures such as cosmetic surgery not required by a disfiguring accident.  The fact that we have the ability to do this and yet must debate whether we should do this shows what fools we are.  Let us be wise, and say, “First we must pay for this, our health care, then we can allow our military to purchase hammers at a price of $750 per and nails for a dollar apiece if that is our pleasure.”

Aron Laub
Law Office of Aron Laub
Woodland Hills, Calif.

Public Option Essential

Legislation must include a public option, completely handled by the government. This option must include full ability to negotiate prices and services. Any bill that does not contain this provision will not fix the problem. The proposed comprises are either plans that will put more money in the insurance companies’ pockets or plans that will neither reduce costs nor provide affordable health care for everyone. It is time for our president and our Congress to decide whether they want a solution that will serve the American people or a bill that will continue to enrich the insurance companies. I have two children facing a world where they will either not have health insurance or will have to pay a huge premium for a bare-bones plan that only covers catastrophic events. As a union officer, I would love to be able to not spend all our time negotiating on new contracts fighting about this issue. Think of the things we could accomplish in the areas of pensions and safety if we could just say, “Keep your plan, boss! The rank and file is going to take the public option!”

Kristjan Dye
Prudhoe Bay, Ala.

Care for All Now

Universal public single-payer health care coverage for every man, woman and child in the United States and its territories, now. The tyranny of actuarial tables and the completely unregulated accumulation of vast wealth based on statistical probabilities and clever investments has come to its inevitable greed-fueled implosion.

It should never have been acceptable to the American people to start with; had anyone ever put forth the proposition that a third of the people in our nation should go without health care so that a tiny sliver of the population could have private jets, no one would have agreed – but they never asked us.

Mark O’Brien
St. Paul, Minnesota

National Health Care System Needed

We don’t need health care reform any more than we needed welfare reform in 1994. We need a real health care system run by the government and financed with taxes like Medicare. We are the only industrialized country without national health care, yet we spend twice as much as other countries for half the care. Our money goes to profits for the medical industry rather than health care and prevention. Congress listens to paid lobbyists and takes major campaign funds from the medical industry. Then, it parrots their arguments to justify doing nothing.

Economic collapse has not changed our spendthrift ways. We spend our money on war, weapons, and corporate excess in the name of national security. The working class pays for these extravagances with both blood and money, and gets shafted in return. We must insist on our rights to health, housing, education, food, and energy. National security and public safety do not exist without them!

Some developing nations and third world countries have refused to cut programs that protect workers, retirees and children. To pay for their investments in the citizenry they are levying taxes on large corporations and the wealthy and eliminating programs that give tax breaks to private sector endeavors. The Scandinavian countries and Germany are also maintaining their social networks while reining in other expenses.

In the 60s, President Johnson was accused of buying guns and butter, without being able to afford both. Our 21^st Century government has decided to only buy guns: To hell with the butter! The truly sad thing is that the amount we spend on the military and weapons is far more then we would need to spend on domestic programs and does nothing to improve our standard of living

Carol R. Campbell
Keaau, Hawaii

Why Not Single-payer?

Why, oh why isn’t single-payer national health on the table? Why does the government insist on protecting and preserving the health insurance industry which contributes absolutely nothing to health care while adding to cost and interfering with health care delivery? OK, if Obama and the politicians can’t or won’t deliver single-payer, then there must at least be a strong, comprehensive public, government program as an alternative to the private insurers.

David Arnow
Brooklyn, N.Y.

Stop Talking, Start Covering

The only solid answer to the health-care mess in the United States is to stop all the gumming that’s going on and go full-speed ahead for a unified single-payer program that emulates Canada and provides coverage for all citizens.

The health-insurance and big pharma lobbies should be run over with a steamroller, so we can and eliminate the billions of funds wasted on the for-profit “insurance” schemes whose primary business is to find ways to deny payment for needed medical expenses. A tight leash must be placed around the pharmaceutical industry’s neck to ban those “ask your doctor” advertisements, and drug prices should be negotiated, as they are in Canada, by a single-payer government program that spreads the medical risks by covering everyone, no exceptions, no problem with “pre-existing conditions.”

This is not socialism. This is to acknowledge that health care is as much as right as public education and police and fire protection in a civilized society.

J. Tyler Resch
North Bennington, Vt.

No Exclusion for Illness

Since it looks they are not going to the single-payer, a must is waiver of pre-existing conditions, caps or schedule of payment for doctors, hospitals, etc.  An MRI cannot cost $2,000 in one place and the same test $5,000 elsewhere.  Preventive medicine and nutritional advice are also very important. That will reduce costs in the long run.

Lourdes C. Garcia
Simi Valley, Calif.

Single-payer System Needed

The USA needs strong single-payer health care.

Kathryn Wood
Bend, Ore

Call to Support Single-payer

Single-payer is the only option that meets the criteria that President Obama has set forth.

There is a single-payer bill before the House.  It is H.R. 676, sponsored by Rep. John Conyers.  It currently has 79 co-sponsors.  It needs 280 to pass.  Can you get your Representative to sign-on?

In the Senate there is S. 703.  The major problem is a Republican filibuster, meaning 60 instead of 51 votes are needed.  In addition, some of the Democrats in a position of authority, like Sen. Baucus, oppose it.  The great mass of ordinary people need to make their weight felt to overcome the overwhelming financial influence of the insurance companies.

Roger Mills
Stockbridge, Ga.

Cut the Paperwork

For reform to save money, it’s got to get doctors off piece work.  See http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande.

Bill Brown
Chapel Hill, N.C.

Easy Answer

Easy answer: We must make sure that the health care that we, the citizens, are paying for doesn’t go to an illegal population. Are we required to provide social services to the world?

John BuPoint
Pleasant, N.J.

Reform to Solve Debt Crisis

Health care reform should be passed in the fall to prepare America to solve its ever-burgeoning long-term debt crisis. However, such legislation must include a timetable of a priority agenda that sets it in motion only after recovery of the economy.

The fact is if we pass a national health care plan, it can actually lower the corporations’ costs of benefits to their employees and make American companies more cost effective against foreign companies that avoid such costs.

Any new health care legislation has to be planned for implementation over years and must be paid for by having a healthy economy restored before actual implementation. Such benefits cannot be paid for by debt but must be paid for in new ways to dream. This may include new taxes on fast food, soft drinks, corn and corn products, and carbohydrates that add to obesity and often cause health problems.

In closing, only unions working with corporations and professionals can make this happen and look out for families and people in need, and that is why Unions Matter!

Joe Janos
Aliquippa, Pa.

Care Same as Congress’

We should have the same health care as our elected representatives. Our president, senators and congress people have a single-payer system that meets everyday medical needs. If these representatives won’t provide the same for us, they should give up their health care.

Alvy L. King
Austin, Texax

Single-payer or Public Option

I am writing about health care reform because I believe strongly that we need single-payer health care, and I would urge its adoption. If not that, then we should certainly have a government-backed plan to compete with private insurers.

Philip Lichtenberg
Kennett Square, Pa.

Eliminate the Profit Motive

My opinion is that we should have a national health insurance plan with premiums paid to a government program similar to Medicare.  The premiums should be able to pay the providers a reasonable amount for the services provided, and the insured should be able to choose the providers that best serve them. We need to eliminate the profit motive.

William R. McDonald
Long Beach, Calif.

Eliminate Health Industry

Single-payer health care: Not some sort of coercive “national health insurance.” An effort to address the health care crisis in this country is not worth the spent political capital if it stops anywhere short of single-payer.  The point is not to reform the health insurance industry.  The point is to eliminate it!

Ric Vrana
TriMet Capital Project Planning
Portland, Ore.

Affordable Health Care for All

There must be affordable health care for everyone.  This protects hospitals and physicians as well as their patients.  Anything else is unthinkable.

Nancy Kay Kennedy
Belding, Michigan

Single-payer Best

Single-payer is best.  At the very least a public option is necessary.  Also there are tons of people not covered by Medicaid who have no money and no job.  These people need to be covered free.

Pay for the public option by a pay roll tax on those with incomes. Let people keep their private insurance (if they still want it) and allow for income tax deductions of all premiums and co-pays etc.

Pat Flierl
Fresno, Calif.

Eliminate the Bureaucrat

Get rid of the middle man, the bureaucrat. With the HMO, a patient needs to make an unnecessary visit to the primary care doctor to get an authorization for a specialist. I have a pimple or a boil or a cyst on the back of my neck. I have had this before when I had an old fashioned plan. I called the dermatologist, got an appointment within three days and went in; he looked at it, and said what needed to be done. The office visit and the time the doctor spent in doing the procedure was about 20 minutes, and problem was solved. (There was some wait time when the nurse injected the anesthetic and we waited for it to work.)

Now I need to call my primary care doctor for an appointment, wait a week get one, spend 45 minutes in her waiting room. Then she spends 3 1/2 minutes looking at my swollen bump. She records into her recorder or writes on my chart and instructs the receptionist to get an authorization and forward it to the dermatologist.

I can call him two days later. They have an answering system. But I’ll have to wait the rest of the afternoon for someone to call me back. They look for the authorization, find it, look for an open time, no not this week, next OK.

Time spent in this office waiting is 45 minutes. He looks at it. By now it is much worse. He says he needs to get authorization to deal with it. And it needs to be done in the hospital. So far 10 hours of accumulated doctor and staff time in doctors’ offices and at the bottleneck of the authorizer offices have been spent on ths. And I still have my painful THING. The system is broken.

Betty Winkler
Corona del Mar, Calif.

Tax Write-off for Health Care

Concerning health care, I oppose government control of this. With the shekels come the shackles. I favor letting all Americans take a 100% tax write-off for all health care expenses they occur, which are not covered by a health insurance plan they might have.

Lawrence K. Marsh
Gaithersburg, Md.

Erase Private Companies

I feel that until the private insurance companies are out of the picture, we don’t have a chance of any kind of fair health care for all.  They’ve effectively destroyed the health care system.

Sally Rosoff
Laguna Woods, Calif.

Diminish Role of Corporations

What we’re talking about as a nation isn’t health care reform, it is health finance reform, and we can’t have any significant reform to the way we finance health care in this country unless we diminish the role of insurance corporations in the delivery of health care. Single-payer is the goal.

Bill Anderson
Silver Spring, Md.

Reform a Sham

What needs to be included in legislation to resolve the health crisis in the U.S. has been excluded; a single-payer universal health care plan.  The current exercise in Congress is a sham and nothing will come of it.  To get health care providers to participate in drafting “reform health care legislation,” President Obama and Congressional leaders had to agree not to even consider a single-payer concept.

As a result, the very same health care executives who have made fortunes while ruining our health care system will dictate the “reform” plan.  The current charade will not improve our health care system or reduce its cost.  Only if and when labor and its allies finally realize that the bosses own both major parties, and they don’t give a damn about working families will we start down the long road to economic justice and health care for all.

Wake up brothers and sisters and cut the cord to sell-out politicians in both major parties, or our children and grandchildren will be stuck in minimum wage jobs and no health care coverage.  We need our own party.

Jan Pierce
Quaker City, Ohio

Single-payer Will Control Costs

In my opinion, a single-payer public option must be included in any meaningful health care reform legislation. A single-payer/public plan is the only way to control costs and provide the competition that the private medical industry needs to bring down its predatory cost structure. This will provide a tremendous saving for American citizens, business, and society at large.

James G. Fordham
Coburn, Pa.

Health Care a Moral Right

A single-payer plan, such as in Canada, or a public plan, must be included. Health care should be a moral right, not a “for profit business.”

The evidence that this is true is in that I know people who have been bankrupted by the cost of caring for a loved one with an unexpected medical condition.

Marty Honig
Arvada, Colo.

Control the Costs!

Debate rages over the virtues of private vs. public health care and vice-versa, but the one issue left uncontrolled by current private and public plans (Medicaid, Medicare, and private insurers) is runaway health services inflation. Bring the rate of (health services) price increase in line with that of the overall consumer price index and the other problems will become much easier to fix. I am listening but am not yet convinced that any of the changes being proposed are going to reign in the inflation.

Extend Medicare to All

I think the most important component of any health care reform effort is to include single-payer as an option. Single-payer is the most efficient way to deliver health care in that it cuts out the obscene profits going to health insurance CEOs. The money saved by taking out the profit motive would probably be enough to pay for the 50 million who are uninsured. Instead of wasting a lot of time with trying to make the lobbyists happy, Congress ought to just pass the bill currently before it that extends Medicare to every American.

Dan Zurosky
Lexington, S.C.

Single-payer Way To Go

Single-payer appears the way to go, but a public option is an alternative more acceptable to the lobbyists that run this country.

Jonathan Macy
Boston MA

Government-run Quality Care

There is really just one major reform required – provide an option that doesn’t involve private insurance.  To see the reason why, you merely must consider what the insurance industry extracts from the health care dollar (advertising, CEO bonuses, commissions, salaries, contributions to legislators designed to discourage real change, enormous amounts of paperwork, filing, storage of records, efforts to coordinate benefits, and presently efforts to exclude patients, limit coverage, question doctors’ medical decisions about optimum treatment plans, and lawsuits to contest costly adverse – from their  perspective – decisions of doctors, patients, and hospitals) compared to what the industry contributes to health care – nothing, zilch!

Those who like the current system should be able to continue in it.  Let the insurance bureaucrats decide what procedures are available, restrict coverage, determine the dollars that are paid for all of the activities mentioned above for those who are pleased with the present system.  But we must have a government-run option.  This is the only way to get a handle on what quality care should cost and make it available to all who want it.

Frank Stewart
Windsor, Conn.

Universal Public Coverage

Health care reform must include: Universal public coverage of inpatient and outpatient care to preserve and restore function and comfort. Included must be:

• prescription drugs
• acupuncture and chiropractic treatment
• eye care
• dentistry

Utilization and prioritization should be determined by doctors on the basis of patients’ needs, not by cost accountants.

Income taxes should be graduated up to the level prevailing in the 1950′s to fund health care.

Limits such as the Medicare limit imposed on hospital days per lifetime for the treatment of mental illness should be removed.

June Forbes
Davis, Calif.

Replace Fragmented System

There already is a health care bill in Congress. It’s Sen. Conyer’s H.R. 676, the U.S. National Health Insurance Act, which has more than 70 co-sponsors. It is universal, affordable health insurance. It allows portability if someone is unemployed or changes jobs. Because everyone is covered, it spreads the risk, so the cost per person is reasonable and no one entity is stuck with the cost of coverage of only the oldest and sickest, as Medicare is now.

By removing the financial burden on employers, it allows them to compete with companies the rest of the industrialized world. Because it is single-payer, not for-profit, it diverts the more than 30 percent now going to enrich private insurance corporations, to doctors, nurses and hospitals who provide actual health care. It replaces our fragmented, dysfunctional system with one that works and will go a long way in boosting our financial health as well.

Elizabeth Sheppard
Longview, Wash.

Health Care for All

Health care for all!  Single-payer deserves our support.  I have a “government” health care plan.  I thought it wasn’t that good until I found out what others cost and what they (don’t) offer.  I stopped my complaints–fast.

All the Senators and Congressmen making a big fuss over how lousy a government plan will be also have a government-run health plan.  I don’t hear any of them telling us about how they have rejected the government plans and buy their health care on the “open market.”

On the other hand, they say that the private sector will not be able to compete with a government plan.  Make up your mind folks–either it is lousy or it will attract so many people making a choice to join the government plan that the privates will not be able to compete.

Renee Toback
Yonkers, NY

Health Care as Human Right

The only health care plan that would guarantee health care for all as a human right rather
than as a means of profiteering off others’ misery would be a single-payer health plan like most industrial countries and even some undeveloped ones have. Shame on us for allowing this disastrous state of affairs to flourish!

Paul Bennett
New York, N.Y.

Three Elements Crucial

Whatever comes from the Congress on reforming health care must contain three elements. First, every single person in the United States is covered. Opting anyone out means the rest of us pay for them. If it’s paid by taxes, individuals, employers or whatever, covering everyone is essential. Covering the poor can be the obligation of society. Second, the billing system for payment needs to be on one form. When a patient walks through the door, the health care provider knows who to bill and how much. Third, all drugs must be provided at a price negotiated for the nation as a whole. Prescriptions must be paid for by the insurance carrier.

If the for-profit insurance companies can compete on this basis-good for them. If not, good-bye. Health care providers need not check with anyone prior to treating a patient except for elective care. The definition of elective care is anything not listed as essential to the health of the patient and strictly regulated. Any insurance company will have 60 days to pay claims in full.

Harold Abbe
Camas, Wash.

Three Critical Components

Three things are critical:

Group health insurance must be eliminated.  This will eliminate the very real incentive to discriminate in hiring based on age, since average group age is a well established factor in establishing group rates.  It would allow consumers to “shop” for the best insurance perhaps using money directly paid by employers.

Hospitals receiving any federal funding must accept all government-approved insurances not just cozy deals with favorite insurers.  AARP (Aetna) health insurance, and other major alternatives, are not accepted at a local major hospital effectively driving older, cost conscious citizens, to the independent hospitals; good for their death statistics, good for their grants, bad for older Americans who are thereby discriminated against.

The plan must allow patients to have a knowledge of the costs and effectiveness of treatment options and share in the cost savings of choosing the more economic and additional cost of the more expensive but potentially more effective.  The “free” (knowledgeable consumer) market will then result in improved average care at lower average cost; no other approach can achieve that goal.  As it is, the doctor who operates mainly in fear of attorneys and insurance companies, makes all decisions essentially without regard to cost. Give the doctor and patient a financially safe (known and predictable outcomes based on data) place to practice, knowledge of the facts, a significant financial stake in the decision, and market forces can do the rest.  The financial share should be income-based but never go to zero and never consume more than annual income.

David A. Crosbie
Pittsburgh, Pa.

Single-payer Cheaper

That’s Easy! Throw the whole bunch of them out and craft a new one. Actually, John Conyers, HR 676 is a good start. Comprehensive, publicly funded, privately delivered, single-payer health care for all. We need health care, not healthy insurance profits. If our legislators ever get around to doing the math, they will probably be able to balance the budget with the savings. If we quit waging war with the world, we could probably provide health care for everyone on the planet with the savings.

If businesses would do the math, they would save their companies enough money to hire more staff. If state legislators would do the math, they wouldn’t have to lay off teachers.

Those legislators who don’t like single-payer can go out and buy their own health insurance instead of having it paid with our tax dollars. I wonder if greedy would be considered a pre-condition.

Susan K. Baritell
Petaluma, Calif.

Only One Option

Universal single-payer is the only feasible option.

For-profit health insurance must be stopped.  People go bankrupt every day because of medical expenses even when they have insurance.  No other industrialized nation in the world has a system as messy as ours.

Doris Vician
Albuquerque, N.M.

Don’t Recycle Phony

President Obama’s health care “reform” plan is complete bunk.  All he is doing is recycling a bunch of phony window dressing made to look like “reform.” How sad.

What we need is simple:  Universal, single-payer health care in the US of A.  Anything else is just profit protection for some of the greediest, self interested corporations there are.

Michael J. Germain
Apple Valley, Minn.

Enhance Medicare

A public single-payer system is needed. Enhanced Medicare would eliminate the duplication and waste associated with private, for profit health care insurance. Excessive drug company, hospital and doctors’ profits can be reduced. Folks must maintain the right to select their health care providers. Providers will be paid by insurance premiums from employees and employers, and from asset taxes on the obscene wealth of the very wealthy collected by the U.S. government.  Increased taxes on tobacco, alcohol and gambling products will reduce consumption and help offset the costs and harm done to users.

Unions must unite and push for a public, single-payer health care system – an enhanced Medicare system that is as good as or better than what other western industrialized workers and citizens enjoy.

The U.S. needs good health care services at the cheapest price. Usual medical services provided by doctors, hospitals, drugs and other therapies must be included. Keep folks as healthy as possible. Improve workplace health and safety. Too many workers suffer from an unhealthy work environment; union health and safety committees can provide lists of harmful agents and dangerous work sites. Enable citizens to control their lives with end of life directives. Pay providers to keep citizens healthy; to reduce the incidence of injuries, accidents and illness.

Establish worksite and community wellness programs to encourage folks to live well; eat healthy, exercise, avoid unhealthy behaviors, lower stress to enjoy life.

Bill Weiss
Morganton, W.Va.

Easy – Single-payer

Health Care Reform  –  it’s easy: Single-payer, so that we can recoup the more than $300 billion the insurance industry sucks up in administrative costs and profits and apply it to pay for health care for all.

I prefer the French model but would be content to see Canada’s model here.

Frank Cannonito
Irvine, Calif.

Price Controls Essential

Price controls for insurance policies: I understand that some versions of the plan call for subsidizing low-income people so that they can buy health insurance.  That is well-meaning, but does nothing to stop the rise in costs; it merely transfers them, in some cases, to taxpayers, i.e. the government.  The people most responsible for spiraling costs in my opinion, the health-insurance corporations, will not be made to be accountable. That’s billions of dollars to keep rich people rich. It does nothing to enhance our health. I am a cancer survivor, and if I needed to buy a policy on the market today, it would cost more than my husband and I make together. Protection for people in those cases must precede any mandatory purchase plan.  We’d be bankrupt and homeless. That isn’t a unique situation.  Single-payer is obviously the way to go, but right now there’s too much opposition, well-compensated by the  health-insurance industry.

Preventive/health maintenance:  Costs less to keep people healthy than to intervene once they are very ill.  It’s obvious but not glamorous–or profitable.

Cut loose big pharma:  there are several good sources for information on how the drug companies manipulate, cheat, and fabricate ailments, and how they compare new (more expensive) drugs to placebos rather than to older, cheaper, usually less dangerous drugs.  At the very least, mandate that people don’t pay top dollar for their drugs.

Don’t let the religious-fanatic wing decide what services are offered:
reproductive-health issues are not negotiable. We are not Saudi Arabia; we do not have ayatollahs.  Science, not any religion, should be the basis for health decisions.  Let’s hang onto that great old Constitution!

Mary Lou Carter
Endicott, N.Y.

Competing Government Plan Needed

With respect to health care reform legislation: What must be included in that legislation to resolve the health insurance crisis in the U.S. is a provision for government health care insurance.  It may be necessary to tax health insurance benefits to pay for a government health care plan, but we will never get health care coverage for all U.S. citizens unless the government has a competing plan.  The insurance industry, the American Medical Association (AMA), a large majority of the medical workers who call themselves doctors, and big pharma have turned health care into a profit system that competes not on the basis of the quality of health care but solely on the basis of the profit motive.

Edward L. Osowski
LaGrange Park, Ill.

Best Care, Lowest Price – Single-payer

Fifteen thousand physicians have agreed that a single-payer, national health care system would provide the best care at the lowest price for all Americans. In California this proposal has been examined and passed the legislature twice, only to be vetoed by our insurance-loving governor. If we have a public insurance option, the insurance companies will reject all the sick people, who will then go for the option. Burdened by a primarily seriously ill group, the cost will rise. Universal health insurance will cover everyone, sick and healthy alike, thus spreading the pain and enabling the agency to bargain with the pharmaceutical companies and other health vendors.

No one should make a profit from the suffering of sick people, or drive the sick into bankruptcy.

Peter G Cohen
Santa Barbara, Calif.

Expand Medicare for All

As a participant in Medicare A and B (but not the prescription drug thing), I want to see Medicare continued and expanded so that all can participate.  But procedures need to be changed so that doctors are motivated to make decisions based solely on what is best for the patient and not on economic considerations.  For example, malpractice suits must be handled differently, and doctors must be discouraged from ordering marginally useful tests and doing unnecessary surgery.

Ella Brown
St. Louis, Mo,

In looking back on growing up, I always remember 1957 and 1958 at “the two good years,” They were the only years my working class redneck family ever caught a real break in their working lives, and that break came because of organized labor. After working as a farm hand, driving a hick town taxi part ti me, and a dozen catch as catchcan jobs, my father found himself owning a used semi-truck and hauling produce for a Teamster unionized trucking company called Blue Goose.

Daddy was making more money than he’d ever made in his life, about $4,000 a year. The median national household income at the time was $5,000, mostly thanks to America’s unions. After years of moving from one rented dump to another, we bought a modest home, ($8,000) and felt like we might at last be getting some traction in achieving the so-called “American Dream.” Yup, Daddy was doing pretty good for a backwoods boy who’d quit school in the sixth or seventh grade — he was never sure, which gives some idea how seriously the farm boy took his attendance at the one-room school we both attended in our lifetimes.

This was the golden age of both trucking and of unions. Thirty-five percent of American labor, 17 million working folks, were union members, and it was during this period the American middle class was created. The American middle class has never been as big as advertised, but if it means the middle third income-wise, then we actually had one at the time. But whatever it means, one third of working folks, the people who busted their asses day in and day out making the nation function, were living better than they ever had. Or at least had the opportunity to do so.

From the Depression through World War II the Teamsters Union became a powerful entity, and a popular one too because of such things as its pledge never to strike during the war or a national emergency. President Roosevelt even had a special designated liaison to the Teamsters. But power and money eventually drew the usual assortment of lizards, and by the mid-fifties the Teamsters Union had become one corrupt pile of s$&* at the top level. So rotten even the mob enjoyed a piece of the action. The membership, ordinary guys like my dad, was outraged and ashamed, but rendered powerless by the crooked union bosses in the big cities.

My old man was no great follower of the news or current events, but he tried to keep up with and understand Teamster developments. Which was impossible since his reading consisted of anti-union Southern newspapers, and the television coverage of Teamster criminality, including murders, and the ongoing courtroom trials.

All this left him conflicted. His Appalachian Christian upbringing defined the world in black and white, with no gray areas. Inside he felt he should not be even remotely connected with such vile things as the Teamsters were associated with. And he sometimes prayed for guidance in the matter. On the other hand, there was the pride and satisfaction in providing for his family in ways previously impossible. He’d built a reasonable working class security for those times and that place in West Virginia. Being a Teamster certainly made that possible. But for damned sure no one had handed it to him. He drove his guts out to get what he had.

There were rules, and log books and all the other crap that were supposed to assure drivers got enough rest, and ensure road safety and fairness for the truckers. Rural heartland drivers saw it for the bull it was, but it was much better paying bull. For a little guy hauling produce from Podunk USA  to the big cities, it still came down to heartburn, hemorrhoids, and longer hauls and longer hours than most driver’s falsified log books showed. And sometimes way too much Benzedrine, or “bennies.”

Bennies were a type of speed commonly used by truckers back then because of the grueling hauls. As a former doper who has done bennies, I can avow they are some gritty nerve jagging s$%*. Their only virtue is making you wide awake and jumpy, and after you’ve been awake on them a couple days, which many drivers were, crazier than a s&%*house rat.  Nearly every truck stop sold bennies under the counter. Once while hallucinating on bennies Daddy nearly wiped out a roadside joint. He recalled “layin’ on the jake brake, down shifting, and watching hundreds of the witches like in The Wizard of Oz come down out of the sky in the dark.” Somehow he got 30,000 pounds back onto the road while several folks inside the diner were pissing themselves in the window-side booths.

My daddy ran the eastern seaboard in a 12-wheeler — there were no 18 wheelers yet. It had polished chrome and bold letters that read, “BLUE GOOSE LINE”. Parked alongside our little asbestos sided house, I’d marvel at the magic of those bold words, the golden diamond and sturdy goose. And dream of someday “burning up Route 50″ like my dad.

Old U.S. Route 50 ran near the house and was the stuff of legend if your daddy happened to be a truck driver who sometimes took you with him on the shorter hauls: “OK boy, now scrunch down and look into the side mirror. I’m gonna turn the top of them side stacks red hot.” And he would pop the clutch and strike sparks on the anvil of the night, downshifting toward Pinkerton, Coolville and Hanging Rock. It never once occurred to me that his ebullience and our camaraderie might be due to a handful of bennies.

Yessir, Old 50 was a mighty thing, a howling black slash through the Blue Ridge Mountain fog. A place where famed and treacherous curves made widows and truck stops and cafes bloomed in the tractor trailers’ smoky wakes. A road map will tell you it eventually reaches Columbus and Saint Louis, places I imagined had floodlights raking the skies heralding the arrival of heroic Teamster truckers like my father. Guys who’d fought in Germany and Italy and the Solomon Islands and were still wearing their service caps these years later, but now pinned with the gold steering wheel of the Teamsters Union. Such are a working class boy’s dreams.

I have two parched photos from that time. One is of me and my brother and sister, ages ten, eight and six. We are standing in the front yard, three little redneck kids with bad haircuts squinting for some faint clue as to whether there was really a world out there, somewhere beyond West Virginia. The other photo is of my mother and the three of us on the porch of that house on route 50. On the day my father was slated to return from any given run we’d all stand on the porch listening for the sound of air brakes, the deep roar as he came down off the mountain. Each time my mother would step onto the porch blotting her lipstick, Betty Grable style hair rustling in the breeze, and say, “Stand close, your daddy’s home.”

And that was about as good as it ever got for our family. Daddy’s heart later gave way from a congenital defect and he lost everything. He was so scrupulously honest about debts he could never recover financially. Unable to borrow money, uneducated and weakened for life, he set to working in car washes and garages. After his union trucking days were over, we were assigned to the margins of America, a million miles from the American Dream, joining those people never seen on television, represented by no politician and never heard from in halls of power.

Now it was only a little house by the side of the road with not enough closets and ugly asbestos shingle siding. But it was ours, just like the truck and the chance to get ahead that it offered. And we had felt like we were some small part of America as it was advertised. All because of a union job during the heyday of unions in this nation.

It was also a period of Teamsters Union corruption, replete with criminal moguls such as Dave Beck, George Meany and Jimmy Hoffa. Yet the history of the few top lizards on the national rock of greed is not the history of the people.

If a few pricks and gangsters have occasionally seized power over the dignity of labor, countless more calculating, bloodless and malevolent pricks — the capitalist elites — have always held most of the card — which is why in 1886 railroad and financial baron Jay Gould could sneer, “I can always hire one half of the working class to kill the other half.” And why a speaker at the U.S. Business Conference Board in 1974 could arrogantly declare, “One man, one vote has undermined the power of business in all capitalist countries since World War II.”  And why that same year Business Week magazine said, “It will be a hard pill for many Americans to swallow — the idea of doing with less so that big business can have more. Nothing in modern economic history compares with the selling job that must now be done to make people accept this new reality.”

The new reality is here, and has been since 1973, the last year American workers made a wage gain in real dollars. Hell, it’s been here so long we accept it as part of America’s cultural furniture. Only about 12% of American workers are unionized and even with a supposedly union friendly Democratic Congress, unions are still fighting to exist (although government employees are unionized at 36%, because the Empire allows some leeway for its commissars ). In fact, things are worse than ever. Employers can now force employees to attend anti-union presentations during the workday, at captive audience meetings in which union supporters are forbidden to speak under threat of insubordination. Back in 1978 when I was working to organize the local newspaper, the management was not even allowed to speak to the workers on the matter until after the union vote results were in.

Then there’s President Obama, the guy soft headed liberals think is going to turn this dreadful scenario around. He talks a good game about unions, when he is forced to. But Obama is working on the things that will “create a legacy,” such as health care (which is simply a new way to pay the insurance industry’s blackmail) or the economy (by appointing the same damned people who fucked it up to fix it), and immigration reform, a nicely nebulous term that can mean whatever either side of the issue wants it to mean. Obama’s not going to publicly ignore the unions. But he’s not going to sink much political capital into this corporatized nation’s most radio-active issue either. For him, union legislation is just a distraction from the “legacy building” of a very charming, savvy, and ambitious politician. That is the assessment of Glenn Spencer of the U.S. Chamber of Commerce, one of the most anti-union institutions in America. (Many thanks to Washington writer Ken Silverstein for publishing Spencer’s astute observations).

Things are changing though. Union membership climbed 12 percent last year. Twelve percent of twelve percent ain’t s&$*, but at least it’s forward motion. At that rate it will only take us 21 years to get back to the 1956 level of union membership. We can expect no miracles, top union leaders are still among the Empire’s elites. And they are still technically accountable to whatever membership will still have jobs when the 2012 elections roll around. The least they could do is make it harder for Obama to lick off those millions of hard earned union support dollars from the top of the campaign contribution ice cream cone as he did in ’08.

But who can be sure? Because the new union elites and their minions are lawyers and marketing professionals. They’ve never come down off the mountain with both stacks red hot, or gathered on the porch of a crappy but new roadside bungalow, proud because they owned it, and stood up straight because, “Boys, your daddy is coming home.”

I’m not going into the current brouhaha about the Employee Free Choice Act (EFCA) or the “card check” bulls%&* here. Because what it’s gonna take to restore dignity to laboring America, ain’t gonna be more legislative wrangling. What it takes won’t be pretty, maybe not even legal in this new police state, and sure as hell won’t be “within the system.” Because the system is the problem.

So it will be up to us, just like it always has been … the writer, the Nicaraguan janitor, the forty year old family man forced to bag groceries at Walmart, the pizza delivery guy, the welder and the certified nurse … the long haul trucker and the short order cook. And they will snicker at us from their gilded roosts on Wall Street and Pennsylvania Avenue.

Some people are bound to get hurt in the necessary fight. In fact, people need to be willing to get hurt in the fight. That’s the way we once gained worker rights, and that’s the way we will get them back. The only way to get rid of the robbers’ roost is to burn the f*#$er down.

Anyone got a match?

***

For more of Joe Bageant’s thoughts, visit his web site: http://www.joebageant.com/joe/2009/06/worker-rights-no-balls-no-gains.html

Robert Borosage

By Robert L. Borosage
Co-Director of the Campaign for America’s Future

We’re headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many Senators are still standing in the way.

The reform includes a broad range of measures to extend and improve care and help curb rising costs, but the epicenter of the debate is over what is called the “public option.” Health care reform will mandate businesses provide insurance or pay into a general fund. Individuals will be responsible to get health insurance, with subsidies for those that can’t afford it. We’ll able to retain the insurance we have, or have the choice of a range of plans, including a public option, modeled after Medicare. A strong public option, competing with private insurance, is key to helping to get costs under control.

And costs must be brought under control. We now spend nearly 50% more on health care per capita than any other country, with mediocre results. We ration care by price, with some 47 million Americans uninsured. It costs the rest of us about $1000 a year to pay for the price of their care when they are forced finally to check themselves into emergency rooms.

Tell stories, not statistics, the pollsters tell us. But after adjusting for inflation, health care costs have soared by 58% since 2000; while wages for most Americans were stagnant or lost ground. As the auto companies showed, businesses increasingly can’t afford health care. Families find it unaffordable. Virtually the entire long term debt challenge facing the US government is from the projected rise of health care costs. Get health care costs under control, the US has no long term fiscal problem. Fail to get them under control, the costs will bankrupt the federal government, state governments, businesses that offer health care (and increasing numbers won’t) and families. Reform that gets costs under control is imperative. There is no choice.

A key to getting costs under control is the public plan. It can take advantage of its purchasing power to gain cost reductions. It can model best care practices. Private insurance — which in most localities translates into a couple of dominant providers that don’t compete on price — will be forced to measure up with greater efficiency, innovation, and cost savings techniques.

Yet the debate in the Senate has been fixated on how to weaken or abandon the public plan rather than strengthen it. Republicans, for the most part, have taken themselves out of the adult conversation. Like first generation robots, they endlessly repeat the exact same words crafted by Frank Luntz – “government takeover,” “no choice of doctor,” “bureaucrats not doctors prescribing medicine.” It’s frankly pathetic. We have no choice as a society but to figure out how to fix this – and Republican leaders have chosen simply to peddle lies and scare stories and absent themselves from any serious discussion.

A gaggle of Democratic Senators — led by Senator Baucus and the so-called “moderate” Senators — have publicly thrashed around for ways to weaken or gut the public option. Outside groups like the Third Way have provided guidelines for disemboweling it. Some have suggested putting it off until private insurance competition proves it can’t get costs under control — as if that hasn’t been proven over the last decades. Baucus suggested decentralized local “co-ops” would serve as the public option — an idea notable for being both unmanageable and ineffective. Even if a network of coops somehow arose to insure that people had an option, they wouldn’t have the clout to hold costs down and force private insurance to compete.

Others, remarkably, have detailed ways to deprive the public option of the power to lower costs. They call for a “level playing field” with private insurance. The public plan can’t be subsidized, can’t use its buying power to lower costs, can’t take advantage of lower administrative overhead.

This sounds silly. We face soaring health care costs that will literally cripple our future. Surely, no Senator concerned about the country would work to undermine the key idea that would help get a lid on costs. They wouldn’t, as Barack Obama warned, just “create a system where the insurance companies have more customers on Uncle Sam’s dime, but still fail to meet their responsibilities.” If you assume that, you would be wrong. They’ve done it repeatedly in the past.

For example, early in Bush’s first term, Republicans decided that passing a prescription drug benefit for seniors would help cement Karl Rove’s permanent majority. The benefit would help 41 million Americans with a soaring cost of care not yet covered by Medicare. It would also create massive new market for the drug companies. And, of course, Medicare could do what governments across the world do — use its buying power to lower the cost of the drugs.

Only, when Republicans passed the law — in the dead of night, twisting arms to get it done — it actually prohibited Medicare from negotiating a lower price for drugs. Don’t worry, they argued, competition would lower drug costs (even as they banned the import of cheaper drugs from Canada or Mexico).

Why? Well, using government muscle violated “free market” sensibilities. More importantly, the drug companies have one of the most powerful lobbies on Capitol Hill. Billy Tauzin, the chair of the key House committee ushering the bill through, left soon after to get a two million dollar a year job as a head of Big PhRMA, the drug company lobby. Tom Scully, the administration’s point person who helped secret the actual cost of the bill, was already negotiating his million dollar job as the debate was going on. In all, 15 congressional representatives, aides and administration officials involved in the debate left shortly thereafter to take jobs with the drug lobby. With a $9 billion increase in annual profits at stake, the drug industry got an amazing return on its investment.

Today, seniors pay 60% more for the same drugs than the price charged veterans becuse the Veteran’s Administration does negotiate lower prices.

Extreme? Not really. The health insurance companies decided they should be allowed to compete with Medicare in providing health insurance options to seniors. Seniors would get more choice; Medicare, the bureaucratic behemoth, would get agile competition. Win, win, they argued, calling the program “Medicare Advantage.”

Only the insurance companies couldn’t compete with Medicare straight up. So they demanded subsidies from the government to enable them to vie with the Medicare program they described as horrendously inefficient, unpopular and bureaucratic.

And they stand to pocket an estimated $177 billion in excess payments over 10 years to compete with Medicare – subsidies that Obama would sensibly cut to help pay for health care reform.

Money talks. Nine Republican Senators on the key Senate Finance Committee wrote President Obama to say they would oppose any reform with a public plan. The Center for Responsive Politics reports that the nine had had pocketed $17.7 million in contributions from insurance and health care interests over the course of their careers.. http://www.bio-medicine.org/medicine-news-1/Senators-Who-Signed-Letter-Opposing-Public-Health-Plan-Took–2417-7-Million-in-Campaign-Donations-from-Health-Care-and-Insurance-Industries-48233-1/

Not surprisingly, the 20 largest insurance and drug companies and their trade associations have pumped up their lobbying by 41% over last year — with reported spending over $75 million in the first quarter alone.

This is the corruption of crony capitalism; a compromised congress using taxpayer’s money to enrich entrenched interests. Only now, the cost of this in health care is not sustainable. Dramatic reform is vital or we all follow the auto companies and go belly up.

So if your Senator says he or she is opposed to a public option, or wants a weaker public option, or a non-profit co-op that isn’t big government, or prates about the “government takeover of health care,” about losing your choice of doctor, about bureaucrats not doctors prescribing medicine, don’t fall for it. Either he or she is either utterly clueless or more likely is representing the interests of the industry, not the voters.

This business as usual is no longer affordable or acceptable. We shouldn’t let cynicism lower our expectations. Soaring health care costs and the human tragedy of those without insurance can no longer be ignored. Reform can’t be postponed. It is a stunning disservice that Republicans have taken themselves out of serious discussion. And it is an open scandal that Senators are catering to the private insurance industry that has profited from the problem rather than helping to solve it. We must expect more and demand more from those given the privilege to represent us.

 

By Sen. Bernie Sanders
Independent U.S. Senator from Vermont

Let’s be clear. Our health care system is disintegrating. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11 – but this occurs every year.

In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on health care than any other nation – and health care costs continue to soar. At $2.4 trillion dollars, and 18 percent of our GDP, the skyrocketing cost of health care in this country is unsustainable both from a personal and macro-economic perspective.

At the individual level, the average American spends about $7,900 per year on health care. Despite that huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. From a business perspective, General Motors spends more on health care per automobile than on steel while small business owners are forced to divert hard-earned profits into health coverage for their employees – rather than new business investments. And, because of rising costs, many businesses are cutting back drastically on their level of health care coverage or are doing away with it entirely.

Further, despite the fact that we spend almost twice as much per person on health care as any other country, our health care outcomes lag behind many other nations. We get poor value for what we spend. According to the World Health Organization the United States ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventable deaths.

As the health care debate heats up in Washington, we as a nation have to answer two very fundamental questions. First, should all Americans be entitled to health care as a right and not a privilege – which is the way every other major country treats health care and the way we respond to such other basic needs as education, police and fire protection? Second, if we are to provide quality health care to all, how do we accomplish that in the most cost-effective way possible?

I think the answer to the first question is pretty clear, and one of the reasons that Barack Obama was elected president. Most Americans do believe that all of us should have health care coverage, and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way. In that regard, I think the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly-funded, single-payer Medicare for All approach.

Our current private health insurance system is the most costly, wasteful, complicated and bureaucratic in the world. Its function is not to provide quality health care for all, but to make huge profits for those who own the companies. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible (30 percent) of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for far less.

In recent years, while we have experienced an acute shortage of primary health care doctors as well as nurses and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the numbers of physicians. Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It’s not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion or Cigna CEO Edward Hanway who made more than $120 million in the last five years. The reality is that CEO compensation for the top seven health insurance companies now averages $14.2 million.

Moving toward a national health insurance program which provides cost-effective universal, comprehensive and quality health care for all will not be easy. The powerful special interests – the insurance companies, drug companies and medical equipment suppliers – will wage an all-out fight to make sure that we maintain the current system which enables them to make billions of dollars. In recent years they have spent hundreds of millions on lobbying, campaign contributions and advertising and, with unlimited resources, they will continue spending as much as they need.

But, at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Like the civil rights movement, the struggle for women’s rights and other grass-roots efforts, justice in this country is often delayed – but it will not be denied. We shall overcome!

 

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By Leo W. Gerard
International President

Republican Party Chairman Michael Steele appears to be suffering philosophical identity confusion, you know, like some people experience sexual identity confusion.

He’s got an organization named United STEELE Workers Union, white hardhat emblem and all, collecting members for him on Facebook. It had 255 worldwide as of June 19.

This is disconcerting on so many levels, least of which is that I head the original, authentic United Steelworkers Union (USW). It has, by the way, 1.2 million retired and active members in North America.

Far more importantly, Steele historically has expressed hostility toward unions. When President Obama agreed to help General Motors restructure in bankruptcy, for example, Steele said it was “another handout to the union cronies who helped bankroll his presidential campaign.” Now that there’s a union created in his own image, if Steele slams labor organizations, is he criticizing himself? Has he become a “union crony?”

Steele can perch that white hard hat atop his head, but he’s going to have to labor at learning some hard philosophical lessons before becoming a real steelworker, a true union man.

A union brother or sister knows it’s all for one and one for all. Our union brothers and sisters don’t see themselves as “ownership society” islands. That’s because they know when the sun stops shining, it’s nice to have union siblings to help clean up after the hurricane.

To join, Steele must learn that a union man has his brother’s back; he doesn’t stab him in the back. This may be a tough lesson for the Republican. Consider, for example, what Mark Bergeron, the STEELE Worker Union Facebook group administrator, says on his blog about the party’s 2008 nominee for president:

“How far to the left do we as Conservatives go to satisfy some of our Moderate ( Liberal ) Republicans? What sacrifices will we make to the Moderates? Abortion? Illegal Immiration [sic], a little more Socialism? Less Fiscal Responsibility? My point is that we have already made concessions to these softies and we got John McCain.”

In addition to insulting McCain, that smacks of exclusion. It is the Republican Party wringing itself out, shedding diversity at the insistence of its most conservative, self-appointed, over-amplified leader, Rush Limbaugh. So it has been reduced to little more than wealthy white protestant males — and wannabes. A union, by contrast, is a collective. By nature, then, it is inclusive. This may be a tough one for Steele to accept, considering he refused to stand up to Limbaugh earlier this year when the talk show host insisted he, not Steele, headed the Republican Party.

The STEELE Worker Union Facebook site says the group is interested in organizing. That’s a great first step in the correct direction. An important function of an international union, like the United Steelworkers, is to help employees at individual workplaces organize their local unions. Those efforts in recent years, however, have been thwarted by corporate campaigns of intimidation against union organizers and sympathizers. This is documented in a study called, “No Holds Barred: The Intensification of Employer Opposition to Organization,” released in May by Cornell University professor, Kate Bronfenbrenner.

Bronfenbrenner, who has researched labor issues for a quarter century, documents employers obstructing unionization by firing union organizers, threatening to close down the shop, cutting wages and benefits, and forcing workers to meet one-on-one with supervisors who interrogate them to determine whether they support the union. Bronfenbrenner found employers conducted these coercive tactics, many of which are illegal, in the run-up to union elections more frequently than in the past to dissuade workers from voting for unionization.

The upshot is that organizers and union sympathizers risk their livelihoods and corporations are increasingly killing unions. The Employee Free Choice Act now before Congress would significantly reduce that. It would allow workers — rather than the employer — to decide how to form the union. It would give workers the right to choose whether to form their union by collecting signatures from a majority of the workers or by conducting a secret ballot election. The threat-filled period before balloting could be eliminated, if the workers wanted.

The United Steelworkers union actively and vociferously supports the Employee Free Choice Act. If Michael Steele wants to be a real union man, he must do so as well. I will be waiting to hear from him. If I do, I will be glad to take him under my wing and mentor him. I will make him an Associate Member of the real United Steelworkers union. We will embrace him. Of course, I will warn my male members to be careful not to actually hug him because this is a guy, so touchy about unions, that he even used the word “crazy” to describe civil unions.

By Dean Baker
Co-Director, Center for Economic and Policy Research

The Obama administration is having a tough time getting its request for $108 billion for the IMF through Congress. Bank bailouts are rapidly losing popularity. And bailouts of foreign banks are probably even less popular than bailouts of U.S. banks.

But, NPR is rushing to the rescue. It had a piece this morning telling listeners that it was important to get the IMF more money to help the poor countries of the world. The piece never mentions the fact that the bulk of the IMF lending at present is going to East European countries, not the developing world.

The basic problem is simple. The West European bankers proved to be every bit as stupid as the Robert Rubin-Citigroup crew in dishing out loans. The main outlet for their bad loans was Eastern Europe, where they made enormous loans denominated in euros.

It is very difficult for the countries of Eastern Europe to maintain their exchange rates against the euro without large amounts of assistance. However, if they let their currencies fall against the euro, then the default rates on the loans from Western European banks will explode.

Of course West Europe is rich enough to bail out its own banks, but the governments in countries like France and Germany know that their people will not stand for this sort of handout. In steps the IMF, with a big assist from NPR, which managed to not even mention East Europe in the piece.

NPR made one major misrepresentation that is worth noting. It referred to a “global savings glut” which it attributes to developing countries’ fears that the IMF won’t have enough resources to bail them out in a crisis, and therefore their need to self-insure. WRONG!!!!!!

Developing countries only began to accumulate massive amounts of foreign exchange (i.e. savings) after the East Asian financial crisis in 1997. There was no talk at the time about the IMF not having enough money. Rather, the explicit motive of most of these countries was to accumulate enough reserves that they would never need to turn to the IMF for a bailout.

The conditions that the IMF imposed on the East Asian countries, who had previously been the superstars of the developing world, were seen as being so onerous that other countries wanted to make sure that they never were forced to turn to the IMF for help. Therefore they deliberately kept their exchange rates under-valued so that they would run huge trade surpluses, which let them rapidly build reserves.

In short, the IMF’s conduct was a major cause of the global imbalances that led to the current economic crisis. NPR turns history on its head in telling listeners that more support for the IMF is the solution.

By Stewart Acuff
Special Assistant to the President, AFL-CIO

On Saturday July 11th, national AFL-CIO Secretary-Treasurer Rich Trumka will join Steelworkers President Leo Gerard and hundreds of union and civil rights activists and faith leaders in a statewide caravan, march, rally and catfish fry in Arkansas to call for passage of the Employee Free Choice Act.

Union members and faith leaders will caravan from Texarkana, Fort Smith, Fayetteville, and Pine Bluff to Central High School in Little Rock. There at 12:30pm, they will be met by members of the Little Rock 9, and Arkansas union and faith leaders for a rally that will connect today’s campaign for workers rights and passage of the Employee Free Choice Act to our nation’s struggle for civil rights.

As Dr. Martin Luther King said, “Civil rights without silver rights are empty… It does no good to be able to eat at a lunch counter if you can’t afford to buy a hamburger.”

From Central High, Trumka and Gerard will lead a march to Senator Blanche Lincoln’s office for a rally to call for her to vote for the Employee Free Choice Act. Faith leaders, civil rights leaders, and elected leaders will join national union leaders to call on Senator Lincoln to lead the Arkansas congressional delegation to support the Employee Free Choice Act.

After the rally, the Steelworkers Union will host an old-fashioned Arkansas catfish fry.
The Steelworkers Union has just endorsed Rich Trumka for President of the AFL-CIO. Trumka is widely considered the successor to John Sweeney when Sweeney retires in September.

Never before in Arkansas history, have two of the most important national labor leaders led such a high profile march and rally in Little Rock.

Increasingly, faith leaders, civil rights leaders, and elected leaders have stepped up the call for the Arkansas congressional delegation to support the Employee Free Choice Act. The Arkansas Legislative Black Caucus and the Arkansas Democratic Party Black Caucus have passed resolutions of support for the Employee Free Choice Act.

Just two weeks ago, the Turn Around Arkansas coalition held a 24-hour vigil at Lincoln’s offices around the state and at the First Presbyterian Church in Little Rock, to call for Senator Lincoln’s support for the Employee Free Choice Act.

The Employee Free Choice Act has been endorsed by every major national civil rights organization including the NAACP and the Leadership Conference on Civil Rights.

In Arkansas, more and more significant elements of the Democratic Party coalition are joining the campaign to pass the Employee Free Choice Act. In Arkansas and across America, the campaign to pass the Employee Free Choice Act is the largest grassroots legislative campaign in the history of the American labor movement.

By Stewart Acuff
Special Assistant to the President, AFL-CIO

After trillions of dollars in federal spending to lift our economy out of the greatest economic crisis in 75 years, we now know that besides financial deregulation and insatiable greed, the biggest cause of our crisis is 30 years of stagnant and declining wages. We also know that we cannot get out of this economic mess without increasing consumer demand.

Thirty years of stagnant and declining wages are the result of the systematic, intentional, strategic destruction of the freedom of American workers to form unions and bargain collectively. That is why we are working so hard to pass the Employee Free Choice Act.

But, corporate America did not erase these freedoms by itself. Radical right wing Republicans like those in Congress and the now disgraced Bush Administration did all they could to destroy collective bargaining.

They removed millions of workers from coverage of any labor laws including graduate workers at universities, misnamed and ill-defined supervisors, some disabled workers, and others.

But, it is in the federal government itself that the Bush Administration really concentrated on destroying collective bargaining. They destroyed collective bargaining for 160,000 workers at the Department of Homeland Security including 40,000 screeners in the Transportation Security Administration. They tried to destroy collective bargaining for almost a million workers in the Department of Defense. The American Federation of Government Employees (AFGE) and a coalition of AFL-CIO unions stopped the assault at the Department of Defense.

And AFGE has waged a remarkable creative, strategic and energetic campaign to give TSA workers collective bargaining and organizing freedoms. In the absence of collective bargaining AFGE has organized a union of TSA workers to demand and campaign for collective bargaining rights.

Now AFGE has introduced legislation called the Transportation Security Workforce Enhancement Act (HR 1881) to grant TSA workers the same collective bargaining rights and workforce protections as other federal workers and end TSA’s flawed personnel rules that have denied their workers thousands of dollars in increased wages.

It is critical that the Democratic Congress and the Obama Administration pass HR 1881 and reverse the Bush Administration’s assault on collective bargaining in the federal workforce.

It should be abundantly clear and obvious by now that unions and collective bargaining are not economic culprits but are essential to long term, sustainable economic well being.

Collective bargaining is by far the best, more efficient and cost effective way to increase consumer demand by allowing workers to negotiate a fair share of the fruits of their work and productivity. Collective bargaining is the only way to build, expand, strengthen, and deepen the American middle class. The destruction of collective bargaining freedoms is the reason we all feel the squeeze on the middle class.

And unions are the most effective counterweight to Corporate Power. The thirty years assault on workers and their unions are the major reason that Corporate Power is out of control in America.

The cozy relationship between the Radical Right wing Republican Party and Corporate Power brought us a war in Iraq and billions of dollars to Dick Cheney’s Halliburton Corporation and KBR in sole source military contracts, a deregulated financial services sector, insatiable corporate greed, a corrupt you’re on your own business and government ethos, the destruction of the notion of the common good, our deep, painful economic crisis, and the consequent loss of trillions of dollars of U.S. wealth.

At least in part change we can believe in, means changing where the nation’s wealth and bounty goes.

As 1000 business owners have shown, everyone benefits when working families have more to spend.