BATTLE LINES FORMING OVER HEALTH CARE
By Mark Gruenberg
PAI Staff Writer
A PAI news analysis
NEW YORK (PAI)—With the Democratic-run 110th Congress set to open on Jan. 4 and with several top Democrats making clear health care will be part of the agenda, battle lines are already forming around competing plans.
And unionists, their families and their allies have an interest in the outcome, since if lawmakers undertake radical revision of the nation’s $2 trillion health care system, it could also determine the future of employer-based health insurance.
That insurance covers almost everyone. Exceptions include those on Medicaid, the elderly on Medicare and 47 million uninsured. But private health insurance has a high cost for workers: Large deductibles, increasing co-pays, at least 20 percent of its funds wasted on overhead, and insurers’ demands for hospitals to cut staffing and care.
Worst of all, the private insurers feature company bean-counters ordered to both pocket workers’ hard-earned money while denying coverage. That denial kills people.
The coming fight on health care has multiple sides:
• On one side is the private health insurance industry. Insurers and their allies—including the pharmaceutical companies that get a $140 billion windfall from GOP President George W. Bush’s prescription drugs law—will lobby for the status quo, and their own pockets, using advertising spin, outright lies, and huge campaign contributions.
• On another side is Bush. He and his business backers want to shove more of the health insurance costs onto workers. They claim, wrongly, that forcing workers to make decisions on how to spend their money on health care will induce “competition,” which will moderate prices. Health care inflation has been running in double digits yearly.
• On third side are the state of Massachusetts, Sen. Ron Wyden (D-Ore.), Service Employees President Andy Stern, Families USA President Ron Pollack and Safeway CEO Steve Burd. They espouse a plan, which Wyden crafted and which is similar to legislation passed and signed in the Bay State last year, which requires individuals to buy health insurance, just as they buy car insurance. Wyden plans to use his Senate Finance Committee seat—the panel handles health legislation—to push his plan.
Wyden claims individuals could pay for insurance because his “Healthy Americans Act” would require employers to take the money they now pay insurers to cover workers and instead give it to them as raises. Wyden’s bill does not say how it would guarantee that.
States would set minimum coverage standards that all insurers must meet before they can sell policies, and there would be subsidies for the poor and working class. What neither Wyden nor Massachusetts have is any method of controlling health care costs.
• On the fourth side are advocates of government-run single-payer health coverage, similar to Medicare or to Canada’s system. They include Senate Health, Education, Labor and Pensions Committee Chairman Edward M. Kennedy (D-Mass.) and Reps. John Conyers and John Dingell (both D-Mich.), who will chair important committees in the new Congress. Dingell’s committee is one of those handling health care.
All three, along with the Steel Workers and Physicians for a National Health Plan (PHNP), advocate some form of universal health care that cannot be taken away when workers switch jobs. They, especially Conyers, would virtually abolish the private insurance industry, cutting overhead and duplication, while allowing wide consumer choice of physicians and hospitals, advocates say. But their big political problems are cost, and who pays. Solutions range from payroll taxes to elimination of waste.
USW President Leo Gerard is a particular advocate of single-payer government-run health care. Like other union leaders, he’s seen health care costs damage negotiations and destroy raises for his members. By contrast, Gerard, a Canadian, knows the edge firms and individuals there have from government-run single-payer health care.
The debate over health care has been relatively dormant ever since the insurers’ lies and a business-backed Senate GOP filibuster doomed President Clinton’s health care plan. Debate started to rise during the campaign and took a recent heated turn with Wyden’s proposed Healthy Americans Act. Stern, backing Wyden, warned “the perfect should not be the enemy of the good,” but PNHP says the Wyden plan is far from good.
PHNP New York research director Len Rodberg calls Wyden’s scheme “one of the most radically destructive proposals ever put forward to address the failings of the American health care system. It would eliminate the system of employer-based health insurance on which more than 90 percent of the insured depend today.” Everyone would have to buy insurance—a windfall for the companies—with the subsidies for the poor afterwards.
Rodberg also targeted Wyden’s lack of cost controls: “Literature from Wyden (says) the Healthy Americans Act relies on competition to drive down costs and promote quality. But nothing would make competition among insurers work any better than it has.” Wyden’s reliance on the insurers could lead to fewer of them and less competition.
“Why should millions who now receive insurance from employers, including members of unions which fought for decades for those benefits, give up this coverage for the uncertainties and inequities of the private for-profit insurance market? In the face of continuing increases in the cost of health care exceeding general inflation as well as the
growth in average wages, why should workers want to take over responsibility for paying for their health care? It is not the employer base that is collapsing, it is the entire system of private insurance which is becoming increasingly unaffordable,” he says.