Posted on February 23, 2009

Health care bills suffer conspiracy of silence


Saul Friedman
Gray Matters
February 21, 2009

Too often journalism ignores or belittles reports or proposals as outside the mainstream and bound to fail, thus assuring they will remain outside the mainstream and fail.

That, I believe, is what has been happening to proposals by three Democratic members of the House of Representatives to provide health care for all Americans through a system like Medicare, rather than depending, as now, on many private insurance companies.

The lawmakers, among the most senior House members, are Pete Stark of California, chairman of the health subcommittee of Ways and Means; John Dingell of Michigan, the longest-serving member of the House and chairman emeritus of Energy and Commerce, and Judiciary Committee chairman John Conyers, also from Michigan.

Last month, Stark reintroduced his proposal, called Americare, which would open Medicare Parts A and B to everyone, but allow people to keep their employer-based insurance. A few days later, Dingell and Conyers reintroduced their bills, which would expand Medicare to become the nation’s comprehensive health care program, paid for by premiums and taxes. The Conyers bill has dozens of co-sponsors and the support of most AFL-CIO unions.

On Jan. 28, a coalition of advocacy groups representing 15,000 doctors and more than 50,000 nurses, met at the Capitol to present a new study asserting that the Conyers’ bill, called the National Health Insurance Act (HR 676), could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers.

Only Congressional Quarterly covered it. The Kaiser Family Foundation’s daily online report on health care developments at didn’t mention it. Nor has Kaiser, the most comprehensive online source of health care information, made any mention of “single-payer” (the government as the payer), or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls. (After my insistent inquiries, Kaiser says it will publish charts next month comparing the Stark and Conyers bills.)

AARP, another key source of health care information, briefly mentioned single-payer in the AARP Bulletin, sent to its 35 million members. But neither single-payer nor the Conyers bill have been discussed in any of its other publications or its advocacy materials at

Why? Many health care writers and advocates believe it’s because single-payer and the Conyers bill would bar any role for private insurance companies, which would have central roles in all the other proposals under discussion.

The Kaiser Family Foundation was founded with insurance money, but its president, Drew Altman, says it receives no money from and has no connection with Kaiser Permanente, a large health insurer. And AARP’s chief strategist, John Rother, insists that its $700 million insurance business, mostly with UnitedHealth Group, does not affect its policies.

But reader Elaine Fox of Southampton, a physician and health care activist, contends there is evidence the health insurance industry opposition to government-sponsored health care has contributed to the effort to black out discussion of the Conyers bill.

She noted that in “An Analysis of Leading Congressional Health Care Bills, 2007-2008,” an online article posted in January by the Commonwealth Fund, a nonpartisan public policy research organization (, the Conyers bill was ignored. The Stark bill, which includes an insurance option, was analyzed. But Conyers’ bill and single-payer were not discussed in the analysis, which was done for Commonwealth by the Lewin Group, health care consultants.

As Fox pointed out, the Lewin Group had been independent and in 2005 its analysis supported passage of a single-payer bill in California. In 2007, Fox said, Lewin was purchased by Ingenix, a health information firm that helps set the rates insurance companies pay providers. Ingenix is owned by one of the nation’s largest insurers, UnitedHealth (which recently paid a $50 million fine in New York to settle a charge that Ingenix underpaid out-of-network doctors who provided service for United’s subscribers).

On Jan. 13, Fox said, the RAND Corp., a think tank, launched an online tool for policy makers to compare health care proposals called “Comprehensive Assessment of Reform Efforts,” or COMPARE. It did not include the Conyers bill or any single-payer alternative. RAND acknowledged that COMPARE is funded in part by AARP and health insurers, including UnitedHealth. A RAND spokesman said COMPARE will “get around to including” single-payer plans.

AARP’s Rother cites other reasons than the insurance industry for the blackout. He’s in favor of a single-payer system, he says, but insists he’s not encouraging such proposals because they’re outside the mainstream and are not likely to pass. Despite broad support for national health insurance and Medicare, Rother says, “This is simply a matter of pragmatism. Single-payer advocates could play a destructive role in the coming debate.”

Fox argues: “There cannot be a credible debate when one side disappears.”

WRITE TO Saul Friedman, Newsday, 235 Pinelawn Rd., Melville, NY 11747-4250, or by e-mail at