In this report I attempt to summarize the current status of healthcare reform, which has been a dominant theme in the news this year. Please note that the opinions below are not my own. I have simply tried to compile for the interested reader a summary by quoting from recent articles and alternative perspectives not usually covered by the corporate media. Therefore, all credit should be attributed to the extensively quoted sources below.

On November 7, 2009, the House of Representatives voted in favor of the Affordable Health Care for America Act, a bill that would, in summary, expand healthcare coverage and bar insurance practices such as refusing to cover individuals with pre-existing medical conditions. In the November 9, 2009, online issue of Democracy Now, journalist Amy Goodman noted that the Affordable Health Care for America Act “has been described as the biggest overhaul of the country’s healthcare system since the Medicare and Medicaid Act of 1965. . . Two hundred nineteen Democrats and one Republican, Louisiana’s Joseph Cao, voted for the bill. The no votes included thirty-nine Democrats and 176 Republicans. Among those who voted no was Ohio Democrat Dennis Kucinich, a leading proponent of a single-payer, Medicare-for-all healthcare system.”¹

The following excerpts summarize the main points of the Affordable Health Care for America Act according to David Espo² in a recent article in The Huffington Post: “The legislation would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government's mandates.

“Insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. In a further slap, the industry would lose its exemption from federal antitrust restrictions on price gouging, bill rigging and market allocation.”

“At its core, the measure would create a federally regulated marketplace where consumers could shop for coverage. In the bill's most controversial provision, the government would sell insurance, although the Congressional Budget Office forecasts that premiums for it would be more expensive than for policies sold by private firms.

“The bill is projected to expand coverage to 36 million uninsured, resulting in 96 percent of the nation's eligible population having insurance.

“To pay for the expansion of coverage, the bill cuts Medicare's projected spending by more than $400 billion over a decade. It also imposes a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families.

“The bill was estimated to reduce federal deficits by about $104 billion over a decade, although it lacked two of the key cost-cutting provisions under consideration in the Senate, and its longer-term impact on government red ink was far from clear.

“Democrats lined up a range of outside groups behind their legislation, none more important than the AARP, whose support promises political cover against the cuts to Medicare in next year's congressional elections.

“The nation's drug companies generally support health care overhaul. And while the powerful insurance industry opposed the legislation, it did so quietly. . . ”

Espo² further stated that “as drafted, the measure denied the use of federal subsidies to purchase abortion coverage in policies sold by private insurers in the new insurance exchange, except in cases of incest, rape or when the life of the mother was in danger.

“But abortion foes won far stronger restrictions that would rule out abortion coverage except in those three categories in any government-sold plan. It would also ban abortion coverage in any private plan purchased by consumers receiving federal subsidies.”

However, Espo also noted that Rep. Jan Schakowsky, D-Ill., “detailed numerous other benefits for women in the bill, including free medical preventive services and better prescription drug coverage under Medicare.”²

Blogger Jane Hamsher, who was asked on Democracy Now¹ to explain what that bill would mandate if it joins with the Senate and is then reconciled, stated that “we would get a bill that has a public option that would cover not a lot of people in it. But it would get rid of people being excluded for pre-existing conditions. It has a community rating, and it also has a provision that grants an endless monopoly on biologic drugs, sort of the drugs of the future, that mean that they will never come into generic form and will cost, in perpetuity, you know, fifty to eighty to a hundred thousand dollars a year and only be able to be available to people who can afford them.

“It also has a provision barring any insurance company or a public option who offers insurance on the exchange from providing abortion services, which means that you would have to go to a private insurance company that wasn’t on the exchange in order to get a policy that covered it, effectively keeping poor people from being able to afford those policies.”

Ohio Representative Dennis Kucinich, who was also interviewed on Democracy Now¹ just days after the bill was passed, voted against it “Because it’s not the best we can do. It mandates people purchase private insurance. It is a $70 billion giveaway to private insurance companies and locks in this system that’s the problem, not the solution.

“And so,” he stated, “I made every effort, right from the beginning, as you know, as a single-payer advocate. We couldn’t really make this bill single payer; that was taken off the table. But we did something else: We were able to get a bill in the committee passed that would protect the right of states to be able to have—to pursue a not-for-profit healthcare plan at a state level to shield it from legal attack. And that was taken out of the legislation after it had passed. It was taken out by the administration, which has whittled down the public option to the point of not having it truly compete with insurance companies.

“So what you have here is people continuing to be at the mercy of the insurance companies, except in this case the government is going to subsidize the policies. People are still going to have premiums, co-pays and deductibles to deal with. And, you know, there’s really a great deal of question here as to what in the world we’re doing in creating a healthcare system that’s really based on the premises of private insurance.”

When asked by Goodman whether or not this new bill would be an improvement over the existing situation, Kucinich answered, “No. Actually, it’s not, because it locks us into a for-profit system that the government subsidizes. It’s not going to save money in the long run. It’s not going to provide the kind of broad healthcare services the American people need. It’s going to limit the choices that people have over a longer period of time. And people will have to buy private insurance. I mean, what’s going on in this country? We’re told that the only choice we have is to buy private insurance, and with the robust public option being gone, it makes sure that there’s little competition with the insurance companies. This bill doesn’t effectively moderate what they can charge for premiums or co-pays or deductibles. It just says people have to have insurance. Well, insurance doesn’t necessarily equate to care, and care comes at a cost.

“Keep something in mind. When Mr. Hacker first came out with his proposal for a public option, it was going to cover 129 million Americans. That really would compete in an exchange with private insurance. But that’s been whittled down to, depending on who you talk to, covering six to 11 million people. So only a fraction of Americans will have access to the public option, which means that there’s not effective competition with the insurance companies to drive down rates.

“But as far as the House bill that I was confronted with . . . I just felt that it increased privatization of the healthcare system. Requiring the purchase of private insurance, the government subsidizing it, it ends up being a redistribution of the wealth of this nation upwards, which lately seems to be the sole purpose of the government.”¹

When Kucinich was asked to comment on whether political stripes influenced the passing of the bill, he said¹,“Well, you know, making this about liberal and conservative is a phony argument, to begin with. I mean, when I heard the Republicans attacking this bill in the House as a government-run healthcare system, I said, “I wish.” I wish that it would have been a not-for-profit, single-payer, universal system. Nothing like that.

“The fact that there’s a shrinking public option is not a credit to the bill. And the administration, obviously, was terrified that anything could be identified as being adverse to the insurance companies, which is why they took privatization, they took single payer off the table immediately, they knocked down the robust public option. And after an amendment that would have protected the right of states to pursue a single-payer system was passed by the Education and Labor Committee, the administration weighed in heavily and influenced the leaders of Congress to take it out of the bill.

“I mean, American people are being locked into a for-profit insurance structure. And we have to ask ourselves, why is this the best that we can do? Why should we settle for this without fighting back? Why shouldn’t we insist that a robust public option is the only way to make sure that the American people really have a fighting chance with the insurance companies? As it is now, the government is going to be subsidizing the insurance companies.

“And we’re being told all the time . . . that our options keep getting limited. We were told last year the only way people could get unemployment benefits is if Congress votes for war, the only way we can pass a hate crime is if Congress votes for war, the only way we can get housing is to give Wall Street a bailout. And that didn’t put people back in—most people back in their homes who lost them. You know, we’re going to get jobs by giving Wall Street a bailout; that didn’t work. Businesses are going to be helped by giving Wall Street a bailout; that didn’t work.

“Our whole economy is being organized in a way that takes the wealth of the nation and sends it right to the top. And this healthcare bill is no different. And we’ve got to fight back, and that’s why I could not vote for this. If we were able to get a single payer—to protect the right of states to have a single-payer plan, maybe the bill would have been worth voting for. But that was taken out. So what are we left with? Private, for-profit health insurance, with the government subsidizing it.”

When Goodman asked Kucinich if there were a way to accomplish the goals that he had just described, he replied¹ “Yes, if we are able to get back in the bill a provision that says states will be shielded from legal attack by insurance companies if those states go with their own single-payer plan. I mean, states should have the right to do that. You have ten states which are actively involved in single-payer movements. And I fought to get that amendment in the bill to make sure that states would not be subject to the kind of legal attacks that are building by the insurance companies against efforts at local, county and state levels to have their own single-payer system, so they’re not strapped by the rising cost of insurance companies, their administrative costs, their profits, their stock options.

“You know, we’re stuck with a model here. And we’re putting this model in place and keeping it there. That’s what this bill does. So the only way that I think we can get out of it—at least have the hope to—is to be able to have a path towards single payer at the state level. But the administration has been blocking this. And frankly, if I give my vote to that, what I’m essentially doing is putting a nail in the coffin of the single-payer movement. And I’m not going to do that.”

Fast-forward now to the Senate, where the debate has begun on the Democrats’ plan to overhaul the nation’s healthcare system. According to Democracy Now, ³ the Congressional Budget Office (CBO) on November 30, 2009, “issued a report saying the Senate bill would significantly reduce costs for many people who buy health insurance on their own but that premiums will not substantially change for the vast numbers of Americans who receive coverage from large employers. The CBO report contradicts assertions by the insurance industry that the average family’s coverage would rise by thousands of dollars if the proposal became law. The CBO did conclude that health premiums would go up for a portion of the population – the 14 million Americans who buy their own coverage and earn too much to get proposed subsidies.”

The most recent update from Democracy Now (December 4, 2009)⁴ is that “the Senate began voting on the first major amendments to a healthcare reform measure…. Republicans lost an attempt to undo $500 billion in Medicare cuts that Democrats say are essential to expanding health insurance. The Senate also approved an amendment that would ensure women younger than fifty can receive coverage for undergoing mammograms.”

Stay tuned for more details as they unfold.

References:

1. Goodman A. House Passes Landmark Healthcare Bill with Amendment Backed by Anti-Abortion Lawmakers. Democracy Now. November 9, 2009. Available at: http://www.democracynow.org/2009/11/9/house_passes_healthcare_bill_with_amendment. Accessed December 13, 2009.
2. Espo D. House narrowly passes landmark health care bill. The Huffington Post, November 7, 2009. Available at: http://www.huffingtonpost.com/2009/11/07/health-care-passes-house_n_349758.html. Accessed December 13, 2009.
3. Democracy Now Web site. Senate begins debate on healthcare reform. Available at: http://www.democracynow.org/2009/12/1/headlines#7. Accessed December 13, 2009.
4. 4. Democracy Now Web site. Senate rejects amendment to undo Medicare cuts. Available at: http://www.democracynow.org/2009/12/4/headlines#8. Accessed December 13, 2009.