Wednesday, October 21, 2009

Health care reform pressure

Organizing for America (Obama 2.0) was at work today, making over 200,000 phone calls from over 1000 sites on behalf of health care reform. These smiling folks were snagging passersby in front of the Millberry Union at UC San Francisco -- that's the Med School campus.

It's hard to know what Congress will make of this show of strength. At this point the question is more what kind of "health care reform" we'll get than whether we'll get something called "health care reform." Judging by the med students I've run into, single payer and the public option are very popular around here.

This doctor waved his sign outside Obama's Democratic party fundraiser in downtown San Francisco last week.

obama in campaign mode-10-20-09.jpg
Late in the day, the President made a campaign-style presentation to his loyal workers via webcast. You can watch it here. He reminded us [my paraphrase]:

...the bill you like least would provide 29 million Americans with health will prevent insurers from denying insurance to people because of 'pre-existing conditions' will set up exchanges where people can buy health insurance...

I'm not tired.. I don't know about you, but I'm just getting started, because of you.

His promises were all about improving access for the uninsured and decreasing the society-wide cost of health care; not about changing the underlying health care system. Medicine for profit will thrive in Obama's world. Changing that is not on the President's agenda (nor has he ever said it was).

Democrats better hope this "reform" they are creating works. For a lot of people, "works" means individual (not social) cost containment: they are sick of employment-linked insurance that requires such expensive co-payments that they can't use it. A health care reform that "works" would mean the end of "job lock" -- the inability to change jobs for fear of not being fully covered even if they got a new job with benefits. If most insurance is to be employer-based, the system won't "work" if employers continue to cut back on benefits or stop offering health insurance at all. It won't "work" if insurers can deny insured people medical treatment they believe they need, as managed care plans did in the 1990s.

These are the kind of "details" that the President didn't mention today -- nor did he mention the public option. But this is what people will care about in practice. Do any of these people in Washington understand the feelings of helplessness most of us have in confronting the profit-making behemoths that can decide whether we live or die?

Senator Ron Wyden's office tried to get this across to his Democratic colleagues today. The Congressional leadership was flogging talking points about reform:

"Under our [health-care reform] plan, if you like what you have you can keep it, but if you don’t there will be affordable choices for you that can’t be taken away."

Wyden's aide fired back:

...under the current legislation, seven years after implementation, more than 90 percent of Americans will remain barred from shopping for insurance in the exchange. This means that not only will MOST Americans be stuck with the coverage they have – whether they like it or not – if reform establishes a public option, more than 90 percent of Americans won’t be able to choose it.

via Ezra Klein

I want this President and this plan to succeed as much as anyone, but no amount of rah-rah speeches yet give me confidence that the Dems in Washington are going to get this right. They've made a lot of compromises with the drug pushers, the hospital industry, the medical profiteers. What will be left for the rest of us?


Darlene said...

I felt like any meaningful reform was not going to happen after Rahm Emmanuel and others in the administration made it clear that the president was not pushing for the public option, but seems to be willing to take the easy way out and sign any type of reform just to say he accomplished health care reform.

I am so depressed.

naomi dagen bloom said...

You and Darlene express the core of the real American problem. Most citizens understand what it is that a true democracy needs to provide its citizens. However, we do not have the cash to confront the big money guys who work every day to keep us from what we need.

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