In my final post of this year, I want to say that my heart is with rebellious progressives but my head is telling me that a health care bill must be passed, even if it has no public option.  As I have said in past posts, the Senate version would expand eligibility of Medicare to millions of low income workers.

Let me mention one more reason (this year) for hoping we will get passage of health care reform: the employer mandate that will certainly be in a final bill.  Employers will be required to  either provide health insurance or pay into a fund.  This “play or pay” provision was the core of the Nixon plan as well as the Clinton plan.

Although there is a justifiable amount of angst about driving millions of people into the arms of the insurance industry because of a mandate for everyone to purchase insurance, with the expansion of Medicaid and the employer mandate, we don’t know how many individuals will be faced with purchasing insurance on their own.  I do find it interesting that there was little outrage – that I can remember at least – when somewhere around 40 million people over 65 were driven into the arms of the insurance and the pharmaceutical industries as a result of passage of Medicare Part D.

Let’s face it, when the final bill is passed and signed, our (us activists) work will just begin.  We have to organize and take on the insurance and pharmaceutical lobbies.  It is obvious theyhad to power to stop health care reform in its tracks and were, therefore, bought off by the Obama Administration and Congress. 

Have a happy holiday season!

I am becoming increasingly concerned with my side – the progressive side – of the political spectrum.  Ed Schultz of the MSNBC Ed Show and Jane Hamsher of Firedoglake.com, for instance, are ranting and raving about the bills moving through Congress and are irrationally and destructively attacking President Obama and the Democrats for what appears to be the best reform to come down the pike since Medicare was passed.

They are focusing solely on the mandate that everyone obtain insurance.  I share their concern about that but I am not ready to help the left destroy the Democrats’ majority and the chance of a second term for President Obama because of it.  Furthermore, these progressives are ill-informed.

They are overlooking  major changes that move this country toward fairness and a truly humane health care system for everyone.  For instance, I posted a blog yesterday regarding the first move in a long time toward progressive taxation.  Today, I will mention just one other very good thing in the Senate bill (and there are many) that has passed the cloture hurdle:  expanding eligibility of Medicaid to 150% of poverty.  Since 150% of poverty is $16,245 for an individual, this means that the the working poor will be covered by a single payer system – everyone making up to $7.81 per hour, working 40 hours per week, would be eligible for Medicaid.

Most people don’t know that Medicare now pays for 36.2% of hospital stays and Medicaid pays for 19.5%, which means that, excluding the VA and Indian Health Service, approximately 55.7% of hospital stays are reimbursed by a single payer system.  The Senate bill would expand that coverage to the working poor.

We will get a health care reform bill.  It won’t be what we – the progressives – have our heart set on.  But it will be totally stupid to help the Republicans use it to undermine 2012 liberal candidates and the Obama Administration.

Ed Schultz has a radio show that will take your call.  The number to call is 1-877-934-6833.  The hours are 12 PM – 3 PM Eastern.  Call him and tell him to study the history of health care reform and how the current bills in the House and Senate will be a step ahead.  Tell him that we have nothing to gain and everything to lose by tearing up the Democrats for passing health care reform that isn’t everything we would like it to be.

It is important to support the essential facets of health care reform bills moving through the House and Senate.  These bills will eventually be melded into a final bill with some very good reform measures.  The final bill coming out of conference committee and finally passed and signed will not fully satisfy the demands and desires of progressives like me.

However, I have believed from the beginning of this process that a single payer, universal health care system would not at this time be a remote possibility.  I very much wanted to see a strong public option but that isn’t going to happen.   Having said this, I believe, for the following reasons, progressives will be making a big mistake if they lose their grip on their emotions (as seems to be happening to some my soul mates) and attempt to scuttle legislation making its way through congress:

1. The final passage of a bill that will most certainly include some meaningful reform (discussed below) will be a huge victory for President Obama and the Democrats.  Conversely, it will be a huge defeat for the Republicans.  On the other hand, failure to pass this legislation will be a crippling blow to the President and the Democratic Party.
2. It appears certain that a final bill will include one of the few (if not the only) progressive tax measures since the beginning of the radically regressive tax movement underway since the Reagan Administration.  The Senate version would increase the Medicare payroll tax .9% for individuals earning more than $200,000 ($250,000 for couples).  As it is now, everyone pays 1.45% with no cap, which makes this a regressive tax.

   The House version would charge a surtax of 5.4% on individuals making more than $500,000 ($1,000,000 for couples).  This will be reconciled in some manner with the Senate version.    

   Either way the tax increase goes, it will be a move back toward progressivity.  This is a big deal.  Hopefully, this will open the door to take the $102,000 payroll cap off of the 6.2% Social Security deduction.

3. Although everyone seems to be focused on the public option, it is important not to overlook the massive number of individuals who, heretofore unable to obtain coverage, will be able to buy insurance – many with very good subsidies.   Both the House and Senate bills are too complex to discuss in any detail in a blog.  However, if you are a fourth-degree policy wonk and want to Google the bills and read them, please note, for instance in the Senate bill, along with coverage provisions, the sections on the health care workforce (Title IV), preventing fraud and abuse (Title V), and improving access to innovative medical therapies (Title VI).  These are much needed reforms and we need to support these bills. 

A lot of wailing and gnashing of teeth is going on right now amongst liberals and progressives.  Senator Lieberman and the obvious loss of a public option in some form or other are, no doubt, cause for outrage.  However, there seems to be an unfortunate abundance of threats to “sit out the next election” and other such expressions of intended self destructive behaviors.  I like Ed Shultz (the Ed Show), Keith Olberman, Rachel Maddow, and even Ariana Huffington now that she is a liberal.  However, these talk show hosts and progressive pundits have been engaging in a bit of an over blown, heated rhetoric of late.  Furthermore, they are coming down way too hard on President Obama.  That is a huge mistake.

The bill that is likely to come out of this congress is not all that different and probably every bit as good as the health care reform bill that President Clinton attempted to push through congress in 1993.  Certainly, the health insurance exchange or something like it is very similar to the alliances in the Clinton plan, which included no public option.  I think the MSNBC progressive talk show hosts are overreacting and failing to look at reality.  They are also failing to read the history of health care reform – especially the Nixon and Clinton attempts (see Tom Daschle’s book as well as The Heart of Power on the book page of this blog).  If President Obama and the Democrats can pass health care reform in its current, survivable state, they will have accomplished a long-time-coming basis for a complete overhaul of the health care system.  Let’s hope we can make this first step.

  The president can count to 60.  He is being attacked by our fellow progressives for attempting to finesse the best plan possible through congress.  That attack on our (the progressives’) president makes no sense to me. 

If liberals and progressives can stop wringing their hands over political polls and start showing up at organizing events and working as hard as the other side to organize events and political activities, we can take the basis for reform that will surely be passed and work to make it what we would like it to be.  However, we must get off our duffs – including me. 

It will be a big mistake to take our frustration out on President Obama and the Democrats by staying away from the polls in 2012 or by other such passive aggressive behavior such as withholding financial support for Democratic candidates or by not volunteering in their campaigns.   I say that after we throw ourselves on the ground and cry, kick, and scream, hold our breath until we turn blue, and, after having had our hissy fit, we need to remember that we are mature adults that can make a difference if we jump in and help organize a movement to take on the insurance industry and other lobbies that are buying our congress.

We are not going to get all that we what we want in the health care reform bill that passes but it will be a beginning.  Let’s get going and go after Lieberman and the insurance industry.  Believe it or not we have the power to do that.  What I can’t stand is defeatism, cynicism, and pessimism.  These are the signs of “copping out.”

The Webster’s New World College Dictionary, 4^th Edition, 2007 definition of commodify is as follows:  “to treat as or make into a mere commodity to be bought and sold or to be used in selling something else.” It is high time that we began to talk about the increasing treatment of various groups of people in the United States as commodities.  African American men are supplied to Correction Corporation of America to fill its prison cells and produce profits for investors at no apparent benefit to society.  College students and their families have become fodder for the banking industry (many of us can remember when college loans were made by the federal government and more Pell grants were available).  Examples abound of legislation designed for legislative transformation of human subpopulations into revenue streams for private enterprise.  Medicare, Part D, the subject of this post, is a sterling example of legislation for commodification of a demographic group.

The Bush Administration and Republicans did not pass a prescription drug benefit because they wanted to do something nice for the elderly.  This so-called benefit forces persons 65 and over to purchase insurance coverage for overpriced prescription drugs.  It is a mechanism for fleecing the elderly on behalf of the insurance and pharmaceutical industries.

 Perhaps at age 65 you will not need one or more prescription drugs on a regular basis.  If you do not have an ongoing need for one or more prescribed drugs and fail to sign up, the penalty for that decision will be a 1% per month penalty for each month past the age of 65 to the age at which you actually have a need for the benefit.  This means that you will be assessed this 1% per month on top of any premium you pay at the time you need prescription drug coverage.  For instance, in the Lawrence area, the cheapest insurance available will cost you about $30 per month (this is with rather high copay).  You can either choose to pay some insurance company, e.g. Cigna, Humana, etc, at least $30 per month – even if you do not now and will not for many years need an expensive prescription drug – or else incur a hefty penalty at some future date.

Also, the lobbying power of the pharmaceutical industry has insured that your copays and deductibles will be for drugs that cost double and even triple that paid for the same drugs by residents of Canada, the United Kingdom, and other European countries as well as Australia and New Zealand.  The law enacting Part D bars the federal government from exerting its purchasing power in negotiating with drug companies – negotiation is a violation of the law.

Given its arcane rules and complicated processes, Part D looks, on its surface, bizarre, stupid, and downright irrational.  Look deeper.  The real purpose makes a lot of sense – to “big Pharma,” the insurance industry, and their political hacks in congress.  The purpose of this law is to squeeze the 65+ population for as much of their retirement benefits and savings as possible.

Last night we attended a screening of the film “What’s The Matter with Kansas,” at Liberty Hall in Lawrence.  The film is the work of two filmmakers from Chicago.  I have some thoughts about the film and, due to the length of my essay on the matter, have added it to this blog as a separte page.”  If you are interested in the film and some thoughts about it click on the “Kansas” tab.

It is hard to describe the impact that patients and volunteers at the Kansas City free clinic had on my emotions and thinking.  I can say that the humility and appreciation of patients along with the caring and sincerity of so many volunteers from across the United States has deepened my belief in the basic decency of people in general.  However, that doesn’t fully capture the emotions and thoughts with which I came away from the experience.

For two days, people needing health care streamed into Bartle Hall in Kansas City, Missouri.  They came by the hundreds each hour – old people, young people, obviously very poor people, people that could have been my neighbors.  I had the opportunity to help them to triage, to labs, to dental care, to physicians, to eye care, and to a variety of other services.  I was able to spend a considerable amount of time with these patients and to connect with them as fellow human beings.  I can say that it was my good fortune to have the opportunity to be involved in this amazingly well-run operation by the National Association of Free Clinics and the Kansas City, Missouri Free Clinic.

Meeting and working with these patients and volunteers from Johnson County, Kansas City, Missouri, other local communities, California, Iowa, Washington, DC, and from practically every state in the Nation, was an experience that I will cherish.  It was hard to maintain my professionalism at times during the two days.  On many occasions, looking across the massive hall and seeing people sitting patiently in waiting areas and seeing health care professionals giving their best professional services in other areas, it was hard not to “choke up.”

I must mention that Keith Olberman is a mensch.  By promoting free clinics on his program, he has raised over two million dollars and has made several clinics like the one in Kansas City possible.  Also, if you watch his show, you will often see Nicole Lamoureaux, Executive Director of the National Association of Free Clinics.  Nicole is an absolute angel.  With her leadership and Keith Olberman’s support, thousands of uninsured Americans have had health care they would have not have had.  They have undoubtedly saved many lives.

In the latest issue of Reason Magazine, John Mackey, co-founder and CEO of Whole Foods, following up on an op ed piece in the August 16^th edition of the Wall Street Journal (in which he made the inane statement that the U.S. Constitution doesn’t say anything about health insurance), has further denigrated the U.S. government and any health insurance that could emanate from it .  In fact, his photo graces the cover of the issue.

In case readers aren’t aware of the provenance of Reason Magazine, I will point out that it is the house organ of the Koch billionaire, anti-people, ultra right wing, tea bagging political machine (the Kochtopus).  The Kochtopus has housed Reason Magazine in the Reason Foundation.

The Reason piece is actually an interview with Nick Gillespie, editor, Koch apparatchik, and doyen of a warped form of libertarianism pushed by right wing billionaires like the Kochs, Mellon-Scaife, and a racist outfit called the Bradley Foundation (which put up the money for the racist-tome The Bell Curve).  In the interview, Mackey explains how he came to his political views by reading the likes of Ayn Rand and Milton Friedman.  He cobbled the views of these typical right wing theorists together into the same form of claptrap nonsense that is generally used by right wingers to support their mean spirited views on the role of government.

In addition to the interview, the article listed the seven principles of Mackey’s health care plan.  They could be boiled down to this:  cut taxes and, metaphorically speaking, let people sink or swim.  Isn’t that what the U.S. Government has been doing?

According to the interview, the WSJ piece caused some immediate and furious blow back from left of center shoppers, which has since “died down.”  I intend to do all I can to kick it up again. Mackey states that 80% of Whole Foods shoppers have a college degree.  You can bet that a large portion of that 80% is liberal and wouldn’t particularly appreciate his attacks on plans for some needed social justice.  The same could probably be said about the 20% that aren’t college educated.

DON’T SPEND YOUR MONEY IN WHOLE FOODS.  BOYCOTT WHOLE FOODS!

No one knows for certain what  is happening but reports indicate that the public option is dead.  The ten Senators negotiating a deal (five liberals and five conservatives) have sent a bill to the CBO for a cost analysis.  If initial reports are correct, the negotiations have produced a trade off for the public option.  Essentially, individuals will be able to buy into Medicare at age 55.  It has also been reported by various sources (Senator Bernie Sanders, Reuters, and Governor Ed Rendel), that Medicaid eligibility will be raised to 150% of poverty  ($33,000 for a family of 4 in Kansas).

We will probably need to fight the right wing forces in Kansas that would like to keep us from participating in this plan.  Basically, progress has been made but the struggle must continue for full social justice through health care for all.