Michael Moore's movie, SiCKO, shows all you need to know about the faults of the US health care system. In addition to the plight of the nearly 50 million Americans who are uninsured and dependent upon charity hospitals and clinics for rudimentary health care, Moore's movie focuses on the problems faced by the 250 million Americans who have health insurance.
Members of the middle class might think they are safely covered until they go to the hospital and find they must battle the insurance bureaucracy as well as infections. Or until their job is "outsourced."
Meanwhile, citizens of Canada, Britain, France and other industrialized democracies, regardless of employment or income status, simply show up at clinics and get treatment free of charge, with prescription drugs furnished at a fraction of the cost paid by Americans. Even Cuba does a better job of providing health care for its citizens than the United States.
Moore proposes a single-payer national health program under which:
1) Every resident of the United States must have free universal health care for life.
2) All health insurance companies must be abolished.
3) Pharmaceutical companies must be strictly regulated like a public utility.
We're not sure Congress can abolish insurance companies, but HR 676, the US National Health Insurance Act sponsored by Rep. John Conyers (D-Mich.) would make insurance companies obsolete. Moore supports the Conyers bill, as well as California's SB 840, a "single-payer" bill that was vetoed by Gov. Schwarzenegger last year. (See organizations seeking to reform health care at www.populist.com.)
Conyers' bill establishes a unique American national universal health insurance program. The bill would create a publicly financed, privately delivered health care system that uses the already existing Medicare program by expanding it to all US residents, as well as residents living in US territories.
It would cover all medical services, including primary care, emergency care, prescription drugs, medical equipment, long-term care, mental health services, dentistry, eye care, chiropractic and substance abuse treatment. Patients would have their choice of physicians, hospitals, clinics and practices. All fees would be covered by the national program.
National health care is a good deal for citizens as well as businesses that find it increasingly difficult to find affordable private insurance plans. Dean Baker of the Center for Economic Research and Policy found that under HR 676, a family of three making $40,000 per year would spend approximately $1,900 per year for health-care coverage. In 2007, the average annual premium for families covered under an employee health plan is $11,000, according to the National Coalition on Health Care.
The average employer that offers coverage now contributes $2,600 per employee (for much skimpier benefits). Under HR 676, the average costs to employers for an employee making $30,000 per year would be reduced to $1,425 per year.
The government would maintain current federal and state funding for health care. Employers and employees would each pay a payroll tax of 4.75% (9.5% total). In addition there would be a 5% tax on the top 5% of income earners; a 10% tax on top 1% of wage earners and one third of 1% stock transaction tax. Additional funds would come from closing corporate tax loop-holes and repealing Bush tax cuts for highest-income earners.
Sen. Ted Kennedy (D-Mass.) and Rep. John Dingell (D-Mich.) are pursuing another bill, HR 4683, the Medicare for All Bill, which would allow Americans under 65 to enroll in Medicare or in the health coverage enjoyed by Congress. The plan would be less comprehensive than the Conyers bill provides, financed with a 7% tax on payrolls.
Ron Wyden (D-Ore.), wants to replace employer coverage with subsidized private insurance for all Americans. His Healthy Americans Act would require every American to purchase health insurance from new Health Help Agencies in each state.
The Kennedy and Wyden bills have good points, and would be improvements over the current dysfunctional system, but the Conyers bill is the gold standard. It is a plan the US can well afford if we have the will to take care of all our people. As former British Labor Party leader Tony Benn says in SiCKO, "If you can find the money to kill people, you can find the money to help people."
The insurance and pharmaceutical companies will fight any meaningful reforms. Democrats should welcome their enmity and force Republicans into the position of defending bloated insurance bureaucracies and greedy pharmaceutical profits.
Much of the action has been at the state level. Massachusetts last year decided to require all residents to obtain health insurance, through state-subsidized policies if necessary. Schwarzenegger in January proposed a similar plan for Californians, funding its $12 billion cost partly through fees on employers, hospitals and doctors.
San Francisco is implementing its own universal health care program that would give all city residents access to medical services regardless of their immigration or employment status. To offset the $200 million price tag, firms with 20 or more workers would be required to spend $1.06 for each hour worked by an employee, and those with more than 100 workers would have to pay $1.60 per hour. The ordinance went into effect for businesses with more than 50 employees July 1. It will expand to businesses with 20 or more workers in April 2008.
But Ezra Klein in the July/August Washington Monthly notes that past efforts to expand health care at the state level in Washington, Hawaii, Tennessee and Oregon have foundered during regional recessions as resulting high unemployment drove up health costs just as state revenues were dropping.
While the state and local initiatives are helping to reinvigorate the debate over national health care and ought to be pursued as interim fixes, we feel a national health plan such as Conyers' proposal offers the best platform to provide equitable and efficient health care for all.
The White House is pushing for confrontation with Congress over executive powers. It is past time for Congress to call the president on his abuse of power.
The Constitution gives the president considerable authority but it also sets up Congress as a co-equal branch of government with authority over the purse and oversight of the executive. The president might have the right to fire US attorneys, for example, but Congress has the authority to investigate what prompted those firings. Congress also ought to question the ill-considered invasion of Iraq, the apparent repeated violation of wiretapping laws, the use of "signing statements" to refuse to follow the law, and other high crimes and misdemeanors.
Without the ability for Congress to question members of the administration on the record, under oath, the Constitution is, indeed, "just a goddamned piece of paper," as Bush reportedly has said. GOP members of Congress should be put on record whether they stand with the president or with the Constitution.
Congressional Democrats have said that impeachment of Bush and Cheney will take too much time and Republicans will stop the action in the Senate. But House Judiciary Chairman John Conyers is increasingly willing to talk about the possibility. The hearings already are practically going on; they just aren't called impeachment hearings yet. If a change in terminology is necessary to make the White House accountable, congressional leaders should get on with it. -- JMC
From The Progressive Populist, August 1, 2007
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