ELDER MUSIC: Classical Again – Part 2 of 3

The (Non)Public Option

category_bug_politics.gif On Sunday's political talk shows, journalists and others who purport to have the inside scoop on the progress of health care reform in Congress said the White House – that is, President Obama – prefers the “trigger” style of public option.

That's Senator Olympia Snowe's idea – to kick the can of the public option down the road leaving the status of health care in the U.S. pretty much quo, and guaranteeing that the market requirements (trigger) for a public option to go into effect will never be met.

That's what happened with the Medicare prescription drug plan, Part D. Not many people know that a trigger was included in that legislation. But the pharmaceutical industry wrote the Part D bill and set the bar for a prescription drug public option so high that it has never been met.

Never met, even though premiums for many of next year's Part D coverage plans have doubled (mine has), deductibles have been added (mine has) or increased and some insurance companies have switched to co-insurance (mine has) which is more expensive for insureds than co-pays and many co-pays have increased (mine have). All this even though there will be no COLA increase for Social Security beneficiaries in 2010.

And, as I reported last week, the premiums for two of the most popular Part D plans have increased dramatically since the prescription drug program went into effect in 2006: AARP has doubled; Humana PDP Enhanced has tripled – in only three years.

Medicare Part D, then, is a good template for health care reform with the trigger, certain to please the health care industry. Trust me, THERE WILL NEVER BE A PUBLIC OPTION if a trigger is included in the reform bill, and therefore no way to control the prices of coverage from private insurers.

But that is the intention of Congress, isn't it – to try to fool the public into believing they are doing something that will benefit voters, while further lining the pockets of the health industry and in the process, lining their own pockets.

After watching the Sunday shows, I wondered how much Congress members have collected so far from the health industry for their upcoming elections. Relying on opensecrets.org, I checked donations to representatives and senators who have often been in the news during the health care debate of the past few months.

The amounts below are contributions from the industry in parentheses (which are OpenSecret's designations) and are as of 30 September 2009. The industry is the number 1 largest contributor to each legislator unless otherwise noted. An asterisk indicates the senator is up for re-election next year. All representatives are up for re-election.

Make what you will of this:

House Speaker Nancy Pelosi *
$134.8K (health professionals)

House Majority Leader Steny Hoyer *
$250.5K (health professionals #1, insurance #4 )

House Minority Leader John Boehner *
$272.9 (insurance #1, pharma #3)

Senate Majority Leader Harry Reid *
(no health-related donations in top 5)

Senate Minority Leader Mitch McConnell
$795.8 (health professionals #5 contributor)

Senator Charles Schumer *
$261.3 (insurance #4)

Senator Olympia Snowe *
$175K (health professionals #2)

Senator Susan Collins
$400K (health professionals #4)

Representative John Weiner *
(no health-related donors in top five)

Senator Jay Rockefeller *
$268.4K (health professionals #2)

Senator Max Baucus
$2.32million (health professionals #2, pharma #3, insurance #5)

Senator Chris Dodd
$1.4million (insurance #3)

[You can find contribution information for any member of Congress on this page at OpenSecrets.]

This is hard to say publicly, but I become more discouraged every day about there being a robust and meaningful health care reform bill. Between triggers and opt out for states, Congress seems to be doing everything possible to negate a public option and without it, there will be no reform. And without reform, health care costs will ruin the economy in less than a decade.

It could have been so simple. A single-payer system – Medicare for all - would fold everyone into the same risk pool spreading costs over all 300 million-plus citizens. There are examples and history of it working well in every industrialized democracy in the world. But President Obama took that option off the table before the debate even began.

What was he thinking? I'm afraid it wasn't the public.

At The Elder Storytelling Place today, Mort Reichek: How I Almost Became a Texas


Well Done as always. Thank you. But we cannot be discouraged. We must take this information to the public and make noise. Make a lot of noise. Tell our reps we are mad as hell....tell them we may not give them as much money as pharma, insurers, and others, but we control whether or not they stay where they are...we vote!

You know, Nancy - I'm thinking what a piss poor system it is that allows mega-corporations with their millions to control government while there is no comparable leverage for citizens. The vote isn't enough because money can so easily influence it.

I think after health care is done, the next effort must be campaign finance reform.

I agree, both on the negative aspect of the "trigger" and on campaign reform.

Part D is a money maker for the insurance companies, rife with confusion, misrepresentation and greed. The drug companies benefit because the ability of Medicare to negotiate prices was removed, and any bargaining between the insurance and drug companies is subject to under the table negotiations. The insurance companies are supposed to pass on the savings - anyone truly believe that happens?

I am tired of contacting my Senators and Congressman and the President. It apparently means little.

If true health care reform fails (A
'genuine' Public Option) this will be a one term presidency. We will not be fooled and we won't forget.

Those contribution $$ is outrageous. And I feel so helpless to do anything, but I'm writing soon & often. At least it may help me feel better. Thanks again, Ronni. Dee

It is disillusioning but on the 'it's not over until it's over' side, late last night I read that Obama does still favor the public option. I had also read that triggers, which there have been others, are just trickers to make us think they did something.

If Obama wants to be re-elected, something most of them do want, he better fight for the public option.

Taking the single payer off the table before it began was a huge mistake either showing naivety in the system or that he didn't really want it despite what he says. Either one will prove a trigger for independents to turn from him (and Congress) next election and if necessary vote for a third party candidate rather than either of the main parties who are owned by donations.

What I think is impacting this on Obama's thinking is the stock market and they are worried it will go down if the insurance companies aren't protected thereby hurting his poll numbers even farther.

Right now, we don't have a real recovery but they are claiming it by the stock market going up again. If it goes down, then he really looks bad. When so many pensions were converted into 401Ks, it forced the little people into also worrying the market does. Even those with public pensions (about the only ones left with pensions) are impacted by the fall of the market as their pensions were invested in it. I fear it's a Trojan horse to totally undo the American system for the benefit of the wealthiest using those 401Ks as Trojan horses to get people to put the market ahead of their own good. We need to forget what the flighty market does for awhile, even those of us who do have money in it, and concentrate on what is good for the country.

I think we find Obama confusing because we see a contrast between a man who clearly is smart enough to see looming collapse for this country (after the previous incumbent that's novel) -- and a person who will not step out and lead to avert known dangers. We keep thinking: if he can see it and name it, why won't he do something? This pattern applies in all areas, not just health care reform.

We are left with the "make him do it" mode. In this consumer society, it is not only our "leaders" who prefer to be affluent spectators to civic life -- we are all so inclined; it is so much easier. But real problems require real enagement, something we've been told not to bother our pretty heads with since Reagan.

I am sooo tired of the lack of understandng and action on the part of the administration and the House and Senate on an issue so crucial. I'm guessing that people are dying because of it -- and that, my friends, is murder. Our leaders sold out long ago.

Open Secrets certainly makes interesting reading. I checked on the two representatives I know that are on record favoring a public option. The amount they got from Health related PAC's were negligible most of their contributions were from individuals. The other representative from this area who is a Blue Dog Democrat got more but still wasn't in the top 5.
So it would seem the people who get the money are the ones who have control in the House and Senate.
I wish I had more influence but the Members of Congress I write to are already in favor of the public option. The Senators are a lost cause but I still let them know my opinion.

I have given much thought to why Obama seems to be strong on rhetoric and weak on actions. I believe that Obama is pragmatic to a fault. He knew that starting with a single-payer system would never get past Congress, so he devised a back door way to get to it. If the strong Public Option worked it would be easier to go to the Single Payer system for real reform in the future.

Now that the strong Public Option is proving to be difficult, if not impossible, he is willing to compromise just to get something done to say, "Yes, we did."

You are absolutely right, Ronni. The next challenge that should unite Republicans, Democrats, and Independents is campaign finance reform. As long as money is involved we will continue to be governed by the powerful and greedy.

A longtime political watcher, and thus cynic, I'm surprisingly optimistic that we will see real progress on health care reform out of this Administration. I think he has a good sense of what's achievable and a long-range game plan. Think about it. Take the hole that this man started out in: (global recession, two simultaneous wars, financial industry in self-induced meltdown, etc.) Add in the fact that he's the first black President and that his political opposition will do whatever it takes to see him fail.....and I think he's managed health care reform pretty nicely so far. Given that every President since Truman has fallen short.

Bottom line is that the majority of Americans don't want single payer,Living in Nevada and taking my Dad to lots of Doctors... they are all against the current reforms and everyone I hear is against single payer. Too bed.....

Interesting that as a health care service provider myself and one coming in lots of contact with many others, including doctors, I'm hearing lots of support for reforms and single payer. Many are unwilling to be openly outspoken on the issue but talk privately 1:1 with me.

Partly, I think there may be concern the insurance companies will prevail and they could receive subtle or not-so-subtle repercussions, a possibility to which I have not been oblivious myself since I still work part time. I concluded at some point I would be more open in local newspaper, and other venues, hoping I would not jeopardize my excellent relationship with insurers and those in a position to effect my ability to work, but prepared to accept any consequences.

I received a written response recently to my D.C. phone call to my Representatives office following the Senate passage of a reform bill. I asked that he drop the party line vote and act in the best interest of the people and our country. I urged my Rep. to vote for reform in the House with a single payer, or pubic option plan.

In his letter I received his assurance he recognizes there is need for change, so is working on legislation, H.R. 99, the Fair and Simple Tax Act. Now, we know the insurance companies will be only too happy to see that plan go through. He goes on to say, "...and government bureaucrats should not stand between patients and doctors." Obviously, in his mind it's much better to allow profit-seeking insurers to stand between patients and doctors.

Thanks for this link to Open Secrets. Insurers, pharmaceuticals have poured money into that Representative's coffers.

I think your assessment is right on and I wish it wasn't so.

I say, even if the end result turns out to be a losing battle, it's vital we keep making our views strongly known in any way each of us can. Victory, or even partial victory, can sometimes be wrested from the jaws of defeat. We'll all feel better for having at least tried.

Sometimes I write just about the day to day, in the now stuff because I am so very discouraged about the politics of our land. What a mess. Then again, I just finished re-reading "Ruffles and Flourishes" by a favorite of mine, Liz Carpenter. To read that now knowing the behind the scenes realities makes it seem all so very sad and edited.

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