The Ballad of Howie

My act of civil disobedience took place during a picket of
WellPoint’s Syracuse offices sponsored by the Mobilization for Health
Care for All, Single Payer New York, and the local chapter of
Physicians for a National Health Program. Our letter demanded that
WellPoint stop denying benefits to sick policyholders and use its
revenues for care instead of lobbying and profits.

Insurance companies are the real death panels in America. They are
the bureaucracies that stand between you and your doctor and decide
whether they will pay for the care your doctor recommends. For-profit
insurance companies have a direct conflict between profits and care.
Their Wall Street investors demand that insurers boost profits by
denying claims. Reforming these predatory insurers into public servants
is as futile as reforming piranhas into vegetarians. The purpose of our
demonstration was not only to expose the evils of for-profit health
insurance, but also to expose the folly of the Democratic health care
plan, which tries to reform for-profit insurance.

The Democrats took single payer, the least-cost option, off the
table, and offer the most expensive option, an insurance industry
subsidy plan. The Democrats’ plan will spend about $100 billion a year
over the next decade subsidizing our inefficient, high-cost mixed
system of public and private insurance, which shuttles the costly old,
poor, and sick to public insurance and steers the profitable young,
affluent and healthy to private insurance.

The individual and employer mandates in the Democratic plan force
you to buy insurance or pay a fine or go to jail. The mandates deliver
at least 21 million new customers, many of them subsidized by taxpayers
and at least $70 billion new annual revenues to private insurers. The
public option is just a fig leaf for this corporate option. The
Democrats gutted the original “robust” public option, an option for
everyone to buy into Medicare, enrolling 130 million. Now it’s a token
option limited to a few, enrolling only 6 million by 2019. The
Republicans who call this plan a “government takeover of health care”
are nuts. The Democrats who still call it a “public option” are just as
nuts.

Prescription drug prices will remain the highest in the world thanks
to the deal the Obama White House cut with Big Pharma to bar
bulk-purchasing discounts by public insurance. Insurance costs will
continue to explode because the plan impotently relies on competition
in monopolistic local markets to keep prices in check. Private insurers
will even use the good reforms in the plan, such as the banning limits
on lifetime coverage and exclusions for pre-existing conditions, to
raise prices. The Kucinich amendment protecting the right of states to
enact single-payer nonprofit health care was stripped from the House
bill adopted Nov. 7 at the request of the Obama Administration and then
denied a floor debate and vote by House Speaker Pelosi.

Health care should be a right provided as a public service, not a
buy-or-die commodity. A single public payer, as provided for in the
National Health Insurance bill, HR 676, could provide universal access
to top-notch care at less cost than we now spend on our inefficient
multi-payer system. Patients could choose any doctor and clinic, unlike
the managed care of most insurance today. The savings from single payer
are well-documented by many studies over the last two decades by the
Congressional Budget Office, the Government Accountability Office, and
the Harvard Medical School.

Even better would be a single-payer health service, as provided for
in the US Health Service bill, HR 3000. Salaried physicians and other
health workers would provide care in publicly budgeted nonprofit group
practices. It would be democratic and responsive, governed from the
bottom up by community health boards elected by local residents and
health workers. A single-payer health service would cost even less than
single-payer health insurance because it eliminates the other
inflationary cost drivers: fees-for-service and profit-maximizing
providers. Prospective budgets for community health boards on a per
capita basis, in place retrospective fee-for-service reimbursements by
third-party insurance, would enable the correction of other major
health system problems: the shortage of primary care doctors, the bias
toward acute curative care over preventive care, and the inequitable
geographic and class-based distribution of health resources.

Whether or not the Democrats’ plan passes, the health care cost and
coverage crisis will continue. It’s time to abandon illusions about the
public option and for-profit insurance reform and go straight for the
only solution that works: non-profit health care for all. As Amilcar
Cabral, the West African anti-colonial leader, wisely advised: “Tell no
lies. Claim no easy victories.”

—Howie Hawkins

Syracuse