Against the Democrats’ health care bill

For so many reasons that have already been stated. It looks to me like a step backwards, and I don’t see it doing much for my people, working-class people, the uninsured and underinsured.

Between now and 2013, what do we get out of this? Supposedly there is something in the House bill that would expand Medicaid, but I have never read any explanation of how this would work. If it requires the states to put up more money forget it, because they’re in financial trouble already.

After 2013, what do we get out of it?  Apparently the exchange, whatever that is, will only be open to a few, so most people aren’t going to qualify for subsidies or the “public option”, which will be very small, if it even survives the Senate.  The exchange is usually described, very sketchily, in news accounts as some kind of online market. Sometimes it’s also said to be an insurance pool which could negotiate to lower premiums, but I’ve seen no explanation of how that would work. At this point, the exchange appears to be a black box.

What do people on Medicare get out of this? They say it will reduce the drug benefit (part D) “donut hole”, but they’re also going to take hundreds of billions of dollars over the next decade out of Medicare to finance subsidies to the insurance companies to cover the uninsured.  How do they do that without cutting benefits to people on Medicare, which includes me?

Also, how does that transfer even work mechanically, since Medicare has a trust fund?  How does the money get from the trust fund to whatever fund will pay the subsidies? Are they going to lower Medicare payroll taxes so that less money goes into the trust fund? Won’t lowering payments to doctors and hospitals for Medicare and Medicaid just result in fewer doctors being willing to take people on these programs as patients?  Doctors are claiming that they’re being reimbursed below costs now. Any change to Medicare should have been considered as a separate bill, with a thorough national debate just on that.

This looks to me like a huge transfer of our tax money to insurance corporations. It also looks like a huge complicated mess that the Democrats have thrown together to try to get enough votes in Congress to pass it.  It reminds me of what a friend said about the Clinton’s 1994 health care bill, that she would rather have no bill than that one.

We are told that this is the best they can do, and we just have to accept it.  That seems to me like a good argument for never voting for Democrats again. They never give the left what we want, on any issue, they just say the right things, string us along for months and then dump us.

Meanwhile Health Care for All Oregon (HCAO), at both the state and local level, appears to be trying to straddle the issue, supporting both single-payer and the Democrats’ plan. This isn’t going to work. We need to dump the Democrats and just support single-payer.

For so many reasons that have already been stated. It looks to me like a step backwards, and I don't see it doing much for my people, working-class people, the uninsured and underinsured.

Between now and 2013, what do we get out of this? Supposedly there is something in the House bill that would expand Medicaid, but I have never read any explanation of how this would work. If it requires the states to put up more money forget it, because they're in financial trouble already.

After 2013, what do we get out of it?  Apparently the exchange, whatever that is, will only be open to a few, so most people aren't going to qualify for subsidies or the "public option", which will be very small, if it even survives the Senate.  The exchange is usually described, very sketchily, in news accounts as some kind of online market. Sometimes it's also said to be an insurance pool which could negotiate to lower premiums, but I've seen no explanation of how that would work. At this point, the exchange appears to be a black box.

What do people on Medicare get out of this? They say it will reduce the drug benefit (part D) "donut hole", but they're also going to take hundreds of billions of dollars over the next decade out of Medicare to finance subsidies to the insurance companies to cover the uninsured.  How do they do that without cutting benefits to people on Medicare, which includes me?  

Also, how does that transfer even work mechanically, since Medicare has a trust fund?  How does the money get from the trust fund to whatever fund will pay the subsidies? Are they going to lower Medicare payroll taxes so that less money goes into the trust fund? Won't lowering payments to doctors and hospitals for Medicare and Medicaid just result in fewer doctors being willing to take people on these programs as patients?  Doctors are claiming that they're being reimbursed below costs now. Any change to Medicare should have been considered as a separate bill, with a thorough national debate just on that.

This looks to me like a huge transfer of our tax money to insurance corporations. It also looks like a huge complicated mess that the Democrats have thrown together to try to get enough votes in Congress to pass it.  It reminds me of what a friend said about the Clinton's 1994 health care bill, that she would rather have no bill than that one.

We are told that this is the best they can do, and we just have accept it.  That seems to me like a good argument for never voting for Democrats again. They never give the left what we want, on any issue, they just say the right things, string us along for months and then dump us.

Meanwhile HCAO, at both the state and local level, appears to be trying to straddle the issue, supporting both single-payer and the Democrats' plan. This isn't going to work. We need to dump the Democrats and just support single-payer.

Obama & Afghanistan

I wrote this in response to an email from Dr. Rick Staggenborg, who is planning to run against Oregon Sen. Ron Wyden on the Pacific Green Party ticket.  I’ve added a little more information.

Rick,

Regarding your comments on Obama, it seems to me that the U.S. is the world’s main “terrorist-producing” country.  I suggest looking at the list of “Asians killed as a result of direct and indirect US action, 1950-2003″ in the References section of the book The World According to Washington, An Asian View by Indian writer Patwant Singh, 2005.  His total, which does not include Iraq after 2004 or the current Afganistan war, comes to over 10 million.

His figures on Cambodia surprised me as they’re rather different from what we usually hear, and I’m not sure what his source is, although he lists the books he consulted.  On that subject, however, I recommend the documentary, “The Trials of Henry Kissenger” from Netflix.  The movie denies that we were directly responsible for the killing fields of the Khmer Rouge, but says we prepared the way with Nixon’s massive bombing, which helped to destabilize the country, and a CIA-backed coup.

On Iraq, estimates of excess deaths caused by the Bill Clinton backed economic sanctions of the 1990s, according to Wikipedia, vary widely. The highest, by the Iraq government, is 1.5 million.

A 2008 survey by Opinion Research Business estimated Iraqi deaths from the current war at over a million.  The majority were caused by Iraqis killing each other but we set off the civil war, and we did a lot of the killing.  There was a brutal indifference, on our part, to killing noncombatants.  Check out the documentary “The Ground Truth” from Netflix, which has some soul searching interviews with American veterans of the Iraq war.

An October 5 article in Common Dreams says that, “While it is difficult to know exactly how many civilians have been killed in Afghanistan, estimates range from 12,000 to 32,000 deaths directly and indirectly caused by war.”

We have a lot of blood on our hands, and most Americans seem to be in denial.  I would like to see you campaign against the American Empire, which requires mass murder to keep it going, mostly for the benefit of American corporate business interests.

I’m not impressed by Obama’s rhetoric.  There is always a massive gap in American politics between what the politicians say and what they do.  Obama is killing people, just like every other American president has done.  Mass murder seems to be one of the perks of the job.  And Ron Wyden has not been willing to vote against war funding (1), which should be one of the two main focal points of your campaign, the other being health care.

Even if the Democrats’ health care plan passes, and actually works, which is doubtful, it won’t even start to increase health insurance coverage until 2013.  With a third of the country either uninsured or underinsured, this is unacceptible.  Working-class people can’t wait for this.  We need help now.

Lynn Porter

1. From December of 2005 to June of 2008, Oregon Sen. Ron Wyden voted for 6 out of 8 war funding bills.  In addition, this year he has voted for a supplemental and the Dept. of Defense Authorization and Appropriations bills, all of which contained money for the Iraq and Afghanistan wars.

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Recent letters to the editor

Afghanistan = murder

Obama recently said that his plan for subsidizing health insurance corporations would cost less than our current wars and Bush’s tax cuts for the rich.  He doesn’t seem to recognize the obvious implication of his words, which is that we should end the wars and tax cuts.

All empires have failed in the end. What we’re doing in Afghanistan is murder, and our evil deeds will come back to haunt us.  We are poisoning our souls, and the soul of our country.

Health care & single payer

For reasons I don’t understand, in spite of all our letters to the editor, op-ed columns, etc., a lot of people do not understand “single payer.”

Single payer is a way of achieving universal health care. It is a health insurance system under which one agency, the government, pays all medical bills.  As opposed to the multi-payer, private insurance system we have in the U.S. It is financed by taxes, which replace premiums. Medical care providers remain private.

Because single payer eliminates the profits of the insurance companies, and greatly reduces administrative expense due to its simplicity, it saves enough to cover all the uninsured, for the same amount of money.

Single payer also breaks the connection between health insurance and employment, resulting in much greater security.

This is the only practical way to cover everyone. The Democrats’ plan, which keeps the insurance companies in the loop, will be too expensive and will not work. Find out more at hcao-eugene.org.

Single-payer or public option vs. regulated private insurance

In a Washington Post opinion column, Matt Miller argues that instead of single-payer or a public option we need a system of regulated private insurance companies, such as they have in Switzerland and the Netherlands.

He says that “The central progressive breakthrough in any reform should be to make it possible for every American to access group health coverage outside the employment setting….”

I agree, but the insurance exchange won’t come online until 2013.  What are the uninsured supposed to do meanwhile?  The Democrats have talked about expanding Medicaid, but I don’t know how extensive that would be or when it will happen.  When Obama signs the bill?  Before 2013?

If insurers are still allowed to set premiums based on age, a lot of older people will not be able to afford individual policies from the exchange without subsidies.  Can we really depend on competition within the exchange to lower premiums?  Or negotiation between the exchange and insurance companies to get group rates?  I don’t understand the mechanism of that.  Who does the negotiating?

There is also the question of the underinsured.  The insurance exchange will apparently require a basic benefit package for participating insurance companies, but the exchange will only be open to those not covered by employers.  If your employer gives you crappy insurance, apparently you just have to live with it.  Or die with it.

Contrary to Miller, it is unacceptable to “have billions of ‘health’ dollars siphoned off by middlemen and marketers,” and no, I don’t want to think of health insurance as a jobs program.  There are better ways to employ people than bureaucratic paper shuffling.

Letter to the Register-Guard

Don Richey (letters, Sept. 6) asks, “Why should those who live responsible and healthy lifestyles be required to pay for those who don’t?”

I would like to pass on some wisdom my mother told me, a few years before she died at age 79: “The body wears out, you know.”

I’m 69 and have had cancer, treatable but nor curable, since age 58.  I’m all in favor of people watching their diet and exercising, I do.  It may improve your odds somewhat, and can’t hurt.  But the simple fact is that most health problems are due to aging or bad luck.  Someone wrote that every cell in your body is a tiny stick of dynamite that can go off at any time, resulting in cancer.

Everyone will eventually get seriously ill, it’s just a question of when, and the timing is mostly unpredictable.  Major illness is very expensive to treat — each of my three chemotherapy treatments have cost as much as buying a new car — and only the wealthy can afford to pay for it.  That’s why we have insurance, to spread the cost out over as wide a risk pool as possible.

The private health care insurance market doesn’t work, and is slowly crashing.  What we need is a single-payer system, in which the government pays all medical bills, supported by taxes, which replace premiums.  The money saved in profit and administrative expenses would easily cover all the uninsured.

The Democrats’ deal on health care

I sent the following letter to Eugene Weekly:

The Democrats’ health care “reform” bill boils down to a deal with the medical insurance corporations. The uninsured will be forced to buy expensive individual insurance policies from the corps, with government subsidies to help pay the premiums for some. In return the corps will stop playing games.

The only good part of this deal is that, for some, it will break the connection between employment and health insurance. The bad part is that it will increase our dependence on the corps.

The public plan, if it happens at all, will be too small to make a difference.

The really bad part is that nothing happens until 2013. Meanwhile, the growing number of uninsured are out of luck.

This is morally unacceptable. We need to demand something better.

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I know a working-class couple in their mid forties with a six year-old child.  The husband was laid off from an RV manufacturing job in December and has been collecting unemployment.  The wife has a part-time job running an office for a roofing company.  Since the husband was laid off, they have had no health insurance.

They recently applied for the Oregon Health Plan (Medicaid) and SCHIP for the child, but were told they made too much money to qualify — $76 too much for SCHIP.  In January the state will expand OHP and SCHIP, with negotiated taxes on insurance companies and hospitals, and then maybe this family will be able to qualify, but we don’t know if that will be the case.

Is it any wonder, then, that working-class people, insecure in their jobs, don’t see why they should pay taxes to support government programs?

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The Democrats’ health care reform plan

The Democrats’ health care reform plan is still what Rep. Peter DeFazio recently called a rough draft.  We’ll know more when it gets boiled down to a single bill.  The news is changing daily, so it’s hard to follow and confusing.  Five Congressional committees, three in the House and two in the Senate, have been working on the bill, producing different versions which will have to be merged.  The House bill is around 1,000 pages long.

If the Kucinich amendment remains in the bill, states would have the option of adopting a single-payer plan that would include money now going to Medicare and Medicaid.  I’m dubious about this, given the financial instability of most states and the Oregon legislature’s horrible cuts to OHP in the last recession.  I don’t trust them to take over Medicare.  States have a problem because most of them cannot run a deficit during a recession, as the federal government does.  I think single-payer is only possible on the federal level.  On that level I would take a chance on turning Medicare money over to a single-payer system.  On the state level, I think not.

Right now, there is a lot I don’t like about the plan.  They’ve just dropped the public option, a government-run insurance program that would compete with private insurance.  It had already been watered down so that it would probably have been too small to have much impact.  Now they’re talking about reducing the idea to insurance cooperatives, which are also expected to make little difference.

It seems like what’s left is a tradeoff — the private health insurance companies accept some limits and, in return, are handed a new, government-subsidized customer base.  Anyone uninsured would be required to buy private insurance, with premium subsidies for poor people, and tax penalties if you don’t buy it.  But the subsidies to expand coverage won’t begin until 2013.  Meanwhile the problem just keeps getting worse.  In my opinion, 2013 is unacceptable.

How the subsidies will be paid for is still up in the air.  The Senate Finance Committee is trying to work out a deal between three Democrats and three Republicans, so they can get a “bipartisan” bill, to provide 60 votes in the Senate to stop a filibuster.  There is a process called “reconciliation” which supposedly could pass the bill without having to stop a filibuster, with a simple, 51 vote majority, but I’m unclear over whether that would work.

So right now three Republican senators, representing a small fraction of Americans, are holding things up.

I’m wondering what’s in it for the uninsured and underinsured.  Seems like it has become an insurance reform bill, for the benefit of middle-class people who have good insurance and secure jobs. For those people, the bill will reduce the ability of insurance companies to play games with them.

For working-class people, with jobs that provide no insurance or bad insurance, and are subject to frequent layoffs, the only advantage would be in the premium subsidies to buy private insurance.  I don’t know if that’s worth our support.  It will be so expensive, since we’ll have to keep supporting the insurance companies, that it may be financially and politically unsustainable.  The voters are starting to rebel against incurring huge amounts of federal debt to bailout corporations.  When we see the final bill we’ll have to make a decision.

For now, I think we should focus on pushing single-payer, to try to influence the September vote in the House on HR 676.  It won’t pass, but the more votes we get for it the better, as it will help establish single-payer in the public mind.  I suggest contacting your Rep. and asking them to vote for it.

Lynn Porter

Single-payer — A medical insurance system, covering all residents, in which the government pays all medical bills. Financed by taxes, which replace premiums. Medical providers remain private.

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Organizing for legislators’ town hall meetings

Video here of rightwing, anti-health care reform town hall meeting disruptors.

The best way to counter this is for us all to show up at these town hall meetings this month with signs, and just stand silently around the edges of the room, so that our legislators, the audience and the TV cameras can see us.  We need to outnumber the disruptors.  We’re working on organizing this in Eugene for Rep. Peter DeFazio’s town hall meetings on the 18th.

Signs should say, “Single payer now!”  We need to focus on that, because the House will be voting on single-payer in Sept.  We need to establish where the left end of this debate lies.

It would also be helpful if someone would video these meetings and post the video online — YouTube, your Facebook page, etc.  Seeing is believing.

On the other hand, I’m not happy with the present fuzzy form of the Democrats’ bill(s).  The essence of it seems to be that they’re going to force everyone who doesn’t have insurance through their employer into the private insurance system, with some subsidies for poor people, and some restrictions on the insurance companies.  Possibly with some kind of weak public plan that is too small to compete with private insurance.

Like Medicare part D, this hands a guaranteed market to the giant insurance corporations, which are already making big profits, and allows premiums to keep escalating.  They won’t be able to base premiums on pre-existing conditions, but they can still base them on age.  People in their 50s  and early 60s who are unemployed, self-employed or working for small businesses are still going to find insurance unaffordable.

And, worst of all, there will be no expansion of coverage until 2013!

We need to be telling our senators and reps that this is not acceptable.  We can’t wait until 2013.  Give us single-payer or a strong public plan now, or lose our support.

Congressman Peter DeFazio Town Halls:
August 12 -  Cottage Grove Community Center 9:30 am
August 18 -  Eugene City Hall 4:45 Rally-meeting
August 18 – Springfield City Hall  6:45 Rally-meeting

City and State Town Hall on Health Care with our Oregon elected officials
August 26,  Eugene City Hall  7-9 pm

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I’m now on Facebook.

Electrical generation and nuclear power

I wrote this as a response to an email from someone advocating nuclear power.

Environmentalists are opposed to nuclear power because:

1.  We see no prospect of there ever being a good way to dispose of the wastes generated.

2.  We are concerned about the possibility of accidents.

3.  Reactors are very expensive, take a long time to build, and are heavily subsidized by the government, meaning us.

 

As I recall, Trojan was finally shut down because of cracks in its pipes.  Apparently repair was not economically feasible.  It was a business decision.  Nuclear plants eventually wear out.  I believe Trojan wore out early.

 

The cost of decommissioning these plants has to be factored into the price of the electricity they produce, also the cost of storing their waste for thousands of years.  Assuming that any form of government will last long enough to do that.  Looking at history, that seems highly unlikely.

 

Because of global warming, we are also opposed to coal plants.  At present, there is no such thing as “clean coal”.

 

We would like to see federal subsidies put instead towards developing alternative energy sources, such as wind and solar.  This could also be encouraged through a carbon tax.

 

Right now, I’ve read, wind is the most economically feasible, although it requires adding more transmission lines to the grid.  I’ve read that the U.S. electrical grid is antiquated, due to our unwillingness to spend money on infrastructure, and will have to be upgraded.  One of the many public expenses we have put off, in favor of private consumption.

 

For the coasts, one possibility being considered is offshore wind.

 

There seems to be a lot of invention going on in solar.  If the cost comes down that would be my preference, because it can be decentralized and requires no new transmission lines.  We have lots of available roofs.

 

I keep hearing that the most effective way, per dollar invested, to “generate” new energy — i.e., decrease the amount we need — is through “efficiency”, such as better insulation of buildings, etc.  Local solar experts say you should do that first before installing solar on your roof.

 

A book you might be interested in is Power of the People, America’s New Electricity Choices by Carol Sue Tombari, 2008.  She discusses the pros and cons of various means of electrical generation.  She says that the “United States’ energy demand doubles about every seven years”  (p. 52),  and explains why such an exponential increase cannot be sustained.  We are going to have to change the way we live.

Difficult choices on Medicare spending

I wrote this for the Health Care For All Oregon (HCAO) discussion email list, which is delivered, unless you choose another option, as a daily digest. You can subscribe by sending an email (no message required) to healthcareoregon-subscribe@yahoogroups.com.  The HCAO website is at http://hcao.org.

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I found the article linked below on the Rick Ray blog on the Archimedes Movement “We Can Do Better” website. I’m wondering what you all think about it. Please reply to the list, not to me, preferably in your own words.

(If you’re getting the “fully featured” version of the daily digest, it includes a “Reply to group” link at the bottom of every post.)

I have mixed feelings. I think we need more medical effectiveness research, by people who don’t have a financial conflict of interest, with the results published on the Web so that we can avoid unnecessary, and risky, medical treatment. We also need to pay more attention to the research already done. See Overdosed America by John Abramson and Overtreated by Shannon Brownlee.

On the other hand, I’m uneasy about using this research to make rules about what treatments should be paid for by private or public insurance. I would like to know more about how that would work, a specific plan. Who will make the rules? Both private and public insurance, rightly or wrongly, already have treatment exclusions. One of the most bizarre is that Medicare part B doesn’t cover physicals.

The article says, “It’s not the profits of the drug companies or the overhead of the insurance companies that make American health care so expensive, but the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective.”

We have frequently heard that 30 cents out of every health care dollar goes to pay for insurance company profits and administration, and dealing with the insurance companies by health care providers. How can he say that’s not what makes “American health care so expensive”? Surely it’s at least a major factor. It is the reason most health care activists prefer a government-run, “single payer” system.

I do agree that we need to curtail the “financial incentives for doctors and medical institutions to recommend more procedures”. One way to do that, suggested by Brownlee, is to put doctors on salary, as is done by Kaiser and the VA.

Lynn Porter

“Obama’s Difficult Choices on Medicare Spending”
http://wecandobetter.org/node/2911

http://hcao.org
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Tabling in Eugene

The peace movement to me is not so much about vision as about providing information and simple, basic organizing.

Over three Saturdays, Hope Marston and I have been tabling opposite the Saturday Market for Eugene PeaceWorks.  We have been getting signatures on our “Cut the funding” petition, passing out literature and talking to people.  (Hope does most of the talking.)

 

So far, in a total of about six hours, we have gathered 133 petition signatures and 37 email addresses for our “Cut the funding” list.  It seems to me to be a reasonable use of our time, a way to do public outreach and bring some people into our network, which hopefully will help motivate them to take action.

 

But it requires a large tolerance for indifference.  Most people just walk by us, and probably we would get very little attention if Hope weren’t standing on the sidewalk in front of our table actively engaging people.  In a polite way, she makes herself hard to ignore.

 

Part of the problem may be the location.  The Saturday Market is a big weekly party, with a lot of visual clutter competing for attention.  We have a big sign, and Hope and I both wear “Eugene PeaceWorks” T-shirts, but I notice most eyes slide right by us.  I’ve been thinking about trying a visually quieter venue, such as the library or Kiva.

 

However, from some of the verbal responses we get, a larger problem is that most people don’t know much about the wars, and don’t care.  They don’t think it affects them.  One woman told us that as long as we’re fighting these wars they have to be funded, which has it exactly backwards: As long as they’re funded they’ll be fought.

 

My guess is that will change when we enter an economic crises, which could happen any day now, and people finally understand that the U.S. does not have limitless resources, and we cannot afford the wars.  Yesterday I read that polls show Americans are already turning against government spending and deficits.

 

If anyone in the Eugene-Springfield area wants to work with us on this EPW outreach project, please get in touch.

 

Lynn Porter

http://twitter.com/eugenepeace