Progressives and Conservatives Agree: Single Payer Healthcare Is Inevitable

The new health care legislation is a step toward elimination, by slow strangulation, of private health insurance and establishment of government as the ‘single payer.’”            – George Will, in his weekly newspaper column, Sunday July 11, 2010

Everyone loves to pick on the Affordable Care Act (ACA), and well they should.  This 2,000+ page contraption, this heap of handouts to the special interest lobbyists with a few shiny baubles thrown in to placate the common folk, was not only written by the for-profit health insurance industry but now will be implemented by former WellPoint/Anthem Vice President Liz Fowler who actually penned much of the law in her role as Max Baucus’ chief healthcare counsel for the Senate Finance Committee.  You don’t have to make this stuff up, as emptywheel reported on FireDogLake July 14, 2010, “Former WellPoint VP Liz Fowler to Implement Health Care Oversight”

But what about George Will’s fine whine that the insurance industry faces strangling regulation?  Robert Pear wrote in the New York Times on August 2 that the new law will lead to more regulation of the industry, and “the transition is full of risks and uncertainty for all involved.” If the Obama administration is going to “regulate the industry for the benefit of consumers,” he noted, then “they can’t help but destabilize or disrupt the existing market.”

Wall Street doesn’t like uncertainty.  It detests being destabilized.  Stock analysts are not missing out on this.  The brokerage firm Edward Jones “downgraded the ratings on the stocks of the three health insurers it covers – UnitedHealth Group, WellPoint and Aetna — to ‘sell’ from ‘hold’ late on Friday [7/30]. Those companies are the three largest U.S. health insurers.” (Reuters 8/2/10)

This new blow comes after legendary investor Warren Buffett pulled the plug on WellPoint and United Health, selling all Berkshire Hathaway’s holdings in the insurance giants during the first quarter of 2010 (“Buffett’s Berkshire Disposes Stake in UnitedHealth, WellPoint”)

Speaking in Virginia, former House Speaker and presumed presidential candidate Newt Gingrich said on May 14,

“The employer-based system will collapse because [the ACA] encourages businesses to drop health care coverage and incur the fine. When employees realize the high costs of the health care exchanges, they will demand a nationalized health care system.”

It only gets worse, or better, depending on your perspective.  According to Gingrich, the business community is going to lead the call for single payer Medicare for All.

And well they should.  Gingrich wasn’t making this up.  On May 6, CNN Money released documents showing that “many large companies are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for paying penalty fees to the government…  AT&T revealed that it spends $2.4 billion a year on coverage for its almost 300,000 active employees, a number that would fall to $600 million if AT&T stopped providing health care coverage and paid the penalty option.”

Is the Affordable Care Act unaffordable?  Isn’t it at least a step in the right direction?

Those questions can only be answered by considering whether the ACA ends up strengthening or weakening the health insurance corporations. Progressive critics of the bill point out that the new legislation hands over $350 billion in government subsidies to the private insurers while mandating consumers to buy the industry’s shoddy products.  That, combined with a lack of price controls means the ACA could prove to be a bonanza for the corporate stakeholders in the medical-industrial complex.

On the other hand, the changing marketplace is full of perils, even if the conservative icons quoted above are exaggerating them to stir up fear of Socialized Medicine (and maybe scare up some donations).

If we stand back and rest on our laurels, believing that the ACA will save us, then we are doomed. The industry lobbyists are working overtime to take the best parts of the bill and weaken them, while destroying any good that is in the bill (see Wendell Potter in the Huffington Post on July 27, Health Insurers Leaning on State Insurance Commissioners to “Reform” Reform).

We believe that Medicare for All is inevitable in the United States.  It is up to all of us to determine when the inevitable becomes the reality.”

– Representatives Dennis Kucinich (D-Ohio), John Conyers (D-Mich.), and U.S. Senator Bernie Sanders (I-Vt.), statement for Medicare’s birthday, July 29, 2010

If you’re not inclined to believe George and Newt, then how about Dennis, John, and Bernie:  “It is up to all of us to determine when the inevitable becomes the reality.”

The reality is that single payer, Medicare for All, is not inevitable, nor is there any guarantee the ACA won’t bankrupt us while enriching the corporations that lobbied for it.

It reminds me of a slogan we have in Indiana, “Healthcare Reform:  We’re Still For It, and We’re Not Done Yet!”

From California to Vermont, Medicare for All advocates are working for bills to create state single payer systems.  The grassroots are pushing up thru the disappointment of the Affordable Care Act.

Nationally, with the growing recognition that the health insurance giants stand as the greatest barrier to affordable healthcare for all, investors are beginning to see that this is not an industry socially responsible stockholders should be in (Huffington Post May 12, Napalm, Big Health Insurance, and Divestment).

I went to medical school to take care of sick people.  The insurance companies fulfill their fiduciary responsibility to their investors by finding ways not to pay for the care of the sick.  All their innovation and creativity go to this goal of not paying for care.  No other sector in our crazy healthcare system operates under this incentive.

It will take a mass movement, like those for women’s suffrage and civil rights.   It will take a divestment campaign like the one against apartheid in South Africa.  We must keep the pressure up, shine a light on their nefarious deeds, drive down their stock prices, and expose them for what they are: parasitic middlemen who add no value while sucking billions out of our economy.

It is up to all of us to determine when the inevitable becomes the reality.”

What Would FDR Do?

I had some face time with Rahm Emmanuel two weeks ago at my friend Owen’s. (Owen’s brother-in-law is the former Chair of the Democratic National Committee.)  Rahm said nothing surprising, but made his points.  He had just finished David Kennedy’s 1999 book Freedom from Fear about WW II, the Depression, and, germane to this conversation, the tremendous compromises involved in forging the New Deal.  Politically, he asserted, if you want to make big changes, you have to choose your battles and win the big ones.  If health reform goes down, then energy, global warming, financial reform, and labor’s legislative agenda are all at risk.  He stayed right on message.

I posed this to him: “Many Democratic politicians, including our Blue Dog Rep. Baron Hill, tell us in private conversations that they believe we have to get to single payer eventually. What advice would you give on how to get there?” Without a blink, he replied it’s “going to be a long haul”, and if we don’t pass this bill it’s going to be even longer.  He asserted that this bill begins building the required infrastructure for any future progress.

Since then, with the loss of the Democrats’ super-majority in the Senate everything is up in the air.  Which brings us back to the recurring question – Should we Kill the Bill?  There has been an incredible amount written in the Progressive community about this.  At one end is Helen Redmond (CounterPunch 12/23) Beware the Progressive Democrat arguing that we can’t trust Sanders, Weiner, or Conyers and that we’ve got to build our movement without any of that unreliable crew (kind of a rough “logical” conclusion, if you ask me).

At the other end is Nate Silver of FIveThirtyEight  (12/16) Health Care: The Elevator Pitch (and a number of other posts) where this bright political analyst makes the case for incrementalism.  Silver also notesI’ve gotten as many nasty comments and e-mails from Democrats on this issue [over the last two weeks] as I have in the past six months from conservatives on all issues. That emotion is a factor in this debate seems self-evident to me.”

All that emotion is evident as the blame is ladled out for Scott Brown’s Senate victory.  Is the message that the country is turning against the Progressives’ urge to legislate change, or that Obama has compromised the hope for change he promised by reverting to Washington business-as-usual and disappointing his base?

The healthcare bill will be at the center of this cyclone, and it’s too soon to say what gyrations the Dems will attempt to push it through.  Our response as single payer advocates should remain unchanged – we have strong, informed positions on the poor policy provisions in the bill.  I think we are best to remain silent on the political strategy (tragedy?) to be pursued.  I see an important distinction between being a pointed, persistent, insistent, carping, kvetching, nagging critic of this bill for policy reasons on the one hand, and joining in the political discussion about the merits of killing the bill on the other.

Let’s not be drawn into the classic Progressive Circular Firing Squad.  Our message is clear.  If the Democrats still manage to pass some form of health reform, they can celebrate, but WE’RE STILL FOR HEALTH REFORM, AND THIS AIN’T IT!

If no bill passes, then we have a different set of problems/opportunities.  If those who predict Republican ascendancy in the ’10 elections are right, then our work is really cut out for us.  Meanwhile, all those who forsook single payer for the allure of the public option are ripe to be brought back into our fold.  Movement building will continue.  Opportunities to form coalitions will appear.  As the business community becomes even more frustrated they will open to our message.

Here are the real lessons learned as we look back to the Iowa caucuses last January, from our vantage point looking out on the chaos this January:

  1. As much as we had hoped that this was a historic opportunity to make drastic, needed changes in our healthcare system, there really wasn’t the support to go all the way to single payer.  We can second guess Obama and Rahm forever, but I don’t believe there ever was a chance in hell that Evan Bayh, much less Lieberman or Ben Nelson would have ever voted for single payer.
  2. We should look again at a strategy of incremental reforms, a strategy that has been fruitful for many movements.  That is a longer story to explore later.
  3. No matter how hard we try to predict the future, we will always be surprised. Remember that even if single payer had passed in the full glory of HR 676 without amendment, we would have to defend it, improve it, and deal with its unintended consequences.  This work will never end.

How can we ever hope to win?  As Bill Moyers asked David Corn on his PBS show January 8, “Have people been so politically abused that the will to fight for democracy, the political will has been dissipated? “

Will it first take campaign finance reform, to break the grip of the big money? Where will that movement come from?  What other options do we have?

There is no better issue to organize around than universal health care.  In the environmental movement we learned the word NIMBY – Not In My Back Yard. Sometimes people distain NIMBY’s, but many a NIMBY activist has started locally before coming around to a global perspective.  Healthcare is everyone’s back yard, front yard, and right inside the house.  Our issue’s not going away, even if some politicians do.

We will stay in this fight for the long haul.  There is no real alternative except to quit.  When I get discouraged, I turn to one of the original crusading journalists and a real hero, IF Stone (no relation):

The only kinds of fights worth fighting are those you are going to lose, because somebody has to fight them and lose and lose and lose until someday, somebody who believes as you do wins.  In order for somebody to win an important, major fight 100 years hence, a lot of other people have go to be willing – for the sheer fun and joy of it – to go right ahead and fight, knowing you’re going to lose.  You mustn’t feel like a martyr.  You’ve got to enjoy it.

One of the great joys of being in HCHP/PNHP has been the joy of meeting and working with so many wonderful people.  I’m in this for the long haul and look forward to seeing you all many more times in the years to come.  And I can’t wait to see what’s going to happen next.

Is the House Bill Better Than Nothing – Continued again…

 

One of my professors years ago was a round little man who liked to warn us, with a twinkle in his eye, “Making predictions is very difficult, especially predictions about the future.”  Will a bill pass, in what form, and then what will the long term implications be?  It’s hard to predict.

The incomparable Dr John Geyman, former president of PNHP, makes another strong case [below] that whatever bill this Congress is able to pass will likely set the cause of single payer healthcare back because it “would leave in place an inefficient, exploitive insurance industry that is dying by its own hand, even as [the bill] props it up with enormous future profits through subsidized individual and employer mandates.”

But below that, Sam Stein writing in the Huffington Post reveals the Goldman Sachs analysis for the health insurance behemoths is that no reform would benefit them the most, and if we end up with a version close to the House bill, that would cause the industry the most financial difficulty.

It is clear that many of the supporters and opponents of the bills, both in Congress and the general public, are clearly deluded, and single payer is what has them flummoxed.

On the Left I keep talking to supporters of the public option who claim to be “single payer at heart”, and they believe that whatever passes will be the camel’s nose under the tent, the slippery slope to single payer.  Seems delusional. If only they are right….

Speaking of the Right, many of them also believe that any bill this Democratic Congress will pass will become the same camel’s nose, the same slippery slope to socialism.  Could they be right, too?

There is still work to do. The handwriting was on the wall Saturday 10/31 when anti-abortion Democrats had enough political oomph to get their Stupid Amendment debated and passed while the Progressive Caucus couldn’t muster enough support to bring either the Kucinich or Weiner Amendments to the floor.

No matter what happens, one thing is certain:  we have to continue to build our movement.  Next time around we have to get all those Representatives and Senators who voted for reform this time, to vote for real single payer reform.  And that would prove the delusional ones were right after all.

Rob

THE AFFORDABLE HEALTH CARE FOR AMERICA ACT (HR 3962):ENOUGH REFORM TO SUCCEED?

by John Geyman

As we know, the House passed its health care reform bill on October 29, 2009  after many months of contentious debate. By a narrow margin, 220-215, the 1,990 page, almost 20 pound bill was passed. It laid out the most liberal health care reform that might be expected out of Congress this year, since any bill that may clear the Senate will certainly be more restrictive.

In order to answer our question as to the value of the House bill, we need to re-state the original major goals of reform: (1) contain skyrocketing costs of health care and health insurance; (2) expand access to care by including everyone; and (3) improve the quality of care.

At a gross cost of $1.055 trillion over ten years, the House bill would do some good things, including reduction of the uninsured by up to 30 million; helping many Americans to pay for insurance through government subsidies; helping small business to provide coverage to their employees; expanding Medicaid and community health centers; establishing a new Center for Comparative Effectiveness Research to study and recommend the most effective treatments; initiating limited reforms of the health insurance industry, such as termination (four years hence) of its common practice of denying coverage based on health status and pre-existing conditions; phasing out government overpayments to private Medicare Advantage plans; revoking a decade-old anti-trust exemption for insurance companies; and creating a new long-term care program (CLASS ACT) to supplement Medicaid and/or private long-term care insurance.

However, the negatives far outweigh the positives, and adopting this bill would delay real reform for years to come. Despite a chorus of accolades about the bill by its supporters, even comparing it with the historic importance of Social Security and Medicare, this monster bill instead bears the heavy imprint of corporate stakeholders who themselves are largely responsible for out-of-control health care costs. After months of lobbying and campaign contributions to legislators crafting the legislation, their multiple conflicts of interest and political compromises, this bill ends up being a bailout for the insurance industry and a bonanza for stakeholders in the medical industrial complex.

Here are some of the major problems with the bill:

•  It will not “bend the cost curve” for many reasons—with the exception of a provision that the government negotiate drug prices with manufacturers (as the VA does so effectively), there are no real restraints on the prices of health insurance or health care services; insurers have already warned that premiums will continue to surge in future years; perverse incentives would remain in the system to continue providing large amounts of inappropriate and unnecessary services, especially by specialists in more highly reimbursed areas; and recommendations based on studies by the new Center for Comparative Effectiveness Research could not be used to mandate coverage or reimbursement policies.

•  As the crisis in declining access to care only grows (with already 46 million uninsured and at least another 30 million underinsured), expansion of Medicaid, subsidies, and limited restrictions on insurers would not take place for four more years. And as many states struggle with their deficits during the recession, access and benefit levels available to patients on Medicaid will be seriously jeopardized in many parts of the country. Meanwhile 45,000 Americans are dying each year as a result of being uninsured—one every 12 minutes.

•  Because of a number of small-print provisions in the bill, bought by industry interests and crafted by their representatives, we would see a growing epidemic of underinsuranceamong the newly insured. These are some of the reasons: low requirements for actuarial value, the proportion of health care costs that insurers are required to pay for care (probably ending up as low as 65 or 70 percent when further compromises are made with the Senate); restricted levels of benefits to be covered (the minimal essential benefits package would be in four tiers, has yet to be developed, and we can expect that it will fall far short of all necessary care); in a last-ditch effort to pass the bill and assuage pro-life legislators, new anti-choice language was added by the Stupak amendment that would deny coverage of abortion care to millions of women; and coverage shortcomings of private plans already in force will be grandfathered in without reform.

•  Even after the expenditure of more than $1 trillion, the bill would still leave some 18 million Americans uninsured.

•  The public option, diminished as it has been to the point where it could only include 2 percent of Americans by 2019, would not have enough market clout to “keep the insurers honest.” The Congressional Budget Office (CBO) has already concluded that the public option would not offer real competition to private insurers, and that its premiums would even have to be higher than private premiums. It would not be available until 2013 through the new Health Insurance Exchange, and then only to the uninsured and some employees of small businesses without coverage. Moreover, such Exchanges have no track record of success. After 15 years of experience in California, that Exchange failed, mostly due to lack of pricing power and adverse selection by attracting sicker enrollees.

•  The CBO has projected that rising insurance costs could mean that middle-income families would spend 15 to 18 percent of their income on premiums and co-payments.

This bill would not reverse the unraveling of the employer-sponsored insurance system because of rising health care costs that outpace the rest of our economy; despite subsidies to small business, employer-sponsored insurance would remain unsustainable.

This bill would only add to the already large burden of complexity and bureaucracy, together with their additional costs. At the same time, it would forego savings of some $400 billion a year that could otherwise be achieved through a simplified, more efficient single-payer system.

So in sum, this bill, while well intentioned, is fatally flawed. It would not effectively address the three major system problems demanding urgent reform, and would delay real reform by letting much of our population falsely think that reform is at hand. It would leave in place an inefficient, exploitive insurance industry that is dying by its own hand, even as it props it up with enormous future profits through often subsidized individual and employer mandates.

The most fundamental single question about how to reform our health care system should be whether or not we abandon our multi-payer, mostly investor-owned financing system or move to a not-for-profit single-payer system, Medicare for All, which this year’s political process has carefully kept off the table. The lesson of history in this country tells us that, as long as we retain private health insurance at the core of our health care system, we can never achieve universal access to affordable, comprehensive high-quality care.

John Geyman, M.D. is Professor Emeritus of Family Medicine at the University of Washington, past President of Physicians for a National Health Program, author of a number of books on health policy, and a member of the Institute of Medicine.

Goldman To Private Insurers: No Health Care Reform At All Is Best

Sam Stein
First Posted: 11-12-09 05:12 PM   |   Updated: 11-13-09 12:02 AM

A Goldman Sachs analysis of health care legislation has concluded that, as far as the bottom line for insurance companies is concerned, the best thing to do is nothing. A close second would be passing a watered-down version of the Senate Finance Committee’s bill.

A study put together by Goldman in mid-October looks at the estimated stock performance of the private insurance industry under four variations of reform legislation. The study focused on the five biggest insurers whose shares are traded on Wall Street: Aetna, UnitedHealth, WellPoint, CIGNA and Humana.

The Senate Finance Committee bill, which Goldman’s analysts conclude is the version most likely to survive the legislative process, is described as the “base” scenario. Under that legislation (which did not include a public plan) the earnings per share for the top five insurers would grow an estimated five percent from 2010 through 2019. And yet, the “variance with current valuation” — essentially, what the value of the stock is on the market — is projected to drop four percent.

Things are much worse, Goldman estimates, for legislation that resembles what was considered and (to a certain extent) passed by the House of Representatives. This is, the firm deems, the “bear case” scenario — in which earnings per share for the top five insurers would decline an estimated one percent from 2010 through 2019 and the variance with current valuation is projected to be negative 36 percent.

What the firm sees as the best path forward for the private insurance industry’s bottom line is, to be blunt, inaction.

The study’s authors advise that if no reform is passed, earnings per share would grow an estimated ten percent from 2010 through 2019, and the value of the stock would rise an estimated 59 percent during that time period.

The next best thing for the insurance industry would be if the legislation passed by the Senate Finance Committee is watered down significantly. Described as a “bull case” scenario — in which there is “moderation of provisions in the current SFC plan” or “changes prior to the major implementation in 2013” — earnings per share for the five biggest insurers would grow an estimated ten percent and the variance with current valuation would rise an estimated 47 percent.

The report, a Goldman official stressed, was analytic not advocacy-based. Their job was to provide a sober assessment of the market realities facing private insurers under various versions of health care reform.

Story continues below 

“If no reform at all happens you would see the largest rise in EPS,” a Goldman official acknowledged. “But what we are doing is just analyzing what the stocks would do under different scenarios.”

The study does note on the front page that the firm “does and seeks to do business with companies covered in its research reports.” Those companies include Aetna, Wells Point and United Health.

In the context of the current health care debate, the findings provide a small window into the concerns that have driven the private insurance industry’s opposition to reform legislation. Simply put: health care reform is going to hurt their bottom line. No less a prestigious voice than Goldman Sachs is telling them so.

Some insurers, in the end, will be hit harder than others. CIGNA is the lowest of the big five, for instance, because it does little business providing insurance plans to Medicare patients, individuals and families buying health plans directly, or small employers that offer health plans to their workers.

In addition, some reforms are going to hurt the industry more than others. Regulatory changes — such as prohibiting the prejudice against consumers with pre-existing conditions — will have an impact across the board, as will the funding cuts to Medicare Advantage.

Overall, Goldman calculates the probability of reform passing Congress at 75 percent. Though the limitations of Goldman’s political prognostications were on full display earlier in the document:

By mid-late October, we expect a cloture vote (60 votes) to bypass a potential filibuster followed by several weeks of debate over proposed amendments on the Senate floor (with a similar process under way in the House). If both the Senate and House are able to pass legislation (perhaps before the Thanksgiving recess), a House-Senate conference negotiation should produce combined legislation for final approval (perhaps by mid-December).

 

National Call-in Day February 12

 


The National Single Payer Alliance

National Call-in Day for HR 676
February 12, 2009     Lincoln’s Birthday

Dear Friend,
  
The Leadership Conference for Guaranteed Healthcare is encouraging everyone to participate in the next National Call-in Day for HR 676. Mark your calendars.
  
February 12, 2009: Call Congress – Congressional switchboard: 202-224-3121 – ask for your representative’s office, and the President – 202-456-1414
  
If your member is a current co-sponsor,  thank your rep. and ask him or her to stand firm for HR 676 and actively seek additional co-sponsors.
  
If your member was a co-sponsor in the last Congress, ask him or her to sign on immediately as a co-sponsor in this Congress.
  
If your member has yet to co-sponsor HR 676, ask him or her to please become a co-sponsor, select one or two talking points here.


 
In a letter to Col. William F. Elkins written November 21, 1864, Lincoln wrote: “I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. . . . corporations have been enthroned and an era of corruption in high places will follow, and the money power of the country will endeavor to prolong its reign by working upon the prejudices of the people until all wealth is aggregated in a few hands and the Republic is destroyed.”
 
 
In celebration of Abraham Lincoln’s birthday, remind your member of Congress to honor his words and heed his warning as we look to reform his precious nation’s healthcare system. 
  
Sincerely,
  

Quentin D. Young, MD
National Coordinator
Phyisicans for a National Health Program

Donna Smith
Community Organizer
California Nurses Association
National Nurses Organizing Committee

PDA National Healthcare NOT Warfare Co-Chair

Tim Carpenter
Executive Director
Progressive Democrats of America

Katie Robbins
Assistant National Coordinator
Healthcare-NOW!

P.S. Don’t forget to call (202-456-1414) or fax (202-456-2461) the White House to make sure our current President recalls how very troubled another young lawyer from Illinois was as he viewed the future of the nation under the control of the monied and corporate interests just like those swirling in the for-profit health insurance industry.

 

Is Daschle part of the problem or part of the solution?

Published on Saturday, January 31, 2009 by Politico
Health Care Groups Paid Daschle $220k

by Kenneth P. Vogel

Tom Daschle, tapped to be President Obama’s health czar, was paid more than $200,000 by the health-care industry in the past two years, according to documents obtained by Politico.

[US President Barack Obama’s pick for secretary of health and human services, Tom Daschle, seen January 8, paid over 100,000 dollars in back taxes in January after failing to report services from a wealthy friend, US media reported Friday. (AFP/Getty Images/File/Mark Wilson)]US President Barack Obama’s pick for secretary of health and human services, Tom Daschle, seen January 8, paid over 100,000 dollars in back taxes in January after failing to report services from a wealthy friend, US media reported Friday. (AFP/Getty Images/File/Mark Wilson)
The former Senate majority leader, who gave speeches to firms and groups with a vested-interest in the administration’s upcoming health reform, collected the checks as part of a $5 million windfall after he lost reelection to his South Dakota seat.

This weekend, Daschle’s nomination to be secretary of Health and Human Services became embroiled in controversy over the last-minute revelation that he had only recently paid long-overdue taxes.

Daschle made nearly $5.3 million in the last two years, records released Friday show, including $220,000 he received for giving speeches, many of them to outfits that stand to gain or lose millions of dollars from the work he would do once confirmed as secretary of Health and Human Services.

For instance, the Health Industry Distributors Association plunked down $14,000 to land the former Senate Democratic leader in March 2008. The association, which represents medical products distributors, boasts on its website that Daschle met with it after he was nominated to discuss “the impact an Obama administration will have on the industry.”

This week, the group began openly lobbying him, sending him a letter urging him to rescind a rule requiring competitive bidding of Medicare contracts.

Another organization, America’s Health Insurance Plans, paid $20,000 for a Daschle speaking appearance in February 2007. It represents health insurance companies, which under Obama’s plan would be barred from denying coverage on the basis of health or age.

There was a $12,000 talk to GE Healthcare in August, a $20,000 lecture in January to Premier, Inc., a health care consulting firm, and a pair of $18,000 speeches this year to different hospital systems, among other paid appearances before health care groups.

The speaking fees were detailed in a financial disclosure statement released Friday, which showed that Daschle pulled down a total of more than $500,000 from the speaking circuit in the last two years, and $5.3 million in overall income.

That includes more than $2 million in consulting fees from InterMedia Advisors, a private equity firm.

Daschle, who represented South Dakota in the Senate for three terms, initially failed to pay taxes on the free use of a car and driver that had been provided to him by InterMedia’s founder, high-rolling Democratic donor Leo Hindery Jr., according to the New York Times. It reported that Daschle this month paid more than $100,000 in back taxes and filed amended tax returns.

Daschle reported $182,520.26 of “company provided transportation” on the disclosure form, which also indicates he owns a stake in the company worth between $200,000 and $500,000, as well as a “5 % limited partner profit sharing interest.”

But he reported that only about half of his interest is vested, and he indicates that “upon confirmation, I will divest all my vested shares and unvested shares and relinquish any benefit to which I may otherwise be entitled.”

Daschle reported that he has been a consultant and chair of the company’s advisory board since January 2005, the same month he left the Senate after being upset in his reelection bid by Republican John Thune.

He also became an adviser to the law and lobbying firm Alston & Bird, which paid him $2.1 million in wages last year and also provided him a 401k and profit sharing plan worth between $100,000 and $250,000, according to the report.

In his three years at the firm, it’s earned more than $16 million lobbying on behalf of some of the health care industry’s most powerful interests before the department he’s in line to lead. Though Daschle himself did not register to lobby for the firm, he has advised the firm’s clients on health care issues, according to the firm’s website.

His disclosure indicates he provided “policy advice” to such clients as United Health, AT&T and the politically connected consulting shop Glover Park Group.

After leaving the Senate, Daschle also landed a host of lucrative board spots, including with the energy giant BP Corporation, which paid him $250,000 in fees, developer CB Richard Ellis, which paid $121,000, and ethanol processor Mascoma Corporation, which paid him $75,000, according to the disclosure.

It shows that Daschle has hundreds of thousands of dollars in stocks and options from CB Richard Ellis and Mascoma, though he indicated he forfeited his unvested stock options and wrote that “if confirmed, I will divest my vested stock options with CB Richard Ellis.”

He reported owning homes worth as much as $250,000 each in Aberdeen, S.D., and Altus, Okla., with his wife, a high-powered lobbyist for Baker, Donelson, Bearman, Caldwell & Berkowitz.

Daschle wasn’t required to disclose her income, but did report that her retirement plans through the firm were worth more than $260,000.

Chris Frates contributed to this report.

For the New York Times 1/31 on Daschle see http://www.nytimes.com/2009/02/01/us/politics/01daschle.html?_r=1&hp

Hchp’s Weblog › Tools — WordPress

Hchp’s Weblog › Tools — WordPress.

Is single payer healthcare reform too radical a step for America to take?

Tell MoveOn it is the right step.

“If you bend your back, people will ride your back.“- Taylor Rogers, retired Memphis Sanitation Department worker

There is a vigorous debate among those who agree that the US must move toward universal health insurance coverage, but disagree on how to get there. Health Care for America Now (HCAN) has pushed forward with a plan remarkably similar to that proposed by Barak Obama. It is based on the premise that the most politically feasible path forward requires giving Americans the choice between keeping their current insurance, or buying into a government sponsored plan based somehow on the Federal Employees Health Benefits Program, like members of Congress have.

Obama used to be a single payer advocate, and more than once has said that in the ideal world, single payer health insurance would be the best system possible, but given current political reality his plan is the best way to go. There are articulate voices arguing that the Obama-HCAN plan would be a strong step toward single payer. And there are others who argue that Obama and HCAN are simply afraid of the power of the insurance industry and their well-funded lobbyists.

If single payer is the ideal plan, then why compromise before we’ve even sat down at the negotiating table? I’m reminded of a piece NPR did on the 40th anniversary of Martin Luther King’s assassination. They interviewed two of the sanitation workers on whose behalf Dr King had gone to Memphis. Mr. Taylor Rogers was one of those men, and he recalled how bad the working conditions were, and how inspired they were by the words of Dr. King. He explained how thirteen hundred sanitation workers decided they werent going to take it any more. You know, if you bend your back, people will ride your back. But if you stand up straight, people can’t ride your back. So that’s what we did. We just stood up straight.

I went to medical school 35 years ago to learn how to take care of sick people, and that’s what I still do. I serve the sick and the suffering. I love my work, but I hate how I’m paid. The cost shifting, the complicated crazy undecipherable bills, the lives ruined by my unpaid bills turned over to collections, and on and on. The insurance industry, on the other hand, is here to serve its shareholders, not its customers. It takes money in the form of premiums from the healthy, and in order to make a profit, it must put all its ingenuity and guile into not paying for the care of the sick. That’s how they are profitable, take in money as premiums, but find ways to not pay it back out for health care. I am completely at odds with that. I want to take care of the sick, and they want to avoid taking care of them.

The sins of the insurance industry are well documented, and I don’t need to recount them here. Our entire system has become distorted, inefficient, and administratively bloated, and the reason is as simple as this: Americans want the sick to get taken care of, and the private insurance industry doesn’t want to take care of them. The insurance companies are the problem. They are not going to be a helpful part of the solution, but the HCAN plan protects them. And yet they are collapsing as our bloated system collapses. The for-profit insurance industry is like a dinosaur stumbling toward a tar pit. Let them go.

On the other hand, we have over forty years experience with a universal single payer system. It’s called Medicare, and although not perfect, it works very well. It already takes care of our sickest and most expensive patients, folks over age 65. Medicare is very popular. Medicare runs at about 3% overhead, compared with 15-30% overhead with private insurance. Expanding Medicare to cover everyone can hardly be called radical. It,s the most commonsense idea on the table.

As we seek our way forward, let’s hold our heads high and our backs straight. Who can foresee what compromises may have to be made to bring about true universal health care in America, but let’s start our with a clear voice: We want the best health care system in the world! We can have the best. If we walk into the room already compromised and bent over, they will climb on and ride. Stand tall, America. Medicare for All.