Healthcare And The Economy: Time To Put The Public Back In The Policy

Digby points to a Catherine Rampel piece at NYTimes.  In it, Rampel underscores a universal political truth:

According to two recent polls from The New York Times/CBS News and The Wall Street Journal/NBC News, Americans appear very worried about controlling the federal deficit.

…that most Americans put a higher priority on keeping the budget deficit down than on spending more money to stimulate the economy.

Creation of perception makes your political reality come to life, including through carefully Luntzian-crafted questions and manipulation of the after-messaging, regardless of the underlying facts and hard numbers.

Rinse, lather, repeat.

But only if we let it, as Digby aptly points out:

The fiscal scolds don’t stop when the numbers turn around. They keep up the fear mongering because it isn’t really about balanced budgets or paying down debt. It’s about keeping government from bringing positive results to the people. As long as they can keep people focused on debt, whether it exists or not, they always have the rationale to stop any sort of government action that could empower average citizens.

And thus we come back to the question I find myself asking over and over again when mouths yap up and down about the "good of the country" and "too big to fail" and "the market will sort it out" — what’s in it for the person whose gums are flapping?

What skin do they have in the game? What promotional interest or PR ploy or electoral backscratch is involved on the down low?

Krugman has a piece on the health-care-palooza traveling carnival show we’ve all been watching. And Paul asks the question I keep asking myself:

If I had to guess, I’d say that what’s really going on is that relatively conservative Democrats still cling to the old dream of becoming kingmakers, of recreating the bipartisan center that used to run America.

Bipartisan zombies must go.

At what point does the public’s interest get put back into the policy?  As Yglesias says, the public option still has overwhelming support from the…public. 

From the Blue Dogs, the well-heeled lobbyists, the suits and well-bonused fatcats….the elected officials who seem more interested in "what’s in it for me" and whether the public gets the shaft?  That’s pretty much an empty bench when it comes to the public’s interest these days, isn’t it?

I don’t know the answer on how to fix this, but I’m sick and tired of just being so pissed at the wasteful, self-serving bullshit.

John Anderson’s wonderful piece on the Pecora Commission keeps haunting me:

To an extraordinary degree, in the halls of Congress, the conspiracy of silence continues to protect sinners on both sides of the aisle. That it is patently obvious that there are more sinners on one side of the aisle than the other doesn’t seem somehow important enough to alter the equation.

And so, as it was not quite 80 years ago, and as it was again in 1973, someone—some one man, some one woman—must break the logjam if ever we are to get at the truth.

I’m sick of waiting for the man (YouTube). Let’s find a way to force the public back into the policy. Now.

 
44 Responses to "Healthcare And The Economy: Time To Put The Public Back In The Policy"
Christy Hardin Smith | Monday June 22, 2009 05:37 am 1

Morning all. Anyone have some spare coffee? I’m about a quart low.

Got home really late last night. Hope everyone had a good weekend.


msmolly | Monday June 22, 2009 05:52 am 2

Happy to see you back, Christy. Did the Peanut get to American Girl for tea?

And I noticed someone in comments suggested you “rename” the Peanut to something more befitting her grown up status as a soon to be first grader. How about the Princess? Alternatively, a diminutive of her real name? My daughter calls her two “Kiki” and “Boo” on her blog (”Boo” is the Peanut’s age).

And have you tried making ice cream in a bag? Recipe on my daughter’s blog, with photos of the action. http://www.themomexperience.com/

Just random Monday morning ruminations. Glad you had such a great time!


Christy Hardin Smith | Monday June 22, 2009 05:59 am 3
In response to msmolly @ 2

Morning Molly — we got over to American Girl for lunch on Friday. It was adorable. We got her their little dog — Coconut — with her little carry bag for him, and she proudly carted that thing all over NYC for the rest of the trip. She’s not quite old enough for the bigger dolls yet — they don’t have that click-in meaning yet for her. But she loves the movies and we picked up a couple of tiny ones with books that she and I will read together this summer.

They have these adorable chairs for the tables at the restaurant there that the kids can use to place their doll/animal to “eat” and “drink” with a little tea set with the family. It was girlie heaven for her, and I’m so glad we did it on a really rushed trip.

But I’m so, so glad to be home. I’ve missed being on the page here profoundly, and despite being exhausted (we got in after 11 last night), my brain is racing on some new ideas.

Can’t wait to hear how everyone else faired for the weekend, too.


Christy Hardin Smith | Monday June 22, 2009 06:02 am 4
In response to Christy Hardin Smith @ 3

Oh, meant to mention, ever the rebel, she decided the dog’s name was not Coconut. It’s a boy, it’s named Butterscotch, and she’s been introducing it to all her stuffed pals all morning.

Some other girls on the train ride home who were in that “tween” age (maybe 10?) were chatting her up about the dog with their American Girl dolls (they did a weekend with the grandparents there same time we were there), and The Peanut was beyond annoyed that they kept misnaming him and told them she thought “coconut” was just all wrong. It was really funny.


selise | Monday June 22, 2009 06:04 am 5

hi christy, welcome back. i hope you had a good trip.

right now we, as a nation, spend enough money on health care to provide everyone with complete coverage for all medically necessary healthcare. with no co-pays, no deductibles, no co-insurance. there is even a bill in congress with 83 cosponsors – hr 676.

the reason we have millions uninsured, millions more underinsured (which means they can’t afford the healthcare they need even though they have insurance), thousands of unnecessary deaths, medical bankruptcies, etc is because we insist on protecting the health insurance industry instead of people.

i posted this interview earlier, but it really belongs here. from the boston globe today: Single-minded on healthcare

The debate in Washington about how to overhaul the nation’s healthcare system has included little from advocates for a single-payer plan. Dr. Steffie Woolhandler, a Cambridge Health Alliance internist and Harvard Medical School professor who cofounded Physicians for a National Health Care Program, has been raising her voice for a national plan for more than two decades, contending that the current system based on private insurance – including the Massachusetts model mandating near-universal coverage – does not serve people well, whether they are rich or poor, insured or uninsured. Here is an edited version of an interview last week.

Q. What do you think of current efforts in Washington to improve healthcare?

A. What’s currently on the table, what [President] Obama and [Senator Edward M.] Kennedy are talking about, will not fix healthcare. They don’t have any way to pay for it. We can’t just keep pumping money into the system. We actually have to fix the system.

Q. Why aren’t single-payer advocates at the table?

A. I think that was due to the tremendous influence of the private health insurance industry. We’ve pushed some and the process has moved some. At first Senator [Max] Baucus had 13 people, mostly doctors and nurses, arrested outside the hearing he was leading. We did get a hearing on single payer for the first time in history in the House Education and Labor Committee.

Q. How would a single-payer system pay for itself?

A. A single-payer system contains its own funding. It would fix the system by dramatically reducing administrative costs. Just the complexity of having competing insurance firms and the system overhead make costs go way up. In the United States, administration costs us 31 cents of every healthcare dollar. In Canada, it’s about 16.5 cents for every healthcare dollar. If we could have the administrative efficiency they have in Canada, we could move $400 billion in annual costs

.

btw, woolhandler is a co-author with elizabeth warren on the medical bankruptcy studies


Christy Hardin Smith | Monday June 22, 2009 06:06 am 6
In response to selise @ 5

Ooooh — great find. Thanks mucho! Looking forward to reading that through when my brain unmuddles a bit more from the travel.

Had a great trip. Spent the whole day Saturday at the Natural History museum, and it was amazing to see it through The Peanut’s eyes all fresh and amazing all over again, I have to say.


SanderO | Monday June 22, 2009 06:17 am 7

Obviously health care is a biz and all the players are in it for profit except the grunt workers like nurses.

No one is going to give up their place at the teat and as Selise points out it’s administrative costs, marketing “services” which is part of a competitive system and of course returning profits to investors.

Removing private ie profits from “anything” is deemed anti American, socialists, communists or other such nasty. Yet we have not for profit police, fire and schools which work quite well.

The dems are the other party of corporate suck ups so it’s tweedel dee and tweedle dum with a few voices of reason like Bernie Saunders who no one listens to. Even see him on the Sunday morning chats fests?

There is little or no hope as long as corporatism rules America. The people will be screwed until they take direct action and change this corruption. All the BS proposals are kabuki and anyone with half a brain knows that.


selise | Monday June 22, 2009 06:18 am 8
In response to Christy Hardin Smith @ 6

it’s a really short interview, i have tons of links from steffie woolhandler and also david himmelstein (who is also a co-author on the medical bankruptcy studies with elizabeth warren).

but i need coffee too…. more later if you are interested.


redfish | Monday June 22, 2009 06:26 am 9

Unfortunately, with the stimulus preceding it health care may not pass at all this year if at all due to cost. Like her or hate her, Diane Feinstein was communicating the reality that one trillion plus just isn’t going to fly.


SouthernDragon | Monday June 22, 2009 06:27 am 10

Don’t feed the chickenhawk.


Peterr | Monday June 22, 2009 06:29 am 11

Shark-fu, the Angry Black Bitch, seems to be channeling Dr. Woolhandler, though in her own vernacular (with some Aretha singing along):

Mmmmhmmm, a bitch doesn’t like what I’m reading on the internets about Congress people fretting over whether healthcare reform will happen.

Uh, uh…not one bit.

The chorus to a bitch… “But why, bitch? What disturbs thee?”

And a bitch replies to the chorus… “People are talking as if they have lost their damned minds!”

Allow me to explain.

Healthcare costs too much…right now.

Healthcare is not working for millions of Americans…right now.

Healthcare costs are crippling families and businesses…right now.

Americans have to wait, make unhealthy choices, and ration our care…right now.

[snip]

Our healthcare system is suffering from a disease that has an identifiable treatment. The patient fears the treatment because the patient is still holding onto the delusion that should no action be taken she will survive.

And our healthcare system will not survive without reform.

There’s a LOT of fear in the insurance and Pharma industries right now about the recommended treatment for their disease. “But I won’t be able to play the violin if we follow your recommendations.” “Yes, but you don’t really play the violin now, do you?”


STTPinOhio | Monday June 22, 2009 06:31 am 12

is because we insist on protecting the health insurance industry instead of people.

This would be a “Bingo!”

Private insurance has to make a profit.

It is the fiduciary responsibility of their executives to see that it does.

Public insurance has no such burden, therefore will always be the lower cost option.

Always. End of story.

Because of this, the insurance companies will go to the mat on eliminating a real public option, because they think (and I agree, btw) that it would be wildly popular with most people and end the days of annual double digit cost increases so beloved by their shareholders.

So, knowing that, to paraphase Sean Connery in “The Untouchables”, “What are we prepared to do in response?”

If we can’t organize strong, visible public support for this issue (which 75% of the country agrees with) we deserve whatever hosing we’ll eventually get.


SouthernDragon | Monday June 22, 2009 06:32 am 13
In response to STTPinOhio @ 12

If we can’t organize strong, visible public support for this issue (which 75% of the country agrees with) we deserve whatever hosing we’ll eventually get.

Right on.


oldoilfieldhand | Monday June 22, 2009 06:33 am 14

Thank you Christy! Please keep this on the front burner and front page. We don’t need health care reform! We don’t want to change a system that works so well that it is the “envy of the world”. We are only asking for the same medical insurance and treatment that our employees in the U.S. Senate, House of Representatives and the Federal Government receive at our expense. Seems fair to me. We provide it for them, they legislate it for us. They don’t legislate it for us, we don’t provide it for them.


Christy Hardin Smith | Monday June 22, 2009 06:38 am 15
In response to STTPinOhio @ 12

Insurance has to be in the business of not paying claims on any number of levels. Loopholes are and always have been the great industry mantra.

Which is why health “care” ought not be an industry. If it’s about care, it’s about the people receiving it — not doling it out in a miserly fashion. But it’s not about prevention or knowledge or anything else — it’s about maximizing profit at all other expense, isn’t it?


redfish | Monday June 22, 2009 06:39 am 16

The public clearly supports a pubic option — whether that will translate into congressional action is another story. The forces collected against it are formidable to say the least and cost is the 800 pound gorilla in the room. The deficit is a huge problem and 1+ trillion more is going to be an almost impossible sell.


Adie | Monday June 22, 2009 06:40 am 17
In response to SouthernDragon @ 10

Yes sir! I won’t, Sir!

But Good Morn to you Sir, and Christy, and all the glorious Puppies at the Lake.

We’re inundated with moving boxes, panicked at the schedule looming over our next few weeks, but determined to conquer our move to smaller, more manageable quarters, if we can just survive the experience.

Won’t be commenting. WILL be lurking.

Best to all, even that weird thing under the bridge. Every theme and variations has a segment in minor key eventually. Makes it stick out like a …. minor cueball. Rack ‘em.

Over & out for now, except for lurking. Be careful out there in the real world, folks, and keep up the good fight. ;->


STTPinOhio | Monday June 22, 2009 06:40 am 18
In response to redfish @ 9

Diane Feinstein was communicating the reality that one trillion plus just isn’t going to fly.

She is full of doo-doo.

They can always find money for every damn thing else; (unwanted wars, Wall Street Goldman Sachs bailouts, etc.) they can sure find money for something to benefit the country for a change.

This issue should be the line in the sand for all of us, if you (Congress) can’t deliver on improving the access and quality of health care for everyone, then what are we paying you for?


Christy Hardin Smith | Monday June 22, 2009 06:43 am 19
In response to STTPinOhio @ 18

She can sure find money for her hubby’s defense contractor pals when they need it in a hurry, can’t she?

Call me crazy, but I’m not certain Dianne Feinstein is the voice of reason on much of anything other than what’s good for DiFi’s career ambitions of the moment. (Say what you really think, Christy. *g*)


perris | Monday June 22, 2009 06:44 am 20

I happen to be worried about the deficit myself, but the first thing I want obama to do is get the money back from the casinos who make believe believe the are banks

then I want him to close the deficit by creating jobs and infrastructure so that we can start getting positive return on our investment instead of debt on our investment


Adie | Monday June 22, 2009 06:44 am 21

Thank you for this post, Christy, and your clear voice. ;->


oldgold | Monday June 22, 2009 06:44 am 22

Do you know what field the top medical students have been pursuing? The answer stunned me. It is dermatology. The reasons are the money and lifestyle.


foothillsmike | Monday June 22, 2009 06:46 am 23

All of these clowns in public offices are now running around saying how much they are in favor of democracy in response to events in Iran. As usual they are full of shit. They believe in POWER. If they believed in democracy there would be no debate about whether or not to include a public option but rather how to form it.


redfish | Monday June 22, 2009 06:48 am 24

As I said love her or hate her – I saw her as a messenger communicating what unfortunately I think is a possibility. That the appetite in Congress for a 1+ trillion dollar expenditure will be a tough go right now. Jamming something through via reconciliation is an option, but that has it’s dificulties and consequences too and it that is known to be a serious possibility – who knows if and what will ever get to the floor vote.


STTPinOhio | Monday June 22, 2009 06:51 am 25

So true.

I’m sorry, (no I’m not), but money is just a smoke screen.

Single payer and/or it’s weak cousin public option will save money.

That is a fact.

Obama has already put aside over 600 billion of the cost in his upcoming budgets.

What has to be stressed in these discussions when this nonsense is put forth is we can’t afford not to revamp health care. (Sorry for the double negative.)

This system of “Wait until it’s time to go to the emergency room” care is extremely wasteful and must end.


Christy Hardin Smith | Monday June 22, 2009 06:53 am 26

I think Krugman hit that squarely, though, with the ”bipartisan” CW comment he made. DiFi is generally a good finger in the wind barometer of the Beltway CW as it begins to coalesce.

Which is why we have to find some way to upset the status quo applecart or else suck it up that things are not going to change. Again.

And I find the kick the problem down the road approach to be unsatisfactory. But you probably guessed that. *g*


oldnslow | Monday June 22, 2009 06:53 am 27

Perhaps it would help if we start by getting our elected representatives to stop using the phrases “health care” and “health insurance” as if they are the same thing . As selise has already pointed out, we pay more than enough for every citizen and visitor in this country to have health care whenever needed. As you have pointed out, we pay it to the wrong “industry”.

I hope you see this redfish. NO NEW MONEY IS REQUIRED.

HealthCare NOT health insurance. NOW!


billybugs | Monday June 22, 2009 06:54 am 28

I don’t hold out much hope that there will be any meaningful change to our health system.
We have public health care here in massachusetts ,and it sucks !
Take a look at Massachusetts and you’ll see what we’ll get from Washington.
The insurance industry is the problem ,their influence will ruin any chance of reform nationally ,just like they did in Mass.
We could follow the example of the Iranians their protests go on for days and attract thousands . Here in the US we protest for an afternoon pat ourselves on the back and then return to our regular lives thinking we’ve accomplished something.
Sorry no hope here !!


STTPinOhio | Monday June 22, 2009 06:56 am 29

That the appetite in Congress for a 1+ trillion dollar expenditure will be a tough go right now.

We all know what “the appetite in Congress” is at any given time — whatever the lobbyists want.

So, if we wait for the Congressional appetite to come around to us, we’ll all be dead.


redfish | Monday June 22, 2009 07:01 am 30
In response to oldnslow @ 27

To say no new money would be needed is not believable. I have not heard a single democrat say that. CBO, etc. I think we should live in the real world — to think the American public and a majority in congress are going to buy that is not reasonable.


dcblogger | Monday June 22, 2009 07:06 am 31

The poll published by the NYT has not had time to sink in, but I have to think that it will make a difference. On Thursday of this week there will be a major demonstration in Washington, if that has a good turnout, that will make a difference, especially if people who can’t come to the demonstration us that day to visit the district office of their Senator to ask for single payer or a public option.

There is a huge bubble of denial in Versailles, they clearly have no clue as to how shabby they look to the public. Somehow we need to communicate that they have to produce.


Christy Hardin Smith | Monday June 22, 2009 07:06 am 32
In response to redfish @ 30

Honestly, I don’t think anyone can really know what is or is not an appropriate answer on that because the numbers are so deliberately muddled, obfuscated and craptastic. It’s like any other shell game in DC where there is budget money to hide in dark corners for your pals — and it’s exhausting just trying to ferret any real truth out.

Which is exactly what people who push status quo want — because the moment you throw your hands up in disgust and walk away instead of constantly banging about accountability and making a stink about the need for sunshine? Then they all get to crawl back under their profit-filled rocks and gloat.

Not good enough for me, thanks. No matter how frustrated, annoyed, disgusted…I refuse to go quietly away without a fight. Period.


Christy Hardin Smith | Monday June 22, 2009 07:08 am 33
In response to dcblogger @ 31

It just boggles the mind how warped that lens must be. It’s like the Emperor’s New Clothes on roids.


dcblogger | Monday June 22, 2009 07:09 am 34
In response to oldnslow @ 27

precisely oldnslow. Medicare for All would save up $350 Billion a year. We need to communicate to the general public that the proposed funds for the Senate plan are NOT for health care but for even more money to health insurance companies.


ekunin | Monday June 22, 2009 07:12 am 35
In response to STTPinOhio @ 12

If we can’t organize strong, visible public support for this issue (which 75% of the country agrees with) we deserve whatever hosing we’ll eventually get.

Got any suggestions? If you think commenting on this blog is organizing strong, visible public support, I disagree. I don’t see us winning on meaningful health care reform any time soon, but we should start laying the groundwork for taking the country back. You must realize though that in a nation where an inordinate number of citizens expect to win the lottery, lots of fantasies stand in the way.


selise | Monday June 22, 2009 07:18 am 36
In response to dcblogger @ 34

i think we have to fight for single payer if we want to capture that wasted money and redirect it to health care. the so-called public option debate so far strikes me as a protection racket for protecting the private insurance industry instead of people.


redfish | Monday June 22, 2009 07:22 am 37

Thanks for that and I don’t disagree in concept. I think confusion is certainly a tactic that is used by both sides of the aisle and unfortunately it works. When things become so muddled no one is confident what the truth really is. We saw this on the stimulus/banking/wall street debate — ask someone to explain credit default swaps, etc. Of course the problem is that even if someone as you said, “ferrets out the real truth”. How will that truth be recognized as such and not just another sound eminating from the white noise.

In this environment, more simplistic perspectives take hold and that is what we all have to deal with. It’s almost universally perceived that any kind of meaningful health care/reform would have a steep price tag attached to it. Truth or not — that’s a reality, especially for moderate and blue dog dems.


selise | Monday June 22, 2009 07:25 am 38
In response to ekunin @ 35

you didn’t ask me, but i’ll answer anyway.

imo, part of the fight is the at the level of the battle of ideas. this past year groups like hcan (which i HATE) have done a lot of damage in taking discussion of single payer solutions off the table… not with better ideas but by attempting to move it from the circle of progressive consensus to the circle of deviancy (see jay rosen)… right now, i’d be happy if we could even haul single payer solutions back into the circle of legitimate debate in the progressive blogosphere.


ekunin | Monday June 22, 2009 07:34 am 39
In response to selise @ 38

On the contrary-I asked you along with everyone on this list. You are right about ideas. Every thing is ideas and perceptions. The issue is how to get people organized around an idea and how do you get a handle on the number of believers? The march in Washington which I just heard of here will not accomplish anything IMHO even if it attracts a million marchers which it probably won’t. I’m for Medicare for all as much as anyone, but I’m not about to make the six hour trip to DC to express my point of view.

We habitually reset to hierarchical thinking. We look to leaders to pull our chestnuts out of the fire. The first step is deciding we are on our own. If it is to be done, we must do it. I don’t think we’re there yet.


bobh | Monday June 22, 2009 07:38 am 40

The portion of healthcare expenditures paid by insurance companies has been steadily shrinking- it is now down to 35-40%. So we already have a lot of experience with government paid for healthcare, and the customers are mostly happy.

Why provide a gross, unaffordable subsidy to private plans so that they can hold onto the steadily shrinking share of the pie they still have left?


darms | Monday June 22, 2009 07:57 am 41

And isn’t it obvious that deficits only matter under democratic leadership? Been through this before, why should we once again be forced to do the ‘responsible’ hardships to get the ‘economic house in order’ only to have the next Reagan/Bush blow up the budget for their wealthy friends?


frederic | Monday June 22, 2009 10:24 am 42
In response to darms @ 41

And of course the dem’s had absolutely no hand in this… Carter was not to blame for any of it and neither were the house dems during the Reagan and Bsuh years…

Lesson… Remember everyone, the President does NOT spend money with out the approval of Congress…


satgent03 | Monday June 22, 2009 02:01 pm 43

Hello folks, this is my first post after registering, and I love the topic. I had a liver transplant in 2002 and had to fight for my life and fight the insurance company that was determined to see me die so they would not have to pay for the transplant. If you want to educate yourself on all the talking points and facts to refute them go to the following web site and check out the FAQ section: http://www.pnhp.org/sitemap/ It is a site that some Doctors have who are in favor of a public option and it is an awesome education site. I love this site too Christy so keep up the great work!


selise | Monday June 22, 2009 03:03 pm 44

welcome satgent03!

i am so glad that you are here to tell your story.


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