Take away the loonies, the ones shouting comparisons of President Obama to Hitler, the ones talking about “death panels” and all the other stuff. Imagine a reasoned discussion of the pros and cons of the health care reforms now before us.
The health care reforms now before us? Excuse me, but what are they? We have no final bill from the Senate, we have three different bills from the House that await passage, and we have nothing specific from the White House. Here we are, arguing about a 17% slice of the American economy, and we don’t know what we are talking about.
Oh sure, we are talking about a public option, but we don’t know who will be eligible to join, we don’t know whether such an agency will be permitted to charge lower rates than the private insurance companies, we don’t know whether it will be allowed to negotiate lower fees from the drug manufacturers. We talk about Medicare remaining intact, but at the same time we are talking about reducing its cost by some $300 billion, much of this by moving toward a results-based medicine, which would surely mean some adjustments in Medicare, quite possibly very major adjustments.
We want — presumably even the Republicans want — a system that costs less and delivers more. We are — or should be — embarrassed by our low ranking, compared to other industrialized nations on such elemental matters as life expectancy and infant mortality. When all the chest thumping’s done, ours is not, by any measure, the “best” health care system in the world; it is only the costliest. And there’s also that minor issue of nearly 50 million uninsured people and another 25 million underinsured.
I’m afraid we’re having the wrong debate, even without all the absurd charges and the outrageous behaviors that have characterized altogether too many of the town meetings. It’s the wrong debate because it’s trying simultaneously to increase coverage and to reduce costs, and if that has left the public confused, there is good reason for the confusion. It is not possible, within the current structure, to do both at the same time.
Or, more precisely, there is only one way in which both goals can be accomplished. It is the way that has been chosen by Canada, by Great Britain, by France, by Germany, by Spain — indeed, by every other industrialized nation. It is — dare I speak the words? — universal coverage with close government supervision of costs.
That option, endorsed by a significant number of members of Congress (and, presumably, supported privately by many more), has been off the table since the debate’s been joined. President Obama supported it — but only back when he was a state senator in Illinois. Here’s the full quote, from an Obama speech to the Illinois AFL-CIO on June 30, 2003: “I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14% of its Gross National Product [now 17%] on health care cannot provide basic health insurance to everybody…. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”
Well, guess what? We have the White House; we have the Senate; we have the House. But we not only do not have single-payer, we are not even talking about single-payer. It’s possible that Obama suffers from a failure of nerve, or from a surfeit of bipartisan aspiration. It’s also possible that he and his people are better vote-counters than those of us who wish he’d given single-payer a real test.
Still, it would not be that complicated a test, since the truth is we already have single-payer for all Americans over the age of 65. It’s called Medicare, and it solves both coverage (everyone) and cost at the same time, running very substantially below the private insurance companies in administrative costs.
But the way to “sell” single payer is not to persuade people that it is fiscally sound and medically appropriate. The way to sell it is to insist that there is something fundamentally wrong when the system designed to provide health care is set up as a profit center. There are those who define a mix of public and private insurance systems as “the American way,” but the stark truth is that the insurance companies bring no added value to the health care system, none at all. (Unless you want to count their clerical contribution in processing claims.) What they contribute to the system is, alas, money for lobbyists and for legislative campaigns.
There are more modest potential fixes (savings) of other key components of the health care system — some improved efficiencies in hospitals (most are still nonprofits), drugs (where much better prices could be negotiated), professional compensation of some specialties, tinkering with the costs of malpractice premiums — but none promises nearly the saving that the elimination of private health insurance would provide. Between 2000 and 2007, the net profits of 10 of our largest health insurance companies increased by 428% (that includes WellPoint, up from $226 million to $3.345 billion — a 1,380% increase, and Aetna, up from $127 million to $1.831 billion, a 1,342% rise.) In 2007, the chief executive officers at these 10 companies collected a combined total compensation of $118.6 million — an average of $11.9 million each. That is 468(!) times more than the $25,434 an average American worker made that year. (We may assume that the CEOs all have health insurance; we know that many American workers of average income do not.)
Can government do the job? Look at Medicare, look at the V.A. hospital network. Government is already doing the job — or a significant chunk of it. By going for half a loaf instead, we may end up with a pile of crumbs.
Mr.Fein We also see media report after report of waste,fraud in the programs you cited.There is a long record of gov't saying a law or program will or willnot do something falsely.The numbers reported by gov't in regard to economy are treated as a joke so why trust anything it says on healthcare.Your liberal boomer group doesn't get it-the country doesn't trust or respect the scum in power democrat or republican for good reason.
It's gratifying to see an honest appraisal of what is wrong together with a reasoned explanation to what is needed in the Jewish press.
I have had numerous conversations with those in power, including Congressional representatives, a conservative Democratic Senator, and high executives in the health care and insurance industry. All of them will privately admit, as does President Obama, that a single payer system would be the best way to address the access problems and the cost explosion in the health care system, yet they all back away from open support of this option. Interestingly, as evidenced by their support for the Kucinich amendment in the House Education and Labor Committee, an amendment which would allow for state by state experimentation with single payer plans, even Republicans may get it.
Single payer is indeed the elephant in the room..... dare we speak its name......
As usual the left does not get it. Mr. Fein's article is a total left wing view of the Health Care problem. Two steps that could reduce the cost of Health Care very quickly would be (1)Tort Reform and (2) Removing the blocks to true competition set up in individual states. Of the 1200 Health Insurers in the USA, California has access to 6 of them. Why do the Democrats stay away from those issues? As for "Death Panels" in yesterday's news a group of UK doctors revealed that there ARE death panels in the UK. There are hundreds, maybe thousands of Canadians that come into the USA, for treatment because of the waiting time for life saving care in Canada. Is that what we want? Mr. Fein, what happens when we add 50 million people to the Health care rolls with no increase in doctors? I will tell you, RATIONED CARE, with the elderly bearing the brunt of this rationing, because of the "Government controlling COSTS". Don't remove $500,000,000,000 from medicare to fund Health Care for people younger and stronger or can, but will not pay for a health care plan. Mr. Fein, your article is flawed with inacuracies and lies. LET THE FREE MARKET SYSTEM WORK, LIBERALS, STOP SCREWING UP THE SYSTEM WITH NEEDLESS LEGISLATION THAT MAKE TRUE COMPETITION IMPOSSIBLE. Mr. Obama, I would rather die than sign up for a health care system that will take this country down the road to Liberal-Socialism RIGHT NOW THIS COUNTRY NEEDS JOBS, NOT A PLAN THAT WILL DRIVE MORE COMPANIES OUT OF BUSINESS
"Take away the loonies, the ones shouting comparisons of President Obama to Hitler,"
I THINK ONE OF THE "LOONIES" WOULD LIKE TO RESPOND TO MR. FEIN
by Pam Geller
I am a student of history. Professionally, I have written 15 books in six languages, and have studied history all my life. I think there is something monumentally large afoot, and I do not believe it is just a banking crisis, or a mortgage crisis, or a credit crisis. Yes, these exist but they are merely single facets on a very large gemstone that is only now coming into a sharper focus.
Something of historic proportions is happening. I can sense it because I know how it feels, smells, what it looks like, and how people react to it. Yes, a perfect storm may be brewing, but there is something happening within our country that has been evolving for about 10 - 15 years. The pace has dramatically quickened in the past two.
We demanded and then codified into law the requirement that our banks make massive loans to people whom we knew could never pay back? Why? We learned recently that the Federal Reserve, which has little or no real oversight by anyone, has "loaned" two trillion dollars (that is $2,000,000,000,000) over the past few months, but will not tell us to whom or why or disclose the terms. That is our money. Yours and mine. And that is three times the $700B we all argued about so strenuously just this past September.
Who has this money? Why do they have it? Why are the terms unavailable to us? Who asked for it? Who authorized it? I thought this was a government of "We the People," who loaned our powers to our elected leaders. Apparently not.
We have spent two or more decades intentionally de-industrializing our economy. Why?
We have intentionally dumbed down our schools, ignored our history, and no longer teach our founding documents, why we are exceptional, and why we are worth preserving. Students by and large cannot write, think critically, read, or articulate. Parents are not revolting, teachers are not picketing, school boards continue to back mediocrity. Why?
We have now established the precedent of protesting every close election (now violently in California over a proposition that is so controversial that it wants marriage to remain between one man and one woman. Did you ever think such a thing possible just a decade ago?). We have corrupted our sacred political process by allowing unelected judges to write laws that radically change our way of life, and then mainstream Marxist groups like ACORN and others to turn our voting system into a banana republic. To what purpose?
Now our mortgage industry is collapsing, housing prices are in free fall, major industries are failing, our banking system is on the verge of collapse, Social Security is nearly bankrupt, as is Medicare and our entire government. Our education system is worse than a joke (I teach college and know precisely what I am talking about.) The list is staggering in its length, breadth, and depth. It is potentially 1929 x 10. And we are at war with an enemy we cannot name for fear of offending people of the same religion who cannot wait to slit the throats of your children if they have the opportunity to do so.
And now we have elected a man no one knows anything about, who has never run so much as a Dairy Queen, let alone a town as big as Wasilla , Alaska . All of his associations and alliances are with real radicals in their chosen fields of employment, and everything we learn about him, drip by drip, is unsettling if not downright scary (Surely you have heard him speak about his idea to create and fund a mandatory civilian defense force stronger than our military for use inside our borders? No? Oh, of course. The media would never play that for you over and over and then demand he answer it. Sarah Palin's pregnant daughter and $150,000 wardrobe is more important.)
Mr.. Obama's winning platform can be boiled down to one word: Change...radical change. Why?
I have never been so afraid for my country and for my children as I am now. This man campaigned on bringing people together, something he has never, ever done in his professional life. In my assessment, Obama will divide us along philosophical lines, push us apart, and then try to realign the pieces into a new and different power structure. Change is indeed coming. And when it comes, you will never see the same nation again.
And that is only the beginning.
I thought I would never be able to experience what the ordinary, moral German felt in the mid-1930s. In those times, the savior was a former smooth-talking rabble-rouser from the streets, about whom the average German knew next to nothing. What they did know was that he was associated with groups that shouted, shoved, and pushed around people with whom they disagreed; he edged his way onto the political stage through great oratory and promises. Economic times were tough, people were losing jobs, and he was a great speaker.. And he smiled and waved a lot. And people, even newspapers, were afraid to speak out for fear that his "brown shirts" would bully them into submission.
And then he was duly elected to office, with a full-throttled economic crisis at hand [the Great Depression]. Slowly but surely he seized the controls of government power, department by department, person by person, bureaucracy by bureaucracy. The kids joined a Youth Movement in his name, where they were taught what to think. How did he get the people on his side? He did it promising jobs to the jobless, money to the moneyless, and goodies for the military-industrial complex. He did it by indoctrinating the children, advocating gun control, health care for all, better wages, better jobs, and promising to re-instill pride once again in the country, across Europe , and across the world.
He did it with a compliant media - Did you know that? And he did this all in the name of justice and...change. And the people surely got what they voted for. (Look it up if you think I am exaggerating.) Read your history books. Many people objected in 1933 and were shouted down, called names, laughed at, and made fun of. When Winston Churchill pointed out the obvious in the late 1930s while seated in the House of Lords in England (he was not yet Prime Minister), he was booed into his seat and called a crazy troublemaker. He was right, though.
Don't forget that Germany was the most educated, cultured country in Europe . It was full of music, art, museums, hospitals, laboratories, and universities. And in less than six years - a shorter time span than just two terms of the U. S. presidency - it was rounding up its own citizens, killing others, abrogating its laws, turning children against parents, and neighbors against neighbors. All with the best of intentions, of course. The road to Hell is paved with them.
As a practical thinker, one not overly prone to emotional decisions, I have a choice: I can either believe what the objective pieces of evidence tell me (even if they make me cringe with disgust); I can believe what history is shouting to me from across the chasm of seven decades; or I can hope I am wrong, close my eyes, have another latte and ignore what is transpiring around me.
Some people scoff at me; others laugh or think I am foolish, naive, or both.. Perhaps I am. But I have never been afraid to look people in the eye and tell them exactly what I believe - and why I believe it. I pray I am wrong. But, I do not think I am.
About the author via Google...
Pamela "Atlas" Geller began her publishing career at The New York Daily News and subsequently took over operation of The New York Observer as Associate Publisher. She left The Observer after the birth of her fourth child, but remained involved in various projects including American Associates, Ben Gurion University and being Senior Vice-President Strategic Planning and Performance Evaluation at The Brandeis School.
The term we need to discuss is rationing. Why should someone who opposes the social good get treatment before someone who fights for the social good. Lets say that two people with heart attacks appear in the emergency room. One of them belongs to J street and the other belongs to AIPAC. Since J street fights for the social good and AIPAC fights for the entrenched insterests of zionists, the J street patient needs to be seen first. As a sociatey with limited resournces, we need to triage and people need to take responsibility for bad lifestyle and political decisions
The comments published in response to this article so far indicate why Mr. Fein is so wrong. Let's assume that he is correct that single payer is the way to provide universal coverage and simultaneously control costs. He's still wrong.
The key to all of these discussions is that we are a democracy. Our democracy does not require the electorate to be right; the electorate gets what it wants whether it is right or wrong.
Surveys show that the majority of Americans are happy with their health care. Our side (left) is having enough trouble getting even the watered down (from single payer) proposals we currently have enacted into law. Beating the drum for single payer would be the death knell of universal coverage. That is, unless Mr. Fein has some way to sell single payer that no one has seen so far. And no, obsessively repeating the same arguments does not qualify.
To Rabbi Jutner
Isn't that what the Nazis did? "Preferrential Treatment for the Preferred People"
I, personally think Liberal Rabbis should go to the end of the line because they contribute nothing to society.
It is becoming more and more evident to many Jews that Reform Judaism is a political movement, NOT a religous movement
I guess for those who want a "public option" they can always move to a place like, say, Israel, or another nation that doesn't have a very clear Constitution that limits what their government can impose on its citizens in the name of the Borg collective.