President Obama: Hypocrite and Hater on Single Payer Health Care

Obama likes to say that the insurance industry employs tens or hundreds of thousands, and we cannot just displace them. That’s hating. But his advisors know perfectly well that single payer health care insurance would create 2.6 million new jobs , after allowing for the 440,000 insurance company jobs it would do away with, a fact detailed in the groundbreaking report issued earlier this year by the National Nurses Organizing Committee. Instead, in the spirit of a dishonest hater, Obama has tried to ban from public forums any discussion of the single payer health care option, despite the fact that it has massive support among the people who voted for him. That is hypocrisy.

When the Obama campaign asked for house meetings across the nation on health care, the option suggested most often was indeed single payer. So you didn’t hear much of anything about the outcomes of those meetings. If that’s not dishonest hating on single payer health care it’s hard to imagine what is.

Instead, the Obama Administration’s emerging health care plan is expected to be based upon a model that has failed multiple times, most recently in Massachusetts, which includes “individual mandates” requiring people above a certain income level to purchase private insurance or face a fine, and provides some kind of care at subsidized rates to those with the lowest incomes. A recent study by physicians at Harvard Medical School meticulously exposes the predictable failure of the Massachusetts Plan to live up to any of its promises, and explains succinctly why no “individual mandate” that subsidizes private insurance companies should be a model for any national health care plan.

It’s called “Massachusetts’ Plan”: A Failed Model for Health Care Reform,” and you can find it online here.

In it, Drs. Rachel Narden, David Himmelstein and Steffie Woolhandler, all of Harvard Medical School, deliver a withering assessment of the plan’s failure, and explain why it must not be a model for any national health care plan worthy of the name.

These are the key features of the Massachusetts Plan upon which Obama’s health care plan is modeled.

1. Subsidized private insurance is made available for the poorest at reduced or no cost through a state agency.

2. Unsubsidized private insurance at controlled costs was to be made available for those who made a little more.

3. As with automobile insurance, those not qualifying for subsidized insurance would be fined ($912 a year in 2008, $1,068 in 2009, collected with your state income tax) for failing to purchase insurance.

4. Employers were required to pay $295 a year for each employee they didn’t give health insurance to.

5. To control costs, funds to pay for the program were taken from the existing pool that previously financed “safety net” care for the poor and uninsured, leaving many with fewer options and less care than was available before the “reform”.

But the subsidized health insurance policies available to the poor in Massachusetts often covered fewer services than they were already receiving under previously existing conditions, and the greater the “income” of these poor people, the lower the subsidy and higher the deductibles. Under the Massachusetts Plan, the subsidies vanish altogether when one makes 300% of the ridiculously low Federal Poverty Level — about $31,000 per year.

Despite the fines for persons who fail to buy health insurance under the so-called “individual mandate” plans, many remain uninsured because coverage is simply not affordable.

[T]he reform law specifically exempts uninsured families from fines if no affordable private plan is available. About 79,000 Massachusetts uninsured residents received this exemption in 2007, which excused them from fines, but left them uninsured.

“The private insurance plans available through the Commonwealth Choice program can be extremely expensive. According to the Connector website (accessed December 29, 2008) the cheapest plan available to a middle-income 56-year-old now costs $4,872 annually in premiums alone. However, if the policy holder becomes sick, (s)he must pay an additional $2,000 deductible before insurance kicks in. Thereafter the policy holder pays 20% co-insurance (i.e. 20% of all medical bills) up to a maximum of $3,000 annually ($9,872 in total annual costs including premium, deductible and co-insurance). A need for uncovered services (e.g. physical therapy visits beyond the number covered) would drive out-of pocket costs even higher. It is not surprising that many of the state’s uninsured have declined such coverage.

How can someone making $31,000 a year pay $90 a week in premiums alone, plus $20% of all medical bills up to $3,000 if they get sick? Is calling this “reform” even the least bit honest? Or is it hypocrisy?

The study makes the point again and again that access to health insurance is not the same as access to health care. A full third of every health care dollar is already diverted to private insurance companies. The Massachusetts Plan, and the emerging Obama Plan seem intended to preserve this cut for private insurers, even at the expense of needed care. “[T]he new inssurance policies that replced the (previous) free care system require co-payments for office visits and prescriptions, which are difficult for many low income patients to pay . . . ” says the study, hence patients suffering from HIV-AIDS and other chronic conditions have had to reduce doctor visits or skip their meds due to the high co-payments that the “reform” required.

The report outlines how the advocates of these private insurance industry endorsed versions of health care reform have lied in state after state where this has been tried — in Oregon, Maine, Vermont, Tennessee and elsewhere. We encourage our readers to download and read it, at only 18 pages, as an antidote to whatever form of “individual mandate” health plan is finally proposed by the Obama Administration.

Plans of this type have not lowered overall health care costs, either. They provide no incentive to tone down the over-reliance on expensive techniques and specialists, and produce more primary care physicians, the doctors who provide day-to-day, person-to-person coverage. Obama’s offer to “let’s computerize medical records” as a cost-saving procedure sounds nice, but falls flat. Most of the unnecessary paperwork is between caregivers, hospitals and insurers with a vested interest in saying no to this or that treatment, test, or medicine.

During the presidential campaign, Barack Obama declared we should judge his first term by whether, under his leadership, the nation finally enacted national health care system that takes care of everybody and lowers the cost of health care. Now we are in the middle of a completely foreseeable economic crisis caused in part by many of the people who are advising the president. Single payer health care has come to the fore as a viable means to create 2.6 million new jobs, a proposal that Obama’s advisors neither address nor discuss.

Sixty days into his presidency, the clock is ticking. Lofty rhetoric and lawyerly evasions are giving way to actual policies, many of them deeply disappointing to the people who campaigned and voted for this president. It looks like national health care for everybody is a dream that, if left up to this president and his advisors, will be deferred again. The question is: should we leave it up to them at all?

Bruce Dixon is the managing editor of the Black Agenda Report, where this article first appeared. Read other articles by Bruce, or visit Bruce's website.

8 comments on this article so far ...

Comments RSS feed

  1. pontesisto said on April 1st, 2009 at 12:55pm #

    If you want to help pressure Congress for Single Payer Health Care please join our voting bloc at:

    If we stand together on this issue we can make it happen!

  2. Monkismo said on April 1st, 2009 at 1:45pm #

    We can’t provide affordable health coverage–which, aside from improving the quality of people’s lives, would give them greater freedom in choosing where and for whom to work–because it would cost jobs in the insurance industry.

    We can’t cut military spending because it would cost thousands of jobs at military contractors and in the military itself.

    And yet both major parties continue to view an expanding population AND an expanding economy as non-negotiable conditions, even though these forces are mutually exclusive in themselves, and almost guarantee a diminishing standard of living for everyone.

    We are whistling through the f-ing graveyard, and Obama’s calling the tune….

  3. Kaelieh said on April 1st, 2009 at 5:57pm #

    To hell with Washington, let’s just go to our states to provide universal healthcare. The federal government can’t manage squat, let alone 330 million people.

    11 states do not allow medical underwriting when a resident applies for an insurance policy, which for people with pre-existing conditions is golden. But for the 39 states that don’t, people blessed with pre-existing conditions and like never go to the doctor benefit from medical underwriting by getting lower premiums. People with HIV, diabetes, epilepsy, etc get totally screwed by it. Eleven states don’t approve of the practice and thirty-nine either think it’s not their place or don’t think it’s a problem.

    I know Switzerland requires their residents to have health insurance, but I don’t know if it works for them or is a total flop like Mass.

    Plus, I don’t know about y’all but I am so opposed to electronic medical records. There is no way those records would stay private.

  4. lichen said on April 1st, 2009 at 7:00pm #

    Single payer healthcare only requires the government to pay the bill; they don’t “manage” anything, Kaelieh.

    It looks as if the special powers of rich washington (and the capitals of many “states”) scum have ensured that we will not have single-payer healthcare, but will instead be locked into a bogus everyone-buyer plan that will not work but will, like the wars, be almost impossible to change to single-payer afterwards because people will become more cynical and the white house will insist on ‘staying the course.’

  5. rsgrady said on April 2nd, 2009 at 4:39pm #

    The catchy title of this article intrigued me to read it. I am totally baffled by the author’s position. Obama never campaigned on a single payer platform so it should be no surprise that he has continued not to “campaign” on it now that he is in office. I was a little disappointed that the author did not make a case for a single payer system, other than to say, he wanted it. Kind of reminds me of my kid when he asks for a brownie. Too bad, I’m not an advocated for single payer, but was willing to read, listen and learn.

  6. jude said on April 2nd, 2009 at 9:34pm #

    I understand that the health forum held March 6 – excluded those championing single payer; until protests begrudgingly allowed a rep at the table.

    I told my husband- well now the Democrats are in office/ people have waited these long years for medical care – if not now, then it’ll be never. Reading this article – my God who can afford such costs especially in the midst of a DEPRESSION! President O has SIX doctors with him on this European jaunt…while here many doctors refuse those on Medicaid or Medicare. The ‘news’ has shown people DYING on ER floors while waiting hours & hours for treatment!

    A U.S.Congressman (C-Span) told of how they are afforded the choice of five different plans – free prescriptions – dental – eyeglasses and WE pay 72% of their premiums! Unlike the laid off worker, (losing his health care) they take this coverage with them upon retirement/voted out of office! Thus Sen.Kennedy got immediate care (the best) – President Clinton had his by pass surgery thanks to us – Sen Specter had his cancer surgeries on us etc.

    Little wonder they care nothing about the ‘herd’. President Obama’s supposed ‘health coverage’ will see RATIONED care with some drone in a cubicle telling your doctor ‘”Sorry we don’t cover MRI’s or prostate testing et al”. But then these bozos (politicians) are the same ones who feel $7.00 per day is plenty for food stamps (laid off workers) while they slop down all organic foods (private dining rooms) and $150.00 per lb Kobe beef!! God help us it’s business as usual with the corporate hucksters (pharmaceuticals – HMOs – Insurance) calling the shots!

    Meantime trillions are being given out to the ‘high rollers’ who have brought the nation to financial ruination! Forever War – sees the continuing BILLIONS per month (Iraq – Afghanistan) to keep the military industrial complex moneyed. Meantime we’re informed (AHH) that we will be building schools, hospitals, infrastructure in 13th Century Afghanistan while our bridges – levees, damns collapse and a trip to the grocer breaks an axle! We now have Obamavilles (Tent cities) springing up from Hawaii – Florida – California – Seattle etc –with those suffering the millions in job losses!

    The only secure jobs are political – with them getting obscene pensions (yearly cost of living included in them) and continual medical. I don’t care what Michele Obama is wearing – or that they pay $10,000 per child on dance -music lessons. Property taxes are driving people from their homes, with rising water – electric – home heating oil. I feel sick – just sick. We waited so long for health care and we’re not going to have it. What you will see is the great Die-Off!

    Only the rich will receive care. Have you ever witnessed a senior crying at the prescription counter in a generic mega drug store (they don’t care) because they can’t AFFORD their medicine? I have. But then we pay 4 to 6 times what other countries pay. I had a spinal canal tumor. I so wanted to take the physical therapy for my legs (numb) – I can’t afford it. Please wake up – there is no Messiah – it’s not ‘change we can believe in’ but CHAINS.

  7. Mulga Mumblebrain said on April 3rd, 2009 at 1:29am #

    You Yanks are just going through the process of brutal disillusionment that the Poms endured after the election of Bliar in 1997. After pretending to be something else, Bliar soon revealed himself to be a true-blue Thatcherite, and even worse in the mass murder stakes than the ‘Iron Alzheimic’ itself. And a secret ‘God-Botherer’ as well.
    Here in Australia we have suffered a similar dawning of reality with the ersatz ‘Labor’ regime of Kevin Rudd, another egotist, but with a prissy sanctimoniousness even Bliar lacks. Having succeeded the morally putrid and cynically mendacious Howard regime (whose cappo John Howard had to be surgically removed from George Bush’s ‘orifice of the fundament’ on retirement)Rudd keeps virtually all Howardite policy in place. He prefers joining in the massacre of Afghan women and children to that of Iraqi, but otherwise it is business as before. Total grovelling obeisance to Israel is a speciality, with much contempt for the Palestinians and support for Israel as they eviscerated Gazan children, and a manic scheme of extreme toadyish inventiveness, to attempt to arraign Ahmadinejad before the ICC for ‘incitement to genocide’ over his non-existent calls to ‘wipe Israel off the map’. The total control of the local political and media worlds by the pro-Israel Lobby provokes great competition in arse-licking between the two Rightwing parties tolerated by the business Bosses of the country.
    Now, alas, you poor Yanks are getting the treatment. The Obama phenomenon was pretty plainly fraudulent, at least to these cynical eyes, and US ruling elites no doubt hope to see a generation repelled by the betrayal, and be removed from the political process, an advantage of non-compulsory voting.

  8. Laurel said on July 12th, 2009 at 8:27am #

    We need a single payer system. The health insurance companies are deciding our fate. Let’s relieve them of that chore, and quit paying premiums. Then we can pay a reasonable tax for our single payer system. Insurance companies put a lot of money into advertising and discrediting Michael Moore’s movie, Sicko. Watch Ed Schultz when he goes to Canada to check out how happy her citizens are with their health plan. Don’t be afraid of the word socialism. What the heck do you think Medicare is?