THE REAL REASON SINGLE PAYER IS INEVITABLE

                                                                                         
                                                                               

                                                                                 
A recent Associated Press article by Ricardo Alonso-Zaldivar outlined a number of problems with the Affordable Care Act (ACA) that “are leading some to wonder whether “Obamacare” will go down as a failed experiment.” Paradoxically, news that Obamacare is in crisis should be encouraging for anyone who understands the economics of health care.  Until people heavily invested in defending it against unfair attacks see that it won’t work, they won’t understand the need to demand a health care system that will.

While it’s a shame that the number of uninsured will rise before the problem can be fixed, that is the inevitable cost of dismissing the only real solution to rising health care costs and decreasing access:  a single payer system. Robert Reich recently argued this, but he missed the main point. He was right that Obamacare has led to decreased competition as insurance companies consolidated and took over state markets, but this is not what will kill it.  The real reason was evident before the debate on health insurance reform began. It’s called the “death spiral” of health care costs.

The death spiral is simple to explain. The more health care costs rise, the fewer people can afford it. This leads insurers to increase premiums and deductibles in order to maintain profits, leading in turn to fewer people buying insurance, and the cycle repeats. A 2005 study published in American Family Physician projected that the average individual would pay 100% of her income for health care at then-current rates of inflation! This trend started before Obamacare. It was built into the system. It is the reason 45 million Americans were underinsured in 2008. It was the inescapable consequence of a system of private insurance.

Of course, no one will pay all of their income for medical insurance. Very few would pay half of that. However, that’s exactly what the AFP study predicted that would have been the average cost in 2015. That hasn’t happened, but it isn’t because Obamacare has decreased the rate of health care cost inflation. The relative stability of health care costs over the last few years started before ACA’s main provisions took effect, and the rate of inflation has picked up again, worse than before.

ACA manages to mask some of the astronomical cost of medical insurance by providing billions of tax dollars to prevent large premium subsidies for a significant segment of the market.  According to the AP article cited above, over 80% of Healthcare.gov customers get subsidies of about 70% of their premiums. That’s tax money going straight into private pockets for a “service” that adds nothing of value to the provision of health care. Obamacare was, more than anything else, a bailout of a failing Wall-Street owned medical insurance industry. The question is, at what point are Americans going to catch on and realize that pouring all that money into the system just to maintain shareholder profits is a fool’s game?

Obamacare only delays the day of reckoning for a system that is pricing itself out of existence.  If the ACA had not passed, it would be on the verge of collapse now. As it is, insurers are dropping out of exchanges due to unanticipated costs of meeting the standards of ACA that are hurting the bottom line, despite large rate increases as the major provisions of Obamacare kicked in. Rates for individual insurance outside the plan continue to rise by double digits. It’s so bad that the largest provider in Tennessee is requesting increases averaging 62%. In part because of uncontrolled costs, the ACA has also left 29 million uninsured. According to the Congressional Budget Office, that number is not expected to change much even if states currently resisting Medicaid expansion join the program.

There are many other major problems with Obamacare, almost all of which arise from the fact that it is insurance-based. For instance, subsidies still leave a 40 year old man earning $25,000 per year liable for up to $5000 in copays and deductibles. Such costs deter many from seeking needed care.  Those trying to minimize premiums, especially young, healthy adults, often opt for high-deductible plans that could leave them responsible for the first $10,000 in bills and a share of anything over that. In case of catastrophic illness or injury, almost anyone can end up bankrupt. Medical expenses are estimated to be the cause of 60% of bankruptcies. Single payer health insurance thus amounts to bankruptcy insurance as well. That is just one of many benefits of such systems, in addition to the fact that they can provide universal health care at a fraction of the cost of our current non-system.

It’s time to face the facts. Obamacare may have been the best that Democrats could produce, but it is not even close to a solution to the problem of rising costs and declining access to health care. There is no excuse for claiming that single payer is not possible, as Clinton has. To say this is an admission that it is impossible to address the corrupting influence of money in politics. That is not acceptable in a nation that claims to be a democracy. The vast majority of Democrats favor single payer. It’s time they stand up and demand it. Waiting until a Congress awash in Wall Street money to do it on its own is never going to work. We can wait for the system to collapse of its own dead weight, or we can work to make our members of Congress force a real debate on health care reform.

HOW’S FASCISM TREATING YOU?

As I write this, I am en route to Madison for the Democracy Convention, of which Alliance for Democracy is a part. As a member of the national council of this partner in the Move to Amend coalition, my hope is to convince as  many  organizers and attendees as possible that we are at the point where we can quit playing defense and launch an all-out coordinated assault on the corporatocracy. By working together each in our own way as individuals and members of such groups we can get a constitutional amendment introduced in Congress in time to affect the outcome of the 2012 elections.

I have been working to convince people since 2009 that the economic catastrophe brought on by the greed of an unregulated banking/finance industry was only the first of many consequences of turning control of the government to corporations that would give us the hook to help Americans get over their learned helplessness and get involved in the revolution that must take place in order to ever realize the dream of democracy in the United States.
 

The international corporate terrorists that control the US government have no loyalty to the United States, its people or the Peoples of any other nation. Like a series of timed dynamite explosions, we have seen the predictable consequences of unregulated capitalism unfold, one outrage after another. Only the corporate media and the corporate Puppets in Congress and the White House are preventing open revolt by creating the illusion that these crises are all unrelated.

First the Massey disaster revealed the ineffectiveness of token regulation of energy interests, then the BP spill revealed the power of an international corporation over our government and military. Next, the Fukishima disaster failed to slow plans to spend billions of taxpayer dollars to prop up an economically and environmentally indefensible private industry. Together, these events proved to anyone who didn’t know it that big Energy and the banksters control the levers of power in government.

 

Amid all this, the medical-industrial complex flexed its muscle by controlling the process of the “health care reform” debate that was a thinly veiled bailout of a medical insurance industry. On the verge of collapse as its inefficiencies and lack of cost controls were making it increasingly inaccessible to millions of Americans, private insurance would have become unaffordable to the vast majority of Americans in just a few years without the massive infusion of taxpayer money provided by the “Affordable” Care Act. 

Adding to the 45 million without access to medical insurance before the debate began were the swelling numbers of unemployed and underemployed victims of the housing crisis.  The myth of the free market promoted by the corporate media and corporate politicians was enough to head off any efforts to find the only real solution, a single payer Medicare-for-All universal health plan. Instead of advocates being invited to the table, they were arrested for speaking at the Finance Committee hearings without being recognized by chairman Max Baucus.

The promised savings of PPACA will be proven an illusion as surely as Part D was found to cost several times what the Congressional Budget Office forecast on the basis of the unrealistic assumptions they were forced to work with. It defies common sense to conclude that adding millions of less healthy citizens who have not had access to health care to the pool of those covered by taxpayer-funded health programs is going to save money when the act eliminates the use of pre-existing conditions and other methods of denying insurance to those who need it. This has to drive up costs to private insurers, which will lead to further numbers of uninsured who will then qualify for taxpayer-funded assistance. Even if it were true that the taxpayer will save a bit initially, the difference will be more than made up for by the already skyrocketing premiums we have seen for those who do pay for their own, increasingly shoddy insurance.

The banksters of Goldmann Sachs who financed Obama’s campaign were rewarded with control of the Fed, Treasury and several regulatory agencies. The Democratic banking “reform” bill was as much of a sick joke as the medical insurance “reform” corporate-dependent Democratic leaders were able to eke out. The Wall Street casino that crashed the world economy was financed by the savings of investors used by banks gone wild after the removal of the barrier between investment and commercial banks erected to prevent just such an economic collapse. This eerily paralleled the stock market crash in 1929 that led to the previous Depression.

In the 1930s, people had been brought up to take care of themselves and their families. In the Roaring 20s work was plentiful and successive Republican Presidents promised that everyone could get rich if they trusted the invisible hand of Big Business to assure that the economy would be self-correcting without any messy government interference. We saw how that worked out, but a combination of the decline of the American educational system, the rise of a media that is completely devoted to advancing the corporate agenda and a jaded citizenry that has lost interest in politics produced the conditions that have until now prevented the rise of a grassroots revolution that would unite the Left and Right in the cause of ending fascism in America.

Complicating all this of course is the intensification of the use of the politics of division to keep Americans fighting each other instead of fighting together against the real threat: corporate personhood. Since 1968 the Republican Party has honed the technique to a fine art. They have systematically used the corporate media as a means of misinforming voters and keeping them angry and fearful at the prospect of creeping socialism in a society that has been sliding into fascism the entire time. In 1968, Nixon’s southern strategy used racism to split the Democratic majority of Americans in response to the passage of the 1964 Civil Rights Act.

1968 was also the year of the police riot in Chicago at the Democratic National Convention, when peaceful protestors were assaulted by Mayor Richard Daley’s goon squad while many union leaders looked on in approval. Traditionally conservative police, fire and construction unions abandoned McCarthy, who had been a loyal union supporter, in favor of the candidate of the Party representing corporate power. With union leaders like this, who needs union? 

Union membership has been declining ever since for a variety of reasons aside from their systematic demonization and scapegoating by the corporate media and corporate politicians. The most important reason for loss of union membership is the manner in which national union leaders have remained cozily in bed with corporate Democrats even as these cynical corporate Puppets were increasingly abandoning the worker in pursuit of corporate campaign cash.
 

In Wisconsin, even at the state level many unions have failed the workers in this time of crisis. While very good at organizing large rallies, union leaders resisted using the strike, the very instrument by which unions came to power. It is true a strike should only be called in response to an outrage, but what could be more outrageous than an assault on the right to collective bargaining? With virtual unanimity of purpose of all Wisconsin unions in fighting this attack on democracy and the rights of workers, the time has never been better for a general strike. Had this happened months ago, Democrats would likely have now been in control of the Wisconsin Senate. 

The absence of national Democratic leaders in Wisconsin during the united stand of Wisconsinites against the fascist takeover of their state government was instructive. It once more illustrates graphically the price of remaining loyal to a party whose leadership depends on the patronage of the same international corporate terrorists who are waging war on America’s middle class.

Republican leadership is waging total war against the social safety net constructed in response to the horrifying suffering of the first Great Depression and the only thing preventing an equal amount of suffering today after they and corporate Democrats sold out the country by turning it over to fascist corporate interests for a few pieces of silver. The only solution is to do what we did in 1775 and again in the years 1890 to the 30s as union power slowly built up: We must put aside our differences and fight in common cause to move the country in the direction of democracy. The alternative is to allow our children to be trapped in the nightmare of a permanent fascist New World Order in which Americans will be as repressed as citizens of the nations now under military siege by the Armies fighting for corporate Empire.