Monday, September 27, 2010

In which I ask Michael Crowley if he remembers Canditate Obama's health care plan

by Stuart Zechman

At Swampland, Michael Crowley casually makes the case for the PPACA, and I respond in commentary, as reprinted below:

Michael Crowley,

You write:

"The ongoing publicity around those new measures--and the tangible changes in many Americans' lives-- might warm the public to Obamacare."

What many of us movement liberals particularly resent is the tiny population of beneficiaries being trotted out like public relations hostages by the Administration and this policy's (mostly partisan) supporters, with the message being "See? Vote for Democrats, or these poor, sick folks get it!"

Health care reform was never supposed to be about charity, about welfare, about all of us middle-class people putting aside our selfish concerns and donating to the unfortunate, worst-case scenario victims of the system that doesn't work for any of us (except the wealthiest).

Moving the goal-posts in Bush/Iraq fashion only serves to underscore the failure of this policy; we're not so completely stupid out here that we don't recognize a public relations strategy when we see it.

We also happen to have memories that are longer than mosquitoes' and the political press corps', Michael Crowley.

We remember when the President campaigned against the individual mandate he then advocated and signed into law, declaring:

OBAMA: "Let’s break down what she really means by a mandate. What’s meant by a mandate is that the government is forcing people to buy health insurance and so she’s suggesting a parent is not going to buy health insurance for themselves if they can afford it. Now, my belief is that most parents will choose to get health care for themselves and we make it affordable.

Here’s the concern. If you haven’t made it affordable, how are you going to enforce a mandate. I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don’t buy a house is they don’t have the money. And so, our focus has been on reducing costs, making it available. I am confident if people have a chance to buy high-quality health care that is affordable, they will do so."

Do you, Michael Crowley? Does your profession remember? We do.

We also remember when the President campaigned on giving people a choice between the broken, expensive, denial-based system in which they're currently trapped, and a new, parallel system that didn't share the same incentives as the stock-price driven, for-profit private insurance cartels:
Specifically, the Obama plan will: (1) establish a new public insurance program, available to Americans who neither qualify for Medicaid or SCHIP nor have access to insurance through their employers, as well as to small businesses that want to offer insurance to their employees; (2) create a National Health Insurance Exchange to help Americans and businesses that want to purchase private health insurance directly...

We remember, because we were so enthused about the prospect of real change coming to compete with a health care system whose incentives are so at odds with consumers' interests. We were enthused because the Obama plan was so specific in its promised actions:

1. OBAMA’S PLAN TO COVER THE UNINSURED. Obama will make available a new national health plan which will give individuals the choice to buy affordable health coverage that is similar to the plan available to federal employees.The new public plan will be open to individuals without access to group coverage through their workplace or current public programs. It will also be available to people who are self-employed and small businesses that want to offer insurance to their employees.

The plan will have the following features:

-- Comprehensive benefits. The benefit package will be similar to that offered through the Federal Employees Health Benefits Program (FEHBP), the program through which Members of Congress get their own health care. The new public plan will include coverage of all essential medical services...

-- Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need assistance will receive income-related federal subsidies to keep health insurance premiums affordable. They can use the subsidy to buy into the new public plan or purchase a private health care plan.

-- Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.

-- Portability and choice. Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing or jeopardizing their health care coverage.

-- Quality and efficiency. Participating hospitals and providers that participate in the new public plan will be required to collect and report data to ensure that standards for health care quality, health information technology and administration are being met.

The whole idea was to construct for the benefit of everyone a new system designed to compete at a national level with the old, broken one, not to hand out medical welfare with one hand, and guaranteed profits with the other.

Do you remember, Michael Crowley? Has your profession forgotten? We haven't.

Remember the pre-campaign speeches against lobbyist access, secret deals and corrupting negotiations with powerful interests?
TOPIC: Ethics & Lobbying Reform, January 26, 2006

Lobbying Reform Summit, National Press Club Washington, DC

OBAMA: ...people shouldn't lump together those of us who have to raise funds to run campaigns but do so in a legal and ethical way with those who invite lobbyists in to write bad legislation. Those aren't equivalent, and we're not being partisan by pointing that out.

...when big oil companies are invited into the White House for secret energy meetings, it's no wonder they end up with billions...

When a Committee Chairman negotiates a Medicare bill at the same time he's negotiating for a job as the drug industry's lobbyist, it's hardly a surprise when that industry gets taxpayer-funded giveaways in the same bill that forbids seniors from bargaining for better drug prices.

In 2004, over $2.1 billion was spent lobbying Congress. That amounts to over $4.8 million per Member of Congress. $4.8 million per member so that oil companies can still run our energy policy and pharmaceutical companies can still raise our drug prices and special interests can still waste our tax dollars on pet projects.

See, one of the reasons why lobbyists...and their allies in Congress have been able to manipulate the system is because most of their backroom deals are done in secret. Just the other day, we heard that because of pressure from health care industry lobbyists, Republican negotiators met behind closed doors and changed a budget bill to provide a $22 billion giveaway to HMOs...

This is an outrage...

Do you remember, Michael Crowley? Can your profession contrast this kind of campaigning with the corrupt process that actually transpired? We can.

Based on these fabricated claims, Michael Crowley, most movement liberals had very little idea that the system overhaul proposed by Obama would turn into a Third Way think tank's dream legislation.

We remember this broken promise in particular:
Remarks of Senator Barack Obama: A Change We Can Believe In

Spartanburg, SC | November 03, 2007

...this is also a moment of great promise. It's a chance to turn the page by offering the American people a fundamentally different choice in 2008 - not just in the policies we offer, but in the kind of leadership we offer. It's a chance to come together and finally solve the challenges that were made worse by George Bush, but existed long before he took office - challenges like health care...

That's how I'll pass a universal health care bill that allows every American to get the same kind of health care that members of Congress get for themselves and cuts every family's premiums by up to $2500.

That is the change that's possible in this election. That is the moment I want to seize as President. And I ask you all to join me in this journey. Thank you.

Well, Michael Crowley?

Do you remember the President campaigning on an openly-negotiated, transparently-constructed, parallel health care system that lowers prices through national economies of scale, that allows every American to get the same benefits that Congress enjoys, and cuts every family's yearly premiums by $2500?

Do you remember a liberal health care policy being campaigned upon by this President, Michael Crowley?

The kind of system we movement liberals propose would do exactly those things, because we're not devoted to a political ideology that says we can't look to Germany or France, Canada or Japan --all the countries in the First World who do health care better and cheaper than we do-- for solutions. We're neither ideologically devoted to a "uniquely American solution," nor to guaranteeing private profits, unlike the President who appeared to us in office after the 2008 campaign was over.

The kind of system we got was the DLC's long-proposed "reforms", not liberal policy:

DLC | Key Document | August 1, 2000
The Hyde Park Declaration: A Statement of Principles and a Policy Agenda for the 21st Century

3. Promote Universal Access and Quality in Health Care

That more than 40 million Americans lack health insurance is one of our society's most glaring inequities. Lack of insurance jeopardizes the health of disadvantaged Americans and also imposes high costs on everyone else when the uninsured lack preventive care and get treatment from emergency rooms. Washington provides a tax subsidy for insurance for Americans who get coverage from their employers but offers nothing to workers who don't have job-based coverage.

Markets alone cannot assure universal access to health coverage. Government should enable all low-income families to buy health insurance. Individuals must take responsibility for insuring themselves and their families whether or not they qualify for public assistance.

Finally, to help promote higher quality in health care for all Americans, we need reliable information on the quality of health care delivered by health plans and providers; a "patient's bill of rights" that ensures access to medically necessary care; and a system in which private health plans compete on the basis of quality as well as cost.

Goals for 2010

# Reduce the number of uninsured Americans by two-thirds through tax credits, purchasing pools, and other means.

# Create a system of reliable "report cards" on the quality of care delivered by health plans and providers.

Public disappointment with the legislation currently being re-sold to us is not merely about the obviously false claims about what the new system would do, it's about what kind of new system we would have.

So, we remember, Michael Crowley, we remember the new system, the change that was held out to us, the promise of something fundamentally better than what we know is going to hell beneath our feet.

It's why we're offended when images of health care hostages are waved in our faces as a defense against the indefensible, indisputable fact that we were sold a counterfeit bill of goods in 2008. It's not that we didn't "get everything we wanted," it's that we got something we know won't work, and now we're being told that these unfortunate, sick people will die, if we try to hold those responsible accountable for their promises and claims. It's disgusting, it's cynical, and it certainly isn't change we can believe in --or that even works.

Does your profession remember? Is it capable of memories not provided for it by professional public relations campaigns?

Do you remember, Michael Crowley?

We do.

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