Two days after George Bush’s State of the Union healthcare proposals, the bid for reform hits rocky shoals in the states and continues to split America’s business community. California sees problems with the employer mandate, Massachusetts sees trouble with its individual mandate, and New York sees further threats to its already-declining public health system. Meanwhile there are rumbles from the national businesses sector over the broken healthcare system, and editorialists continue to look at Bush’s proposals.
Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of Single-Payer Healthcare.
Before we get into the details, go look at the genius cartoon by Tom Tomorrow.
The politics of healthcare remains turbulent in the states. The Los Angeles Times picks up on two big problems with Schwarzenegger’s proposals.
"Whatever the governor eventually comes up with — and whether he calls it a tax or a fee — could wind up becoming the target of a lawsuit, said Allan Zaremberg, president of the California Chamber of Commerce.
Business groups such as Wal-Mart could challenge any proposed healthcare benefit mandate under the federal law. For their part, Republican lawmakers and anti-tax activists are likely to sue if the payroll levy does not receive what they contend is a constitutionally required two-thirds vote in the (California) state Legislature.
"This is the dilemma that any solution faces in California," (Chamber of Commerce President Allan) Zaremberg said.
Schwarzenegger's “employer mandate,” requiring companies to cover workers, might well be illegal thanks to a recent Maryland court ruling, and he also faces trouble from conservatives over its funding.
In Massachusetts, the “individual mandate” (mandating individuals buy insurance) is also running into problems. When Governor Mitt Romney announced his plans, he predicted state residents could buy basic insurance for about $200 per month. Whoops! The insurance industry rolled up their sleeves and came back with a plan to charge residents nearly double that, $380 per month. The Globe reports:
But yesterday, Eric Linzer, vice president of the Massachusetts Association of Health Plans, said that the board was being "overly prescriptive" and that it would be "a huge challenge" for insurers to meet all requirements and keep costs down."
Which is likely true: there is no way that private insurance companies can keep costs down. They lose money paying people like Mr. Lizner to dial up the press, and paying politicians like Romney to pass laws favorable to them—all told about one-third of care dollars are lost when insurers get their mitts on them (no pun intended). And the costs will only rise rapidly once the insurance industry has the market locked up. That's why real solutions can't depend on private insurers.
So we have two main ideas floating around the states to rescue our current insurance-based system: employer or individual mandates, each of which force patients into becoming insurance customers. Each is running into problems.
Meanwhile, reports from New York State remind us of how urgently we need to continue pressing for single-payer health insurance.
The New York Times analyses Bush’s State of the Union proposals and finds it would strip New York City public hospitals of 7% of their operating budget, or $350 million a year. The upshot:
“We would have to do a wholesale dismantling of our ambulatory care system and scale down our emergency departments,” said Alan D. Aviles, president of the Health and Hospitals Corporation.
The poor would even less access to medical services. This comes on top of recent plans to close public hospitals around the state, which has inspired some very brave healthcare workers to embark on a 320-mile protest march.
Given all this, you would think New York Governor Eliot Spitzer would look into the single-payer solution already working in every other industrialized nation? Blogger Rick Lippin says no:
Mr Spitzer like these other big state Govs have proposed complex plans that 1) are not fully understood because they are overly complex 2)in some cases require federal and state legislation to implement and 3)take too damn long to achieve desperately needed health care for all in their states now. Mostly however they all seem to buy into continuing their relationships with Big Insurance whose overhead costs and greed are bankrupting the health care system- to put aside Big PhRMA/BIO for the moment.
While the states continue to fumble for answers, the business community is increasingly split over whether it really wants healthcare reform. If they want really things to change for the better, they could help the drive for single-payer healthcare right along.
News today that Ford Motor Company—possibly the world’s largest health care provider—lost $12.7 Billion dollars this past quarter should force them to think about it.
The right wing of the business community is increasingly forced into ridiculous positions like this one: our healthcare problem is caused because Americans use too much of it (never mind every indicator shows the quality of healthcare received in this country is scandalously low.)
But there may be signs that the business community is coming around. Alan Webber argues that if we can truly solve the health care problem, it would unleash a transformative entrepreneurialism like nothing this nation has ever seen. And Milt Freudenheim of the New York Times tests the wind and finds some businesspeople ready to look for real solutions:
“There is more frustration and less acceptance of the current system among employers than we have ever seen in my 30 years in this field,” said Helen Darling, president of the National Business Group on Health, an organization made up of large companies.
So let’s find a real solution.
Of course many of the biggest stakeholders like things just the way they are:
Jack O. Bovender, chief executive of HCA, the hospital company, said that a patchwork of state plans would not work. For one thing, he said, state regulation of health care financing had often been overturned by lawsuits filed under the federal Employee Retirement Income Security Act, which the courts have said was intended to let big companies set up uniform health benefits across the country, rather than navigate state-by-state requirements.
Finally, the San Jose Mercury News is looking beyond Bush and wants our next crop of Presidential wanna-be’s to lay our their plans:
Since it's becoming increasingly clear that the president isn't going to be able to lead a national debate on health care for his remaining years in office, it's time for the 2008 presidential contenders to start offering ideas.
They can begin by talking about their reaction to what innovative states -- including California and Massachusetts-- are doing to provide potential national models for health care reform.