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Stark vs Conyers: Prolegomena

By Owen Paine on Monday April 27, 2009 07:49 PM

The Bolshevik Conyers:

... and the Menshevik Stark:

Here's a single-payer-now advocate posting up at Alex's bloc house:

"...Democrats, with the exception of John Conyers and a few others -- don’t want to abolish the private insurance industry.

They are capitalists and believe in the capitalist system that makes health care a commodity to be bought and sold.

For them, [either] health care is not a human right [or] they don’t want to take on President Obama... Like the true cowards they are, they will not oppose Obama on health care reform even though they disagree with him."

Really quite impassioned, eh? The author is one Helen Redmond, and she lays out more or less just why, in her estimation, the Stark public-option plan stinks like the coils of Echidna:
  1. It doesn’t make health care a human right that can never be taken away.
  2. It continues to divide, devalue, and define people by their health status.
  3. It can’t address the endemic racial and gender disparities in the system, including the 12 million undocumented.
  4. It leaves the employer based system of health care provision intact.
  5. The link has to be broken so workers are free to change jobs, go on strike and not fear loss of coverage.
  6. The system would continue to have multiple payers [with] the complexity and gaps in coverage that are inevitable when there are numerous bureaucracies to navigate.
  7. Where will the money come from to finance the plan? In a time of economic recession.... A public plan [option] is not fiscally sustainable because it’s rooted in a multiple payer system that foregoes at least 84% of administrative savings.
Here's her money line:
"Single-payer.... would immediately inject 400 billion into the system by eliminating bureaucracy, billing apparatus, administrative waste, advertising, corporate profits, and CEO compensation. That’s enough money to bring everyone into the system with no co-pays or deductibles."
Here's my version of her money line, redrafted to emphasize certain aspects: We're just $400 billion away from full publicly-financed free health care for all American residents, and we can extract that $400 billion from the systemic cost reductions we will produce by demolishing the current private sector structure of corporate-profit induced, hedgerow-like segregation of individual risks into pools of individuals with signifigantly different inter-pool risks. With this I cannot disagree at all:
"It’s a proven fact that a single-payer system can cover everyone and control costs. Period, end of discussion."
Yes, single-payer now would be great. The question is, can single-payer pass now. If not, then is utter defeat better then some deceptive compromise that is in reality a sellout?

Enter Health Care for America Now (HCAN). Here's Helen's characterization:

"HCAN thinks it’s impossible to get rid of the insurance companies, they’re too powerful, and they have too much money and influence. They don’t believe a large social movement can be built to take on and win against the insurers and the government.. "The leadership of HCAN are the ones who would have said under slavery, “We can’t win abolition, so let’s settle for a few reforms that make the lives of slaves more bearable.”"

Above, the face of squalid compromise, Rep Sacagaweakowski. A shrewd posssibility artist or a simple coward, or a con-artist sell-out?

Here's the wonderful Ms Redmond taking on the congresslady:

"In a heated exchange with Schakowsky before the rally, [Schakowsky] argued HR 676 (she is a cosponsor of the bill, yes that’s right) has no chance of passing and something has to be passed this year. She lied and said there isn’t enough support for single-payer, but there is for a public option -- We said the insurance industry is going to fight just as hard against a public option as it will single-payer so let’s have a smackdown for single-payer."
In other words, Helen, there is enough support in congress? Or are you just pointing out there's enough support among us, the weebles of weightless impact?

Then comes this -- and I feel compelled to ask -- does it swallow its own tail?

"Their solution: the creation of a public plan to compete against the private insurance industry they despise. Speaker after speaker projected a wish list of health care reforms onto the nonexistent public option plan: benefits must be comprehensive, coverage must be affordable, no denial of care, and equal access to quality care. Who could disagree if a plan like that could actually be enacted? The problem is the United States will never, ever get a plan like that while the private insurance industry is still breathing. "
But, my dear, the insurance industry is still breathing.

Her thesis:

"Only a single-payer system, one that drives a stake through the heart of the insatiably greedy insurance corporations once and for all, can deliver on those promises."
I can only conclude Helen expects to lose the smackdown, but lose with righteous beauty. Like a latter-day Bill Garrison, there are no virtuous half measures after all.

Then again -- to continue her heroic parallel -- it was half-measure Abe and an army imbued with Unionist horsefeathers that finally "engineered " emancipation. Clio plays bank shots on occasion.

But really, I think Helen needs to be answered in detail. The question becomes a two-parter, both an 'if' and a 'can': if it can pass, where a single payer can't -- then can pub option lead to single-payerlike consequences down the road, or only back to the present profit-cancer hodgepodge?

In order to pre-empt known and possibly unknown sources of hysteria: I owen T S Paine support single payer 100%. Other options are presumed guilty here till proven innocent. Single payer wears the title belt.

In an earlier post I foolishly -- as is my wont, alas -- threw out a lifeline to the pub-option boys led by Peter Starkweather I should have then, and do now, reframe this issue:

Let us examine the pub-op for its potential economic and political dynamic with an open mind and a keen analytic pair of eyes. As I understand it, Father Smiff even as I type this, is hard at work on his portion of this joint project

While you wait, here's a poser by Ms Redmond:

"... why don’t the Democrats and HCAN fight to get rid of the parasitic private health insurance industry once and for all, instead of constantly and unsuccessfully, decade after decade, trying to rein in, regulate, and do an end run around them?"
From the answer to that, one can build a world view.

Comments (25)


Very good post, a bit hard to follow -- arghh -- I guess I'll have to look in at Alex's place.

Why don't the Dems "fight to get rid of the private health insurance industry. . .? This was a joke, right?

The only other way, which the industry considers more than unlikely, is a mass popular movement. BTW, OP, what is labor's position on single payer health?


As if there's room in the budget for single payer health care...

There's plenty of room in the budget for single payer--because of the inefficiences of the U.S. private system, health-care costs in this country are double per capita what they are in all other industrialized nations, which have equal or life expectancy at half the average cost.

Putting the blood-sucking HMOs out of business would be a tremendous net savings to this hard-pressed economy.

Panie conveniently omits some of the most trenchant arguments in Redmond's piece with his conveniently selective quotations.

I urge everyone to read the Redmond article in its entirety at this URL:


I personally consider it disgraceful to see someone on a purportedly radical left blog making the same kinds of arguments about political possibility that have always emanated from the mealy mouths of oppressors: "the time is not right," "it's just not possible," "don't push too hard," etc., etc. If the Paines of this world held sway rather than, say, the the suffragists, the militant unionists, the civil rights marchers, the antiwar demonstrators, women would still lack the right to vote, we'd still be in Vietnam, unions would be illegal (rather than merely declining), and Old Black Joe would still be picking cotton--with maybe Saturdays and Sundays off thanks to the benefactions of "Half-Measure" Paine and his ilk.

Notwithstanding Paine's unctuous pretense of supporting single payer, his relentless mission here is to shill for the blood-sucking HMOs Plan B--the compromise hybrid public option plan so beloved of DLC Obama . . . and pseudo-socialist Paine. As I will make clear in a subsequent post, this plan is not a half-step to single payer--it is a cynical contrivance designed to sabotage the prospects for single payer once and for all by saddling the public sector with all the sickest and oldest patients, thereby making the public sector appear inefficient because of the vastly greater costs it would incur as a result of depriving it of the risk pooling that would obtain under single payer for all.

Aside from the economic sophistry of the Paine/DLC faction, there is moral blindness. As millions of Americans lose their jobs in this imploding economy, most also lose their employer-tied health insurance. Some 50 million Americans already lack any medical coverage at all--18,000 of them die each year in America's pay-or-die system. Those that are covered face destitution or bankruptcy because of extortionate premiums and deductibles and selective coverage of the private plans. Every state experiment in public private hybrid plans has failed to achieve increased coverage or reduced costs--the whole business is a sham, a flimsy Rube Goldberg construct designed to keep the HMO execs and stockholders in their designer suits, summer homes, and Lexuses--along with the Congressional and White House recipients of their campaign largesse.

For those facing death or penury because of this country's irrational health system, the issue is one of the gravest urgency. "Half-Measure" Paine, with full medical coverage in his comfy Upper West Side redoubt, seems not to share this urgency . . . Gee, I wonder why? Could it be a lack of understanding of what is at stake, or simply a void where a conscience should be?


"Political language -- and with variations this is true of all political parties, from Conservatives to Anarchists -- is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind."

-- George Orwell, Politics and the English Language --

sanctimonious horse shit
by a scum winged stool pigeon

so it belongs as part of this thread


"As if there's room in the budget for single payer health care"

gotta assume that's some variety
of lethal irony mr prop

there's room to begin the world anew

like your site btw

Paine wrote:
"sanctimonious horse shit
by a scum winged stool pigeon
so it belongs as part of this thread

Notice the painstaking care and analytical acuity with which Paine addresses the specific points of Redmond's article and my response to him in this thread.

No . . . wait! I was mistaken--all that he served up was another serving of rancid, ad hom psychopathy, because he can't answer the arguments! The man's got nothing! He's a big ole pompous fraud! And a DLC-sucking, liberal-centrist, HMO-shilling fraud at that!

Now--maybe in a subsequent post I'll tell you something we all DON'T already know!

For all those interested in doing something to push for a single-payer health system in the United States, please go to the following Web site:


The group, founded by Russell Mokhiber of Multinational Monitor (with an assist from Ralph Nader), is seeking organize the single-payer advocates in this country into a coherent activist force.

Two other worthwhile sites:

Physicians for a National Health Plan

And Healthcare Now (not to be confused with HCAN, which is pushing the Stark-Paine sop to the HMOs)


Note the upcoming national day of action on May 30.

From the Health Care Now Web site:

Cost control, universal care impossible without single-payer health system

April 23, 2009 by Healthcare-NOW!

Policy expert challenges effectiveness of lesser reforms at House panel

With President Obama and congressional leaders vowing to pass a health reform bill by the end of the year, a prominent Harvard-based health policy analyst warned a House subcommittee Thursday that the leading incremental models for reform, including those patterned after the Massachusetts plan, are incapable of containing skyrocketing health care costs or providing quality, affordable care to all.

Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School and a primary care doctor at Cambridge Hospital in Cambridge, Mass., told the House Subcommittee on Health, Employment, Labor and Pensions that only a major overhaul of the existing system, one which replaces the wasteful, for-profit, private insurance industry with a publicly financed, single-payer program similar to Medicare, can rein in costs while guaranteeing universal, comprehensive coverage.

“A single-payer reform would make care affordable through vast savings on bureaucracy and profits,” Himmelstein said in his statement. “As my colleagues and I have shown in research published in the New England Journal of Medicine, administration consumes 31 percent of health spending in the U.S., nearly double what Canada spends. In other words, if we cut our bureaucratic costs to Canadian levels, we’d save nearly $400 billion annually - more than enough to cover the uninsured and to eliminate co-payments and deductibles for all Americans.”

A national health insurance program would slash the enormous paperwork burden on hospitals, doctors and patients, Himmelstein said, resulting in hundreds of billions in savings that could be redirected to patient care.

Half-measures like those proposed by the Obama administration and key lawmakers like Senators Max Baucus (D-Mont.) and Edward Kennedy (D-Mass.), many of which mirror aspects of the Massachusetts reform of 2006, can’t match the savings of a streamlined, publicly financed system, he said.

Even if a “public plan option” emerges as part of the House and Senate reform bills, Himmelstein said, it won’t be sufficient to challenge the inefficiencies and wastefulness of a multi-payer system: “A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare’s level, the administrative savings would amount to only 9 percent of the savings under single payer.”

Citing his direct experience with the Massachusetts plan, which is facing critical financial problems, Himmelstein commented: “Prevention, disease management, computers and a health insurance exchange were supposed to make reform affordable. Instead, costs have skyrocketed, rising 23 percent between 2005 and 2007, and the insurance exchange adds 4 percent for its own administrative costs on top of the already high overhead charged by private insurers. As a result, 1 in 5 Massachusetts residents went without care last year because they couldn’t afford it. Hundreds of thousands remain uninsured, and the state has drained money from safety-net hospitals and clinics to keep the reform afloat.”

While the conventional wisdom in Washington is that single-payer national health insurance is “not feasible” and therefore “off the table,” public opinion polls have shown solid majorities continue to support such an approach. In a survey published by the Annals of Internal Medicine a year ago, 59 percent of U.S. physicians said they favored government action to establish a national health insurance program, a 10-percentage-point leap from only five years prior.

In addition to their pioneering research on the high administrative costs in U.S. health care, Himmelstein and his colleagues have also published other groundbreaking studies, including one that shows medical bills contribute to half of all personal bankruptcies in the United States and another that shows how taxes already pay for more than 60 percent of U.S. health spending.

A co-founder and national spokesperson for Physicians for a National Health Program, Himmelstein regularly writes and speaks about health policy issues before a diverse national audience.



Just got my marching orders
From ralph nader

Now is not the time to evaluate
Pub op
Now is the time to push for single payer
I was being an egg head
The battle between pub ops and pri ops
Can be exemplified
In other areas

All goo goo hysteria aside
The fight for sing-pay is still

Paine doesn't take his marching orders from Nader. Perish the thought! Paine is a good soldier, though--he takes his cues from the HMOs and the DLC. Paine not only has been out here beating the drums for the public-option program (e.g., last-ditch attempt to save the blood-sucking HMOs), but he has also, in another thread on this topic, offered a comparative study of various health-care options that omits single payer--a study cosponsored by a research outfit that is a subsidiary of the HMOs! Paine is the kind of loyal purveyor of HMO propaganda that you would normally expect to find on Meet the Press or the op ed page of the Washpost.

Paine appears to be backtracking just a bit--in the previous thread he was gung-ho for the Stark public/private HMO-bloodsucker bailout plan. Now that I've shown that this plan is not a half-step to single payer--as the clueless Paine portrayed it--but an elaborate attempt to discredit and bury single player, the clueless and callous Paine seems anxious to conceal his obvious DLC-centrist tropisms and recast himself as a champion of single payer once again.

But we're wise to you, Paine--too late to put the toothpaste of your conservatism back in the tube. Paine's softness for the HMOs is no aberration--he has made it clear that he is essentially a centrist Democrat at heart. As he stated in a post on the Pelosi/Torture thread,

"The dems do go into new deal mode

Ie turn their back
To the imperial project for a spell
and seriously restructure
the economy "

This blog is a potentially rich resource for dialogue about the manifold treacheries of the Dems and the ways in which the American left might advance beyond them. The presence of Paine--clearly a centrist liberal despite his superficial overlay of leftist cant--clearly defeats that purpose.

So politically, Paine's presence on this list is an anomaly. The only explanation seems to be MSJ's felt obligation to allow his buddy Paine to arrogate the list to himself as a vanity press for his ridiculous prose poems and incoherent pomposity. MJS is a terrifically deft, witty, and perceptive writer, but his taste in friends undermines the political objectives of this otherwise admirable blog.

Oh well, as MJS himself reminded us in another thread recently, De gustibus non est disputandum.

Published on Wednesday, April 29, 2009 by CommonDreams.org
Standing Against Single Payer
My Ron Pollack Problem — and Yours

by Russell Mokhiber

Karen Ignagni is not the problem.

As president of America's Health Insurance Plans, Karen Ignagni represents the health insurance industry.

The same health insurance industry that would be wiped out by a single payer national health insurance system.

We know where Karen Ignagni stands.

She stands with the health insurance industry.

Against the will of the American people.

If she stood with the will of the American people, she would effectively be asking her member insurance companies to commit suicide.

Not going to happen.

Ron Pollack is executive director of Families USA.

Ron Pollack identifies himself as a consumer advocate.

Or more precisely as an advocate for health care consumers.

The majority of the American people stand with single payer.

And against the health insurance industry.

And against the pharmaceutical industry.

But Ron Pollack stands against single payer.

Against the will of the American people.

With the health insurance industry.

And with the pharmaceutical industry.

Think we're kidding?

Well, on Thursday at 3 p.m., Ron Pollack will join Karen Ignagni in a live web chat to discuss "health reform."

The live web chat is sponsored by The Campaign for an American Solution.

The Campaign for an American Solution is a fake grassroots group created by the health insurance industry.

The idea is that we can't have single payer because it's not American.

Or as Senator Max Baucus put it when asked about single payer last month - "We have come up with a uniquely American solution which is a combination of public and private, because we are America."

Yes we are, Max.

But there is a uniquely American solution and it's called single payer.

Check out Jonathan Cohn's New Republic interview with Michael Chen of Taiwan's single payer system. Chen told Cohn that when Taiwan was in our predicament years ago, they searched the world for a better health care system. They came to the United States and studied Medicare. And they then went back to Taiwan and modeled their single payer system on Medicare.

Anyway, on Thursday at 3 p.m.,this so called consumer advocate, Ron Pollack, will be standing with Karen Ignagni, advocating against single payer.

Last week, Ron Pollack joined with Billy Tauzin, the head of the Pharmaceutical Manufacturers Association, and unveiled "a campaign to promote three key policies designed to help achieve high-quality, affordable health coverage for all Americans."

None of which will do anything to fundamentally alter the private health insurance industry and drug industry's death grip on America's health consumers.

So, no Karen Ignagni is not the problem.

Billy Tauzin is not the problem.

The Republican Party is not the problem.

We know where they stand.

They stand with big corporations.

Against the American people.

The problem is Ron Pollack.

The problem is Max Baucus.

The problem is the Democratic Party. [ED note: and pseudo-leftists like Owen Paine who
run interference for the Dems and the HMOs]

The problem lies with people who say they stand with the people.

But end up standing with Billy Tauzin.

And Karen Ignagni.

And big pharma.

And the private health insurance industry.

The problem is that the so called opposition is no opposition at all.

Yesterday, I attended a conference on Capitol Hill sponsored by the Alliance for Health Reform - another "collegial group."

Dirksen 106 was packed with over 200 staffers and lobbyists.

The topic: Public Plan Option: Fair Competition or a Recipe for Crowd Out?

There were four people on the panel.

Two argued against giving consumers a choice between public plan and private plan - Karen Ignagni and Stuart Butler of the Heritage Foundation.

Two argued for giving consumers a choice for a public plan - John Holahan of the Urban Institute and Karen Davis of the Commonwealth Fund.

In opening remarks, John Holahan was downright defensive.

Holahan said a public plan was not part of a "a secret plot to destroy the insurance industry and bring about a single payer system."

There were no advocates for single payer at the table.

Of the 75 or so health policy experts listed in the packet, I couldn't find one advocate for single payer.

So, when question time arrived, I got to a microphone:

"John Holahan said that he's not part of a secret plot to destroy the insurance industry," I said. "But there is actually a public plot to destroy the private insurance industry. It's called HR 676. It's single payer. And it has 76 members of the House who support it. The Lewin Group did a side by side analysis of all of the plans, and they found that single payer saves the most money. The single payer idea is that the private health insurance industry deserves to be destroyed. In Canada and the UK it's unlawful to sell private health insurance for basic health needs. That's the idea behind single payer. Other than the fact that it would be the death penalty to Karen Ignagni's companies, why not do it?"

Out of deference to Karen Ignagni, the panelists pretty much ignored the question.

It was as if the question hadn't been asked.

That's the problem with collegiality.

The industry is facing the death penalty.

It's either them.

Or us.

No amount of collegiality can mask that stark reality.

Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime Reporter. He is also founder of singlepayeraction.org.


my marching orders:

"Good morning comrade

There are no more excuses for the Democrats.

The Democrats now admit that they control the procedure in Congress and can pass whatever health care reform they want.

Without one Republican vote.

And President Obama can sign it.

What should they do?

They should pass single payer.

Everybody in. Nobody out.

For prevention and treatment.

For free choice of doctors and hospitals.

No more premiums, deductibles, exclusions, co-pays, in-network, out-of-network rigamarole.

No more family medical bankruptcies.

No more pay or die.

No more pay or become sicker.

Single payer is the only system that will work.

It's the most efficient.

Single payer will cut out literally hundreds of billions in administrative fat, billing fraud and unconscionable profits.

These savings will be used instead to insure the 50 million uninsured and the millions more underinsured.

This will save lives.

Starting with the more than 21,000 Americans who die every year from lack of health insurance.

According to recent polls, the majority of the American people want single payer.

So do the majority of doctors, nurses, and health economists.

So, what will the Democrat leadership do?

They will keep single payer off the table.

Because they fear the insurance industry and the pharmaceutical industry - and want their campaign money - more than they fear the American people.

Or as Speaker of the House Pelosi told reporters last week:

"Over and over again, we hear single payer, single payer, single payer. Well, it's not going to be a single payer."

Who is Nancy Pelosi speaking for?

Not for the American people.

Not for those who will die or get sicker month after month.

How are we to respond?

Focus our collective creative energy on Congressional offices around the country -- offices of all 435 members of the House and 100 members of the Senate.

That's why we have set up Single Payer Action.

Less than two months old - and already Single Payer Action is making waves.

In front of Congressional offices from Martinsburg, West Virginia to Seattle, Washington.

On Capitol Hill, standing up to the corporate lobbyists and their lackeys in Congress.

And on the web, challenging the corporate controlled media to put single payer back on the table of public debate.

There is support in Congress for single payer.

Already, 76 House members support HR 676 - the single payer bill in the House.

But the Democratic leadership in Washington has taken single payer off the table.

They meet regularly behind closed doors with insurance and drug industry lobbyists - to thwart single payer.

Time to turn up the heat - and get the word out to the American people.

(Just last week, I was at the University of Colorado in Boulder where I spoke to an enthusiastic audience. Topic: Single payer, full Medicare health insurance for all.)

We need your help now.

To send speakers to all four corners of this country.

To fund organizing drives at Congressional offices around the country.

To shake up the system for single payer.

Last week, many of you responded enthusiastically to a note from my colleague Jason Kafoury by donating $10,000 to Single Payer Action.

Thanks to you, we are a third of the way to our goal of $30,000 by May 14.

This week, we need to expand the base again.

If you have not donated yet to Single Payer Action, please donate now whatever you can -- $10, $25, $50, $100.

And notice - if you donate $100 or more by May 14, 2009, we will send you two galvanizing books that concisely detail the case for single payer in America.

Health Care Meltdown by Robert LeBow, MD, revised and updated by Dr. C. Rocky White - a Republican doctor so fed up with the needless suffering caused by the insurance industry that he has become a leading advocate for single payer..


Ten Excellent Reasons for National Health Care, Edited by Mary O'Brien and Martha Livingston.
The goal: raise $30,000 by May 14th for Single Payer Action.

To make single payer a reality in America.

Together, we can break the logjam in Congress - and deliver health care to all.

Let's get it done.

Onward to single payer.

comrade Ralph

PS: This two book offer ends 11:59 p.m. May 14, 2009.

So don't miss out. Donate now.

We're building toward one million Americans strong for single payer.

Please share this e-mail with friends and family.

Urge them to sign up and donate at singlepayeraction.org."

Thanks to Owen Paine for posting Ralph Nader's alert on single payer action.

To be scrupulous, the addition of "comrade" in the greeting and closing are OP's editorial insertions--Ralph hasn't quite joined the Party yet . . . although, it should be noted, that Nader's earliest published article seems to have appeared in an obscure journal called the American Socialist, published by Bert Cochran, who had formed a faction that split from the Socialist Workers Party in the 1950s.

Buh- but, Ralph, what about STALIN?!

Ralph's article appeared in a journal edited by a semi-Trotskyist, so Ralph's record is impeccable on Stalin. And he's managed to remain a consistent radical through the years; for example, you wouldn't find him supporting the Stark plan to save the HMOs, nor would you find him expecting the Democrats to restructure the economy and turn their backon imperialism, as Paine does.


Van M: I dont always understand OP, but I haven't seen any evidence in the two-three years I've been reading him for calling him a DLC centrist Dem. Anymore than for calling you a follower of Bill O'Reilly.

If you haven't seen any evidence of Paine being a centrist DLC-style Democrat, then you must have been in a coma for the past week or two.

Two key pieces of evidence:

1. Paine has been pushing hard for the Stark health-care bill, which is a version of the hybrid public/private option plan so beloved of centrist DLC types everywhere. This places Paine to the right of the Joseph Stiglitz and the PDA, etc. It is a thoroughly inept, deceptive contrivance designed to salvage a role for the HMOs--and Paine has been plumping for it here with unrelenting consistency. At least the Washington pols get millions of dollars to do the bidding of the HMOs--Paine carries their water for free.

2. Even more revealingly, in the recent Nancy Pelosi/torture thread, Paine made very clear his hopes for the Democratic Party:
"The dems do go into new deal mode

Ie turn their back
To the imperial project for a spell
and seriously restructure
the economy"

If not for the fractured, pretentious prose-poem format, this starry-eyed assessment could have come straight from the forked tongue of any oily talking-head, Sunday-talk-show "Democratic strategist" type. It's a stupendously naive--even delusional--vote of confidence for the "progressive" potential of the Democratic Party and a 180-degree rebuke to the stated philosophy of this blog.

There's an overlay of Marxoid-lefty rhetoric to Paine's impenetrable gabbing out here, but these are glimpses into a soul that is centrist-liberal at heart.


here's a nice piece

the interview at the end puts a nice rope around the conflict points

"President Obama said during the campaign that he wanted to give Americans an option of buying into a public plan that would compete with the private health insurance industry.

Single payer advocates say the public plan option won’t work – it will be too costly and leaves too many billions of dollars in savings on the table.

But that hasn’t stopped Obama and the public plan forces from pushing ahead.

Yesterday, the architect of the public plan, UC Berkeley’s Jacob Hacker, was in Washington at a press conference unveiling the details.

Hacker was joined by the Institute for America’s Future Roger Hickey.

The Hacker plan gives people without workplace coverage access to an “exchange” with private and public plan options.

The public plan mirrors Medicare’s administrative infrastructure, but would be run separately from Medicare.

The plan has its own risk pool and offers the same benefits and coverage terms nationwide.

Hacker said offering a public health care plan option is the only feasible way to design a sustainable health care system and ensure everyone has access to the care they need.

“Without public plan choice, private health insurers will still be able to game the system to maximize their profits while failing to provide health security over the long run,” said Hacker. “Providing a public health insurance option that competes fairly with private plans is critical to ensuring access, controlling costs and improving the quality of care for all Americans.”

Dr. David Himmelstein of Physicians for a National Health Program, said Hacker’s public plan won’t work.

Himmelstein called the Hacker plan “a compromise aimed at avoiding insurance company opposition to a single payer plan.”

“But it can’t solve our nation’s health care crisis,” Himmelstein said.

“The proposed plan would realize only a small fraction – at most 16% – of the administrative cost savings that could be achieved through single payer,” Himmelstein said. “That’s because insurance overhead – which might well be lower in a public option plan – accounts for a small part of the overall administrative costs of the current system. The need for hospitals and physicians to continue to bill dozens of different insurance plans would mean that their internal cost accounting and billing apparatus that causes most of the excess paperwork at present would continue.”

“As a result, the public option plan would not save nearly enough on bureaucracy to make care affordable,” Himmelstein said. “Absent massive savings on administration, the expansion of coverage would be very costly, and costs would continue to rise in future years since the proposed plan has no means to achieve real health planning or use global budgets to set enforceable limits on cost growth. Hacker’s plan would also do little or nothing for the tens of millions who are currently underinsured – they have coverage but still can’t afford care.”

To get a sense of what the public plan faction is up to, we interviewed Hickey after the press conference.

Single Payer Action: Physicians for a National Health Program argues that the public plan leaves too many billions in savings on the table.

Hickey: I agree.

Single Payer Action: Given that the insurance industry is opposed to a public plan anyway, why not just go single payer?

Hickey: It’s possible that we may fail to get a public plan into this reform. But we have more of a chance to get a public plan than we do of winning a majority for single payer right now.

Single Payer Action: You would prefer single payer?

Hickey: Yes, in the best of all possible worlds, single payer with some amount of choice, at least for a transition period. But I’ve been around politics long enough to know that it is very unlikely to get single payer with this Congress. It sees to me that single payer people are saying – whatever reforms get done are insufficient and need to be pushed farther. Some single payer people are saying – don’t do any reforms because that will simply prevent single payer down the road. But I’m pushing what I believe is both doable and would set off a virtuous dynamic of reform.

Single Payer Action: Is it back door single payer?

Hickey: That will have to be determined by the future. I could live with a mixed system. Germany and Switzerland and many other countries have mixed systems. The evolution there is that the private insurance companies have evolved into non profits, but there are still several different players.

Single Payer Action: I got an e-mail from a doctor in Germany. And he said another good reason to get rid of the private health insurance corporations is so they don’t go overseas to pollute and corrupt the systems over there, which they are now doing in Germany now.

Hickey: I understand. There are only a few private insurance companies that have anything worth emulating – Kaiser Permanente and a few others. But the chances of getting a majority in Congress vote to outlaw the private insurance companies are virtually nil.

Single Payer Action: So, is it just a political calculation on your part?

Hickey: Everybody in the world is making a political calculation. And it’s mixed in with moral calculations. Do you want to expand health care coverage while you are trying to perfect the best system you can possibly get. Or do you want to wait until things get so bad that the country turns to single payer?

I’m making the observation that there is nowhere near a majority in the Congress for anything like single payer. So, I’m not willing to sit and wait for the perfect. It’s possible to take major steps forward in covering everybody. My friends who support the Massachusetts plan say – now we are going to turn to cost control and that’s going to transform the Massachusetts plan. Maybe not. I’m not a big fan of Massachusetts plan.

I’m trying to get something better than Massachusetts for the country. And I don’t for a minute think that’s the end of reform.

Single Payer Action: Do you believe that the insurance industry can be persuaded to come on board with the type of public plan that you outlined today?

Hickey: I’m hopeful that the Congress can be persuaded to come on board. And I’m hopeful that the Congress will ignore obstructionism from the insurance industry.

Single Payer Action: What do you hear about what Obama is going to do?

Hickey: We know what he campaigned on – which is something similar to Hacker’s plan. And his people keep reinforcing that they are going to go for a public plan. But it’s not just Obama’s job. Our Health Care for America Now coalition has got to get members of Congress, including good liberals, to come out for a plan. I don’t know if you saw the recent statement by the Progressive Caucus. They said look – many of us are in favor of a single payer plan. But in terms of the reforms going on now, we want to insist on a public plan. That’s the right kind of attitude for single payer people to take.

Single Payer Action: PNHP came out in response to the Progressive Caucus and said – it won’t work.

Hickey: The PNHP line seems to be – don’t do any reform at all unless it’s pure single payer. I can understand that is it’s position. I just don’t share it. It means that you are condemning a lot of people to no health care at all for many years to come.

Single Payer Action: They would argue that you are condemning 22,000 Americans to death every year for lack of insurance.

Hickey: I’m not going to support anything that makes things worse. If the Congress passes something like what Obama ran on, large numbers of people who don’t have insurance will get insurance. And they we’ll begin the process of transforming the health care system.

Single Payer Action: PNHP people argue that anything but single payer will make things worse because you don’t get the savings to make it work and the private insurance companies will engage in cherry picking, driving healthy people into the private system and bankrupting the public system.

Hickey: It depends on the rules of the game. Obama is trying to get rid of Medicare Advantage. That’s the direction of a level playing field that we need to have. And we need it to be – as Hacker was saying – rated for risk, so you don’t have that death spiral. I acknowledge the danger there. But it depends on the rules of the road that we establish. The Democratic majority at least understands that the Medicare Advantage programs are a bad deal and want to get rid of those extra subsidies.

Single Payer Action: On the political calculation, could it be that if they would accept what you are proposing, they would also accept single payer?

Hickey: I don’t see either Obama or a majority of the Democratic members of Congress, much less the Republicans, voting to outlaw the insurance industry and to herd everybody into a public plan that they don’t understand. That is pretty unlikely to happen. Certainly in this Congress. If things get worse, if the private insurance companies continue to mistreat people the way they do, down the road, things could come to a head and you might get a single payer plan. But I don’t quite understand the calculations of single payer people. They know they are not going to get it this year. I guess the assumption is we wait until things get really bad. But I certainly respect people who have thought it through and support single payer. I hope the single payer movement gets stronger. It will put pressure on Congress to do something."


"The Lewin Group. The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option,
showed that the insurance industry
would lose 32 million policy holders
if a public plan is enacted.
Lewin’s health reform policy guru, John Sheils, told the Associated Press: “The private insurance industry might just fizzle out altogether.” "

so much for pub op losing the head to head
so far as the pri insure agitprop line goes

could the compromise bill draft in poison pill restrictions on the pub op ??

hey why not
its a bi pertisan
corporate congress

then again
“The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.”

fuller text

" Lewin Group has conducted studies on single payer at the state level – and their studies consistently show that single payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676 – which would create a single payer for the entire country and drive The Lewin Group’s parent – UnitedHealth Group– out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said – “the President didn’t propose single payer, did he?” No, he didn’t. That’s why he too is on this list. (Sheils says The Lewin Group has studied national single payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill – including one by Congressman Pete Stark (D-California). Stark’s bill would give every American the option of opting into Medicare. But that’s not single payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. “The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.” Sheils says that of all the plans studied, the Stark bill saves the most money.)"


we all agree
only a maximum effort to get single payer now
is worth mobilizations
like may 30

and any pub option
is at the very best a danger frought
pale rider of a fall back

i appreciate your display of trust
in my radical pedigree though i suspect few here were in much doubt
and if so
all the better

trust no one mates

if u must trust something
i suggest u trust
the red sea split
that emerges when organizing
for direct job site action


"The public plan mirrors Medicare’s administrative infrastructure,
but would be run separately from Medicare."

why ???

"The plan has its own risk pool and offers the same benefits and coverage terms nationwide."

this pool sounds like it might be
full of fishy fish

these two hacker plan provisions
start to weaken the pub option

its hardly my area
why not simply provide
an option to sign up for medicare now
as if you were 65
only pay diiferent premia
and co pays
depending on objective risk metrics
and if we must
with certain medicaid like aspects ???

i understand the meme

why take any chances
if your taking on the hmos
go for a kill shot

ahh what an egg heads field day this all might be ....

I'm glad to see Paine has gotten around to posting an expose of the Lewin group--he was touting there work here a week ago, until I posted some links exposing their connections to the HMO industry; Paine culled this material from the links I posted in the Nancy Pelosi thread. Better late than never for Paine to educate himself on this topic.

If there are premiums for the public sector, there's no point. People are already having trouble paying HMO premiums--in a hybrid plan, saddled with the oldest and sickest people, the public sector would be under tremendous pressure to have higher premiums than the private plans, which would aggressively--and probably unscrupulously-market the young and the healthy. The whole hybrid business is fraught with irrationalities and stupidities--it's a specious PR con all the way, just another way of trying to keep the HMO execs and stockholders in clover, and the hell with the public--the usual Washington ethos.

The multiple payers in Germany are all nonprofit. Any profit-making sector in health care is absurd and unworkable.

Why Paine keeps contorting himself into a pretzel over this fraudulent hybrid plan is beyond me; to me it's just a matter of his stubborn centrist-liberal instincts refusing to reckon with the truth.


"..some anti-single payer inside the beltway corporate liberals like Ron Pollack, Andy Stern, Len Nichols, and AARP.

Again, the insurance industry is not the primary problem in this health care fight.

Health insurance corporations are fighting for their corporate lives.

Single payer health insurance would put them out of business.

It’s the corporate liberals like Baucus, Pollack and Stern that are the primary problem.

They say they are standing with the people.

But in fact they are working hand in glove with the health insurance industry to keep single payer off the table"

The HMOs are not the main problem in the sense of not being the immediate problem, but they are the mediate problem. But they are the main problem in the sense that they are the primal problem. The immediate problem is the corporate liberals like Baucus, Pelosi, and Obama who front for the HMOs; but the pols' strings are being pulled by the HMOs. The HMOs call the tune, and the pols dance to it.

I think what Russell means (in the excerpt quoted by Paine) is this: we should not be calling demonstrations at meetings of AHIP, because it's foolish to expect AHIP to do anything other than fight for its member companies' survival; we should be demonstrating against and harassing the pols who do the HMO's bidding. I've seen Healthcare-Now--a worthy single-payer activist group--calling for demonstrations at meetings of AHIP. I agree that this is misplaced--the main public pressure and scrutiny should be on the Washington politicians who are implementing the HMOs' agenda. In principle they have the power to thwart the HMO agenda and act in the public interest--they can and must be harassed/pressured/humiliated into doing so. The HMOs never will.

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