Guaranteed Healthcare

By Donna Smith

WASHINGTON, DC – Imagine my joy in hearing Sen. Tom Daschle say during one of his confirmation hearings for his appointment as President Obama's Secretary of Health and Human Services that he supports reforming the healthcare system without being wedded to any strict ideology.  Great, I thought, finally a health reform leader without allegiance to the dogma of the free market which would squelch any discussion of public options for reform except of course the infusion of public cash into those private markets to make them even more profitable. 

Finally.   Yes, Sen. Daschle, let’s get the big boys of free market dogma to stand down.

But then came Tuesday and the inauguration and the marvelous celebrations that followed.  It was truly a glorious moment in time for millions of us.  So watching this transition is exciting and a relief from the trauma of the past eight years.  Even seeing the White House website quickly reflect the new era of openness and transparency in government seemed wonderful.

So, I quickly clicked my way to the healthcare agenda and read with interest the plan for reform.  It isn’t free of ideology, that’s for sure.  It takes a direct hit at “government run” systems and even uses the old, worn scare tactic of “higher taxes” as a way to try to crush even the idea that a publicly funded system is in the offing.  That's not so very transparent or honest.

I am an advocate of a publicly funded, privately delivered healthcare reform plan.  I’d like to see us use the best and most responsible funding mechanism but retain the private doctors and providers I like to be able to choose.  I really hate it that when I want to go to the doctor in the current system, I first have to worry about huge co-pays and deductibles in addition to my premiums and then still see providers pre-selected by an insurance company and not necessarily by me.  There isn’t much choice in that for me.

I read deeper into the Obama-Daschle plan and picked up plenty of deep-seated ideology rooted in making this healthcare system sing for the big boys of insurance and health industry – but not so much for you and me, the patients – and frighteningly enough perhaps the most unfavorably handled group under this plan will be those who need care the most.

The spoken rhetoric on healthcare sounds so humane and so decent, but read carefully, and you’ll see the blueprint that puts patients in a worse position than ever – and protects competitive interests above all else.

Look at just one section of the White House agenda (and I captured a print screen of the pages so I have my own record of the plan as stated on January 22, 2009, after all those in-home healthcare discussions promised some measure of responsiveness from this administration):

“Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in: Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs, and taking on drug companies that block cheaper generic medicines from the market.

Require hospitals to collect and report health care cost and quality data.

Reduce the costs of catastrophic illnesses for employers and their employees.

• Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.”

Look at that… think it through.  What is it saying?  It is signaling to the American public and to the big money interests in healthcare that the insurance markets and industry will fare just fine, thank you very much, as the “anticompetitive activity” that is patients who actually need and use healthcare are removed from the private, for-profit health insurance markets and “taken on” by someone else -- like the public plan option. 

That will do two things.  First, it will make insurance companies more profitable than they already are, and second, it will make the government or public plans more costly and ultimately unsustainable.

Cancer patients like me?  We are “anticompetitive activity.”  Patients with chronic illnesses?  We are “anticompetitive activity.”  You get the picture.  The Obama-Daschle plan will not only allow cherry-picking of the healthiest among us by the profit-takers, it is going to solidify the cherry-picking by the for-profit, market drive interests into national policy.  It may as well be called the “survival of the fittest” for healthcare reform.  And I’m not sure that’s the way a basic human right like healthcare can ever be codified.

How will they sell this under the guise of healthcare as a “basic human right?”  They won’t need to do that.  This administration will use ever available PR tool in the book to make the American public buy into thinking about saving money through streamlining medical records and health information technology and finally by “mandating” or forcing every person to buy private insurance or be lumped and dumped into the “anticompetitive activity” pool of undesirables to be included in some public option.

I have heard long-time Obama followers describe him as “scary smart.”  And when I saw myself listed in his White House reform plan as “anticompetitive activity,” I knew exactly why.  My neighbors and friends won’t even know how they are bailing out the for-profit private insurance industry because they’ll be told that down the road they’ll get some sort of tax credit or other concession if they are not one of the undesirables.  The vast majority of Americans will see the plan as a way to “cover” everyone and won’t know until they face the need for care in some of life’s most vulnerable moments that they have bailed out an industry so rotten to its core that many of us already avoid using the healthcare system (and our defective product that is health insurance) even when it puts our own health in peril.

I know Sen. Daschle knows that some of us are smart enough to question the plan.  My hope is that he also knows many of us are committed enough to make sure Americans do indeed understand the reality of what is being drafted and crafted so carefully protecting the same industry that has only one true interest and that is to make money  -- not healthy citizens or a healthy nation. 

We also may need a more direct effort to expose all the money ties to those drafting our health reform policy.  If we but "follow the money," we will almost always find out what we seek to know -- who are the ultimate masters of our fate and who are their servants?  I suspect we while we won't be surprised we may be even more angry. 

As a former journalist, I used to love “sunshine laws” and freedom of information efforts that upheld the idea that “sunlight is the best disinfectant” to flush out those who would do the public’s business behind closed doors and often without the best interests of the public at heart.  And this administration is talking a lot about transparency.  But I am afraid that it’s time for those of us from outside the administration to make sure the light shines very brightly indeed on this health reform process, including all the slick, policy wonk language that hides the agenda of the profit mongers and the politicians that benefit from keeping us ill-informed.

So far the plans may be elaborate in terms of the appearances of "stakeholder involvement," but I think we all need to ask more and more questions and never mistake kind words for real policy. We will have to keep our interests and our health front and center in this debate or we will be left behind in the weakened position of being labeled as "anticompetitive activity."

I may be “anticompetitive activity” in some markets but rest assured I am one of the committed souls who stood many hours in freezing temperatures for just a moment to witness history this week – I’m not likely to shy away from this battle. I didn't work this hard to lose what matters to me.  And justice in this nation's healthcare policy is my agenda. 

See the White House website (I captured the page on January 22, 2009, below):http://www.whitehouse.gov/agenda/health_care/#TB_inline?height=220&width=370&inlineId=tb_external