The Washington Post
February 12, 2002
By Thomas J. Donohue, President and CEO of the U.S. Chamber of Commerce, and John J. Sweeney, President of the AFL-CIO
“When representatives of business and labor meet, it’s usually across the table. Today there is an issue in America that compels us to sit side by side.”
“It is the quiet crisis of the uninsured. For all our miracle cures that are saving lives every day, we have failed to solve our biggest health problem -the fact that so many Americans lack access to even the most basic care because they lack health coverage. It has gotten worse despite good economic conditions, and it certainly won’t improve during a downturn. Today, we are urging our fellow Americans and elected leaders in Washington to join with us and begin the hard work needed to solve this problem.”
“We have different perspectives on the problem, as do our partners in this effort – employers and workers, insurers and consumers, doctors, hospitals and nurses. Though we will undoubtedly disagree on specific solutions, our unified goal is to make the problem of the uninsured our nation’s top health priority and to help America solve it.”
Comment: Another step backwards. “We will undoubtedly disagree on specific solutions,” is a concession that no interested party is willing to abandon its own agenda. And, even though the preliminary findings of the California Health Care Options Project reveal, once again, that single payer models can assure comprehensive health care for everyone while reducing overall health care costs, the parties involved in this latest process have already rejected single payer reform before the discussions begin. They will continue to look at various solutions that the California study indicates will only increase health care costs while perpetuating flawed health policies.
Twelve organizations plus the Robert Wood Johnson Foundation have set up a website for this new effort to publicize the plight of the uninsured and to begin to seek solutions. The website:
The glossary at this website is revealing in that it includes terms such as medical savings accounts, catastrophic health insurance, purchasing pools, tax credits, refundable tax credits, group insurance, flexible spending accounts, cafeteria plan, FEHBP, HMO, PPO, managed care, and other concepts that the various factions continue to debate. But conspicuously absent from the glossary is which term? Single payer! Not only should it be in the glossary, it should be on the negotiating tables!
The compromise recommendation that will be reached is quite predictable when considering the organizations that are participating and the positions already taken by each of these entities. The organizations include the U.S. Chamber of Commerce, the AFL-CIO, The Business Roundtable, SEIU, the American Medical Association, the American Nurses Association, the Health Insurance Association of America, Families USA, American Hospital Association, Federation of American Hospitals, Catholic Health Association of the United States, AARP, with the support of The Robert Wood Johnson Foundation. There will be general agreement that public programs should be expanded in order to cover the low-income sector. The affluent will be granted medical savings accounts and other options. And the great compromise will be that tax credits will be accepted as the means of providing access to coverage for the majority. Without elaborating on the serious flaws inherent in this approach, there is no question that the result will be that health care costs will continue to escalate, and greater financial barriers will be erected thereby further impairing access to care.
Representatives of each organization spoke at the press conference announcing this effort. They all agreed that they were committed to compromise with most of them specifying that reform would be “incremental.” Most alarming was U.S. Chamber of Commerce’s Donahue stating:
“The other thing we should know is that there are a lot of private conversations going amongst the people here. I mean, we didn’t just show up here today to, you know, make a statement. We’ve been having a lot of conversation and I’m encouraged by it because it hasn’t got the vitriolic kind of who shot Jack, you know. It’s really-if this is the kind of problem-then how could we fix it and what ways might work.”
“If we move vigorously towards a single payer system which, by the way, doesn’t work anywhere in the world, we’re gonna find a great migration away from the people that are providing the coverage, and we can’t afford that.”
The fix is on. They already shot Jack! How could a process that begins with an agreement to keep the strongest advocates of health care justice, the single payer advocates, out of the negotiating rooms ever result in a just health care system? Tragically, special interests already have killed another attempt at rational reform before it even got off the ground.