Health Leaders Seek Consensus Over Uninsured
By Robert Pear
The New York Times
May 29, 2005
At a time when Congress has been torn by partisan battles, 24 ideologically disparate leaders representing the health care industry, corporations and unions, and conservative and liberal groups have been meeting secretly for months to seek a consensus on proposals to provide coverage for the growing number of people with no health insurance.
The participants, ranging from the liberal Families USA to the conservative Heritage Foundation and the United States Chamber of Commerce, said they had made progress in trying to overcome the ideological impasse that has stymied action on the problem for eight years.
The group’s overarching goal is to agree, by the end of this year, on proposals that expand coverage to as many people as possible as quickly as possible. By meeting in secret, the group has tried to shield itself from political pressures.
“This effort holds as much promise as any I’ve participated in over the last decade, probably more,” said Kate Sullivan Hare, the executive director of health care policy at the United States Chamber of Commerce.
“People are uninsured for different reasons,” said Dr. Mary E. Frank, the president of the American Academy of Family Physicians and a participant in the talks. “No one solution will work for everyone. We need different solutions for different groups of the uninsured.”
E. Neil Trautwein, assistant vice president of the National Association of Manufacturers, said the consensus group was “not biased in favor of big government solutions,” and assumed that health care would continue to be provided through a mix of private insurers and public programs.
The group is applying lessons learned in the battle over the Clinton health plan. Members said they were listening carefully to one another, trying to build the trust. They are not trying to remake the health care system or guarantee insurance for every American through one big program, they said.
Comment: And the options that they are considering? (My comments in
parentheses)
* Individual mandate for children (criminalizing parents who cannot afford
coverage?)
* Voluntary payroll contributions made by employees not covered by employer-sponsored plans (causing employers to drop coverage now that it is the employees’ responsibility, even if unaffordable to them)
* Tax credits sent to insurers to help pay for a portion of coverage for low-income individuals and small businesses (a direct subsidy for the flawed private plans, but which would be inadequate for these sectors surviving on very limited budgets)
* Voluntary action on the part of states to expand Medicaid to adults under the poverty level ($9600) (with the budget crises the states are facing, they would be looking for a voluntary way to go deeper in debt?)
* Small federal grants to states to establish insurance purchasing pools (funding a portion of administrative costs only, but not funding health
care)
Everyone recognizes the political ineptitude of the Clinton attempt at reform. Their process could never have ended in a consensus.
Now we are presented with a process that allegedly is firmly based on consensus. But what are they proposing? They have gone to the bottom of the health policy barrel and scraped off the stinky, slimy scum and presented that to us as politically feasible, incremental reform. These policies will increase the numbers of uninsured, reduce the effectiveness of coverage already in place, and fail to control costs. Millions of Americans will suffer and tens of thousands will die as a result of these policies.
Why does Kate Sullivan Hare of the U.S. Chamber of Commerce say that “this effort holds as much promise as any I’ve participated in over the last decade”? It’s because these policies will reduce employers’ responsibilities for requiring coverage; they will enhance business opportunities and profits for insurers; they will maximize the flow of tax dollars towards private interests while ensuring that public programs will remain profoundly underfunded; and they will shift more of the responsibility and burden of paying for care to the individual, regardless of affordability.
But this process has accomplished their unstated primary goal. They were successful in keeping single payer supporters out of this secret process.
And their greatest fear is that Americans might actually demand a program that would provide affordable, comprehensive care for everyone, if Americans only understood that we could have it merely by enacting a single payer system.
By redefining incrementalism as a process that gradually reduces comprehensive coverage, affordability and access, this group has lost all credibility as advocates of reform that would be for the benefit of patients. That’s tragic, because several of these individuals know better and should have been a part of a legitimate process. But their ******* egos got in the way!
And, oh yes, some were there to make sure that the enablement of greed was a defining element in their model of reform. Those individuals need to be banned from the bargaining table forever. But those who know better and really do care should be welcomed back into the process once they have had their personal epiphanies.
