Ralph Nader on U.S. Health Care Reform.

This is a hard hitting article that brings up issues that are not emphasized in many reports. The fact that Obama had a series of meetings with drug and health insurance bigwigs is a sure sign that any reform will try to ensure that their interests are not hurt. Obama did get some cost concessions which he trumpeted briefly as a big victory but as the article shows these promises were not made free and without the interests getting a great deal in return. But kowtowing to the big boys has not helped him that much. It shows him as weak and ripe to be attacked to give even more. Obama did not even bother to talk to any of the prominent single payer advocates. They do not count, or rather Obama probably figures they can be counted on to support whatever weak compromise he is able to push through legislatively.
The single payer system was never really considered by Obama, the great pragmatist. Now it seems that even though a majority of Americans actually support a public alternative it may be dropped to try to bring a few Republicans and blue dog Democrats on board. However, this could be the last straw for progressives. I even noticed that some progressive economists have the same worry expressed at many town halls that reform will involve cutting back on Medicare services to seniors as some scare ads by right wing opponents of reform have claimed.
It may be that Obama will not only face a right wing campaign against his reforms but also a growing revolt on the left who will block his compromise. Once again health care reform in the U.S. may not happen at all. For those who are well off or have good plans through their workplace this will be just fine. For the rest they can line up at free clinics as they are now in California. A group that formerly brought health care to far off locales with virtually non-existent health care services are now finding that they are needed at home in their own country.


"Now Make Me Do It"
by Ralph Nader
Never much of a fighter against abusive corporate power, Barack Obama is making it increasingly clear that right from his start as President, he wanted health insurance reform that received the approval of the giant drug and health insurance industries.
Earlier this year he started inviting top bosses of these companies for intimate confabs in the White House. Business Week magazine, which proclaimed recently that "The Health Insurers Have Already Won" reported that the CEO of UnitedHealth, Stephen J. Hemsley, met with the President half a dozen times.
These are the vendors. They and their campaign slush funds cannot be ignored in the power struggle over the legislation percolating in the Congress. One public result of these meetings was that the drug industry promised $80 billion in savings over ten years and the health insurance moguls promised $150 billion over the same decade. Mr. Obama trumpeted these declarations without indicating how these savings would be guaranteed, how the drug companies could navigate the antitrust laws and what was given to the health care industry by the White House in return.
We have now learned that one Obama promise was to continue the prohibition on Uncle Sam from bargaining for volume discounts on drugs that you the taxpayer have been paying for in the drug benefit program enacted in 2003.
Unknown is whether the health insurance companies were also promised continuation of Medicare Advantage with its 14% added taxpayer subsidy to induce the elderly to make the move out of public Medicare. Also unknown is whether the Medicare public option that Mr. Obama formerly espoused but since has wavered on has been put on the concession table.
The whole secret process is seedy and demonstrates cruel disregard for the millions of American who, whether in dire need of medical services or not, voted in "change we can believe in."
By stark contrast, President Obama has never invited to the White House the leading consumer-patient champions in this country who favor full Medicare and free choice of physician and hospital-often called "a single payer" system. Open to the corporate barons who have failed decade after decade to deliver what patients need, the White House door is closed to the likes of Dr. Quentin Young-a founder of the Physicians for a National Health Program and an old Chicago friend of Obama's, Dr. Sidney Wolfe, who heads Public Citizen's Health Research Group, Drs. Marcia Angell, Stephanie Woolhandler, and David Himmelstein, who are nationally known and accomplished single payer advocates or Rose Ann DeMoro, executive director of the fast-growing California Nurses Association.
Mr. Obama even tried to exclude any advocate of a single payer system-previously favored by Obama and still favored by a majority of the American people, doctors and nurses-from his roundtable meetings convened to receive the views of different constituencies.
"Make me do it" was the advice of Franklin Delano Roosevelt to reformers when faced with legislation he desired but did not have the votes for in Congress. Mr. Obama is not exerting that plea for people power. Were he to do that, he would be encouraging daily public hearings in the Senate and the House on the bureaucratic waste, greed, overbilling, collusion, and fraud that many in the corporate world have inflicted with their costly, pay or die health care industry.
Such publicized hearings would keep him on the offensive. It would arouse the public and focus energies on the main problem-the corporatization of medicine. This commercialism has left tens of millions of people without health insurance, caused 20,000 fatalities a year, and cost Americans twice or more per capita than have full Medicare systems in western countries, which have better health outcomes than the U.S.
Further indication of Obama's corporate dealings is that he never identified himself with a specific bill with a House and Senate number that he could rally the people around. No wonder people are confused, frustrated and angry. President Obama did not stand for an unambiguous proposal.
He thereby emboldened both the cash and carry Blue dog Democrats to rebel and the Republican yahoos to launch their lies and distortions via Rush Limbaugh and similar trash media.
Obama is about to make his biggest mistake to date by favoring the bipartisan deal his assistants are working out with Blue Dog Senator Max Baucus and his Republican counterparts on the Senate Finance Committee. This proposal has no public option, no consumer protections or restraints on the mayhem and skyrocketing charges of the so-called health care industry.
Already the less corporate-indentured bills being reported from the House Committee by Rep. Henry Waxman (D-CA) and his allies are getting short-shrift from a White House that clearly views the forthcoming Baucus-Grassley "compromise" as the "more practical" go-to legislation.
There is reliable word that the AFL-CIO will endorse whatever Obama approves, with the exceptions of the California Nurses Association and the Sheet Metal Workers' union. The latter, through their president, Michael J. Sullivan, announced in late July that it was suspending all future campaign contributions to any candidate for Congress or the Presidency.
Already over sixty progressive members of the House, headed by Congresswoman Lynn Woolsey (D-CA) have declared opposition to these unacceptable compromises moving forward in both the House and the Senate.
So is gridlock around the corner? Will there be a health insurance reform of any stripe signed into law this year? It depends on the alliances that settle for the lowest corporate denominators being blocked by the unyielding principled stands of the progressives who want something that puts patients above the failed profiteering vendors.
The guess here is that Obama will sign anything which squirms through a cowardly Congress that cannot give to the American people in 2009 the health care system Congress stopped President Harry Truman from establishing in 1950.
It is up to the people of our country to "make him do it" whether this year or next. A mere one million immediate calls to members of Congress by one million assertive citizens will start sobering up these legislators who think they can get away with another sale of our public trust.
The Congressional switchboard is 202-224-3121. The full Medicare, single payer bill (backed by nearly ninety legislators) is H.R. 676. The go-to citizen group for your sustained engagement is singlepayeraction.org. The rest is up to you, the majority, who want to put the people first.
Ralph Nader is a consumer advocate, lawyer, and author.