Archive for the ‘Obama’ Category

A History of Overhauling Health Care – Interactive Feature – NYTimes.com.

Com todas as limitações da aprovada healthcare bill, a América tornou-se hoje mais justa. Não nos esqueçamos, contudo, que 15 milhões de americanos continuam excluídos, assim como um número incerto de indocumentados, e que o fundamentalismo neoliberal excluíu uma mais que necessária public option.

healthcareFear Strikes Out, by P. Krugman

How does US healthcare compare to the rest of the world?

Medicare (United States)

Michael’s Moore open letter to our Republican friends after last night’s health care vote

Yes We Can ! E. U. A. – França

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A history of failed attempts to introduce universal health insurance has left us with a system in which the government pays directly or indirectly for more than half of the nation’s health care, but the actual delivery both of insurance and of care is undertaken by a crazy quilt of private insurers, for-profit hospitals, and other players who add cost without adding value. A Canadian-style single-payer system, in which the government directly provides insurance, would almost surely be both cheaper and more effective than what we now have. And we could do even better if we learned from “integrated” systems, like the Veterans Administration, that directly provide some health care as well as medical insurance.

Yet Obama is not prepared to grasp the nettle. His speech was even weaker than the spin preceding the joint address to Congress suggested. I thought the Obama people were lowering expectations with a view toward a big positive surprise and they managed to go even lower than the bar they set. He took caricatured positions on single payer in order to create a false “centrist” option. The President has basically has reduced the public option to a marginal welfare style program for 5% of the population, rather than seeing it as a way to break the monopoly of the private health insurance companies, thereby helping to reduce costs. He’s basically forcing everybody into a private health insurance run program.

The bad news is that Washington currently seems incapable of accepting what the evidence on health care says. The Obama Admininstration remains under the influence of the health insurance and pharmaceutical industry lobbyists, and is captive to a free-market ideology that is wholly inappropriate to health care issues. As a result, it seems determined to pursue policies that will increase the fragmentation of our system and swell the ranks of the uninsured.

We need affordable health care, not health insurance. Just look what is happening in MA. It’s not solving the problem at all, because there was no mechanism introduced to REDUCE HEALTH INSURANCE COSTS. Physicians for a National Health Program’s (PNHP) study of the Massachusetts model found that the state’s 2006 reforms, instead of reducing costs, have been more expensive than expected. The budget overruns have forced the state to siphon about $150 million from safety-net providers such as public hospitals and community clinics:

“We are facing a health-care crisis in this country because private insurers are driving up costs with unnecessary overhead, bloated executive salaries and an unquenchable quest for profits — all at the expense of American consumers,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group. “Massachusetts’ failed attempt at reform is little more than a repeat of experiments that haven’t worked in other states. To repeat that model on a national scale would be nothing short of Einstein’s definition of insanity.”

Yet Massachusetts seems to be the implicit model. Despite the obvious popularity of Medicare, there was no serious discussion of expanding it as a possible public health care option (as we had suggested earlier) and there was no attempt to use the public option as a means of expanding choice and competition if a worker was unhappy with the health care program offered by his employer.

The Clinton health care version at least tried to deal with the issue of portability, so that health care did not get tied in directly to employment (a highly germane consideration in a time of double digit unemployment and mounting economic insecurity). There is no hint of that in the Obama plan. If anything, it represented a retrograde step from what was on offer in last year’s campaign via the Clinton or Edwards health care proposals. Most advanced countries have dealt with the defects of private health insurance in a straightforward way, by making health insurance a government service. Through Medicare, the United States has in effect done the same thing for its seniors. We get the status quo. The paucity of imagination of the proposals themselves were completely at variance with the President’s soaring rhetoric, something which is unfortunately becoming a recurrent theme of the entire Obama Presidency.


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That was a great speech, as usual. It left people energized. It sounded like he’s going to take the fight to the other guys. Obama knocks it out of the park again.

So, why do I have to be bah humbug about this again? Because the speech went almost exactly as predicted. Great rhetorical flourishes, but did anyone hear him say that he was definitely going to fight for the public option? No.

I said before the speech that he would say very good things about the public option. That was never the question. He is savvy enough to know that he can’t say something negative about it when he has promised it over and over in the past and that his base is obviously very animated about it. In fact, I think he means what he says – he really does believe in the public option. But again, that’s not the question. The question is whether he would draw the line on it. Tonight he did the opposite.

He said it was a rigidly ideological position of the left to insist it must be in the bill. Here are the exact words he had for progressives on the public option:

“It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal.”

He went on to say the public option would only apply to five percent of the population anyway, a clear attempt to diminish its importance. He mentioned co-ops as a good alternative. And he said vaguely that he will insist on some sort of “choice” for the consumer (“But I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice.”). He didn’t say what choice that would be. That’s a long way away from insisting on the public option. In fact, an excellent case could be made that he is signaling a willingness to negotiate something less than the public option.

But he covered up those facts with so much praise for the public option that a lot of people left feeling like he was really in favor of it. Being in favor of it and insisting on it are two different things.

Look, I hate to do it to you. And I am positive a lot of people will be really pissed at me for being pessimistic after that lovely speech. They already are. We covered the speech live on our show and we were flooded with comments afterward saying that Obama proved me wrong by showing that he would fight for the public option. I still have hope, and his position might harden in favor of that option as we move forward, but that is not what he said tonight.

I don’t want people to get me wrong. It was a great speech. I loved the way he finally went after the Republicans in a forceful way. He made clear and convincing arguments for nearly every provision in his proposal, including the public option. He did a great job of pointing out the other important parts of the bill – getting rid of the practices of denying coverage because of pre-existing conditions and rescission.

The reason I bring up my criticism here is because we can’t afford to let up (also, simply because it is true). If you think it’s enough for Obama to say he wants the public option, you’re not right. He has to go to battle for it – and in the end, there is no way around it – he has to insist it’s in the bill when the Republicans, the lobbyists and health care industry fight him tooth and nail on it.

Unfortunately, we do not have nearly enough evidence that he will do that. We must continue to push him in that direction. If we don’t, then it will be just as much our fault as his for not getting it done. The other side never lets up. They never stop pushing. If we do, then we still haven’t learned the political realities of Washington. So, it’s more important than ever not to get seduced by just appealing words. We must demand action.

Cenk Uygur: The Problem with Obama’s Speech.

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The debate over the “public option” in health care has been dismaying in many ways. Perhaps the most depressing aspect for progressives, however, has been the extent to which opponents of greater choice in health care have gained traction — in Congress, if not with the broader public — simply by repeating, over and over again, that the public option would be, horrors, a government program.

Washington, it seems, is still ruled by Reaganism — by an ideology that says government intervention is always bad, and leaving the private sector to its own devices is always good.

Call me naïve, but I actually hoped that the failure of Reaganism in practice would kill it. It turns out, however, to be a zombie doctrine: even though it should be dead, it keeps on coming.

Let’s talk for a moment about why the age of Reagan should be over.

First of all, even before the current crisis Reaganomics had failed to deliver what it promised. Remember how lower taxes on high incomes and deregulation that unleashed the “magic of the marketplace” were supposed to lead to dramatically better outcomes for everyone? Well, it didn’t happen.

To be sure, the wealthy benefited enormously: the real incomes of the top .01 percent of Americans rose sevenfold between 1980 and 2007. But the real income of the median family rose only 22 percent, less than a third its growth over the previous 27 years.

Moreover, most of whatever gains ordinary Americans achieved came during the Clinton years. President George W. Bush, who had the distinction of being the first Reaganite president to also have a fully Republican Congress, also had the distinction of presiding over the first administration since Herbert Hoover in which the typical family failed to see any significant income gains.

And then there’s the small matter of the worst recession since the 1930s.

There’s a lot to be said about the financial disaster of the last two years, but the short version is simple: politicians in the thrall of Reaganite ideology dismantled the New Deal regulations that had prevented banking crises for half a century, believing that financial markets could take care of themselves. The effect was to make the financial system vulnerable to a 1930s-style crisis — and the crisis came.

“We have always known that heedless self-interest was bad morals,” said Franklin Delano Roosevelt in 1937. “We know now that it is bad economics.” And last year we learned that lesson all over again.

Or did we? The astonishing thing about the current political scene is the extent to which nothing has changed.

The debate over the public option has, as I said, been depressing in its inanity. Opponents of the option — not just Republicans, but Democrats like Senator Kent Conrad and Senator Ben Nelson — have offered no coherent arguments against it. Mr. Nelson has warned ominously that if the option were available, Americans would choose it over private insurance — which he treats as a self-evidently bad thing, rather than as what should happen if the government plan was, in fact, better than what private insurers offer.

But it’s much the same on other fronts. Efforts to strengthen bank regulation appear to be losing steam, as opponents of reform declare that more regulation would lead to less financial innovation — this just months after the wonders of innovation brought our financial system to the edge of collapse, a collapse that was averted only with huge infusions of taxpayer funds.

So why won’t these zombie ideas die?

Part of the answer is that there’s a lot of money behind them. “It is difficult to get a man to understand something,” said Upton Sinclair, “when his salary” — or, I would add, his campaign contributions — “depend upon his not understanding it.” In particular, vast amounts of insurance industry money have been flowing to obstructionist Democrats like Mr. Nelson and Senator Max Baucus, whose Gang of Six negotiations have been a crucial roadblock to legislation.

But some of the blame also must rest with President Obama, who famously praised Reagan during the Democratic primary, and hasn’t used the bully pulpit to confront government-is-bad fundamentalism. That’s ironic, in a way, since a large part of what made Reagan so effective, for better or for worse, was the fact that he sought to change America’s thinking as well as its tax code.

How will this all work out? I don’t know. But it’s hard to avoid the sense that a crucial opportunity is being missed, that we’re at what should be a turning point but are failing to make the turn.

Op-Ed Columnist – All the President’s Zombies – NYTimes.com, Krugman.

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300109-steve-bell-on-ne-0012Steve Bell, the guardian, Friday 30 January 2009

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