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March 1st, 2010
Freethought San Marcos: Why health insurance reform is an essential government responsibility

Freethought San Marcos: A column
by LAMAR W. HANKINS

Sixty years into the health care-for-all debate, some people continue to call health insurance reform socialism. If, by socialism, such people means that the control and operation of the health care system will be done collectively by and through the government, the proposals now before the Congress are not socialism. Even the public option, Medicaid, and Medicare are not socialism. None of the proposals before the Congress place the government in the position of providing health care. Of course, health insurance companies do not provide health care either. They merely pay for health services provided by mostly private parties, such as physicians and hospitals, with money collected from individuals and businesses. But for most Americans, the health insurance corporations do control access to health care.

Our representatives (or a majority of them, at least) and most Americans have concluded that the present private health insurance system is a colossal failure because too many of our citizens do not have access to adequate health care. With nearly one-third of our population without any health insurance or with health insurance so inadequate that they are one major illness away from personal bankruptcy, it is clear that our present health insurance system does not work well. These nearly 100 million Americans cannot afford adequate health insurance, which Medicare provides to seniors, those with renal failure, and some people who are disabled.

The health insurance market is a failure. Sadly, people blinded by the ideology of free markets as the solution to all ills are willing to sacrifice the lives of others for their ideology. And the lives of others are being sacrificed. The American Journal of Public Health reported two months ago that about 45,000 people per year in the U.S. die because, without health insurance, they cannot pay for health care.

The values I grew up with and try to live by compel me to conclude that people’s lives should be more important than ideology. With respect to health insurance, the free market is a failure. I will listen to anyone’s ideas, no matter what they are called, if they work, but the free market has failed us in this instance.

Research published in several medical journals concludes that “The Canadian single payer healthcare system produces better health outcomes with substantially lower administrative costs than the United States (healthcare system).” In Canada, as most readers probably know, the provincial governments collect taxes (and some collect modest insurance premiums) and pay the health insurance costs for their citizens, much as health insurance companies in the U.S. are supposed to do, except that all Canadians are covered without regard to pre-existing medical conditions. In Canada, there are federal standards which must be followed by the provinces.

But in America, our health insurance companies will not provide health insurance for most pre-existing conditions. Yet, our health insurance companies enjoyed record profits this past year (as well as throughout the past decade) and the largest such companies are preparing to raise their rates by incredible amounts. The five biggest for-profit health insurers–UnitedHealthGroup Inc., WellPoint Inc., Aetna Inc., Humana Inc., and Cigna Corp.– reported profits for 2009 up 56 percent from 2008.

Anthem Blue Cross (owned by WellPoint), the largest health insurance provider in California, plans to raise rates for individual policyholders by 39%. Anthem is requesting a rate increase in Maine of 23% and 50% in Indiana, with double digit increases in eight other states already being sought. Health and Human Services Secretary Kathleen Sebelius warned last week that rates in at least six states could go up by as much 56 percent. Exorbitant increases in insurance premiums, refusal of coverage for pre-existing conditions, and denial of claims by existing customers are all evidence of a broken system. The health insurance market is not working for a substantial segment of the population. In such circumstances, the government is the only hope for America’s families.

The health insurance companies are doing what they are supposed to do–make as much profit from our cancer, heart attacks, broken bones, prostate problems, asthma, and strokes as possible. But the American people have seen that making profits has not been the solution to our health insurance needs.

This is why the public options that already exist in this country are so popular–Medicare, VA health services, and Medicaid. These programs have provided affordable health care to millions of Americans. Now the rest of us need access to equally good programs so that we cease being the victims of the corporatization of health care in this country.

The simplest way to compel the health insurance corporations to alter their practices so that most Americans can receive adequate health insurance is to allow anyone to buy in to Medicare. But as most people realize, Congress–under the influence of corporate lobbyists–seldom seeks the simplest solution to social and economic problems.

Current proposals to provide meaningful health insurance reform provide that those who like their present health insurance coverage can keep it. Such reform would make available affordable coverage through subsidies and tax credits to those who need help for whatever reason, whether a job loss, inadequate income, or excessive insurance premiums that exceed a certain specified level relative to their income.

Acceptable reform will help small businesses with insurance coverage for their employees. And seniors will receive improvements in their Medicare so that preventive care is fully covered, their drug costs don’t end because of the exclusion (called the donut hole) after their prescriptions exceed $2830 a year, greater access to community and home-based care is provided, insurance company gouging for Medicare Advantage programs is ended, and better efforts are made to expose and correct fraud, waste, and abuse among Medicare service providers.

For those with private health insurance plans, adequate government reform will require that at least 80% of insurance premiums are spent on health care, not insurance company overhead and profits. And all preventive care should be covered. Incentives should be provided to physicians to serve under-served areas, particularly in rural parts of the country, and to provide primary and geriatric care, practice areas where we have a shortage of doctors.

Worthwhile health insurance reform will assure that health insurance companies are subject to our laws prohibiting price-fixing and collusion in the marketplace. To accomplish this, the anti-trust exemption should be abolished.

The Republican position on health insurance reform seems to be that these matters should be left up to the states. This position has appeals to states’ rights voters, but it is virtually without merit. Except for Massachusetts, few states have even tried to fix the private health insurance mess and are unwilling to tackle the problem in a meaningful way. Since the states won’t do it, it is left to the federal government to make the system work for all Americans.

A public option–like Medicare–will rein in the health insurance corporations’ abuses or they will lose business because they don’t provide an adequate product. In recent polling in Nevada, Illinois, Washington, Missouri, Virginia, Iowa, Minnesota, and Colorado, independent voters polled said that they want a public option by ranges from 56% in Missouri to 69% in Illinois. Democrats support the public option by overwhelming majorities. Only Republicans don’t seem to care that the system is broken and needs public competition or reform to correct the imbalances and abuses in the private system.

Many of us understand the United States as a cooperative venture among our people, a kind of social contract, which underlies our system of government and is reflected in the preamble to our Constitution:

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

There is nothing in the Constitution about the private market model and that model does not represent how the American economy has worked throughout our history. From its beginning, Americans have accepted this proposition: If the marketplace cannot or will not provide a good or service needed by the people, the people have the right to satisfy that need through their own cooperative efforts, whether through private cooperation or through cooperative government action.

As proof, look at all the credit unions, consumer cooperatives (providing housing, water, electricity, telecommunications services, child care, health care, food, books, and funeral services), producer cooperatives (owned by people who produce products, such as farm crops, cattle. milk, crafts and other artistic products), worker cooperatives (businesses owned by workers, including employee-owned food stores, bakeries, restaurants, taxicab companies, sewing companies, timber processors, and other industrial manufacturers), and government cooperatives (businesses, cities, and state governments have banded together to purchase goods and services that they need in order to lower costs, improve services, and increase competitiveness).

While all of these kinds of cooperatives are vital to the economic health of the nation, they exist alongside profit-making businesses that offer the same or similar goods and services. Cooperatives usually exist where the private market has failed to provide people something they need, at a price they can afford, and on terms they find acceptable.

Our government as a kind of cooperative venture operates under different rules and structures from those followed by either the private, market-driven sector, or the cooperatives sector. Government usually provides streets, roads, and highways; fire and crime protection; schools; libraries; recreational facilities; airports; sewer services, garbage collection, and recycling services; water, electrical, and gas utilities; low-income housing and a range of social services, including health care and health care insurance for the elderly, children, the disabled, those with special medical conditions, and the military (TRICARE and VA).

It is the government’s responsibility, acting on behalf of the people, to make our society work for the people’s benefit when the socioeconomic system has become dysfunctional. When that dysfunctionality results in the unnecessary deaths of tens of thousands of Americans each year, that responsibility becomes an imperative.

For nearly 100 million Americans, having meaningful health insurance reform will do more than almost anything else at this time in our history to assure that the promises of that preamble are fulfilled. It is time for Congress and the President to give us a government of, by, and for the people, not of, by, and for the giant corporations who now control access to the health care system.

© Freethought San Marcos, Lamar W. Hankins

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24 thoughts on “Freethought San Marcos: Why health insurance reform is an essential government responsibility

  1. It is clear that you don’t have a clue! There are three points I want to make here:

    1) The preamble of the US Constitution is just that: A preamble, a mission statement. It does NOT hold the force of law and 2)It says “promote the general welfare”, not PROVIDE it.

    2) The United States is a republic, NOT a democracy. Unfortunately, too few Americans realize this fact. A democracy is little more than mob rule, where a majority of 51% can force the other 49% to pay for their ideas.

    3) The problem with our health care system is a direct result in government intervention in it. Federal mandates have forced medical professionals and institutions to recoup costs from those who actually pay for their services. In addition, since the crooks in Congress have exempted health insurance companies from anti-trust laws people who want insurance are forced into too few choices. Medicare and medicaid are both BROKE. As is Social Security. In what universe should the federal government be allowed to take a larger role? Not this one!

    You sir, have shown in this article that you have little understanding of the issues. There is so much more wrong with this article than the areas that I have addressed. Do your homework, or go ahead and declare yourself a socialist and be done with it.

  2. Lamar, for an attorney, you have an astonishingly ignorant understanding of the US Constitution. Almost as ignorant as your understanding of the current proposals to seize our health care.

    As for Tammy’s comment, “There is so much more wrong with this article than the areas that I have addressed.” – par for the course for this bumbling, progressive moron.

    Lamar, give me one example where an unrestricted, unregulated free market failed. Give me one example where government control of an economic sector succeeded. You can use any country, in any period of modern society – and you will still come up with nothing. Because everything governments’ have controlled as been a disaster.

    Lamar, if you want to really understand how economies work, you should familiarize yourself with the Austrian school of economics. History has proven, time and again, that the Austrian’s model for economics will prevail. And history continues to show that Keynesian economics will fail at every attempt.

  3. “With respect to health insurance, the free market is a failure.”

    With respect to this article, Lamar is a failure. We don’t have a free market when it comes to health insurance. Our health insurance industry is riddled with regulations. You should learn more about a given subject before publish anymore embarrassing articles.

  4. Lamar, do you read the news much?

    You said, “Research published in several medical journals concludes that “The Canadian single payer healthcare system produces better health outcomes with substantially lower administrative costs than the United States (healthcare system).””

    Here’s some news for you: http://www.google.com/hostednews/canadianpress/article/ALeqM5h0QC7bditrEb3wYz_6_b-gsGGDxA

    “An unapologetic Danny Williams [Canadian Provincial Premier] says he was aware his trip to the United States for heart surgery earlier this month would spark outcry, but he concluded his personal health trumped any public fallout over the controversial decision.

    In an interview with The Canadian Press, Williams said he went to Miami to have a “minimally invasive” surgery for an ailment first detected nearly a year ago, based on the advice of his doctors.

    “This was my heart, my choice and my health,” Williams said late Monday from his condominium in Sarasota, Fla.”

    So Lamar, still want to make the claim that Canada’s health care system is superior to the United State’s?

  5. “our health insurance companies enjoyed record profits this past year”

    Typical Marxist non-sense. Attack profits, attack profits.

    Here’s something that Lamar would wish we didn’t know:

    For Q4 of 2009, the Health Care Plan industry (includes Humana, Aetna, WellPoint, Magellan, Unitedhealth Group, etc.), and the health insurance industry slipped to #88 [from #86] with a profit margin of 3.4%. Actually, that industry profit margin was boosted by WellPoint’s 18% profit margin for Q4 2009, which was due largely to a one-time sale of its Pharmacy Benefit Management division. Without that sale, WellPoint’s profit margin would have been only 3.9%, the industry average profit margin would have been closer to 3%, and the ranking for the industry would have fallen a few places down to #92.

  6. “This is why the public options that already exist in this country are so popular–Medicare, VA health services, and Medicaid.”

    So, Lamar, your a smart fellow. Tell me again which of these public options are NOT bankrupt?

  7. “The Republican position on health insurance reform seems to be that these matters should be left up to the states.”

    So, what your saying Lamar, is that the Republicans have actually read the U.S. Constitution? What a novel idea!

  8. Lamar, you said, “Government usually provides streets, roads, and highways; fire and crime protection; schools; libraries; recreational facilities; airports; sewer services, garbage collection, and recycling services; water, electrical, and gas utilities; low-income housing and a range of social services, including health care and health care insurance for the elderly, children, the disabled, those with special medical conditions, and the military (TRICARE and VA).”

    Your clearly missing something huge. You should replace “Government” with, “State Government” or “Local Government” and understand that division. You are misleading people to believe that the Federal Government does all those things. Well, news flash genius – THE FEDS DON’T PICK UP YOUR TRASH!!!!!!!!!

    “When that dysfunctionality results in the unnecessary deaths of tens of thousands of Americans each year, that responsibility becomes an imperative.”

    Unnecessary deaths? Are you kidding me? Health insurance doesn’t mean that you will not die. Many people die every day that have health insurance. Your plucking at your fiddle, hoping it will pull at someone’s heart-strings, knowing that MIGHT keep them from thinking in a rational, logical way.

    See, here’s the difference Lamar: Liberals use emotions to make decisions. Conservatives use logic to make decisions. Emotions serve to cloud your perspective and keep you from thinking rationally.

    Another key difference: Liberals are never judged on the outcomes of their policies. They are only judge on their intent. ALL LIBERAL POLICIES HAVE BEEN ABSOLUTE FAILURES! Case closed.

  9. “It is time for Congress and the President to give us a government of, by, and for the people, not of, by, and for the giant corporations who now control access to the health care system.”

    Hey, Lamar. Giant corporations don’t control access to the health care system. Everyone and anyone can access the health care systems. Have you ever sat in an emergency room? HELLO McFLY!

    And everyone and anyone can get access to health insurance too. They just have to get off that fat, lazy bums and earn a living. It’s pretty simple then. Just spend your money on health insurance rather than new rims for your ride, a larger flat screen t.v., a new iPod, a liter of gin, a gram of cocaine, and ounce of dank, a new pair of Air Jordans, a new XBOX, a couple cartons of Newport cigarettes or whatever else society’s leeches prefer to pay for instead of their own health!

    Get a clue Lamar.

  10. Physicians react to 21% Medicare payment cut

    1st on the web (March 2, 2010)
    While the House of Representatives voted last week on a bill that would stall the scheduled 21% Medicare physician payment cut, the Senate adjourned without passing its own version of the bill thereby allowing the cut to go into effect March 1.

    Physicians say that the massive cut will put patients’ access to care at risk.

    “The Senate had over a year to repeal the flawed formula that causes the annual payment cut and instead they abandoned America’s seniors, making them collateral damage to their procedural games,” J. James Rohack, MD, the American Medical Association (AMA) president stated in a release. “Physicians are outraged because the cut, combined with the continued instability in the system, will force them to make difficult practice changes including limiting the number of Medicare patients they can treat.”

    Call to action
    According to an AMA release, physicians will meet with seniors this week during the AMA’s National Advocacy Conference and call for a permanent repeal of the sustainable growth rate (SGR) formula.

    “The AMA is hearing directly from physicians, and seniors should be very concerned about how the Senate’s inaction will impact their ability to see a doctor,” Rohack stated in the release. “Military families are also hurt as TRICARE ties its payment rates to Medicare.”

    A potential delay
    Some have noted that Medicare claims are not immediately paid after submission and believe that Congress will intervene before the cuts will be implemented.

    “I feel the implementation of the reductions will be delayed in the next week or 2 [weeks] for at least 6 months to 1 year while a longer term solution is brought forward,” Orthopedics Today Chief Medical Director Douglas W. Jackson, MD, told OrthoSuperSite.com.

    If the cut is implemented, he will no longer participate in Medicare as a physician.

    “I have been willing to work with the Medicare fee reductions over the years,” he said. “I enjoy taking care of this population. The 21% reduction is too large. It would mean I would have to lower my overhead more than I want to and still deliver the quality of care and maintain the support staff to assist in caring for Medicare patients. Some physicians will drop out of the program. Some will reduce the number of Medicare patients they see or stop taking new patients with this coverage.”

  11. Postmaster delivers bundle of bad news
    By Ed O’Keefe
    Tuesday, March 2, 2010; 9:02 AM

    The U.S. Postal Service estimates $238 billion in losses in the next 10 years if lawmakers, postal regulators and unions don’t give the mail agency more flexibility in setting delivery schedules, price increases and labor costs.

  12. I am 33 years old, I will gladly let you keep all the social security and medicare payments that yall have stolen from me so far if you will allow me to opt out now and not pay another dime to your evil ponzi schemes. I am smart enough to insure myself and save for my own retirement. I am declaring my intent for Independence from this system of theft. Anyone older than me is to blame for this because you didn’t fight hard enough to keep them from stealing from your children, you should all be ashamed and be held responsible, don’t worry you will be when its time to send you to that old folks home.

  13. I really find Lamar difficult to stomach. Still, I can’t help but mention that three “unique” posters in a row used “your” where they should have used “you’re.”

    Any chance we can shore up the system, to ensure that each poster is truly unique? You know, just in case there happens to be a discussion about a local issue (one more important than microchipping pets and shooting ranges, that is).

  14. Ted, Are your suggestions inferrin’ we aint’t who we say we are ?
    Quack Quack !

    Sincerly
    Donald

  15. It appears I’m late to the “bash Lamar” party.

    But I’ll throw in my two cents anyway.

    The United State Constitution is pretty simple and straight-forward. The 10th Amendment states, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

    It’s pretty clear, Lamar. Health care can, and should only be, managed by individual States, assuming it is not in violation of their respective constitutions. It cannot be taken over by the Federal Government without a constitutional amendment. And I don’t think the Democrats have raised that issue. That should be the end of it.

  16. Ted, you might be on to something. With that said, we all know what an absolute failure public education (government-controlled education) has been. Therefore, is it really that unusual for posters, without the aid of MS Word or proof-reading, to type “your” rather than the correct usage “you’re”?

  17. We have heard a great deal about the costs and benefits of a “public option” and “single-payer system.” We have heard about the financial costs — and the other costs — of allowing the government to interfere with matters of life and death. However, we haven’t heard whether the Constitution gives Congress the power to enact these plans. What does this say about the status of the Constitution in the minds our policymakers today? If a concerned citizen asks a proponent of nationalized healthcare to point to the constitutional authority for such a law, he may hear that the “General Welfare” clause, the “Necessary and Proper” clause, or the “Interstate Commerce” clause enables Congress to create national public health insurance to act.

    None of these clauses — or any others found in the Constitution — gives Congress the power to create a government healthcare system.

    The “General Welfare” clause gives Congress the power “To lay and collect taxes, duties, imposts, and excises, to pay the debts and provide for the common defense and general welfare of the United States.” This clause is not a grant of power to Congress. It is a limit to a power given to Congress. It limits the purpose for which Congress can lay and collect taxes.

    During the founding, some Anti-Federalists were concerned that this clause “amounts to an unlimited commission to exercise every power which may be alleged to be necessary for the common defense or general welfare.” But James Madison, the “Father of the Constitution,” explained very clearly that it granted no power to Congress. If the “General Welfare” clause gives Congress the power to promote the general welfare, then why specifically list the other powers in Article I, such as the power to establish post offices and post roads, or to coin money? Wouldn’t it be redundant to list them?

    In short, as Madison argued, Congress derives no power from the general welfare clause, which merely serves to limit Congress’s power to lay and collect taxes. Congress can only do so for purposes of common defense or general welfare, in the service of the powers granted to it elsewhere in Article I.

    Second, “Necessary and Proper” gives Congress the power “to make all laws necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States.” Like the general welfare clause, this clause was not a stand-alone grant of power to Congress. Rather, it authorizes Congress to make laws that are necessary (and also proper) to make the other grants of authority in Article I effectual.

    In other words, the necessary and proper clause cannot itself authorize national public health insurance. One would have to show that national public health insurance is necessary and proper to execute some other power granted in the Constitution. This puts the proponents of nationalized healthcare back where they started.

    Lastly, proponents might argue that national health insurance is part of Congress power “to regulate commerce…among the several states.” While progressives have often used this clause to expand the federal government, it does not apply especially to the creation of a national health insurance, because to create and engage in commerce is not the same thing as regulating commerce among the several states.

    Nobody during the framing generation expected the commerce clause to expand the federal government’s authority to anything relating to or resembling commerce. James Madison wrote that it is a power “which few oppose, and from which no apprehensions are entertained.” The clause was designed to prevent some states from taxing goods that passed through their boundaries as those goods proceeded to market.

    Of course, most progressive advocates of national health insurance are unconcerned whether the Constitution authorizes such a law when a pseudo-constitutional reasoning to reach the desired result will suffice. But constitutionalists should not allow such attempts to dismiss the Constitution go unanswered.

  18. If you read my column, you should have noted that I did not claim the Preamble confers any particular powers on the federal government. I wrote that “Many of us understand the United States as a cooperative venture among our people, a kind of social contract, which underlies our system of government and is reflected in the preamble to our Constitution.”

    I understand that not everyone shares the cooperative view of government. If you don’t share my views about government, that does not make you or me bad people. We may just have different worldviews. I’m sorry that I don’t have time to respond to every comment, but I always hope that my readers will be willing to consider views other than those presented by the mainstream media, Fox News, and Rush Limbaugh.

    That’s all the explaining you will get from me this week.

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