Health Care: The Alice in Wonderland Debate

Jesse Jackson | 9/17/2009, 4:28 p.m.
The health care debate seems upside down and inside out. The legislators who claim to be worried about costs are ...

The health care debate seems upside down and inside out. The legislators who claim to be worried about costs are railing against the measures that would help get costs under control. The angry Tea Party protesters who feel they are getting shafted by the government are aligning themselves with the very folks who are selling them out. The seniors worried about Medicare are fearful of the changes best designed to protect Medicare. What we have here, despite the president's speeches, is a failure to communicate.

The health insurance industry, the drug companies and the conservative ideologues have roused fears about the "government takeover of health care." President Obama rightfully dismissed this as fear-mongering and invited an adult conversation about health reform. Then Rep. Charles Boustany, a Louisiana surgeon who delivered the official Republican response, labeled the president's plan a "government takeover of health care." So much for adult conversation.

Here's the stark reality: We do have a government run single payer health care plan in America, where government pays the bills, and patients get their choice of doctor. It's called Medicare. For all of its many limits, it is the most popular health care system we've got.

We already have socialized medicine in America where government not only pays the bills, but hires the doctors, runs the hospitals and controls the costs. This provides veterans with health care through the Veterans Health Administration. Despite its many faults, it is very popular, as virtually any veteran will tell you.

The president's reform proposal isn't a single payer plan like Medicare -- that was already ruled off the table. It isn't a socialized medicine plan like the VA. It allows people to keep the insurance they have, while mandating businesses -- other than small businesses -- to provide health care for their employees. For those small business employees and other individuals without health care at work, it offers an "exchange" where you can select from many private insurance plans -- just as congressional legislators do -- pooling the individuals to help lower costs. One of those choices, under the Obama plan, would be a public insurance option like Medicare that would help keep the insurance companies honest and, through competition, put a lid on prices.

Not surprisingly, the insurance companies hate it. They want the guarantee of millions of new customers without any restraint on prices or practices. Obama's plan would force them to make significant changes in the ways they do business. They can't refuse you insurance if you are already sick. They can't cut off your insurance if you get sick. They can't discriminate against women in health care rates. These are big deals. And insurance companies have been ready to accept them so long as they could continue to ratchet up rates on millions of new customers. That's why they hate the public option so much. It would derail their gravy train.

Similarly, the pharmaceutical companies got billions from the prescription drug plan offered seniors. Then they lobbied hard to make sure that Medicare would be prohibited from negotiating lower prices for drugs. So America -- which invents most of the new drugs in the world, largely with public research and development funds -- pays the highest prices for drugs of any country in the world. The Canadians -- who do have a single payer system -- negotiate bulk prices and pay significantly less for the same drugs that we invent. Yet, the same conservative legislators who rail against spending are the ones who passed the prohibition on Medicare negotiating lower prices. This isn't free-market ideology; it is simply serving their contributors.

Americans are certain that they are getting shafted by government -- and understandably so. If the insurance and drug companies control the government, then we end up subsidizing their bloated bonuses. But the answer isn't to roll back regulation or stop reform. The answer is to mobilize against the lobbies to make certain that the regulation protects our interests and the reforms serve citizens not corporate lobbies. On health care, the insurance and companies have created a system that cannot be sustained. We -- families, businesses and government -- simply can't afford it. Their power has to be curbed; reforms have to guarantee that health care is affordable. Our only hope is not to condemn government -- we all need health care -- but to take it back from the lobbyists and use it to police and limit those companies. The public insurance option is a small step in that direction. If the insurance lobby succeeds in knocking it out of the bill, we will all pay the price -- a price that many simply cannot afford.