by John M. Curtis
(310) 204-8700

Copyright July 3, 2009
All Rights Reserved.

                 Battling the same special interests that torpedoed then First Lady Hillary Rodham Clinton’s 1993 national health plan, President Barack Obama’s work got a little easier with Al Franken (D-Minn.) officially beating Sen. Norm Coleman (R-Minn.).  Obama now enjoys a potentially filibuster-proof majority, as long as Bernie Sanders (I-Vt.) and Joe Lieberman (I-Conn.) go along.  Obama wants to offer 50 million uninsured Americans a version of the same health plan given to members of the U.S. Congress.  Barack’s plan doesn’t go as far as Hillary’s that would have provided a true single-payer national health plan.  While not all the details are yet available, Obama plans to provide government insurance, only available to those lucky enough to have federal employment. Speaking at a tightly choreographed event in Annandale, Va., Barack vowed to help the struggling uninsured.

            Republican opposition, like it did in 1993, stems from the insurance industry, fearing a hit to profits should the government compete in the private insurance market.  Unlike private insurers that exclude so-called preexisting conditions, Barack’s “group plan” would require no proof of insurability, covering everyone applying for coverage.  “We are going to try to find ways to help you immediately,” said the president, responding to Debby Smith, 54, whose kidney cancer left her jobless and uninsurable.  Private insurers claim they would be hurt by a government plan, cutting into their near monopoly.  Insurance companies routinely provide unrestricted coverage to groups, making individuals pay higher premiums and suffer exclusions for preexisting conditions.  Barack’s plan would insure all individuals under group health coverage, excluding no one or prior conditions.

             Republicans call Barack’s plan “socialized medicine,” a vast government plan introducing mediocrity into the health care system.  They object to the government picking up the tab but have no problem with subsidizing foreign wars.  “Americans are already skeptical about the cost and adverse impact of the president’s health care plan,” said Republican National Committee spokesman Trevor Francis, in Orwellian-like doublespeak.   Today’s 50 million uninsured Americans don’t object to the government helping them with health insurance.  They object to insurance companies excluding them from coverage and charging extravagant premiums.  Those same Republicans objecting to national health care were the same voices opposing Medicare in 1964.  Members of Congress and wealthy senior citizens have no problems letting the government pay their insurance bills.

            Banning insurance companies from excluding pre-existing conditions is an essential part of Barack’s plan.  Private insurers—beholden to Wall St. or private investors—show no mercy to consumers, especially individuals without the benefits of group plans.  Providing a national insurance would correspondingly reduce the costs for Medicare and Medicaid, the two behemoth federal health plans designed for seniors, the disabled and the poor, respectively.  Republicans, during the reign of former President Lyndon B. Johnson, fought the idea of a single-payer national health plan for seniors, known as Medicare, tooth-and-nail.  Republican seniors in Congress have no problem using their Medicare, not complaining one iota about “socialized” medicine.  Those same Republicans are leading the fight against Obama’s national plan, despite knowing it’s not socialized medicine.

            Obama will have to make some concessions to the insurance lobby, whose fears about declining profits are at the heart of the industry’s objections to national health care.  Allowing insurance companies to sell government plans to individuals and employers groups should solve the conundrum of how to get the industry to buy in.  Medicare currently allows insurance companies to offer senior advantage plans, making sizable profits for the industry.  Though it would add to the government’s costs, incentivizing insurance companies is the best way to win approval.  Selling government plans would enable the insurance industry to make hefty profits by adding bells-and-whistles to the McDonald’s-style plan likely to emerge.  Obama wants to reduce costs but he can’t do so at the expense of the insurance industry profits.  Giving the insurance industry a way to make money is the shortest path to approval.

            President Obama is in the driver’s seat, pushing his version of national health care.  While Republicans will keep squawking, they know they’ve run out of arrows in the quiver now that Franken becomes the filibuster-proof vote in the U.S. Senate.  It won’t take too many concessions to bring independents Lieberman and Sanders along to support Barack’s plan.  “The biggest thing we can do to hold down costs is to change the incentives of a health care system that automatically equates expensive with better care,” said Barack, urging physicians to join his historic effort to hold down costs.  Like Medicare, physicians will have to get used to reduced reimbursements to make national health care work.  Using Medicare fee schedules should help make national health care affordable, while, at the same time, satisfying the government’s interest in assuring insurance industry profits.

About the Author

John M. Curtis writes politically neutral commentary analyzing spin in national and global news. He's editor OnlineColumnist.com and author of Dodging The Bullet and Operation Charisma.

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