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United States

Healthcare for the Insurance Companies

By Bonnie Weinstein

Single-payer healthcare, that would get rid of private health insurance companies and replace them with a government run, expanded, Medicare-type program with the same benefits available to all, has been abandoned and replaced by the feeble demand for a “public option” in a sea of private insurance companies. Free, quality, universal healthcare for all is a basic human right like public education and the fire department—it’s beneficial and necessary to the wellbeing of the whole society. And HR676, the United States National Healthcare plan, was the closest to it to be introduced in the U.S.

But in an October 29, 2009 New York Times article by David M. Herszenhorn entitled, “Pelosi Unveils House Healthcare Bill” Ms. Pelosi presented HR3692, the 1,990-page, Affordable Healthcare for America Act that the House Democratic leaders have been working on for months. It’s a plan to run health insurance much like how the auto insurance industry is run, i.e., individuals must purchase insurance through private insurance companies and the more you pay the better your insurance coverage is; and if you’re caught sick without insurance, you get fined—just like getting caught driving without insurance.

It is designed to take the place of HR676. (By the way, HR676 is less than 30 pages long.)

HR676 United States National Healthcare (USNHC)

I have excerpted the key elements of HR676, the United States National Healthcare program legislation for single-payer healthcare, as follows (the entire bill can be read online at opencongress.org. It’s worth reading to appreciate its simplicity as compared to the 1,990-page, HR 3962 Affordable Health Care for America Act):

“All individuals residing in the United States (including any territory of the United States) are covered under the USNHC program entitling them to a universal, best quality standard of care. Each such individual shall receive a card with a unique number in the mail. An individual’s social security number shall not be used for purposes of registration under this section.

“Individuals and families shall receive a United States National Health Insurance Card in the mail, after filling out a United States National Health Insurance application form at a healthcare provider. Such application form shall be no more than two pages long.

“Individuals who present themselves for covered services from a participating provider shall be presumed to be eligible for benefits under this Act, but shall complete an application for benefits in order to receive a United States National Health Insurance Card and have payment made for such benefits.

“The Secretary shall promulgate a rule that provides criteria for determining residency for eligibility purposes under the USNHC Program.

“The Secretary shall promulgate a rule regarding visitors from other countries who seek premeditated non-emergency surgical procedures. Such a rule should facilitate the establishment of country-to-country reimbursement arrangements or self pay arrangements between the visitor and the provider of care.

“The healthcare benefits under this Act cover all medically necessary services, including at least the following: Primary care and prevention; Outpatient care; Emergency care; Prescription drugs; Durable medical equipment; Long-term care; Palliative care; Mental health services; The full scope of dental services (other than cosmetic dentistry); Substance abuse treatment services; Chiropractic services; Basic vision care and vision correction (other than laser vision correction for cosmetic purposes); Hearing services, including coverage of hearing aids; Podiatric care.

“Such benefits are available through any licensed healthcare clinician anywhere in the United States that is legally qualified to provide the benefits.

“No deductibles, copayments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits.

“No institution may be a participating provider unless it is a public or not-for-profit institution. Private physicians, private clinics, and private healthcare providers shall continue to operate as private entities, but are prohibited from being investor owned.

“For-profit providers of care opting to participate shall be required to convert to not-for-profit status.

“For-profit providers of care that convert to non-profit status shall remain privately owned and operated entities.

“The owners of such for-profit providers shall be compensated for reasonable financial losses incurred as a result of the conversion from for-profit to non-profit status.

“There are authorized to be appropriated from the Treasury such sums as are necessary to compensate investor-owned providers as provided for under paragraph (3).

“The payments to owners of converting for-profit providers shall occur during a 15-year period, through the sale of U.S. Treasury Bonds. Payment for conversions under paragraph (3) shall not be made for loss of business profits.

“The Secretary shall promulgate a rule to provide a mechanism to further the timely, efficient, and feasible conversion of for-profit providers of care.

“Healthcare delivery facilities must meet State quality and licensing guidelines as a condition of participation under such program, including guidelines regarding safe staffing and quality of care.

“Participating clinicians must be licensed in their State of practice and meet the quality standards for their area of care. No clinician whose license is under suspension or who is under disciplinary action in any State may be a participating provider.

“Patients shall have free choice of participating physicians and other clinicians, hospitals, and inpatient care facilities.

“There are appropriated to the USNHC Trust Fund amounts sufficient to carry out this Act from the following sources:

“Existing sources of Federal Government revenues for healthcare. Increasing personal income taxes on the top five percent income earners. Instituting a modest and progressive excise tax on payroll and self-employment income. Instituting a small tax on stock and bond transactions.”

Well, that’s basically it. There’s a bunch more stuff about staff appointments and rates people will be paid, quality control and other such details. But what you see here is the meat and potatoes of HR676. It covers everybody living in the U.S. and its territories, young, old, documented or not—no social security numbers required.

HR3962 Affordable Health Care for America Act

According to an article written by Mike Kruger entitled, “Affordable Healthcare for America Act” that was posted October 29, 2009 to the Committee on Education & Labor website, some of the key components of the 1,990-page, HR3962 Affordable Health Care for America Act, unveiled by House Speaker Pelosi, include:

“For individuals who aren’t currently covered by their employer, and some small businesses, the proposal will establish a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality healthcare options that will include private plans, health co-ops, and a new public health insurance option. The public health insurance option will play on a level playing field with private insurers, spurring additional competition.”

In other words, the extent and quality of your benefits will depend upon how much you can pay, just like auto insurance. And whatever “public option” is built into it, it will not get funding on the scale that will ensure quality healthcare for all, but will be minimal, and destined to be reduced, coverage for the poorest working people.

To continue:

“This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors will have control over decisions about their healthcare, instead of insurance companies.

That is, workers will have the control over the decision whether to pay more for better care!

“Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable healthcare system.”

Simply put, this means everybody has to pay something. And the insurance companies will be assured of having a guaranteed, steady income. It’s healthcare for the insurance companies—buyers beware!

“Employers can continue offering coverage to workers, and those who choose not [to] offer coverage contribute a fee of eight percent of payroll.

“All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.”

That amounts to a $750.00 fine for being caught sick without insurance if you earn $30,000.00 per year—much more for “repeated offenses.”

“The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.”

Simply put, the government determines how much working people can afford to pay—again, working people themselves get no say in the matter. And, according to an Op-Ed in the New York Times by Paul Krugman dated October 30, 2009 entitled, “The Defining Moment:”

“…96 percent of legal residents too young to receive Medicare — would get health insurance.”

That is, “non-legal” residents get nada, zip, zero and must fend for themselves, young and old alike. And those are only some of the poison pills built into the 1,990-page, HR3962 Affordable Health Care for America Act. The rest are yet to be discovered!

Labor bureaucrats cave-in and give up on single-payer

Organized labor’s leadership could be amassing tremendous pressure in favor of the HR676 United States National Healthcare single-payer plan among its membership and among unorganized workers if it paired support to HR676 with the demand for the passage of the Employee Free Choice Act.

A serious labor-based campaign for these two demands could lead to victory for both—especially in light of the outrage among working people at the multi-trillion-dollar bank bailouts and corporate bonuses! This would be a chance for working people to get a piece of that back!

But, according to an article by Seth Michaels entitled, “Hundreds Protest as Health Insurance Lobby Plots to Kill Reform,” that appeared October 22, 2009 on blog.aflcio.org, the AFL-CIO news blog:

“…AFL-CIO President Richard Trumka laid out the principles that must underlie any healthcare reform: a real public option to decrease costs for families and create competition.”

But in his retreat from support of single-payer HR676, Trumka does not point out that the “decreased costs” for families choosing the public option under HR3962 translates into decreased, or non-existent care for the poor and undocumented!

Even the authors of HR676 turn-tail and run

As for HR676, not only has labor abandoned single-payer healthcare, Congressman Kucinich, who is among those who introduced the bill, has, according to his own website, Kucinich.us, retreated to begging for a “robust public option.”

And Congressman Conyers, who introduced HR676 in the first place has written House Speaker Pelosi recommending, “…that yearly out-of-pocket costs should be capped at 2.5 percent of a family’s adjusted gross income,” in effect, endorsing the poison pills in HR3962. (This is quoted from an October 20, 2009 news release posted to U.S. Congressman Conyers’ website at conyers.house.gov.)

So much for single-payer healthcare. And, in contrast to HR676, which covers all healthcare needs (except elective surgery) including prescriptions, dental, vision and hearing care, HR3962 only guarantees that every child in America (except, of course, those who are not “legal residents”) will have this coverage—adults and non-legal residents will have to fend for themselves for those needs.

Tragically, working people are going to experience first-hand this latest betrayal by the Democrats and the labor bureaucracy that supports them.

HR676, while not perfect, would have been a giant step forward for all working people residing in the United States and all its territories. Instead, with the passage of HR3962, or something similar, the insurance companies will have been awarded a guaranteed, government-enforced, multi-billion-dollar yearly bankroll, gouged from the pockets of working people and the poor—documented and undocumented alike—and thousands more will die for lack of care.

But this is yet another straw on the proverbial working-camel’s back. Which straw will be the last one before us camels decide to unite, stand up and fight back?

Hopefully, it will be the one before our backs are broken.