Below is an excerpt from Ed's new book, "Killer Politics: How Big Money and Bad Politics Are Destroying the Great American Middle Class."
Health Care
Your Inalienable Right
Exhausted . . . I was dead tired when I made a guest appearance on msnbc’s Morning Joe show on December 17, 2009. Just a few days before that I had been broadcasting from Kansas City at a free health clinic, seeing something I never thought I would see in America—thousands of good people, most of them the working poor, some of them the struggling middle class, all lined up for health care they could not otherwise afford. The clinics were Keith Olbermann’s idea, and donations from some twenty-five thousand msnbc viewers made them possible. I spent two days broadcasting from Kansas City. It was emotionally wrenching.
Strung out from traveling, tired, battling one helluva cold, and just plain heartbroken about what I had seen, I told Joe Scarborough’s viewers that morning what I thought about the compromised health care bill on the table that day. Although it improved many things, it contained no public option and, as I saw it, provided no real competition for the insurance companies. “The president never drew a line in the sand . . . he hasn’t been tough,” I said. “Barack Obama is not listening to his base.”
Well, somebody was listening to me, because moments later, a remarkable thing happened. One of the president’s closest advisors, David Axelrod, called the show, and we got into it. “Where’s the competition?” I asked. “People in this country right now the progressives don’t believe that the White House has stood up to the insurance industry.”
Axelrod responded, “Ed, let me ask you a question. Why is the insurance industry so vigorously opposing this bill? . . . We fought for years as progressives for a patient’s bill of rights. Everything that was in that patient’s bill of rights is now enshrined in this legislation. And yet people say, let’s just throw it away [the health care bill], we don’t need it anymore. Why is the insurance industry fighting us so hard?”
“Respectfully, Mr. Axelrod, I’ll answer your question if you answer mine,” I said. “I’ll answer your question: [The insurance industry has] the money to play a shell game on the American people. They’re creating this facade that [the health care plan you propose] is really bad for them. It’s not, it’s a handout.”
It is, too. The insurance companies were crying wolf over the Senate health care plan, doing some serious melodrama, and then laughing all the way to the bank. Wall Street sure thought so. Insurance stocks went through the roof! C’mon! Don’t piss on my leg and tell me it’s raining.
The proposed legislation mandated that all Americans must buy insurance from a private company. Yes, those who can’t afford it would get government subsidies, but the bottom line was: The insurance companies would get 31 million new customers and no pesky government insurance option to compete against them. I call that a handout.
My exchange with Axelrod reflected two things. First of all, it reflected the angst Americans were feeling about all this. Second, on a personal level, it reflected the chill that had developed between the White House and me during the course of the health care debate.
I carried plenty of water for Barack Obama during the campaign, because I thought he was the right man at the right time, and I still think that. But the White House has developed rabbit ears. They don’t understand that I may be one of the best friends they have, because I am not an enabler. I tell it like it is at least how I see it and a lesson I learned long ago is that the best friend you can have is the guy who tells you what you don’t want to hear but need to. You have to be able to differentiate the tough love from an attack.
One of the most infuriating things about writing this book has been that while I’ve been writing it, the fight for health care reform has been a real time emotional roller-coaster ride. The public option is in! No, it’s dead! It’s alive! No, it’s been traded for Medicare expansion! And on and on it went. When Scott Brown won the Senate seat Ted Kennedy had held for nearly fifty years, it cost the Democrats their filibusterproof majority, and threatened to undo the bill
Every day, I felt it was my duty to be fully informed on every twist and turn in the legislative pro-cess in Washington, so I could fight for health care each afternoon on the radio and each weekday eve¬ning on msnbc. I had a pulpit during a crucial time for health justice in the United States, and I was determined to use it well. I’m a redhead who wears his heart on his sleeve, so all the twists and turns just about did me in sometimes. Some days I felt wrung out! Why, I wondered, can’t we come together as a country? Why can’t we do the right thing, which I know it is in our nature to do? Why must we move forward in such excruciating increments?
None of us, including me, has learned patience. The twenty-four hour news cycle drives our emotions. But it shouldn’t. This is the age of instant gratification, and we expect our presidents to solve every problem in the first year. That’s insane.
In light of the fractious nature of Congress, the obstructionist policies of conservatives, and the power of the health care industry, it is clear that the journey to where we need to go with health care will be one measured over decades.
In my mind there are a few things that ought to be basic human rights in our system. I believe every person has an equal right to a good education. I believe every American has the right to retire from the workplace in dignity, with a reasonable standard of living. And in my heart I know that it is morally bankrupt to base the quality of health care on the size of the recipient’s wallet to have some insurance company bean counter making a decision that should be left to a patient and the patient’s doctor.
Reasonable access to health care is a basic civil right. That said, the citizen has some responsibilities, too, and we’ll get to that—settle down, righties! As a progressive in this politically correct world, don’t you get tired of feeling like you have to placate archconservatives every few sentences to let them know that, like them, you believe in personal responsibility? Geez! Living under this suffocating Republican influence for so long has us all walking around with our sphincters so tight, if we started eating coal we could crap diamonds.
The fact of the matter is, there are far more things that unite us as Americans than divide us, and one of them is health care. A 2008 survey commissioned by the Commonwealth Fund reported that 82 percent of more than one thousand surveyed thought the system needed to be overhauled. You think? Other surveys showed a majority of Americans favored a government--run option to compete with private insurers. Meanwhile, the House Republican leader, Representative John Boehner of Ohio, claimed “I’m still trying to find the first American to talk to who is in favor of the public option.” That’s the equivalent of not being able to find your ass with both hands.
Pre-Obama, the United States spent twice per capita what other developed nations spend on health care. Still, life expectancy in America, at 78.11 years, ranks fiftieth in the world. Canada is eighth with a life expectancy of 81.3. Not a single major industrialized nation with national health care ranks lower than the United States.
Macau has the longest life expectancy in the world (84.36), and Japan, at number 3, is the highest ranked industrial nation (82.12). Meanwhile, U.S. infant mortality is 6.26 per 1,000 births, forty-fifth best, ranking just behind Cuba. Singapore is at the top with a 2.31 infant mortality rate. Tell me again that health care in the United States is the best in the world.
If you’re wondering how Singapore does it, a nationalized health insurance plan there is funded by payroll deductions, some government subsidies, and through price controls. Many Singaporeans also have supplemental insurance for ser¬vices not covered by the government. The country spends 3 percent of GDP on health care, compared to 17 percent ($2.4 trillion) in the United States. Compare that to 10.9 percent of the GDP spent on health care in Switzerland and 9.7 percent in Canada.
Someday we will come to the conclusion that universal health care is the optimum solution. We already have a program that works Medicare—all we have to do is expand it to everyone. We will find it makes the most sense for our economy as a whole and, more importantly, that it is the moral thing to do. The frustrating thing about this cause is that we can only get the votes for baby steps. “You can’t pass legislation with polls,” Senator Kent Conrad told me on my radio show. “You need votes and we don’t have the votes.” What? For the first time since 1979, the Democrats had sixty votes in the Senate, and still I was hearing “Well, you know, Eddie, we jest can’t get ’er dun.”
You’re kidding, right? You’re telling a guy who, like millions of others, busted his ass for a victory for Barack Obama and a Senate majority, all on the promise of change, that the Democrats are still kowtowing to the minority! “Excuse me there, would it be OK if we passed a little health care legislation?” Those sixty votes lasted just a year, and the Democrats failed to take advantage of the opportunity.
What the hell! What would Bush have done with sixty votes? We’d be in Iran by now! The Dixie Chicks would be in jail and Toby Keith would be the secretary of defense. What is with the Democratic Party? I keep hearing about these Chicago Thug Politics. Yeah? Well, gimme some! The opportunities afforded by a sixty vote Senate majority come around as often as Haley’s Comet or Dick Cheney telling the truth and the Democrats acted like they were on life support. Where’s our Tom DeLay? Why, as Democrats, can’t we put the hammer down?
OK, OK! As we discovered, the sixty vote majority was strictly theoretical, anyway. Smokey Joe Lieberman (I‑CT) long ago abandoned any fealty to the Democratic Caucus. (Note the use of the word “Democratic.” I find the use by conservatives of the term “Democrat Party” insulting. They can’t stand our association with democratic principles, apparently. We don’t call them the Republic Party, do we?)
I appreciate the president’s efforts to try to work with Republicans, but they are too invested in his failure. Olive branches are not working, so at least try a bigger branch, Mr. President! Sometimes you do need a big stick. Barack Obama needs to set aside Lincoln for a while and model LBJ. Heck, Landslide Lyndon was known to pick up senators by the ears! That’s how I heard it, anyway.
Republican opposition to health care reform has little to do with the actual issue. It’s about taking the president down, as Tim Dickinson explained in Rolling Stone: “Behind the scenes, top Republicans including House Minority Whip Eric Cantor, Minority Leader John Boehner and the chairman of the GOP’s Senate steering committee, Jim DeMint worked hand in glove with the organizers of the town brawls.
Their goal was not only to block health care reform but to bankrupt President Obama’s political capital before he could move on to other key items on his agenda, including curbing climate change and expanding labor rights. As DeMint told an August [2009] teleconference of nearly 20,000 townhall activists, ‘If we can stop him on this, the administration won’t be able to go on to cap and trade, card check and the other things they want to do.’ ”
When I think of good Americans suffering through health and financial issues while politicians play games with their lives in Washington . . . well, how can that not just infuriate you? They don’t seem to care about doing what’s right. They just want the Democrats to lose!Strategically, the White House made some mistakes, too.
First of all, Obama took the ultimate health care fix universal coverage off the table early. Well, any horse trader knows you don’t give ground right out of the gate. You need to leave room to negotiate. So you start high and negotiate from there. Seemingly, Obama started at the point he thought was politically achievable, which did not give him room to move. From a political standpoint, your supporters feel sold out from the beginning and your detractors are angry because they don’t feel you have given up enough in the process.
All of that may well have been a moot point because it seems the Republicans care more about winning than doing the right thing. And maybe sixty consistent votes in the Senate was a pipe dream. Democrats have never organized as tightly as the Republicans. You want sixty votes on any issue? You probably need seventy Democrats because many of the Democrats come from conservative districts. Really, in some respects in America, we have two conservative parties, one is just less extreme than the other.
Here’s the landscape: We are expecting one hundred senators with job security, a great pension, and the best health care on the planet to fix this problem. The institutions in the health care industry that don’t want change are filling the campaign war chests of their favorite lawmakers. Health industry lobbyists outnumber lawmakers in Washington by at least four to one.
For all the mistakes and foot dragging on the part of Democrats, do you want to know the biggest reason why you and your children will not be seeing universal health care anytime soon? Not only did the Republicans oppose reform in a strategic effort to damage Obama, they set the table for this bitter feast by helping George W. Bush blow up the budget. Had Bush been fiscally responsible, the debt would have been erased and the nation could have much more easily afforded an investment in universal health care.
Your Choice: Financial Ruin or Dying
If you don’t have health insurance and you come down with a big medical problem, you must choose one of two options financial ruin or dying. And in my America, we have to debate the politics of it all? Let me tell you, brother, when you are circling the drain, you just want a lifeline. Just a chance at making it. Just a few more heartbeats to spend some time with the grandkids, to see a few more sunrises. That’s what this is all about.
When it has been tried, socialized medicine has worked. Take Medicare for instance. Could you find ten retired Republicans in America willing to give up their Medicare benefits? Of course not. Not even the dozens of congressmen on Medicare would give it up. So what’s the big argument about? This one was decided long ago. Opponents are wrong now and they were wrong in 1964 when LBJ delivered on Medicare.
In 1964 the Saint of Conservatism, Ronald Reagan, blasted Medicare in a speech. “Will you resist the temptation to get a government handout for your community? Realize that the doctor’s fight against socialized medicine is your fight. We can’t socialize the doctors without socializing the patients. Recognize that government invasion of public power is eventually an assault upon your own business.”
Let’s break that down.
Handouts for Whom
Who’s really getting the handouts in our health care system? In 2003, President George W. Bush drastically expanded the Medicare program with Medicare Part D (which subsidizes prescription drug costs for Medicare recipients), which I guess was OK, although it was as much a benefit to elderly Americans as a license to commit highway robbery for the pharmaceutical companies, which get to sell drugs under the program without any pesky negotiations to drive down prices. Oh, that was fiscally responsible.
Socializing Patients
I guess Medicare makes Grandma and Grandpa Commies. I’ll bet if you check the closet, you’ll find a statue of Karl Marx. Well, you had better hope Grandma and Grandpa have plenty in the bank, because according to Fidelity Investments, retiring elderly couples will need $250,000–$300,000 in savings to afford most basic medical coverage.
An Assault on Business
Are you kidding me? The assault on businesses has been the inability to be competitive while shouldering employee health care costs. From a competitive standpoint in the global economy, -doesn’t it seem ludicrous to expect our businesses to start in such a deep hole? The natural reaction is for businesses to relocate, taking away American jobs, in the interest of competitiveness. Yes, there are all sorts of other factors, from tax havens to the disparity in environmental regulations, but, ironically, the burden of health care has become unsustainable for the free market to bear.
According to Micah Weinberg, a researcher and expert on health care reform for the nonpartisan New America Foundation, “American businesses large and small are being hamstrung by soaring health care costs that are more than twice those of foreign competitors.” Twice? America can compete in a global economy, but the days have long passed when we could afford to spot every competitor that many points.
As far back as 2005 General Motors was spending more on health care costs (over $1,500) per car than on steel! That’s an unreal advantage to foreign carmakers. Didn’t anyone see this coming? The brilliant Bill Clinton, who has an uncanny way of cutting to the heart of the issue, told Jon Meacham in a 2009 Newsweek interview that the difference between what the United States spends in GDP (17 percent) on health care and what other industrialized nations spend, the average 6 percent difference, amounts to giving them a $900 billion competitive advantage!
It should be so simple, yet some conservatives are so dug into their dogma that they can’t see that the policies they support are the ones killing the free market and the independent businesses they claim to revere.
Unchecked capitalism creates negative socialist outcomes
Between 2000 and 2007, the average worker’s insurance premiums grew twice as fast as his or her wages. During the same time frame, according to Joseph Antos of the American Enterprise Institute in Washington, premiums for employer-sponsored insurance jumped 98 percent -four times faster than wages.
This employee-based system has led to workers chasing benefits from job to job, not necessarily doing what they love or are particularly good at. Common sense tells us that this is no way for any society to thrive. Think about it. Poorly regulated capitalism has forced Americans into jobs for which they are ill suited, which is one of the great fears people have of socialism. Paradoxically, if we free workers from taking jobs based on whether or not that job provides health care, we strengthen capitalism because we encourage people to do what they are best suited to do.
Careening toward insolvency
“You can’t fix the economy without fixing health care,” President Obama has said. While I have been critical of the White House strategy on health care reform, I do understand what an incredibly difficult lift this is. Had he not inherited such a wretched economy and massive debt, President Obama could have passed much more substantial legislation because he would have had the money in the bank to make the initial investments. Instead, he had to settle for reforms that were immediately budget neutral or that promised savings. Had Bush II been held to that standard, Medicare Part D, which Republicans passed despite its $1.2 trillion price tag (over ten years), would have been sunk. As it was, the unfunded plan floated away in a sea of red ink. Because Bush wrote all those hot checks then, average American families are paying the price now.
Before the Democrats took on health care reform, the New America Foundation projected that health insurance in 2016 could cost $20,400 annually for a family. Some will say if we are paying anything less than that in 2016, it is a victory. If so, it’s a small victory, and I don’t plan any kind of celebration in the end zone. The tiresome term used during the health care debate was that proponents wanted to “bend the curve” on costs in other words, tamp down the pace of the increases.
The reality is, even with the consumer protections in any new health care legislation, there just isn’t enough leverage to bring about any kind of immediate relief for most people. Families will probably still see their costs rise but at a slower rate than had this runaway train been allowed to keep rolling. Under the proposed legislation under consideration as this book went to press, Americans will no longer be denied coverage, but what we don’t know is how high rates will go. Can we expect real competition? Will we finally have a country in which getting sick doesn’t mean financial ruin? Folks, it’s too early to tell.
According to a Harvard and Ohio University study in 2007, medical-related expenses triggered almost two thirds of all bankruptcies in the United States that year, a 50 percent increase from 2001. “Our findings are frightening. Unless you’re Warren Buffett, your family is just one serious illness away from bankruptcy,” lead author Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School, said in a news release.
Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and coauthor of the Harvard and Ohio University study, said, “Only single-payer national health insurance can make universal, comprehensive coverage affordable by saving the hundreds of billions we now waste on insurance overhead and bureaucracy.”
Sadly, as the health care debate unfolded, we could see that most Republicans and some Democrats enough to screw things up were more concerned with the health of health insurance companies than they were about American workers.
Here was the response of Representative Eric Cantor (R‑VA) in a town hall meeting after hearing about a woman who had recently lost her job and her insurance and then discovered that she had stomach cancer: He encouraged her to look to “existing government programs” or “charitable organizations.” Maybe she could get a tin cup and beg on the streets.
Representative Alan Grayson (D‑FL) said sarcastically during a speech on the House floor, “Don’t get sick. If you get sick, America, the Republican health care plan is this: Die quickly.” The failure of health care reform to cover everyone does kill, and the sad thing about the new health care legislation is that it will not cover some 23 million Americans.
A family that falls between the cracks and is living hand to mouth in a tough economy can’t afford cancer screening. Too many people wait too long for treatment because they cannot afford it. How many victims of our for profit health care system will we accept before we finally do the right thing and embrace universal care?
Think about this: During the past eight years, there’s been about a 428 percent increase in profits for the insurance industry giants, while middle-class families have been getting financially butchered and the Republicans want to blame big government!
This is not America. This is not the country I grew up in. Fairness left the building with Elvis.
Excerpted from KILLER POLITICS: How Big Money and Bad Politics Are Destroying the Great American Middle Class by Ed Schultz. Copyright (c) 2010 Published by Hyperion. Available wherever books are sold. All Rights Reserved.