What IS that new health care system that we are arguing about?

July 24, 2009 | By | 9 Replies More

I’ve been wondering about this for months. What IS the new health care system that we are arguing about? How can I know if I’m for it or against it until I know what it is? That was one of the topics Bill Moyers discussed with his guests, Trudy Lieberman, director of the health and medical reporting program at the CUNY Graduate School of Journalism, and Marcia Angell, senior lecturer in social medicine at Harvard Medical School and former editor in chief of the New England Journal of Medicine.

TRUDY LIEBERMAN: [Barack Obama] has essentially advocated is throwing more money into the current system. He’s treating the symptom and he’s not treating the underlying cause of our problem. Our problem is that we spend two and a half times as much per person on health care as other advanced countries, the average of other advanced countries. And we don’t get our money’s worth. So, now he says, okay, this is a terribly inefficient, wasteful system. Let’s throw some money into it . . . Into the same system. That’s his problem. The other problem, in the press conference, was that he was trying to mobilize public support for a bill, and we don’t know what that bill is.

Here’s a big problem with the current system:

MARCIA ANGELL: Well, that goes to the cause of the problem. We are the only advanced country in the world that has chosen to leave health care to the tender mercies of a panoply of for-profit businesses, whose purpose is to maximize income and not to provide health. And that’s exactly what they do.

Angell then strongly states that the system that Obama is apparently pushing doesn’t change this sad situation, even though 2/3 of Americans prefer the Canadian-style single payor system.

Is Obama going to change health care for the better? Angell says she’s not optimistic:

But what I would say this time around, and now I am going to be very pessimistic, Bill. This time around, I don’t think it’s going to happen because of the power the pharmaceutical and insurance lobbies. I don’t think it’s going to happen. But I would rather see Obama go down fighting for something coherent and practical that the public could mobilize behind, than go down fighting for this amorphous plan that tries to keep these private insurance industry in place . . . Well, he will have to fight . . . I think he’ll go down. I don’t think he’s grasped the nettle. And I don’t think that even the best of the proposals that he is considering are going to be effective. And I worry about even the public option, because the power of the insurance industry is so great that I believe that they would use their clout in Congress to hobble the public option in some way.

What’s the only solution? Angell says it forcefully:

I think we have to go for a single payer system. You could institute that gradually. You could do it state by state. You could do it decade by decade. You could improve Medicare. That is, make it nonprofit. But extend it down to age 55 and age 45 and age 35. It would give the private insurance industry a chance to go into hurricanes, earthquakes or something. To get out of the health business. It could be done gradually. I think that has to be done. And it’s the only thing that can be done.

As always, Bill Moyers and his guests give you details and arguments that you won’t find in most news sources.


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Category: Health, Politics

About the Author ()

Erich Vieth is an attorney focusing on consumer law litigation and appellate practice. He is also a working musician and a writer, having founded Dangerous Intersection in 2006. Erich lives in the Shaw Neighborhood of St. Louis, Missouri, where he lives half-time with his two extraordinary daughters.

Comments (9)

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  1. Erich Vieth says:

    Bill Maher hits the nail on the head:

    When did the profit motive become the only reason to do anything? When did that become the new patriotism? Ask not what you could do for your country, ask what's in it for Blue Cross/Blue Shield.

    If conservatives get to call universal health care "socialized medicine," I get to call private health care "soulless vampires making money off human pain." The problem with President Obama's health care plan isn't socialism, it's capitalism.


  2. jacksmith says:


    We have the 37th worst quality of healthcare in the developed world. Conservative estimates are that over 120,000 of you dies each year in America from treatable illness that people in other developed countries don’t die from. Rich, middle class, and poor a like. Insured and uninsured. Men, women, children, and babies. This is what being 37th in quality of healthcare means.

    I know that many of you are angry and frustrated that REPUBLICANS! In congress are dragging their feet and trying to block TRUE healthcare reform. What republicans want is just a taxpayer bailout of the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry, and the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry. An insurance bailout is all you really get without a robust government-run public option available on day one.

    These industries have been slaughtering you and your loved ones like cattle for decades for profit. Including members of congress and their families.

    Republicans and their traitorous allies have been trying to make it look like it's President Obama's fault for the delays, and foot dragging. But I think you all know better than that.

    But you don't have to put up with that. And this is what you can do. The Republicans below will be up for reelection on November 2, 2010. Just a little over 13 months from now. And many of you will be able to vote early. So pick some names and tell their voters that their representatives (by name) are obstructing TRUE healthcare reform. And are sellouts to the insurance and medical lobbyist.

    Ask them to contact their representatives and tell them that they are going to work to throw them out of office on November 2, 2010, if not before by impeachment, or recall elections. Doing this will give you something more to do to make things better in America. And it will help you feel better too.

    There are many resources on the internet that can help you find people to call and contact. For example, many social networking sites can be searched by state, city, or University. Be inventive and creative. I can think of many ways to do this. But be nice. These are your neighbors. And most will want to help.

    I know there are a few democrats that have been trying to obstruct TRUE healthcare reform too. But the main problem is the Bush Republicans. Removing them is the best thing tactically to do. On the other hand. If you can easily replace a democrat obstructionist with a supportive democrat, DO IT!

  3. Niklaus Pfirsig says:

    Our current system is broken in many ways.

    First, there is a disconnect between the health care consumer and the payer of the services. The "Free market" interactions simply does not represent the patients.

    The free market pundits claim that the industry will self regulate through the forces of supply and demand, but in reality, the corporations only compete for corporate and government accounts, not for individual accounts. The result is that most people are not given a choice for insurance coverage. they either accept the terms negotiated by their employer, cough up enough money to pay for individual coverage or do without.

    Second, as publicly traded corporations, the insurances companies are required by law to put profits ahead of the needs of the insured. The best way to profit is to pay as little as possible, why finding bulk sources of income. This encourages practices to drop the people who most need the benefits.

    The insurance companies have developed a "collective persona" that reflects the paranoia and avarice of their leadership. This comes from the fact that individual employees are rewarded for saving the company's money.

    Third, the profit motive produces an economic environment that is not responsive to the needs of the patients, but to the financial needs of the investors.

    The problem with health care is, like the economy, is the result of corporate irresponsibility and unaccountability. These problems are so firmly entrenched in our culture that we often fail to se them.

  4. Peter says:

    The rabbit warren of agencies with oversight on medical care runs underneath the inefficiency of US medical care. If a hospital or physician has to meet regulatory criteia of agencies unrelated to one another(which they do), the amount of time actually spent on patient care will continue to fall. Until these agencies are done away with in favor of one central medical agency, there will be no 'reform,' and no universal health care. Think that'll happen? I don't.

  5. Tony Coyle says:


    you decry 'agencies' without citation. Perhaps you could be more specific.

    One specific challenge to you. Most agencies are in place to curtail or constrain the recipients of healthcare – the patients – and many of the regulations they audit are at there at the behest of the healthcare industry. Please cite where this is NOT the case (that should be a much shorter list than the alternative)

    The vast majority of healthcare in the US, be it primary care from GPs, through specialist care, intensive care, and nursing, is suborned to the almighty dollar. If there isn't a profit in a procedure, the "healthcare industry" will not cover it. Period.

    For everything else, the sick are left with care that would be substandard in a third world country.

    Fact: The US has some of the best doctors, and some of the best medical facilities in the world.

    It's a pity most of the population will never be able to take advantage of that fact, isn't it.

  6. Tony Coyle says:

    Peter: one other thought… Much of the challenge comes from 'States Rights'. The federal government must regulate health provision (for many reasons). States also must do so (for other and similar reasons). The fact that many states insist on duplicating already functioning federal agencies is a 'fault' of the federal government, not of the states themselves (right). The fact that many agencies are grossly understaffed and overworked, causing delays in responsiveness also has no bearing (right!!). And the fact that healthcare lobbyists manage to promote so many contradictory provisions that make healthcare law so tortuous has no bearing on the regulatory landscape that actual providers then have to navigate.

    None of that has any bearing, right? It's all the fault of the damn agencies.

  7. Erich Vieth says:

    Dennis Kucinich recently discussed health care reform with Amy Goodman, further warning us of the corruption that runs Washington DC:

    REP. DENNIS KUCINICH: Well, it’s an aphorism in politics and in business that he who pays the piper calls the tune. One of the calamities of a—of the current political financing system we have is that healthcare is held hostage.

    I mean, think about it. You know, you hear Michael Steele talking about what they’re not going to tolerate. Well, how have we tolerated 50 million Americans being without health insurance? The insurance companies have almost a death grip on our political system. And they can have so much power that they can exclude 50 million people and trap another 50 million in confiscatory premiums, co-pays and deductibles, just jettison millions of Americans into bankruptcy. And yet, we still have this system. And people are saying, “Well, you know, we can’t have a government-run system.” Well, frankly, we tried this system controlled by private insurers, and it’s been a calamity for America.

    AMY GOODMAN: And so, what is happening right now, Congressman Kucinich? The latest, the possibility that the bill will not be passed by August, which some have taken to mean it’s going to give more time for Republicans and the Blue Dog Democrats to water it down. But they’re not even with the public plan. I’d like you to explain what is being offered, even coming close to the idea of single payer.

    REP. DENNIS KUCINICH: Well, it’s not close to the idea of single payer. It’s mandating that people buy insurance. And it’s telling insurance companies they have to sell insurance. Well, you know who wins in that deal.

    The fact of the matter is, this debate is all skewed right now. You know, there are—both political parties are in trouble on the issue of healthcare. Our political system is failing the American people, and it’s a bipartisan affair. So, what we have right now is a mishmash, which is being offered up as reform. Well, no wonder it’s in trouble from all sides.

    I mean, if people were offered a clear choice of a single-payer plan or not and told what the advantages are of having the government paying the bills, eliminating the overhead, enabling all Americans to have not just basic coverage with doctor of choice, but vision care, dental care, mental healthcare, prescription drugs, long-term care, all covered, if people knew that was the choice they could have, there wouldn’t even—there wouldn’t be much of a debate at all.

    But we’re falling back on old ideological arguments, when the fact of the matter is the insurance companies are running Washington and we have to break their hold. And that’s why the single-payer amendment that I offer that gives states an option is a small step in the direction of trying to give states the ability to be able to determine their own destiny, and then hopefully America will be able to see in these laboratories of states that we can have a single-payer plan that can save people money and protect people’s economic security and their health. Healthcare is a basic right. We still don’t hear of that talked about in the major debate here in Washington about the bill that is being presented.

    AMY GOODMAN: But do you think that a public plan, that’s being proposed, could lead ultimately to single payer? Because most people would opt for the public plan, which is the health insurance companies’ greatest nightmare, and ultimately would go in that other direction.

    REP. DENNIS KUCINICH: I don’t know that, Amy. I mean, right now what I see is a public plan that gives the insurance companies the option to pick the people’s pockets. As long as you have a public plan, which now is going to be supported by what? Cuts in Medicaid, on the other hand? And undermining benefits to the elderly? Are you kidding me? I mean, this is—the balance that’s being constructed right now indicates an inherent flaw in the proposal, to begin with. Now, I will vote for it, if we can keep the single payer in, because I think it would be worth the price. But without the single-payer provision in it, I don’t know what’s in the bill that would really be worthy of supporting.

  8. Niklaus Pfirsig says:


    from what I've seen, the "rabbit warren of agencies" are nothing when compare to the complex private bureaucracy imposed by the insurance industry.

    The regulatory agencies have been rendered impotent through the deregulation of the Bush administration, and no longer have the ability to effectively enforce the few remaining regulations. Basically, all they can do is fine the corporations and in an environment where it is much more profitable to ignore the rules and pay the fines than it is to abide by the rules.

    The complexity of he private insurance requires many office workers who must be paid, and that money must come from somewhere. Furthermore money is directly related to the rewards and perks gained through the internal office politics found in any organization, and actually encourages fraud within the companies. Employees looking for a promotion can and often do produce fraudulent documentation to deny legitimate insurance claims, and are rewarded for this work.

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