August 24, 2009 2:12 PM

Shocked, Yet Awed by Single-Payer Logic

(The Nation)  Leslie Savan is the author of Slam Dunks And No-Brainers: Pop Language in Your Life, the Media, and, Like...Whatever and The Sponsored Life: Ads, TV, and American Culture.

Something rather remarkable happened on Tuesday's Morning Joe. Rep. Anthony Weiner of New York pointed out that the health insurance industry has no clothes, and Joe Scarborough, after first trying to spin it some gossamer threads, broke down and said, By God, you're right, this emperor is a naked money-making machine!

Well, he didn't use those exact words, but Joe did seem to finally get that America has granted insurance companies the right to create bottlenecks in the financing of healthcare in order to extract profits out of the suffering of ordinary people--without providing any actual healthcare whatsoever.

"Why are we paying profits for insurance companies?" Weiner asked Scarborough. "Why are we paying overhead for insurance companies? Why," he asked, bringing it all home, "are we paying for their TV commercials?"

Weiner, who recently warned that President Obama could lose as many as 100 votes on a health bill if a public option is not included, really wants single payer--Medicare for all Americans is his goal. What a crazy, way-out, reckless notion, Joe went into their encounter believing. But Weiner asked some simple, direct questions that no politician, much less Obama or HHS Secretary Kathleen Sebelius, has managed to pose:

What is an insurance company? They don't do a single check-up. They don't do a single exam, they don't perform an operation. Medicare has a 4 percent overhead rate. The real question is why do we have a private plan?

"It sounds like you're saying you think there is no need for us to have private insurance in healthcare," Joe asked at one point.

Weiner replied: "I've asked you three times. What is their value? What are they bringing to the deal?"

Scraping the bottom of a seemingly bottomless pit of spin, Joe is repeatedly left speechless, "stunned" and "astounded," he said, by the questions themselves. Indeed, when confronted with unfettered capitalism's massive failures, the right usually has nothing to say. The "free market" is supposed to eternally grow, not crash under its own greed. They're left ideologically crippled.

But unlike, say, Lou Dobbs, who began dobbering when confronted with similarly direct argument for single-payer, Joe was able to take a deep breath and return from a break with his eyes opened.

He even repeated Weiner's points clearly: The goverment would take over only the "paying mechanism" of healthcare, not the doctors or their medical decisions themselves. His ears perked up every time Weiner mentioned that the nonprofit Medicare spends 4 percent on overhead, while private insurers spend 30 percent.

And Joe, who has been criticizing mob rule at town halls, seemed to appreciate the way Weiner counters the fearmongering over Medicare: After decades of railing against the program's wasteful, "runaway" spending, Republicans have done a 180 and are now trying to scare seniors that the Democrats' proposed Medicare cuts will come directly from their medical care and not, as is actually proposed, from wasteful, stupid practices in the system--like, as Weiner mentions, putting people into a $700-a-night hospital bed when all they really need, and often prefer, is a visit by a homecare attendant in the two-digit-a-day range.

Maybe the real turning point came when Weiner asked, "How does Wal-mart offer $4 prescriptions?" Joe and co-host Mika Brzezinski looked as if they'd been thwacked by a hardback copy of Atlas Shrugged, and sat back to let the congressman explain it all to them:

"...They go to the pharmaceutical companies and say, "Listen, we have a giant buying pool here. You're going to give us a great deal."

"....Who's bigger than Wal-Mart? We are, the taxpayers. Do we do that? No. Because we have outsourced this to insurance companies who don't have necessarily as much incentive to keep those costs down because, frankly, they are getting a piece of the action.

Progressives tend to understand this stuff, but many conservatives won't trust such logic, especially in the abstract, which is how most Dems have been communicating. But Weiner, aware that if you can't visualize something it ain't going to stick, argued with a specific, familiar visual--that of a successful, supercapitalist, and, as Mika might say, "real American" company. And suddenly, as the mote dropped from the MJ crew's eyes, Weiner went from "scaring American citizens," in Joe's words, to instant celeb.

"That was SO great!" said Mika, as she and Joe asked Anthony to please, please come back soon, this week if possible!

"You have succeeded in doing something that no one else has done on this show in two years," said Joe, his fists rapidly knocking the table in excitement. "You made me speechless. And you made me speechless because you so clearly came here and stated your position."

While maintaining that he and Weiner have "different worldviews," Joe nevertheless raved, "This is fascinating, and one of the problems with the president's message is that it's muddled." And, damn, that's true.

Could this episode herald a Single-Payer Awakening? Or is this just the thrill of logic running up Joe's leg, soon to be forgotten as corporate media try to undermine real reform of a system that feeds the nets millions in ad revenue? When the big mainstream players shouted in unison to prematurely declare the public option dead, I couldn't help but think: In the corporate media's total takeover of ideas, they, too, have a death panel--made up of three or four conglomerate owners and chaired by Rupert Murdoch--that will determine whether an idea lives or gets its plug pulled.

On Thursday, Morning Joe replayed Weiner's best hits, but Joe was occasionally dobbering himself, complaining that our healthcare problems come down to costs, costs, costs but "now all the President is talking about is a moral imperative." (Of course, Obama put morality on the table only yesterday; until then, he focused on costs, costs, costs.)

We'll see how far this relative openness to single-payer goes. In the meantime, though, the education of Joe Scarborough is, as always, a sight to behold:










By Leslie Savan:
Reprinted with permission from The Nation

The Nation
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by parkerj010 November 5, 2009 12:13 PM EST
I'm not going to pretend to be smart enough to know the answers, but those of you who are just pointing fingers and calling out "the other side" are helping nothing. Name calling and pointing out how the opposition is "stupid" (conservitard??? really?) doesn't fix the problem. I'm depressed that there's no one (and I mean NO ONE) who seems to actually care about cutting the B.S. and fixing the problem. I guess now I understand what our grandparents were talking about when they used to say this country is going to hell in a handbasket.
I don't understand this hatred for the rich. They worked harder and got a better education than we did. Who said life is fair? So they are rich and we're not, does that mean they are now responsible for the rest of us who aren't?
I also don't understand this disdain for the middle class and /or the poor. For any individual on any given day, you are where you are but for the grace of God. What microscopic percentage of pure chance keeps each of us from being homeless?
I don't know about any of you, but my parents and grandparents raised me to understand that when you have a problem you go to work to fix it. Our current government is not capable of laying aside party lines to come up with a real solution.... Who's fault is that??? OURS. We elected them and keep doing so. GET RID OF THEM ALL. That is the only way we as a nation can truly express our disgust at the current situation.
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by IssieG August 30, 2009 4:52 PM EDT
This morning I decided to take some time and express what is truly happening. I spent over 30 years as a group health insurance agent. I have seen health insurance deteriorate and erode the wealth of the middle class of this country. Below are some things to think about and then please express your views to your congressional leaders for both houses. You are being sold out again by big insurance. Remember all the big insurance companies that were once mutual and are now stock companies sharing in the gains with you on your policies. You were sold a bill of goods by top executives then and again now, another bill of goods.

I get very aggravated when I see all this mis advertisement on TV, radio, any printed news regarding health care and what many are trying to do to health care. Doctors take the Hippocratic Oath to treat the sick and injured. Big business and especially those involved in the health care industry take an oath of GREED. Our congressional leaders on the right and some on the left are buying into this and they are also being paid well with contribution to buy into this GREED.

Have you ever stopped to think where all this money comes that is used for false advertising, town hall disruptions, lobbing, and of course congressional donations. This money comes from the premium dollars collect from the insureds (individuals and businesses that buy insurance products) of the insurers here in the United States of America. Yes, believe me you are paying for it all.

I recently read an article that said that when asked 39% of the people polled thought the government should stay out of Medicare. Where have these people received their education? This is a government program, always has been, and the best medical insurance available. Yes, it is not perfect and it is run by the WHO? The government.

Today 35% of every premium dollar paid to and insurance company goes to expense (expense ratio) which include administration, salaries, bonuses, and lobbyist, yes 35% (35% came to me from a UHC exec). Having been an agent with many group health clients I have a handle on the large group expenses dating back to the 70's. I want to give a great big thank you to Mr. Reagan, Clinton, and not to forget the congress in late 2000, for helping to get rid of the insurance agent who advised clients on large group health care

In 1975 I wrote a mid size group a calender year $100 deductible, 3 deductibles per family, 100% coverage plan. The premium per month including $10,000 of Life and AD&D was $11.00 for the individual and an additional $14.00 for his family or a grand total of $300.00 per year. This was the total premium and included the employers participation.

Let us look at another part of this premium dollar. In 1976 and 1977 our agency as the agent represented several large employers. When dealing with as many as 8 or 10 insurance companies cost of doing business (expense ratio) became a very important factor. At the time in the State of Florida, Gulf Life Insurance Company had one of the lowest, 5%. Expense ratio ran in those times up as high as 7%. Again premium of $25.00 per family or $300.00 per year. Compare this to today where similar coverage to the one above for $300.00 per year if you could find, would cost at a minimum per family of at least $20,000.00 per year.

Now my math tells me that in the 70's the administration cost were $21.00 per year per family and that is using 7%, whereas today, $7000.00 of a $20,000.00 premium is going to the administration expenses of the insurance companies. This is big business folks, BIG BUSINESS.

Now do we understand better what is happening with todays health care plan. If you do not let your congressional leaders know where you stand on this issue, ?Kattie bar the door?, this country may become a 3rd world power because we have no money. The money will be in the hands of a few which represents less then 0.1% of the USA population..
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by KarlQuick August 28, 2009 12:04 AM EDT
I did a bit of research...
The Fortune 500 summary of the Health Insurance / Managed Health Care industry:
http://money.cnn.com/magazines/fortune/fortune500/2009/industries/223/index.html

Total profits for the top 12 companies in this sector, $ 8 BILLION.
...that is the horrible "cost" we want to eliminate.

Now compare that with the $ 340 BILLION bill for interest on the National Debt.
...realize that is all "profit" for those who loaned us that money.

Which industry, HI/MHC or Federal Government, is "crushing" our economy?
...who is "wasting" money on "profits" going to the rich?

Also note that the total revenues of these companies was about $275 Billion
if I added correctly, yielding a profit margin on cash flow of about 3%...
pretty small by comparison to most other industries.

So exactly how will this save us ENOUGH money to be worth going single payer?

Another idiocy: administrative overhead for Medicare is small compared to the insurance companies, yes, but the fraud is massive. If we go single payer, all those insurance company clerks costing all that "overhead" will have to be hired to go after the fraudsters who will be able to expand their business beyond just Medicare into the entire health care system. Then administrative overhead will be as large as before, but we'll be paying civil servants (so responsive) to "be tough" on the mean old criminals who sell you junk and bill the government for it.

And as to our "investment" in Social Security... I'm very appreciative of my 4 children who together with their spouses are paying 15% of everything they earn into the system so that my wife and I can get our SS checks! I am not at all happy that the government FORCES them to support us.

I long for a world in which parents are able to take care of their children out of love, not for a ADC check; I long for a world in which children are able to take care of their parents out of love, not because the tax man withdrew the money for my SS check from their pay. Is that degree of love and personal social responsibility too much to ask for?
Reply to this comment
by AK-47_Justice August 26, 2009 5:14 PM EDT
by rational_1
"The SS taxes are LENT to the government, they don't just vanish and SS loses them outright."
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If the Social Security Trust Fund causes government spending to be higher and/or income tax rates to be lower, then the trust fund is not contributing to national savings. No money is being saved. On the other hand, if government spending and tax rates aren't affected by the existence of the trust fund, then the trust fund has contributed to national savings. If trust fund increases national savings, then it really is a trust fund and has fulfilled its purpose. This has been the subject of considerable controversy.

An interesting comparison concerns the secondary market for third world debt, where traders have actually assigned dollar values (generally as a percentage of face value) to the obligations of certain third world governments. According to some, the "value" of the Social Security trust funds hinges critically on the federal government's ability to pay back the money that it has borrowed from Social Security.

The economic question is NOT whether the bonds represent legal obligations that will be fulfilled, the economic question is whether the U.S. bonds held by Social Security represent savings by allowing Social Security taxes collected in the past to reduce the need for taxes in the future. Was $1 of taxes collected in 1980 saved so that it could be spent on a retiring baby boomer in 2020 (without tax increases)? If the only way for the federal government to repay the bonds held by Social Security is by raising taxes in 2020, this suggests that the money collected in 1980 was spent on other government activities, not Social Security. Those who believe the trust fund is real would say that tax increases would have been even higher without the trust fund.
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by rational_1 August 26, 2009 3:28 PM EDT
To AK_47

You might consider carefully reading the sentences that you quote. I'll highlight ONE very important word in what you quoted me.

"Since the assets in the Social Security trust funds consists of Treasury securities, this means that the taxes collected under the Social Security payroll tax are in effect being LENT to the federal government to be expended for whatever present purposes the government requires."

The SS taxes are LENT to the government, they don't just vanish and SS loses them outright. So this demonstrates the truth of my argument - the social security funds are not being siphoned off to the military. SS is going broke because of how it was implemented. All the funds put into it are all still accounted for (basically the government owes itself). And if you think this lending is that insidious, the Feds could just as easily gotten that money by alternate routes such as increasing the deficit.
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by AK-47_Justice August 26, 2009 4:55 PM EDT
Start here:
"Since the assets in the Social Security trust funds consists of Treasury securities, this means that the taxes collected under the Social Security payroll tax are in effect being lent to the federal government to be expended for whatever present purposes the government requires. In this indirect sense, one could say that the Social Security trust funds are being spent for non-Social Security purposes."

Social Security Online - HISTORY: Budget Treatment of Social ...The Social Security Trust Funds and the Federal Budget ... In other words, a formal trust fund was established for the Social Security program and the .... The FY 1969 budget would not be implemented by President Johnson; ... and outgo to these funds) be treated as separate budget functions, starting with the 1985 ...
www.ssa.gov/history/BudgetTreatment.html
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by rational_1
"The SS taxes are LENT to the government, they don't just vanish and SS loses them outright."
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"In this indirect sense, one could say that the Social Security trust funds are being spent for non-Social Security purposes."

GEEZ.....YOU certainly are very gullible, and I really hope when you finally grow-up and start receiving SS checks, that the $3 TRILLION or so of surplus that has already been spent for WARS and TARP bailouts will mysteriously appear just for YOU!

Right now we're spending over $1 Billion per day for interest on the national debt of $11+ Trillion, and I'm just not as optimistic as you seem to be, to pay back the ever-increasing national debt or "trust funds" that have been spent on other items like WARS.

How did the busheviks afford the endless WARmongering over the past 8 years? --- Easy.....borrowed from the "trust funds" to pay the military/industrial complex, which is also how the republican'ts paid-for the tax cuts for the wealthiest Americans too!
by AK-47_Justice August 26, 2009 1:17 PM EDT
by inesje88
Many on the right claim that we are Capitalist. That may have been correct in the past. By having 3 to 4 times as many lobbyist in DC than elected representatives, who donate large sums of money to the elected, we have allowed lobbyists to influence the elected. It is dificult to have an elected rep. understand issues faced by those he is to represent, when he benefits greatly financially by not understanding. In essence, lobbyists have bought not only the votes but the souls of our elected. Replace the white DC street lamps with red ones and be done with it. All this talk about single payer health care creating socialism is nonsense. What we presently embrace in health care is in essence, Fascism. When corporations and government united in creating public policy, fascism results. The health care lobbyists donate anywhere from $1.4 to $1.3 million dollars a day to the prostitutes on the hill to keep the health care corporation profits flowing uninterupted.
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This is exactly true, despite the illogical republican't rants about "socialism," America has turned much more to corporatism or FASCISM -- the blending of corporate America with the government!

Just whom is paying for these lobbying tactics on Capital Hill but the corporate interests that have the deepest pockets, while giving WE THE PEOPLE the middle finger.
Reply to this comment
by AK-47_Justice August 26, 2009 1:02 PM EDT
Maybe the real turning point came when Weiner asked, "How does Wal-mart offer $4 prescriptions?" Joe and co-host Mika Brzezinski looked as if they'd been thwacked by a hardback copy of Atlas Shrugged, and sat back to let the congressman explain it all to them:

"...They go to the pharmaceutical companies and say, "Listen, we have a giant buying pool here. You're going to give us a great deal."

"....Who's bigger than Wal-Mart? We are, the taxpayers. Do we do that? No. Because we have outsourced this to insurance companies who don't have necessarily as much incentive to keep those costs down because, frankly, they are getting a piece of the action.


Progressives tend to understand this stuff, but many conservatives won't trust such logic, especially in the abstract...
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Simply because conservitards are illogical and irrational.
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by smoknmirrors August 26, 2009 7:41 PM EDT
This guy is a weiner. First he says private enterprise is so bad because it costs so much (30%) and then private enterprise is so great because it does what it does so cheaply ($4.) He lambasts private enterprise for having the profit motive and wants to get rid of it and then extolls the virtues of the largest profiteer in the market and wants to emulate it.

He doesn't even stop to consider that a pharmaceutical company that can be intimidated by Sam's can also be intimidated by an FDA-flouting Government Purchasing Agent, who tells them how to package, when to test, when not to test, what quantities to market, which parts of the country in which to market them, which foreign countries to patronize for its supplies, etc. If a government is big enough to protect us from the largest of the industrial giants, it is also big enough to dictate to them. Wasn't it government that dictated that banks make more housing loans to people with marginal credit histories? Wasn't government just trying to do the right thing then, too?

What insurance companies bring to the table is the question. First, they decide who will be covered and eliminate those who are bad risks (likely to use services) and thus likely to diminish profitability. It is "insurance," not prepaid medical debit cards. Second, they decide what will be covered, how it will be covered, when it will be covered and where it will be covered. All of these decisions are likewise determined by the degree to which usage would diminish profitability. This is 'private insurance,' not social welfare entitlements. If the policyholder wishes the insurance company to pay, the company will decide where treatment will take place, e.g. hospital, clinic, outpatient, etc. Further, they even decide in which country treatment will take place and which treatments are efficacious and which are not worthy of payment on their part. In essence, they are a paying machine with powerful controls on the kind, extent and timing of any medical care their policyholders will receive. All of this they accomplish without bothering to possess a single medical degree. So, my question is: If we boot them out of the game, what does the government bring to the table? In changing to a single-payer government bureaucracy, "we do not provide a single check-up. We do not perform a single exam, we do not perform an operation." We haven't improved medical care or medical care delivery one iota. We haven't made one person healthier, given one shot, stopped a single case of H1N1. And we do all this still without possessing a medical degree. We just changed bookkeepers to get one who works accounts payable cheaper.
by AK-47_Justice August 27, 2009 12:36 PM EDT
by smoknmirrors:
"we do not provide a single check-up. We do not perform a single exam, we do not perform an operation." We haven't improved medical care or medical care delivery one iota. We haven't made one person healthier, given one shot, stopped a single case of H1N1. And we do all this still without possessing a medical degree. We just changed bookkeepers to get one who works accounts payable cheaper.
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First off, don't kid yourself, since these for-profit insurance companies have many doctors with medical degrees and lawyers that have passed the bar exam on their staffs -- only to deny "coverage" to those insured that will affect their bottom lines. That's exactly how they have amassed a 500% increase in profits since just 2000 -- at the expense of those diagnosed with life-threatening problems, yet they "thought" they were covered by paying their insurance premiums!

The whole point of REAL health care reform is saving MONEY since we already spend more than twice what the rest of the industrialized world does on a very poor 'cesspool of waste and abuse' known as the 37th ranked health care system in the world. So changing "bookkeepers" that provide no medical services whatsoever to save 30% of $2.5 Trillion spent annually, or $800 Billion, is a bad motive in your conservitard mind, but HUGE SAVINGS to the rest of us!

I'm willing to bet heavily, that we could save closer to $1 Trillion per year or OVER 30% from that ridiculous price of $2.5 Trillion per year, by giving all those GREEDY for-profit insurance companies the boot, covering ALL Americans with health care - not health insurance -- changing all billing to electronic with ONE STANDARDIZED FORM instead of hundreds of different ones, changing all medical records to electronic in order to stop multiple tests when different doctors' offices do not communicate with others, and investigate fraud and abuse within the system by GREEDY doctors that get paid for QUANTITY instead of QUALITY of health care!

This single-payer universal health care will save America from bankruptcy in the coming years as 80 million baby boomers get set to retire over the next 2 decades, jumping on both SS and Medicare, and all projections are showing that this will be tens of trillions of unfunded future liabilities mainly due to the 'cesspool of waste and abuse' with the for-profit health care debacle!

A SP-UHC system is the only way to save America from sure bankruptcy!
by AK-47_Justice August 26, 2009 12:52 PM EDT
He even repeated Weiner's points clearly: The goverment would take over only the "paying mechanism" of healthcare, not the doctors or their medical decisions themselves. His ears perked up every time Weiner mentioned that the nonprofit Medicare spends 4 percent on overhead, while private insurers spend 30 percent.

And Joe, who has been criticizing mob rule at town halls, seemed to appreciate the way Weiner counters the fearmongering over Medicare: After decades of railing against the program's wasteful, "runaway" spending, Republicans have done a 180 and are now trying to scare seniors that the Democrats' proposed Medicare cuts will come directly from their medical care and not, as is actually proposed, from wasteful, stupid practices in the system--like, as Weiner mentions, putting people into a $700-a-night hospital bed when all they really need, and often prefer, is a visit by a homecare attendant in the two-digit-a-day range.
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Why do the irrational republican'ts continue to lack any LOGIC when it comes to REAL health care reform?
Reply to this comment
by AK-47_Justice August 26, 2009 12:48 PM EDT
But Weiner asked some simple, direct questions that no politician, much less Obama or HHS Secretary Kathleen Sebelius, has managed to pose:

What is an insurance company? They don't do a single check-up. They don't do a single exam, they don't perform an operation. Medicare has a 4 percent overhead rate. The real question is why do we have a private plan?

"It sounds like you're saying you think there is no need for us to have private insurance in healthcare," Joe asked at one point.

Weiner replied: "I've asked you three times. What is their value? What are they bringing to the deal?"

Scraping the bottom of a seemingly bottomless pit of spin, Joe is repeatedly left speechless, "stunned" and "astounded," he said, by the questions themselves. Indeed, when confronted with unfettered capitalism's massive failures, the right usually has nothing to say. The "free market" is supposed to eternally grow, not crash under its own greed. They're left ideologically crippled.
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Again.....I ask you constipated conservitards the same question:

What does the for-profit insurance industry bring to the table of providing health care for Americans, besides raising costs?


Nothing!
Reply to this comment
by AK-47_Justice August 26, 2009 12:26 PM EDT
".......but Joe did seem to finally get that America has granted insurance companies the right to create bottlenecks in the financing of healthcare in order to extract profits out of the suffering of ordinary people--without providing any actual healthcare whatsoever."

"Why are we paying profits for insurance companies?" Weiner asked Scarborough. "Why are we paying overhead for insurance companies? Why," he asked, bringing it all home, "are we paying for their TV commercials?"
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At last, a GOP ex-representative sees the light, and that is that some sort of single-payer universal health care system is the ONLY way America will ever fund health care without going bankrupt!

Why are we paying for these exorbitant profits, TV ads, CEO pay and bonuses, and the huge amount of money going to the for-profit health care industry for lobbying to keep the status quo?
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