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Monday, September 21, 2020
Analysis by Bankole Thompson*
DETROIT, Michigan, Aug 26 2009 (IPS) - The message machine of the Barack Obama administration appears to need oiling, as the U.S. president's push for a Sep. 15 deadline for a bipartisan deal on healthcare reform in the U.S. Congress continues to meet stiff resistance.
The debate is playing out like the "battle of Armageddon" between forces who want serious changes in the healthcare system to cover an estimated 47 million U.S. citizens without health insurance, and those with vested interests in preserving the status quo.
According to an analysis by Plunkett Research Ltd, total U.S. healthcare expenditures will increase from 2.39 trillion dollars in 2008 to 2.72 trillion dollars in 2010, with annual increases averaging about 7 percent.
More than a fifth of all federal government spending in 2007 was poured into the Medicaid and Medicare programmes – the first for very low-income people and the second for senior citizens.
The firm noted that health expenditures in the U.S., representing about 16.5 percent of Gross Domestic Product (GDP) in 2008, will grow to 19.6 percent by 2016 "unless drastic reforms take place".
By contrast, the average of 33 OECD nations – including the U.S., – was 8.9 percent of GDP spent on healthcare.
Last year, President Obama campaigned on a mantra to alter the way Washington does business as usual.
At rallies across the country, the Democratic nominee repeatedly gave the example of his own mother whom he watched battle with insurance companies while dying of cancer in a hospital bed.
Obama related his mother's experience with the insurance industry to underscore the urgency of the issue and to convince voters that he is personally familiar with their pain.
As the battle for a meaningful overhaul of the healthcare system rages in towns and cities across the country, many who supported the Democratic Party want Obama to stick to his campaign mantra of a public option healthcare plan.
The "public option" plan would create an affordable government-run insurance programme similar to Medicare through a health exchange where everyone can buy insurance – private or public – based on their medical needs.
The Republican Party and its right-wing defenders contend that such a plan would drive insurance companies out of business and that employers may be induced to drop private insurance already in place for the "public option" plan.
Supporters argue the competition would force insurance companies to drop their exorbitant rates.
According to the AFL-CIO, pharmaceutical company CEOs average 4.36 million dollars a year in compensation. For health insurance companies, it's 8.75 million dollars a year.
The labour union cited one insurance company CEO, Aetna's Ronald Williams, who takes home more than 32 million dollars a year.
Meanwhile, an estimated 47 million people have no health insurance, including 8.7 million children. The AFL-CIO predicts that by 2013, 56 million will be without health insurance.
In Detroit, where the unemployment rate in June rose to 17 percent – the highest rate among major U.S. cities – and bankruptcy filings are on the rise, some due to exorbitant medical fees, most people don't want the president to waver on the public option.
"It's the most important thing to me after my salary," said Janie Jones, a recent University of Michigan-Dearborn graduate. "That would determine which job I would take depending on the level of benefit."
"I think we should have a public option because it keeps the healthcare industry competitive and it would keep prices down," she said. "Everybody out here needs healthcare because it determines your quality of life."
The president's supporters insist he has the political capital to push his plan through. But it remains unclear how effective the White House message machine is in rallying the troops when Republicans and their conservative allies appear to be shaping the debate.
Last year, in the middle of the heated presidential campaign, Obama had a conference call with reporters during which he said his healthcare plan would cost 65 billion dollars and would be paid for by rolling back the tax cuts of President George W. Bush.
"We would be able to pay for our healthcare plan as well as eliminate programmes like the Medicare Advantage programme – which basically is just a subsidy of the insurance companies under the Medicare plan," Obama said.
"It was pushed through by George Bush and it hasn't saved any money or improved quality of care. So we're going to change that," candidate Obama said at the time.
In presenting himself as an agent of change who is coming to Washington to take on the lobbyists and their status quo friends, voters gave Obama an overwhelming mandate and bestowed the kind of confidence in him no other president has recently enjoyed.
On Nov. 4, 2008, voters responded to Obama's message of change, giving him 364 electoral college votes to Republican nominee John McCain's 162.
There is a sea of difference between those who want change, including revamping the healthcare system, and those who want things to remain the same.
Some observers are therefore baffled that the White House and the Democrats in Congress have not been able to channel the momentum that manifested on Election Day.
Instead, their opponents seem to be winning the public relations battle, aided by polls that suggest that the president is losing ground on the healthcare debate because supposedly most people now want the healthcare system to remain the same.
However, the media has given little or no information about the demographics of the polls being conducted, and whether respondents include the estimated one in three citizens who lacked health insurance at some point in 2007-08.
Added to this political conundrum is an estimated 25 million so-called "underinsured" in this country – those who have limited health insurance, but cannot afford their high medical bills.
Again there is little information in the media about whether these people are being polled as well.
Today's debate recalls the 1990s, when then first lady Hillary Clinton championed a similar overhaul during her husband's tenure.
But the difference is that Hillary Clinton was not elected. She did not have the institutional power of the Oval Office that Obama has as an elected president.
The success of this reform will presage things to come for the Obama administration in seeking any other major changes within the body politic.
Not surprisingly, there has been a strong pushback from the insurance industry because of the competition a public option would create. Yet competition in the marketplace is the thrust of free market enterprise.
Obama said, "If you like your doctor, you can keep your doctor. If you like your private health insurance plan, you can keep your plan."
*Bankole Thompson is a noted journalist, public lecturer and host of "Center Stage with Bankole Thompson" a weekly public affairs show airing on WADL TV 38 in Michigan and reaching over two million households in Detroit and Canada.
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