Why I've changed my mind on health care "reform"

[w¡n9Nµ7 §£@¥€r 123]

Health Care on the Road to Neo-Feudalism

If the Senate health care bill passes as Joe Lieberman has demanded it–with no Medicare buy-in or public option–it will be a significant step further on our road to neo-feudalism. As such, I find it far too dangerous to our democracy to pass–even if it gives millions (perhaps unaffordable) subsidies for health care.

20% of your labor belongs to Aetna

Consider, first of all, this fact. The bill, if it became law, would legally require a portion of Americans to pay more than 20% of the fruits of their labor to a private corporation in exchange for 70% of their health care costs.

Consider a family of 4 making $66,150–a family at 300% of the poverty level and therefore, hypothetically, at least, “subsidized.” That family would be expected to pay $6482.70 (in today’s dollars) for premiums–or $540 a month. But that family could be required to pay $7973 out of pocket for copays and so on. So if that family had a significant–but not catastrophic–medical event, it would be asked to pay its insurer almost 22% of its income to cover health care. Several months ago, I showed why this was a recipe for continued medical bankruptcy (though the numbers have changed somewhat). But here’s another way to think about it. Senate Democrats are requiring middle class families to give the proceeds of over a month of their work to a private corporation–one allowed to make 15% or maybe even 25% profit on the proceeds of their labor.

It’s one thing to require a citizen to pay taxes–to pay into the commons. It’s another thing to require taxpayers to pay a private corporation, and to have up to 25% of that go to paying for luxuries like private jets and gyms for the company CEOs.

It’s the same kind of deal peasants made under feudalism: some proportion of their labor in exchange for protection (in this case, from bankruptcy from health problems, though the bill doesn’t actually require the private corporations to deliver that much protection).In this case, the federal government becomes an appendage to do collections for the corporations.

Mind you, not only will citizens be required to pay private corporations. But middle class citizens may be required to pay more to these private corporations than they pay in federal and state taxes. Using these numbers, this middle class family of four will pay roughly 15% in federal, state, and social security taxes. This family will pay around $10,015 for their share of the commons–paying for defense, roads, some policing, and their social safety net share. That’s 15% of their income. They will, at a minimum, be asked to pay 9.8% of their income to the insurance company. And if they have a significant medical event, they’ll pay 22%–far, far more than they’ll pay into the commons. So it’s bad enough that this bill would require citizens to pay a tithe to a corporation. It’s far worse when you consider that some citizens would pay more in their corporate tithe than they would to the commons.

And, finally, while the Senate bill does not accord these corporate CEOs a droit de seigneur–the right to a woman’s virginity the night of her marriage–if Ben Nelson (and Bart Stupak) get their way, it would make a distinction in this entire compact for how the property of a woman’s womb shall be treated.

Single payer for the benefit of corporations

And for those who promise we’ll go back and fix this later, once we achieve universal health care, understand what will have happened in the meantime. The idea, of course, is to establish some means to get people single payer coverage (before Lieberman, this would have been through a public option or Medicare buy-in) and, over time, expand it.

In fact, this bill will move toward single payer, too–though not the kind we want. For the large number of people who live in a place where there is limited competition, this bill will require them to get health care through the oligopoly or monopoly provider. It’ll work great for the provider: they will be able to dictate rates. But the Senate bill allows these blossoming single payer providers to keep up to 25% of the benefit in profits and marketing costs, and pass little of that benefit onto citizens. If we make private corporations our single payer, how are we going to convince them to cede control when we ask them to let the government be the single payer?

The reason this matters, though, is the power it gives the health care corporations. We can’t ditch Halliburton or Blackwater because they have become the sole primary contractor providing precisely the services they do. And so, like it or not, we’re dependent on them. And if we were to try to exercise oversight over them, we’d ultimately face the reality that we have no leverage over them, so we’d have to accept whatever they chose to provide. This bill gives the health care industry the leverage we’ve already given Halliburton and Blackwater.

The feudal health care filibuster-proof majority

It’s the 9.8% tithe that bothers me the most. But for those who think we can fix it, consider this, too. If the Senate bill passes, in its current form, it will mean that the health care industry was able to dictate–through their Senators Joe Lieberman and Ben Nelson–what they wanted the US Congress to do. They will have succeeded in dictating the precise terms of legislation.

Now, that’s not the first time that has happened. It certainly happened on telecom immunity. It certainly has happened, repeatedly, on Defense contracting (see also Randy Cunningham). But none of these egregious instances of corporations dictating legislation included a tithe–the requirement that citizens pay corporations to provide their service, rather than allowing the government to contract the service.

This is a fundamentally different relationship we’re talking about–one that gives corporations vast new powers. And the fact that–with one temper tantrum from Joe Lieberman–the corporations were able to dictate the terms of this new relationship deeply troubles me.

When this passes, it will become clear that Congress is no longer the sovereign of this nation. Rather, the corporations dictating the laws will be.

I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.

We’ve seen our Constitution and means of government under attack in the last 8 years. This does so in a different–but every bit as significant way. We don’t mandate tithing corporations in this country–at least not yet. And it troubles me that so many Democrats are rushing to do so, without considering the logical consequences.

http://emptywheel.firedoglake.com/2009/12/...-neo-feudalism/

[Danno 1,228]

<<<<I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.

We’ve seen our Constitution and means of government under attack in the last 8 years. This does so in a different–but every bit as significant way. We don’t mandate tithing corporations in this country–at least not yet. And it troubles me that so many Democrats are rushing to do so, without considering the logical consequences.>>>>

GReat post, it presented one point I had not even considered.

[SMR 368]

Most reasonable Americans agree that Health Care is screwed up. We need reform. Problem is, the vast majority of Americans don't have Health care choices. I'm just skeptical of the government.

Right now, bureaucrats in HR and health insurance companies make health insurance decisions. The people that really care about cost and quality are divorced from the decision. Move to single-payer. It's the same thing except that the bureaucrat is now in Washington. You still don't have health care choices.

There was a good article yesterday about how government regulation has restricted competition in the Health insurance industry. That is why we have no choices.

[Peikko 1,575]

Skeptisim gets you squat. Goverments can and do deliver good health care systems if the people care enough to reform the system comprehensively. You Americans scoff at the rest of the world, but there are many excellent systems out there which give health care access to all citizens. It may not be always be 5 star care for everyone, but if you have that extra cash you can and people do supplement to get more in terms of elected surgery sooner, private rooms etc. There is a lot of choice within these systems but the bottom line is, it's affordable for the tax payer, no one goes bankrupt because they get sick.

Competition? Yeah, that'll be why it's expensive.

[chri'stina 190]

Interesting read. (and I actually read it all)

[AlHayatZween 2]

When can we storm the Senate?

i'm ready.

[zqt3344 21]

Good thinking, needs to be done now!

When can we storm the Senate?

i'm ready.

[Danno 1,228]

Good thinking, needs to be done now!

When can we storm the Senate?

i'm ready.

The time is coming..... some are actually hoping this bill does pass to give even more momentum against supporters.

THe logic being it can be undone easy enough.

[mamaSue 38]

Skeptisim gets you squat. Goverments can and do deliver good health care systems if the people care enough to reform the system comprehensively. You Americans scoff at the rest of the world, but there are many excellent systems out there which give health care access to all citizens. It may not be always be 5 star care for everyone, but if you have that extra cash you can and people do supplement to get more in terms of elected surgery sooner, private rooms etc. There is a lot of choice within these systems but the bottom line is, it's affordable for the tax payer, no one goes bankrupt because they get sick.

Competition? Yeah, that'll be why it's expensive.

I totally agree!!

I come from a country that has the much-maligned "socialised medicine" !!

I've had excellent healthcare all my life, without having to pay a penny!!

I've had second-class healthcare in the USA on 2 occasions... uninsured, on self-pay. Insurers won't touch me without a ridiculously high monthly premium, as I had cancer 12 years ago!

I love the USA.... I hate the health system!!!