Sunday, August 2, 2009

Not "Special Interests": The Wealthy and Powerful


One thing a blog might do is to provide connections between seemingly disconnected news stories. I have tried to do that, as well as focus primarily on medicine and health issues, but also with an emphasis on the social justice implications (or at least that is my attempt). I will make that effort here.

On July 31, 2009, the New York Times has a lead article titled “Big banks paid billions in bonuses amid Wall St. Crisis” by Louise Story and Eric Dash ( I have often made clear my feelings about those big bankers and financiers (that they should have all their money taken away and either be put in prison or in surplus FEMA trailers), but apparently the bankers do not share that opinion. The information for this story came from NY Attorney General Andrew Cuomo, and reports that “At Goldman Sachs, for example, bonuses of more than $1 million went to 953 traders and bankers, and Morgan Stanley awarded seven-figure bonuses to 428 employees. Even at weaker banks like Citigroup and Bank of America, million-dollar awards were distributed to hundreds of workers…. ‘If the bank lost money, where do you get the money to pay the bonus?’ said Mr. Cuomo." Good question; apparently the answer is either directly (from our deposits or loan payments), or indirectly (from TAFP funds), from you and me. “Some compensation experts questioned whether the bonuses should have been paid at all while the banks were receiving government aid.” You can add some non-compensation experts, like me, to that group.

On the health reform front, we are treated to news reports that President Obama’s popularity has slid to 53% with only 42% approving and 47% opposing their understanding of the President and Congress’ health plans (NPR July 28, 2009, and widely reported). I have been following the health reform debate pretty closely and I am not sure I understand what the President’s health reform plan is; even the ones that are proposed variously in the House and Senate keep changing, and are hard to tell even with a scorecard, such as that offered by the Kaiser Family Foundation website,
Thus, there is a possibility that most of the Americans surveyed for this report also may not have a clear understanding. One of the reasons, of course, is the reporting in the media, which is always interested in conflict, as it sells better, and in the case, at least, of much of TV news – the source of most Americans’ information – frequently biased. One source of bias, even among less egregious offenders than Fox, is the constant parade of Republicans, a group whose contribution to the health debate has been limited to attacks and scare tactics.

The Republicans, of course, have no plan; it is a lot easier to shoot arrows at the Democratic proposal – any proposal – than themselves offer an actual plan that might be criticized. And, of course, it would be torn to shreds, since the only values that the Republicans share on health care is making sure that the wealthiest are protected in their wealth, that insurance and pharmaceutical companies make out like bandits, and that there be no government sponsored health plan, which effectively means not only would the currently uninsured be left out, but the currently underinsured and scared would be at even more risk.

The President has said the right things: Everyone must be covered. Costs must be controlled. There is no “null” option, the alternative is to continue things as they are and see massive growth in health care costs combined with more and more uninsured and underinsured people getting less and less health care that they need resulting in worsening health status for Americans. But the health plans being proposed by the Congress with the support of the White House are second rate (that is to say, they will not cover everyone and save money the way that a single player plan would). However, the big mistake is that the Congress has not supported the President’s play. Committed to repeating the mistakes of the Clinton health plan, they insist on compromises to try – absolutely without hope of success – to get bipartisan support. This is a mistake, as the Republicans have no credibility and are worthy of no respect or attention; this is, after all, the party of Alabama Senator Jeff Sessions, who voted against the confirmation of Sonia Sotomayor in the Judiciary Committee the same day because she has a judicial philosophy that is not consistent with the American ideal of Blind Justice. I suppose Sessions – whose own Supreme Court nomination faltered on the fact that he was tied to the Ku Klux Klan – has managed to pull the sheet over his own eyes.

Unfortunately, too many of the Democrats, as well as Republicans, are in the pockets of the lobbyists of wealthy billionaires and the huge companies, especially insurers and pharmaceutical companies but also large hospitals and hospital chains who stand to lose a great deal of money if we enact real health reform. After all, if there is “waste” in this system – and I think most informed people believe that there is – it is going into someone’s pocket. I call “waste” all those billions – hundreds of billions – of dollars spent on “health care” that is not spent on health care at all but insurance company profits and bloated administrative structures that are designed (on the insurance company side) to not pay, and (on the provider side) to try to get the insurance companies to pay. And the enormous mark-ups for certain drugs, such as cancer chemotherapy drugs. If we save all this money, certain companies won’t make it, and they are lobbying like heck to keep their piece of this huge, bloated, tasteless pie.

To call these “special interests” is, on the face of it, accurate, but deceptive because the term is without meaning. It has been developed and put forward precisely to hide the influence of wealthiest and most powerful corporations by conflating them with much smaller and weaker groups as “special interests”. Let us be clear: the influence of the Health Insurance Association of American or PhARMA is not the same as that of, say, those seeking rights for the transgendered. Or even of labor unions. These groups are powerful in our lives outside government all the time – hey, that is the problem, that the health insurance companies deny us coverage if we have pre-existing conditions, won’t insure us if we don’t work for a big company and don’t have the money to pay, makes us pay huge deductible and coinsurances, and still won’t pay the bills all too often. The one area of society that should be responsive to the needs of the people and not big corporations is our elected government, but the fact is that those companies have bought Congress too. After all, they have to run again and that requires a lot of money and it is a proven fact that wealthy individuals and corporations contribute a lot more money than poor and middle-class people. (What is it with those poor folks? Why don’t they contribute more to their congressmen?)

Which, of course, brings us back to the beginning of this piece. The problem facing health reform is the same problem facing reform of the financial and banking system. Money talks. Even after the gigantic disaster perpetrated by the banks and financial houses, the one that took down YOUR retirement, as well as, coincidentally, the entire US and world economy, they still have way more power than you do, and Congress is still feeding their interests. My last blog post addressed the “Tragedy of Meaning”, and how we like to explain suicide by people (like Adolph Merckle) as their reacting to bad events rather than because they suffer from depression. The best argument for that is in the first paragraph of this piece – of all those financial leaders who brought this ruin on all of us who are not committing hara-kiri but are demanding, expecting, and getting huge payoffs. The position being put forward that some of them are not the same individuals who were in charge before is nonsense; they have the same values, beliefs, and arrogance.

What can regular people do? We can be clear that we need a health reform plan that 1) covers everyone, every single one of us, 2) covers our needed services based on evidence, 3) doesn’t pretend that choice of insurance companies is the same as choice of doctors or hospitals. And that makes for every one of us to have access to all of the proven preventive and treatment modalities for the diseases we have or might get. And to write that email or make that phone call to our congressman daily if we have to. Start, for example, with urging them to vote for the Weiner Amendment in the House, which will come to the floor in September, that calls on the House to replace the current, flawed, patchwork HR 3200 health bill with HR 676, the Improved and Enhanced Medicare for All Bill, which will put us all in the same program (Medicare, the most popular government program in history) and at the same time revise payment structure to encourage what is GOOD for us rather than what is PROFITABLE for providers.

If the President and the Congress would just take the lead in not only saying, but proposing a plan, that would cover everyone and pay for it using the dollars currently wasted on both insurance company profit and the huge administrative infrastructure necessary to run that system; to say and propose a plan that says “we want health and health care for the American people and do not care a whit for the insurance industry”, the American people would be behind it.

Time to send that email.


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