Killer Politics Page 9

  But if we socialize medicine, won’t medical research—deprived of big pharma investment—stop dead in its tracks? Of course not; that kind of thinking sells our basic humanity short. There are always people motivated to make the world a better place. I’d like to think it’s in everyone’s DNA—except maybe Dick Cheney’s. When Jonas Salk discovered an inoculation against polio, he refused to patent and profit from his years of research. When asked once who owned the patent, Salk replied, “There is no patent. Could you patent the sun?” We certainly should find a way to reward medical advancements handsomely, but we ought to be able to do so without holding sick people hostage to the high cost of new drugs and technology.

  Perhaps we need to examine the funding relationship between private pharmaceutical companies and the government. The relationship has merit—certainly there have been some remarkable advances—but why haven’t we licked cancer yet? Meanwhile, we have a number of remedies for erectile dysfunction. Hey, I’m all for good wood, but doesn’t it suggest that maybe our priorities get skewed when the potential for profit gets involved?

  It took us decades to get in this health care mess and maybe it is unrealistic to expect to change overnight. We lost an entire generation and a golden opportunity under the Clinton administration. You can place the blame for that one right at the feet of the Republican Party.

  What was even more ironic about the way the Republicans destroyed our chance for health care reform that time was that the Clinton plan was almost a mirror image of one proposed in 1974 by President Richard Nixon, who called for universal health care in his final State of the Union address. According to a 2007 report in McClatchy newspapers, “Nixon first proposed national health insurance as a conservative California congressman in 1947. He grew up poor and lost two brothers to tuberculosis, which marked him for life. He frequently pointed to the cure for tuberculosis as a medical marvel that underscored the need for a public-private partnership on health care.”

  Of course, with Watergate coming to a boil, Nixon’s dream of universal coverage faded. His successor, Gerald Ford, abandoned the idea when the economy went south. And that has been the story—we just keep pushing our problems down the tracks—and the price tag keeps getting higher every day.

  In reality, there is no free health care. There is no free anything. At some level, we all must contribute. The emerging model of health care reform mandates that Americans buy insurance. That isn’t new. We pay for Social Security and Medicare. What is different is that we are being forced to buy a product from private industry. I wrestle with that. It’s a sticky, possibly unconstitutional issue.

  We all understand that there is a price to citizenship, but I would feel a whole lot better if my mandated payment went to my government for universal coverage rather than to a proven den of vipers in the health insurance industry.

  NATIONAL HEALTH CARE IS THE MONEY SMART SOLUTION

  Anything less than a national single-payer option is like using Band-Aids on a sucking chest wound. It’ll end up wasting more time and more money.

  The next baby step is the public option, a viable government competitor to existing health care insurers. If that happens, two things are possible: One, health insurers will slowly go out of business or find niche roles as they do in Singapore and other countries with government health care, or two, they will do what they should have done long ago, get efficient, get competitive, and for God’s sake, get some ethics.

  If government health care is as inefficient as the ideologues say, there should be nothing to fear from a government option. People will choose the best product. It’s not like we’re reinventing the wheel here. According to a 2009 report from the nonpartisan New America Foundation, “There are many examples of public and private insurance plans peacefully coexisting. More than 30 state governments…offer their employees a choice between traditional private health insurance products and a plan that the state insures. In Washington State, for example, the publicly insured option called the Uniform Medical Plan is the most popular choice, but about a third of public employees choose a private plan instead.”

  And Medicare, a government program, works. Again, no one wants to say much about this, but I will. Yes, I trust my government with health care. I don’t expect it to be perfect, but I expect it to be more efficient than private insurance. It’s a well-established fact that 3 percent of every Medicare dollar is spent on administration compared to 13 percent and higher with private plans. What if doctors only had to contend with paperwork from one insurer? Instead, we pay paper pushers to deal with fifteen hundred insurers with different forms and requirements. Going to a single-payer system would save $350 billion a year, according to Physicians for a National Health Program.

  A friend of mine who worked in the medical industry argued that a single-payer system would mean fewer people entering the field, because they wouldn’t make as much money. My answer? If people are becoming doctors just to become rich, they’re part of the problem. I want a healer—not a businessman. That said, I want my doctors to be fairly compensated. We certainly cannot expect them to come out of medical school owing hundreds of thousands of dollars and then work for minimum wage—which brings me back to my belief that education has to be accessible and affordable (ideally, a right of citizenship) for everyone. In any case, I have no doubt that good people will still go into medicine when we have a national health care system. Smart, caring people still become doctors in Sweden and in France; nationalizing health care doesn’t stop people from loving medicine and wanting to excel in that field.

  AND, YES, IT’S ALSO TIME FOR TORT REFORM

  While I do believe there has to be legal recourse for malpractice, the insurance premiums doctors are paying are oppressive, ranging as high as $200,000 a year. I support tort reform—changes in the civil justice system that would reduce a doctor’s liability in the case of medical malpractice—because I believe it is part of the ultimate solution to reducing health care costs. According to a 2008 report by Dr. Michael Lynch in the Concord Monitor, medical malpractice premiums have gone up 50 percent in five years.

  According to the Associated Press, malpractice lawsuits alone add about $6 billion annually to the cost of health care. The Congressional Budget Office found in 2009 that the cost of malpractice insurance and lawsuits accounts for about 2 percent of health care costs—about $35 billion. Placed in context with the overall cost of our national health care system, $2.4 trillion, it isn’t much, but the threat of lawsuits alone influences costs. It causes doctors to order battery after battery of unnecessary tests to avoid accusations of malpractice. The insurance company pays more, premiums rise…and well, you can see how prices begin to spiral out of control.

  I can understand a physician’s frustration at being treated like the enemy when something goes wrong. We have to understand that there are so many variables and uncertainties that sometimes patients just don’t make it. If there is gross negligence, all right then: Consider a lawsuit. But we have to create an environment in which physicians don’t have to feel as if they are always working with the Sword of Damocles over their heads.

  TACTICIANS AND DREAMERS

  There were two provisions in the new health care legislation that were made to placate Republicans. One was that abortions would not be funded under the program and the other was that illegal aliens would not be covered. Well, the notion that anyone with a sucking chest wound is going to be left to die on the emergency room steps is complete fiction. And are we really going to inoculate only American citizens and leave a large segment of the population unprotected, spreading disease? The last time I checked, the H1N1 virus was unable to distinguish between documented and undocumented workers. What if something far more serious began to spread? This is a dangerous political game.

  I want to find one senator or congressperson who will look me in the eye and tell me first of all that this is plausible, let alone workable. It’s fiction—a bullshit fairy tale for the American public to make them
feel better. At some point, someone is going to have to run the numbers through the Congressional Budget Office on this issue. We may actually save money by including illegal immigrants in the program rather than limiting them to high-priced emergency care.

  During the debate over health care, many members of the House and Senate acted like ostriches. They were willing to run to the CBO to make sure the bill saved money, but no one wanted to ask the CBO how real universal health care would pencil out. They didn’t ask because they were afraid of the answer. I am going to get behind legislation to make the ostrich the national bird—it will be perfect for this crowd.

  Given a credible universal health care proposal, the CBO might well have discovered it to be cheaper than the present system. Americans would have been marching in the streets demanding it, and Congress would have been faced with a choice between doing what was right for the health care industry or for the American people. That’s like asking Archie to choose between Betty and Veronica. Who to choose? If you are a politician, the chances are you’re going to pick Veronica—the rich girl.

  Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, made every effort to ram through a watered-down health care bill that to me looked like a giant suck-up to the health care industry. This is a guy who had raised nearly $12 million in five years for his reelection efforts. Let me tell you, that kind of money doesn’t come from Billings, Montana. According to the Washington Post, “Baucus collected $3 million from the health and insurance sectors from 2003 to 2008…. Less than 10 percent of the money came from Montana.”

  The Washington Post story continues: “Craig Holman, government affairs lobbyist for the Public Citizen advocacy group, said the continued fundraising by Baucus during the health-care debate is very troubling. ‘He’s doing all this fundraising right in the middle of this effort to mark up a bill,’ Holman said. ‘When you put these events close to matters concerning these lobbyists, clearly it’s a signal. You are expected to show up with a check.’”

  This begs the question: Who is Max Baucus looking out for? There are plenty of similar examples. In 2008 the Senate Finance Committee members received a total of $13,263,986 from health care industries. Do you think that influenced the process? According to the Center for Responsive Politics, the health care sector gave almost $170 million to federal lawmakers in 2007 and 2008, 54 percent of that amount going to Democrats.

  Senator Charles “Don’t Pull the Plug on Grandma” Grassley, an Iowa Republican, has received a cool $2 million from the health care and insurance industries since 2003. Grassley, a big supporter of the Medicare Part D boondoggle, apparently was good with end-of-life counseling when it was included in that bill!

  Senator Joe Lieberman, the erstwhile independent from Connecticut, has pocketed $1.5 million in donations from the health care and insurance sector since 2003. This guy has the world’s biggest ego matched with the world’s smallest conscience—in short, the perfect politician. Two industries will make a mint off of Lieberman’s cronyism and health care obstructionism—the insurance companies and the shoe repair shop that will replace all the heels Lieberman ruined from digging in against anything that might constitute a break for the American family. The only good thing about Bush II winning in 2000 was that it kept Joe Lieberman’s wrinkly ass out of the vice president’s office.

  According to OpenSecrets.org data, Senator Blanche Lincoln, the Arkansas Democrat who helped shoot down a public insurance option—a huge favor to her friends at Blue Cross–Blue Shield—received more than three quarters of a million dollars from the health and insurance industry in the last five years. BCBS dominates 75 percent of the market in Arkansas. Lincoln is also a friend of Walmart, and predictably she opposes the Employee Free Choice Act, which would make it easier to form unions.

  With Democrats like that, who needs Republicans?

  And let’s not forget another politician who helped throttle meaningful health care, Senator Mary Landrieu, a Louisiana Democrat, who has been showered with nearly $1.7 million from the health care and insurance industries during the course of her federal career. She famously received $100 million for her state—another Louisiana Purchase—in exchange for not stalling the health care process.

  Both Landrieu and Lincoln have former staffers who are high-powered lobbyists for health care and insurance interests. Are you beginning to see how this works?

  We have met the enemy, and some of them are us. Take Senator Ben Nelson (D-NE), who insisted his state receive special Medicare funding before he would vote for health care reform. In the end he was shamed into backing down. Campaignmoney.org, the website of the Public Campaign Action Fund, notes, “Nelson spent his career as an insurance executive, insurance company lawyer and, early in his career, Nebraska’s state insurance regulator. He was chief executive officer of an insurance company and has sided with and received political support from business groups opposed to a public health plan as part of health reform.” The Center for Responsive Politics (OpenSecrets.org) reports that Nelson has received more than $2 million from insurance and health care interests in three campaigns for federal office.

  I was especially disappointed in Senator Kent Conrad (D-ND), a member of the Senate Finance Committee and a longtime friend, for not supporting a public option. During his career, according to the Center for Responsive Politics, he has received in campaign donations more than $828,000 from insurance companies, $610,000 from health professionals, and $255,000 from pharmaceutical and health product companies. I know he thinks that health insurance co-ops can make a difference and that he didn’t have the votes for a public option, but there is a time to attempt the impossible. This is a guy who, at the age of thirty-eight, achieved the impossible in 1986 by knocking off a favored incumbent, Mark Andrews, who had been in Washington since 1963! Until it was settled, no one thought he had the votes then either, but he had a slim 2,100-vote margin. That’s all it took to win. When he went to the U.S.

  Senate, he pledged to help balance the budget or come home. Well, he did neither, but I thought he was a terrific senator who just overestimated the task and the times ahead. I loved the audacious Kent Conrad who dared to dream big.

  This health care debate was another opportunity to dream big, but that big-dreaming Kent Conrad was absent from the debate, replaced by just another political tactician. No one in Washington understands the budget better than Kent Conrad, and few senators work harder than he does. He’s learned a lot in Washington, but I fear Kent Conrad has forgotten how to dream. Regretfully, he is not the only one.

  Perhaps it has become politically passé to dream, but that’s what Barack Obama sold us, and that is what inspired Conrad to endorse Obama—one of the first senators to do so. What happened to the dream? Where are the dreamers? Are forty Senate Republicans that damn tough?

  At times like this, I hear in my mind the words of another dreamer, Senator Robert Kennedy, who said, “There are those who look at things the way they are, and ask why?…I dream of things that never were, and ask why not?”

  Why not? The only thing stopping us from accomplishing big things is that we have forgotten how to dream big.

  IT’S GOING TO TAKE TIME

  In the future, generations will be astonished that health care was ever considered anything but an inalienable right. Until then, we have work to do. What’s it going to take to get to this promised land? It may well take a movement for a basic human right like the one led so majestically by Martin Luther King.

  When I said this to Stephen A. Smith, the Philadelphia Inquirer columnist and one of my favorite guest commentators, he said the health care issue was even bigger than that because that cause was about African-Americans. This one is about everyone. This isn’t an issue of politics or capitalism versus socialism or even dollars and cents. This speaks to who we are as a country and who we aspire to be.

  The pragmatist in me can accept that change may take longer than the idealist in me wants to accept. The goal is to low
er the cost for consumers to an affordable or sustainable level. And we have to realize that at some level we all pay for the services we receive as citizens of this country. I just happen to believe universal health care is the best alternative.

  What is so hard about doing the right thing?

  I know we’re better than this.

  We have to be.

  CHAPTER FOUR

  RETHINKING ENERGY

  Another Fight for Independence

  I CAN’T HELP BUT THINK ABOUT THE FUTURE. NOT MINE SO MUCH, but the world we are leaving the next generation—my kids and yours. As I said earlier in this book, one of the handicaps of a democratic society is that our political and corporate leaders tend to think in election cycles and in quarters, not in a generational context. We don’t address growing problems until they become a crisis. Then we muster the will to change. But that way of doing things can be much more painful than it has to be. The issues that are looming before us are not the ones that should divide us. It’s not about gays, guns, and God. Those are social issues manufactured to get votes. The real issues coming down the pike affect us all and in a big way.

  What if it were possible to rise above partisan politics, to bring both parties together, to find common ground and common goals? What if we were able to set out national goals that most of us could agree upon? We could seek a balanced budget in five years. Reduce cancer deaths by 75 percent in ten years…energy independence in ten years…Really, the sky is the limit if we could get a bipartisan think tank of politicians and others from the private sector to take on these key issues.