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Reich writes: "The Supreme Court's recent blessing of Obamacare has precipitated a rush among the nation's biggest health insurers to consolidate into two or three behemoths."

Robert Reich. (photo: Robert Reich)
Robert Reich. (photo: Robert Reich)


The Choice Ahead: A Private Health-Insurance Monopoly or a Single Payer

By Robert Reich, Robert Reich's Blog

06 July 15

 

he Supreme Court’s recent blessing of Obamacare has precipitated a rush among the nation’s biggest health insurers to consolidate into two or three behemoths.

The result will be good for their shareholders and executives, but bad for the rest of us – who will pay through the nose for the health insurance we need.

We have another choice, but before I get to it let me give you some background.

Last week, Aetna announced it would spend $35 billion to buy rival Humana in a deal that will create the second-largest health insurer in the nation, with 33 million members.

The combination will claim a large share of the insurance market in many states – 88 percent in Kansas and 58 percent in Iowa, for example.

A week before Aetna’s announcement, Anthem disclosed its $47 billion offer for giant insurer Cigna. If the deal goes through, the combined firm will become the largest health insurer in America.

Meanwhile, middle-sized and small insurers are being gobbled up. Centene just announced a $6.3 billion deal to acquire Health Net. Earlier this year Anthem bought Simply Healthcare Holdings for $800 million.

Executives say these combinations will make their companies more efficient, allowing them to gain economies of scale and squeeze waste out of the system.

This is what big companies always say when they acquire rivals.

Their real purpose is to give the giant health insurers more bargaining leverage over employees, consumers, state regulators, and healthcare providers (which have also been consolidating).

The big health insurers have money to make these acquisitions because their Medicare businesses have been growing and Obamacare is bringing in hundreds of thousands of new customers. They’ve also been cutting payrolls and squeezing more work out of their employees.

This is also why their stock values have skyrocketed. A few months ago the Standard & Poor’s (S&P) 500 Managed Health Care Index hit its highest level in more than twenty years. Since 2010, the biggest for-profit insurers have outperformed the entire S&P 500.

Insurers are seeking rate hikes of 20 to 40 percent for next year because they think they already have enough economic and political clout to get them.

That’s not what they’re telling federal and state regulators, of course. They say rate increases are necessary because people enrolling in Obamacare are sicker than they expected, and they’re losing money.

Remember, this an industry with rising share values and wads of cash for mergers and acquisitions.

It also has enough dough to bestow huge pay packages on its top executives. The CEOs of the five largest for-profit health insurance companies each raked in $10 to $15 million last year.

After the mergers, the biggest insurers will have even larger profits, higher share values, and fatter pay packages for their top brass.

There’s abundant evidence that when health insurers merge, premiums rise. For example, Leemore Dafny, a professor at the Kellogg School of Management at Northwestern University, and her two co-authors, found that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The problem isn’t Obamacare. The real problem is the current patchwork of state insurance regulations, insurance commissioners, and federal regulators can’t stop the tidal wave of mergers, or limit the economic and political power of the emerging giants.

Which is why, ultimately, American will have to make a choice.

If we continue in the direction we’re headed we’ll soon have a health insurance system dominated by two or three mammoth for-profit corporations capable of squeezing employees and consumers for all they’re worth – and handing over the profits to their shareholders and executives.

The alternative is a government-run single payer system – such as is in place in almost every other advanced economy – dedicated to lower premiums and better care.

Which do you prefer?


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+67 # MsAnnaNOLA 2015-07-06 14:11
Well none of us will have any choice if we allow the TPP, TTIP and related treaties be passed. These treaties effectively lock in our laws and programs at the point that the treaties are enacted. Do you think the country is perfect? Do you think we will never see a new chemical so toxic it must be banned? Do you think the minimum wage should never be raised?

You need to get pissed off about these treaties. The effect of the investor state arbitration clauses is that any law, program or regulation that affects any corporate profits in any way at all will either pre-emptively disallowed by congress because we would lose in arbitration court, or it will go to arbitration court after it is passed and we as tax payers will have to pay billions to compensate the corporations for having the temerity to pass laws protecting our citizens from toxins, or granting us universal healthcare.

Think about it. No matter what side of the political divide you are on, do you think America's laws are perfect right now? I didn't think so.

Just say no to Toxic Trade Treaties. We the people need to preserve our sovereignty and that of our worldwide brothers and sisters.
 
 
+11 # harleysch 2015-07-07 09:36
Reich is right about the solution -- single payer -- but wrong when he says it is not the fault of Obamacare.

Remember, Obamacare was Romneycare, an insurance bailout disguised as a health care policy. The insurance companies are now getting government subsidies; plus, they are writing policies for those with subsidies with deductibles which are so high, that those insured by them still can't afford medical care.

We must move to a Medicare-for-al l system, which Obama NEVER even considered. MsAnna is right making the connection to the TPP, etc. The Obama Presidency has been a regime which, from Day One, prioritized guaranteeing super-profits for banks, financial interests, and insurance companies. The obscene profitability for big insurance, which Prof. Reich is reporting, is just more damning evidence of that.
 
 
+18 # mavrant 2015-07-07 11:54
Single payer I'm sure had been considered, but the best that could be squeezed out of the "negotiations", shall we say, was the "public option", and that was left on the "cutting room" floor when Mr. Lieberman voted against it in the senate, because it seems he "owed" more loyalty to the health insurance industry, than to the people of America, from what I understand.
We must remember who many of the members of congress seem to really work for. And it ain't you and me boobie. We all pretty much know who many of them work for. I'm in California, as well as a retired healthcare provider (pharmacist) and I have to give credit to Mrs. Pelosi for trying till the last minute to save the public option, that would have been an option as an insurer(probabl y Medicare type), in case we didn't want any of the Anthems of this world as our health insurance company.
The vast majority of the American Public actually favor a Medicare For All type single payer system. But it's tough for the general public to keep from getting confused by the mind games, and lies perpetrated by the "health insurance industrial complex", and their allies in congress. But what the heck do I know.
As for me, I'm voting for Bernie. He's the real deal!
 
 
+6 # lfeuille 2015-07-07 16:18
Quoting mavrant:
Single payer I'm sure had been considered, but the best that could be squeezed out of the "negotiations", shall we say, was the "public option", and that was left on the "cutting room" floor when Mr. Lieberman voted against it in the senate, because it seems he "owed" more loyalty to the health insurance industry, than to the people of America, from what I understand.
We must remember who many of the members of congress seem to really work for. And it ain't you and me boobie. We all pretty much know who many of them work for. I'm in California, as well as a retired healthcare provider (pharmacist) and I have to give credit to Mrs. Pelosi for trying till the last minute to save the public option, that would have been an option as an insurer(probably Medicare type), in case we didn't want any of the Anthems of this world as our health insurance company.
The vast majority of the American Public actually favor a Medicare For All type single payer system. But it's tough for the general public to keep from getting confused by the mind games, and lies perpetrated by the "health insurance industrial complex", and their allies in congress. But what the heck do I know.
As for me, I'm voting for Bernie. He's the real deal!


It wasn't considered. Obama rejected it out of hand.
 
 
0 # Rain17 2015-07-08 07:55
"The vast majority of the American Public actually favor a Medicare For All type single payer system."

Then, if that's the case, why do they often vote for Republicans who are totally opposed to any and all kinds of healthcare reform?
 
 
+3 # Billy Bob 2015-07-08 20:22
Who's "they"? 36.4 of "eligible" voters voted in 2014.

Stop bullshitting us with what "they" want.
 
 
+1 # Rain17 2015-07-09 08:31
Well, Billy Bob, apparently the other 63.6% of the voters didn't care enough to vote. So their opinion doesn't matter because they didn't show up. The opinions of people who vote matter. Those who stay at home don't count.
 
 
+5 # Karlus58 2015-07-08 08:37
I certainly agree with you that Medicare for All is the best way forward, and always has been. And for the life of me, I could not understand why Obama never allowed the debate. It was shut down...period! That should give you a sense of the immense power the "powers that be" have in this country. Obama new darn well it was politically impossible to have Single Payor. For goodness sakes, he didn't even have the support from the Democrats who many are in bed with the corporatists, as are the majority of the Republicans. Single Payor has always been the right choice. Its good for everyone! Except the insurance cartels wielding the power to exploit us all.
 
 
+15 # Vardoz 2015-07-07 11:09
This is why we should vote for Sanders. He has been against every treaty that has crossed his desk. And it won't just be him - he will have a team working with him for us! We need someone on our side in a position of power to help fight all the assaults that are being perpetrated on us by corporations, big money, and our sold out reps! And please do not respond with hopelessness. We have to take a chance with a guy who knows the ropes inside and out. There are never any guarantees but Sanders is a move in the right direction. I have been calling and emailing my reps who are already against these trade agreement for a long time and emailing Obama. Right now we are not marching in the streets. There is no movement. Do people tell their reps they won't vote for them again if they are behind these treaties? Not enough. So Sanders is a beginning and we are behind him 100%
 
 
+35 # davidr 2015-07-06 20:41
The change proposed by Reich is inevitable. The amount of GDP devoted to health care is simply overwhelming and can't be ignored. The question is how to change the current system and when will the Dems have a filibuster-proo f Congressional majority (and the clarity of vision) to get it done.

One way to approach reform is to deem health insurance, especially in its hyper-consolida ted form, a public utility subject to regulation by an Executive Department along the lines of the CFPB. Another way would be to oversee & insure the loss reserves of these insurance giants and to regulate their practices — something like a Federal Reserve/NTSA model. Yet another way, and probably the most preferable, is to enact Medicare-for-al l and permit insurance companies to provide coverage under its overall rubric, much as Medicare Advantage plans work today. I doubt that there would be any political support for directly nationalizing the health insurance companies, and anti-trust won't work because it's logically inconsistent with wanting a single-payer system. So I come up with 3 paths, but I'm no expert & I wonder who else is thinking about this right now.
 
 
+4 # MsAnnaNOLA 2015-07-07 09:30
Quoting davidr:
The question is how to change the current system and when will the Dems have a filibuster-proof Congressional majority (and the clarity of vision) to get it done.


Ha ha ha. You do realize the Dems is how we got there to begin with. HCA was a giant giveaway to big pharma, big healthcare and big insurance. So now they are going to go against all those deals and go for single payer? Sure. Keep dreaming. We no longer live in a country where what the public wants matters. 70% of Americans are for de-criminalizat ion of Marijuana, yet as another giveaway to drug companies Obama is enforcing those laws in states that have de-criminalized . Unless we put the fear of total loss and devastation and possibly jail in these people, nothing will change. The former Attorney General who failed to prosecute systemic fraud on Wall Street just re-jointed the wall street firm he worked for before his tenure as a cabinet level government official. You can bet there is no threat of any sort of jail time for any of the powers that be. Covering each others criminality is part of the status quo now.
 
 
+10 # davidr 2015-07-07 10:43
Quoting MsAnnaNOLA:
We no longer live in a country where what the public wants matters.


I think there's more problem with "the public" than you let on. The big one: the public doesn't vote! Yes, there's voter suppression & gerrymandering, we know that. But even after those manipulations, if office-seekers knew that 80% of those permitted to vote would actually do so in every local, state & federal election, we'd be living in a truly Progressive country (and very quickly one without voter suppression & gerrymandering).

Today, it's a huge turnout when 60% vote. Who would the other 20% be? Poor people, young people, "non-political" people, cynics who think there's no point. If they voted, they'd overwhelmingly vote left-of-center, and the reactionary right simply doesn't have a big enough base to compete.

A country with 80% turnout would have public campaign finance, universal single-payer healthcare, a more equitable justice system, a means of maintaining full employment, more transparency, fairer taxes, more spending on education, infrastructure, R&D, and less on the military. That isn't a guess. Polling tells us this.

FDR's aphorism holds true for Obama & any of his successors: "I agree with you, I want to do it, now make me do it." The public has a responsibility here.
 
 
+6 # MsAnnaNOLA 2015-07-07 13:48
Agreed. Also don't forget that we are still voting on 100% unverifiable black box electronic voting systems in most jurisdictions. As long as the results are hackable, they will be hacked. When they have been hacked as has been verified by statistically improbable election results like more votes than voters there was absolutely nothing that can be done to fix the situation. We can't even hold politicians accountable at the ballot box by voting if the vote counts are rigged. See coverage at bradblog.com for election coverage of this important issue.

Please remember folks that exit polls were historically very accurate at predicting the winner until the magic of electronic voting. Electronic voting allows the hackers to know just how much to flip the vote through the exit polls.
 
 
+2 # lfeuille 2015-07-07 16:20
Quoting davidr:
Quoting MsAnnaNOLA:
We no longer live in a country where what the public wants matters.


I think there's more problem with "the public" than you let on. The big one: the public doesn't vote! Yes, there's voter suppression & gerrymandering, we know that. But even after those manipulations, if office-seekers knew that 80% of those permitted to vote would actually do so in every local, state & federal election, we'd be living in a truly Progressive country (and very quickly one without voter suppression & gerrymandering).

Today, it's a huge turnout when 60% vote. Who would the other 20% be? Poor people, young people, "non-political" people, cynics who think there's no point. If they voted, they'd overwhelmingly vote left-of-center, and the reactionary right simply doesn't have a big enough base to compete.

A country with 80% turnout would have public campaign finance, universal single-payer healthcare, a more equitable justice system, a means of maintaining full employment, more transparency, fairer taxes, more spending on education, infrastructure, R&D, and less on the military. That isn't a guess. Polling tells us this.

FDR's aphorism holds true for Obama & any of his successors: "I agree with you, I want to do it, now make me do it." The public has a responsibility here.


It's a vicious circle. People get discouraged when voting doesn't make things better.
 
 
+3 # davidr 2015-07-08 16:06
Yes, and there's a science to discouraging them. The GOP anti-government , "just say no", gridlock strategy is, whatever else it may be, a way to teach people that the public thing, res publica, civics, is worthless. Why vote if the government doesn't work, and we're showing you that it doesn't.
 
 
+58 # billgbsn 2015-07-06 21:48
Reich has the ONLY solution: single payer. What an ENORMOUS amount of money could be saved by taking the PROFIT out of health insurance!
No more need for bargaining for benefits. Not only $$$, but TIME will be saved. Let's get to the 21st century!
 
 
+24 # lewagner 2015-07-07 01:09
That's what people voted for.
Let's not neglect to vote for single payer again in 2016!!
 
 
+5 # Rain17 2015-07-07 07:59
Is it what they "voted" for? Then why do they keep voting for Republicans in midterm elections who are totally opposed to any kind of healthcare reform?
 
 
0 # Billy Bob 2015-07-08 00:15
The word you should have put in quotes was "they". Is the "they" you're referring to, the "they" who elected Obama on the promise of Single-Payer, or the "they" who voted in midterm elections, after the Obama voters stayed home disappointed in the lies they were sold?

There's more than one "they" involved here.
 
 
0 # Rain17 2015-07-08 07:53
Billy Bob, why is it so hard to get the point through to you THAT SINGLE-PAYER WAS NOT GOING TO PASS WITH THAT CONGRESS THAT WAS IN OFFICE IN 2009-2010 NO MATTER HOW MUCH OBAMA FOUGHT FOR IT?

Again what you and the Obama bashers still haven't explained is how the votes would have materialized, especially after Scott Brown won Ted Kennedy's seat and Robert Byrd died. You act like somehow the votes were magically there. They were not--AND THEY WEREN'T GOING TO BE THERE NO MATTER HOW OBAMA LOBBIED FOR THEM.

Do you think Obama could have waved a magic wand and that somehow AHIP, PhRMa!, the AMA, and other groups would have wilted? They would have spent all their lobbying money to ensure that no bill passed.

The bottom line was that Obama had two choices: 1) either pass the ACA, however flawed; or 2) kill the bill and let millions of Americans die. Had the ACA not passed at least another 16 years would have passed before any president tried healthcare reform again--if at all.

I want single-payer as much as you. But I am also not in denial about what the political reality was at the time. The options Obama faced sucked and he went with the one that at least ensured some people got coverage.

Again I'll say it for the millionth time. I think too many people except one or two candidates to be their "saviors" and then create impossible/unre alistic expectations. When said candidate inevitably can't meet them they sulk and threaten to vote third party or stay at home.
 
 
0 # Rain17 2015-07-08 07:54
Continued from last post.

What you all don't get is that it is going to take one or more than two candidates to get long-term change. But some of you expected Obama to somehow reverse 30-40 years of bad policies in two years. That was unrealistic.
 
 
0 # Billy Bob 2015-07-08 20:23
It seems that EVERYONE doesn't "get it" but you.

You must be a "genius".
 
 
+1 # Rain17 2015-07-09 08:26
Billy Bob, given the Congress that was in office at the time, which Senators and Congressman would have voted for single-payer? Where would you have gotten the votes? Please show me who would have voted for it. Please show me how a single-payer bill, in spite of the fact that the entire GOP was not going to vote for the ACA and that some Democrats were not either, would have reached Obama's desk.
 
 
+5 # jdd 2015-07-07 03:27
Obanacare did pave the way for this as the president pulled out all the stops to get his way by derailing the initiatives, already in the House, for a single-payer system. A better way to formulate it for the majority of citizens was expressed in Cong. Conyer's bill for "Improved Medicare for All," which would build upon the overwhelming ppularity of that program.
 
 
+4 # Rain17 2015-07-07 08:01
And where were you going to find the votes? Answer: they were not there and they weren't going to be there, especially after Robert Byrd and Ted Kennedy died. When Scott Brown won Kennedy's seat the ACA became even more imperiled. That the ACA passed is a miracle.
 
 
+5 # lfeuille 2015-07-07 16:25
Quoting Rain17:
And where were you going to find the votes? Answer: they were not there and they weren't going to be there, especially after Robert Byrd and Ted Kennedy died. When Scott Brown won Kennedy's seat the ACA became even more imperiled. That the ACA passed is a miracle.


Instead of ignoring single payer and therefore allowing the media to ignore it, Obama could have run a two year campaign for it leading up to the midterms, making sure the electorate knew that in order to get it they had to elect the right people.
 
 
-1 # Rain17 2015-07-08 07:39
So basically you would have let nothing pass--and probably sentenced millions of Americans to death or financial ruination. And there would have been no guarantee that the next Congress would have even been more supportive.
 
 
+1 # Billy Bob 2015-07-07 19:59
You need to start copying and pasting a new argument. That one's getting stale.
 
 
-1 # Rain17 2015-07-08 07:45
It's not a stale argument. You and the other Obama bashers don't want to deal with the reality that existed at the time. I fully agree that Obama handled the messaging poorly; but, at the end of the day, no matter how much you and other people here think otherwise, the reality is that they didn't have the votes--and they were never going to have the votes to pass the public option, let alone single-payer.

I agree that Obama should have fought for it longer. Maybe he could have negotiated a slightly better ACA. But Medicare for All, the public option, or single-payer was not going to pass in that Congress no matter how much you pretend otherwise.

On this issue you and the other Obama bashers just don't want to acknowledge the reality of what existed at the time. I think about it from the perspective that the choices at the time were:

1) Pass the ACA, however much it fell short of what you and others wanted

or

2) Kill the bill, all but sentencing millions of Americans to death or financial ruination

I agree that the ACA is far from perfect. But it would have arguably saved the life of a family member of mine who didn't have insurance.

And given what I went through I view the ACA as a step forward, not something to whine about like you do because, ultimately, if it had been up to you, you would have killed the bill.
 
 
-2 # Billy Bob 2015-07-08 20:24
It's the same argument over and over, no matter how many times it's rebutted. That's a stale argument.
 
 
+2 # Rain17 2015-07-09 08:29
Billy Bob, what Senators and Congressman would have voted for single payer? Please tell me, especially when not every Democrat was going to support it. If you can show me how Obama could have gotten the votes, and gotten single-payer to his desk, I'll admit that I'm wrong.

But again they didn't have the votes. I don't know why you can't and refuse to grasp that reality. It's like you want to ignore the reality at the time.

You and I wanted single payer. The votes were not there for single payer. They were not going to be no matter how much you insist otherwise.

You act like that these political obstacles didn't exist.
 
 
+3 # lfeuille 2015-07-07 16:33
Quoting jdd:
Obanacare did pave the way for this as the president pulled out all the stops to get his way by derailing the initiatives, already in the House, for a single-payer system. A better way to formulate it for the majority of citizens was expressed in Cong. Conyer's bill for "Improved Medicare for All," which would build upon the overwhelming ppularity of that program.


Right HR 676. It was originally co-sponsored by Kucinich. I think it has been reintroduced. It's great on benefits. No co-pays or deductibles. I think it covers mental health and dental. It was totally paid for, but I don't remember the mechanism.
 
 
+1 # Rain17 2015-07-09 08:35
And it would never have gotten close to getting the votes needed to pass either House of Congress.
 
 
+24 # leftcoast 2015-07-06 21:54
I'm a recent convert to Kaiser in Southern California. I love their concept - individual doctors don't have to pay for their own malpractice insurance. Kaiser covers it. Doctors are recognized as having lives outside their practices and don't either work ungodly hours or overprescribe expensive procedures to make a living. Their research standardizes the best medicines for various conditions and prescribes them within their individual doctor's parameters.
I can email my doctors and get prompt and helpful responses. Kaiser is adequately staffed and my lobby wait times have never been overly long.
Here's our model for single-payer.
(What's more, they're Union.)
 
 
+25 # Farafalla 2015-07-06 22:49
That's true. I live in California and pay premiums for CalPERS. It costs a bundle at my age and has caps on all kinds of things. The Public Option that Obama and Pelosi killed in the ACA battle would have worked as the beginning of single payer system. Why is it that so many Americans scream "socialism" when they hear single payer? This country needs to grow up and get over the irrational hatred for government programs.
 
 
+5 # lfeuille 2015-07-07 16:27
Quoting Agricanto:
That's true. I live in California and pay premiums for CalPERS. It costs a bundle at my age and has caps on all kinds of things. The Public Option that Obama and Pelosi killed in the ACA battle would have worked as the beginning of single payer system. Why is it that so many Americans scream "socialism" when they hear single payer? This country needs to grow up and get over the irrational hatred for government programs.


I don't think people would scream socialism if the media didn't present it that way.
 
 
+23 # reiverpacific 2015-07-06 22:07
Another example of "America DEFIES the civilized world", "We're #1, were #1 rah-rah-rah" a.ka. "Fuck y'all"!
The ONLY way to approach this blatantly regressive, anti-populist aggression is Universal Health Care.
Can anybody even begin to realize how many people, families or small business owners -still the main source of employment in the US of Armaments-, have been denigrated, ruined and bankrupted by the already ludicrous for-massive-pro fit-and to-Hell-with-th e-result excuse for an anti-populist network of collaboration between big pharma', insurance and hospital chains (like fast food outlets -and providing the same quality of treatment), since the recent and still-lingering "Great Recession"?
Do you EVER see Universal Care addressed on the US owner media (which as far as I'm concerned, includes PBS)?
It all links up with the corrupt, hugely inaccurate and impossible to deal with so-called Credit Bureaus, three in total, completely privately-run and owned, financed and "regulated" by the major banks, who can make or crush any person or business that has gone through a rough spell due to conditions beyond their control.
They get you down and kick you in the kidneys, bollocks, head -whatever they can get at, rather than offering any solutions.
Just another point in favor of the dominant oligarchy that really runs this fragmented nation.
And they continue to get away with it.
It's a vicious circle of, as George Carlin stated, "A club -and you and I ain't IN IT!"
 
 
+14 # sufisays 2015-07-06 22:52
What do we need to do to get Single Payer, Robert?
 
 
-5 # lewagner 2015-07-07 01:11
We need to vote for the Democratic candidate. I did in 1992 when they were talking about "Hillary-care".
Don't neglect to vote for the Dem candidate in 2016. :)
 
 
+8 # Rain17 2015-07-07 08:11
It's more than voting for Democrats. It's also going to require a long-term messaging campaign to shape public opinion. I've said it a million times in threads here about healthcare, but American attitudes toward the government and social programs are going to have to significantly change before single-payer becomes a political reality. You have too many Americans whose position on single-payer is:

"I shouldn't have to pay for other peoples' healthcare with my precious tax dollars. I don't want my tax dollars going to lazy, irresponsible people on elfare.

The problem here is that, instead of starting the debate from the principle that access to basic healthcare is human right, the discussion begins with the question over who is "deserving" and who is "not deserving". Once the debate starts being about who "deserves care" and who "doesn't", those who have opposed single-payer are the wiiners.
 
 
+23 # swimdoc 2015-07-06 23:28
How do we get to single payer? We can start by supporting and electing Bernie Sanders President. Of course, the President can't do it all by himself (or herself), but if the excitement among the 99% generated by Sanders' candidacy were to swell to the proportion needed to get him nominated and elected, there would be real effects on who gets elected to Congress and, more important, on what they do when they get there.

The second thing to do is to start talking with friends and neighbors about what an improved and expanded Medicare program covering everyone (yes, even the undocumented) could do in reducing costs (an increase in taxes that would, for nearly all of us be less than what we would save in not paying for lousy private health insurance); an end to narrow preferred provider networks; much reduced or eliminated cost-sharing (co-pays, deductibles, etc.); and relief from the stress of not knowing how our family will survive financially if a member gets sick.

Spread the word!
 
 
0 # Rain17 2015-07-07 08:12
How do you expect Sanders to pass single-payer as Congress is likely to remain in the GOP hands after the 2015 elections?
 
 
+1 # Billy Bob 2015-07-07 19:59
We need it. We sure as hell won't get there with Corporate sHillary.

Every election matters - EVEN the presidential election.
 
 
0 # Rain17 2015-07-08 07:37
Again, Billy Bob, how do you plan on getting single-payer through a hostile Congress? I ask this of Bernie supporters because, were he elected, as soon as he had to compromise on anything, all too many people here would be ranting about what a "sellout" he is.
 
 
+3 # CAMUS1111 2015-07-08 11:15
How about dems start by introducing a form of single payer at least as often as the gop'er neo-fascists have tried to repeal the ACA? Dems need to start being a helluva lot more aggressive both on the congressional level and presidential level.
 
 
+1 # Billy Bob 2015-07-08 20:24
Ssshhh. Rain doesn't want to hear that.
 
 
+2 # Rain17 2015-07-09 08:36
I actually agree with Camus1111 on that point. Now that the ACA is here, trying to pass single-payer over and over again seems reasonable because it isn't going to result in people dying or ending up financially ruined.
 
 
+1 # CAMUS1111 2015-07-09 10:13
See, I am such a consensus builder!
 
 
0 # Billy Bob 2015-07-08 20:25
Of course he'll compromise, eventually. But, he has a proven track record as a fighter. sHillary doesn't. As much as you like to think she does, the only people she ever stands up to are the base of her own party.
 
 
0 # Rain17 2015-07-11 19:33
Billy Bob, I have a feeling that, were he elected, people here would definitely turn on Sanders once he had to compromise on anything. And believe me, if he became President, he would definitely have to compromise to get anything passed, especially if he has a GOP House and Senate.
 
 
+1 # reiverpacific 2015-07-08 11:35
Quoting Rain17:
How do you expect Sanders to pass single-payer as Congress is likely to remain in the GOP hands after the 2015 elections?


2015?
 
 
0 # Rain17 2015-07-09 08:37
I meant 2016. It was a typo.
 
 
+5 # Robbee 2015-07-06 23:50
everything that, but for the 1%'s money speech, makes sense - goes from next to impossible all the way to easy - that is, if we get a constitutional amendment that gets private money out of elections

shining light on money in politics helps spur bernie's movement to get private money out of politics - it also helps spur the narrower movement of alot of dems to let congress decide whether or not to, and if so how much, limit money in politics, or, in other words, bounce us back to the bad old days before CU, that gave us a whole hellofa lot of money in politics, so much so that almost all members of congress eagerly spent the vast majority of their time begging the rich 1% for campaign contributions, rather than working for we the people

in other words the only way SURE to "disrupt" private money in politics is a constitutional amendment that publicly funds, only, all federal, state and local elections - no one but a candidate for office can advertise anything political - no one can give any money or thing of value to any candidate or officeholder - in every campaign, a candidate can only spend public money

reich, what is so good about dem and repub members of congress getting together and deciding whether or not to disrupt money in politics and, if so, by how much? who does this serve - members of congress or we the people - it cannot serve both!

what do you say, reich, will you please stop shilling for business as usual, albeit business as usual before CU?
 
 
+9 # Robbee 2015-07-07 00:03
re : The Public Option that Obama and Pelosi killed in the ACA battle would have worked as the beginning of single payer system.

- how soon we forget! single payer was not killed by the prez or anybody in the house of reps - it was killed by 6 blue dog senators needed to break the zomblican filibuster of single payer - 54 dem senators supported single payer - 6 blue dog dem senators rejected single payer - they made themselves the "deciders"

when you believe in things, that you don't understand, Agricanto, you're gonna suffer - stevie wonder
 
 
+7 # RnR 2015-07-07 03:54
Obama would not even allow single payer advocates to the table
 
 
+7 # Merlin 2015-07-07 07:18
Robbee 2015-07-07 00:03

You are simply wrong here. Agricanto is correct. (ooopsie)

You are confusing Single Payer with the Public Option. They are not the same. Obama killed the Public Option in the summer in a backroom deal with the big corps, all the while publicly claiming he was pushing for it.

The Public Option was a half way deal, giving people the CHOICE whether they wanted to go with the government plan or private industry. The insurance corps knew this would open the doors wide to Single Payer and could not allow that choice.

http://www.beyondchron.org/did-obama-kill-the-public-option-in-july/

From the article linked:
“In late December, I lamented on Beyond Chron that 2009 was the year change fell prey to backroom deals – where the rich and powerful have undue influence. Never in my wildest dreams did I think my theory was so true. That Barack Obama – the community organizer from Chicago, the man who used to live three doors down from me in Hyde Park, the politician who endorsed single payer when he first ran for public office – would go behind closed doors and kill the public option before we proved that we had the votes.

And the fact that none of us would know about it until nine months later is infuriating.”
 
 
+2 # lfeuille 2015-07-07 16:36
Quoting Robbee:
re : The Public Option that Obama and Pelosi killed in the ACA battle would have worked as the beginning of single payer system.

- how soon we forget! single payer was not killed by the prez or anybody in the house of reps - it was killed by 6 blue dog senators needed to break the zomblican filibuster of single payer - 54 dem senators supported single payer - 6 blue dog dem senators rejected single payer - they made themselves the "deciders"

when you believe in things, that you don't understand, Agricanto, you're gonna suffer - stevie wonder


Obama kill single-payer. He just refused to consider it.
 
 
+9 # torch and pitchfork 2015-07-07 06:51
This subject has been debated to death. We know we need medicare for all but our current government system protects profits over humanity. Until that is changed, stay in line and be the worker drone, consumer unit you were meant to be.
 
 
+6 # Merlin 2015-07-07 07:37
torch and pitchfork 2015-07-07 06:51
“This subject has been debated to death.”

Horsepucky! If you understand all about Single Payer, great! If you are tired of reading about it, then don’t read about it anymore.

The fact is, aside from you, we need MORE discussion about Single Payer because so many people have the wrong idea about it. Additionally, in general, people are quite happy with the ACA and have bought the corporatist propaganda regarding it, while not understanding what they have. We need to make a lot more noise to change that.

You advise:
"Until that is changed, stay in line and be the worker drone, consumer unit you were meant to be and be!"

If you want change, you don’t become the worker drone you have chosen to be, nor do you suggest others to join you. But then, maybe you don’t want change. It is your choice after all.
 
 
+3 # Rain17 2015-07-07 08:14
Merlin, I get that the ACA isn't perfect; but it is saving lives and increasing access for millions who didn't have it before.
 
 
+8 # tedrey 2015-07-07 08:54
Rain 17, I get that we've successfully gotten from a sinking ship into a lifeboat, but we shouldn't give up on reaching shore.
 
 
-1 # Billy Bob 2015-07-07 20:01
Rain's idea is to stay on the lifeboat until everyone starves, while arguing with them that they're better off and that the shore just wasn't realistic.
 
 
+1 # Rain17 2015-07-08 07:35
Billy Bob, there was no way Obama could get single-payer passed with the Congress that was in office in 2009 - 2010. I've argued this many times with you, but they didn't have the votes--and the votes weren't going to be there for it. I don't know why you and so many people here ignore that fact.
 
 
+1 # Billy Bob 2015-07-08 20:28
There's no way Bush could have started a war in Iraq and Afghanistan by that same logic. There's no way torture would have been ok'd or the "Patriot" Act, except that, oh YEAH, THEY WERE.

Stop making tired excuses why Republicans can go against a Democratic Congress by Democrats can't do the same to a Republican Congress.

It's literally disgusting.
 
 
+1 # Rain17 2015-07-09 08:42
Billy Bob, please show me how the votes would have materialized. What Senators and Congressmen would have voted for single payer? Please tell me how Obama could have assembled the votes when it was clear that they were not going to be there, especially after Ted Kennedy's seat went to Scott Brown.

What Republicans would have voted for single-payer? Olympia Snowe and Susan Collins, the only two GOP moderates, made it clear they would support no bill.

So again, Billy Bob, where were you going to find the votes? Why do you insist on refusing to admit what the political climate was at the time?

You can bash Obama all you want. But at the end of the day single payer was not going to pass that Congress. You can whine and throw temper tantrums and deny it all but it won't change that fundamental fact.

Again it's a matter of basic math. Please tell me how Obama could have made it happen and what Congressmen and Senators would have changed their mind.

As for the Patriot Act that was after 11 September. No one was going to not vote for it. Ditto for the war in Afghanistan. As for the votes on the war in Iraq cowardice prevailed there unfortunately.
 
 
+2 # Rain17 2015-07-08 07:36
Of course not. We shouldn't give up on the public option or single-payer.
 
 
-1 # Billy Bob 2015-07-08 20:28
Too bad we already did. Maybe in another generation or two.
 
 
+1 # Rain17 2015-07-09 08:49
Billy Bob, they didn't have the votes. Why is it hard for you to grasp that reality? Please show me how Obama could have gotten single-payer passed in a Congress that made it clear that it was a political nonstarter. What Senators and Congressmen would have changed their minds? Please show me step by step how it could have been passed when it was clear that the votes were not there.

It's clear that you don't want to deal with the political realities at the time. Instead you want to blame Obama for failing when it was clear at the outset that single-payer was a political nonstarter.

The point that you refuse to accept is that American attitudes will significantly need to change toward social programs before single-payer becomes politically valuable. Otherwise the scary negative ads wouldn't work.

But it's clear that you refuse to acknowledge the political reality that existed at the time. So I'm not sure what else there is to discuss because you won't listen to reason.

I fault Obama for handling the messaging and negotiating badly. You are right about that. But at the end of the day the votes in both Houses of Congress were not going to be there no matter how much you hysterically rant otherwise.
 
 
+4 # lfeuille 2015-07-07 16:45
Quoting Rain17:
Merlin, I get that the ACA isn't perfect; but it is saving lives and increasing access for millions who didn't have it before.


It is driving people with chronic conditions into deep debt. Drug prices keep going up. It does nothing to control them. Insurers are forcing people to pay a ever higher cost for their drugs. There was an article in the Washington Post about this on Sunday. There are thousands of people who are paying $50.000 or more a year for drugs. They either run up hundreds or thousands of dollars in debt or they have to stop taking their medication and risk serious health ramifications or death. This is not acceptable.
 
 
+3 # torch and pitchfork 2015-07-07 13:28
Merlin,

Unfortunately I don't know the punctuation for irony/sarcasm which was how I meant my comment to read. We have a solution in place now Medicare, just expand it for all. No mystery in that, now tell me how you propose to get our Representatives to pass it?
 
 
+2 # lfeuille 2015-07-07 16:48
Quoting torch and pitchfork:
Merlin,

Unfortunately I don't know the punctuation for irony/sarcasm which was how I meant my comment to read. We have a solution in place now Medicare, just expand it for all. No mystery in that, now tell me how you propose to get our Representatives to pass


It needs to be enhanced first. It only covers 80%, which was fine when it was introduced, but isn't any longer.
 
 
+1 # Merlin 2015-07-07 21:34
torch and pitchfork 2015-07-07 13:28
OK, I accept your explanation. Sorry I did not see your intent.

If you note something like "Snark ahead" or even this ";-)" (a wink) you alert readers to your intent. If you don't Indicate anything, some not to sharp readers (like me) will misread you.
 
 
+6 # davegre2000@yahoo.com 2015-07-07 09:10
The insurance companies wrote Obamacare and bribed congress one million dollars a day to get what they wanted and they succeeded. Government of the people, by the people, and for the people was sadly ignored. Obamacare is doomed to bankrupt the country. Improved Medicare for all is, in my opinion, the solution to reduce our health care costs by as much as one trillion dollars per year. Bernie Sanders is our only hope of achieving this goal. The entrenched democrats and republicans have sold their souls to the insurance companies. Bernie is our only hope. Let's send him to the white house. I bet he might even say that he would want no inauguration balls to save money and to get right to work. He is not your average politician. He is a real person like the rest of us.
 
 
0 # Rain17 2015-07-09 08:50
How do you expect Bernie to get single-payer through a House and Senate that is likely to almost certainly remain majority Republican after the 2016 elections?
 
 
+4 # Robbee 2015-07-07 09:36
okay, merlin, i've read http://www.beyondchron.org/did-obama-kill-the-public-option-in-july/ and let me tell you what it means to me, tho somehow it means something quite different to you -

"public option ... 51 Senators are on record saying they would vote for it"

all 40 zomblican senators were united to filibuster ANY health care bill - that meant that, to get public option, dems could not afford ONE defection - in effect it only took ONE dem senator to keep us from getting public option, ONE

6 blue dog senators came out against public option - they wanted to save their jobs, did not - but opposing public option, they decided, gave them the best shot at staying senators

obama never drew a stupid breath - he knew he COULD NOT GET all 60 votes he needed for public option - so he cut the best deal with insurers he could, to, at least, subsidize healthcare for the working poor and to expand medicaid for the non-working poor - thus covering tens of millions of americans, who otherwise had no healthcare outside of an emergency room - no mean accomplishment

that's what i just read - i am also very disappointed obama could not get us single payer or public option - but he never had the 60 votes it took - to get the best possible deal for the people he bargained and compromised - for the sake of the working and non-working poor, he cut a deal and got insurer backing (they did not call it undoable) - if bernie becomes prez, i hope!, he will have to cut deals too, sorry
 
 
+1 # Rain17 2015-07-09 08:51
Robbee, unfortunately, too many people here on this board don't want to accept that unfortunate reality. Instead they want to build castles in the sky.
 
 
+6 # ChrisCurrie 2015-07-07 09:53
Obama should have simply extended Medicare to cover everyone in the first place.
 
 
-3 # Buddha 2015-07-07 10:56
Don't fool yourself, a government-run single-payer system is also a de facto Monopoly. Not that I am against it, it has been shown in nations across the earth to be the best way to insure if keeping alive a for-profit provider system.
 
 
+4 # lfeuille 2015-07-07 16:49
Quoting Buddha:
Don't fool yourself, a government-run single-payer system is also a de facto Monopoly. Not that I am against it, it has been shown in nations across the earth to be the best way to insure if keeping alive a for-profit provider system.


Of course it is a monopoly, but it is one without a profit motive.
 
 
0 # Buddha 2015-07-09 11:12
Indeed. Again, I think everyone missed my point, I am totally FOR a single-payer healthcare system for that exact reason, I do not believe there should be a profit motive in healthcare insurance. In fact, I'd go further and say I'd prefer we had a government run PROVIDER system as well.
 
 
+1 # Billy Bob 2015-07-07 20:02
I think the point of the headline was to point out the irony of conservatives arguing against "government run" for the reason of it being a monopoly. For some reason, private monopolies don't bother them.

By the way, I just checked your avatar.

Mmmmm, Enlightenment… DOH!
 
 
0 # Billy Bob 2015-07-08 20:31
Buddha, I hope you didn't give me the negative. I don't really care if I get them, but I wasn't against your comment. I really like your comments, and was just trying to explain what I think is the intended irony of headline.

I love your avatar too. I was just making a Simpsons reference.

If you're not the one who gave me the negative, you can see how much I actually care what you think, even though I don't usually care about negatives.
 
 
0 # Robbee 2015-07-08 08:35
in sum, i think that when reich offers a choice between a private monopoly that, by law, can profit up to 20% on premiums it collects for healthcare services, and, on the other hand, a public monopoly, single-payer, that incurs administrative costs at 3%, reich offers a false choice - there is no choice

either humans have a right to healthcare or we don't - i believe we do

i believe that one day - just like every other industrialized nation on earth, we will

bernie and i believe that once we get private money out of american politics - in other words, public funding, only, of federal, state and local elections, our reps will have time to stop begging the 1% for campaign funds, and, suddenly, ta da!, have time to do what the government of every industrialized nation must do, it's job, representing we the people
 
 
+1 # Robbee 2015-07-08 08:37
it astounds me that an economist like reich cannot connect the dots - go bernie!
 

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