July 26, 2009

Bill Moyers interviewed health care experts Marcia Angell and Trudy Lieberman about the Obama healthcare reform proposals this week, and their remarks are being quoted all over the blogosphere this weekend. Sounds like pretty depressing stuff - it has many bloggers upset. (Complete transcript here.) But read it carefully:

BILL MOYERS: Given what you've said, why the rush? Why not slow this down and give this very big issue more due deliberation?

TRUDY LIEBERMAN: It's really a political calculation. And I think that they believe that they have to act quickly, because it might not happen. Because the sooner you have the special interests going back home, during the August recess and holding town hall meetings and talking to people in coffee shops, they're going to find that maybe this isn't something that people really want or have doubts about.

MARCIA ANGELL: Well, I think we are in a hurry. I think that President Obama's worried, that what happened with the Clinton plan can happen with him. And I do have a feeling of déjà vu all over again. That this is like 1993. That the opposition is having a chance to mobilize. To march out these Canadians who say they had brain tumors and had to die. Or these ads that say 20 percent of Europeans drop dead.

TRUDY LIEBERMAN: And Harry and Louise are back.

MARCIA ANGELL: And I think he does. He is right to worry about that. And he is right to want to do it in a hurry. The problem is he is not doing the right thing.


MARCIA ANGELL: Well, the plan is not for all the reasons we've said. It leaves the bad guys in place. And it tries to kind of make concessions. And what the Clintons found out is they too wanted to keep the private insurance industry at the table. And maybe regulate them a little. And what the private insurance industry decided was, "Why should we take half a loaf when we can have the whole thing?" And that's what I'm seeing happen. Happening now.

TRUDY LIEBERMAN: We are having the same debate, almost, that we had in '93-'94. And it's something I've written about for the Columbia Journalism Review. It's actually the same debate we've had decades before. And it's the unwillingness to look at what we could learn from other systems. Single payer, multiple payers, as they have in Germany and Japan. Or even in the Netherlands, where there are private payers. What's really happening there?

So, I think there's an unwillingness on the part of politicians-- on the part of advocacy groups, some advocacy groups, to really educate Americans on what the possibilities are. And we at C.J.R. have been saying we really have not had a vibrant discussion about other possibilities.

MARCIA ANGELL: I think we have to start all over on this. I really do. I think we have to go for a single payer system. You could institute that gradually. You could do it state by state. You could do it decade by decade. You could improve Medicare. That is, make it nonprofit. But extend it down to age 55 and age 45 and age 35. It would give the private insurance industry a chance to go into hurricanes, earthquakes or something. To get out of the health business. It could be done gradually. I think that has to be done. And it's the only thing that can be done.

Okay, so the experts have looked at what's happening and they have their own recommendations. Now, let's look at this comment at Open Left in response to the Moyers piece:

And now, besides "starting over," what is the difference in the approach suggested by these policy analysts? "You could institute that gradually. You could do it state by state." I thought the gradualism was awful? And I thought the most vibrant version of the Bill moving out of the House HELP committee had an Amendment, passed bipartisanly, that makes provision for, makes the rules allowing, gives permission to: States Implementing Statewide Single Payer Systems.

They continue:

"It could be done gradually. I think that has to be done. And it's the only thing that can be done."

So except for "starting over" - they are in complete agreement with the present process. I think they want a title on the final Bill that says "We are moving to Single Payer, don't be too patient or in too much of a hurry." But otherwise, despite their trepidation, they have a descriptive laying out of congress's and the administration's arm-twisting, panderer-molifying, greed distracting, regionally diverse and constantly-attacked plan of action, as it appears to be moving through the tunnel of that resembles Hunter S. Thompson's description of "The music business is a cruel and shallow money trench, a long plastic hallway where thieves and pimps run free, and good men die like dogs. There's also a negative side."

What they want is so close to what is happening as to be merely a description.


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