Robert Reich on Health Care
Former Secretary of Labor; Democratic Challenger MA Governor
The problem isn't ObamaCare per se. It lies in the structure of private markets for health insurance--which creates powerful incentives to avoid sick people and attract healthy ones. ObamaCare is just making this structural problem more obvious. We end up with the most bizarre health-insurance system imaginable: One ever better designed to avoid sick people.
[We can postpone the problem with policy] band aids. Or else a government-run single payer system--we're going to have to choose eventually.
Drug prices are high in America partly because, while other governments set wholesale drug prices in their countries, the law bars the US government from using its considerable bargaining power to negotiate lower costs. But the bigger reason drug prices are so high in America is that drugs are patented--and those temporary monopolies often last beyond when the patents are supposed to run out (now 20 years); the Patent Office often renews patents on the basis of small changes to the original drugs that technically make them new and therefore patentable.
Many drugs that are available over the counter in other countries can be bought only by prescription in the US. It is illegal for Americans to shop at foreign pharmacies for cheaper versions of the same drugs sold in the US, either branded or generic.
Every Republican in Washington has been programmed to use the word "disaster" whenever mentioning the Act, always refer to it as ObamaCare, and demand its repeal. Republican wordsmiths know they can count on Fox News and right-wing yell radio to amplify & intensify all of this in continuous loops of elaboration & outrage, repeated so often as to infect peoples' minds like purulent pustules. The idea is to make the Act so detestable it becomes the fearsome centerpiece of the next election.
It will become apparent that the 2010 reform cannot adequately contain soaring health care costs. The main reason for the soaring costs and poor results is the way our system is organized. We are the only advanced nation whose citizens largely depend on private, for-profit insurers. The result is complicated, expensive, and inequitable.
"We won't get a public option, or anything close to it, unless people who feel strongly about it make a racket," Reich said. "1. Be very loud & very vocal: Write, phone, & e-mail. 2: Get others to do the same. 3: Get voters and make a hell of a fuss. 4: March on Washington."
Democrats also shy away from any mention of universal health care because they still believe that Hillary’s ill-fated plan of 1994 was responsible for the Republican takeover of Congress later the same year. Their memories need jogging. Hillary Care sank of its own complex weight--which also made it a perfect foil for right-wing demagoguery. But it didn’t go down without a fight, and not without substantial public support at the start. In 1993, a majority of Americans listed “universal health care” as the most important unmet public need and their highest priority for government action. What better time to revive the idea of universal health care than now, since the federal budget is flush and working families need it more than ever?
A: The President proposed a minimum wage increase in 1992 during the campaign, and then when health care reform was on the table, when there was a possibility that employers would be providing health care for all employees, we felt that we didn’t want to add an additional few pennies to payrolls. But the minute health care was no longer viable - and that very ambitious health care plan, as you recall, did not get enacted -- we went back and proposed, in January of 1995, an increase in the minimum wage, and we’ve been fighting for that for the last year and three quarters. Hopefully, we will get it because Americans at the bottom, twelve million of them, deserve at least a livable wage.
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