On the issue of health care, as on virtually every other important political issue, the American people are way to the left of their elected representatives in Washington. On health care, that means that the American people want – and have wanted for a very long time – a universal national health care plan that provides decent quality health care for all Americans. In other words, the American people in general favor a health care system that will benefit ALL Americans, in comparison with our elected representatives, who are comparatively much more sensitive to the needs of wealthy special interests.

Yet, we have never universal health care, though the issue has been raised numerous times, because every time it is raised the conservative special interests and the politicians who they are in bed with manage to block it. It is well worth understanding this situation because until we do and manage to address it at its root causes, millions of Americans will remain without adequate health care, and approximately 23,000 Americans will die every year because of this sad state of affairs.


What Americans believe about health insurance

The most salient fact regarding the position of most Americans on this issue is that they want a national health insurance plan that will ensure decent quality health care for ALL Americans – and they have wanted this for at least 18 years. A New York Times / CBS News poll, taken on July 24-28, 2009, makes this point clearly, as indicated by responses to numerous questions:

Dissatisfaction with the status quo
Several poll questions simply measure dissatisfaction with the status quo, without precisely specifying the reasons for that dissatisfaction:

Amount of change needed in our health care system:
Minor or none – 16%; Fundamental – 49%; Completely rebuild it – 33%.

Comment: It is worth noting that these numbers have been fairly consistent in polls taken since at least 1991. In fact, most polls since that time have shown even fewer Americans who would be satisfied with only minor changes. The time periods characterized by the highest percentage of Americans being satisfied with only minor changes to our health care system correspond to those periods in which the special health care interests threw tons of money into propaganda campaigns arguing for the status quo. That was in 1994, shortly after the defeat of the Clinton health care plan (19%) and currently (16%).

Who has better ideas for reforming health care – President Obama or Congressional Republicans?
Obama – 52%; Congressional Republicans – 26%

How fast is Congress moving on health care reform?
Too quickly – 23%; too slowly – 39%; right pace – 33%

Comment: Thus the good majority of Americans are either glad that at least Congress is moving on this issue or (even more common) feel that Congress isn’t moving fast enough.

Fundamental beliefs about the proper rule of the federal government in health care
Even more important than dissatisfaction with the status quo are fundamental beliefs about what should be the proper role of government in health care. These poll results indicate that a very clear majority of Americans believe that their federal government should actively be involved in ensuring decent health care for everyone:

Favor a government administered insurance plan
Favor – 66%; oppose – 27% (Down from 72% - 20% last month)

Should government guarantee health insurance for all?
Yes – 55% ; No – 38% (Down from 64% - 30% last month)

Are you concerned that in the absence of health care reform, the number of uninsured people will continue to increase?
Very – 43%; somewhat – 37%; not too much – 11%; not at all – 7%

Should health insurance companies be allowed to refuse to cover people with pre-existing conditions?
No – 52%; Yes – 19%.

Comments: Thus a clear majority of Americans favor government involvement in health care to ensure that all Americans receive decent health care. These figures are consistent with other polls taken from at least as early as 1996. And again, we find that current numbers have recently become worse with the huge infusion of propaganda created by wealthy interests who are fervently attempting to block meaningful health care reform.

Especially noteworthy is the altruistic nature of some of these responses. Of the 55% of responders who said that government should guarantee health insurance for all, 42% (of the total) said that they stand by that belief even if it means increasing their own health care costs, compared to 10% who would not agree with it if it increased their own health care costs.

Scare tactics
I’ve already noted that even though the good majority of Americans want meaningful health care reform to ensure decent quality health care for all of us, those numbers have begun to decrease with the recent propaganda campaign mounted by special interests. The results from some of the poll questions help to explain how that propaganda has affected the perceptions of the American people. These questions ask about the concerns that Americans will have “if government CREATES a system of providing health care for all Americans”:

Concern that the quality of your own health care will go down
Very – 41%; somewhat – 28%; not too much – 18%; not at all – 11%

Concern over your own access to medical care
Very – 43%; somewhat – 30%; not too much – 17%; not at all – 10%

Concern that you will have to change doctors
Very – 37%; somewhat – 25%; not too much – 21%; not at all – 17%

What will government health insurance for all Americans do to the cost of health care for most Americans?
Increase it – 59%; decrease it – 15%; not change it – 16%

Comments: There are three points that need to be made about these numbers: First, all of these concerns have increased substantially in just the past month, as wealthy special interests have bombarded the American people with their propaganda. For example, the percentage of Americans who are concerned that a national health care plan will decrease the quality of their own health care has increased from 28% to 41% in just the past month.

Secondly, these concerns are all bogus – that is, they’re manufactured out of whole cloth by the special interests whose only interest is to maintain the status quo or increase their profits. There is no way that government sponsored health insurance will lead to a decrease in quality of or access to health care for the American people. On the contrary, by providing health insurance to those who currently cannot afford it, and by providing competition to the private insurance companies from which most Americans currently receive their access to health care, government sponsored health care can only improve the quality of and access to health care for the American people. Nor do any of the plans contain any specification that would require people to change doctors. And if President Obama keeps his pledge to increase taxes only on the wealthy (that is, reverse the Bush tax cuts for the wealthy), the cost of health care will rise only for the wealthy.

And thirdly, it is worth noting that despite the fact that the good majority of Americans are “very” or “somewhat” concerned about these bogus propaganda points, most of them still continue to support universal health care for all Americans.


The effect of special interest contributions to U.S. Congresspersons

I’ll start with the twin observations that the Senate Finance Committee Chairman, Senator Max Baucus, has been a major obstacle to meaningful health care reform, and that he has received many hundreds of thousands of dollars in campaign contributions from the health insurance industry. Next, consider the fact that, although there are enough Democratic Congresspersons in both the US Senate and House to pass a good universal national health care plan, there are still 13 Democratic Senators who have not agreed even to support a public option plan. The inclusion of an option (for all Americans) to receive a government sponsored health insurance plan is an absolute prerequisite for meaningful health care reform, since without it the private for-profit health insurance companies will pretty much have free reign to continue the status quo.

So, what is the root cause behind this current failure of our elected representatives to come up with a universal health care plan that the good majority of Americans want? Nate Silver has performed a statistical analysis of the influence of receiving money from insurance industry PACs on the likelihood of a U.S. Senator supporting the public option. This analysis is a little outdated (June 22), and a few Democratic Senators have since announced their support for the public option (bringing the number of holdouts from 21 to 13), but that doesn’t negate the general principles shown by this analysis. Three factors were considered in the analysis: ideology; receipt of health insurance PAC money; and, health care spending in the Senator’s home state. Between those three factors, the model was highly predictive (R squared = .61, meaning that the model provides 61% of the information needed to predict a Senator’s stand on the public option) of a Senator’s likelihood of supporting a public option plan. Ideology was the most predictive, next was receipt of PAC money, and lastly was home state spending on health care. This graph summarizes the main results:



The graph shows that the receipt of health insurance industry PAC money greatly influences, in a downward direction, the support of Democratic Senators for the public option – especially mainline Democratic Senators.

Of the top 8 Senate recipients of health insurance PAC money since 2004, three were Democrats (Baucus, B. Nelson, and Lincoln). What the data shows is that if a mainline Democrat received $60,000 from health insurance PACs over the past six years (compared to receiving no money at all from them), his/her likelihood of supporting the public option is cut approximately in half, from 80% to 40%. This statistical model estimates that the effect of completely removing the influence of health insurance PAC money would increase the number of Senators who supported the public option by nine percent – from 37% to 46%.

Keep in mind that this model applies only to the data available as of June 22, 2009 – not to any future changes that may occur as the process continues. What it shows in general is that receipt of money from the health insurance industry is very influential (inversely) in predicting a Senator’s support for meaningful health care reform. There is no reason to believe that that phenomenon is likely to disappear over time. We can only hope that public pressure will eventually be sufficient to persuade enough Congresspersons to support a health care plan that will provide decent health care for all Americans.


Legalized bribery in a so-called democracy

It is a terrible shame and scandal that in a so-called democracy, public policy should be so disproportionately influenced by a small minority of people with great wealth. This situation makes a mockery of the “one person - one vote” principle that has been declared by our courts.

“Money bundling” is one of the processes that greatly facilitates this travesty. It is the process whereby a single person, typically the CEO, owner, or other high level personage of a wealthy corporation, collects money from hundreds of individuals and hands it over to a political candidate as a “campaign contribution”. This is a blatant attempt to avoid our campaign finance laws. The Bipartisan Campaign Reform Act of 2002, better known as the McCain-Feingold Act, among other things established inflation-adjusted individual contribution limits for political campaigns. In 2009-2010, those limits are $2,400 per individual per election. Therefore, money bundling allows corporations to contribute hundreds of thousands of dollars to a candidate instead of only $2,400.

This is bribery in every sense of the word. Bribery is supposedly illegal in our country. But in our current hypocritical interpretation of bribery in the political context, it is legal as long as it is not explicit (unless you’re a political opponent of someone like Karl Rove).

Our Supreme Court sanctioned this kind of outrage with its Buckley v. Valeo decision in 1976, in which it said that money can be equated with speech and therefore is protected by our First Amendment. The problem with that decision of course is that some people have a lot more money than other people, so by virtue of Buckley v. Valeo they also have much more right to influence legislation through bribery.

The practice also facilitates discrimination in the work place against those who would like to choose not to contribute money to support the political candidates desired by the corporation they work for. Anyone who doesn’t believe that refusal to do that could fatally compromise a person’s job security doesn’t have a very good grasp of reality.

Bill Moyers explains what this all means in his book, “Moyers on Democracy”:


What could be better suited to turn our democracy into a corporate state? How can democracy exist when the rich and powerful have so much disproportionate influence on our elections and the legislation passed by our Congress? No wonder our elected representatives are so far to the right of the American people.