OurFuture.org Blogs: Tom Sullivan

Which Public Is That?

Tom Sullivan — Thu, 05 Nov 2009 21:05:50 -0800

The Beltway cognoscenti keep telling us that a bipartisan solution to health care reform is what the public wants. Just what public is it that's more interested in process than results?

Conventional wisdom says that Obama has failed to make Washington more bipartisan if Democrats ram through a health reform bill without Republican support. That would be the Republican support that House Republican whip Rep. Eric Cantor just swore Democrats will never get. “[N]ot one Republican will vote for this bill," Cantor told a “tea party” crowd on Thursday.

Republican strategist Mike Murphy from Thursday’s Morning Edition (NPR):

… I think the great mistake of the Obama presidency, the thing that has taken his numbers among the critical independents who put him in office from very high to low now, is they were elected as a bipartisan problem solver, almost a post-partisan politician. But from the day they've been in, they got a little drunk on the power and they've governed as a one-party liberal party. It's been more of the Democratic dogma, particularly in the House under Pelosi.

And while they have the pure political power to force some things through with their majorities, the Democrats, in my view, are governing too far to the left. They're losing the middle of the country.

Put aside for a moment the up-is-downisms. The public is disillusioned because, as Murphy suggests, Democrats aren’t being bipartisan enough? Or is it really because they have accomplished too little in trying to placate an avowedly obstructionist opposition party?

Observe the coverage of the off-year elections. It is the end of the honeymoon, says Murphy. The media made it out to be a turning point for the White House -- picking up two House seats is, of course, bad news for the Democrats. It's a wonder television news didn't brand the coverage with a catchy name and trademarked graphics.

This should give health care reformers in Congress pause, suggest our media mavens. Why?

Suspense, drama, conflict and histrionics are the stuff of good TV. One would think the media would be egging on Democrats to use the reconciliation process to pass health care reform – with a public option. Think of the ratings. You ain't seen nothin' yet.

See Rep. John Boehner crying on the House floor, streaking his bronzer! Hear Congresswoman Michele Bachmann declare President Obama the antichrist on the steps of the Capitol! Experience the riveting oratory of Joe the Bummer! Watch conservatives in Congress rend their garments as tea partiers fling themselves onto a pyre of burning Constitutions!

Now that’s must-see TV. So why is our “liberal” media suggesting that that would be the worst that could happen? For whom, exactly? It is because the corporate titans behind mass media have a vested interest in seeing health reform fail?

There are more questions than answers.

What public is it that would rather have a bad bipartisan bill rather than a more robust single-party one? The public that's disenchanted because health reform has not been passed already? The majority of Americans that consistent polling shows want a bill with a public option? The people already suffering under a failed and costly health care system? The pragmatic average Joes who go to see Larry the Cable Guy shout "Git ‘Er Done!" from the stage?

That public is more interested in process than results?

Lucky or Good?

Tom Sullivan — Mon, 02 Nov 2009 07:06:05 -0800

The congressman’s staffer said her goodbyes and left the service desk. The cashier, pleasant-looking and about fifty, had listened to the health care conversation from behind the counter. Now that it was just the two of them, she opened up to my wife.

It has been a bad three years. She had been healthy, she said, until she developed a blood disorder. After the diagnosis, her health insurance was cancelled.

There has been a string of cancers diagnosed in her family – six or seven – including her father. The stress on the family is severe. Her mother had a stroke.

But she is lucky – blessed she said – to have this new job. And in this economy, she’s right. The health benefits are especially good. The women’s clothing company is a big supporter of the Susan G. Komen for the Cure movement to fight breast cancer.

Lucky for her again. Since taking the job, she has been diagnosed with breast cancer. Fortunately, her employer is supportive.

Because what with her mother’s stroke, she didn’t want to stress her parents further. She avoided telling them about her breast cancer until she began radiation treatments recently.

They say it’s better to be lucky than good. That is employer-based health care in America. The lucky get treatment until they are too sick to work and their employer has to let them go. Business is business.

It is a good thing the cashier likes her new job. She had better not lose it – for any reason. She’ll lose her insurance too.

Wide-eyed, it had never occurred to her that she could call her congressman or senators and tell them her story, that they might actually listen. My wife urged her to visit or call, and soon.

Because very soon, all of America will find out if they’re listening and if we're lucky.

The Public Necessity

Tom Sullivan — Mon, 26 Oct 2009 00:55:37 -0700

The health care debate – with its leaks, mixed signals and close-to-the-vest dealing – has reform supporters losing their cool while Obama, infuriatingly, maintains his. The uncertainty has strained the tenuous loyalties of a fickle American left. How much talk about "triggers" is real, how much is process, and how much is rope-a-dope?

David Dayen defines the problem for Firedoglake:

Is the White House “insisting” on triggers to take the heat off of Harry Reid, who is having trouble finding the last votes for cloture? Are they drawing fire away from Senate moderates? Are they doing it to keep Snowe thinking the White House is on her side? Do they want to pull a switcheroo in conference committee? Do they actually think that the public option will need some time to get right, so a trigger might help to aid that delay? Are these the words of one rogue faction in the White House that can’t stand the public option and the “left of the left”?

Reports about Thursday night’s White House meeting between Senate Majority Leader Harry Reid and President Barack Obama suggest that Obama is not prepared to twist the arms of remaining Senate holdouts to secure a bill with a public option (sans “triggers”), even though that goal now seems within reach:

"Everybody knows we're close enough that these guys could be rolled. They just don't want to do it because it makes the politics harder," said a senior Democratic source, saying that Obama is worried about the political fate of Blue Dogs and conservative Senate Democrats if the bill isn't seen as bipartisan. "These last couple folks, they could get them if Obama leaned on them."

Meanwhile, Obama's Organizing for America (OFA) found its legs on October 20th, generating 315,000 phone calls to Capitol Hill in support of health care reform. While the approved script called for supporting the “the President’s plan for health reform” – whatever that is – many OFA volunteers support a “robust public option.” OFA’s back channel exhortations for supporters to increase the pressure and “win this thing” tell a very different story from the media narrative about a reluctant, unengaged president.

After eight years of Bush-Cheney, the left was primed for the change Obama promised – and thoroughly distrustful of Washington politics, even his. The mixed signals have Obama’s base clinging to the hope that their leader is playing rope-a-dope with opponents, while other progressives are already declaring Obama a conservative.

If it makes them dig in and fight harder, fine.

But Thomas P.M. Barnett's warning to the Pentagon is one to which progressives should pay heed: "we field a first-half team in a league that keeps score until the end of the game." Progressives have to maintain focus and momentum if they hope to punch through the insurance industry’s goal-line defense. “Allies” in Congress won’t manage that on their own. One year after November 2008, will voters again rise to the occasion or remain on the sidelines with an “Obama hangover”?

A society accustomed to sitting on the couch and being passively entertained is one more accustomed to being governed rather than to governing. Once the vote-counting is over, many citizens tune out again until the next election. A colleague echoing the familiar FDR “make me do it” anecdote, noted that few realize just how hard it is for even their favorite leaders to change things themselves without being pushed hard by supporters.

Anna Quindlen argues in Newsweek that the founding fathers engineered our system to resist radical changes of direction, that Obama is a process-oriented centrist more than the populist firebrand progressives thought they were electing, and that health reform therefore may be more incremental than sweeping.

Perhaps. But that very system did not inhibit the Bush administration from taking the country in a radical direction overnight, nor did it stop a population alarmed by those radicals from firing them overnight. Obama didn’t do that. We did.

Quindlen concludes by reminding readers that if Americans want change, they had best not sit back and expect someone else to do it for them, because

“... if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn't want to go.”

OFA got a taste again of what that's like on October 20th. If the rest of America really believes that the health reform it needs is not just a public option, but a public necessity, more Americans will have to get up off the couch and go get it. Neither Obama nor the Democrats will deliver it to their doorstep like a pizza.

What Civilized Country Operates Like This?

Tom Sullivan — Tue, 13 Oct 2009 02:42:18 -0700

You have seen it. The plastic bucket beside the cash register at the convenience store. A photo is taped to it. A child needs an operation. His father lost his job. The family lost its insurance. They are about to lose their home. Can you spare some change?

What civilized country operates like this? In case God-and-country defenders of the status quo need reminding, America’s for-profit health insurance system serves neither.

Reform advocates must hammer away at this relentlessly: health insurance reform is a moral issue more than an economic one.

Nicholas Kristof delivered further proof that the system is morally bankrupt in the October 4 New York Times.

Travis and Michael Waddington hoped to donate a kidney to their father, David, 58, a wine retailer and victim of polycystic kidney disease. PKD had destroyed David’s kidneys. Since the disease is genetic, Travis and Michael needed to be tested for the disease themselves before donating. Yet a positive result might mean the sons might never be able to get insurance. So their doctors advised against getting tested. Another advised getting tested under fictitious names. To protect their sons, husband and wife shot down the idea, even at the risk of David’s life.

Eventually, David received a kidney from a deceased donor, but Michael recently began experiencing PKD symptoms and now faces an insurance nightmare now all too familiar, obtaining affordable insurance – or any insurance – after being diagnosed with a serious illness.

Closer to home, an acquaintance recently donated a kidney to his father under somewhat different circumstances, but with similar risks. Such acts of mercy by organ donors (talk about risky behavior) present insurers with an elective pre-existing condition, and present donors with a moral dilemma. Fortunately, his father’s insurance covered both transplant surgeries. But both the son’s own physician and the transplant surgeons recommended that he say nothing to his insurer. It was illegal to deny coverage or insurance to organ donors, doctors told him. Nonetheless, they often heard of it happening.

Why tempt fate? He told his insurer nothing.

Kristoff calls an insurance system that forces patients into such impossible choices, “the disgrace of the industrialized world.”

But that’s putting it mildly. As T.R. Reid puts it in The Healing of America, our system is virtually a worldwide laughingstock. One thing on which experts at international health care symposia can agree, Reid explains, is that the U.S. for-profit insurance system is a mess. “Bashing the U.S. system is a standard agenda item.”

Joanne Ford, a patient on Social Security disability and wearing Coke-bottle eyeglasses, arrived for a Remote Area Medical free clinic in Knoxville. She came hoping to get a new pair for free. But nearly last in line, she almost missed her chance. Interviewed by 60 Minutes, Ford said tearfully, “I am sad that we are the wealthiest nation in the world and we don’t take care of our own.”

Even the socialist bogeymen of Europe treat their own better.

For-profit insurance can be cruel and capricious, not unlike the age of Dickens that Keith Olbermann invoked in a recent hour-long commentary. America’s uninsured have "a 40 percent higher risk of death than their privately insured counterparts," a new Harvard study finds. Furthermore, 45,000 Americans a year die from lack of health insurance. Like Dickens’ London, America’s working poor too often are either invisible or else blamed as surplus population –– impediments to the economic fortunes of their “betters.”

It is a seasonal tradition to revisit cherished redemption stories during the coming dark nights around the solstice, to refresh human connections not just to family and friends, but to our fellow men. Defenders of the status quo, especially, need to refresh theirs.

America would do well to revisit those redemption stories earlier this year as it considers how best to rehabilitate a business more informed by Wall Street than A Christmas Carol. For-profit health insurance is rare in the civilized world, and rightly so. It is a cold-hearted business more interested in serving the numbers on its balance sheets than the humanity behind the numbers.

That calls into question the humanity of its defenders, like the conservative radio icon who brags about taking on all comers with half his brain tied behind his back. That would be the feeling half. The human half. The half that Messrs. Scrooge and Potter let atrophy as an impediment to being good men of business.

Right now, a popular caterer downtown has posters on her door. A child needs an operation. A strawberry blonde boy in an adult-sized straw hat. He has a severe immune deficiency disease. He is with his parents at Duke University Medical Center for a bone marrow transplant. There's a pancake breakfast to raise money.

You might as well hold a bake sale to buy a bomber.

What civilized country operates like this?

If You Like Medical Bills, You’ll Love These

Tom Sullivan — Mon, 21 Sep 2009 01:28:43 -0700

Activists in the blogosphere are studying well over 500 amendments to Sen. Max Baucus’ Senate Finance Committee health care reform bill, including three “public option” amendments. All sides will hotly debate, soundly trash, and amend the hell out of the Baucus bill, H.R.3200 (on the House side) and any others that come out of the woodwork by October.

But those aren’t the only kind of bills Americans should be worrying about.

My sister died at 37 from a metastatic sarcoma (the same cancer that took Ted Kennedy, Jr.’s leg). I watched her die, went to her funeral, and then went back to her apartment to sift through stacks of medical bills.

In exhaustion and grief, we couldn’t tell which bills were paid, which were not, which were rejected, which were under review, and which were still in the pipeline and wouldn’t arrive for weeks or months. This doesn’t happen in most industrialized countries and shouldn’t happen here. It's a disgrace, a disgrace that none of the bills pending in Congress will cure. A disgrace that health insurance conglomerates and their allies in Congress are fighting hard (and spending hard) to preserve, along with the profits the billing process helps generate.

Over 60 percent of personal bankruptcies in the U.S. are from medical bills. Over three-quarters of those are in families who had health insurance, were probably satisfied with it, and thought their coverage was adequate until a serious illness proved otherwise. But it's the burdensome billing process itself that the health care reform debate has not addressed.

At the America’s Future Now! conference in June, Dr. Salomeh Keyhani of Mt. Sinai Hospital detailed the number of weeks doctors, nurses and their staffs spend each year dealing with insurance paperwork and procedures. Insurers make it as difficult as possible for customers to collect. Bottom line: if patients and doctors get frustrated and go away, the insurer won’t have to pay. Keyhani described the labyrinthine claims process as “passive aggressive” by design.

Keyhani's name came up again last week in connection with a nationwide poll published in the New England Journal of Medicine. Keyhani helped conduct the survey funded by the Robert Wood Johnson Foundation of 5,000 physicians representing a spectrum of specialties and regions, including American Medical Association members. The survey, Keyhani told NPR, found that "nearly three-quarters of physicians supported some form of a public option, either alone or in combination with private insurance options." That included AMA members, whose organization opposes a public option.

Yet only a single-payer-style plan promises to eliminate the mountains of bureaucratic paperwork that make our patchwork system cost nearly twice what other advanced countries pay. But since a nationwide single-payer system is off the table, even if a strong public option gets to the president's desk, most Americans will be sifting through confusing stacks of insurance paperwork for years to come. Some reform.

The anti-reform forces had their Tea Party in Washington on September 12. They offered no alternatives and screamed loudly about not being heard, but not loudly enough to drown out a majority that decides to speak with one voice.

President Obama must know that he has only to say the word and a sea of pro-reform supporters will travel to Washington in support of real reform and a robust public option. If summoned, supporters should bring their collections of medical bills, rejection letters and appeal forms and wave them overhead.

Talk about “Don’t Tread On Me.” Medical insurance paperwork is universally recognized and universally loathed. It could serve as a potent symbol of everything wrong with America’s dysfunctional, for-profit health insurance system.

Reform supporters might, en masse, flood congressional fax machines with their medical bills. Or stage media events with fax machines set up in public spaces for patients to fax their medical bills to Congress -- just to put an exclamation point on demands for meaningful reform.

There's something viscerally satisfying about feeding documents into a fax machine and knowing they're spitting out onto the floor of your congresscritter’s office. It's the next best thing to being there.

What Does Happen Here

Tom Sullivan — Mon, 14 Sep 2009 01:17:47 -0700

Last weekend, tens of thousands of health reform protesters prompted by Glenn Beck descended on Washington. They fear America is turning fascist because Barack Obama wants health insurance reform that reduces cost, guarantees choice, and is affordable and high quality for every American.

Diabolical.

The 1930s had Father Coughlin, the inspiration for Sinclair Lewis’ Bishop Prang in “It Can’t Happen Here.” We've got Glenn Beck.

But it was Nicholas Kristof’s commentary, "The Body Count," in Sunday’s New York Times that brought the phrase “it can’t happen here” to mind for another reason. Kristof cites T.R. Reid’s “The Healing of America” and the tragedy of Nikki White.

Diagnosed with lupus at 21, Nikki became too sick to work, lost her job and lost her insurance. Collapsing in her home made Nikki eligible for free emergency room care. Twenty-five emergency surgeries and six months of critical care later, Nikki lost her life needlessly at age 32.

“Nikki didn’t die from lupus,” her doctor told Reid. “Nikki died from complications of the failing American health care system.”

That can and does happen here. Kristof laments,

After Al Qaeda killed nearly 3,000 Americans, eight years ago on Friday, we went to war and spent hundreds of billions of dollars ensuring that this would not happen again. Yet every two months, that many people die because of our failure to provide universal insurance — and yet many members of Congress want us to do nothing?

Nothing is just the alternative Beck’s paranoid patriots offer to reform proposals in Congress. You find only the “spitting, incoherent rage” Paul Krugman observes, not policy alternatives on their posters. They can tell you what they think the way forward isn’t, but just try asking what they think the way forward is.

Obama’s Organizing for America collected many thousands of health care horror stories. Yet those stories, like Nikki White’s, make no impression on Americans blinded by inchoate fear of the Other — any more than warnings about hot stoves make an impression on small children until they burn their fingers. Until it affects one of their own, it’s someone else’s story, someone else’s child, someone else’s problem.

It is an impoverished view of America protesters hold, all patriotic symbolism but lacking a soul. It is an America they will defend with their lives and their sacred honor, but not with their fortunes, HELL NO. Their taxes might help those who are not “real Americans,” people not of their tribe — My family, My friends, My neighborhood, My church, My ethnic group — or people who don't share My opinions.

“Don’t Tread On Me” is their battle cry — emphasis on “Me.” There is no "we" in their America, no welcome for your tired, your poor, your huddled masses of Americans, much less immigrants. E pluribus unum is Greek to them. They have reduced freedom to a fetish.

This is the kind of cheap, plastic, made-in-China patriotism you buy at Wal-Mart at everyday low prices — all packaging and empty on the inside.

Sadder still is seeing corporate capitalism crudely alloyed with and sold as Christian faith. Bill McKibben critiqued the trend in the August 2005 issue of Harpers. Three-quarters of Americans wrongly believe “God helps those who help themselves” comes from the Bible. This Benjamin Franklin quotation isn't just not biblical, McKibben observed, “it’s counter-biblical.” Yet how neatly it reinforces the gospel of self-interest preached by conservatives. McKibben writes,

How nice it would be if Jesus had declared that our income was ours to keep, instead of insisting that we had to share. How satisfying it would be if we were supposed to hate our enemies. Religious conservatives will always have a comparatively easy sell.

“It's hard to imagine,” he continues, “a con much more audacious than making Christ the front man for a program of tax cuts for the rich or war in Iraq.” And yet, it is a con Americans in significant numbers not only embrace, but celebrate as heroic, noble and Christian.

Kristof considers the issue of how America cares for its sick a moral one: “Do we wish to be the only rich nation in the world that lets a 32-year-old woman die because she can’t get health insurance? Is that really us?”

But can a people who don’t know the Bible from Ben Franklin really know who they are? As Allan Bloom complained two decades ago, Americans have little idea where many of their bedrock “American” ideas hail from (Europe). Or simply believe they thought them up on their own.

As a result, the conservative rank-and-file who disrupted town hall meetings have got their Edmund Burke, Ayn Rand, and Friedrichs Hayek and Nietzsche — all of whom most have never read — so confused with their Jesus Christ that they have no idea where one ends and the other begins. No wonder, as comedian John Fugelsang suggests, they want a Christian nation that denies healing to the sick.

It’s The People Who Got Small

Tom Sullivan — Mon, 10 Aug 2009 01:03:49 -0700

The organized intimidation and minor violence at health care town halls around the country is cause for concern. Sara Robinson asks the question, Is it fascism yet?

But so far, the "shock troops" who have shown up here (Americans for Prosperity) got off their tour bus armed only with signs, beer guts and Ban Lon. Others protesting socialized medicine at town halls around the country are pensioners already on "socialized medicine," i.e., Medicare. TBogg calls them the "Creamed Corn Mafia."

The upside of last November's election is that young people supported Obama overwhelmingly and overwhelmingly support health care reform. When town hall protests begin attracting large numbers of foot soldiers youthful enough and fit enough to engage in organized violence, be afraid.

That's not to say that there will be no violence from these protests until then. The line between a personal responsibility crowd and a diffused responsibility mob is a thin one. A mob of any age can do serious harm before even its members realize what they've done.

Some recent town hall protesters were inspired by Glenn Beck's 9/12 Project. One of his 9 Principles is a threat against "you", as in "If you break the law you pay the penalty." The remainder are "self" centered, built around me and mine. Per Beck's folksy-kitsch, that's probably because there's a me in America, but not a we.

Principle #7 is important to health care protesters: “I work hard for what I have and I will share it with who I want to. Government cannot force me to be charitable.”

My point exactly. Protesters are inflamed by the idea that a black president might use their tax dollars to help people not of their tribe. Or, as Frank Schaeffer wrote last week:

"They can't reconcile their idea of themselves with the fact that white men like them don't run the country any more -- and never will again. To them the black president is leading a column of the "other" into their promised land. Gays, immigrants, blacks, progressives, even a female Hispanic appointed to the Supreme Court... for them this is the Apocalypse."

"E pluribus unum" has been on our money and national seals dating from the founding of the republic. "Out of Many, One." Yet, for all the patriotic chest-thumping and flag-waving, protesters seem to have missed that spirit behind the whole America thing. E pluribus unum is Greek to them.

Thankfully, wiser men created the republic they merely inherited.

During World War II, Americans sacrificed for it at home and died for it abroad. They pulled together. They defended the world from tyranny, sure, but in the fog of war many died, not for abstracts like freedom or democracy, but for the guy beside them.

People thought better of the general welfare then, before Cold War paranoia confused promoting community with promoting communism.

Moral forces, not market ones, broadened individual rights and made American democracy more perfect. New Deal and post-war programs served public goals and produced broad prosperity. They improved infrastructure, promoted small businesses and allowed millions of veterans to attend college and own homes. They spurred technological innovation, conquered disease, and created a military and economic superpower - all while allowing our parents and grandparents to enjoy healthier retirements with security and dignity.

Bent on tearing that down, conservatives have made America an abstraction they pledge to support with their lives and their sacred honor, just not with their fortunes. It's every man for himself - hardly the spirit that led this country to the greatness they don't have the stomach for. Their time is past.

With apologies to Billy Wilder:

“You’re the United States of America. You used to be a world leader. You used to be big.”

“I am big. It’s the people who got small.”

Death Tax for the Rest of Us

Tom Sullivan — Thu, 09 Jul 2009 05:46:53 -0700

Art and Edna (not their real names) are long-retired and both are having memory and other health troubles. Their son and daughter-in-law have taken them in to see to their care. Even in a down market, Art and Edna’s small home in Florida sold quickly. Too quickly.

Within months, their son and daughter-in-law realized that the seniors would need more care than the working couple could provide at home, so they began looking at nursing homes – a costly option. Because the seniors have few resources, their relatives applied for Medicaid assistance. But because they now have cash from the home sale, they are not poor enough, and thus ineligible for Medicaid.

Had they transferred their home to their son and daughter-in-law instead of selling prior to their application, Medicaid would have picked up the nursing home costs. Now, after long, productive lives, Art and Edna will turn over their remaining money – and probably a lot of their childrens’ – to America’s for-profit health industry to pay for nursing home care until they are poor enough to qualify for Medicaid. Unless they die first.

Under America’s for-profit health care system, this is the real Death Tax. And a majority of Americans will pay it.

Bringing Wellness to an Insurance Fight

Tom Sullivan — Sun, 28 Jun 2009 19:48:44 -0700

Twice now, when asked his position on single-payer health care or a public option, our congressman launched into a dissertation on the problems of junk food and childhood obesity, and how wellness must be part of any health care reform. [Full disclosure: I worked on his first campaign.]

The first time, it just seemed like a pretty odd segue. But okay, who can be against wellness or reducing obesity?

The second time wellness made an appearance, it was head-scratching strange. Constituents come to talk about insurance and end up hearing about fat kids and eating more fruits and vegetables. And personal responsibility. Who can be against personal responsibility?

So, what's going on? Why are we bringing wellness to an insurance fight?

The wellness meme has been circulating widely on Capitol Hill of late. It pops up with talking-point regularity in House and Senate hearings on health care reform, among insurance CEOs and among politicians in the habit of calling for “clean” bills uncluttered by side issues.

Some Democrats may hope wellness, prevention and personal responsibility elements will be the sugar that makes the reform medicine go down for Republican obstructionists. But they are also rather convenient distractions for health insurance giants eager to divert opprobrium from their bad habits – rescission, for example – to their customers’.

“I’m sorry, Senator, but how can we agree to keep insurance costs down and not rescind cancer patients' coverage when our customers are fat? Do you realize that obesity in America is....”

Congress seems nervously eager to water down any form of public insurance option. Co-ops and triggers have been attacked as obvious gimmicks for sabotaging a robust public option. However, it is harder to find fault with promoting wellness and reducing obesity.

So, what could be wrong with encouraging Americans to eat more vegetables? Why not include wellness provisions in a health insurance reform bill?

For one, because the food industry is big business.

A recent Guardian article profiled anti-junk food activist, MeMe Roth, and her one-woman crusade, National Action Against Obesity. But someone else provided the money quotes:

Marion Nestle, the author of Food Politics and professor of nutrition, food studies and public health at New York university, explains that "the basic problem is that if people are going to do something about obesity, they need to eat less, and eating less is bad for business. The food industry is a trillion-dollar-a-year business." Nestle tells me that 3,900 calories are produced per capita every day - roughly twice the average need. "We're talking about capitalism here," she says. "It was very difficult for the Bush government in particular - they couldn't tell people to eat less." Couldn't they? I ask. "Well, they could if they hadn't cared about getting elected."

Nestle also argues that nutrition and medical societies won't act because they are funded by the food industry.

To date, the health care reform fight has been mainly with the powerful, well-funded insurance and pharmaceutical lobbies. Add harmless-sounding wellness provisions to insurance reforms, however, and you invite the food industry to start throwing its money into the fight as well. Achieving the meaningful insurance reform that the public demands is going to be hard enough without inviting another family to the feud.

Promoting healthier lifestyles is good policy. But for the American people, passing health care reform is fundamentally about their health insurance. It should remain fundamentally about their health insurance. Passing a separate bill specifically designed to promote wellness and fight obesity would make a dandy encore.

Our elected leaders' first priority should be to make sure that all Americans can get health coverage as good as theirs. They can tackle problems like reducing Denny Hastert’s girth later.

Not the Health Care Co-ops They Had in Mind

Tom Sullivan — Tue, 16 Jun 2009 23:25:28 -0700

Efforts continue in the Senate to water down any public health insurance option included in comprehensive health care reform, regardless of what 83% of the American public wants.

First it was the trigger provision designed never to be pulled, like that floated by Sen. Olympia Snowe (R-ME). Last week, Sen. Kent Conrad (D-ND), proposed creating non-profit health insurance cooperatives. Politico dubbed it "a potential game changer." Jacob Hacker called it Conrad's co-op cop-out.

Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, supported the co-op proposal, saying, “I am inclined, and I think the committee is inclined, toward a co-op.” Iowa Sen. Charles E. Grassley, the panel’s senior Republican, said, “If it can be presented... as an entirely private-sector operation and is like co-ops we know generally in the Midwest, I think it's got some possibilities."

Fine. Here is one possibility we could see and, given the abandonment of single-payer and what looks like a systematic effort to sabotage the public option, a co-op that a growing number of Americans would gladly join:

Democratic Party Lays Plans for Insurance Cooperative

Democratic Party insiders have quietly begun laying plans for a national nonprofit insurance cooperative owned and operated for the benefit of its members.

Inspired by an idea suggested by Senate Budget Committee Chairman Sen. Kent Conrad, D-N.D., the proposed plan, code-named Trenton, would be open to all registered Democrats and their families.

Leaders from both major parties have declared a single-payer health care plan dead on arrival in the U.S. Senate.

This month, Rasmussen’s partisan identification survey estimated the number of Democrats at 39.4% (leading Republicans by 6.8 percentage points). Dr. Michael McDonald of George Washington University recently estimated the 2008 voting-eligible population in the U.S. at roughly 213 million.

By those estimates, nearly 83 million Democrats and their families would be immediately eligible, with another 60 million independents up for grabs. When launched, Trenton could attract the largest single pool of insurance customers in the United States.

“We’re looking at a pool with far more bargaining power for driving down costs than the VA," said an unidentified official.

The proposed Democratic insurance co-op would not deny coverage to patients with preexisting medical conditions.

It's not a headline many on Capitol Hill, in Big Pharma or Big Insurance would welcome, and certainly not the co-op Kent Conrad envisions. But it's one alternative frustrated Democrats have kicked around for years.

Why? Because their own politicians – those in a position to deliver real health care reform – are too weak to stand up for what 83% of Americans want. Because GOP spokesmen are too busy parroting Frank Luntz's advice on how to defeat reform; they don’t care what 83% of Americans want. Because too many senators from both major parties are just as bought-and-sold as Illinois Democrat Sen. Dick Durbin recently acknowledged.

In her career, Sen. Blanche Lincoln has taken $1.8 million from health and insurance interests (according to Open Secrets) and is understandably noncommittal about supporting real reform. The Arkansas Democrat is also up for reelection in 2010. Blue America is preparing to target her district with television ads to remind her who she really works for.

The Change Congress and Gov. Howard Dean’s Democracy for America will cooperate in targeting Louisiana Sen. Mary Landrieu (D-LA), for her reluctance to support a public option. They plan to employ direct mail, e-mail and television ads. Landrieu has taken $1.6 million from health care and insurance interests.

Robert Reich warns that Big Pharma and Big Insurance are "pulling out all the stops" to kill the public option. They can expect opposition.