I want to delve more deeply into how the health insurance industry won its vision of health care reform at the expense of the vast majority of Americans. The industry played both sides of the U.S. two-party system. The industry does this by giving politicians and parties millions of dollars, by employing former politicians and party staffers as lobbyists and executives, and by sending those lobbyists and executives back into the party machinery.
As I pointed out in my last column, the medical-industrial complex (health insurance companies, pharmaceutical companies, etc.) gave Obama the largest amount of money it has ever given any presidential candidate, $19 million, and it gave the Democrats $90 million in total. It gave the Republicans slightly less, $76 million. This makes perfect sense. The Democrats controlled the White House and both houses of Congress (with a majority in the House and a supermajority in the Senate), so the industry gave them the larger, unprecedented sums. But even though the Republicans couldn’t actually block the bill on their own (the Democrats passed the bill in 2010 when they still held majorities), the Republicans could still drum up a media spectacle and rally their base, providing the Democrats with pressure and the industry with leverage.
The industry insiders who shaped the bill included Nancy Ann DeParle. Obama appointed her his chief health care adviser, after she spent more than a decade working for for-profit health industry firms such as DaVita, Medco Health Solutions, Cerner, and Boston Scientific.
Then there’s the pivotal Democratic Senator Max Baucus, chairman of the Senate Finance Committee, who orchestrated the first Senate meeting of interested parties to discuss health care reform and played a large role in debates and writing the bill. Representatives from pharmaceutical groups, insurance companies, HMOs, and hospital management companies were all invited. Representatives from groups calling for single-payer healthcare were barred from the meeting; none were invited, and advocates, doctors and nurses were arrested and removed.
Why? Money and personal connections. Baucus has been given nearly $4 million by the "health" sector, more than almost any other senator. Baucus also has at least two-dozen ex-staffers working as lobbyists on K Street, more than 96 other senators. Many of these ex-staffers work in health industry lobbying. In fact, two of his former chiefs of staff have founded their own health industry lobbying firms. This is how lobbying works best. These ex-staffers now-lobbyist-bigwigs have a direct connection to Baucus. They have his ear. They know that they can help him and he can help them. Baucus is actually infamous as K Street’s favorite Democrat.
But it isn’t just Baucus. Ten of the thirteen Democrats on the crucial Senate Finance Committee were connected to at least twenty different former staff members who became health industry lobbyists. And at the end of the day, even normally dissident progressives such as Democratic congressmen Conyers and Kucinich bowed down to the party line, paid for by the industry. House speaker Pelosi pressured them to withdraw a single-payer bill that Conyers himself had put forward. Obama had a one-on-one talk with Kucinich on Air Force One and that was the end of their principled stand for single-payer healthcare.
At the same time as the industry corrupted any chance for health care reform from the inside, they bombarded it from the outside. The health industry and its allies like the US Chamber of Commerce and the Koch brothers funded anti-reform and Tea Party organizations to make it seem as if there was grassroots pressure against health reform. This gave the industry and anti-health politicians leverage in meetings and debates.
Ironically, however, the Republicans have been railing against a bill they would have gladly passed had they been in power. This partially explains the unlikely "ally" that Obama found in the Supreme Court. While Romney denounces "Obamacare," he signed fundamentally the same bill in Massachusetts. In fact, when one takes a look at the outlines of Obama’s healthcare reform plan – a mandate requiring all people to buy health insurance, taxing health care benefits for those with good benefit packages, cutting $500 billion from Medicare to finance the plan, giving the industry $447 billion in federal subsidies – one sees these are the same outlines put forward by the conservative Republican alternative to the 1993-94 Clinton plan.
There are many, many more dirty connections and infuriating capitulations than can fit here, so instead I will write what I think we must do to win. We have to build an independent, fighting movement for universal healthcare from the ground up, starting with local struggles such as the fight for single-payer in Vermont and the successful struggle that won life-saving liver transplants for two undocumented immigrants in Chicago. Only through these kinds of struggles can we expose the crooked priorities of the for-profit health care industry and push for the sane solution, affordable healthcare for all.