Why This Isn’t the Time for a Public Option or Medicare for Some
By Margaret Flowers – Health Over Profit – March 28, 2017
This has been a tumultuous week for healthcare reform. First there was the pleasantly quick defeat of the American Health Care Act in the House of Representatives Friday afternoon. Then, that evening, Senator Sanders spoke at a town hall in Vermont with Senator Pat Leahy and Representative Peter Welch where he announced that he would introduce a Medicare for All bill. Medicare for All and Bernie supporters lit up social media with their excitement over the announcement. This should have been great news, but it wasn’t exactly.
Over the weekend, more information was revealed in a series of interviews with Sen. Sanders. Sunday, he said on CNN that single payer legislation wouldn’t have the votes, so the first priority will be to improve the Affordable Care Act (ACA) with a public insurance, called a public option, and possibly lowering the age of Medicare eligibility to 55.
There are a number of reasons why this isn’t the time for tinkering with the ACA. We have a healthcare crisis now and the means to solve it. The ACA is fundamentally flawed and cannot be tweaked into a universal program. And Sanders’ proposals are exactly the same ones used in 2008-10 to divide and weaken the movement for National Improved Medicare for All. We can’t be fooled into going down that path again.
The Current Crisis and its Solution
Right now in the United States almost 30 million people have no health insurance. On top of that, tens of millions of people who have health insurance can’t afford health care. When people experience a serious accident or illness, they face a stark choice: seek care and risk financial ruin or go without it and risk disability or death. Hundreds of thousands of families go bankrupt each year due to medical illness and an estimated 29,000 people die each year due to lack of access to care.
Think about how the country galvanized when 3,000 people were killed in the attacks on 9/11 or when the 2,000th soldier was killed in Iraq, but that amount of death happens ten times a year or more in the US and we hardly hear a peep of outrage.
Health outcomes in the United States are not very good. A recent study found:
Notable among poor-performing countries is the USA, whose life expectancy at birth is already lower than most other high-income countries, and is projected to fall further behind such that its 2030 life expectancy at birth might be similar to the Czech Republic for men, and Croatia and Mexico for women. The USA has the highest child and maternal mortality, homicide rate, and body-mass index of any high-income country, and was the first of high-income countries to experience a halt or possibly reversal of increase in height in adulthood, which is associated with higher longevity. The USA is also the only country in the OECD without universal health coverage, and has the largest share of unmet health-care needs due to financial costs.
Yet, of all of the industrialized nations, the United States spends the most per person on health care, in some cases double the amount and those countries cover everyone. We are already paying for universal comprehensive health coverage, but we aren’t getting it because the bottom line of the system in the US is profits for a few rather than health for all.
The US has the most complex and heavily bureaucratic system in the world because it is a market-based system with a few public programs to try to fill in the gaps. A third of our healthcare dollar goes to administration for the hundreds of different insurance plans with their differing coverage, networks and rules. And we pay the highest prices, by far, for health services and pharmaceuticals because there is no rational system to set a fair price.
To begin to solve the healthcare crisis in the US, we need a system that is based on health and the money to pay for it. The proven solution is a universal not-for-profit, publicly-funded system that provides all medically-necessary care. House Resolution 676: “The Expanded and Improved Medicare for All Act,” which has 72 co-sponsors, is the model for that system. This would address the fundamental causes of the healthcare crisis.
The good news is that not only do we have the money to pay for this system, but there is also widespread support for it. For decades many independent polls have shown more than 60% support by the general public, plus more than 80% support by Democratic Party voters, rapidly growing support by Republicans who earn under $75,000 and majority support by health professionals.
Why a Public Option and Medicare for Some Plans will fail
Steve Bannon, President Trump’s chief strategist, had an interesting statement in the New York Magazine recently. He criticized the Republican’s American Health Care Act (AHCA) because it was “written by the insurance industry.” That same criticism can be made of the Democrat’s ACA, which was basically written by Liz Fowler, a former executive for WellPoint. She also oversaw the regulations’ process.
The ACA is fundamentally flawed because it treats health care as a commodity, not a public necessity. It has achieved the best that it can do, and similar to other attempts at the state level that don’t address the roots of the crisis, it is starting to deteriorate with stagnant coverage and rising premiums and out-of-pocket costs.
Attempts to improve the ACA with a public insurance or Medicare for some will bring coverage to a few more, but they will similarly fail over time because they will not change the system or control healthcare costs.
Sen. Sanders and others are pushing a public option. This would be a public insurance that people could choose instead of private insurance. It sounds good in theory but has not worked in practice because it draws the sickest patients and struggles to cover their care while keeping premiums and out-of-pocket costs affordable. Private insurers are experts at attracting the healthiest enrollees. In fact, I have argued that a public insurance is just what the private insurers want (though they are unlikely to admit it) because it serves as a relief valve to take sick people off their hands. That leaves private insurers to focus on the young, employed and wealthy, from which they can collect premiums and who won’t need much in the way of health care.
Sen. Sanders is also raising the possibility of lowering the age of Medicare to 55, just as Alan Grayson suggested in 2010. This is another gift to the insurance industry because it takes a group that is more likely to have health problems off of their books. It will place more of a burden on the Medicare system without bringing the cost savings needed to cover health needs. I call this Medicare for some to contrast it with Medicare for all.
The basic reasons that Medicare for all works are because the administrative simplicity of one universal plan provides over $500 billion a year in administrative savings and its ability to negotiate fair drug prices means over $100 billion per year in savings on pharmaceuticals. The savings offset the cost of paying for care and getting rid of out-of-pocket costs that currently keep people from seeking necessary care.
Rather than wasting time and effort on a public option or Medicare for some, which will still leave people out and maintain the high costs of health care, we need to mobilize to win national improved Medicare for all. Like other industrialized nations, we need to create a universal high quality health system. It doesn’t make sense to leave anybody out when we have the resources to achieve it and public support for it. The only thing lacking is support from members of Congress. But as we witnessed last week with the defeat of the AHCA, changing the minds of members of Congress is within the power of the public.
The public option and Medicare for some are being used to divide and distract supporters of Medicare for all in order to weaken them and make them believe they are asking for too much, just as happened during the health reform efforts in 2008-10. We can’t be taken off track again.
What is the real purpose of a public option or lowering the age of Medicare when neither is an effective nor a lasting solution? It is only because the Democrats are unwilling to take on the powerful health insurance and pharmaceutical industries. The problem is that we can’t solve the healthcare crisis until we do.
Margaret Flowers is co-director of It’s Our Economy, co-host of Clearing the FOG Radio and an organizer of the occupation of Freedom Plaza in Washington, DC. She is also with the Health Care is a Human Right campaign in Maryland.
US Decision to Sanction Russian Companies Pre-Dates Trump Administration
© Sputnik/ Michael Klimentyev
Sputnik – 28.03.2017
WASHINGTON – The US decision to impose new sanctions against Russian entities was made during the final days of President Barack Obama’s administration, a Department of State official told Sputnik.
On Saturday, the United States announced new sanctions on eight Russian companies for alleged nonproliferation-related violations. The Russian Foreign Ministry said the move contradicts the White House’s alleged desire to improve relations with Moscow.
“These determinations to sanction this group of individuals and entities were made by the State Department on January 17, 2017… and subsequently reviewed by the incoming administration prior to transmission to Congress,” the official stated on Monday.
The official noted that the sanctions decisions were then delivered to Congress on March 21 as part of a report related to violations of the US Iran, North Korea, and Syria Nonproliferation Act (INKSNA).
The companies affected by the INKSNA sanctions include the 150th Aircraft Repair Plant, Aviaexport, Bazalt, Kolomna Design Bureau of Machine-Building, Rosoboronexport, Ulyanovsk Higher Aviation Academy of Civil Aviation, Ural Training Center for Civil Aviation, Zhukovskiy and Gagarin Academy.
All Sanctions Imposed Against Russian Companies Illegal – Moscow
Sputnik – 28.03.2017
MOSCOW – All sanctions imposed against Russian companies, including Rosneft, are illegal, Russian Deputy Foreign Minister Aleksei Meshkov said Tuesday.
“Only one thing can be said about this – all sanctions taken against Russian companies are illegal. I would propose to this court to familiarize itself with the UN charter. Only the UN Security Council has the political right to announce sanctions against countries and foreign companies,” Meshkov told reporters.
Earlier in the day, the European General Court in Luxembourg ruled that the sanctions adopted by the EU Council against Rosneft were valid.
Rosneft commented on the sanctions by saying that they are groundless and politicized.
Single-Payer Bernie Morphs Into Public Option Dean
By Russell Mokhiber | CounterPunch | March 27, 2017
Right before our eyes, we are seeing the transformation of single payer Bernie Sanders into public option Howard Dean.
During the 2016 Presidential campaign, Sanders took off like a rocket, fueled by the promise of a single payer, Medicare for All single payer system.
His single payer plan paralleled HR 676, the single payer bill in the House of Representatives that now has 72 co-sponsors.
HR 676 is the gold standard of single payer bills.
It would deliver one public payer, no deductibles, no co-pays, lower costs, everyone in, nobody out, no more medical bankruptcies, no more deaths from lack of health insurance and free choice of doctors and hospitals.
That was the promise of Bernie Sanders during the 2016 campaign.
But since then, Bernie Sanders has endorsed Hillary Clinton for President.
Then become part of Senator Chuck Schumer’s Senate Democratic leadership.
And this weekend, Sanders has been telling people he will introduce health care reform legislation in the Senate within a couple of weeks.
But it’s not going to be a companion bill to HR 676.
Instead, Sanders is telling reporters he wants to “move toward Medicare for all.”
“Right now we need to improve the Affordable Care Act and that means a public option,” Sanders tweeted yesterday.
The public option?
That would be the plan put forth by the Democratic corporatist Howard Dean, currently a member of the public policy and regulation practice of Denton’s, the multinational corporate law firm.
Dean got into nasty confrontations with single payer activists who confronted him during the Obamacare debates with questions about his corporatist connections and his support of the public option over single payer.
Don McCanne of Physicians for a National Health Program, the premiere single payer health care group in the country, has argued persuasively that the public option — allowing Americans to opt into a public plan — would not solve our healthcare crisis.
“The tragedy is not so much that on this path we will end up with a public plan that will be only one more feeble player in the dysfunctional market of private plans, but rather that we will, once again, have walked away from single payer, perhaps for decades, because of this meme about lack of political feasibility,” McCanne wrote last year. “Instead of making private plans compete with a public option, we should get rid of them and establish our own single public plan.”
And PNHP, in a paper titled The Public Plan Option: Myths and Facts, says that
“the current Medicare experience combined with experience in many different states that have tried this type of reform shows that public plans are left with the sickest patients and fail due to rising costs while the private insurers continue to collect premiums from the healthiest patients and maintain their high profits.”
Sanders also told reporters this weekend that he would consider legislation that would drop the Medicare age from 65 to 55.
David Himmelstein, a PNHP founder, said that while the public option would be a “modest improvement” and dropping the Medicare age to 55 would be a “good step,” “neither could realize most of the vast savings on administration available under single payer, nor would they achieve universal coverage or address the problems of the tens of millions who are currently underinsured.”
“Introducing a public option will divide and confuse supporters of Medicare for all,” said Margaret Flowers, MD a pediatrician who co-directs Health Over Profit for Everyone, www.HealthOverProfit.org. Flowers is also a member of PNHP. “Senators who should co-sponsor Medicare for all will be divided. Sanders seems to be urging a public option to please the Democratic Party, but Sanders cannot serve two masters – Wall Street’s Chuck Schumer and the people. Sanders must decide whom he is working for.”
“While it might seem politically pragmatic to support a public option, it is not realistically pragmatic because a public option will not work,” Dr. Flowers said. “Senator Sanders knows that and he knows that the smallest step toward solving the healthcare crisis is National Improved Medicare for All. This would fundamentally change our health system that currently treats health as a commodity so that people only have access to what they can afford to a system that treats health as a public necessity so that people have access to what they need. Medicare for all achieves the savings needed to provide comprehensive coverage to everyone.”
“If Senator Sanders believes that it is acceptable to promote a policy that leaves some people out, then we want to know who should be left out. The US is already spending enough to cover everyone and that’s what we need to do.”
“The Affordable Care Act, built on a heavily subsidized private insurance industry, is not possible to fix. The ACA must be replaced by a national health policy that serves the needs of the people by replacing private insurance with publicly-financed Medicare.”
“Sanders wants to lower drug prices,” Dr. Flowers said. “Only a single payer system can negotiate lower drug prices. Sanders says healthcare is a human right, but human rights should not be commodities or profit centers. People do not pay for their human rights.”
“We look to Senator Sanders to act on what he promised during his presidential campaign, a National Improved Medicare for All now, not tomorrow. Tomorrow never comes. It is not up to him to decide if single payer can pass in Congress. That task is for the people to decide.”
Russell Mokhiber is the editor of the Corporate Crime Reporter.
Russia-Iran strategic ties keep US guessing
By M K Bhadrakumar | Indian Punchline | March 26, 2017
For a variety of reasons, Iranian President Hassan Rouhani’s visit to Moscow on March 26-27 will attract attention in world capitals. The scheduling of the visit when there is less than eight weeks left for Iran’s presidential election on May 19 where he is hoping to secure a second term, makes a very important point. To be sure, there is much visible mix-up in the conservative camp in Iran, while the reformist-moderate forces have rallied behind Rouhani. Iranian elections are notoriously unpredictable, but Russia seems to expect continuity in Iranian policies for another 4-year period.
Most European and Middle Eastern capitals will share this perception, and, arguably, even the Donald Trump administration cannot be unaware of it. Nonetheless, a ‘bipartisan’ group in the US senate announced a new bill on Thursday that would impose tighter sanctions against Iran’s ballistic missile program. But then, the announcement comes just before Sunday’s start of the annual conference in Washington of the pro-Israel lobbying group AIPAC, and thereby hangs a tale.
The Trump administration’s tough talk on Iran notwithstanding, Tehran remains committed to the 2015 nuclear deal. The litmus test will be whether Washington holds up its end of the bargain as regards the lifting of nuclear–related sanctions. So far, the Trump administration has done nothing to unilaterally tear up the nuclear deal – and, Iran too has been careful not to give cause to complaint regarding failure on its part in implementing the deal.
On the other hand, the European Union has maintained support for the Iran nuclear deal. At a recent Track II held in Beirut, former Iranian diplomat and a close associate of Rouhani, Seyed Hossein Mousavian gave his prognosis on the US’ options: “They would let the deal go on, but they would try to undo practically the Iranian nuclear deal through many other sanctions under … the umbrella of terrorism, missiles, human rights and regional issues.”
The net result of such new sanctions would be to deprive Iran from the economic benefits of the nuclear deal. However, the US can only create conditions where Iran is unable to optimally reap economic benefits out of the nuclear deal, but not to ‘isolate’ Iran from the world community. This is where Rouhani’s trip to Moscow serves a big purpose for Tehran. Russia is an irreplaceable partner for Tehran today. The reports from Tehran suggest that Rouhani is carrying a substantial economic agenda for discussions in Moscow.
Having said that, for both Russia and Iran, their cooperation is of strategic importance and is hugely consequential on the ground in regional and international politics, especially on the Syrian frontlines. That is why sustained attempts by the West, GCC states and Israel to exploit any daylight in the Russian-Iranian relationship failed to make headway. Writing for the influential Fox News, Frederick Kagan at the American Enterprises Institute – neither a friend of Iran nor of Russia – in an opinion piece titled Pitting Russia against Iran in Syria? Get over it urged the Trump administration to recognise Russia-Iran cooperation as a geopolitical reality for a foreseeable future:
- American policy-makers must get past facile statements about the supposed limits of Russian and Iranian cooperation and back to the serious business of furthering our own interests in a tumultuous region. The Russo-Iranian coalition will no doubt eventually fracture, as most interest-based coalitions ultimately do. Conditions in the Middle East and the world, however, offer no prospect of such a development any time soon.
To my mind, Trump’s policies toward Iran are evolving cautiously and there could be surprises in store. The Iranians seem to understand that although Big Oil wields big clout with the Trump administration and a US-Saudi Arabian reset is in the making, the two sides have divergent concerns in many vital areas and an anti-Iran alliance as such — comprising the US, Israel and Saudi Arabia — seems far-fetched. In a fascinating op-ed last week in the establishment paper Tehran Times, Mousavian wrote:
- The fight against ISIS also cannot be won by America alone. Trump’s… challenge will be to form a new coalition to defeat and destroy ISIS. To be successful, it will need to be far more cohesive and effective than the one built by Obama. Engaging more with the actors most effectively fighting ISIS on the ground, namely Russia and Iran and their allies, will be critical in this regard.
To a great extent, Russia and Iran are sailing in the same boat. Entrenched groups in the US oppose tooth and nail any improvement in the US’s relations with Russia and Iran. However, Russia and Iran will not take no for an answer from Trump administration in the fight against the ISIS in Syria. Both are grandmasters in reconciling contradictions. Both would hope that cooperation over Syria would help them leverage their respective relationship with the US. Mousavian’s opinion piece titled Trump’s ISIS challenge is here.
Arms Race Fears Roused in Sweden by Saab’s Indiscriminate Campaigning
Sputnik – 27.03.2017
As the Swedish manufacturer Saab experiences growing problems trying to market its Gripen fighter jet, the company is forced to try and woo previously unbeknown markets. This, however, has attracted criticism from peace researchers, who claim the move contradicts Sweden’s long-lasting foreign policy goals.
A group of peace researchers from Uppsala University condemned Saab’s campaigning in Botswana, saying the move was in direct conflict with Sweden’s foreign policy goals. These are peace, human rights and poverty reduction, according to an opinion piece published by the Swedish daily Svenska Dagbladet.
In 2016, a high-ranking Swedish delegation, led by Defense Minister Peter Hultqvist, toured Botswana. The subsequent scandal involving ballooning costs diverted Swedes’ attention from more pressing issues, such as Sweden’s plans to market JAS 39 Gripen fighter jets to the African nation. According to peace researchers Johan Brosché, Kristine Höglund and Sebastian van Baalen, the deal is highly controversial, especially given the bribery scandals that followed a similar deal with South Africa.
Firstly, in Botswana, which has long been touted as an African success story in terms of equality, human rights and economic development, democracy has gradually eroded. The country’s government is hardly an eligible partner for Sweden, which is trying to emerge as a champion of human rights on the international arena. Botswana, according to Uppsala University researchers, is clearly heading in an authoritarian direction, with growing surveillance, reduced opportunities for freedom of expression and reprisals against anti-government views.
Secondly, a Saab deal would contradict Sweden’s goal of combating poverty, as Botswana is facing major economic problems. Over a fifth of its population of two million live in absolute poverty and subsist on less than two dollars a day, despite the country’s large diamond resources. The billions to be invested in fighter jets would undermine efforts to curb unemployment, and fight drought and corruption.
Third, the idea of Botswana acquiring a fleet of advanced fighter aircraft may trigger a regional arms race, with Namibia and other neighboring countries to follow suit, with detrimental consequences for everyone but the arms dealers. At present, Botswana is not faced with any direct external threat and it is unclear why huge sums must be invested in the acquisition of advanced fighter jets. Whereas the need to protect the country’s tourism industry, combat poaching and monitor the flow of refugees previously were indicated as reasons, none of these problems can be solved with advanced fighter jets.
The Swedish researchers concluded that the arms deal with Botswana would worsen the economic and democratic development in the country, undermine regional security and mar Sweden’s reputation in Southern Africa.
The Saab JAS 39 Gripen is a light single-engine multi-role fighter aircraft in the same class as Airbus’ Eurofighter Typhoon, the Rafale by Dassault and Lockheed Martin’s Joint Strike Fighter.
Despite Saab’s ambitious hopes for the Gripen to “dominate the market,” the company’s bids were consequently rejected by Norway, Poland, Denmark and the Netherlands. The Rafale and the Eurofighter Typhoon are also regarded as favorites in Malaysia, where the government will decide on an aircraft fleet upgrade.
So far, Sweden remains the largest consumer of the Gripen, with an order of 60 new-generation Gripens placed by the Defense Ministry. Saab’s agreement with Brazil on 36 planes worth 40 billion SEK ($4.5bln) remains the company’s largest overseas success. Other Gripen consumers include South Africa and Thailand, while the Czech Republic continues to rent Gripens from Sweden.
French presidential candidate Le Pen predicts death of EU
Press TV – March 26, 2017
France’s far-right presidential candidate Marine Le Pen says the European Union will “die” and she vows to save France from globalization.
During a Sunday campaign rally in Lille, Le Pen said that the upcoming elections will be the next stage in a global popular rebellion.
“The European Union will die because the people do not want it anymore … arrogant and hegemonic empires are destined to perish,” she added.
She stressed that the time has arrived to overcome globalists, and added that her main rivals in the French presidential elections, conservative Francois Fillon and centrist Emmanuel Macron, were both guilty of treason because of their pro-EU and pro-market stances.
Le Pen added that she would replace the EU with a different Europe which she said would be called “the Europe of the people.”
“It must be done in a rational, well-prepared way,” she said in interview with Le Parisien daily. “I don’t want chaos. Within the negotiation calendar I want to carry out … the euro would be the last step because I want to wait for the outcome of elections in Germany in the autumn before renegotiating it,” she added.
Russia’s banking system has SWIFT alternative ready
RT | March 23, 2017
If the Society for Worldwide Interbank Financial Telecommunication (SWIFT) is shut down in Russia, the country’s banking system will not crash, according to Central Bank Governor Elvira Nabiullina. Russia has a substitute.
“There were threats that we can be disconnected from SWIFT. We have finished working on our own payment system, and if something happens, all operations in SWIFT format will work inside the country. We have created an alternative,” Nabiullina said at a meeting with President Vladimir Putin on Wednesday.
She also added that 90 percent of ATMs in Russia are ready to accept the Mir payment system, a domestic version of Visa and MasterCard.
Izvestia daily reported that as of January 2016, 330 Russian banks had been connected to the SWIFT alternative, the system for transfer of financial messages (SPFS).
In 2014 and 2015, when the crisis in relations between Russia and the West were at their peak over Crimea and eastern Ukraine, some Western politicians urged disconnecting Russia from SWIFT.
In November 2015, Nabiullina said the SPFS was close to being completed.
The central bank’s website says the system was established “as an alternative channel for interbank cooperation with the aim of ensuring the guaranteed and uninterrupted provision of services for the transmission of electronic messages on financial transactions.”
At present, the system has some drawbacks. It doesn’t work from 9pm to 5am Moscow time and costs up to five cents per wire transfer, which is regarded expensive.

