2009

28 October 2009: Issues abound in health-care debate

Issues abound in health care debate

It’s been a fight for the ages, but two tangential issues have moved to center stage in the health care reform brouhaha: majority rule in a democracy and monopolies, which are most undemocratic.

Thomas Jefferson addressed the principle of majority rule:

“The first principle of republicanism is that the lex majoris partis is the fundamental law of every society of individuals of equal rights; to consider the will of the society enounced by the majority of a single vote as sacred as if unanimous is the first of all lessons in importance, yet the last which is thoroughly learnt.”

Nearly two hundred years after penning this, it is apparent some—primarily, U.S. Senate Republicans—still have not learnt that “first of all lessons.”

While access to health care is a right, the method by which it is administered is a process not a right carved in stone or the Constitution. While health insurers have a right to do business, they have no inherent, inalienable right to a guaranteed middle-man cornering of the market securitized by law.

That has implications for the U.S. Senate with the likelihood of the 40 Republicans and a few conservative Democrats—yes, such do exist—voting not to end endless debate. If the vote to cut off debate—cloture—is successful, it would allow for an up-or-down vote on the bill, which would, more than likely, result in passage of a public option mandate.

Compounding the irony of Republicans and conservative Democrats disregarding the will of the majority is the fact they invariably come from small states like Wyoming and Utah. The four conservative Republican senators—yes, am being redundant for that is all that is “left” in the party—from our neighboring states have a disproportionate amount of power in the Senate compared to that of the two progressive Democrats from California.

Based on the 2008 estimated populations by the Census Bureau, the two Democratic senators from California represent nearly 37,000,000 million people while the two Utah Republican senators represent less than 2,750,000 with the two in Wyoming representing a grand total of 532,668 windblown souls. Those four senators that represent less than one-tenth of California’s population then have twice the actual votes than the two from California.

Here in Colorado, Senators Mark Udall and Michael Bennet represent almost 5,000,000 folks. So the guys from Utah have twice the power our guys have, and the two from Wyoming have 10 times more power: the power to say no.

In a reply to the Citizens of Adams County, Pa. in 1808, Jefferson wrote, “[Bear] always in mind that a nation ceases to be republican only when the will of the majority ceases to be the law.” Yes, Republicans are causing our nation to be less republican.

In addition to the monopoly small conservative states have on the U.S. Senate, there is the other correlative matter of the monopoly health insurers have enjoyed since 1945 when the McCarran-Ferguson Act exempted them from anti-trust laws.

That put health insurers on a tier with Major League Baseball, the only other for-profit entity exemption of which I am aware, which gets into another mind-boggling dimension.

In their report on the website of the Center for American Progress, Stephanie Gross and David Balto, whose credentials include stints in the Antitrust Division of the Department of Justice and the Federal Trade Commission, succinctly describe the folly of having given the health insurers anti-trust exemption.

States, especially smaller ones like Utah and Wyoming—note above—often lack the resources to track and pursue claims against the health plan insurers.

“Lack of adequate oversight and enforcement,” write Gross and Balto, “means that health insurers enjoy the freedom to engage in the anticompetitive, fraudulent, and deceptive practices that are being directly targeted by health care reform.”

That lack of oversight results in the raising of premiums “while offering poorer coverage, denying coverage to inflate profits, and maintaining effective monopolies.”

And, I add, the potential for buying of their politicians. There is a verifiable strong correlation between anti-reform senators and the amount of cash Big Health has contributed to their campaign coffers.

By itself, eliminating the exemption would not be the cure-all given the dominance Big Health Insurance has in the markets, but it would be major step forward to reining in the abuses and excesses of the “industry.”

One of the beauties of this intense no-holds-barred scrape is that it has torn the veil from an pock-marked and deformed face of an “industry” that claims it wants nothing more than to advance the health needs of the nation.

Altruism and a sense of decency were never among its values. By pursuing profit-at-any-cost, it has given profit a black eye. It’s time to return in kind the same type of coverage, rates, and consideration to Big Health Insurers they have given us.

 

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