Multinational Monitor Editors blog

There is only one solution to the twin problems of escalating health care costs and the epidemic of the uninsured: a Medicare-for-All, single payer system.

Unfortunately, the healthcare debate on Capitol Hill has evolved without serious consideration of the Medicare-for-All single payer health proposal. There are many reasons for this, but one is that many who actually support Medicare-for-All have claimed that the proposal is “not feasible.”

With the House leadership having settled on a single proposal, now is the time to set aside worries about feasibility. The House process is resolved. Members of Congress should have the opportunity to vote on the merits, up-or-down, on a Medicare-for-All single payer health proposal.

Whether they will have this chance is in the hands of Speaker Nancy Pelosi, and likely to be decided today. Contact her right away to urge that the House be permitted to vote on a Medicare-for-All single payer health proposal. Call (202) 225-0100 or (as a second best alternative, submit comments on the Speaker’s web page.

Representative Anthony Weiner, D-New York, has proposed to introduce such a Medicare-for-All measure on the House floor in the form of an amendment to the leadership’s healthcare package. If a vote is permitted, it will mark the first time either house of Congress has voted on Medicare-for-All, and will be a landmark in the inevitable march to a national Medicare-for-All system.

Meanwhile, Representative Dennis Kucinich, D-Ohio, is seeking to enable states to implement their own Medicare-for-All single payer health initiatives. Representative Kucinich introduced an amendment in the House Education and Labor Committee to facilitate such action, by providing for waivers of ERISA (employee benefit) requirements for states adopting single payer plans. This amendment passed the committee with bipartisan support. If Speaker Pelosi decides to incorporate it into the leadership bill, it stands a good chance of becoming law.

Although there are reasons to be skeptical, one can hope that the health reform package that ultimately becomes law will significantly expand coverage and curb insurance industry abuses.

But it is certain that the health reform package will not solve the overwhelming problems of coverage, cost and quality of care facing the country. Solving those problems requires going to the source: the health insurance corporations.

With its private health insurance industry-dominated system, the United States spends far more than other wealthy nations on health care (at least 50 percent more than every country except Luxembourg) but sports middling health indicators.

The private health insurance industry-dominated system in the United States permits 45 million people to live without health insurance, denying them access to preventative and routine care, resulting in the death of at least 35,000 people a year.

The private health insurance industry-dominated system tolerates private health insurance companies making life-and-death rationing decisions for millions of people with only minimal accountability.

The private health insurance industry-dominated system lets private health insurers refuse to take sick people as customers and engage in endless manipulations to discard its customers if they do become sick.

The private health insurance industry-dominated system features a system in which medical bills and illness contribute to almost two of every three personal bankruptcies — even though three-quarters of these bankrupt people had insurance when they became sick.

Not least, the private health insurance industry-dominated health care system translates into a private health insurance industry-dominated political system. As a result, too many politicians refuse to consider real solutions.

There is a cure all for these ills. It is a Medicare-for-All, single-payer system, in which the government pays medical bills (thus operating as the “single payer”).

In a Medicare-for-All system, health care is available as a matter of right. No one is denied treatment because they can’t pay. No one is mandated to buy coverage. No one is denied coverage because of pre-existing conditions. No one goes bankrupt paying medical bills.

A Medicare-for-All system would save $350 billion – $400 billion a year in costs (up to $4 trillion over the 10-year period routinely analyzed by the Congressional Budget Office) –- enough to cover all of the uninsured. No scandalous CEO pay packages. No money siphoned out of the system by rent-seeking middlemen. No needless paperwork and bureaucracy.

A Medicare-for-All system succeeds by doing away with the private health insurance industry.

The powerful insurers, understandably, don’t like this idea. Yet despite waves of deceptive and misleading propaganda about the purported horrors of government-run insurance, the people do like the idea of Medicare-for-All — polls show it is supported by a majority of the public.

But insurance industry dollars have spoken louder than the people’s voices. And so Medicare-for-All hasn’t been given a serious hearing in Congress. Speaker Pelosi should at least enable a clean up-or-down vote. Call (202) 225-0100 and urge her to do so.

One year ago, Lehman Brothers declared bankruptcy, bringing to a head the growing chaos on Wall Street.

In the days and weeks that followed Lehman’s September 15, 2008, collapse, credit markets would freeze, the stock market plunged, the government took a controlling interest in AIG, Wachovia and Merrill Lynch merged themselves out of existence, the Congress approved a plan to spend $700 billion to bail out Wall Street, the Federal Reserve innovated an array of programs involving trillions of dollars worth of support for Wall Street and the credit markets, and the national economy — and much of the global economy — declined precipitously.

As the crisis unfolded, it quickly became commonplace to suggest that nothing would ever be the same, on Wall Street or in the national economy. The Wall Street goliaths had been humbled — and many had gone out of business, via merger or bankruptcy. Deregulation went out of style and even former Federal Reserve Chair Alan Greenspan indicated that the conceptual underpinnings of his deregulatory approach had proven flawed.

One year later, it is clear that the conventional wisdom emerging as the crisis developed was wrong.

Some things have changed dramatically — notably in the real economy — but Wall Street’s political power remains intact. No new rules are in place to prevent a recurrence of the crisis. Major questions remain about whether any such rules commensurate with the scale of the crisis — with the important exception of a new consumer financial protection agency — will be seriously considered.

The financial crisis has had a devastating impact on regular people — and the situation continues to worsen, even as the economy enters what may be a potential recovery.

Overall economic growth fell by more than 5 percent (on an annual basis) in the fourth quarter of 2008 and by more than 6 percent in the first quarter of 2009.

Thanks to this economic crash, the official unemployment rate is racing to 10 percent, with many believing it will persist at or near double digits through the end of 2010. The actual unemployment rate — taking into account underemployment and discouraged workers — has topped an astounding 16 percent. A staggering one in six workers is out of work or underemployed.

The poverty rate has worsened dramatically, just based on the available data for 2008 alone. The official poverty rate in 2008 was 13.2 percent, up from 12.5 percent in 2007. There were 39.8 million people in poverty in 2008, 2.5 million people more than the previous year. The 2008 poverty rate — and things have surely gotten worse — was the highest since 1997.

The mortgage crisis continues to worsen. More than 1.5 million foreclosures were filed through the first seven months of this year. By mid-2009, roughly a third of outstanding mortgage borrowers were underwater — meaning they owed more than the value of their home — and the number is growing. Mortgage modifications — almost none of which touch principal — do not come close to keeping pace. Goldman Sachs projects there will be 13 million foreclosures between the end of 2008 and 2014.

The causes of the financial crash continue unabated and in some cases have worsened.

Out-of-control compensation packages, linked to short-term profit performance, drove top Wall Street and big bank executives and traders to take reckless risks. For them, it was a game of heads we win, tails you lose: If their firms registered short-term profits, they received outrageous bonus packages; if there was a longer-term fallout, that would hurt shareholders, but they would have already pocketed their bonuses. Wall Street bonuses are already on track to match or exceed the glutinous pace of 2007.

Banks and other financial institutions deemed “too big to fail” engaged in wild speculation, secure in the knowledge that they would ultimately be backstopped by federal support. These behemoths helped generate the crisis as well by leveraging their political power to peel back the regulatory restraints on Wall Street. Now, thanks to a series of shotgun mergers, the banks are bigger than ever, and there is a greater combination of commercial banking and investment bank operations in single corporate entities.

The proliferation of exotic financial instruments led to massive leveraging and complicated interconnections among top firms that no one could track. The unraveling of these ties led to the downfall of AIG, among other things. While financial derivatives are justified as helping economic players hedge against risk, it turns out they are primarily speculative tools used overwhelmingly by a small number of players. This concentration of massive speculative betting continues, with five banks owning more than four-fifths of the notional value of all outstanding derivatives in the United States. The notional value of these banks’ derivatives exceeded $190 trillion in the first quarter of 2009.

Wall Street’s go-go years earlier this decade were fueled by a housing bubble and deceptive lending practices. Consumer rip-offs continue apace — and appear to be central to the banks’ business model. Overdraft fees alone will bring in more than $38 billion in revenue to the banks in 2009.

Meanwhile, the public is paying massively for rescuing Wall Street from itself. The Special Inspector General set up to oversee the bailout estimates that government agencies, including the Federal Reserve, will ultimately put out more than $23 trillion in various programs and supports related to the financial crisis. This total is almost three times what was spent on World War II, in adjusted dollars.

Most of these trillions will return to the Federal Reserve or the Treasury, but that hardly mitigates the scale of the public investment and risk committed to save Wall Street. And the Treasury Department is certain to lose tens of billions — quite likely hundreds of billions — in the deal.

The deregulation that led to the financial crisis, the bank-friendly immediate response to the crisis and the failure to impose meaningful restraints on Wall Street after the crisis can all be traced to Wall Street’s political power. Wall Street spent more than $5 billion on federal campaign contributions and lobbying from 1998 to 2008, and its fervent spending continues. The financial sector has spent more than $200 million on lobbying in 2009 alone.

In spring of this year, the banks defeated a proposal, which had been expected to pass, to authorize “cramdowns” of mortgages in bankruptcy. This modest measure would have permitted bankruptcy judges to adjust mortgage principal in bankruptcy, to help people stay in their homes. It would have had relatively limited application and likely would have helped the banks, which are hurt by foreclosures in an environment where they cannot sell houses from which they have evicted borrowers. But cramdown violates the banks’ ideological commitment to preventing adjustments of principal. They mobilized to defeat it, leading a frustrated Senate Majority Whip Richard Durbin to say the banks “own the place” — meaning the Congress.

And now, the Financial Services Roundtable has openly announced its intention to “kill” the most important reform measures urged by the Obama administration: creation of a consumer financial protection agency.

Perhaps one of the most telling statistics is the number of stand-alone pieces of financial reform legislation passed, one year after the collapse of Lehman Brothers: zero.

Can things get still worse in Washington?

Yes, they can. And they will, if the Supreme Court decides for corporations and against real human beings and their democracy in a case the Court will be hearing today, Citizens United v. Federal Election Commission.

Until reaching the Supreme Court last year, this case has involved a narrow issue about whether an anti-Hillary Clinton movie made in the heat of the last presidential election is covered by restrictions in the McCain-Feingold campaign finance law. However, in a highly unusual move announced on the last day of the Supreme Court’s 2008 term, the justices announced they wanted to reconsider two other pivotal decisions that limit the role of corporate money in politics.

The Court ordered a special oral argument on the issue, before the full start of their 2009 term in October.

The Court will today hear argument on whether prior decisions blocking corporations from spending their money on “independent expenditures” for electoral candidates should be overturned. “Independent expenditures” are funds spent without coordination with a candidate’s campaign. The rationale for such a move would be that existing rules interfere with corporations’ First Amendment rights to free speech.

Overturning the court’s precedents on corporate election expenditures would be nothing short of a disaster. Corporations already dominate our political process — through political action committees, fundraisers, high-paid lobbyists and personal contributions by corporate insiders, often bundled together to increase their impact, threats to move jobs abroad and more.

On the dominant issues of the day — climate change, health care and financial regulation — corporate interests are leveraging their political investments to sidetrack vital measures to protect the planet, expand health care coverage while controlling costs, and prevent future financial meltdowns.

The current system demands reform to limit corporate influence. Public funding of elections is the obvious and necessary (though very partial) first step.

Yet the Supreme Court may actually roll back the limits on corporate electoral spending now in place. These limits are very inadequate, but they do block unlimited spending from corporate treasuries to influence election outcomes. Rolling back those limits will unleash corporations to ramp up their spending still further, with a potentially decisive chilling effect on candidates critical of the Chamber of Commerce agenda.

The damage will be double, because a Court ruling on constitutional grounds would effectively overturn the laws in place in two dozen states similarly barring corporate expenditures on elections.

More than 100 years ago, reacting to what many now call the First Gilded Age, Congress acted to prohibit direct corporate donations to electoral candidates. Corporate expenditures in electoral races have been prohibited for more than 60 years.

These rules reflected the not-very-controversial observation that for-profit corporations have a unique ability to gather enormous funds and that expenditures from the corporate treasury are certain to undermine democracy – understood to mean rule by the people. Real human beings, not corporations.

In arguing to uphold the existing corporate expenditure restrictions, the Federal Election Commission has emphasized these common sense observations.

“For-profit corporations have attributes that no natural person shares,” the FEC argues. Noting that corporations are state-created — not natural entities — the FEC explains that “for-profit corporations are inherently more likely than individuals to engage in electioneering behavior that poses a risk of actual or apparent corruption of office-holders.” The FEC also notes that corporate spending on elections does not reflect the views of a company’s owners (shareholders).

Although the signs aren’t good, there is no certainty how the Court will decide Citizens United. There is some hope that the Court will decide that it is inappropriate to roll back such longstanding and important campaign finance rules, in a case where the issue was not presented in the lower courts, and where the litigants’ dispute can be decided on much narrower grounds.

Public Citizen is organizing people to protest against a roll back of existing restrictions on corporate campaign expenditures. To join the effort, click here. People are pledging to protest in diverse ways — from street actions to letter writing — today, and in the event of a bad decision, and also networking for solutions to corporate-corrupted elections.

Ours is a government of the people, by the people, for the people — not the corporations and their money. Corporations don’t vote, and they shouldn’t be permitted to spend limitless amounts of money to influence election outcomes.

Robert Weissman is president of Public Citizen. Public Citizen attorney Scott Nelson serves as counsel to the original sponsors of the McCain-Feingold law, who have filed an amicus brief in the case, asking that existing restrictions on corporate election expenditures be maintained.