Health care bills suffer conspiracy of silence

By Saul Friedman

Too often journalism ignores or belittles reports or proposals as outside the mainstream and bound to fail, thus assuring they will remain outside the mainstream and fail.

That, I believe, is what has been happening to proposals by three Democratic members of the House of Representatives to provide health care for all Americans through a system like Medicare, rather than depending, as now, on many private insurance companies.

The lawmakers, among the most senior House members, are Pete Stark of California, chairman of the health subcommittee of Ways and Means; John Dingell of Michigan, the longest-serving member of the House and chairman emeritus of Energy and Commerce, and Judiciary Committee chairman John Conyers, also from Michigan.

Last month, Stark reintroduced his proposal, called Americare, which would open Medicare Parts A and B to everyone, but allow people to keep their employer-based insurance. A few days later, Dingell and Conyers reintroduced their bills, which would expand Medicare to become the nation’s comprehensive health care program, paid for by premiums and taxes. The Conyers bill has dozens of co-sponsors and the support of most AFL-CIO unions.

On Jan. 28, a coalition of advocacy groups representing 15,000 doctors and more than 50,000 nurses, met at the Capitol to present a new study asserting that the Conyers’ bill, called the National Health Insurance Act (HR 676), could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers.

Only Congressional Quarterly covered it. The Kaiser Family Foundation’s daily online report on health care developments at didn’t mention it. Nor has Kaiser, the most comprehensive online source of health care information, made any mention of “single-payer” (the government as the payer), or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls. (After my insistent inquiries, Kaiser says it will publish charts next month comparing the Stark and Conyers bills.)

AARP, another key source of health care information, briefly mentioned single-payer in the AARP Bulletin, sent to its 35 million members. But neither single-payer nor the Conyers bill have been discussed in any of its other publications or its advocacy materials at

Why? Many health care writers and advocates believe it’s because single-payer and the Conyers bill would bar any role for private insurance companies, which would have central roles in all the other proposals under discussion.

The Kaiser Family Foundation was founded with insurance money, but its president, Drew Altman, says it receives no money from and has no connection with Kaiser Permanente, a large health insurer. And AARP’s chief strategist, John Rother, insists that its $700 million insurance business, mostly with UnitedHealth Group, does not affect its policies.

But reader Elaine Fox of Southampton, a physician and health care activist, contends there is evidence the health insurance industry opposition to government-sponsored health care has contributed to the effort to black out discussion of the Conyers bill.

She noted that in “An Analysis of Leading Congressional Health Care Bills, 2007-2008,” an online article posted in January by the Commonwealth Fund, a nonpartisan public policy research organization (www.commonwealth, the Conyers bill was ignored. The Stark bill, which includes an insurance option, was analyzed. But Conyers’ bill and single-payer were not discussed in the analysis, which was done for Commonwealth by the Lewin Group, health care consultants.

As Fox pointed out, the Lewin Group had been independent and in 2005 its analysis supported passage of a single-payer bill in California. In 2007, Fox said, Lewin was purchased by Ingenix, a health information firm that helps set the rates insurance companies pay providers. Ingenix is owned by one of the nation’s largest insurers, UnitedHealth (which recently paid a $50 million fine in New York to settle a charge that Ingenix underpaid out-of-network doctors who provided service for United’s subscribers).

On Jan. 13, Fox said, the RAND Corp., a think tank, launched an online tool for policy makers to compare health care proposals called “Comprehensive Assessment of Reform Efforts,” or COMPARE. It did not include the Conyers bill or any single-payer alternative. RAND acknowledged that COMPARE is funded in part by AARP and health insurers, including UnitedHealth. A RAND spokesman said COMPARE will “get around to including” single-payer plans.

AARP’s Rother cites other reasons than the insurance industry for the blackout. He’s in favor of a single-payer system, he says, but insists he’s not encouraging such proposals because they’re outside the mainstream and are not likely to pass. Despite broad support for national health insurance and Medicare, Rother says, “This is simply a matter of pragmatism. Single-payer advocates could play a destructive role in the coming debate.”

Fox argues: “There cannot be a credible debate when one side disappears.”

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  1. Barbara Vargason on February 24, 2009 at 5:40 pm

    Could we start a e-mail and calling blitz to the Media to pressure them to at least cover this important information?

  2. James Davidson on August 2, 2009 at 2:06 am

    As an American I believe in the prinicple of personal responsibility not government intervention. No matter how much or how little I have earned in my life I have always carried insurance on myself and my family regardless of the cost. As a husband, father and man it is my responsibility to provide for my family not the governments. All that aside I have travelled this world extensively and have never seen any other nation with the quailty of care available to citizens of this country and the surest way to erode that care is to put it in the hands of the government who has a 100% track record of poorly managing any program that it creates. A one payer system will not lower cost it will in fact lead to much higher taxes. A one payer system will not improve quality of care. We already have a shortage of doctors and nurses now, turn the system over to the government with a one payer system and that shortage will be amplified immediately and will grow over time as more and more doctors opt to retire rather than have the government dictate how they can treat their patients.

    Rationing of health care services and waiting times for diagnostic testing will also be the inevitable outcome of government health care. It exists in all nations with a one payer system and contrary to the popular supposition we are not able to bring anything new to the idea to counter this problem. Rationing and waiting is the only logical outcome to adding millions of more people to an already understaffed system. You cannot force people to become doctors and nurses unless of course you propose to skip over socialism and adopt facism or communism.

    All an intelligent person has to do to recognize the failure of a single payer system is to look at Medicare and Medicaid. Both programs spend hundreds of billions each year on fraudulent claims wasting taxpayer money. Thousands of doctors no longer accept medicare or medicaid patients due to the complex paperwork required to file claims and the extremely below market payments for services. Both programs are rife with waste and as a result require ever higher taxes to continue to offer the mediocre service that they cover.

    What America needs is strong tort reform to lower medical cost, more streamlined options for existing medical insurance, laws that prohibit exclusion for pre-existing conditions or higher premiums due to those conditions. Controls on prescription drug cost by refusing to allow other nations like Canada to cap their payments and thereby force all of the research and development cost on the American consumer. If they aren’t willing to absorb some of that cost then let them develop all their own drugs. America also needs one set of rules on what must be offered in medical insurance plans instead of 50 different sets of rules. Consumers need more choice in what they want to be covered for. Seniors shouldn’t be saddled with policies that include maternity coverage or pediatric care and younger families shouldn’t be forced to pay for geriatric care until it is needed. Coverage such as substance abuse, mental health care, etc. should be options for each consumer to pick and choose not a mandated part of every health insurance plan. Tort reform and free market competition can lower health care costs but a one payer system is a recipe for lower quality health care and higher taxes. Worse it will have the most diliterious effect on our elderly as the care they are allowed is streamlined in an effort to reduce cost. One look at programs like the one in Canada and the one England clearly show a lack of preference in treating the elderly as a means of cost control. Do we sacrifice the well being of our parents and grandparents in order to join the ranks of socialized medicine?

  3. sankofa on August 18, 2009 at 8:56 am

    james the internet is extremely anonymous, and you benefit from that right now, because no one knows who you are or who you work for. What i do know is that you sound like you work for some kind of insurance interests. And I also really like the unsupported generalization at the end about Englands’ and Canadas’ health care system. You really should stop using fear as a tactic to sway the masses. We’ve had 8 yrs of fear tactics with your buddy bush, and id really like a break. Bottom line is, I’m TIRED of being SCREWED by my PRIVATE Insurance companies and They have not the intestinal fortitude or moral restraint or OVERSIGHT to not screw me on their own so now its time to get rid of their ASSES and conyers suggestion, or a single payer system does just that. Sanctimonious prick!

  4. Sherry I on September 2, 2009 at 2:02 pm

    James is entirely correct – tort reform is what we need to start with! AGAIN, when has the government every run anything efficiently? If there are any examples, please inform me!