People Power Versus Lobbyists in the Health Care Debate

At the center of the national debate are figures like Max Baucus, head of the powerful Senate Finance committee, who’s received more contributions from the health care industry than any other member of congress: $3.9 million since 2003.(1) The same Max Baucus has been hosting $10,000 a head chicken cordon blue dinners for lobbyists in his palatial San Francisco mansion, while average Americans seeking real health care reform protest outside.(2) When doctors and nurses advocating for single payer health care were blacklisted from Baucus’ May health care hearings, they stood in silent protest in the gallery and Baucus had them arrested.(3)

Perhaps it wasn’t entirely surprising to health care advocates then when the AP reported Monday: "After weeks of secretive talks, three Democrats and three Republicans on the Senate Finance Committee were edging closer to a compromise that excludes a requirement many congressional Democrats seek for large businesses to offer coverage to their workers. Nor would there be a provision for a government insurance option, despite Obama’s support for such a plan, officials said."(4)

There is a certain irony in the fact that Senators who have tax payer-subsidized universal health care are stripping the health care reform bill of a public insurance option. Meanwhile, a recent NY Times/CBS poll poll found 72 percent of Americans favor a public option.(5)

Can Vermont Lead the Rest of the Country to Health Care Reform?

A world away from this pay-for-access system of influence auctioning, the state of Vermont has begun it’s own, and decidedly more grassroots, health care debate. Instead of millionaire lobbyists, the leading voices are small town health care providers like Dr. Deb Richter. Richter has practiced medicine for the last 23 years as a primary care physician in Cambridge, VT, population 3,186. Asked to describe the health care system in the US she says, "I feel like I’m in the foxholes. People are getting angry, they’re absolutely livid about the bailout for the banks – this apparent bailout for the insurance industry – while they are struggling to pay for shoes for their kids to wear. The people are are ready for single payer, the people have have had it, Medicare looks pretty good. Patients are saying I can’t wait to get old. The majority who get sick can’t work, I see them all the time in my practice. I kind of smell a revolution coming."

Buttressing Richter is a recent report from the NY Times which found that "an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured."(6) As for the prospects of the House and Senate crafting a policy solution, Dr. Richter says, "I don’t expect this [public option] to solve the problem if this isn’t going to be implemented until 2013, this is going to be a calamity."

Asked for her critique of the debate happening inside Washington, Dr. Deb explains, "Our democracy is corrupt; it is not a true democracy. The debate started with including the insurance industry and that’s why single payer was immediately off the table. I don’t think the public option is going to solve the problem, the public will pay for the sickest people and the private will pay for the healthiest. Single payer would get an immediate cost savings, an immediate effect. A recent national study found that with single payer we could spend five percent less of our GDP (Gross Domestic Product) on administrative waste. In order to do single payer you virtually eliminate the insurance industry, but they the subsidize congressional campaigns."

Health Care is a Human Right

On May 1st of this year Richter spoke at a Health Care is a Human Right rally of approximately 1,000 people at the Statehouse in Montpelier, Vermont’s usually sleepy capital of 8,000. The Vermont Workers’ Center organized the rally and is building "a grassroots network to fundamentally change how we approach health care as a basic public good, as a human right," says its director James Haslam. The Vermont Workers’ Center desribes itself as a "democratic, member-run organization dedicated to organizing for workers’ rights and living wages for all Vermonters."

"There is so much suffering and there is so much injustice that we are going to keep organizing our tails off until we can win in Vermont and hopefully show other states," Haslam said in a recent interview. "But it’s going to have to come from people organizing in their communities and in their neighborhoods, it’s definitely not going to come from any charismatic politician that just gets our votes and is going to try and work magic with these millionaire health care lobbyists." The Vermont Worker’s Center strategy includes "holding public accountability forums with legislators in every place we can," and gathering thousands of constituent postcards to deliver on the first day of the legislative session. Haslam says the campaign seeks to demonstrate "that there’s more people out there that believe in fundamental change than there are that believe in continuing with the status quo or tinkering with a broken system."

Vermont’s wild-haired junior Senator Bernie Sanders has never been one for tinkering with the status quo. Recently Sanders authored the "States Right to Innovate in Health Care Act," a bill in the Senate which would allow five states to administer a single payer system (See the full text of the bill here). He has been one of the leading voices pushing against the powerful health care lobbyists, and advocating for single payer in the Senate.  In regards to the severity of the health care crisis, Sanders had the following to say in a recent editorial, "Let’s be clear. Our health care system is disintegrating. Today, 46 million people have no health insurance and even more are under-insured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11 – but this occurs every year."(7)

Profits at Any Cost

While the Max Baucus’ of the world debate in gilded marble halls with lobbyists and CEOs, the direness of the American health care crisis worsens unabated. According to the L.A. Times, a Los Angeles hospital settled out of court for dumping more than 150 mentally ill patients from their hospital beds onto the steps of Skid Row homeless shelters in 2007 and 2008.(8) In order to maximize their profits, hospitals have created a globalized world version of patient dumping. According to the NY Times "Many American hospitals are taking it upon themselves to repatriate [deport] seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance…The hospitals are operating in a void, without governmental assistance or oversight, leaving ample room for legal and ethical transgressions on both sides of the border."(9)

Senator Sanders writes that the prognosis hasn’t been dire for everyone. "From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It’s not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion or Cigna CEO Edward Hanway who made more than $120 million in the last five years. The reality is that CEO compensation for the top seven health insurance companies now averages $14.2 million."

Even the very media, who are suppossed to be reporting critically on the legislative process surrounding health care reform, has tried to rake in the massive profits by selling access to the right influential politicans. The Washington Post was scheduled to host $25,000 a person "salon" to bring together lobbyists and health care CEO’s with the very policy makers drafting the health care bill.(10)

Besides Baucus, other high profile Democrats have also lent their names to the cause of maximizing Big Pharmaceutical, Insurance, and HMO’s profits at the expense of real reform. "It’s kind of a give-and-take, quid pro quo kind of environment," said Tom Daschle, President Obama’s intial choice for health secretary, who still serves as an advisor to the Obama administration on health care policy. "I think that the stakeholders [the Health Care Industry] wouldn’t do this if they didn’t think there was something in it for them."(11) One of Obama’s closest advisers, White House Chief of Staff Rahm Emanuel, in a Wall Street Journal interview, stated, "It is more important that health-care legislation inject stiff competition among insurance plans than it is for Congress to create a pure government-run option."(12)

The Road Forward

When asked about the trajectory for health care reform in Vermont, Haslam of the Workers’ Center responds with cautious optimism, "We still have our work cut out for us. Democrats who have been in power of the legislature have had excuses for not taking action and going the direction we need to go. Before it was ‘Governor Douglas could veto it’, which is true, but now they have overridden two vetoes. Now it’s ‘we need these waivers.’ So we’re not going to let them have excuses. We’re going to get so many people involved to make it politically possible. In the end if we do a good job there will be somebody, some ambitious politician who will see the writing on the wall, who will see the winds are changing and that people are ready for this, people are demanding it. People will take to the streets and do whatever we have to do to get [the politicians] to do what people have wanted for a long time."

As for Max Baucus, Obama, and the fight for meaningful health care reform on the national level, a much anticipated piece of the bill from Baucus’ Finance Committee is expected this week.

Meanwhile, nine more health care activists, including doctors and an 11-year-old girl, and were arrested Monday, in a Des Moines, Iowa Blue Cross Blue Shield. According to the Des Moines Register, "The protesters, who were supporting creation of a single-payer health care system, denounced private insurance companies as ‘bloodsuckers’ and carried a sign decorated with pictures of tombstones and a declaration that ‘Insurance Profits Make Us Sick.’"(13)

Whether or not the powerful Max Baucus will listen remains to be seen.


1. Center for Responsive Politics – Top 20 Industries contributing to Campaign Committe and Leadership PAC 

2. Industry Cash Flowed To Drafters of Reform  

3. Baucus Healthcare Plan: Arrest Doctors, Nurses 

4. Top House Democrats struggling on health care bill 

5. In Poll, Wide Support for Government-Run Health 

6. Insured, but Bankrupted by Health Crises 
7. Health Care is a Right, Not a Privilege 

8. College Hospital to pay $1.6 million in homeless dumping settlement 

9. Immigrants Facing Deportation by U.S. Hospitals 

10. Washington Post cancels $25,000 "salon" with lobbyists

11. Health Deals Could Harbor Hidden Costs
12. White House Open to Deal on Public Health Plan 

13. Nine arrested in demonstration at Wellmark 

Photo from Flickr by NESRI