A column by Thomas Frank in the Wall Street Journal made us pause and scratch our heads this week because it prompted one of those questions that we think lots of Americans must be asking themselves. The question is simply this:

Are President Obama and his Democratic Party up to no good in this health reform battle?

[Conservatives: Insert "Obviously!" here.]

The question, more specifically, might be “Is President Obama trying to turn the government into a predator?” or “Would the passage of a public option be a predatory move by government?”

[Conservatives: You can again insert "Obviously!" here.]

Phrase it however you like. As the WSJ column points out, Sen. Charles Grassley (R-IA) – who has been up to his hip waders in the health reform battle – said last week that a public option turns the government into a predator. And Sen. John Thune, (R-SD), has apparently agreed.

‘I know you are but what am I?’

The WSJ’s Frank thinks those two legislators have it backwards. Could be he right?

After all, what seems more predatory? A government insurance option, the stated purpose of which is to increase competition with private industry to drive insurance costs down for all consumers? or “actuarial-minded hardliners of the insurance biz, the ones who deny your claim or cancel your policy?”

We understand the concept of a “predatory government.” It’s a government that stands back and watches as the foxes of private industry feed on the hen house of American citizenry. We’ve seen it happen when corporations sucked the economic lifeblood of the nation through no-bid defense contracts. And we’ve seen it happen when, as Frank points out, the government used a prescription drug benefit to herd millions of Americans into the waiting arms of the pharmaceutical industry.

The “predator state,” Frank writes, materializes “when consumer protection, worker protection, environmental protection, and policing against fraud are handed over to lobbyists. And when health care is run for the benefit of private insurance companies, whose business model . . . is to target coverage on the healthy and delay payments to the sick.”

Keys to the hen house?

So is a public option “predatory?” We don’t think so. But we agree with Frank that without a public option, Congress may be putting its efforts into getting all of our hens in one hen house – and then committing the most predatory act imaginable: handing the foxes the keys.

Fundraising scorecard

Political contributions from the health industry:
Grassley: $2.9 million (despite the fact Iowans support a public option)
Thune: $1.2 million

Okay, we know that it’s the conservative members of the House that are called “Blue Dogs” (not members of the Senate), but what a perfect visual for the actions of the North Dakota Democratic-NPL party’s put-down of its own senator, Kent Conrad (D-ND).

The party’s members recently reaffirmed a commitment to an even much more progressive health reform idea – single payer – but support a public option as a fallback. And in a letter to its three-member congressional delegation, it put its disagreement with Conrad out for all to see.

Conrad has been a nattering nabob of negativity when it comes to the public option – and as a member of the Senate Finance Committee, he’s used his position to try to euthanize. As far as the public option is concerned, several conservative Dems on the finance committee have essentially been their own  death panel for the proposal.

The Democratic party in Nebraska is also wielding a rolled-up newspaper. Senator Ben Nelson (D-NE) is another example of an elected official stubbornly pulling back on the leash while his masters are trying to walk forward.

Looks like the winter temperatures in these Midwestern states are going to be more frigid than ever for these two senators, bringing to mind the old Warner Bros. cartoons where the shivering dog looks longingly through the window while Sylvester lies curled up by a roaring fire.

That ain’t dog food

Political contributions from the health industry:
Conrad: $1.6 million
Nelson: $2 million

Hmmmm. A CBS/New York Times poll says 81 percent of Democrats favor a public option; yet five Democratic senators on the Senate Finance Committee vote against it. Strange.

Go to the raw story, for the full scoop!

One of the most interesting reactions to the ongoing health reform debate has to be the public’s revulsion at the prospect of increased government control of the health care system.

I understand concerns about additional financial burdens that come with new government programs … and concerns about adding to the nation’s deficit. I get that.

What I don’t understand is the apparent revulsion at the idea of government intervening to improve the health care system. I don’t understand it because I also see the public’s concern about the existing system – its steadily rising premiums, the private insurance industry’s denial of coverage to those with pre-existing conditions, the fact that people (even those with policies) can lose everything to health bills.

It’s so odd: the public wants to prevent additional government involvement in the health care industry when any honest citizen would agree that the private industry could have used at least a little more – and probably a lot more – oversight. Seriously, how can it have taken THIS long for the government to step in and stop denial of policies over pre-existing conditions?

But the other thing that stumps me is the shouting that I hear in town halls about how – and I’m paraphrasing – the government will screw up health care like it screws up everything else. The government can’t do anything right?

I could ask whether the military should be privately run … or whether we should just let private industry decide where and when the next interstate will be constructed … or whether we should just let banks police themselves. But I’m going to stick with health care. And so my question to those concerned about what government will do to health care is this: Do you have any idea what government is already doing?

Serving those who are proud to serve …

• Do you know that the government covers 9.2 million Americans through Tricare, the system set up to care for active-duty military?
• Did you know that Tricare – like Canada’s Medicare – is a single-payer health care system? (One payer – the government.)
• Did you know that even the most vocal opponents of more government intervention believe Tricare is “first-class health care?“
• Did you know that within this single-payer system (Tricare), users do not face rationing? That patients are not refused because of pre-existing conditions? That users have choice of physicians? Yes. This is government-run health care AND it’s single-payer health care.

… and those who have served

• Do you know that the government covers 5 million Americans through the Veterans Health Administration? Do you know that it owns and operates “a vast network of hospitals, outpatient clinics, nursing homes, residential rehabilitation treatment programs, and readjustment counseling centers?”
• And do you know that means? It means that the VHA is socialized medicine. It is a system where a single entity owns and operates everything: it owns the hospitals, pays the physicians. And while the VHA has received plenty of criticism in recent years, it’s also been hailed increasingly as a model of efficiency and possibly, a model for a national system.

Covering Congress

• Who else does the government cover? As the President often points out, government employees get their coverage through an insurance exchange called the Federal Employees Health Benefits Program. That’s right, folks. It’s an insurance exchange just like the proposed Health Insurance Exchange – and with almost 9 million covered, it’s considered the largest employer-sponsored group health insurance program in the world. The employer? The government.

Protecting Grandpa, Grandma and their friends

• And how about Medicare? The government covers 44.8 million Americans through the program. When you hear people at town halls raising their voices, they’re often yelling, “Don’t touch my Medicare!” and “Save my Medicare!” They understand that the system has funding problems and it may not be the best system possible, but they also know that people who are approaching retirement are eager to enjoy its benefits.
• Do they know that Medicare is an example of a single-payer system? A single payer – the government – pays health providers for the care they provide to the users. Perhaps that’s why some nutty liberals have proposed expanding Medicare. But perhaps it’s because one study estimated that a “‘Medicare-like option with enhanced benefits’” would cost only $259 per month for individuals and $702 for families – considerably cheaper than many private plans.”
• In reporting the findings, the Commonwealth Fund goes on to estimate that the system could cover 44 million of the 48 million uninsured AND improve coverage for 60 million more “while increasing health spending by no more than 1 percent.”

So when opponents of proposed health reform angrily demand that members of Congress take their own medicine – a government health plan – it reminds me of the old Monty Python bit where the guy’s being “tortured” by having to sit in a “comfy chair.”

Those who have fears about the health care system have plenty to shout about: maybe about how the health insurance industry is not helping control costs or how the industry continues to operate on a model that’s based on denying coverage.

People should shout. But until opponents of a government plan, socialized medicine, a single-payer system or a Health Insurance Exchange know anything about those topics, I’d prefer not to hear their shouting.

As George Eliot noted, “It’s better to remain silent and be thought a fool than to open your mouth and remove all doubt.”

Dueling Chucki: Senators Grassley (R-IA) and Schumer (D-NY) have differing views on health care reform. We'll back Schumer on this one.

Sen. Chuck Schumer (D-NY) is claiming a public option in upcoming health care legislation is now a slam-dunk with the long-awaited seating of Al Franken of Minnesota. Across the aisle, Sen. Chuck Grassley (R-IA) is saying a public option will succeed only with bipartisan support.

While we like bipartisan support as much as the next guy, Democrats should be cautious in giving away the farm. They are, for the first time in 30 years, a position of unique strength. If the Republicans were in their position, history demonstrates that they would be ruthless. However, Democrats often seem too eager to compromise — if one is to be charitable — or spineless, if one is being less so.

Single-payer the best, but not on the table

We think a majority of Americans would prefer a single-payer system if they understood what it was, and how well it works in the many modern societies such as France, the Scandinavian counties and yes, even Canada.

Insurance companies like to vilify these other countries, claiming long waiting lines and an impersonal government system. But the horror stories about American health care are far more scary … and have the added benefit of being real. If you talked to regular people in many of these other countries you’d find many more of them are happy with their system than we are with ours. They shake their heads in disbelief when they hear of American families going bankrupt because of medical bills — it simply never happens in these other countries, where health care is a right of citizenship. In France, doctors regularly make house calls. Americans flood the borders of Canada to enjoy its cheaper prescription prices.

But the United States is not going to get a single-payer system. The politicians using this as a straw man are being disingenuous as its not even on the table. It should be, but for political reasons (mainly insurance and drug industry lobbies) its not. The best we can hope for in this round is a public option for health care — a government run plan that can compete toe-to-toe with the plans of private insurance to, as President Obama puts it, “keep them honest.”

You’ll keep your doctor, current plan if you wish

This government plan would be completely voluntary. No one would be required to change their insurance company or doctor. And there’s nothing to say that you’d have to change doctors to enroll in a cheaper, government-run health care plan — most will likely accept their payment as readily as that from private companies. Another straw man being constructed by the for-profit medical industry.

Medicare’s administrative costs are in the low single digits. That of private insurance companies is around 30 percent, which means that out of every dollar of premium you page, a third of it goes for paper shuffling, commissions, CEO salaries and stockholder dividends. The largest savings of the public plan will be running it as a service and not a profit center.

Choosing a “Chuck” … we like Schumer

We like both Chucks — Schumer and Grassley, and they bring different nuances to a wide variety of issues, given their polar-opposite political philosophies. But on health care, its the Democrats that are spot-on … it needs to be a right of citizenship and not a protected industry. However, industry influence spreads money on both sides of the aisle, and the the Democrats will need a few fighters, despite their numbers, to get this through. Chuck Schumer will be a valuable one.