Single Payer Health Care and the Auto Industry

By Bruce Dixon

No presidential administration keeps its promises without relentless pressure from below. It's never happened before, and there's no reason to expect any different. The popular demand for jobs, peace and justice are the concrete “change” Democratic voters believe in, and what swept Obama and his party to power. The self-made crisis of the US auto industry is the perfect opportunity to make good on two of those promises. It's not just the first test of whether an Obama administration intends to serve its voters or its wealthy corporate campaign contributors. It's the first test of whether Obama's popular base can or will hold the new president and his party accountable for producing the “change” they promised.

The US auto industry is in deep trouble. There's no room for doubt about that. But there are plenty of reasons to disbelieve the explanations of and doubt the possible solutions to the crisis put forth by our bipartisan political elite, their mouthpieces in the corporate media and public office.

The media and politicians have exhibited amazing discipline in that few of the analyses and none of the solutions advanced in the mainstream media take into account the competitive advantage of universal free health care enjoyed by auto makers in Canada, Japan and Western Europe. The biggest difference between US and foreign auto production is that only US automakers are saddled with the burden of paying the health care costs of current workers and retirees.  

To make matters worse, beginning in the Reagan administration, federal laws allowed automakers to spend their employee pension funds on executive bonuses and bad investments and not repay them. After three decades of executive raids on the money that should pay for pensions and medical care, there is nothing left. GM alone has at least $5 billion in unpayable pension and medical liabilities, money it deducted from worker paychecks for decades and promised to prudently invest and safeguard but instead spent.

What well-disciplined mainstream pundits never mention is that more than any other single factor over the last thirty-five years, the drive to avoid paying medical benefits for its current and retired workers has shaped the US auto industry's decisions about which plants to open and close and where to locate its new operations. When foreign automakers began locating plants in the US in the 1980s they enjoyed a competitive edge over US production lines located in Michigan, Ohio, Indiana, Wisconsin and Illinois for a generation because their younger workforces had fewer medical bills and they had no retired workers to pay pensions and medical benefits for. GM, Ford and Chrysler learned that lesson quickly and well. They abandoned nearly every assembly plant open thirty years or longer, not because machinery and production methods couldn't be modernized, but to cut the number of workers in their forties and fifties, who use their medical coverage significantly more than workers in their twenties, and to stop new retirees coming online for whose pensions and medical bills they would be liable.

Of course the US auto industry could have produced greener cars in greener plants. They should have invested more in hybrid, electric vehicle and fuel cell technologies. They might have used their marketing muscle to create demand for smaller cars instead of SUVs. But why should they? Foreign automakers haven't done much better at any of these things either, especially in the US market. And apart from health care expenses, many foreign and Canadian auto workers are paid as much or more than their US counterparts. So none of these serve to explain why foreign automakers have out-competed the US for a generation.

The big difference that establishment politicians turn a blind eye to, and media pundits refuse to mention in print or on the air has always been government-paid universal health care as a human right in Europe and Japan compared to a health care system in the hands of private for-profit insurers in the US. Universal free health care is the secret competitive weapon of the Japanese, Canadian and European auto industries.  Unless and until this competitive advantage is equalized, manufacturing automobiles and practically everything else will be far more expensive inside the US than outside it. No amount of money thrown at the auto industry can solve that, and without medical and retirement expenses, foreign automakers are guaranteed to have the extra cash to match and beat anything US automakers invest in innovative green technologies.

Most US politicians omit this vital contextual information because they or their parties take big money from the private insurers. The private health insurance industry eats one third of every health care dollar to finance its executive salaries, its bad investments, its marketing campaigns, and the bureaucratic machinery with which it denies needed care even to the insured. Since they are integral to the our nation's permanent ruling elite, corporate media shamelessly speak for them and exercise remarkable discipline in keeping nearly all discussion of single-payer medical care away from the eyes and ears of the American public. But thanks in part to the internet, the mainstream media's conspiracy of silence against single-payer health care is not working as well as it used to.

What is single payer health care? Who's for it? Who's against it, and has any actual legislation been proposed?

The authoritative web site of Physicians For a National Health Care Plan at http://pnhp.org membership organization tens of thousands of US doctors and health care professionals explains it like this.

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 47 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, long-term care, mental health, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care...”

Detroit's venerable representative John Conyers has, in each of the last several sessions of Congress introduced single payer legislation and sought the sponsorship of his fellow members of Congress. In the current session, that bill is HR 676, the Conyers-Kucinich National Health Care Act, and has been endorsed by dozens of city councils, state legislatures, county boards, and 90 members of Congress, including more than thirty members of the Congressional Black Caucus. If single payer legislation does not make it to the floor early in the next Congress, the blame can only be laid at the feet of the new president and his party.

Still, the internet has not made up for the virtual banning of the subject in mainstream media, or for the unobstructed voices of opponents of single payer health care in the channels and newspapers most Americans rely upon for their news. Organizations like the Citizens Alliance for National Health Care are raising money to buy ads for a national media campaign to achieve single payer health care. But they will have nothing like the nine figure sum the Obama campaign may have left in its coffers after spending a half billion in the campaign.

While president elect Obama has promised what he has called “universal health care”, he and his advisors have explicitly rejected single payer health care. The president elect managed to avoid practically any mention of single payer by name except for the very few unscripted instances he has been asked about it in public. As president, and with a compliant corporate press corps, the opportunities for unscripted questions will be even fewer. The “solutions” advanced by Obama and his advisors will simply make government money available to consumers to buy private health care, and will subsidize a new risk pool, no doubt through other private insurers, for those who can't find any affordable private coverage.

The campaign web sites repeats his claim that he will lower "paperwork costs" by billions through the introduction of new computer technology.  But the big "paperwork" costs are the private insurers' bureaucracy that denies coverage, their executive salaries and bonuses, their marketing and their bad investments.  In fact, the Obama plan on health care does not touch the parasitic insurance companies, and can only raise the cost of health care further without providing adequate care to everyone.  Certainly, it does not relieve the US auto industry or other sectors of their crushing health care debt. There is a reason that every wealthy industrialized nation on earth except this one has adopted some form of single payer health care. It works. The other methods don't.

The president elect and his party need a new plan on health care.  It's up to the base that voted them in to tell them what the new plan is.  They're smart people; it's not that they don't know.  It's just politics.  To get it done, they need us to tell them.  Loudly, insistently and without delay. Power concedes nothing without a demand, and only we can furnish that demand.  If we do not furnish it, if we demand nothing, we get nothing.

This is a place where the Obama administration cannot serve two masters. It's a place where Democratic voters have to stand up and demand what they voted for, whether they are kindly disposed to deliver on their promises or not. The time is fast approaching to hold the feet of the president elect and his party to the fire on jobs and health care. An essential part of any auto industry deal must be single payer health care, or the solution will be as deceitful a sham as the Wall Street bailout. Only single payer health care will protect auto industry and other US jobs and deliver the universal health care that tens of millions of Americans voted for in November.

What We Can Do to Protect US Jobs, Accomplish Universal Health Care, and Hold the New President Accountable.

This won't be easy. Nearly every Democratic president since Harry Truman has aimed at some kind of solution to the health care mess. Producing an aroused public makes it easier for the new administration and its party to do the right thing. But if we don't get loud about the link between saving jobs and delivering health care early in an Obama administration, a precious opportunity will be lost that we may never see again.

BAR managing editor Bruce Dixon is based in Atlanta GA and can be reached at bruce.dixon(at) blackagendareport.com

Source: BlackAgendaReport

*   *   *   *   *

Democrats Set to Offer Loans for Carmakers— Faced with staggering new unemployment figures, Democratic Congressional leaders said on Friday that they were ready to provide a short-term rescue plan for American automakers, and that they expected to hold a vote on the legislation in a special session next week. Seeking to end a weeks-long stalemate between the Bush administration and House Speaker Nancy Pelosi, senior Congressional aides said that the money would most likely come from $25 billion in federally subsidized loans intended for developing fuel-efficient cars. . . . G.M. is seeking $18 billion in loans, but says it needs $4 billion immediately to survive past the year. Chrysler, which is also running out of cash, wants $7 billion. Ford, the healthiest of the three, is asking for a $9 billion line of credit. NYTimes

*   *   *   *   *

posted 21 November 2008