Americans want healthcare, not health insurance.

Today I heard audio of Obama saying that every American should have health insurance. I certainly hope that was a simple semantic error on President Obama's part. Because Americans neither need nor want health insurance. What they need, what they want, is affordable health CARE.

I'm sure it's just a matter of semantics. I'm sure President Obama didn't mean that all Americans should have the same right to pay outrageous copayments for their prescriptions.

Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year.



But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.

The system, often called Tier 4, began in earnest with Medicare drug plans and spread rapidly. It is now incorporated into 86 percent of those plans. Some have even higher co-payments for certain drugs, a Tier 5.

Now Tier 4 is also showing up in insurance that people buy on their own or acquire through employers, said Dan Mendelson of Avalere Health, a research organization in Washington. It is the fastest-growing segment in private insurance, Mr. Mendelson said. Five years ago it was virtually nonexistent in private plans, he said. Now 10 percent of them have Tier 4 drug categories.

I'm sure he meant that all Americans should be able to have access to affordable medecine. I just wish he'd tighten up his semantics and SAY affordable healthcare, not health insurance for everyone. That would lessen people's stress because failure to pay medical bills is the number one cause of bankruptcy in America.

Secause some people might worry that he means everyone should have equal access to an insurance company that won't cover their child's critical leukemia treatment when what I'm certain he must mean is that everyone should receive whatever treatment their doctor deems necessary, at a sliding scale that they can afford.

Otherwise, he might come off sounding like this man who actually DOES get the difference between health insurance and healthcare - in a twisted, right wing sort of way.

I'm sure he didn't mean that every American should have equal opportunity to be denied benefits by for-profit health insurance companies for whatever ridiculous excuse they can some up with. What he really meant was that whenever any American anywhere needs healthcare, they should get it.

It's just semantics, I know, because I read Obama actually told the Illinois AFL-CIO:

"So the challenge is, how do we get federal government to take care of this business? I happen to be a proponent of a single payer health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out."

"A single payer health care plan, a universal health care plan. And that's what I'd like to see. And as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, we have to take back the House." (Barack Obama in 2003 before the Illinois AFL-CIO)

But I just bring this up because now he's saying that those words were taken out of context. Now he's saying that everyone should have access to health insurance, not healthcare.

That's what Bill Clinton did back in the 90's.

Then, in 1992, Bill Clinton (who borrowed extensively from Jackson's 1988 proposals) put the call for universal health care at the center of his program. But, once president, his closeness to Wall Street and his intellectual dependence on Robert Rubin of Wall Street (who became his Secretary of the Treasury) made him leery of antagonizing the insurance industry. It was President Clinton's unwillingness to confront the insurance companies that led to his failure to honor his commitment to work toward a universal health care program (see my article "Why HillaryCare Failed," Counterpunch, November 12, 2007). The type of reform President Clinton called for was a health insurance based model called "managed care," in which insurance companies remain at the center of health care. An alternative approach could have been to establish a publicly funded health care program (which was favored by the majority of the population) that would cover everyone, providing medical care as an entitlement for all citizens and residents. This could have been achieved, such as by expanding the federal Medicare program to cover everyone. To do so, however, would have required neutralizing the enormous power of the insurance companies with a massive mobilization of the population against them and in favor of a comprehensive and universal health care program.

But President Clinton's loyalty to Wall Street prevailed. His administration's top priorities were reduction of the federal deficit (at the cost of reduced public social expenditures) and approval of NAFTA (without amending President George H. W. Bush's proposal, which Clinton had inherited, and refusing to address the concerns of the labor and environmental movements). These actions antagonized and demoralized the grassroots of the Democratic Party. Clinton lost any power to mobilize people for the establishment of a universal health care program. This frustration of the grassroots, and especially the working class, also led to the huge abstention by the Democratic Party base in the 1994 congressional elections and the consequent loss of the Democratic majority in the House, the Senate, and many state legislatures. At the root of this disenchantment with the Clinton administration was its unwillingness to confront the insurance companies and Wall Street. Could that happen again?

And I firmly believe, with all my heart, that President Obama and the new Democratic majority won't let us down AGAIN. They won't bait and switch the American public a SECOND time. I firmly believe that President Obama and the Democratic majority understand that Americans don't want to be at the mercy of for-profit health insurance companies. No thank you.

Americans want affordable healthcare.