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The media slam against Congress and President Obama has been that supporters of health reform don't make a clear, simple argument for what it is and why we need it. Opponents' smear-and-fear campaign grabs the headlines. I've had the same complaint about the mainstream media itself--too much dwelling on politics and little substance. A guy named Wendell Potter is helping change that, most recently in Nicholas Kristof's column in the New York Times.

Potter, a longtime health insurance executive-turned-whistleblower, has a dead simple message: There's no way insurance companies can concentrate on anything but their own profit. White House speechwriters need to be picking his brain. From Kristof's column:

Mr. Potter says he liked his colleagues and bosses in the insurance
industry, and respected them. They are not evil. But he adds that they
are removed from the consequences of their decisions, as he was, and
are obsessed with sustaining the company’s stock price — which means
paying fewer medical bills.

One way to do that is to deny
requests for expensive procedures. A second is “rescission” — seizing
upon a technicality to cancel the policy of someone who has been paying
premiums and finally gets cancer or some other expensive disease. A
Congressional investigation into rescission found that three insurers,
including Blue Cross of California, used this technique to cancel more
than 20,000 policies over five years, saving the companies $300 million
in claims.

As The Los Angeles Times has reported,
insurers encourage this approach through performance evaluations. One
Blue Cross employee earned a perfect evaluation score after dropping
thousands of policyholders who faced nearly $10 million in medical
expenses.

The LA Times, in a terrific news story last week, has also described exactly what kind of reform the insurance companies are intent on getting--the kind that boosts their bottom line at our expense.

Healthchart.pngThat still leaves the issue of clarity about what reform would really mean. The NY Times' Paul Krugman has posted this chart (also at left), courtesy of economic writer Nick Beaudrot, showing in consumer terms how reform, including a Medicare-style public option, would work. Too bad it wasn't being trumpeted when GOP opponents of any health reform, put out its "reform is government takeover" chart months ago.

And in the comments to Krugman's post is a remarkably clear statement of what reform needs to be. I read comments to take the temperature of debate, see who's spewing what. But this one, by Barry Nall, is strikingly clear and short. He pines for single payer, but then smartly describes the original idea of a Medicare-style option--open to all, as a real competitor--before Congress and the White House slashed it to pieces and started dumping it overboard to appease insurance companies.

Nall says: "OK, the chart does help, but I think it is still too complicated a
system to catch on with the general public. Go with what almost
everyone knows, understands, and trusts: Medicare. If 70% of the
general public think they want a single payer system it should be
possible to get the one single payer system (Medicare) they know and
like through congress. Obama needs to state clearly that his healthcare
reform program is simply “Medicare for all” and get people on board to
pressure congress to bring it about. If everyone had Medicare costs
would come down since it is run so much more efficiently.

"Back to the chart. What about those who do not like their current
employer-provided “insurance”? A public option (like Medicare) needs to
be an option for everyone, otherwise there is no competition and people
are locked into employer plans they’d like to dump. If the public
option is not available to all how will competition between public and
private plans keep costs low? Of course competition is kind of a
meaningless concept in healthcare anyway. Competition assumes consumers
know how to tell a good plan from a bad one, and most of us do not
until it is too late."
(emphasis added)