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Roger Hickey of Campaign for America’s Future says reform must be within what’s possible


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Health care reform debate

PAUL JAY, SENIOR EDITOR, TRNN: Welcome to The Real News Network. We’re joined now by Roger Hickey, co-director of the Campaign for America’s Future. So give just quickly what is the Campaign for America’s Future.

ROGER HICKEY, DIRECTOR, CAMPAIGN FOR AMERICA’S FUTURE: Well, we’re a group that is trying to build a progressive majority for change in America. We think that economics is the key to uniting the majority in America for change, and so we have focused on populist economic issues like the economy, like jobs, like Employee Free Choice Act, and like health care. And we do an annual conference every year that brings together the entire political movement of the progressives in America.

JAY: This is Take Back America.

HICKEY: Yes, we call it Take Back America, and now it’s called America’s Future Now.

JAY: Because you think you took it back? Or—?

HICKEY: We do think that we’ve made a first step toward taking back the country.

JAY: So, that being said, the election of President Obama, in the health-care debate there’s a kind of a spectrum of what people are asking, demanding, and in terms of what’s considered progressive. So over here you have, if I understand it correctly, a campaign, which is the California Nurses Association, John Conyers, and others are pushing, which they call a single-payer plan, which is a real government-run insurance plan, which, if I understand correctly, does not involve private insurance companies.

HICKEY: M-hm. Sure.

JAY: Over here you have a model which is essentially giving people more access to private insurance companies. And then there’s various in between. So what is the model you’re advocating? And what do you make of this whole spectrum and how this fight’s going to unfold?

HICKEY: Well, we want to give health-care coverage to everybody in the country. We want to make sure that everybody in America has guaranteed health care that is good-quality health care at affordable prices. Many of the people in our coalition Health Care for America Now would probably like to support single-payer if they thought we could outlaw the insurance industry and put everybody into one big health-insurance system right now, but we think that’s politically unrealistic. And we’ve also done a lot of polling to find that most Americans, their biggest worry is that they’re going to be forced into something that they don’t like. So we put a big emphasis on choice. Hillary Clinton’s attempt to do health care was derailed in part because the conservatives, “Harry and Louise,” and the insurance industry did propaganda that said, “You’re going to be forced into a government-run program, whether you like it or not.” So we think it’s very, very important. First of all, we don’t think we’re going to outlaw the insurance industry, and certainly not—.

JAY: But you could compete against it. Like, you could take Medicaid—

HICKEY: That’s what we’re talking about.

JAY: —and let everybody join Medicaid, but create it without private insurance companies involved would be the counterargument, no?

HICKEY: We want to see a system in which there is a strong public insurance system independent of the insurance industry, something like Medicare, and Medicare for the rest of us, and we want that to be available as a choice for every American. So we’re basically calling for a competition between the private insurance industry, which we know is bloated and inefficient and ignores their clients and their patients, and with a public entity like Medicare, which has a much better track record of serving the American public, senior citizens, and a much better track record of controlling costs. So we think that our plan, which is modeled after Jacob Hacker’s proposal—he’s a political scientist from Berkeley—we think that our plan is realistic, has a chance of passing. And, frankly, we played an important role in shaping the Obama plan in the primaries.

JAY: So is your plan equivalent to what the Obama plan ended up as?

HICKEY: Pretty much. We like what Obama talked about on his website and in the campaign. He talked about this kind of choice between public and private, he talked about a public insurance system that would be like Medicare as one option, and he talked about preserving the employer-sponsored health-care system for now—and we think that that’s also a smart idea, because most people, like it or not, get their insurance here in America from their employers. So it’s a transitional system, it’s a proposal that gets everybody covered, whether their employer does it or not, and it’s also a system which over time, as John Edwards said about his proposal in the election campaign, could evolve into a single-payer system. We think it’s very, very important to establish a level playing field of competition so that the public plan doesn’t get all the hard cases, the sicker portion of the population.

JAY: And how do you do that?

HICKEY: Well, you do it by writing the rules of the game in a way that we’re trying to—we’re doing that right now. It’s about to pass in the Congress with Medicare, where the private insurance companies actually got a hold of a part of Medicare and got subsidized more than Medicare does to provide services. That is going to change in the next few months, because we have a new Democratic administration and a new Democratic Congress. We think this principle of a level playing field between public and private is absolutely essential. And we also are doing a lot of work to explain to the American public what they already know, that the insurance industry of America, the private insurance industry, is not serving their needs.

JAY: Yeah, but why not take on some of the bogeymen? When Obama was accused of being a socialist in the last few days of the campaign by McCain and Palin, he actually didn’t back up; he said, “Well, my Bible tells me I am my brother’s keeper.” So why be so afraid of this idea of socialized medicine and not take on some of this more head-on? Because there’s also been a big debate about some of the research on whether people really are so worried about choice. The people that—you know, certainly there’s lots of evidence people just mostly want to get covered.

HICKEY: No, there’s not a lot of evidence that a majority is open to being in just one government-run plan. And, in fact, when you ask people, “Do you want choice to stay with your current employer-sponsored health care?” a lot of them say yes. And our concern is that if you’re trying to sell people on “Alright. We’re going to march you all out of the current arrangements, we’re going to outlaw the private insurance industry, and we’re going to put you into a government plan,” alarm bells go off in heads.

JAY: Well, but does your model—in terms of a government plan that competes.

HICKEY: Yup.

JAY: But your government plan still includes private insurance companies.

HICKEY: Americans like choice.

JAY: But couldn’t they have a choice between, over here, a privatized model and over here a government model without private insurance companies, and then choose?

HICKEY: Well, that’s in effect what we’re doing. We’re not naive enough to think that the private insurance industry won’t get themselves into whatever passes in terms of health-care reform. We want to make sure that the private insurance industry, if it participates in the way that they participate in the public employees insurance system and the congressional insurance system, is that they’ve got to offer a decent package of benefits at a decent price, and they have to be regulated, and they have to cover everybody who applies. And we’re basically arguing that putting private insurers into a government system would require them to be regulated, would require them to change their business practices and not do what they do now, which is only insure the well and the wealthy, and not the sick and the poor.

JAY: But you have to keep them in play because that’s what’s politically possible?

HICKEY: Yeah. I think this is a matter of political realism here. If you say to the American people, “We’re going to take”—what is it?—”16 percent of the US economy and we’re going to nationalize it overnight,” you’re going to get a bad reaction. If you say to the American—.

JAY: I’m not so sure. Four months ago, maybe. These days it’s hard to know exactly what the reaction of that’s going to be.

HICKEY: Listen, the American public wants coverage. They want the government to play a role in guaranteeing that they have an option to be covered by a public system.

JAY: So your plan is more within the realm of politically possible, but you’re still going to have a war to get this passed. There’s a lot of forces that are there to oppose any sort of serious health-care reform. So how do you get this past what we’ve seen in the last few days, which is compromise after compromise in the Senate to get the Republicans on board? How do you get a health-care plan that’s going to be meaningful?

HICKEY: Well, first of all, we’ve got to acknowledge that we’re playing in a political system, and the political system requires some amount of compromise. We think that Obama ran on a pretty good health-care plan, and he won the election. His plan involves a public insurance option. Yes, the insurance companies and the right-wing think tanks don’t like that, but we think, from what we’ve done in talking to people, in polling, that it’s a very attractive idea as a back-up to the dysfunctional private insurance system that we have in America. So we are taking this idea to the American public. We’ve got a massive coalition of 700 national and local organizations. We are working in every congressional district that matters. And we are doing advertising and building a grassroots movement for health care for all. And we think that our vision of health care is the first step toward a comprehensive health-care solution for America. It’s not the perfect solution.

JAY: In terms of timing, when do you think this—what’s the next major step? When does this hit Congress?

HICKEY: The Obama administration is going to put forward a budget which will contain health care, we hope, in the next few weeks and health-care reform—at least money to indicate that they are moving forward. And we think that this year has got to be the year for action; otherwise you’re postponing it for a long, long time because you’ve got elections, etcetera.

JAY: And does the economic meltdown affect this, your plan?

HICKEY: Most Americans, if you ask them, say: “I need health care more than ever right now because of the high unemployment and insecurity.” We are making an argument with a large number of economists that this would be a boon to the economy, a stimulus to the economy, if we invested in health-care expansion right now. And so Obama keeps repeating what we’ve asked him to repeat, which is that he’s going to make this a priority in his first year in office. So we think that this year’s very important.

JAY: And we’ll come back to you as the battle unfolds.

HICKEY: Absolutely.

JAY: Thanks for joining us. And thank you for joining us on The Real News Network.

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Roger Hickey is co-director of the Campaign for America's Future, an organization launched by 100 prominent Americans to expand the national debate about America's economic future. The Campaign seeks to empower working Americans, middle-class families, and the poor to make their voices heard in support of a populist economic agenda and an expansion of democracy. Recently, Hickey organized and helped to lead a national coalition of citizen leaders known as Americans United to Protect Social Security.