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Paul Jay continues his conversation with Roger Hickey of the Campaign for America’s Future at the Tides Foundation’s Momentum conference in San Francisco. The first segment of this interview was done before President Obama’s speech about his health-care reform. Now, after the speech, they speak about what the president said and the feasibility of the health reform taking on the single-payer system which would allow for everyone to be covered. They also speak about President Obama’s centrism, and that his collaboration with major pharmaceutical companies, also known as Big Pharma. Hickey says that questions about the functioning of the drug and insurance industries and the deal President Obama invariably agreed to with Big Pharma, “are now politicized questions in the United States of America, while a few years ago they were not. Whether or not we get a good bill, and I think we will, that would be only the beginning of the process of getting public power countervailing and regulating and cutting back the private power of those insurance and drug industries that control our lives.”

Story Transcript

PAUL JAY, SENIOR EDITOR, TRNN: Welcome back to The Real News Network. We’re at the Momentum Conference in San Francisco with Roger Hickey, cofounder of Campaign for America’s Future. Thanks for joining us. So, segment one, we went in great detail about the detail. The speech was inspiring, captured the political moment. He did this throughout the whole election campaign—just when doom and clouds were about to take his campaign, he came with a speech and saved the day. So it was another momentum-changing, save-the-day speech.


JAY: The one part of this speech I thought was quite unfair, and where he compared single-payer—he says, on the left, my friends on the left want a single-payer system like they have in Canada and Europe, and then my friends on the right want to undo employer-based insurance and go to individual insurers. This argument is not—it’s a little disingenuous, because the right-wing position of getting rid of workplace insurance is a tiny little rump on the right, and it’s never been a real serious conversation. It’s not what they’ve been fighting for in this health-care debate. The single-payer option has, you know, dozens and dozens of members of the House that support it, people in the Senate that support it, public opinion polls that show, even in certain polls, apparently, even a majority of Americans support a government health-insurance plan. To make these things equal, as if he’s the rational person in the middle, I thought that was very unfair to the single-payer forces.

HICKEY: Well, I agree with you in the sense that single-payer forces really want to cover everybody with health care. It is a clearly thought-out plan for achieving good, high-quality health care in America.

JAY: And he’s trying to suggest two equally dogmatic positions on far ends of the scale. That was kind of what he was saying.

HICKEY: See, I would disagree with you. I think that the Republican Party, epitomized by John McCain, who ran on this plan to essentially get rid of the existing health-care provision through employers, wiping out negotiated contracts [inaudible] and all the rest, and to replace it with a voucher, a tax credit that, of course, low-income people would never be able to use, that is really where the Republican Party is. It probably has more support in the Republican Party than single-payer has in the Democratic Party. So in the sense of characterizing where the conservatives are, he was shooting an arrow that could have hit any one of those members of the [inaudible]

JAY: Okay. So a legitimate attack here. But to make single-payer as if it’s the, somehow, ideological twin, that wasn’t fair.

HICKEY: Hey, he’s done this throughout the election. Barack Obama is a serious man who flirted with single-payer in his youth, and he decided that it was unfeasible. So he was using a rhetorical construct to say, “I am not on the left. I am not for single-payer. I am for a mixed system that’ll get the job done.” And it was a technique used to certify his centrism. All presidents are centrists by definition. The question is whether they’re centrist to the left or centrist to the right.

JAY: And he’s created a bit of a framing, which is center-center.


JAY: So where, in your heart of hearts—and we’ve talked about this off camera, so let me ask you on camera. In your heart of hearts, do you have any doubt that if it was achievable, a single-payer system would be the best system?

HICKEY: A single-payer system—.

JAY: Just, again, government health-insurance plan.

HICKEY: In the United States, yes, a single-payer system would undoubtedly be more efficient, it would undoubtedly use our resources in a much better way, and it would produce pretty much guaranteed outcomes. But my concern is that the American pluralistic system just certainly can’t do that in one fell swoop. The Americans, it’s a diverse country. There’s a huge ideological preference for private-sector stuff and a huge bias in general with the population against the government. Obama took that on directly, that bias against the public sector, in his speech, and he made the case that in some periods of our history, we have been able to understand that the character of our nation is being distorted by the fact that the private sector is corrupting us. And so he is making the best, the strongest case he can make for government involvement in the health-care system. But he has definitely made the judgment, which I agree with, that we cannot achieve, any time in the next few years, a total single-payer system in the United States. We have aspects of single-payer in Medicare and in the VA [Department of Veterans Affairs] system, and we’ve come to appreciate that. And if Obama gets what he wants, the system could evolve into a single-payer plan. But it’s very important to give people choices, especially in this hyper-polarized arena. He has to be able to say, “Unlike John McCain and unlike the single-payer people, I’m not going to march people into a public plan if they don’t want to go into a public plan.”

JAY: Now, not to re-fight the whole single-payer, public-option debate, but this critical issue of costs, if you can’t use the power of—if—at the very least the powerful public option, I mean, everyone knows that one of the great reasons why Canada and Europe pay less GDP is ’cause they bid up the pharmaceutical companies, they have this massive negotiating power. So you give up that, which is one of the main arguments, pro-single-payer arguments, is that you can reduce costs, and everyone that’s looked at it knows it’s true.


JAY: So in the final analysis, can this actually work, what he’s talking about? Like, you can say it’s an achievable victory as a step towards more, but if what you wind up with is monopolized insurance company, still evermore richer and powerful PhRMA, ’cause they’re going to make a killing out of all these new people signing up—. And I’m not sure where that savings is supposed to be coming from PhRMA, because I’m no—you know, there was some reference in the speech that PhRMA’s going to have to kick back something from all these new customers. But, again, what’s the detail? Then, you know, do we wind up, X years out, with this whole thing kind of—you said earlier, kind of blowing up, in which case, has it really been a step forward?

HICKEY: Hey, listen, the president clearly made a deal with PhRMA. He’s going to get some revenue of the drug companies, but not nearly as much as the House bill would achieve by authorizing a real competitive bidding for drugs the way they do naturally in the VA system here. I think the president made a judgment that he wanted PhRMA inside the tent doing advertising in favor of reform, and he got that, rather than outside the tent hurling nuclear bombs at him. So they clearly made a calculation. The question is whether that deal made between some senators and the president and PhRMA will hold in the final bill. The House leaders are much more savvy about this and much more willing to challenge PhRMA. They went through—we all went through the process of passing the expansion of Medicare to cover drugs, where the head of PhRMA wrote the bill, or the future head of PhRMA wrote the bill forbidding competition. And I think it’s very, very—I hope that the House can prevail and toughen up this [inaudible]

JAY: Can the House sink the deal?

HICKEY: The House can sink the deal.

JAY: ‘Cause the White House has no ability to impose this on the house.

HICKEY: No. He is making the case, I am sure, to senators, etcetera, that we’ve got got to hold to this deal. And Nancy Pelosi has made it very clear that she’s not bound by that deal. So there’s going to be a real fight. Americans have learned a lot about the drug companies, and we know that we pay more than every other country for drugs, and it’s because of the power of the drug industry. Obama, to his credit, is making the case in a similar situation that Medicare advantage, where private insurance companies are now in Medicare, should not subsidize those companies the way the current law allows. And he’s getting some money from the abolition of Medicare advantage. So I hate to say everything is a dialectic in which we get better and better as we go forward, but the point is that these questions that you are raising about the functioning of the drug industry, the functioning of the insurance industry, those are now politicized questions in the United States of America, where a few years ago they were not. And what we’re doing, whether or not we get a good bill—and I think we are going to get a good bill—that will be only the beginning of a process of getting public power countervailing and regulating and cutting back the private power of those insurance and drug industries that, you know, control our lives.

JAY: Well, we’ll be there to continue talking about it.


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


Please note that TRNN transcripts are typed from a recording of the program; The Real News Network cannot guarantee their complete accuracy.

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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.