Exchange: ACA vs. Single-Payer—Bury the Hatchet? Exchange: ACA vs. Single-Payer—Bury the Hatchet?
Washington, D.C. As the attorney who filed the amicus brief on behalf of Single Payer Action, It’s Our Economy, and Fifty Medical Doctors Who Support Single Payer, all of which opposed the individual mandate but otherwise supported the Affordable Care Act, I agree with Wendell Potter that it’s time for progressives to bury the hatchet [“No Time for Infighting,” July 30/Aug. 6]. I invite Potter and other progressives supporting the ACA to join those who never wavered in supporting what we all know is the only solution to the healthcare crisis—single-payer, aka Medicare for All. I hope Potter will blow the whistle on the individual mandate, which he, more than anyone else, must recognize as a deal with the devil. If Potter won’t bury the hatchet by embracing single-payer, he should at least rescind his demand that single-payer advocates support a law entrenching the same for-profit health insurers he now renounces after a lucrative career as their PR man. Otherwise, he’s just perpetuating the same old misinformation. OLIVER HALL New York City Wendell Potter’s insightful critique of his former bosses in big health insurance was marred by his reprimand of his newfound friends in Physicians for a National Health Program and the rest of the single-payer movement for failing to adopt the political style of his erstwhile employer. Potter incorrectly implies that PNHP urged a no vote on President Obama’s health reform by the Supreme Court. Some PNHP members condemned the ACA for boosting private insurers’ financial (and future political) power with a trillion-dollar infusion of public subsidies and mandated premiums. Others welcomed its expansion of Medicaid. All agreed that the reform would leave at least 26 million Americans uninsured and most others underinsured; that it would accelerate the corporate takeover of medicine and increase costs; and that single-payer reform remains an urgent necessity. Potter derides PNHP as a group of strategy-less “die-hards” too “furious at the president and the Democrats” to vote in November or pursue rational alliances. How odd to see a group of 18,000 doctors—including a number of Republicans, conservatives and libertarians—caricatured as ultra-leftists! His call for diluting the single-payer message in defense of Obama’s reform mistakes the nature of the group and its role in society. Physicians are neither politicians nor corporate lobbyists. On health policy, as in our consultations with patients, we’re ethically bound to tell the truth, not a tale we only wish were true. Aspirin may ease the pain of cancer, but it must not be portrayed as a cure. In Massachusetts, five years into Obama/Romney reform, access to care has barely budged, medical bankruptcy is common and costs continue to spiral. Having lived with such reform, doctors in the state favor single-payer over it by two to one, according to a recent Massachusetts Medical Society survey. Love it or not, Obamacare is the new status quo. Private insurers—whose paperwork and profits siphon off nearly one-third of healthcare dollars—are still in charge. We and our PNHP colleagues remain determined to replace them with a humane, publicly controlled single-payer system. We invite others to join us. STEFFIE WOOLHANDLER, MD, MPH DAVID U. HIMMELSTEIN, MD, founders, Physicians for a National Health Program Potter Replies Philadelphia Our country owes Drs. Woolhandler and Himmelstein an enormous debt of gratitude for their untiring efforts over many years to see our uniquely dysfunctional and inefficient multipayer system of private insurance companies replaced with a more rational single-payer one. As I thought was evident, I’m on their side now. I agree with them and my other friends at PNHP that we must keep working for a more humane system in which private insurers are no longer in charge and can no longer siphon off our premium dollars to cover unnecessary administrative costs and to reward shareholders and executives. I hope Drs. Woolhandler and Himmelstein will take another look at my article. They’ll see I was suggesting that all reform advocates, not just PNHP members, might consider taking a more strategic approach to achieving their goals. In fact, I referred to PNHP only once, in the penultimate paragraph. I did not write or imply that the organization urged the Supreme Court to declare the ACA unconstitutional, only that many single-payer advocates (including some PNHP members I know personally) felt that way and expressed themselves very vocally. I also did not characterize PNHP as a group of “strategy-less ‘die-hards,’” and I did not reprimand advocates, single-payer or otherwise, “for failing to adopt the political style of my erstwhile employer.” Developing a comprehensive research-based strategy and forming alliances with other organizations to achieve a goal is not synonymous with adopting the insurance industry’s political style. Anyone who knows me and what I have written and said about the ACA knows that I always point out that the law falls far short of getting us to universal coverage and controlling costs. But I have indeed written that as flawed as the bill is, it is all we are going to get from the 111th Congress, and that starting over would mean that millions of Americans who now or soon will have better access to care would be out of luck for who knows how long if it hadn’t been enacted. I’ve often cited Drs. Woolhandler and Himmelstein’s 2009 study, which estimates that, as a PNHP news release put it, “nearly 45,000 annual deaths are associated with lack of health insurance.” When the ACA is fully implemented, that number will drop. This means that many friends and family members will not have to die prematurely. That number will not drop to zero, however, which is why we need to “get down to the business of developing a strategy to move forward.” That I did write, and I trust it is something all reform advocates can agree on. As well-written as Mr. Hall’s amicus brief was, it didn’t persuade Chief Justice Roberts to declare the ACA unconstitutional. And as sincere and hopeful as single-payer advocates were at the beginning of the debate on reform in 2009, they regrettably were not able to persuade Congressional leaders or the president to give single-payer even a hearing. So now that the ACA apparently will move forward, where is the strategy to persuade the public and lawmakers to even consider single-payer as a replacement for what we have now? Is it likely that a President Romney and Senate Majority Leader McConnell would be more receptive than Barack Obama and Harry Reid? Is the best strategy to wait until the special interests are no longer as powerful as they are on Capitol Hill and in statehouses or as able to manipulate public opinion? Is it best to wait for the revolution as millions more Americans fall into the ranks of the uninsured and die? No, thank you. My children and your children might be among those who die waiting for the revolution. Any one of us could be. We absolutely need those who have been unwavering in their support of Medicare for All—including the single-payer advocates I’m preparing to meet with as I write this—to stay unwavering and join us to begin the process of developing a strategy to win. I invite anyone interested in seeing a single-payer healthcare system established in this country to join in. WENDELL POTTER
Aug 29, 2012 / Oliver Hall, Steffie Woolhandler, David U. Himmelstein, and Wendell Potter
Exchange: Orlando Figes & ‘The Whisperers’ Exchange: Orlando Figes & ‘The Whisperers’
London Re Peter Reddaway and Stephen F. Cohen’s June 11 “Dishonoring Stalin’s Victims,” about my 2007 book The Whisperers: in a book as large and complex as The Whisperers unintended errors are not unusual. Normally they are dealt with by a writer and his publisher without the intervention of the press or other academics given access to such private correspondence. I reject the insinuation that I used a political smokescreen to conceal shoddy scholarship. The first I heard of Dynastia’s concerns was on April 15, 2011—two years after my one and only comment about politics on the cancellation of the first contract with Atticus in March 2009. In their letter Dynastia drew my attention to about a dozen “factual inaccuracies” and “misrepresentations.” On close examination the alleged faults turned out to be errors of translation, matters of interpretation or derived from Memorial’s own sources—leaving a handful of genuine errors in a book based on thousands of interviews and archival documents. The Whisperers was always going to be a complicated book to translate into Russian. In anticipation of the problems we might encounter, I prepared a 115-page memorandum for the translators but never heard from them. I was not consulted on the translation. I regret any mistakes. It was never my intention to cause offense, to “insult the memory” of anyone or to misrepresent the history of any family included in the book. Nor have I “invented” things. On April 18, 2011, I replied to Dynastia addressing their concerns, pointing out some of the confusions in their translations and offering to make any “revisions” they considered necessary. I received no reply. The misquotation of Natalia Danilova resulted from the accidental substitution of my annotated file for the original transcript. I corrected the error as soon as I was made aware of it. Mikhail Stroikov’s daughter referred in an interview to an “Uncle Boria,” who worked in OGPU. This was the source of my mistake, as Memorial’s researchers suggested. I reject the accusation that I “invented facts” for “dramatic purposes.” According to Memorial’s sources, Dina Ioelson-Grodzianskaia was employed as an “agronomist” and a “specialist” when she was a prisoner—in Solzhenitsyn’s terms, enough to justify describing her as a “trusty”—although I wrote sympathetically about her as a victim of the Gulag. In my letter to Dynastia I offered to withdraw any words that might have caused offense. I am grateful to Memorial, who, three years after The Whisperers was published, gave me access to the valuable archive that forms the basis of Just Send Me Word. It is wrong to suggest that I have misused the “Note From Memorial.” Its inclusion in my book was a condition set by Memorial and one I was anxious to honor. ORLANDO FIGES Reddaway and Cohen Reply Washington, D.C.; New York City In his reply to our article, Orlando Figes presents readers with still more misrepresentations of the truth. Figes now claims that Dynastia, in informing him that it was canceling the contract to publish a Russian edition of The Whisperers, cited only “about a dozen ‘factual inaccuracies’ and ‘misrepresentations.’” To clarify the matter, Dynastia has allowed us to quote the letter to which Figes refers. This letter, dated April 6, 2011, draws attention to numerous errors and misrepresentations in just a few sample fragments of The Whisperers (not the entire book, as Figes would have Nation readers believe), and says that “after revising several chapters we had to stop.” Figes is also dissembling by implying that the “alleged faults” were mostly not his doing but those of Memorial itself, his translators or merely “matters of interpretation.” This too is untrue and, even more, a slur on those dedicated, highly professional Russians. In truth, the chief researcher of Memorial, which had conducted the Russian-language interviews on which the book was based, wrote to the head of Memorial: “I wept as I read it and tried to make corrections…. I gave only a few examples, but the entire text is like this…. It’s even difficult to choose examples; they appear throughout.” Consider Figes’s attempt to explain away two of the examples given in our article. It was Figes alone who alleged that the imprisoned Stroikov had “the support of the political police,” for which there is no evidence at all. And it was Figes, not Solzhenitsyn, who accused Ioelson-Grodzianskaia of “collaboration” with Gulag authorities, which the Memorial researcher characterized as “a direct insult to the memory of a prisoner.” These kinds of distortions, which turn tragic history into melodrama, explain why Dynastia wrote in the letter canceling the contract with Figes that if published in Russia, The Whisperers “would definitely provoke a scandal.” As for a “political smokescreen to conceal shoddy scholarship,” this is Figes’s insinuation, not ours. He made the wholly implausible allegation of “political pressure” in 2009, when his first Russian publisher dropped the book, and he has never withdrawn it—certainly not in his reply to us or in the London Guardian’s front-page report (May 24) on our article, in which he repeated his suggestion “that politics was involved” and astonishingly added that the second cancellation of the book, in 2010, was “pre-publication censorship.” This too impugns the integrity and courage of honorable Russians—the publisher, funding foundation and Memorial alike. Finally, Figes falsely implies that he still has Memorial’s support. As one of its veteran leaders wrote in a statement in April, “In the future, we do not want to link his name with that of Memorial.” PETER REDDAWAY, STEPHEN F. COHEN Clarification Dana Frank’s “Honduras: Which Side Are We On?” [June 11] included a portion of a statement from Miguel Facussé, owner of Grupo Dinant. Here is Facussé’s complete response to a question about what role his security guards played in a November 15, 2010, incident at the El Tumbador farm in which five campesinos were killed: “The group [of campesinos] informed the security guards on site, who were employees of a third-party provider, that they would open fire on the guards and other workers present if they did not abandon their posts and allow them to seize the land within five minutes. Many of the campesinos, armed with illegal weapons, including AK-47s, opened fire on the guards and workers, who were forced to defend themselves. Unfortunately, four campesinos were killed in the gun battle, while a fifth one was found the following day near the plantation. While all the victims were shot with AK-47s, none of the guards were carrying such weapons, as they only carry revolvers and shotguns.” Contrary to Facussé’s claims, two witnesses have testified to human rights observers that the campesinos were unarmed and that Grupo Dinant security guards used AK-47s to ambush and kill the campesinos; one testified that an M-60 was used as well. According to a fact-finding report by FoodFirst Information and Action Network, among other groups, the Honduran government did not release ballistic reports for the arms confiscated from the security guards. No investigation or prosecution of the killings was concluded by Honduran authorities.
Jun 13, 2012 / Orlando Figes, Peter Reddaway, and Stephen F. Cohen
Letters Letters
About NATO, the Postal Service, Gil Scott-Heron and Obama’s record
Jun 5, 2012 / Our Readers
Letters Letters
Responses to Alexander Cockburn, John M. Barry, Katha Pollitt and Jane McAlevey, and another Italian lesson
May 29, 2012 / Our Readers
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On Dorothea Lange, Michael Harrington, Earth Day and solitary confinement
May 22, 2012 / Our Readers and Mark Hertsgaard