In the aftermath of World War II, a Western Europe scarred by a protracted ground war and massive aerial bombardment unprecedented in human history, faced mammoth economic challenges. In spite of that, motivated by the fundamental human drive to care for one another, many of their devastated nations took the occasion to guarantee health care to every last one of their citizens.
In 1945, President Harry Truman announced that “the time has arrived” for America to guarantee care to our sick. He had proposed that we enshrine “the right to adequate medical care and the opportunity to achieve and enjoy good health.” At sixty-five, that proposal has run into a Democrat death panel.
The health care reform ideas coming from the White House and congressional leaders were inadequate from the start, even before a punishing series of compromises stripped them of any hint of positive value. The final bill does more harm than good.
Our health care system is a failure. It leaves too many untreated, it favors expensive reactive medicine over smart and efficient preventive care, it contributes to innumerable bankruptcies and economic insecurities, it produces substandard results by international standards and is unbelievably wasteful. At the root of all these problems is the system of for-profit insurance.
A competitive marketplace of health care providers gives people the chance to choose the best doctors. But no one should be without insurance—without regular access to those doctors of their choosing. Monopolistic insurance companies drive the cost of health care in America through the roof with redundant bureaucratic overhead, advertising expenses, obscene executive pay (one former insider drew a dramatic line from the gold-plated silverware on the corporate jets to all the Americans with no healthcare) and all the money that is flushed out of the bottom of the system as profit. The right solution was clear—a single payer system that replaced the insurance corporations with one government plan, while maintaining a free market of doctors.
What the Congress has given us is the plan that has already failed in states like Massachusetts. Forcing people to buy private insurance is proven to fail on both fronts of the health care fight: it doesn’t get coverage to everyone and it doesn’t control costs. Single payer would do both.
President Obama recited more of his signature empty rhetoric after House passage of the health care bills. It’s hard to count how many times his remarks were 180 degrees from the truth. “We proved that this government…still works for the people,” said Obama. In fact, the health care bill is a crystal clear example of the suffocating grip corporate lobbyists (who essentially wrote it) have on the US government.
He spoke of “conviction that change in this country comes not from the top down, but from the bottom up” after he and his allies deformed the debate. They bent over backwards to silence and suppress advocates for genuine universal coverage, while promoting an impossibly compromised proposal written by the same selfish interests who should have been the targets of actual reform.
He said the bill “answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people,” describing legislation that coerces ordinary Americans into buying coverage that is ineffectively regulated, and potentially prohibitively expensive, from insurance companies.
Perhaps most dishonestly, as he frothed to his conclusion, Obama said, “we did not shrink from our challenge. ” Shrinking from his challenge is all Obama has done on health care.
The Democrats made several attempts to stir emotions by anointing the bill as the legacy of Senator Ted Kennedy. Kennedy died this summer, but if he was behind this bill, who knows how long ago his heart died. Decades ago, he had this to say: “We cannot have a fair prosperity in isolation from a fair society. So I will continue to stand for a national health insurance…The President, the Vice President, the members of Congress have a medical plan that meets their needs in full, and whenever senators and representatives catch a little cold, the Capitol physician will see them immediately, treat them promptly, fill a prescription on the spot…If health insurance is good enough for the President, the Vice President and the Congress of the United States, then it is good enough for you and every family in America.”
The Stony Brook Press
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Your review of the present healthcare legislation was both informative and passionate for the introduction of a single payor system in this country. From both a personal and a professional point of view, your belief in Government healthcare as a method to control cost and improve health is misguided. True, our current system lacks focus, appropriates resources disproportionately to last year of life and is Governed by a confusing mixture of Federal and State rules. The irony is the current mess was created by CMS (responsible for Medicare/Medicaid) Fee For Service (FFS) financing of healthcare. The more you do the more you get paid. The more expensive the procedure, the more money you get. All insurance companies use this same payment system so it’s not surprising that Dr’s drive patients to more expensive procedures. Add to this financial incentive, patients are mostly clueless about who provides good or bad healthcare, know more about buying a car than their health and have appalling lifestyle habits which account for 70%+ of all chronic disease. Without effective cost containment and utilization management, the effect of a single payor system would likely be McAllan County in Texas. In that rural poor county, the majority of patients are either getting Medicaid or Medicare (Government insurance) and the average cost per head is Medicare recipient is $15,000/yr. The average income is $12K/year. Physicians have set up provider owned hospitals and make a fortune. It is not surprising that McAllen hospitals contribute very heavily to Democrats because they see the latest bill a license to print money. So what is the solution?
1. People need to take responsibility for their lifestyle and loose weight. No gimmicks, simply cut down food intake and exercise more.
2. Health insurers should encourage enrollment into exercise classes and to educate people with chronic disease on steps to contain that disease. Preventative health should receive higher reimbursement while insurers would cut down payments for expensive and untested procedures.
3. Health reimbursement and approval of procedures should be reviewed quickly and decisions made. While drugs have to prove they work, amazingly the majority of procedures in place have never been tested to see if they improve health.
4. FDA should introduce a NICE organization to evaluate the costs and ROI on drugs and medical procedures. Frankly, the majority of new biotechnology drugs have not passed the test of improving life expectancy for the cost. If Pharma wants to bring these drugs to market in the UK, they have to prove they are worth it.
5. Take away control of individual insurance from the states and create national risk pools. All of our experience has shown that the larger the buying pool, the better the price for services. We also need to have a consumer reports system that ranks providers on the services they provide at what cost and quality. If you ask a provider for his results, he cannot or won’t provide you that answer. No quality, no business.
It sounds far fetched but companies that have adopted progressive health strategies have contained cost while improving health. Safeway Stores is a classic example of a company that has adopted Consumer Orientated strategies and have made significant difference in their costs and health of their employees and their families.
Look, guys, we all want single payer. It’s really the best way to do it. But we have to recognize that Congress is full of bastards, and is likely to remain full of bastards for the foreseeable future. By all means, work to change that, but recognize that the ideal is a long way off.
The type of bastards we are talking about are A) Republicans who claimed that even a weak sauce public option was some kind of Nazi Marxist Apocalypse and B) Democrats who wussed out and withdrew it rather than argue against the above referenced madness. That being the case, I’m not sure how you expected the President to get a better plan through. Granted, Obama was pretty much MIA for a big chunk of the process, and keeping single payer off the table was another example of silly pre-emptive compromising with people who aren’t interested in compromise anyway. But could Nader Himself (PBUH) have gotten a single payer bill through that bunch? I doubt it.
Like the Krug said, there’s a tunnel at the end of the tunnel. It’s going to take decades to fix this thing. But the idea that the government has a responsibility to provide universal coverage is now law. The foot’s in the door. Once people get used to it, it’ll be untouchable. Case in point: hypocritical Republicans posing as the defenders of Medicare, which God-King Reagan had claimed would destroy freedom in America.
Imagine where we’d be now if Ted Kennedy had settled for Nixon’s compromise plan, and universal coverage had been an American idea since the ‘70s. Hell, we might damn near have all the bugs worked out. But he didn’t, and the next plan on offer was the more-conservative Clinton plan, which failed. So now I think the only sensible thing to do is accept the still-more-conservative Obama plan. I don’t know about you, but I’d rather not repeal it and wait to see if President Romney’s cool with single payer.
I’ll stick with the elimination of preexisting condition restrictions, subsidies for low-income families, extended child coverage on parents’ insurance, and the gradual dismantling of the employer-provided-insurance paradigm. And hey, maybe next year we can reconcile through a Medicare buy-in, or some kind of public option. And after that, who knows? Think about it, bros.