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Et Tu, Atul?: Test-Case for a Single-Payer Hypothesis
A politician says -- I support health care for all.
That is a politician you should support, right?
Wrong.
A politician says -- I support universal health care.
That is a politician you should support, right?
Wrong.
Universal health care.
Health care for all.
More often than not, these are code words for -- keep the private insurance companies in the game.
The only way we are going to dramatically improve the health care system is to get the private insurance companies out of the game.
That means replacing the hundreds of private insurance companies with one payer.
One nation.
One payer.
Single payer.
Single payer already exists for Americans over 65.
It's called Medicare.
Why not single payer for everyone else?
Because the insurance companies don't want it.
And they have a lot of money and political influence.
Last week, Tom Daschle was forced to pull out as Obama's nominee for Secretary of Health and Human Resources because he failed to pay taxes on a limousine and chauffeur.
Or as one DC insider summed up Daschle's problem -- "he's a limousine liberal who didn't pay taxes on his limousine."
But what was widely overlooked in the flood of news last week?
Daschle's close ties to the health insurance industry.
The fact that he gave speeches to the industry's key lobbying group -- America's Health Insurance Plans (AHIP) -- at $20,000 a pop.
AHIP has one litmus test -- you must oppose single payer at all cost.
If you oppose single payer, you are with the insurance industry.
If you favor single payer, you are against the insurance industry.
Daschle opposed single payer.
He was with the insurance industry.
And against the interests of the American people.
Just go down the list of health advocates and advocacy groups -- and apply
this test.
Ron Pollack and Families USA -- opposed to single payer now.
Physicians for a National Health Program -- for single payer now.
SEIU -- opposed to single payer now.
California Nurses -- for single payer now.
Health Care for American Now -- opposed to single payer now.
Public Citizen -- for single payer now.
AARP -- opposed to single payer now.
And if you dig deep enough, you will find that that most people and groups who are opposed to single payer have ties to the health insurance industry.
I decided to test out my thesis with the case of Atul Gawande.
Gawande is the Boston surgeon and New Yorker writer.
And he's being pushed by Pollack and others as a replacement for Daschle at HHS.
In his most recent article in the January 26 New Yorker titled Getting There From Here: How Should Obama Reform Health Care? Gawande argues against single payer now.
I started looking to find out whether Gawande had ties to the insurance industry.
And sure enough, there it was.
Gawande is scheduled to give the keynote speech to AHIP's annual public policy conference on March 11 in Washington, D.C.
So, I shoot off an e-mail to the New Yorker and to Gawande and ask - is Gawande being paid by the health insurance industry for this speech?
And how much has he been paid by the insurance industry for speeches in the past?
And why weren't New Yorker readers informed of his ties to the industry?
Alexa Cassanos from the New Yorker writes back first.
"Atul Gawande does not accept speaking fees from pharmaceutical or medical-device companies, and speaking payments from insurers or insurance lobbyists are relayed directly to charity," Cassanos says.
Okay, a follow-up.
Why does he take money from the insurance industry but not from the pharmaceutical or medical device companies?
And how much has he taken from the insurance industry?
On the phone, Cassanos says "there's no story here," but that she will try and track down the information.
I next hear from Dr. Gawande, via e-mail, who points me to a just updated (February 6, 2009) conflicts of interest disclosure statement on his web page.
In it, Gawande says: "I don't benefit financially from speaking to for-profit medical businesses (whether they are drug companies, device
companies, or insurance companies) -- either I'm not paid or I arrange for the fee to be donated to charity (including my family's church, our WHO work in patient safety, and a rural college my father started in India)."
I write back to Dr. Gawande.
I again ask him why he says he will not take money from medical device and pharma companies, but will take money (for his charities) from health insurance companies.
This time, he clarifies what Cassanos from the New Yorker said.
"The reason I haven't received money from for-profit drug or device manufacturers is that neither have asked me to lecture," Gawande says. "If either did and I accepted, I would donate the fee to charity or not accept the fee."
As for his insurance industry ties, Gawande writes:
"Since I decided in April, 2007, to write on health reform policy - I spoke to AHIP once (and the fee I received was donated to charity), I've scheduled to speak to AHIP again in March (that fee will be donated to charity), and I've not lectured to any for-profit insurers."
AHIP is of course the lobbying group (technically a non-profit) of the for-profit insurance industry.
"I would have received $31,500 in 2008 after the speaking agency's 30% fee was taken, and $28,000 in 2009," Gawande writes.
"I chose the charities independently and AHIP is not informed whom they are," Gawande says. "The charities are the Trinity Church, Boston, the Student Education Support Association which provides for students attending a nonprofit college my father started in rural India, and the Brigham and Women's Hospital Foundation for our work with the WHO to reduce unsafe care globally -- I am not permitted to benefit financially from these funds."
Gawande does not reveal what he was paid by the insurance industry prior to April 2007.
He has been speaking to AHIP groups around the country since at least 2004, according to the AHIP web site.
But more importantly, don't his New Yorker readers deserve to be told that his favorite charities -- including his church, a non-profit set up by his father, and a foundation affiliated with the hospital where he works -- are benefiting financially - and by how much -- when he speaks to the private health insurance industry ?
As for his opposition to single payer, he remains steadfast.
In a q/a with New Yorker readers last week, Gawande defended his opposition to single payer now.
"Replacing the entire health-financing system with Medicare would require most working-age people to leave their current insurance plans," Gawande writes. "It would change the finances of every hospital and doctor in the country overnight. It would require replacing the premiums we pay with a tax, with massive numbers of both losers and winners. It seems simple in theory, but in practice it never is. This would be a whole new path for health care. No country has swept away their health system and simply replaced it like that. As I said in the article, one would have to be prepared for an overnight change in the way people get 3.5 billion prescriptions, 900 million office visits, 60 million operations - because how these are paid for is critical to whether and how they are provided. Doing away with private insurance coverage is no less sweeping than saying we'll do away with public insurance programs or do away with employer-paid health care. No major country has simply swept away the way so many people's care is paid for. And the reason is that people have legitimate fears about what will happen to them."
Dr. David Himmelstein, a founder of Physicians for a National Health Program, calls this argument "bogus."
"Patients do not care what their insurance plan is - just that it pays for the care they need. A transition from a system where virtually everyone has only partial coverage to one where they have full coverage is not a disruption for patients," Himmelstein said when we asked him to respond to Gawande. "Several nations have made abrupt changes in the financing of care. The UK instituted the National Health Service - eliminating insurance and private payment for care at a stroke. Each Canadian province went from a private insurance system very like ours to its current system virtually overnight -- though not all provinces underwent the change simultaneously. Taiwan changed to a single payer system about 10 years ago at a stroke."
"Medicare replaced private coverage for the elderly -- who account for about 30% of all hospital patients -- about nine months after its passage. That occurred in an era before computers. The entire task of enrolling tens of millions of patients, inspecting virtually every hospital in the nation -- to certify that they were desegregated, which was mandated by the Medicare law -- and set up a new payment apparatus was carried out using paper records. Why is a shift of the other two-thirds of our system more difficult?"
"The new payment system would be far simpler than the current one -- hospitals would receive a global budget, which initially would be based largely on their previous year's revenues. Medicare currently collects all of the financial info needed to do such budgeting at the outset. Per-patient billing for hospital care would be eliminated. For doctors, Medicare already has a fee schedule, which should be modified somewhat, but already serves as the benchmark for most private plans. Expanding this payment system to cover all fee-for-service billings would be trivial. Paying for drugs is similarly pretty simple and straightforward, with most of the needed infrastructure already in place."
"In sum, his arguments are bogus unless you assume that we are far less competent than people in other nations, and than we used to be," Himmelstein said.
Gawande will travel to Washington on March 11 to speak to AHIP.
The title of his speech -- Fixing Health Care from the Inside Out: The Physician's Role in Health Care Reform.
The majority of physicians in the United States now support a single payer system.
Dr. Gawande does not and is coddling the private health insurance industry.
When Daschle was driven out of office last week, a DC insider made the following observation:
When people first come to Washington, they see it as a putrid swamp that breeds corruption.
But after they stay awhile, they begin to see it as a hot tub.
Et tu, Atul?
- Posted in
64 Comments so far
Show AllA good article and one that exposes some folks for what they are. Huzza!
Here is what happens when Americans are hit with horrendous doctor bills...we become BEGGARS!!!!!
This is gut wrenching on so many levels it is difficult to fully comprehend. If anyone doubts the damage that drinking and driving can do, here is the ultimate proof…….two families forever shattered……and now one is to be bankrupted. Shame on our government for its failure to protect its citizens from financial devastation when such a catastrophe befalls it !!!!
February 9, 2009
To Whom It May Concern:
I am writing as a request for help for my brother, Matthew Lundy. Matt (21), and his friend Josh Carter (20), were hit by a drunk driver on January 11, 2009. Josh was killed on impact. Matt was careflighted to John Peter Smith Hospital in Ft. Worth. The doctors have remarked that there is not a part of his body that is not damaged or broken. But he survived! His injuries include: skull fracture, two (known) traumatic brain injuries, blood pooling at the base of his skull, facial fractures, broken teeth, cervical fracture (not related to the spine), broken left collar bone, shoulder and elbow, broken bones in his back (again, not to do with the spine), broken ribs, bruised heart and lungs, lacerations to the kidney, liver and spleen, internal bleeding (this has self healed as far as we know), but he has had 4 surgeries and we are worried about the health of his incision, and a crushed pelvis. He has been in the care of their ICU trauma team for a little over four weeks. He has been non-responsive during this time. He is currently fighting a lung infection, but it appears to be working its way out. It has been (and will continue to be) a roller coaster. We have had some good news – the bones in his pelvis are lined up to heal themselves (without surgery)! The surgery was postponed because it was too risky.
Now the doctors are telling us that they want to move Matt to a long term care facility. This will decrease his chance of infection (which is his biggest risk right now). The problem is that Matt has no insurance, and our family does not have the kind of money necessary to keep him in a place long term. The lady that hit him only had liability insurance ($25,000), and Matt had underinsured motorist protection ($25,000). Careflight was almost $13,000 and his ICU bills are about $20,000 a day. So, that money is long gone. He will have to be in a long term care facility for awhile, and then he would move on to rehab (once he wakes up). The doctors say that the brain can heal for up to two years.
We have been approved for Medicaid, but there are virtually no Long Term Acute Care Facilities that accept it. We have also applied for Victim’s Assistance, but again this will not cover his costs. His bills are going to be outrageous. The estimate I received for Matt’s care was $10,000 per day – with 30 days payment up front.
Would someone explain to me why this was flagged?
From a nation of sheep to a nation of beggars. Sounds about right.
Sioux Rose
LIBERAL: I can't believe this kid is supposed to pick up the tab on all this! Talk about an insane nation and its priorities! This situation (if true) should become the poster ad to show all the right wing hate jockeys what could happen to ANYONE. I'll bet plenty of insurance plans (those who think they are covered) would look for reasons to NOT cover all the rehabilitative services needed by this poor kid. A nation that never has to ask twice for money to build bombs, but lets its own citizens beg in the gutters. Unbelievable.
I wonder if a clever attorney could pin it on the LIQUOR company or bar that this woman driver got loaded at?
Long story short:
If his favorite charities benefit from his fees for talks to a health insurance organization, he has a conflict of interest.
Who cares if he doesn't benefit personally, but passes the profits to his favorite charities, and gets to play hero with them?
Get him outa here.
During President Obama's press conference Mara Liasson asked him how we can get Republican support on entitlement reform which will require painful sacrifice. Apparently, Ms. Liasson wants painful cuts in Medicare and/or Social Security, but there is no reason that such cuts are necessary.
According to the Congressional Budget Office, Social Security is fully funded through the year 2049 with no changes whatsoever. Medicare is projected to face serious shortfalls, but only because private sector health care costs are projected to grow explosively over the next four decades. Since Medicare pays for a large portion of private sector health care costs, the projected explosion in costs will have a devastating impact on Medicare and the budget as a whole.
If the United States can fix its health care system to bring costs more in line with health care costs* in other wealthy countries (all of whom have longer life expectancies), then there is no reason for painful cuts in Medicare. The problem is the power of interest groups like the insurance industry and the pharmaceutical industry, not the generosity of Medicare.
--Dean Baker
http://www.prospect.org/csnc/blogs/beat_the_press
*http://www.cepr.net/calculators/iousadeficit/calc_iousa_deficit.html
Part of the vital prescription for the single-payer system is evidence-based medicine. That is, diagnostic tests that are relevant to prognosis, the use of drugs that offer significant rather than marginal advantages over previous, less expensive ones and are subject to proper clinical studies, efficient and effective treatments of all sorts as in the ongoing controversy betwen $1000 skin grafts in periodontal disease and $4000 prosthesis implants. This prescription also applies to public policies in regards to untested, ineffective and often dangerous "alternative medicines" which cost Americans billions of dollars every year and also have their lobbyists in Washington e.g. Bill Richardson, Orin Hatch.
One of the troubles with evidence based medicine and it's based on research done to favor/support the drug and insurance companies. Using that logic Ephedra was banned after 5 people who abused the product died (in spite of centuries of safe and effective use) and the COX 2 inhibitors (Celebrex etc...) were approved. The initial research that showed how deadly the COX 2 inhibitors would be was "right on the money", with an estimated 50,000 patients dieing after using these drugs. Is that the kind of research you want your medical care based on? http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1140734
CounterPunch has a parallel article on Obama's choice for surgeon general of the US Public Health Service:
A Sworn Foe of Single-Payer
Why Sanjay Gupta is the Wrong Man for the Top US Health Job
By VICENTE NAVARRO
http://www.counterpunch.org/navarro02092009.html
All single payer advocates ought to be writing to their congresspeople and Obama to demand that they not stack the deck against single payer & that it be given a fair hearing.
Obama doesn't support single payer healthcare. The sissy flipped a long time ago !
He's not a sissy. He's a realist. That means greedy.
Yea, the whole idea that if a company is "non-profit" this provides a sacred halo over all its activities. Obviously the C.E.O.'s are making hansome profits what with their sometimes 7 figure salaries. They have the same co-pays, exclusions and deductibles. Their activities support big pharmaceutical and medical supply companies. They support the same inefficient and ineffective treatments and they have the same exorbitant back-offices expenses as the "for-profit" sector. Nobody who has made a serious analysis of the situation concludes that there is really any difference as far as the long term interests of the American people are concern.
How long Americans are going to cling to the halos of the non-profits" is anybody's guess.
Provide links or examples...
Also, the difference is that non-profits don't have to provide a surpus for their shareholders...
EUGENICS SLATED TO GO TO NEXT LEVEL IN OBAMA'S HEALTH CARE PLAN??
It seems there are a few very interesting health care items hidden in the "Stimulous" Plan. (Who said Hitler died in that bunker?)
Note the statements by Tom Daschle, one of the architects of Obama's health care plan. It's becoming more clear what Obama had in mind when he spoke of "sacrifice" required of the American people. As far as access to medical care, it appears that the elderly (and anyone else who poses a burden on society) will be sacrificed first. Health care will be rationed according to cost-effectiveness, and once you reach a certain age, your usefulness will be considered on a diminishing scale determining the type of care you are eligible for or whether you are eligible for any care at all.
So let's all hope we can hold Obama's feet to the fire?? BULL. The New World Order becomes more fun-filled with each passing day.
http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs
"The title of his speech -- Fixing Health Care from the Inside Out: The Physician's Role in Health Care Reform."
You see the above phrases more frequently now: "fixing" healthcare--especially from the "inside".
You can't "fix" a for-profit healthcare from doing what a for-profit system is designed to do.
As for doing it from the "inside", the examples of Gawande, Ron Pollack, SEIU, Health Care for America Now, and AARP can attest to the illegitimacy of that.
As one commenter below quoted Dean Baker--"The problem is the power of interest groups like the insurance industry and the pharmaceutical industry..."
At the very least, it's interesting as things move along to see who and who does not become part of the problem.
The only indicator I see that single payer healthcare will pass is when half the MS folks take it seriously and stop associating race and sex with it. Unfortunately, too many folks keep having silly fears and would say stuff like "Well, if single payer passes, illegal aliens and lazy n**ggers will get it ! I don't want my taxpayer money going to those lazy ass motherf***ers !!" or even "Those welfare queenies don't deserve a dime of my taxpayer money to be covered. Let those motherf***ers self-pay !" And then they'll blabber about trial lawyers and personal responsibility like a bunch of buffoons !
You mileage may vary in your state as mine is a hick state.
I live in AZ, which has to be amongst the hick states. I've heard the argument about illegals and niggers, though even the most bigoted are careful with the 'n' word nowadays. Considering this last year, in which our government has spent billions, and is slated to spend trillions on 'bailing out' our banks and financial institutions, anyone who brings up illegals or welfare queenies or anyone else at all really should use some of their health insurance to have their head examined. That argument simply doesn't have much 'currency' any more.
George Markley
Dennis Duncan
Though illegal workers are hurting American workers and costing American citizens a bundle for their support and I am totally opposed to illegal workers or anyone breaking our law..........
But, they have nothing to do with Single Payer Healthcare. It would be restricted to citizens of our country just as it is in other countries that have it like France. As to welfare queenies, where do these idiots think the folks they are referring to get their health care now and who do they think is paying for it. As to those that would refuse health care because they don't like "niggers," the hell with them, aside from which the majority on services are white in most areas.
How sad to hear that pro-single payer people have had to hear vicious and racist comments.
Just a few thoughts. The French cover everyone in their country--legal or illegal because it's a national security issue. We can't have someone with TB or SARS hidden in some back room, afraid to seek care because they are undocumented. If the US should experience a major epidemic, untreated people would endanger us all.
As to those who say they don't want to pay for smokers, or couch potatoes who over-eat and don't exercise, I suggest they look at their own family history. All the treadmills and exercise in the world won't help you if you inherit high blood pressure or a genetic disorder. The fact is that we will all need care at some point--and for those in single payer countries, the care is there when you need it.
Call your Congressperson today. Ask for support for HR 676.
I get a lot of similar arguments against single payer by my conservative friends and coworkers although they're not racist, sexist, or even mean by any means. They're nice and friendly to talk to but bring up an issue such as single payer, they'll hit the self-righteous button and froth at the mouth making it look like government shouldn't give healthcare to "welfare queens" or any of that crap. They'll say that people should somehow shut up and pay for it themselves if they can afford it. They'll call it "Hillary Care" or even "Satan care" ! Talk about the real big government spending on things such as subsidizing agri-business, war spending, bailing out Wall Street, and big drug companies and they'll foam at the mouth about it somehow being good for the "economy" and helping America "feel the victory" on the "war on terror" and even think you're "unpatriotic" for not supporting that kind of spending. Don't underestimate them. Conservatives love big government spending if the intent is to destroy and kill but basic help is a no no to them.
Terrance Mitchell
Redfield, South Dakota
Try this on them tm.....I thought you were an American, a Patriot. I can't believe you are supporting our present form of socialized medecine.
Let em sputter at that!
Do we actually have socialized medicine in this country? If so, could you explain? I would love to write some letters to the editor in my local Tulsa newspapers and expose the conservatives for what they are.
Well...I was semi kidding of course. But how about a view that medecine is socialized for the medical industry? That we have public funded health care as we all pay for our health care, but the benefits are concentrated for the medical industry, not the customers?
Naw, wouldn't fly! Doggone it.
There's socialized medicine but only for the top wealthy but privatized shitcare for the rest of us. Talk about double standards.
Darn Dennis....does this mean you aren't grateful for trickle down healthcare??????
We should be looking for those bootstraps everyone keeps talking about I'm sure.
Unfortunately, in my state, too many people worship the medical industry as if it were like another church. In fact, they'll treat the US Chamber of Commerce as the next best thing as the churches. People are so rude all too often on the matter and will say that "corporations are good for you and if you don't like it, leave the country and move to Canada or Europe where you can have all the socialized medicine you want !"
Interesting connection, Peter Pike. I work as a massage therapist in Kansas, and we are daily educating each client on his/her right to think for him/herself about his/her own body. I have never considered that the deification of doctors implies that the medical industry is a kind of church.
I'd say there is a business Chamber of Commerce, but by calling themselves the "US" Chamber of Commerce they are lying. They have no interest in the United States or American citizens welfare.
Hank B VA is probably the first example of socialized medicine that comes to mind.
Instead try "tyrany" as an angle. For the person who is self-employed or does not receive a health care benefit from his employer, all employee health care benefit packages are a form of tyrany. The cost of the package is actuated into the price of the product or service and the consumer pays it. When a person buys groceries, pays his electric bill, etc., he doesn't have the option of deducting that amount from the bill. In other words, he's forced to pay and has no way to receive any benefit in return. It may be a little far fetched, but even extortion has a benefit tied to it.
You support the insurers, doh.
No I do NOT ! Go talk to my fellow Oklahomans and see if you can knock some sense into the strong conservative ones.
To Peter Pike,
We already have the VA and Medicare, and Indian (Native American) Health Service. Other examples of "social programs" include fire and police protection, Center for disease control, homeland security, department of defense. note that all these agencies are involved with saving lives. That's why we need single payer.
Yes, write to your local paper and please call your Congressperson.
Study the HR 676 bill at www.thomas.loc.gov
Propublic resourced an article on on-going lobbying efforts in Congress over the rules which will govern the new electronic medical records database the funds for which are in every version of the stimulus package. It seems that there are billions of dollars to be made mining this database for various commercial purposes and all the big corporations ( non-profit included)are working desperately to get their chickens lined up.
http://www.washingtonpost.com/wp-dyn/content/article/2009/02/09/AR2009020903263_2.html?wprss=rss_business
This is just the tip of the medical records iceberg which your government will need to seriously address, likely within the current administration.
Harvard is currently sequencing the complete genomes of up to 100,000 volunteers. Meanwhile the per unit cost is expected to fall to $1000 per genome within 5 years. At that price any insurance company contemplating insuring a healthy, young adult would likely require a genome review.
http://www.nytimes.com/2009/02/10/business/10pills.html?_r=1&ref=todayspaper
This article recounts an FDA 'crack-down' on "natural" dietary supplements.Alot more could be done as is also the case with OSHA, both agencies being under-funded, understaffed and with limited mandates
see
Natural Causes; Death, Lies, and Politics in America's Vitamin and Herbal Supplement Industry by Dan Hurley;
Broadway books, N.Y., 2006
"But as the growing evidence shows, our trust in vitamins and minerals has been misplaced. The very bedrock of the dietary supplement industry turns out to be a swamp where the facts go to die." (pg181)
also
How Everyday Products Make People Sick; Toxins At Home and In The Workplace by Paul D. Blanc, M.D.[ holds endowed chair in Occupational and Environmental Medicine U.C.S.F].USC Press Berkeley, 207
" ...Strategies used to block any effective (reform) action are:
1.) characterizing scientific information as limited, overblown, conflicting, or simply "junk".
2.)blaming the victim and simultaneously charging that regulation is overly costly and ineffectual to boot.
3.) labeling opponents as unrealistic visionaries or, worse yet, seditionist Luddites standing in the way of inevitable progress.
4.) reaching out to the invisible hand of the marketplace as the best partner for corrective action, if such action is really needed. (pg 29)
Representative Steve Kagen,a Democrat, from Wisconsin's' 8th district, appears to receive most of his campaign contributions from private health professionals.
Many or the people in his district can not afford health insurance from private insurance companies. Rep. Kagen, is against universal single payer, and will not sign on to HR676. Only 33 representatives have signed on to HR676. I say shame on Rep. Kagen, and the remainder of the House that has not signed on to HR676!
Self interest ahead of the American peoples is unacceptable.
I called my my rep on this and her staff complained that lots of people working in the insurance and pharmaceutical industries will somehow be lost in the state because of it. None of my senators or rep supports the idea as of Jan 27, 2009.
http://74.125.47.132/search?q=cache:jmaQmpcFUw0J:www.ninenineohnine.org/support_by_state.php%3Fstate%3DSD+%22stephanie+herseth+sandlin%22+%22single+payer%22&hl=en&gl=us&strip=1
I always supported the idea even though I used to worry about dealing with the job losses until the folks here helped clear it up for me. I hear Obama doesn't support it. I thought he did before. Oh well, my apologies for voting for him.
Terrance Mitchell
Redfield, South Dakota
gnken
Unfortunately it will the the "Failed Clinton Plan" all over again. Insurance Companies are to rich and powerful. We're defeated before we begin to fight for S.P.H.C.
18,000 die every year in the U$A because of lack of access to health care...so who are the REAL terrorists?
Both Houses of Congress have now passed the largest Corporate Welfare Bill - incorrectly called "The Stimulus"- in the history of humanity. Part of the plan to 'fix' health care is to digitize medical records. That will be a boondoggle and won't make a dent in the 18,000 deaths.
Where's the outrage - there won't be any. The people are getting what they voted for. Obama opposed Universal Health care all during the campaign. He is a strong supporter of insurance companies.
There will not be Single Payer until the people demand it and become informed BEFORE voting instead of getting voters' remorse after the fact. On the Vermont ballot there were 8 candidates for president. Four of them supported a Single Payer health care system. They were rejected by the voters who now are getting what they deserve.
If Obama opposes it, then I shall add this as another reason to have regretted not listening to my wife who voted for Nader while I stuck out for Obama.
Terrance Mitchell
Redfield, South Dakota
You should have listened to your wife. President Nader would have supported Single Payer.
It is Big Pharma and Big Insurance together who are stifling the idea and brainwashing my coworkers and friends against it.
Terrance Mitchell
Redfield, South Dakota
And they'll keep doing it as long as they have the power to do so.
"You can't "fix" a for-profit healthcare from doing what a for-profit system is designed to do." Yup, that's exactly why "reform" in healthcare and education are shams--only the status quo benefits. Nicely put. Where's Donna Smith when you need her? (Just kidding: she's great).
How to move forward? Like Donna, keep beating the drum: stay on message: repeat, repeat, and repeat the message. Make every rep understand that this is the litmus test for them.
Hank B
Has anyone seen or heard anything about the insurance industry having to lay off workers because so many people have lost their jobs and, therefore, their health insurance benefits? The media seems to be very quiet about this aspect of our recession, or how this might influence premiums (i.e., taxes levied by insurance companies without input from the public or their representatives).
The first inconsitency that I found with Dr. Gawande's argument against single payer was his statement, 'Doing away with private insurance coverage is no less sweeping than saying we'll do away with public insurance programs or do away with employer-paid health care.' He must not know anyone who has been recently laid off....in that simple act, went not only a family's income, but the health insurance also. Employees could wake up any morning and find that their employer has decided to no longer offer coverage. No law prevents that, only a union contract could give employees a chance.
We've already seen company after company spent away employee's pensions and retiree's benefits. In this economy we can look forward to more of that happening.
Single payer!
If we went to single payer the only workers hurt would be those in the health insurance offices. They like so many others would be out of work, too. BUT unlike all those presently unemployed, they would have health care. How about them apples!
To me the answer is simple. Allow employers to purchase Medicare for their employees (would cost about $200/month) or continue to purchase from the private sector (about three times the cost). Don't put the privates out of business, let them do it themselves.
Forty cents out of every single dollar going to health insurance companies is already wasted on things other than health care. Humongous CEO salaries and bonuses, fancy offices and private jets, paid out profit for shareholders, commissions to brokers, and advertising to name but a few of the many ways our health insurance companies are making America's health "care" system both the most expensive and least productive of any industrialized country.
What do you bet that the percentage of health insurance premium dollars wasted will go even higher as the insurance companies start pouring uncounted lorry loads of lucre on lobbying efforts to insure that we never get a health care system for all like most rational countries?
Signed: Lawlessone [for more irreverence, see resistence-is-possible.blogspot.com]
While Original Medicare is a true single payer, it must be restructured to cover many of the expenses that a good universal health plan must cover.
For example, many of the preventative screenings require a 20% co-pay or are not cover under Original Mecicare (i.e.bone density screening).
If an individual is hopitalized, there is a $1000 + deductible per 60 day occurance. If a Medicare recipient is hopitalized once every six months, this will cost several thousand dollars.
There is a deductible for Part B coverage and faily substantial co-pays for primary care physicians and specialists.
The biggest problem lies with prescription drugs, where the individual must enroll through a private insurer. There can a high co-pays, a limited formulary and the dreaded "doughnut hole" (doctors should prescribe generics).
Most importantly, there is little emphasis on preventative care, on alternatives to the emergency room, on individual health plans and on the treatment of chronic disease at the early stage.
We often hear that health care expenses are the leading cause of poverty among seniors. If seniors are covered by Medicare (and Medicaid) how can this be tru? We must ensure that Medicare provides necessary safety nets for our seniors (and disabled) before we can use it as a model for universal care.
Medicare for all is a viable option for America. Medicare for all must be changed to meet the health needs of the 21st century.