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Medicare-for-All: The Answer to a President's Call and a Nation's Woes
Open Letter to President Obama on Health Care Reform
President Barack Obama
1600 Pennsylvania Avenue
Washington, D.C. 20500
Dear President Obama,
I was overjoyed to hear you say in your State of the Union address on Wednesday night:
"But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know."
My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.
I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare-for-All health system.
I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:
"I happen to be a proponent of a single-payer universal health care program." (applause) "I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that's what I'd like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
And that is why I was so surprised when the voices of those who support a national single-payer plan/Medicare-for-All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.
There was an opportunity this past year to create universal and financially sustainable health care reform rather than expensive health insurance reform. As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.
The good news is that it doesn't have to be this way. You said that you wanted to "keep what works" and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.
Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.
I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare-for-All national health system. We can implement it within a year of designing such a system.
What are the benefits of doing this?
- It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.
- It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.
- It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market.
- It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.
- It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.
- It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.
- It will allow our people in our nation to be healthy and productive and able to support themselves and their families.
- It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.
Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare-for-All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.
With great anticipation and deep respect,
Margaret Flowers, M.D.
Maryland chapter,
Physicians for a National Health Program
- Posted in
44 Comments so far
Show All"He who pretends to be sleeping cannot be awakened."
I know what you mean. However, as long as she is in 'pretend' mode, she may as well try her best. In that sense, her letter is persuasive and effective. Kudos to the author.
Sorry, my implication was not clear. I meant that Obama is the false sleeper. No amount of elucidation will make him understand what he already knows but does not intend to support.
Oh, I don't think Obama is sleeping at all. He knows very well what the game is. It is those who petition him "as if he was listening" that could be accused of "sleeping". But it's not clear to me which strategy is more promising: do you act as though the national theatrical spectacle is the actual reality, and engage the players (such as by writing compelling letters like this article) as if they actually were the characters they portray to be, or ... do you stop pretending, and instead direct your actions in a way that addresses reality directly? This is the kind of question I've been pondering for years. I trully don't know which approach is likely to be more productive, but I salute people on either side of this question who roll up their sleeves and try something, whatever it may be.
Now you can eat healthy and part company with government and the butcher medical industry that rules it, or continue eating garbage and worship your doctor of choice at his hospital house of worship.
Great letter. Great approach.
Bill from Saginaw
Obama's lip service to helping small business adds insult to injury.
Single-payer, in one fell swoop would give small business a bigger boost than all of the tax cut schemes Obama is proposing.
Yes, it's a wonderful letter.
It was already published on this site. So was Russell Mokhiber's article, still listed on the front page, in which he wrote:
"... And this morning, she traveled to the White House to deliver a letter to Obama spelling out her reasons why.
Unfortunately, when doctor Flowers tried to deliver her letter to Obama, White House security turned her away.
For security reasons, the White House doesn't accept hand delivered letters. ..."
I commend Dr. Flowers and wish her and her colleagues all the best. Still, I doubt very much that this letter will penetrate Team Obama's sociopathic indifference to the plight of the beleaguered, oppressed unprivileged ordinary citizen.
· Yr Obd't Servant
And Dr Flowers along with a colleague were arrested this morning (see photo/article under CD News):
"Dr. Margaret Flowers and Dr. Carol Paris were carrying a sign that said: Just Letting You Know: Medicare for All."
Although the events, failed delivery of letter (printed here) and then arrest for standing with a sign outside BO's speaking venue, are probably unknown to BO, I take this as symbolic of his real attitude toward medical reform (or anything that benefits the populace).
Yes, thanks, I just saw the report of the arrest published on CD.
I started to comment there, too, but it's a repeat of what's here; I wish there were a way to somehow combine or cross-reference comments when multiple articles on the same topic are published almost simultaneously. But then, I wish there were italics.
I take your point that Obama may not have been aware of Dr. Flowers attempts to communicate. If the comments threads go on long enough, we may even see a variation of "if only Stalin himself knew what his ministers were doing, he'd soon set things to rights!"
It's the old "see no evil; hear no evil; speak no evil" okey-doke!
Sigh.
· Yr Obd't Servant
Nice letter unfortunately it will fall on deaf ears. Obama is a shill for a sick land; he has sold his soul at the company store. The only change we have to look forward to is throwing the bum out after one term. He talks the talk but he does not walk the walk. He could have played the House off against the Senate and made the Senate look so bad, we would have thrown them out in place of him. Unfortunately, Obama is going to be elected to a second term because he serves the masters of the universe better than anyone named Bush. All the masters have to do is pump enough money at him, thanks to the SC. Obama will be chanting bad SC all the way back to the WH. Only China can save us now.
Maybe if Dr. Flowers said she had a shovel ready infrastructure project the WH would listen. Maybe we should start referring to healthcare as human infrastructure.
At the beginning of last year, a poll found that 94% of Americans favored spending on infrastructure. Obama made it a feature in the stimulus and lots of money was eagerly spent for everything from roads and bridges to smart grids and rural broadband. At the end of the year he was still calling for $50bn (additional?) in infrastructure investments.
What better investment in creating jobs and caring for the infrastructure of our society could there be than an investment in US? I have found estimates on the percentage of payroll cost going to provide healthcare insurance from 11% to 15%. Legacy costs are even more burdensome with Maryland finding its retiree healthcare costs needing $1.1bn a year - or an additional 27% of its state payroll - to catch up on its $14.5bn liability just for retirees. The senate had a report estimating that by 2016 the average family will need to spend $24K a year on insurance premiums (not actual care), and for more than half the families this would consume over 45% of their income for insurance.
Clearly the pothole-pocked Galloping Girdy knob-and-tube dial-up healthcare system might fall under the heading of vital infrastructure desperately in need of society's investment. And no one in their right mind would claim this mess could be fixed with a few more billion dollars in lipstick, paint and stock options. I don't believe there has yet been a serious markup of what the real costs are to society versus what the benefits would be if we made a real investment in the infrastructure of our health. Let's take a look at single payer from the standpoint of an investment in us.
Edited to add:
The 50 states have a liability for healthcare to retirees somewhere in the neighborhood of $1 trillion. You can add or subtract half a trillion depending on who is counting.
While we're thinking about benefits of a single payer system, there's this:
Wilkinson and Pickett both work as epidemiologists. They study the health of populations, and, over recent decades, pioneering work by Wilkinson has helped reveal the most reliable foundation for good health and long life. Want to live long and prosper? Go live in a relatively equal society.
Over 200 studies since the early 1980s have now documented that people living in societies where wealth has concentrated at the top of the economic ladder live significantly shorter, less healthy lives than people who live in societies that spread their wealth more evenly.
And we’re not talking just poor folks here. All people in unequal societies do worse. Middle-income people in the United States, the world’s most unequal developed nation, have shorter lifespans than middle-income people in Japan, Sweden and a host of other more equal nations.
http://www.alternet.org/economy/145413/radical_inequality_is_literally_killing_us
"Mr. President, I . . . look forward to meeting with you."
Obama will offer you jelly beans, a favorite of his great hero Ronald Reagan. But that's all you'll get from Obama.
Jelly beans tainted with toxic chemicals purchased at Wal-Mart, produced in China. What else would you expect from a corporate rat?
2003: Single-payer. 2008: Single-brayer. 2009: Single-prayer. 2010: Single-betrayer! And so it goes: BOWEL (Barack Obama's Worth Ever Less) Movement. Down and OUT: 2012! Only 1085 days To GO!
The dems really screwed things up with how they presented the health care debate in the very beginning. They screwed things up so badly that it makes one wonder if they did it on purpose to help the insurance companies.
1. One arguement that should have been made was that with Single Payer we ALL have the same health care as the members of Congress and the president.
2. And it saves money because it eliminates Wall Street investors.
3. It eliminates the middle man (insurance company deniers). Puts everyone in charge of their own health care.
4. Must include dental, vision, and long term care. Imagine, no more bankruptcies because of medical bills.
5. Single Payer would save 45,000 lives per year.
THE END - KEEP IT SIMPLE
If we really want Single Payer we have to keep the debate simple. No more 2000+ pages of legalese and loopholes.
Dr. Flowers could have been patient and waited for Obama to respond to her letter but she got into trouble with the law. Single payer is nice piece of free insurance but the public isn't ready for it and the Republicans and Blue Dog Democrats won't allow it to pass so what does she expect from Obama? To be fairy man? Let's just change the constitution and turn our government into a dictatorship so that only the president can pass laws. Is that what she wants? Dr. Flowers should shut up and go back to taking care of her patients. Children need pediatricians, not idealist trespassers who can't stay out of trouble with the law.
This article makes too much sense for a timid President. Is he just glad to be there? Is he scared he's going to mess up? Why must he take half a loaf all the time, maybe the suit is not empty, just half-full.
And to the President:
What we have Mr. President is broken; the people understand that, which is why you were elected. It's time to get on with the Nation's Business. We are being led by a Minority who created the conditions and circumstances with which we wrestle.
Maybe I'm being too harsh, for even Jesus "grew in wisdom".
Let us hope for the sake of our country that is what we are experiencing in your Presidency.
Before the masters of our political system evaluate the claims you make they judge the consequence of what would happen if you might be right. The claims of Single Payer are unbelievable to Barack or Nancy or Harry because if they were true would require that those who who have obstructed it would be discredited and put out of power.
Democrats are just as corrupt as Republicans. We should be well beyond the presumption that they will listen to us. We should concentrate on building a base that can turn them out of power. Save your breath Margret.
Quite so; truth in politics is class truth. Dr. Flowers might as well petition a dead tree. Nor do I excuse her naivete; I condemn it for promoting the "liberal" illusion that our rulers just need a proper talking to for things to come out hunky dory.
But for people to believe that we live in a class society, first they need to understand that our Empire is an intelligence dictatorship with everyone a slave to the next man more intelligent.
Problem is, most believe that 99% of people have an IQ of 120 and anything above or below that is abnormal.
John Ellis must be joking; unsuccessfully. I must have missed the "intelligence" test that rated GW Bush's class inferiors inferior to him in intelligence.
As a former healthcare executive, I fully agree with what Dr. Flowers has written. As a concerned citizen about the pervasive corruption in our government, I heartily agree with "tammons." As an advocate, I suggest you Google A NEW FEDERALIST PARTY and give some thought as to how that concept can be improved. We can change things for the better, but we need the determination to do so and the ability to elicit the talent to make it all happen.
What Dr. Flowers and her companion did is courageous. A lot of so-called lefties talk a lot of bull, but lack the cojones to do anything other than whine and bitch.
While her action may seem futile to some, the reality is that it shows that she has true committment to the cause. As to Obama... remember he received $20 million in bribes from the healthcare cartel in his bid for the presidency two years ago! His State of the Union speech was typical Obama double talk... it ain't real!
"Typical Obama double talk"? No, no, no, anyone who heard President Obama's speech to the Nobel Committee knows that his brand of double speak, even for him, can never be qualified with the word 'typical'. That would be like saying I read a typical sonnet by Shakespeare--please!
It's nice to see doctors coming out for medicare for all but it would be better if they recognized that doctors, nurses, and patients are also part of the problem. Medicare for all or single payer as it's also called is just a substitution of who covers you. Dr. Flowers should have also written about the 200,000 annual deaths caused by medical errors from doctors, nurses, medical equipment, and faulty medicine itself. Single payer only answers a fraction of the health care costs. We need regulations on medical manufacturing and licensing. There are too many unqualified doctors and nurses holding licenses that need to be REVOKED immediately. Patients should also be regulated on what they can demand from doctors as well.
Now your talking about regulation, now your talking about destroying free market capitalism which is markets free of regulation.
Now your talking about an organized overthrow of our capitalist government.
How about this for an idea? Congress could try to lower the age for Medicare elgibiliby by, say, 10 years. Won't pass? Well, how about 9 years? No? How about 8 years? You get the idea. They could keep negotiating downward until something will pass. If we could just lower the age by 1 year progress will have been made. Then the idea could be revisted next year, and maybe we could gain a little more...
Interesting approach.
Shawn Berry said:
"single payer as it's also called is just a substitution of who covers you."
Just a substitution? Getting rid of the private insurance companies would immediately reduce costs by about 30% and eliminate enormous amounts of red tape. It would prevent the barbaric "denial of claims."
That in itself makes single payer the the only viable option. It's what is currently working well all over the world.
Mr. President:
It may seem like those guys that convinced you to barter away single payer for a minimal discount to their bloated insurance premiums represent your base. If so, what have U been smoking?
We, the great unwashed, the working stiffs that pay your salary, do not want or need more stylized crap called health insuranc. We simply want a little respect, a little health CARE. Call it what U will. Just deliver the goods while we yet live.
Ray in Houston, Texas
CHUBBY TED KENNEDY
Just like chubby Ted Kennedy, most of those in Congress suffer bad health and they know full well the root cause of it, a chubby diet. For their diet is the average American refined food diet which is:
50% fat, 40% protein and only 10% complex carbohydrates.
Whereas a healthy balanced diet is 10% fat, 10% protein and 80% complex carbohydrates.
So, do not those in Congress know that the only way to improve the health of America is to improve the health of our diet? Do they not know that both the processed food industry and medical industry would be driven into bankruptcy if Americans started to eat healthy?
And so, a defense economy dependent on wars, a high finance industry dependent on high imports, and a garbage medical industry dependent on our eating garbage.
Therefore, just as we run a police state in Palestine using Palestine police, so shall China do to us. Unless we start now, to organize against it somehow.
Obama will NEVER "do away with" the health insurance industry, so I have a suggestion. Make single payer health care available to everyone in America by extending Medicare. Continue the FICA tax with no cutoff amount -- everybody pays the same percentage of income, which could be even lower than it is now. That alone would fund Medicare for everyone.
Obama, you can keep the insurance companies out of the grave by allowing them to offer "luxury health insurance" to those who can afford it. Those individuals may opt out of single payer health care while continuing to pay FICA tax on the full amount of their income and purchase luxury health care that covers everything that single payer does, and ADDITIONALLY all kinds of optional "health coverage", like cosmetic and plastic surgery, exercise routines in gyms to stay in shape, DNA testing (it costs $1,000.00 a shot right now), optional drug testing for their kids, weekly massages to relieve stress, stays in health spas to lose weight, etc. I'm sure there are many other possibilities that insurance companies could offer to their wealthy customers.
Just make single payer health care sufficient for the needs of human beings, not our unnecessary "desires".
You want Medicare only for the poor, the perfect solution. But that would lead to Social Security funded only by the rich and given only to the poor, another perfect solution.
But that would lead to the downfall of capitalism, which is to maximize profits by giving nothing but hard labor to the poor.
Boy! are you projecting!
I didn't say I want Medicare "only for the poor". There'd be no cutoff of income for those who want to keep Medicare coverage that is funded by everyone. It's the same principle as sending your kids to private school. You may get some breaks, but you still gotta pay for their schooling and your property taxes for everybody else's.
So, get over it. Obama won't do away with the health insurance companies. You obviously want things to continue just as they are....
No, I want you to grasp the reality of our make believe government, and the impossibility of it doing anything but repeat bad history.
"If you don't know history, its like you were born yesterday."
Howard Zinn
Government-run healthcare is desirable but not needed. After all, US grocers cut each other's throats in price wars that are not provoked by a "Public Grocer".
Antitrust legislation and forced competition made kerosene, airline travel, phone rates, etc, markedly more affordable.
Let's demand that the healthcare clepto-cartel be subjected immediately to the full brunt of antitrust legislation !
It would be wholesome to see demobliRat senators and representatives scramble live in front of the cameras to justify shamelessly, explicitly, and incoherently that they want to protect from *free-market competition* the obscene profits of their beloved healthcare leech cartel.
Let's call for binding legislation to be phased-in every 12 months to bring down --*before* obama's first term will be over-- the healthcare cartel's share of the GPD to below 10% and the cartel's profit margins down to those of garden-variety grocery retailers.
Simple, automatically triggered increases in the taxation of the outrageous profits extorted from the nation by the clepto-medical complex would do the job, with the extra revenue going to preschool and elementary education, Medicare, Medicaid, preventive healthcare, and infrastructure improvements especially in rural states.
After health-care-profiteering will become non-profitable the "entrepreneurs" will abandon the healthcare field and the government will have to become the only provider.
A "public option" at this point, or "medicare for all", would be neutered in Congress by the same by-bribe-only demobliRAT congressmen who designed, and/or went along with, W's medicare "drug benefit" that threw humongous amounts of money at the pharma industry.
No healthcare reform proposal should be discussed ever that does not address explicitly the true bottom lines of the healthcare problem:
i) the ~20% share of the GPD that the healthcare leech cartel (insurances, hospitals, doctors, etc) already have, and are about to expand thanks to "reform" by-bribe only demoRats.
ii) the fact that the healthcare leech cartel delivers very little "health" for the humongous amount of GPD it swallows every year.
iii) the huge cost to the USA's national economy of having so many people getting "healthcare" via emergency rooms, which treats health problems only after they become much harder to treat and would remain ultra-expensive even if healthcare profiteering were abolished.
Making central to the healthcare-reform debate such hard benchmarks and measures that connect transparently to true bottom-line issues will make it impossible for by-bribe-only demobliRat senators and representatives to equivocate further around pseudo-issues and obfuscate the public to so defend the illegitimate interests of those who bribe them in order to parasitize the nation.
Last but not least, when confronted with questions about such hard benchmarks and measures, the few progressive push-over senators (like sanders) and the venal-progressive ones (like byrd) --and people like Krugman-- will not be able to hide anymore behind tear-jerking statements like "the bill gives healthcare to another 20,071 rural grandmothers with pre-existing conditions" while they keep mum about the increase of the healthcare leech cartel's share of the GPD to 30% which they are now supporting.
Dr.Flowers
With all due respect and a thanks for your efforts;
DREAM ON
Right. Medicare is unsustainable going forward (as the Baby Boomers retire), and even now it’s increasingly hard for new enrollees to find doctors who will accept them, since Medicare’s reimbursement rates don’t cover doctors’ (and hospitals’) costs. But if we put **everyone** on Medicare, presto, problem solved!
That’s like the old joke about the retailer who loses a little on every item sold but compensates by selling in volume.
The Washington Post and 60 Minutes both ran stories showing that Medicare fraud amounts to about $60 billion/year. (Part of the overhead that insurance companies are reflexively demonized over goes to fraud prevention, a significant benefit.) Why not do incremental things that make sense, like rooting out this ongoing, virtually uncontested fraud, to show that the government can actually do **something** right, before attempt to tie everyone’s medical care to that corpse-to-be, Medicare?
I am NOT a Democrat (at the moment, in fact, I am a disaffected former Green). While I agree that the current Democratic Party (DP) health "reform" is farcical at best, I don't believe there is a way to repair an inherently broken, for-profit health care industry.
In every country where they have tried to do what you propose, they do not get the cost savings that only a Single Payer system like Canada's (or even, if I may, a fully socialized system like the U.K.'s) can deliver. Also, remember that health care reform MUST be primarily about DELIVERY of care and improving results. The DP plan now just passed the Senate will not reduce cost or provide better results.
There are approximately 47 million Americans without health insurance. There are an estimated 30 or 40 million more who have insurance, but still do not get adequate coverage. This adds up to close to 1 in 4 Americans (which includes children and chronically ill) who are uncovered or whose families must struggle to fill in for the exorbitant premiums, deductibles, co-pays, and GAPS in insurance coverage! This issue has become the leading cause of mortgage foreclosures, not unemployment or other reasons, believe it or not.
This debate is not merely 2-sided; in fact, there are probably about 5 or 6 sides minimum. There are several alternatives: (1) Do nothing and let the system eat us alive, (2) Single Payer, the best solution offered at the moment (3) fully socialized medicine, which probably wouldn't agree with most Democrats, let alone Republicans, (4) the public option, which has been tried in Massachusettes, and has failed to accomplish full coverage and is bankrupting the state, (5) faith healing and other wishful thinking ...
Let's be careful not to view the current debate as black-or-white. It isn't, and it is very damaging and disingenuous to the debate to frame it in this manner.
Extending Medicare to everyone is the only politically viable way to win public support for the comprehensive health care reform we need. People understand it because Grandma’s been using it (and liking it) for years. They also understand they need to pay for it because the tax already appears on their pay stubs. They’re likely to accept Medicare tax increases for expanding the program to everyone if doing so eliminates the health insurance premiums that also appear on their pay stubs and ensures they can visit the doctors of their choice and make their own health care decisions without interference from the government or insurance companies. If the Democrats expect to retain control of Congress this year they’ll stop trying to ram through reforms no one understands, take a populist stand against the insurance and pharmaceutical companies, and use their majority to expand a popular program.