Today a local Peace list I’m on, and the Green Party US National Committee Discussion List,
both synergized me on this kore important issue that shows lobbyists easily cajoling politicians
into severely dropping the people’s ball once again on this critically out of control issue.
Apparently 54% – 65% of us* (and 59% of physicians**), want single payer, or some such similar
plan, yet such a plan is not even on the table.
The lobbyists at the table are inclining bargaining towards even more of the worst exacerbations of
the excesses of the current system. Things like requiring us all to funnel our money through the
current (lack of a) system (of private insurers) designed to profit by taking our money to spend much
of it deciding to deny us care our doctors know we need.
We do not need solutions that exacerbate the core human and financial issues. One isssue that is
largely being ignored by the focus on the interests of the insurance and drug industries is the huge
cost of admin for he current system. 31% of US health spending goes to admin*, much of that cost
is spent submitting paperwork to a plethora of providers so they can spend much of their overhead
deciding who to deny care to.
“Taxes already pay for more than 60 percent of US health spending. Americans pay the highest
health care taxes in the world. We pay for national health insurance, but don’t get it.”*
Because the right wing wants to focus on personal responsibility, they have allowed an atmosphere
that has fostered conditions conducive to the giants of finance, insurance, banking, credit, and loans
industries, allowing them to make huge profits from writing the laws their way. They say they do this
to allow more of a “free market” in what has become a tidal wave of personal misery bouying up
profits within the industry and depreseing wages across the board. Still medical bills contribute to
half of all personal bankruptcies*, and yet 3/4 of those recently bankrupted had coverage when their
health issues started them on the road to financial ruin.
The biggest inefficiency of all is that our collective social and security needs require us to administer
emergency care to those without real care; those who would have fared much better with better
primary and preventitive care force the taxpayers and insurance consumers to subsidize the care of
the very poor very inefficiently. This is to say nothing of costs of the human misery of the pain,
disease, and crimes that transpire as a result.
There seems to be no end to the number of health care professionals and other activists they will
arrest to keep the phrase “single payer” out of the chambers of legislation*.
If you look closely at the process writing this legislation, you will see much happening that
underscores the degree to which justice is not being done to one of the the two main desires or
hopes that were so boldy expressed last Nov. I will address war another time, here we focus on the
positive side, what we do want and need? health care that makes sense!!!
Still we see a legislative process that is willing to waste immense amounts of wealth and human
capital through the process of essentially expanding human misery to create a market that favors
larger profits for inhuman corps.
Bill Moyers explores “Who is at the Table?“
Bill takes note of how many times we’ve already bought this bill of goods,
“don’t worry we’ll cut costs voluntarilly, sure. Now health care cots are rising 6% a year.
Anyone with a memory could be excused for raising their eyebrows at these latest promises”
with additional links and comments:
Who Will Be at the Table Archive
Trudy Lieberman is up to 9 articles in her series so far:
Compare the Three Major Offerings on the Table With the Kaiser Foundation‘s Help.
Rhonda has a perspective that most of us need to learn from.
This was the most informative article i read today, and that’s really saying something!
Debunking Canadian health care myths
By Rhonda Hackett; POSTED: 06/07/2009 01:00:00 AM MDT
What do we pay for, anyway?
As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans
and Canadians alike to declare one health care system as the better one.
Often I’ll avoid answering, regardless of the questioner’s nationality. To choose one or the other
system usually translates into a heated discussion of each one’s merits, pitfalls, and an intense
recitation of commonly cited statistical comparisons of the two systems.
Because if the only way we compared the two systems was with statistics, there is a clear victor.
It is becoming increasingly more difficult to dispute the fact that Canada spends less money on
health care to get better outcomes.
Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took
office, with Americans either dreading or hoping for the dawn of a single-payer health care system.
Opponents of such a system cite Canada as the best example of what not to do, while proponents
laud that very same Canadian system as the answer to all of America’s health care problems.
Frankly, both sides often get things wrong when trotting out Canada to further their respective
arguments.
As America comes to grips with the reality that changes are desperately needed within its health
care infrastructure, it might prove useful to first debunk some myths about the Canadian system.
Myth: Taxes in Canada are extremely high, mostly because of national health care.
In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly
higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars,
even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end
result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to
about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.
Myth: Canada’s health care system is a cumbersome bureaucracy.
The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every
dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc.
The provincial single-payer system in Canada operates with just a 1 percent overhead.
Think about it. It is not necessary to spend a huge amount of money to decide who gets
care and who doesn’t when everybody is covered.
Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of
Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent
of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have
inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s.
Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and
eventually seek care. People who cannot afford care wait until advanced stages of an illness to see
a doctor and then do so through emergency rooms, which cost considerably more than primary care
services.
What the American taxpayer may not realize is that such care costs about $45 billion per year,
and someone has to pay it. This is why insurance premiums increase every year for insured patients
while co-pays and deductibles also rise rapidly.
Myth: Canada’s government decides who gets health care and when they get it.While HMOs and
other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada
to do so are physicians. In Canada, the government has absolutely no say in who gets care or how
they get it. Medical decisions are left entirely up to doctors, as they should be.
There are no requirements for pre-authorization whatsoever. If your family doctor says you need an
MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI,
you don’t get one no matter what your doctor thinks — unless, of course, you have the money to
cover the cost.
Myth: There are long waits for care, which compromise access to care.There are no waits for urgent
or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer
waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for
radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to
do with money per se, but everything to do with the lack of radiation therapists. Despite such waits,
however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all
cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer
Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health
care needs.
Myth: Canadians are paying out of pocket to come to the U.S. for medical care.Most patients who
come from Canada to the U.S. for health care are those whose costs are covered by the Canadian
governments. If a Canadian goes outside of the country to get services that are deemed medically
necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or
absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack
of physician expertise), the provincial government where you live fully funds your care. Those
patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to
be more urgent than it likely is.
Myth: Canada is a socialized health care system in which the government runs hospitals and where
doctors work for the government.Princeton University health economist Uwe Reinhardt says single-
payer systems are not “socialized medicine” but “social insurance” systems because doctors work in
the private sector while their pay comes from a public source. Most physicians in Canada are self-
employed. They are not employees of the government nor are they accountable to the government.
Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid
on a fee-for-service basis. Claims are submitted to a single provincial health care plan for
reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers.
Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities
rather than being part of or run by the government.
Myth: There aren’t enough doctors in Canada.
From a purely statistical standpoint, there are enough physicians in Canada to meet the health care
needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona
fide shortages. This situation is no different than that being experienced in the U.S. Simply training
and employing more doctors is not likely to have any significant impact on this specific problem.
Whatever issues there are with having an adequate number of doctors in any one geographical area,
they have nothing to do with the single-payer system.
And these are just some of the myths about the Canadian health care system. While emulating the
Canadian system will likely not fix U.S. health care, it probably isn’t the big bad “socialist” bogeyman
it has been made out to be.
It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has
been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the
superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain,
and her quality of life has been compromised. However, there is a light at the end of the tunnel.
Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less
the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting
14 months for the procedure is easy when the alternative is living in pain for the rest of your life.
Rhonda Hackett of Castle Rock is a clinical psychologist.
© 2009 The Denver Post
The other side, USians familiar with the Canadian system:
Americans Who’ve Used Canada’s Health-Care System Respond to Current Big-Lie Media Campaign
June 13,2009 – Bill Mann
Not long ago, the CBC asked Canadians to nominate and then vote for The Greatest Canadian in history.
Thousands responded.
The winner? Not Wayne Gretzky, as I expected (although the hockey great DID make the Top 10).
Not even Alexander Graham Bell, another finalist.
The greatest Canadian ever?
Tommy Douglas.
Who? Tommy Douglas was a Canadian politician – and the father of Canadian universal health care.
The Healthcare War is Now Official
ROBERT REICH; THURSDAY, JUNE 11, 2009
Yesterday the American Medical Association came out against a public option for health care. And
yesterday the President reaffirmed his support for it. The next weeks will show what Obama is made
of — whether he’s willing and able to take on the most formidable lobbying coalition he has faced so
far on an issue that will define his presidency.
And make no mistake: A public option large enough to have bargaining leverage to drive down drug
prices and private-insurance premiums is the defining issue of universal health care. It’s the only
way to make health care affordable. It’s the only way to prevent Medicare and Medicaid from eating
up future federal budgets. An ersatz public option — whether Kent Conrad’s non-profit cooperatives,
Olympia Snowe’s “trigger,” or regulated state-run plans — won’t do squat.
The last president to successfully take on the giant health care lobbies was LBJ. He got Medicare and
Medicaid enacted because he weighed into the details, twisted congressional arms, threatened and
cajoled, drew lines in the sand, and went to war against the AMA and the other giant lobbyists
standing in the way. The question now is how much LBJ is in Barack Obama.
The big guns are out and they’re firing. All major lobbying firms in Washington — many of them
brimming with ex-members of Congress — are now crawling all over the Hill. Lots of money is on the
table. AMA’s political action committee has contributed $9.8 million to congressional candidates
since 2000, and its lobbying arm is one of the most formidable on the Hill. Meanwhile, Big Insurance
and Big Pharma are increasing their firepower. The five largest private insurers and their trade group
America’s Health Insurance Plans spent a total of $6.4 million on lobbying in the first quarter of this
year, up more than $1 million from the first quarter last year, and are spending even more now.
United Health Group spent $1.5 million in the first quarter, up 34 percent from the $1.1 million it
spent in the first quarter last year. Aetna spent $809,793 between January and the end of March,
up 41 percent from last year. Pfizer, the world’s biggest drugmaker, spent more than $6.1 million on
lobbying between January and March, more than double what it spent last year. It also spent nearly
$3.3 million lobbying in the fourth quarter of 2008. Every one of them is upping their spending.
Some congressional Democrats are willing and able to stand up to this barrage. Many are not.
They need cover from the White House.
The President can’t do this alone. You must weigh in and get everyone you know to weigh in, too.
Bombard your senators and representatives. Organize and mobilize others. And let the White House
know how strongly you feel. This is one of those battles that define a presidency. But more
importantly, it’s one of those battles that define the state of American democracy.
Reich followed this with an appearance on Bill Moyers Journal Friday evening. June 12, 2009.
Bill asks, “Will he (Obama) push back?”
I quote only a short bit with my highlighting a few key pints.
*BILL MOYERS: *Wait a minute. The folks who are fighting for single-payer out there say it is
feasible if only Congress would look at the economics of it.
*ROBERT REICH: *Well, a lot of things are feasible if Congress looks at the economics of them.
But politically, no, unfortunately and I’m a big single-payer fan. Unfortunately, *we cannot get there
from here because the political forces are just too strong against single-payer.*
*BILL MOYERS: *Are the business forces prescient when they say that if we get a public option, it
opens the door down the road to single-payer?
*ROBERT REICH: *If the government simply requires that the public option pay for itself, can be not-
for-profit, just pays for itself that’s not going to be necessarily a direct opening to single-payer.
But it is going to force the private insurers and the drug companies and the medical suppliers to be
honest, to control costs, and to provide better quality.
*BILL MOYERS: *You’ve got these powerful lobbies that you’ve been writing about on your blog.
And you said on your blog this week that the real question for you is the extent to which Barack
Obama will push back against these lobbies. What’s your answer to your own question?
*ROBERT REICH: *I don’t know, Bill. This is the first test where there is huge organized opposition.
And it’s coming from very, very powerful lobbies who have prevailed– not just for ten or 15 years.
You’ve prevailed for decades on this issue. So this is the truth time in terms of how able and willing
the President and the White House is to really set boundaries and push members of Congress.
*So it’s at this point– and I’m talking about the next two or three or four weeks. I mean, we’re
talking about crunch time right now– that the President has got to step in and be forceful and be
specific. And I don’t know whether he will be. I hope he is.*
Bill Moyer’s Profile of Reich
Single-Payer: Is Nationalized Health Coverage the Way to Go?
Bill Moyers; 2009 05
Health Reform for Beginners: The Difference Between Socialized Medicine, Single-Payer Health
Care, and What We’ll Be Getting Ezra Klien
Do You Think Socialized Medicine Would Be:
Better – 45%
Worse – 39%
About the Same – 4%
Who Knows – 12%
I’ve been meaning to write this post for some time. The words “socialized medicine” and”single-
payer health care” get thrown around with such gleeful abandon that they’ve both become a bit
unmoored from their actual meanings. In the American health-care debate, they tend to refer to
“whatever the Democrats are proposing.” But that’s not what they mean.
Socialized medicine is a system in which the government owns the means of providing medicine.
Britain is an example of socialized system, as, in America, is the Veterans Health Administration.
In a socialized system, the government employs the doctors and nurses, builds and owns the
hospitals, and bargains for and purchases the technology. I have literally never heard a proposal
for converting America to a socialized system of medicine. And I know a lot of liberals.
Single-payer health care is not socialized medicine. It’s a system in which one institution purchases
all, or in reality, most, of the care. But the payer does not own the doctors or the hospitals or the
nurses or the MRI scanners. Medicare is an example of a mostly single-payer system, as is France.
Both of these systems have private insurers to choose from, but the government is the dominant
purchaser. (As an aside here, unlike in socialized medicine, “single-payer health care” has nothing in
particular to do with the government. The state might be the single payer. But if Aetna managed to
wrest 100 percent of the health insurance market, then it would be the single payer.
The term refers to market share, not federal control.)
Socialized medicine is far outside any discussion we’re having. Single-payer medicine has a genuine
constituency but is also a vanishingly unlikely outcome. But the promiscuous use of the terms has
created a rather confused population. “Socialized medicine” is the thing we don’t have. In some case,
it’s the thing we don’t like. The graph atop this post comes from a poll conducted by the Harvard
School of Public Health. They found that Americans actually preferred socialized medicine to our
system. Or take this question, about our current system:
Is The Following “Socialized Medicine?”:
HMOs – 31%
Veteran’s Health – 47%
Medicare – 60
(numbers rounded off)
You’re reading that right. About 30 percent of Americans think HMOs are socialized medicine.
Which implies a couple things. First, the term “socialized medicine” has been diluted beyond all
meaning. Second, it’s no longer considered a terrifying outcome. And third, nothing that’s this
amorphous — and actually preferred by a plurality of the population — is likely to prove a terribly
effective attack against health reform. Socialized medicine has become such a stand-in for “not this
system of medicine” that it’s begun to look good in comparison.
Meanwhile, what we’re actually going to get is not socialized medicine or single-payer health care.
It’s a hybrid system. Private insurers, hopefully competing with a public option. Private doctors and
private hospitals. Government regulation and subsidies. It’s going to be complicated and messy and
inefficient and hopeful and the product of a strange mix of corporate preferences and public
compassion and latent populism. It will, in other words, be a uniquely American system, and hard to
describe with a single epithet.
Obama and the Lobbyist
Frank Blair
I have gone on record numerous times in the past as saying that none of us…as voters…has as
much to say about how the government is run as do the lobbying groups in Washington. They run
a massive industry on K Street in the nation’s capital. True, there are “good” lobbyists as well as
those who would oppose legislation which would seem as being advantageous to the people at large
but for the most part it is the lobbyists with the most money….millions of dollars….who grease the
outstretched palms of our elected politicians.
Such an advantage is now being debated everwhere. I am talking about the reformed health care
plan under which a large segment of the population in the US which is uninsured would have
available a government proposal guaranteeing that they would have a plan insuring them of
adequate coverage.
Robert Reich, former Secretary of Labor in Bill Clinton’s cabinet, raises a critical question on this
morning’s AlterNet. Reich has always been a sane voice in what has often been a babble of talk.
And he raises the question of whether President Obama has the fortitude (one might say “guts”) to
confront the lobbyists as they seek to prevent a health care plan forthcoming. In particular he cites
Big Insurance, Big Pharma but most of all (and this may surprise many), the American Medical
Association, as opposing health reform. Millions of dollars are waiting to be thrown into the battle.
The question remains whether Obama has anything beyond a smooth oratorical talent to oppose
these lobbyists. Reich has this to say about Medicare and Medicaid which came into being under the
tutelage of LBJ in the 1960s:
“The last president to succesfully take on the giant
health care lobbies was LBJ. He got Medicare and
Medicaid enacted because he weighed into the details,
twisted congressional arms, threatened and cajoled,
drew lines in the sand and went to war against the AMA
and the other giant lobbyists standing in the way. The
question now is how much LBJ is in Barack Obama.”
This indeed is the question. Lobby groups are powerful entities and throw their weight around in
ways that are hard to resist especially when they contribute to the political funds of those who
legislate!
Will Obama be up to the task? That is the million dollar question.
Email Comment
Scott McLarty, GPUS Media Coordinator; Mon, Jun 15, 2009 at 5:34 PM
Greens “need to take stock of reality and get out the message that Single-Payer will only be possible
when the political landscape changes.
The only hope of changing the political landscape in a way that will lead to Single-Payer’s enactment
(and a lot of other real & systematic changes) is the emergence of a strong alternative party that
doesn’t take money & orders from corporate lobbies.” (Green Parties don’t)
Physicians for a National Health Program
is an excellent source of mind blowing info about health care reform:
The Green Party US on Health Care Reform in 2009:
