Thursday, June 25, 2009

About Health Care

About Health Care
By Jerome Grossman

Dr. Marc Sklar, an endocrinologist in Washington, DC was quoted in the Wall Street Journal, “If we could prevent even a small percentage of people from becoming obese and developing these conditions (diabetes, hypertension, and other chronic problems) the cost of healthcare could go down far enough to cover everyone's insurance.”

Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and now at Harvard Medical School, wrote in the Boston Globe, “The reason our health system is in such trouble is that it is set up to generate profits, not to provide care. We rely on hundreds of investor-owned insurance companies that profit by refusing coverage to high-risk patients and limiting services to others. They also cream off about 20% of the premiums for profits and overhead.”

Paul Krugman, Nobel Laureate in Economics, wrote in the New York Times, “The insurance industry is busily lobbying Congress to block one crucial element of healthcare reform, the public option - that is, offering the right to buy insurance directly from the government as well as from private insurance companies.”

The United States spent more on health care than any other country as a share of gross domestic product in 2006, the most recent year for which totals are available. But the survival rates for American patients on infant mortality and population longevity lag behind other countries.

United States 15.2%
Canada 10%
Australia 8.7%
Brhain 8.2%
New Zealand (2003) 8%

Between 2000 and 2007, the 10 largest publicly traded insurance companies increased their profits 428%, from $2.4 billion to $12.9 billion, according to Securities and Exchange Commission filings

Since its founding, Mayo Clinic has paid physicians with salaries to avoid financial conflicts of interest in clinical decision-making, and to promote multi-disciplinary coordination of care. Less well known, was its principle of billing based on patient’s means.

Senator Ron Wyden, Democrat of Oregon, says,” Democrats always blame the insurance companies, and Republicans always blame the trial lawyers….. A new system also requires tough malpractice reforms….. Cost containment is the Achilles heel of the Massachusetts Universal Coverage plan.”

President Obama said on June 18, “There are already a bunch of liberals who are disappointed because I didn't propose a single payer plan….”

Former Senate Majority Leaders Tom Daschle (D.-S.D.), Bob Dole (R-KS.) and Howard Baker (R-TN) on June 17 unveiled a bi-partisan blueprint for health-care reform that includes a public plan compromise and a requirement that all Americans must purchase insurance. All three men represent private-sector clients in the health-care debate.

The Washington Post wrote about health care holdings of federal legislators: “Nearly 30 lawmakers on committees drafting health-care legislation have financial holdings in the industry, totaling at least $10.8 million dollars and as much as $26.8 million.”

Dr. Abraham Varghese, professor at Stanford University, has written, “All the marvels of science, all the advances of medicine don't replace what patients want of their doctors and what most of us wanted to offer when we felt the calling to medicine: The opportunity to be fully present at the bedside, to bring the human comfort that only the presence of an attentive physician can bring, to convey to patient and family the unspoken promise, I will stay with you through thick and thin.”

Monday, June 22, 2009

The Crisis in U.S./Muslim Relations

The Crisis in U.S./Muslim Relations
By Jerome Grossman

In Cairo, President Barack Obama addressed the world's billion Muslims preaching the values of political freedom, democracy and human rights. Remarkably, he virtually apologized for the repeated Western interference in the affairs of Muslim nations, citing the overthrow of the democratically elected government of Iran in 1953 by the U.S. CIA and its British counterpart, then the installing of a dictator in that country. While this act of contrition was widely welcomed, it had already been performed by Secretary of State Madeleine Albright during the Bill Clinton Administration without improving the relationship. Iran was placed on “The Axis of Evil”.

If President Obama was promising a policy of non-intervention in the Middle East, it did not reflect the operating situation there. The U.S., under Democratic and Republican presidents alike has gone to war, sometimes to protect, sometimes to oust regimes in the area: e.g. in 1991 to protect Kuwait from Iraq, in 2002 to oust Saddam Hussein from Iraq. Another rarely discussed U.S. intervention but high in the consciousness of Iranians is the support the U. S. gave to Saddam Hussein when he attacked Iran in 1980. In this eight year war, Iran lost more than one million lives and suffered Saddam's repeated use of poison gas on civilians and the military.

Obama promises to change the historical behavior of the U.S. in the area. Will his preaching lead to the over-throw of America’s favored dictators? Apart from Israel, the countries we support there are dictatorships, any elections held are merely automatic endorsements of reigning corrupt dictators in Egypt, Jordan, Saudi Arabia, Kuwait, United Arab Emirates, etc. For generations, starting with the administration of Franklin Delano Roosevelt, our politicians, business leaders, military and intelligence staffers and diplomats have found it easier to deal with dictatorial establishments than with the messiness of prolonged negotiations involved in democratic procedures. Guarantees of military support or well-placed financial contributions often produce policies more quickly and efficiently.

Literal adoption of Obama’s good government recommendations would likely impede the U.S. system of dominance in the Middle East, opening it up to competition from other nations now frozen-out. The commercial position of the U.S. oil companies might be in danger. The price of oil might be driven to new heights. The Arab countries might decide to leave the U.S. dollar for better deals with rival currencies and to invest their surplus funds in venues other then American Treasury Bonds. Rival countries might try to play the game of bribing government officials. In a democracy, the possibilities for change and competition are endless when the pool of competitors is expanded.

The crisis in Iran highlights the possibilities for change in all Muslim nations by breaking established patterns of conduct. In Cairo, President Obama set forth the ideals that might not support the current system and world American hegemony. Is the U.S. prepared to sacrifice its preeminence for the ideals of openness and democracy? Will the dominant interests in America, big business and the military, allow such a sacrifice, such a transformation?


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