The advocates of a woman’s legal right to abortion under the Roe v. Wade Supreme Court decision were enthusiastic supporters of the Democratic Health Care Reform Bill. But they were appalled at the deal President Obama made with 13 US Representatives to obtain their votes in exchange for an Executive Order that weakens the rights of women for legal abortions.
With little fanfare, with no glaring lights or TV cameras, no East Room speeches, without a photo or a handshake, President Obama did not commemorate this Executive Order with twenty signing pens. The president of NOW, the National Organization of Women, said, “We wished he would storm the ramparts for every one of our issues. It really pains me to conclude that on balance this law is not good for women. It’s health reform has been achieved on the backs of women and at the expense of women.” Other leaders made similar statements.
The new law requires women to make premium payments on most of their coverage and a second, far smaller one, for abortion coverage. Advocates fear that the executive order will make it more difficult to achieve elimination of the Hyde Amendment that prohibits the use of federal funds for abortion. Hyde ought to be repealed because it penalizes women for a completely legal medical procedure – with the approval of President Obama.
There is another issue affected by Obama's Executive Order. In spite of the fact that abortion is legal in all three trimesters under clearly spelled out conditions and regulations, there is a national campaign of legal activities to discourage and intimidate women, doctors, nurses, hospitals, clinics, etc. from exercising their rights under the law. The systematic harassment sometimes violates laws when the “educational” efforts become threats and when doctors are murdered.
This anti-abortion campaign has been remarkably effective in making it difficult and expensive for women to exercise their right to abortion. In many communities, no doctors or hospitals will perform this service. Some women must travel significant distances to other cities and states, find a new doctor, bring along a friend or relative, make hospital arrangements, all at significant expense. Abortion services are not available in 87% of the counties of the US.
In the debate before the House of Representatives, virtually every anti-abortion speaker emphasized the sanctity of human life. Who could disagree with that principle and its application to the life and death of a child? But humanitarian and religious principles require that this principle be applied to all human activity: the life and health of the mother, the taking of life by the government by capital punishment, the existence of nuclear weapons that could eliminate all human life on planet Earth. President Obama's political arrangement on abortion has not helped to clarify these difficult issues and has encouraged the public campaign to deny legal rights to American women
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Sunday, March 28, 2010
Friday, October 23, 2009
No Health Reform Until 2013
No Health Reform Until 2013
By Jerome Grossman
Most Americans are expecting big changes in our health-care system-and they want them fast. A Kaiser Family Foundation poll reported that 49% of the people responding expected people without insurance would get help in buying coverage this year or next. Twenty-five percent said three years, and 11% said “further in the future”.
Most of them will be disappointed. Even if Congress passes a bill this year, most changes are not scheduled to go into effect until at least 2013 or much later, according to the New York Times.
The lawmakers say change will take a long time, the process is complex, and delaying some changes will make the overhaul seemed less expensive and less upsetting. Remember: five-sixths of Americans now have health-care and some may not be eager to support the subsidies for the other one-sixth. In any case, the long and agonizing debate and the deferred 2013 target date certainly don’t indicate an emergency. But it is an emergency for millions of Americans.
The more likely reason for the delay is political. In the 2010 election, incumbent senators and representatives can run on their health care legislation, even though it will not be operational and therefore temporarily cost free. None of the inevitable errors and inconsistencies of the reforms will annoy the voters..
The delay in implementation will also please President Obama. When he runs for re-election in 2012 his historic achievement will still be cost free and complaint free. He will point out that he has accomplished what no other president could including Theodore Roosevelt, Franklin Delano Roosevelt, Harry Truman, and Lyndon Johnson. Mount Rushmore will be on the horizon to match the Nobel Peace Prize.
Health-care reform in the U.S., whether it turns out to be inadequate and marginal revisions or fundamental change overthrowing the insurance companies (a miracle) will have to wait at least two elections before implementation. In the meantime, many Americans will suffer from the acknowledged inadequacies of our unique system of care.
By Jerome Grossman
Most Americans are expecting big changes in our health-care system-and they want them fast. A Kaiser Family Foundation poll reported that 49% of the people responding expected people without insurance would get help in buying coverage this year or next. Twenty-five percent said three years, and 11% said “further in the future”.
Most of them will be disappointed. Even if Congress passes a bill this year, most changes are not scheduled to go into effect until at least 2013 or much later, according to the New York Times.
The lawmakers say change will take a long time, the process is complex, and delaying some changes will make the overhaul seemed less expensive and less upsetting. Remember: five-sixths of Americans now have health-care and some may not be eager to support the subsidies for the other one-sixth. In any case, the long and agonizing debate and the deferred 2013 target date certainly don’t indicate an emergency. But it is an emergency for millions of Americans.
The more likely reason for the delay is political. In the 2010 election, incumbent senators and representatives can run on their health care legislation, even though it will not be operational and therefore temporarily cost free. None of the inevitable errors and inconsistencies of the reforms will annoy the voters..
The delay in implementation will also please President Obama. When he runs for re-election in 2012 his historic achievement will still be cost free and complaint free. He will point out that he has accomplished what no other president could including Theodore Roosevelt, Franklin Delano Roosevelt, Harry Truman, and Lyndon Johnson. Mount Rushmore will be on the horizon to match the Nobel Peace Prize.
Health-care reform in the U.S., whether it turns out to be inadequate and marginal revisions or fundamental change overthrowing the insurance companies (a miracle) will have to wait at least two elections before implementation. In the meantime, many Americans will suffer from the acknowledged inadequacies of our unique system of care.
Thursday, October 1, 2009
The Politics of Health Care
The Politics of Health Care
By Jerome Grossman
President Barack Obama has been pushing hard for his plan to overhaul the health-care system: speaking to all kinds of audiences across the country; seizing every opportunity on television, radio, newspapers, magazines, Internet; meeting with countless group leaders including Republicans and conservatives. He is everywhere, talking to everybody.
Pay attention to one of Obama's favorite lines: "We have been waiting for health reform since the days of Teddy Roosevelt. We have been waiting since the days of Harry Truman. We've been waiting since Johnson and Nixon and Clinton. We cannot wait any longer."
That riff stimulates tumultuous applause, shouts of "Yes, we can", supporters shouting "We love you!" and Obama responds," I love you back!" If this sounds like a political campaign, that is because it is actually-the beginning of Obama’s campaign for reelection to a second term in 2012. You can't begin too early. Every president has used this strategy in his own style
Remarkably, Obama has maintained his popularity with the voters even when they disagree with him on the issues: unemployment, bank bailouts, handling the economy, the federal deficit, war in Afghanistan, closing Guantánamo, etc.. His favorable rating is 53%, good for these times of trouble and far ahead of Speaker Pelosi and Senator Leader Reid as well as Republican leaders Senator McConnell, Representative Boehner., and Senator McCain.
Obama's political advisors know that love is a many splendored thing that can dissipate if he fails to deliver. But Obama's prospects for resolving Afghanistan and unemployment, the two biggest problems, are dicey at best. Republicans will challenge him saying, "Nice young guy, but what has he accomplished? What national problems has he solved?"
Obama needs a stunning victory in his political bank account, a victory that directly affects every American, an accomplishment that has eluded every previous president of either party in times of prosperity or recession. In 2012, Obama will declaim the names of his predecessors who failed on health-care reform, Roosevelt, Truman, Johnson, Nixon, Clinton, while reminding the voters of his singular deed.
Health-care reform legislation is crucial for Obama: he must pass THE bill. That is why he is prepared to sacrifice content for political victory, better to pass a weak plan than no plan. Furthermore, Democrats have learned never to go to war against the combined forces of corporate America. Heeding the lesson of the Clinton failure on health reform, Obama has neutralized the pharmaceutical and insurance industries by negotiating concessions that will increase their customers and their profits while changing the system to include everybody. The White House has affirmed these deals so Harry and Louise are not campaigning against Obama's plan.
After many months of tortuous appeasement of the Republicans in and out of Congress under the rubric of bipartisanship, Obama has his deal but it is not with the GOP. He found that it is easier to deal with big business than to deal with the Republicans, out of power and cranky.
Obama recently told "60 Minutes" that if a health-care bill passes," I own it", but if it fails, the Republicans will own it. Fear not, America, there will be a health bill, it will be adopted by the Senate and House and President Obama will use it to prove his presidential mettle in the 2012 election.
By Jerome Grossman
President Barack Obama has been pushing hard for his plan to overhaul the health-care system: speaking to all kinds of audiences across the country; seizing every opportunity on television, radio, newspapers, magazines, Internet; meeting with countless group leaders including Republicans and conservatives. He is everywhere, talking to everybody.
Pay attention to one of Obama's favorite lines: "We have been waiting for health reform since the days of Teddy Roosevelt. We have been waiting since the days of Harry Truman. We've been waiting since Johnson and Nixon and Clinton. We cannot wait any longer."
That riff stimulates tumultuous applause, shouts of "Yes, we can", supporters shouting "We love you!" and Obama responds," I love you back!" If this sounds like a political campaign, that is because it is actually-the beginning of Obama’s campaign for reelection to a second term in 2012. You can't begin too early. Every president has used this strategy in his own style
Remarkably, Obama has maintained his popularity with the voters even when they disagree with him on the issues: unemployment, bank bailouts, handling the economy, the federal deficit, war in Afghanistan, closing Guantánamo, etc.. His favorable rating is 53%, good for these times of trouble and far ahead of Speaker Pelosi and Senator Leader Reid as well as Republican leaders Senator McConnell, Representative Boehner., and Senator McCain.
Obama's political advisors know that love is a many splendored thing that can dissipate if he fails to deliver. But Obama's prospects for resolving Afghanistan and unemployment, the two biggest problems, are dicey at best. Republicans will challenge him saying, "Nice young guy, but what has he accomplished? What national problems has he solved?"
Obama needs a stunning victory in his political bank account, a victory that directly affects every American, an accomplishment that has eluded every previous president of either party in times of prosperity or recession. In 2012, Obama will declaim the names of his predecessors who failed on health-care reform, Roosevelt, Truman, Johnson, Nixon, Clinton, while reminding the voters of his singular deed.
Health-care reform legislation is crucial for Obama: he must pass THE bill. That is why he is prepared to sacrifice content for political victory, better to pass a weak plan than no plan. Furthermore, Democrats have learned never to go to war against the combined forces of corporate America. Heeding the lesson of the Clinton failure on health reform, Obama has neutralized the pharmaceutical and insurance industries by negotiating concessions that will increase their customers and their profits while changing the system to include everybody. The White House has affirmed these deals so Harry and Louise are not campaigning against Obama's plan.
After many months of tortuous appeasement of the Republicans in and out of Congress under the rubric of bipartisanship, Obama has his deal but it is not with the GOP. He found that it is easier to deal with big business than to deal with the Republicans, out of power and cranky.
Obama recently told "60 Minutes" that if a health-care bill passes," I own it", but if it fails, the Republicans will own it. Fear not, America, there will be a health bill, it will be adopted by the Senate and House and President Obama will use it to prove his presidential mettle in the 2012 election.
Wednesday, August 19, 2009
Big Business Loves Health-care Reform
Big Business Loves Health-care Reform
By Jerome Grossman
The liberals achieve their maximum political strength in the Democratic Party primary elections: they speak up at meetings, define the issues, make early political contributions, and rarely miss a vote. As political consciousness spreads slowly through the rest of the electorate, the liberal influence and vote diminishes in importance. They know that agreements on issues with candidates must be made early in the campaign and are likely to be modified under the pressures of the wider campaign.
In the 2008 presidential campaign, neither Barack Obama nor Hillary Clinton gave the liberals the health-care position they wanted: the transformation of the U.S. system of private insurance coverage to a single-payer expansion of Medicare that would include all Americans, a system paid for out of general tax revenues. Obama came the closest, saying that if he were to install a new system from scratch it would be single-payer. That was enough for the liberals to vote for him out of love and hope.
And indeed the Obama administration never proposed a health-care revolution challenging the insurance and drug industries. Such a challenge might have been successful if Obama was prepared to play political hardball, using political power to force compliance from Congress and business interests. Like Obama, Franklin Delano Roosevelt and Lyndon Johnson won landslide victories in 1932 and 1964 gaining huge majorities in Congress. They knew how to use their political power generated by the landslides to force liberal legislation through an unwilling Congress by threatening the incumbents with loss of privileges, loss on their ability to pass legislation, loss of political contributions, loss of appointment of friends, etc. That was how they revolutionized the nation by installing the Social Security System, minimum wage, civil rights and voting rights legislation, Medicare, to name just a few, but not as defined by Chris Mathews on TV as merely talking tough.Chris Matthews worked for Speaker Tip O'Neill, a nice guy with no particular ideology whose idea of pressure was scotch and soda and a joke on the nineteenth hole.
Without hardball, President Obama will get a health-care bill but it won't be a revolution and it may not even be reform. His people have already made a deal with the pharmaceutical companies, the Pharmaceutical Research and Manufacturers of America. The industry will offer $8 billion a year in consumer savings for 10 years out of its current annual profits of $300 billion a year. Industry benefits: the barriers against importation of foreign drugs will be maintained; the government's ability to use its enormous purchasing power to negotiate lower drug prices is off the table; the government will subsidize more drug purchases by seniors.
Insurance companies are similarly delighted with other elements of "reform". The government will require the uninsured to buy health insurance, subsidizing them if necessary. These millions of mostly young and healthy customers will demand few services, increasing industry profits far more than the cost of the Obama changes. The oldest and the sickest will be on Medicare, the poorest on Medicaid, the young and healthy new customers must buy from the insurance companies. Looks like a good deal for the health-care industry. And Obama’s lieutenants have discovered that it is easier to deal with big business than with the Republicans and their Blue-Dog allies in Congress.
By Jerome Grossman
The liberals achieve their maximum political strength in the Democratic Party primary elections: they speak up at meetings, define the issues, make early political contributions, and rarely miss a vote. As political consciousness spreads slowly through the rest of the electorate, the liberal influence and vote diminishes in importance. They know that agreements on issues with candidates must be made early in the campaign and are likely to be modified under the pressures of the wider campaign.
In the 2008 presidential campaign, neither Barack Obama nor Hillary Clinton gave the liberals the health-care position they wanted: the transformation of the U.S. system of private insurance coverage to a single-payer expansion of Medicare that would include all Americans, a system paid for out of general tax revenues. Obama came the closest, saying that if he were to install a new system from scratch it would be single-payer. That was enough for the liberals to vote for him out of love and hope.
And indeed the Obama administration never proposed a health-care revolution challenging the insurance and drug industries. Such a challenge might have been successful if Obama was prepared to play political hardball, using political power to force compliance from Congress and business interests. Like Obama, Franklin Delano Roosevelt and Lyndon Johnson won landslide victories in 1932 and 1964 gaining huge majorities in Congress. They knew how to use their political power generated by the landslides to force liberal legislation through an unwilling Congress by threatening the incumbents with loss of privileges, loss on their ability to pass legislation, loss of political contributions, loss of appointment of friends, etc. That was how they revolutionized the nation by installing the Social Security System, minimum wage, civil rights and voting rights legislation, Medicare, to name just a few, but not as defined by Chris Mathews on TV as merely talking tough.Chris Matthews worked for Speaker Tip O'Neill, a nice guy with no particular ideology whose idea of pressure was scotch and soda and a joke on the nineteenth hole.
Without hardball, President Obama will get a health-care bill but it won't be a revolution and it may not even be reform. His people have already made a deal with the pharmaceutical companies, the Pharmaceutical Research and Manufacturers of America. The industry will offer $8 billion a year in consumer savings for 10 years out of its current annual profits of $300 billion a year. Industry benefits: the barriers against importation of foreign drugs will be maintained; the government's ability to use its enormous purchasing power to negotiate lower drug prices is off the table; the government will subsidize more drug purchases by seniors.
Insurance companies are similarly delighted with other elements of "reform". The government will require the uninsured to buy health insurance, subsidizing them if necessary. These millions of mostly young and healthy customers will demand few services, increasing industry profits far more than the cost of the Obama changes. The oldest and the sickest will be on Medicare, the poorest on Medicaid, the young and healthy new customers must buy from the insurance companies. Looks like a good deal for the health-care industry. And Obama’s lieutenants have discovered that it is easier to deal with big business than with the Republicans and their Blue-Dog allies in Congress.
Thursday, July 23, 2009
The Devil in the Details
The Devil in the Details
By Jerome Grossman
Despite President Barack Obama's brilliant performance at his primetime press conference on health care, Republicans and some conservative Democrats are balking at the details of the proposed legislation. But the devil is not in the details. It is in the commitment of the nation to the national health. The president needs to activate the conscience of America to take care of all of its citizens.
The president needs to challenge the country to declare that health care is a natural right of citizenship, like the right to an education, the right to vote, the right to police and fire protection, the right to military defense of the homeland.
Once that principle is established, the Federal Government can determine implementation by examining the best practices on cost and efficiencies in other countries. It is no secret that dozens of nations deliver health care to their people at half of the per capita cost in the United States while attaining better health results than the U.S. in the standard measures of longevity, infant mortality, hospital stays, etc.
The cost of universal health care is unsustainable to the average private citizen. That is why the cost must be assumed by the Federal Government. Health care must be a national enterprise because diseases often spread from those without care to the most cared for sectors of the population. What begins as a moral question becomes an issue of self-defense for the total society.
Our political and moral leaders must emphasize the social aspects of taking care of everybody. If Texas or Florida or California or New York or Massachusetts were invaded by foreign armies, would we not rally to repulse the invader? If any army of microbes invaded the bodies of the 50 million Americans without health care shouldn’t we rally to repulse the invader?
The devil is not in the details. The devil is in our failure to act as one people, liberty and justice and health for all 306,985,793 citizens. We can find the money to defend the health of 50 million Americans the way we found the trillion dollars we spent to defend 28,221,180 Iraqis and the trillion dollars we are spending to defend 32,738,376 Afghanis, 6,930 miles from Washington,D.C.
By Jerome Grossman
Despite President Barack Obama's brilliant performance at his primetime press conference on health care, Republicans and some conservative Democrats are balking at the details of the proposed legislation. But the devil is not in the details. It is in the commitment of the nation to the national health. The president needs to activate the conscience of America to take care of all of its citizens.
The president needs to challenge the country to declare that health care is a natural right of citizenship, like the right to an education, the right to vote, the right to police and fire protection, the right to military defense of the homeland.
Once that principle is established, the Federal Government can determine implementation by examining the best practices on cost and efficiencies in other countries. It is no secret that dozens of nations deliver health care to their people at half of the per capita cost in the United States while attaining better health results than the U.S. in the standard measures of longevity, infant mortality, hospital stays, etc.
The cost of universal health care is unsustainable to the average private citizen. That is why the cost must be assumed by the Federal Government. Health care must be a national enterprise because diseases often spread from those without care to the most cared for sectors of the population. What begins as a moral question becomes an issue of self-defense for the total society.
Our political and moral leaders must emphasize the social aspects of taking care of everybody. If Texas or Florida or California or New York or Massachusetts were invaded by foreign armies, would we not rally to repulse the invader? If any army of microbes invaded the bodies of the 50 million Americans without health care shouldn’t we rally to repulse the invader?
The devil is not in the details. The devil is in our failure to act as one people, liberty and justice and health for all 306,985,793 citizens. We can find the money to defend the health of 50 million Americans the way we found the trillion dollars we spent to defend 28,221,180 Iraqis and the trillion dollars we are spending to defend 32,738,376 Afghanis, 6,930 miles from Washington,D.C.
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.”
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.”
Tuesday, September 18, 2007
MEDICARE FOR ALL
MEDICARE FOR ALL
by Jerome Grossman
The leading contenders for the Democratic nomination for president of the United States have proposed reforms of the nation's health-care system. The plans of Hillary Clinton, Barack Obama and John Edwards are similar in outline, but not necessarily in detail. Especially noteworthy is their retention of the basic system relying on business and insurance companies to finance health care.
However, each candidate articulated themes contrary to the current basic system. They praise government - run Medicare for low administrative costs, high efficiency, and for not cherry picking patients. They praise the government - run Veterans Administration for the same features as well as consumer satisfaction. They praise government -run systems in other industrialized nations pointing out that the U.S. lags behind all most all of these nations in adult longevity and infant mortality. Yet the candidates insist on retaining our current system with minor modifications. Universal Medicare would eliminate the cost of health insurance to businesses and lower insurance costs by about 25% percent by eliminating advertising, big execuitive salaries salaries and insurance company bureaucracy aimed at increasing market share and profitability.
The primary constituency of business is the stockholder and the primary activity is to cut costs and maximize profits. In health care this usually means insure as few workers as possible for the fewest ailments. Insurance companies are also focused on the bottom line, charging as much as the market will bear while avoiding the large expenses of the very sick The maneuvers toward these objectives inflate the cost of healthcare
Expanding Medicare to the entire population would realize the goal of universality, improve the national health, lower administrative costs, shift control of care to doctors and hospitals. Why should seniors and veterans be the only groups receiving government subsidies for health care? What about that 10 year old girl I see through my window? How about the worker who repairs my necessities?
Only a universal health system run by the government is defensible morally and politically. Equality and democracy require it. How long will the voters allow this unfairness and waste of money on a basic right to life to continue? Will one of the presidential candidates, from either party, endorse the Medicare approach and arouse the voters to demand it?
The answer to that question is " NO." American political leaders are understandably intimidated by the economic and political power of the health and insurance industries. They remember how Hillary Clinton's mild health reform proposals of 1993 were defeated, and even worse, ridiculed to such extent that it affects her campaign for president 15 years later.
Any proposed change must not be perceived as attacking the profit motive, the most dynamic element in the American economic juggernaut. However, certain communal activities do not lend themselves to the profit model. Health care, education and the military rely on the values of equality, cooperation and even sacrifice. The model for each is common benefit before individual advancement and profit.
However, there may be a way to resolve the dilemma, by following the example of big business. Our government cannot drive the health and insurance industries out of business to install a universal Medicare, but it could buy them out and make health a government monopoly. Give them their profit, give stockholders, executives, workers a big payout, something on the order of100% profit or a years salary. Even if costs one trillion dollars, the lower costs could return the capital outlay in ten years or less. The new efficiencies, the new satisfactions, the increased longevity, the saving of children's lives could transform our lives as they have already benefited our senior population since 1965. And think of the value of increased happiness, of diminished worry about the precious gift of life. Do we have the courage to break the pattern of the past, for ourselves and future generations?
by Jerome Grossman
The leading contenders for the Democratic nomination for president of the United States have proposed reforms of the nation's health-care system. The plans of Hillary Clinton, Barack Obama and John Edwards are similar in outline, but not necessarily in detail. Especially noteworthy is their retention of the basic system relying on business and insurance companies to finance health care.
However, each candidate articulated themes contrary to the current basic system. They praise government - run Medicare for low administrative costs, high efficiency, and for not cherry picking patients. They praise the government - run Veterans Administration for the same features as well as consumer satisfaction. They praise government -run systems in other industrialized nations pointing out that the U.S. lags behind all most all of these nations in adult longevity and infant mortality. Yet the candidates insist on retaining our current system with minor modifications. Universal Medicare would eliminate the cost of health insurance to businesses and lower insurance costs by about 25% percent by eliminating advertising, big execuitive salaries salaries and insurance company bureaucracy aimed at increasing market share and profitability.
The primary constituency of business is the stockholder and the primary activity is to cut costs and maximize profits. In health care this usually means insure as few workers as possible for the fewest ailments. Insurance companies are also focused on the bottom line, charging as much as the market will bear while avoiding the large expenses of the very sick The maneuvers toward these objectives inflate the cost of healthcare
Expanding Medicare to the entire population would realize the goal of universality, improve the national health, lower administrative costs, shift control of care to doctors and hospitals. Why should seniors and veterans be the only groups receiving government subsidies for health care? What about that 10 year old girl I see through my window? How about the worker who repairs my necessities?
Only a universal health system run by the government is defensible morally and politically. Equality and democracy require it. How long will the voters allow this unfairness and waste of money on a basic right to life to continue? Will one of the presidential candidates, from either party, endorse the Medicare approach and arouse the voters to demand it?
The answer to that question is " NO." American political leaders are understandably intimidated by the economic and political power of the health and insurance industries. They remember how Hillary Clinton's mild health reform proposals of 1993 were defeated, and even worse, ridiculed to such extent that it affects her campaign for president 15 years later.
Any proposed change must not be perceived as attacking the profit motive, the most dynamic element in the American economic juggernaut. However, certain communal activities do not lend themselves to the profit model. Health care, education and the military rely on the values of equality, cooperation and even sacrifice. The model for each is common benefit before individual advancement and profit.
However, there may be a way to resolve the dilemma, by following the example of big business. Our government cannot drive the health and insurance industries out of business to install a universal Medicare, but it could buy them out and make health a government monopoly. Give them their profit, give stockholders, executives, workers a big payout, something on the order of100% profit or a years salary. Even if costs one trillion dollars, the lower costs could return the capital outlay in ten years or less. The new efficiencies, the new satisfactions, the increased longevity, the saving of children's lives could transform our lives as they have already benefited our senior population since 1965. And think of the value of increased happiness, of diminished worry about the precious gift of life. Do we have the courage to break the pattern of the past, for ourselves and future generations?
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