HEALTH CARE / Dr. Stephen R. Keister: The Gauntlet Has Been Tossed

A doctor makes a rare house call to visit patients in Florida. While such house calls are rare in the US, they are commonplace in France. Photo by Gregg Matthews / NYT.

‘The insurance companies are money making businesses that have been on the scene for many years and in the psyche of a well indoctrinated American public are looked at as benevolent institutions, secondary only to one’s place of worship.’
By Dr. Stephen R. Keister / The Rag Blog / November 23, 2008

In view of the election of Sen.Obama as president, and in view of the growing tide to create a system of universal, single payer health care, the Health Insurance Industry entered the fray with a proposal on November 19, 2008, entitled “Health Plans Proposal Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate” One of the key issues is the “Individual Coverage Mandate,” but more on that later. For the public to really understand the issue of universal care some definitions must be reviewed and certain elements of public confusion clarified.

When we speak of “health care insurance” or indeed of any “insurance,” what are we looking at? Just what is an “insurance company?” These money making businesses have been on the scene for many years and in the psyche of a well indoctrinated American public are looked upon as benevolent institutions, secondary only to one’s place of worship. Wrong, an insurance company is marketed to make money for the owners, the executives, the employees and the stockholders. These ends may be achieved overtly or by connivance in the disallowance of claims or other cupidity. The insurance industry is adept in using scare tactics in turning the public away from alternatives to purchasing insurance, such as, “Do you want socialized medicine?” Or, Do you want your health care managed by “bureaucrats?” Heaven’s to Betsy, what do these folks who propose national health care want to do to us?

I am not sure what “socialized medicine” is, save in the lexicon of those opposed to universal health care. I assume that it has something to do with government “interference” in my health care. The closest we come to that in the United States are the Medicare and Medicaid programs, which merely pay our bills, and have nothing to do with choosing our doctors or hospitals. The Veterans Administration is an excellent example of government provided medicine and it did an excellent job of caring for its patients until the massive funding cuts by the Bush administration in recent years. “Care by ‘bureaucrats?’” Again a nasty name for a government employee.

Why such a nasty designation these folks, some of whom are are relatives or friends? These are merely the employees who do the work for HHS which in turn administer Medicare, Social Security, etc, making sure that we get our checks or that our bills are paid, and they have nothing to do with selection of doctors, hospitals or other medical services. The insurance industry, since the companies colluded to take over medical care some 30 years ago, have taken unto themselves 30% or more of the health care dollar, and intruded on the prerogative of your physician to care for you as he/she sees fit.

Another farce that the insurance industry will foist upon you is that those nations with universal care do not provide the excellence of care we get in the United States. This in spite of the fact that the Commonwealth Fund ranks health care in the United States as #25 an the world, and that of seven nations surveyed regarding the treatment of chronic illness, we here in this country rank #7. You will be exposed on TV to a series of talking heads from conservative think tanks such as the American Enterprise Institute, Heritage Foundation, etc, espousing the cause of the insurance industry and demeaning universal, single payer care. (Wikipedia has an excellent run-down on the various think tanks, rating them as conservative, liberal, or center.) You will see TV ads done by actors indicating that care in other nations is far inferior to that here in the USA.

Before going further, let us take a brief look at health care in France, which in numerous surveys rates best in the world. In January 2003, The American Journal of Public Health, Vol. 93, No.1, did an extensive survey of French national health insurance. This is much too extensive to include herein; however, in New Yorker writer Adam Gopnik’s wonderful little book Paris to The Moon he reviews the life that he, his wife and young child lived in Paris for the period 1995-2000. On page 258 he notes that Luke, his four year old, became violently ill and was immediately seen by their pediatrician , who post haste, obtained a consultation with a surgical colleague, In view of the fact that both physicians were in doubt, they were referred to the Necker pediatrics hospital, where the child was immediately taken care of; blood tests, a sonogram and barium enema were immediately done, and two and a half hours later they were back home with appropriate medicine for Salmonella poisoning.

The author concludes that only then did he realize that in the journey that no one had requested money, requested an insurance card, nor that they fill out various forms or do any of the other humiliating things that our American friends have to do with sick children. In another chapter entitled “Like a King” he discusses the excellent pre- and post-natal care that his wife received in Paris during her pregnancy there. In this chapter he notes that under French regulations a woman after giving birth to a child is guaranteed 4-5 nights in the hospital or clinic.

Steve Weissman in TruthOut discusses his personal encounter with French medical care. For instance, one has free choice of doctors, specialists, hospitals. Doctors make house calls! An office call costs 22 euros, the national health system reimburses 70% of this to one’s bank account. In certain instances the single-payer system pays 100%. Prescriptions are free.

Costs to the average Frenchman? Taxes a shade higher than in the United States. But remember, he is not paying for health insurance, gets free or near free medical care, and education is paid for through university for qualified individuals.

Currently there are various plans for universal health care before Congress. These are discussed by David Sirota in “Tuning Out the Braindead Megaphone on Health Care.” There is a discussion of the current Kennedy/Bauchus plan, which surely is wanting. If one is sincere in working for universal care one must be encouraged to review the extensive website for Physicians for a National Health Program, as well as Health Care-Now. We must keep constant pressure on our elected representatives and review their baksheesh from the insurance industry that is available on line at several web-sites. One might even look at several of my, rather dated, articles. Click on “position papers.”

Finally, let’s return to my initial paragraph regarding the plans of the health care industry. They speak of a “coverage mandate,” in other words, requiring one by law to buy health insurance. In the past I have seen this discussed by constitutional scholars who point out that this is going into the legally unknown. TO REQUIRE BY LAW THAT ONE PURCHASE FROM A PRIVATE CORPORATION. Granted the government can require under various statutes that one pays taxes to the government for Social Security, Medicare, etc, but being required to purchase from a profit making private company is entirely a horse of a different color. Further, it is generally conceded that decent private health insurance for a family of four would cost something like $1200/month. Lesser policies now available have large deductibles (such as the first $5000/year), large co-insurance payments, and exclusions.

The battle has been joined. I several weeks ago noted on TV an ad by AARP for national health care. I emailed a question, not noting that I was a physician, as to whether this was single payer, universal care and the email response was that “this would be too expensive.” Recall that AARP has in recent years become one great purveyor of insurance.

We will be exposed to much hypocrisy during this interlude, calling to mind Hannah Arendt’s statement:

“As witness not of our intentions but of our conduct, we can be true or false, and the hypocrite’s crime is that he bears false witness against himself. What makes it so plausible to assume that hypocrisy is the vice of vices is that integrity can exist under the cover of all other vices except this one. Only crime and the criminal, it is true, confront us with the perplexity of radical evil; but only the hypocrite is really rotten to the core.”

The Rag Blog

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2 Responses to HEALTH CARE / Dr. Stephen R. Keister: The Gauntlet Has Been Tossed

  1. Anonymous says:

    Attempting to wade through the plethora of Medicare supplemental policies, I trusted AARP to have simplified the matter and backed a plan most beneficial to the majority of their millions of senior members. My trust was misplaced. Not only had they entered into an agreement with a private, for profit insurer, but they “backed” a plan that did not favorably compare with others available to me. Et tu AARP?
    I nominate Dr. Keister for Surgeon General!

  2. Judith says:

    Written by a true progressive. Thank you Dr. Keister. It is so important to realize AARP is ‘just another insurer’, not truly a supporter of seniors.

    Our country must begin to realize that universal health care is not a dirty term, that single payer health care simply means health care for all guarenteed by goverment.

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