The Rag Blog

Also see, ‘Single-payer health reform bill introduced in Senate,’ Below.

‘…one watches the Republican Senate and House “leadership” posturing on television, in their Seville Row suits, sporting their salon or golf course tans, and one wonders why these folks dislike the poor, the ill, and the mentally impaired so very, very much…’

By Dr.Stephen R. Keister / The Rag Blog / March 26, 2009

‘All conservatives are such from personal defects. They have been effeminated by position or nature, born halt and blind, through luxury of their parents, and can only, like invalids, act on the defensive.’ — R.W. Emerson, 1860.

Digressing briefly, from my topic of health care, one watches the Republican Senate and House “leadership” posturing on television, in their Seville Row suits, sporting their salon or golf course tans, and one wonders why these folks dislike the poor, the ill, and the mentally impaired so very, very much. Why do they look on the homosexual as the folks of the 13th century looked upon the leper, confusing central nervous system developmental problems or illnesses with cultural or theological issues? Where do they develop the self assurance that they are right, and everyone else wrong, akin to the judges of the Inquisition? Where do these arrogant, hypocritical, intolerant folks arise from?

If one listens for long to their rantings one feels that they really believe that it is the insolvency of mortgages purchased by the poor that has caused the current financial collapse, while the majority of the so called TV “journalists” shake their heads in agreement. Yet in an editorial in The National Catholic Reporter, March 20, 2009, former Federal Reserve Governor, Randall Kroszner, speaking late last year, pointed out that half of subprime loans went to middle-class or higher-income borrowers, while fewer than 6% of loans made went to low-income borrowers.

This is the same group of our elected representatives, joined by many of the “blue-dogs,” that tell us that national health insurance is “too expensive,” or falsely assert that under a nationally sponsored health care plan one would not have a free choice of physician, or would encounter long waits to be seen. These are the same folks who howl in concert with the NRA that “Obama plans to take our guns,” i.e., the “blue helicopters are coming.” These prostitutes to the insurance and pharmaceutical industries recall Machiavelli’ statement in “The Prince” from 1513: “Men are so simple and yield so readily to the wants of the moment that he who will trick will always find another who will suffer himself to be tricked.”

It is pleasing to see that every day a number of unions and organizations are endorsing universal, single payer, health care. There is a ground-swell among the public to either enact HR 676 or a lesser, and much more fallible plan, the Obama option of an adjunctive public health care plan, i.e. “Medicare for All.” Even the latter throws our Republican and blue-dog friends into uncontrolled rage, for a public plan, administered as well as Medicare, would attract, in time, the majority of citizens, thus decreasing the billions of dollars of profits of the insurance and pharmaceutical industries and reducing the funds available to their lobbyists to buy the votes of “the peoples representatives.”

Early in my days of practice I became aware of one common scam used by the insurers of the sick. As I recall, it was in the 1950s I saw a lady who had cancer of the stomach. Her insurance carrier contended that the “cancer predated her purchase of insurance.” She had purchased the insurance seven years earlier. I sent documentation of the entire episode to the Pennsylvania Insurance Commissioner, and by George, the insurer paid the claim. Over the years when confronted by like foolishness I never failed to find that the Insurance Commissioner was fair and open minded.

The other frequently used ploy by the private insurance companies is hidden in the fine print, i.e., exceptions for a variety of disease conditions. Always remember any insurance company is a business and businesses are formed to make money. Of course, this is in the interest of any of the great American corporations as the Washington Post pointed out in an article by E.J.Dionne, Jr., March 19, 2000. “A study of compensation levels in 2007 found that the average CEO pay at S&P 500 Companies was 344 times higher than the average worker’s wage, and that the top 50 investment fund managers took home 19,000 times as much as the typical workers earned.”

Harper’s Magazine, in April, 2009, issue, points out that a single-payer health care system would create 2,600,000 jobs. The same article notes that the current recession will cause an extra 71,000 deaths. Of these 1,800 will be suicides and 13,000 homicides. The author does not allude to the thousands of deaths yearly, commented upon in prior articles, occurring from pre-existing poverty or lack of health insurance.

The Republicans, when they develop any positive attitude towards health care, appear to like the Massachusetts model. Remember Gov. Romney helped write it! Yet, The Smirking Chimp, of Feb. 27, 2009, quotes Dr. David Himmelstein of Harvard Medical School, who recountes the shortcomings of the plan. The plan has cost much more than anticipated, covering fewer than the promised universal claims and left states like Massachusetts and those who came before them in the same mess now faced throughout the land with soaring costs, inadequate delivery of what is sold as the financial protection called “health insurance” and begging with health systems for more cash. In the same article Dr. Himmelstein recounts the case of a lady with cancer who was obliged to decline chemotherapy because she could not afford to pay the insurance co-payments.

Then there is that now famous case of the McDonalds employee in Arkansas who came to the defense of a female customer who was being attacked by another man. The abuser shot the employee in the chest. The McDonalds workers comp insurance would not pay the $300,000 medical bill because “the employee was not acting during the normal scope of employment.” Unbelievable, yet the Republicans tell us there is nothing better than private insurance.

Whether we have single payer or Medicare for all, the cost of health care must be reduced. Let us start with the costs of pharmaceuticals and eliminate the absurd practice of TV advertising that must add millions to the cost of prescription medications. There is no real point in these ads since no competent physician gets his information from this source and if he bends to the desires of his/her patient who pushes for these items to placate the patient he is an obvious quack. Let us regulate the price of prescription drugs as we do in this country via V.A. pharmacies, or is done by government regulations in the remainder of the civilized world. For instance I am receiving treatment for cancer of the prostate with a drug named Lupron. I get an injection every four months. In looking at my latest Medicare report the cost of my last injection was $4228! I find that I can get the same medication, in generic form, from various Canadian pharmacies for roughly $1000.

We must, as previously noted, do away with the give away of Medicare money to the “Medicare Advantage Plans.” I have before me an ad widely dispersed locally announcing 10 “seminars” in various locations to explain to our seniors the advantage of joining the UPMC for Life Medicare Advantage HMO. These plans even provide a ‘Personal Health Concierge.”

I would suggest that the tremendous cost of “end of life” care be evaluated by a panel of ethicists and hospice physicians to achieve a realistic, compassionate way of exiting this world. Perhaps we could go as far as to legalize cannabis to lighten the discomfort of those final days.

We must look hard at Medicare fraud and the fraud that indirectly impacts costs because of unholy alliances between pharmaceutical companies and researchers. It is well documented that various clinical studies at well known teaching hospitals, underwritten by pharmaceutical companies, are published or suppressed at the discretion of the pharmaceutical industry. It was recently reported by the New York Times that a student in a first year pharmacology class at Harvard Medical School became wary of a professor promoting the benefits of anti-cholesterol drugs and belittling the side effects. The student did a bit of research on Google and found that the professor was a paid consultant for 10 drug companies, including the makers of cholesterol treatments.

We who support health care for all must push both the House and Senate, No health care legislation will ever get through the Senate unless it is attached to a budget reconciliation resolution or unless the “nuclear option” is employed. Whether our elected officials have the courage to do so is another matter. Whether they have acceded to the largesse of the lobbyists is another matter. The wave of populism inherent in our nation could force the issue; however, as I have noted before, this is a two edged sword. Mass demonstrations, sans violence, are tolerated in Europe; however, my fear, as posed in the writings of Naomi Klein, and others, is that mass nonviolent disobedience in the USA will give the well indoctrinated right wing here a like opportunity to that they seized in Germany in 1932.

I would suggest that someone with the means on the internet start a widespread petition for universal/single payer care to be sent to our elected representatives, and that citizen groups make peaceful visits to the offices of our senators and representatives in home districts and in Washington, and make our desires known. The more the better, but keep it civil. I understand that the target date for debating health care is June at the latest.

[Dr. Stephen R. Keister, a regular contributor to The Rag Blog, lives in Erie, PA. He is a retired physician who is active in health care reform. His previous articles on The Rag Blog can be found here.]

Single-payer health reform bill introduced in Senate

Would save $400 billion on bureaucracy, enough to cover all 46 million uninsured Americans

Challenging head-on the powerful private insurance and pharmaceutical industries, Vermont’s Sen. Bernie Sanders introduced a single-payer health reform bill, the American Health Security Act of 2009, in the U.S. Senate Wednesday. The bill is the first to directly take on the powerful lobbies blocking universal health reform in the Senate since Sen. Paul Wellstone’s tragic death.

The single-payer approach embodied in Sanders’ new bill stands in sharp contrast to the reform models being offered by the White House and by key lawmakers like Senators Max Baucus (D-Mont.) and Edward Kennedy (D-Mass.). Their plans would preserve a central role for the private insurance industry, sacrificing both universal coverage and cost containment during the worst economic crisis since the Depression.

In contrast, Sanders’ new legislation would cover all of the 46 million Americans who currently lack coverage and improve benefits for all Americans by eliminating co-pays and deductibles and restoring free choice of physician. The most fiscally conservative option for reform, single payer slashes private insurance overhead and bureaucracy in medical settings, saving over $400 billion annually that can be redirected into clinical care.

“This is excellent news for the nation’s health,” said Dr. Quentin Young, national coordinator of Physicians for a National Health Program and a past president of the American Public Health Association. “There is now an affordable cure for our dysfunctional health care system. In the face of our present economic calamity, this is an urgent necessity.”

Highlights of the bill include the following:

• Patients go to any doctor or hospital of their choice.
• The program is paid for by combining current sources of government health spending into a single fund with modest new taxes amounting to less than what people now pay for insurance premiums and out-of-pocket expenses.
• Comprehensive benefits, including coverage for dental, mental health, and prescription drugs.
• While federally funded, the program is to be administered by the states.

By eliminating the high overhead and profits of the private, investor-owned insurance industry, along with the burdensome paperwork imposed on physicians, hospitals and other providers, the plan saves at least $400 billion annually – enough money to provide comprehensive, quality care to all.

• Community health centers are fully funded, giving the 60 million Americans now living in rural and underserved areas access to care.
• To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.

“We are confident that Sen. Sanders’ bill will accelerate the national drive for the only reform that we know will work,” Young said. “A majority of physicians endorse such an approach. Fifty-nine percent of U.S. physicians support national health insurance. Two-thirds of the public also supports such a remedy. We remember well that President Obama once acknowledged that single-payer national health insurance was the best way to go. It still is.”

Sanders, who serves on the Senate Committee on Health, Education, Labor, and Pensions, is a longtime advocate of fundamental health care reform. His new bill draws heavily upon the single-payer legislation introduced by the late Sen. Paul Wellstone (D-Minn.) in 1993, S. 491, and closely parallels similar legislation pending before the House, H.R. 1200, introduced by Rep. Jim McDermott (D-Wash.).

A single-payer bill introduced by Rep. John Conyers Jr. (D-Mich.), H.R. 676, obtained 93 co-sponsors in the House during the last session. It has been reintroduced in the new Congress as the U.S. National Health Care Act with the same bill number.

A copy of the bill is available here. (PDF)

Source / Physicians for a National Health Care Program

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