Friday, June 05, 2009

119 Million Americans Must Be Wrong

By Robert Parry
June 5, 2009

As the health insurance industry and its defenders in Congress lay out their case against permitting a public option in a reform bill, perhaps their most curious argument is that some 119 million Americans are ready to dump their private plans and jump to something more like Medicare – and that’s why the choice can’t be permitted.

Read on.


ETSpoon said...

It's too bad your column won't be read by the majority of Iowans.

Many of us have known for a long time that Chuck Grassley's in big pharma and big insurance's pockets. But the Iowa Democratic Party establishment and the state's leading newspapers like Chuck.

The Democrats ran liberal Art Small, a sick, old man, against Grassley in '04. The Iowa Democrats gave Small such token support that Grassley merely dipped into his deep campaign war chest. Chuck only ran one television commercial and won in a landslide.

That's the only explanation I have for why he he stays in Washington.

Opinionator said...

Besides creating an undesirable "public option" by design, they could do the usual Republican thing to "prove" that "government doesn't work" and create the program without funding or staffing it adequately, thus ensuring that patients will become frustrated with it and ill from trying to deal with it, while complaining that "government can't do anything right."

Anonymous said...

I appreciate your focus on the isssue of democracy and the signal example that health care reform provides in the failure of our system. With 30 years in health care it seems to me in addition to the majority of Physicians, Nurses and Health Economists as well as to the majority of the public, that Single Payer is the only efficient and compassionate way for real reform. I am afraid that between Congress and the Administration the public is being set up to adjust their expectations lower and lower. Opinionator is I fear right on target as to the likely scenario with the Dems and the Administration seeking consensus and the Coporate parasites smiling all the way to the banks, make that the off shore hedge funds.

JerryLaRouche said...

To date Obama acts like a Wall Street Slave.

Unlimited bucks for Banker Bailouts and a call for $309-609 in cuts to Medicare. Bush-like privatization is on the Administration's Wall Street agenda.

I have HOPE that Barack will CHANGE--and quit imitating Bush and Hitler.

Anonymous said...

The New York Times reports in this physician written column that Medicare reform would vastly improve the existing system.

The New Yorker writes in a longer article by a physician about the how the system is failing badly.

Sen. Baucus claims that it's too late to consider single-payer health

Michael Moore writes of how Baucus refuses to put single payer health on the table

Just in the last couple of weeks many articles have appeared about how private insurers are blocking a public health plan and that the Baucus committee will not even consider single payer health plan. The game is fixed, and neither Obama nor Congress dare confront the powerful insurance industry. It is pointless anymore to complain, and as a retired pharmacist I am beyond furious, just resigned now, to a plan that will be more like that of the insurance companies and very little like that proposed by Sen. Kennedy.

What is left of real democracy in this country has been crushed by big corporate money, and the millions of advocates of single payer, many of whom are health providers, are left without a voice.

singlepayercentral said...

Great article. Why even bother trying to do that public option shtick at all knowing this - just go straight to the REAL solution: pass HR676, S703, and let's move on to getting something done in the country instead of constantly bailing out industries that need to be "retired"/composted/"re-purposed" or just plain dumped.

We seem to repeatedly choose to maintain industries including tobacco, automobiles, and the private health insurers, whose purpose is solely to provide somebody a profit by destroying the common welfare, treasury, and healthcare of Americans. At some point, one would hope that people begin to adopt an attitude of the short term pain (ie., all the clerks & paper pushers will have to go do their job for somebody else or go back to school or finish school) for long term gain and for our very survival as not only a nation but as a planet.

Civilization_in_2100? said...

We have to start re-casting this issue, and drop the emphasis on how or through what channels the money is going to flow. It must be:

a) Back to the most fundamental economic issues, and,

b) Back to the most fundamental medical issues.

For a) ANYTHING LIKE the continuation of current cost trends bankrupts the nation in 20, 30, 40 years depending on other circumstances. Then we are non-competitive, and the deficit, which will be almost entirely due to the continual rise in medical expenses, will prevent any other kind of social investment. (Plus too many of us are too sick). A dike around NYC--forget it. Educational improvements? Ha! Real repair of infrastructure, full development of an alternate energy economy, fat chance!

For b), see Atul Gawande's June 1 article in the New Yorker. In one community he examines, government is ALREADY a huge payer, in the form of Medicare. It is billed, and pays, excessively, and Gawande tells why. In other areas, costs are under relatively far better control, and Gawande shows how they have come to be that way.

He argues there is a tremendous amount of 'Fat' in the medical system--I use the statement 'The medical entities have claimed a larger and larger slice of the overall economic pie...[particularly since about 1990...' It is fairly clear we don't get what we are paying for.

Thus I don't care about 'single payer,' 'public option', etc. I favor a one-page bill that commands: "Get the costs down and the results up. By 10 years from now, you have a 25% per-capita 'allowance' over an agreed-upon set of international comparisons. YOU, medical-entity folks, work out the details. Americans are smart and creative when they're not being greedy and stupid--we know you can do it. By the end of another 10 years, we have better care at minus 5% per-capita expense, using that same comparison methodology.

In year now +4, we'll assess your progress MOST THOROUGHLY. If you're not truly getting a move on, you can REALLY expect drastic changes, NOT of your own choosing.

Oliphant Family said...

I sit on the board with Utah association of Health underwriters and for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that needs to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.

Anonymous said...

Ramussen latest poll of June 2, 2009 has that voters are now putting more emphasis on deficit than on health care. On June 2, only 26% or 75 million people were still in favour of universal health care. am

Civilization_in_2100? said...

In response to Anonymous, re Rasmussen poll and voters' concern over deficit 'VS.' health care reform. I have emphasized the 'vs.' because that is exactly where a change of understanding badly needs to come. UNLESS we do the right kinds of "medical system reform" (my new preferred phrase), THE MEDICAL SYSTEM will be by far the single largest cause (the overwhelming future cause, in fact) of deficits. If you haven't read the Atul Gawande article I refer to, you'll still be the Emperor in the "Emperor's New Clothes." Once you read it, you will see that "single payer", in the simple sense, at least, has no clothes--nor, necessarily, does the "public option." The core problem lies on another plane entirely. It is in being able to see the difference between those who bill you (OR MEDICARE) visits, procedures, tests, operations, etc., and those who keep YOUR WELLNESS in focus, and place it ahead of their economic return.


Oliphant Family said...

The comments from Civilization_in_2100 is right on. In which is the beginings of a state sponsored program addresses this. Coming from an underwriting background I know where the dime falls. I am of the opinion that large waste occurs from providers billing for proceedures that developed "no outcome". Insurance carriers are not the only bad guys on the block. In most of our purchasing decisions....don't we pay ONLY when we know that we will get a desired outcome? Why is it if you ask the doctor how much this test or proceedure is he doesn't know? Shouldn't providers be held to a transparent cost standard?

Civilization_in_2100? said...

An EMPHATIC YES. I need to recapture the source, but transparency of price structures, doctor ratings, hospital ratings, and so on is a very big potential contributor here, and the web is ideal for it, under impartial controls. So is price standardization. There is a company in SW Minnesota (rough location) that does ONLY MRIs, for a set rate, for everyone who comes there. They therefore set the price for the area. I don't know if their price could be lower, but one could check that out. Point is, no hospital, etc. in that area DARES charge you more than that price for an MRI.
An argument in my prior post was left in pretty terse form. Of course under this or that setup you will get some charge for a visit, a test, etc. It may be a co-pay, Medicare may get billed, or whatever. As long as each item is clearly justified and in line with what we hope are forthcoming "best-practice standards" for diagnosis and treatment(NOT PRESENTLY THE CASE IN MOST MEDICAL MARKETS, although reform leaders within medicine are working on those standards), such charges are cool, have been judged "probably effective in a case like yours at the ___ level of confidence, and do not add undue risk to your situation.
It is when any entity in the medical environment goes beyond that that we get "too much medicine", which piles up costs, adds to risks for you, and overly rewards that entity. Gawande gives excellent examples. And it is that entrepreneurial direction of the present "medical non-system" that will pile up the medicare deficit until it sinks the whole ship of the nation's economy. I still believe in top, reform-minded and risk-conscious doctors setting up these best-practices standards, by the way, and keeping them under constant and transparent review.