Some 25 years ago the insurance industry planned, in concert, to co-opt medical care in the United States, while the medical profession through fear, misinformation, or self interest permitted it to happen.By Dr. Stephen R. Keister / The Rag Blog / April 30, 2009
P.J. Proudhon wrote in 1858: "Justice is spontaneous respect, guaranteed, for human dignity, in whatever person it may be compromised and under whatever circumstances, and to whatever risk its defense may expose us."
We who are in favor of single payer/universal health care face the Rubicon. The next month may well define the national character of the United States. Either we join the remainder of the industrialized world in providing decent, affordable health care for all or we retreat into the immoral, deceitful world of producing profits for the insurance companies, their richly paid executives, and the requisite injustice foisted upon the American people by the pharmaceutical industry and those who profit from it.
The concept of single payer/universal care arose with the Physicians for A National Health Program after the original program for universal care was defeated by a Republican Congress and the American Medical Association, when first conceived under the Truman administration. The sole remnant of that suggestion was the adoption of Medicare which has been a first rate success. Any further suggestions to provide anything like humanitarian care have been turned aside by the interests of those involved in profit by limiting care to those who can pay the big bills.
Some 25 years ago the insurance industry planned, in concert, to co-opt medical care in the United States, while the medical profession through fear, misinformation, or self interest permitted it to happen. We now are the only nation in the western world (add in Australia, Taiwan, and Japan) to have health care not for the good of the populace, but for the profits of two of the industries with major lobbying power in Washington. Various surveys show overall health care in this country ranking 26th in the world. A release from the Connecticut Coalition for Universal Health Care brings several startling facts to our attention.
- The United States ranks 23rd in infant mortality.
- The United States ranks 20th in life expectancy for women.
- The United States ranks 21st in life expectancy for men.
- The United States ranks 50th and 100th in immunizations, depending on the immunization. Overall, 67th, right behind Botswana.
- Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.
- Studies reveal that citizens in universal health care systems have more doctor visits and more hospital days than in the U.S.
- Around 30% of Americans have problems accessing health care due to payment problems or access to care, far more than in other industrialized countries. About 17% of our population is without health care. About 75% of ill uninsured people have trouble accessing/paying for health care.
- Comparisons of Difficulties Accessing Care are shown to be greater in the US than in Canada.
- Access to health care is directly related to income and race in the United States. As a result poor and minorities have poorer health care than the wealthy and the whites.
Although health care provider fees would be set as they are in 90% of cases, providers would have a means of negotiating fees unlike the current managed care system which are set in corporate board rooms with profits, not patient care in mind. Taxes, fees, and benefits would be decided by the public insurer which would be under the control of a diverse board representing consumers, providers, business, and government. It would not be a government controlled system, although the government would have to approve the taxes. The system would be in essence a Public Trust.
To be very specific, I am speaking of two bills before Congress: the Senate bill (S703) introduced by Sen. Bernie Sanders, and the House bill (HR 676) introduced into the by Rep. John Conyers.
On April 27, 2009, The New York Times printed an article titled, "Shortage of Doctors an Obstacle to Obama Goals." This underlines what I have been pointing out for some time in articles published by The Rag Blog. This is indeed a problem of long standing and is a result of two things: the overt effort by certain elements of the medical/educational establishments to limit the number of practitioners in the United States, and the unbearable cost of medical education in the United States. We badly need primary care physicians and internists. This matter has been emphasized by the American College of Physicians in recent publications. In previous articles I have indicated two approaches, and perhaps both should be implemented. First -- as in European nations -- government scholarships to pay for qualified candidates in medical school. And second, the formation of a national Medical Academy similar to West Point or Annapolis. Of course, current medical schools could increase enrollment. In either instance, graduates would be directed into primary care in underserved areas for a number of years to be determined.
In addition to the single payer/universal care legislation there are other suggestions pending. One is the concept of "Medicare for All" proposed by President Obama during the campaign. This in essence would expand Medicare into what has been called by some a "public insurance" company, giving citizens the option to continue with their present private plan should they desire, or to enroll in the public plan, with equal or better medical care, but with payment determined by ability to pay. This concept gives the prostitutes of the insurance industry cat fits as they fear that with equal or better care at lesser cost the public will drift to the public plan.
A third option, put forth by Sen. Max Baucus, a major recipient of campaign contributions from the insurance and pharmaceutical industries, calls for continuation of our present system under the control of the insurance cartels, but requiring (yes, requiring) everyone to buy insurance. Of course, this is overt insanity since a comprehensive, decent insurance plan for a family of four costs something like $2400 a month. This is far beyond what the average family can endure. Several constitutional scholars have questioned whether the government can legislate that a citizen buy a product from a private purveyor. Further, the less expensive the required insurance, the less coverage, i.e. yearly deductible of, say, $10,000 -- high co-payments, numerous exclusions. This is pure ledger domain, a real con-game.
Just yesterday I became aware of what could become a further complicating ingredient. The TV industry has had three major sources of advertising revenue: automobiles, pharmaceuticals, and food products. The auto revenue is disappearing, which is hurting TV advertising budgets. As we have pointed out previously on the Rag Blog, the United States is one of only two nations in the world that permit advertising for prescription drugs (New Zealand is the other); this is one of the many factors that result in prescription medication in the USA costing twice what it would in most other nations. I have suggested, as have many others, that under a universal health care plan there must be cost control of prescription medications, and further that Congress must redo the farcical "Medicare Prescription Drug Plan" to make it a vehicle for the benefit of the consumer rather than for the insurance and pharmaceutical industries.
Be assured there is a tremendous public relations campaign being launched to mislead the public regarding universal health care. The profiting industries, insurance carriers, and "nonprofits,” supported by the Republican Party and some “blue dog” Democrats, will do their best to deceive you, provide you with misinformation, formulate lies that will make you vote against your best interests. At this time we must stand resolute and do what is best for the common good, as well as for the image of our nation. There will be "letters to the editor" written by ghost writers for the powers that be. There will be ads on TV, done by actors, demeaning health care in other nations, There will be recorded phone calls warning you about the horrors of socialized medicine, telling you that they will take away your right to chose your own doctor.
Finally, remember that proper single payer, universal health care can be enacted at 40% less cost to the tax-payer than any other option. According to Ralph Nader, $225 billion to $250 billion each year is wasted on inefficiency and fraud in billing.
[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.]
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