Health Care Is a Right, Not a Privilege

[j_b]

From Senator Sanders:

 

Let's be clear. Our health care system is disintegrating. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11 - but this occurs every year.

 

In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on health care than any other nation - and health care costs continue to soar. At $2.4 trillion dollars, and 18 percent of our GDP, the skyrocketing cost of health care in this country is unsustainable both from a personal and macro-economic perspective.

 

At the individual level, the average American spends about $7,900 per year on health care. Despite that huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. From a business perspective, General Motors spends more on health care per automobile than on steel while small business owners are forced to divert hard-earned profits into health coverage for their employees - rather than new business investments. And, because of rising costs, many businesses are cutting back drastically on their level of health care coverage or are doing away with it entirely.

 

Further, despite the fact that we spend almost twice as much per person on health care as any other country, our health care outcomes lag behind many other nations. We get poor value for what we spend. According to the World Health Organization the United States ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventable deaths.

 

As the health care debate heats up in Washington, we as a nation have to answer two very fundamental questions. First, should all Americans be entitled to health care as a right and not a privilege - which is the way every other major country treats health care and the way we respond to such other basic needs as education, police and fire protection? Second, if we are to provide quality health care to all, how do we accomplish that in the most cost-effective way possible?

 

I think the answer to the first question is pretty clear, and one of the reasons that Barack Obama was elected president. Most Americans do believe that all of us should have health care coverage, and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way. In that regard, I think the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly-funded, single-payer Medicare for All approach.

 

Our current private health insurance system is the most costly, wasteful, complicated and bureaucratic in the world. Its function is not to provide quality health care for all, but to make huge profits for those who own the companies. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible (30 percent) of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for far less.

 

In recent years, while we have experienced an acute shortage of primary health care doctors as well as nurses and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the numbers of physicians. Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the nation's major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It's not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion or Cigna CEO Edward Hanway who made more than $120 million in the last five years. The reality is that CEO compensation for the top seven health insurance companies now averages $14.2 million.

 

Moving toward a national health insurance program which provides cost-effective universal, comprehensive and quality health care for all will not be easy. The powerful special interests - the insurance companies, drug companies and medical equipment suppliers - will wage an all-out fight to make sure that we maintain the current system which enables them to make billions of dollars. In recent years they have spent hundreds of millions on lobbying, campaign contributions and advertising and, with unlimited resources, they will continue spending as much as they need.

 

But, at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Like the civil rights movement, the struggle for women's rights and other grass-roots efforts, justice in this country is often delayed - but it will not be denied. We shall overcome!

 

http://www.commondreams.org/view/2009/06/09-10

 

[Jim]

That's a pretty clear summary of the sorry state of our health care. Given that Japan has national health care, and thus their business carry less cost, you would think that Congress would move this along. But the insurance industry, sensing the national mood, has pulled out all the stops in their lobbying corps.

 

Bacus, head of the Senate finance committee is but in the back pocket of the insurance industry. Patty Murray hasn't been pushing this option either. Polls show a vast majority of Americans in favor of a single payer system. It makes economic and social sense. What is standing in the way it the insurance industry's desire to protect their huge profits, and their ability to bribe Congress.

 

Maybe this will be a start but we're way overdue. There's numerous examples on how to set it up. Why can't we study what has been done and adopt the best and avoid what doesn't work?

[kevbone]

Very much a right.

[KaskadskyjKozak]

 

Is eating like a fucking pig for 40 years and expecting quadruple bypass surgery for "free" a "right"?

[kevbone]

What about the guy who has an accident and needs a $30,000 surgery or he will die......he does not have health coverage. So we let him die? Seems cruel to me. I think he should have access to a Dr. without going bankrupt.

[KaskadskyjKozak]

What about the guy who has an accident and needs a $30,000 surgery or he will die......he does not have health coverage. So we let him die? Seems cruel to me. I think he should have access to a Dr. without going bankrupt.

 

I think you should have to pay for him.

 

 

[mtn_mouse]

I have a friend who was pregnant, then beat up by her husband, resulting in expensive surgery to return her to health. She is now burdoned with costly medical bills due to no insurance.

Was that her fault?

[kevbone]

Was that her fault?

 

The republicans think so.

[j_b]

Bacus, head of the Senate finance committee is but in the back pocket of the insurance industry. Patty Murray hasn't been pushing this option either. Polls show a vast majority of Americans in favor of a single payer system. It makes economic and social sense. What is standing in the way it the insurance industry's desire to protect their huge profits, and their ability to bribe Congress.

 

As of March 2008, 59% of physicians supported a national health insurance program (publication in Annals of Internal Medicine) and it is bound to be more now with that we are even closer to the brink of a health care disaster. Elected democratic officials who oppose single payer should be targeted in their home state now so they know they will be held accountable.

[kevbone]

Elected democratic officials who oppose single payer should be targeted in their home state now so they know they will be held accountable.

 

 

Its congress. Nobody is held accountable.

[j_b]

Well, it better change if we want to be a functional democracy.

[KaskadskyjKozak]

I have a friend who was pregnant, then beat up by her husband, resulting in expensive surgery to return her to health. She is now burdoned with costly medical bills due to no insurance.

Was that her fault?

 

there are lots of people who voluntarily opt not to buy insurance even though they could afford it (at least catastrophic).

 

 

 

[kevbone]

Well, it better change if we want to be a functional democracy.

 

 

I agree. We stopped being a functional democracy the minute Bush took command.

[j_b]

There are even more people who need access to health care and can't afford it.

 

What we need is health care, not insurance. Cut out the parasites.

Edited June 10, 2009 by j_b

[pink]

What about the guy who has an accident and needs a $30,000 surgery or he will die......he does not have health coverage. So we let him die? Seems cruel to me. I think he should have access to a Dr. without going bankrupt.

 

I think you should have to pay for him.

 

 

 

socialism is great idea until you run out of everyone elses money...

[Alpinfox]

Hey mods, just imagine how much better this thread would be without Kevbone and KK.

 

 

edit: OK, mostly just kevbone.

 

Edited June 10, 2009 by Alpinfox

[j_b]

we have already run out of money because we had to grease the paw of profiteers (we pay twice what we ought to for health care)

[j_b]

After 30 years of conservative propaganda about the cost of hammers and toilet sits in government run programs to justify the privatisation of everything (including the military so that Halliburton can better rip off the taxpayer), suddenly the bottom line (how much does it cost) isn't a valid argument anymore. Insurance companies can't compete with medicare type programs so they and we should be protected from such a "socialist" evil. Is there is better evidence that right wing ideologues will say anyhting to get what they want (keep hanging from the taxpayer's teat).

[kevbone]

Hey mods, just imagine how much better this thread would be without Kevbone and KK.

 

 

edit: OK, mostly just kevbone.

 

 

Brother....you would not know what to do without me.

[Alpinfox]

 

I'd love to test your theory. How about unplugging your computer for a few years?

[Stefan]

in the end...it will be a mix of private and public insurancing

 

people will get serviced...but at what level of service?

 

I hear people in the UK don't like their health system very much, but in no way in hell do they want to go the way of the US.

 

I know somebody in the healthcare field. She works 3 days out of 14. She is a semi-doctor and makes $80K a year...comes to about $128 an hour. She has big time loans. I wonder what would happen to that person with a change in the system....less pay? Many doctors are motivated by their own profit too. And why does the schooling of these people cost so much?

[kevbone]

I'd love to test your theory. How about unplugging your computer for a few years?

 

Look here Mr. I know fred becky and climb with fred becky and name drop because I know fred becky and invite all of cc.com because I know fred becky namedropper. Therefor I am super cool.

 

 

no.

[JayB]

That's a pretty clear summary of the sorry state of our health care. Given that Japan has national health care, and thus their business carry less cost, you would think that Congress would move this along. But the insurance industry, sensing the national mood, has pulled out all the stops in their lobbying corps.

 

Bacus, head of the Senate finance committee is but in the back pocket of the insurance industry. Patty Murray hasn't been pushing this option either. Polls show a vast majority of Americans in favor of a single payer system. It makes economic and social sense. What is standing in the way it the insurance industry's desire to protect their huge profits, and their ability to bribe Congress.

 

Maybe this will be a start but we're way overdue. There's numerous examples on how to set it up. Why can't we study what has been done and adopt the best and avoid what doesn't work?

 

Neither life expectancy, nor infant mortality, nor preventable deaths are actually good measures of how well the health care system that we have treats a given medical condition vs the rest of the world. Ditto for the WHO report - which I invite you to read and carefully examine the methodology they used to rank health care systems.

 

I've provided the links, data, and arguments before at length - but it's worth repeating the following. What constitutes a live birth that gets counted in infant mortality stats vary widely from country to country. The fact that the US has one of the highest infant mortality rates in the developed world has much more to do with the relative stringency of our standards for counting very premature or sick babies as live births than it does with any deficiencies that we have in caring for them.

 

Life expectancy stats that purport to measure how well the health-care system works have to account for deaths from murders, suicides, accidents, and variations in lifestyle to generate meaningful feedback about mortality that the health system can actually do something about. Ditto for preventable deaths. Preventable by what? Smoke heavily, drink heavily, overeat and sit on your ass for thirty years straight and there's not a hell of a lot that any doctor can do to spare you from the consequences of your actions.

 

And finally - there's cost. Let's break down the per-capita spending stats in terms of voluntary vs elective care, covered vs out of pocket spending and see where that gets us instead of simply taking "total medical spending" and dividing by population. Do the numbers indicate that people in the US spend more because they can, because they have to, or some combination of both?

 

Having said all of that - I have no problem with a "public option" provided that it doesn't rig the game against private insurers. The following is most of a letter that I've been sending to republican senators.

 

"One mechanism for insuring that legislation which provides for a "public option" that doesn't unfairly rig the game against private insurers would be a provision that mandates equal income-indexed government funding for public and private plans.

 

Allow me to illustrate what that phrase means by way of a concrete example. Let's suppose that under the rules governing a "public option" an individual making $50,000 per year would qualify for a government sponsored health insurance plan with total costs equal to $10,000 per year, provided that he or she paid in income-indexed premium. For the sake of this example, let's assume that the premium for such an individual would be $2,000. So, the individual pays $2,000 and the government pays the remaining $8,000. Under "equal income indexed government funding," the government would be required to grant the same individual the option to accept $8,000 per year in tax-credits or direct subsidies to apply towards a private medical insurance policy of his or her choosing. In short, the government would be required to make same investment in their health care, whether they opted for private or public coverage.

 

Failure to do so would make for unfair competition between the government and private insurance companies and would unfairly favor people enrolled in public plans over those enrolled in private plans. If the choice is between paying $2,000 a year and getting access to benefits worth $10,000 a year, and paying $2,000 a year and getting access to benefits worth...$2,000 a year (or any amount less than $10,000) it's not terribly difficult to predict which plan the public will want to join under such lopsided "competition."

 

Rules that mandated a neutral allocation of government resources between public and private plans would also force the health care delivery system organized under the public plan to compete in terms of value and quality. The only way for the public option to prevail in a competition organized under such rules would be to provide superior care at a lower price per out-of-pocket dollar. This - of course - is entirely consistent with the stated rationale for providing a public option in the first place.

 

Consequently, including such a rule in the legislation would appeal to the motives of those who sincerely believe that a public plan is the best mechanism by which to deliver the best care at the lowest price, and expose the motives of those who are intent on using a public plan as a mechanism to to drive private insurers out of business and thereby bring about a single-payer regime by default."

 

Would all of you single-payer fans find such a compromise acceptable? If not - why not?

 

[JayB]

in the end...it will be a mix of private and public insurancing

 

people will get serviced...but at what level of service?

 

I hear people in the UK don't like their health system very much, but in no way in hell do they want to go the way of the US.

 

I know somebody in the healthcare field. She works 3 days out of 14. She is a semi-doctor and makes $80K a year...comes to about $128 an hour. She has big time loans. I wonder what would happen to that person with a change in the system....less pay? Many doctors are motivated by their own profit too. And why does the schooling of these people cost so much?

 

Compared to what?

 

 

If I'm not mistaken, Canada is seeing something like one private clinic opening per week in the wake of the supreme court ruling that overturned the rules that forced doctors and patients into the public system. Also, the UK has started relaxing the restrictions on patients who want to bypass the restrictions on treatments, medications, etc by paying the difference between the care they want and what the government is prepared to pay for. Both indicate a movement away from, rather than towards, a strict single-payer modality - which moves them closer to the models that prevail in most of Europe and elsewhere.

 

Quick overview of the German system:

http://www.civitas.org.uk/pubs/bb3Germany.php

 

 

[Jim]

I think the system you mention has some merit - it's just that it's inefficient. It's not a single payer system (publicly funded, privately operated) and still includes the high rate of inefficiencies associated with 400+ insurance companies and their Byzantine forms, call in centers, claims denial staffers, marketers, lobbyists, and snake oil sales staff.

 

Whittle it down to two or three providers, set standards for the paperwork, eliminate TV advertising of drugs and move on already. It also should be funded through taxes so all parties are included.