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6/23/09
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john buell On health care politics, why not demand the best?
Why is Barack Obama dodging a single-payer option? Care would be publicly funded, but privately delivered. People would go to the doctor of their choice. Obama recently answered: “If I were starting a system from scratch … a single-payer system could … make sense. [Now] we are entrenched in the current system. We don't want a huge disruption.”
Our health care system is broken. Under our system, health care expenditures are projected to skyrocket from 18 percent of GNP to 34 percent by 2040. Starting from scratch is the practical course. Decades ago corporate health care giants falsely assured citizens that competition would slow health care inflation. Now they promise to cut costs and compete fairly — as long as they get subsidies and regulators treat them gently.
Health care is a right, not a commodity to be bought and sold on markets. Treating it as a commodity impoverishes us both morally and economically. Health insurance is at best a means to an end, just like banks. Neither banks nor insurance companies produce usable goods. Health insurance companies do not and should not compete over which can deliver the best bypass surgery. Since neither delivers direct benefits, the size and rewards to both, as to any middleman, should be as limited as possible.
The U.S. economy is in dire straits in part because unregulated banks went from channeling capital to marketing bets on the future of their own and others’ loans. Private health insurance is a speculative play on the health of each of us. One recent New York Times letter provocatively asked: “Why would any educated society rely on a health care system that has a stated fiduciary responsibility to extract as much money from its customers while giving them as little care as possible?” It meets that responsibility to shareholders by avoiding those deemed likely to need care and denying as many claims as possible.
This debate is trapped in a vicious circularity. Single payer is a nonstarter because Obama and Sen. Max Baucus deny it the visibility they afford corporate health care plans. Corporate interests use our money to buy ads telling us that government-funded health care means federal bureaucrats micromanaging doctor-patient relations and waiting lists.
Public health advocates have demonstrated that public systems give patients more choices with fewer shortages than corporate health bureaucracies provide. Longevity is greater. Health care consumes less domestic GNP and citizens lose less time wrangling with bureaucrats. Unfortunately the public health advocates lack the resources to gain access to our media or money-drenched political process.
We don’t break this vicious circle by dwelling on the obstacles, a self-fulfilling prophecy. Let’s fight Obama’s demand that we do health care quickly. It must be done right — after all voices are heard. Let’s take lessons from unions’ best corporate campaigns. These involved not only workplace organization but also pressure on institutional stockholders and board members.
Some hospitals and hospital associations endorse the current system. What if we told the nonprofit hospitals seeking charitable contributions how their stance might affect our giving? What if the many nurses and doctors who are repelled by corporate health care not only demonstrated, as many bravely have, but also asked their patients to write, call, e-mail friends, papers, politicians? Can we pressure local and national media to cover single payer fairly? Here in Maine, we should follow and publicize the money trail. How much is Sen. Olympia Snowe receiving from these titans and to whom is she responding? There are more modes of interconnection and ways to convey displeasure than any of us can imagine, but once we start the process can build on itself. That Baucus and Obama even mentioned single payer reflects some progress.
Finally, we should demand the whole enchilada. Some reform advocates argue that a public option alongside the corporate plans is the best we can get. I worry that such a program will become a costly dumping ground for the most ill unless there are strong, well-enforced rules on corporate cherry-picking and the public option has full, immediate freedom to market itself and negotiate with health providers. But whoever is right, advocacy of single payer is vital both to assure the best public option and to continually remind citizens of the burdens corporate health insurance imposes on any health system.
• • •
In my June 9 column, I should have said abortion rates declined more slowly under George Bush. Abortions also became more concentrated among low-income and minority women. (For details and interpretation, see www.GuttmacherInstitute.org).
John Buell is a political economist who lives in Southwest Harbor. Readers may reach him at jbuell@acadia.net.
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Howbri - …
Amen John Buell! Single Payer Healthcare Now!
No more profiteering off the sick and dying!
Yeah..there is NO reason why Canada a.) sends their patients to the US for treatment b.) has it's own citizens paying out of pocket for treatment in the US (Including EMMC) because of waiting lists in Canada c.) is enacting laws that allow people to buy their own insurance because of non covered procedures and government inefficiencies.
GIVE ME AN INSTANCE WHERE THE GOVERNMENT CAN DO SOMETHING CHEAPER, FASTER AND BETTER THAN PRIVATE COMPANIES....The fact is that our healthcare costs are more expensive because we have so much freedom in what/who we choose for care and have accessible some of the most cutting edge drugs and procedures that are unavailable anywhere else...and certainly not covered by insurance. In the UK you can only get certain types of treatments for cancer if you are below a certain age because it is RATIONED. Wouldn't you like at the age of 75 to receive treatment that extends your life with your grand kids possibly another 5-10 years irregardless of cost, or available to you at reduced cost via insurance vs. being told you don't meet the criteria to have it administered?
You don't honestly think that the coverage that we will all end up with will be the same as what those that are making these idiotic calls are going to get.....for me but not for thee..
While some of my Canadian cousins will gripe about their health care system, when asked if they would rather have the U.S. nonsystem, even the most conservative among them would recoil at our inefficient system. Readers may wish to see: Debunking Canadian health care myths By Rhonda Hackett at http://www.denverpost.com/opinion/ci_12523427 or 10 Myths About Canadian Health Care, Busted By Sara Robinson at http://www.pnhp.org/news/2008/february/10_myths_about_canad.php . Every system has its flaws, and ours is both too expensive and leaves too many without coverage...and the over-all health of Americans suffers as a result.
Follow the money trail, eh Buell?
Under a government single payer plan, how much of a 'campaign contribution' would I have to give, to which politician, to get my 80-yr old mother the chemotherapy treatments she needs?
Mr. Buell,
Why don't you ask your local physician what he or she thinks of Obama's plan? They will tell you that health care expenditures have skyrocketed because there is no cap on medical malpractice (which is where the bulk of the fees are going to). They will also tell you that government funding will lead to an abuse of the system (as seen in Medicare). In a country where doctors and nurses are already overworked, having people abuse the system will lead to more medical mistakes, more lives lost, and an overall bleak outlook for our country health.
From what I have been able to find, one of the reasons why healthcare costs are so expensive and rising is because of the government "interference" now. If you take a look at the reimbursement schedule for covered Medicare/Medicaid procedures you will find that the government is paying significantly less than the actual cost. To make up for the difference between actual cost and the reimbursement cost, the real cost to other users has to rise. If there is to be a "savings" with this "new" plan why haven't we seen it with Medicare/Medicaid/VA Care. These have been around for at least 30 years and the cost only seems to keep rising.
And if the healthcare plan that is bing foisted on the American taxpayer is so good and bendficial for us, why is that Congress is EXEMPT. (For that matter why is Congess exempt from most of the laws placed on the rest of us. Note that the 401k-type retirement plan that Congress refuses to let us have for Social Security reform is the type of retirement plan that Congress has. And wouldn't it be nice to be eligible for retirement benefits after bing on the job for only 1 day? Congress is. Sure would be nice if we, the people, had a say in what benefits Congress has voted for themselves.)
As for malpractice insurance reform....can't have any of that. What would all them lawyers do for for a living? Become politicians? Aaaarrrrrgggggghhhhh!!!
downfleeced:
Of course, the Canadian system is not the only single payer system to use as an example. In any case, That the Canadians spend half on their health care than we do, have a longer life expectancy and lower infant mortality rate than we do, and do not go bankrupt due to huge medical debts shouldn't be considered. When one considers that 47 million Americans (one out of seven) have no insurance at all, which means no primary care physician. As you know, the emergency room becomes the treatment center for minor things, which then takes time. materials, and energy away from those that really do need emergency care.
GIVE ME AN INSTANCE WHERE THE GOVERNMENT CAN DO SOMETHING CHEAPER, FASTER AND BETTER THAN PRIVATE COMPANIES....
U.S. Postal Service!?!?!?!?! Oh yeah, runs in the red year after year and continues to up rates and cut service. Can anyone remember when the 4th of July was actually the 3rd of July? Some post offices open and some closed on Friday the 3rd and then all offices closed on the 4th.
Amtrak!?!?!?!?!? Now there is an example of a well run government system!! Ah.......yeah also runs in the red year after year and requires governent bail outs before government bail outs became a trendy thing!
FannieMae!?!?!?!?! FreddieMac!?!?!?!? Social Security!?!?!?!?! Medicare!?!?!?! Help I am running out of examples!
It's not about the government running the health-care system it's about the government managing the insurance side of things. For those who think that our current private providers do such a great job, here's a hint: type into your Google bar any of the three largest insurers, WellPoint, UnitedHealth or Assurant. Next type in the word "scandal" and see what you get. I'll save you the time. What you get are accounts of massive financial irregularities. WellPoint has been hiding behind the Blue Cross trademark (formerly non-profit), while pasing out multi-million dollar bonusses. It's CEO wasn't dismissed until his sleazy behavior became a public scandal. There is no room for excess profits in human health-care, in fact it is repugnant. Let the private sector provide insurance at acceptable, regulated rates or let's have a public alternative but let's no longer drink the lobbyists' cool-aid. John Buell sees it exactly right.
People are so worried about losing their job, coverage, denial of treatment, which seems to increase bank deposit latetly. That means stimulus funding mainly goes toward bank deposit for a rainy day increasing jobless rate. It proves again that a healthy society yields better productivity, prosperity.
It is time to 'Change' the notion of the public health as a fundamental human right and install 'a safety system for all' like all of the other industrialized nations, I think.