I just sent the following letter to President Obama.
Dear President Obama,
The reason your poll numbers have fallen is not because Republicans and the health insurance industry have persuaded a significant number of Americans that your health care reforms go too far, it is because folks like me who supported and voted for you are disappointed that your health care reforms do not go far enough.
The insurance companies are framing the debate in Congress.
You and the Democrats in Congress have not given H.R. 676, a single-payer health-care system, a fair hearing.
As you know, in the U.S. today we spend approximately two times as much as other industrialized nations, over $7,000 per person per year, yet have nearly 50 million Americans uninsured.
We are the only industrialized nation that does not have a single-payer system. Instead our system is based on privately owned for-profit insurance companies.
In the average private health insurance company, one-third of the money paid in premiums is used for "administrative costs" – paying for things like sales and marketing, lobbying and huge executive salaries, bonuses, and profits for their shareholders. And, not for providing health care.
In addition, hospitals, nursing homes and physicians need to employ large staffs just to negotiate the maze of rules and regulations from multiple insurance companies.
Adding a "public option" will only increase that maze.
By eliminating these multiple insurance companies and going to a single-payer system, the cost savings to the system would be more than $350 billion each year.
Most people don't realize that the government plan we all know best, Medicare, runs at about 2 to 3 percent overhead while most private for-profit HMOs run 20 to 30 percent overhead, and the Canadian system has only 1 percent overhead.
As President you must educate folks to the fact that a government run system is, and would be far more efficient than a private for-profit system is or will every be.
In a single-payer system the American people and our employers would pay taxes instead of premiums. These taxes would amount to a mere fraction of what we are use to paying in insurance premiums. And, we would get more for our buck. Our taxes would pay for literally all of our health needs – from glasses to dental care to medical and surgical care.
The large cost savings of a single-payer system would come by buying in bulk and demanding volume discounts – greatly decreasing the cost of medication.
The VA system in the United States gets a 40 percent reduction in medicine costs over what most Americans pay.
A single-payer system would also greatly increase the country's access to preventative care. This in turn would reduce the inappropriate overuse of highly costly emergency rooms. Having diseases diagnosed earlier and treated appropriately will vastly decrease the overall cost of treatment.
While doctors and hospitals would be paid somewhat less, their costs of doing business would be dramatically reduced since there would be a very low cost to billing and administration, and providers would get paid more quickly and reliably.
There also would be improvements to our actual patient care with a single-payer system. Having only one payer would allow us to use a unified computer system. A single computer system would allow Doctors and hospitals to have all the information they need at their finger tips to treat us safely with fewer medical errors.
I strongly encourage you to consider supporting H.R. 676, the single-payer system that will fundamentally eliminate a huge waste of health-care dollars and restore our health-care system.
Thank you,
Dee Newman
Tuesday, August 4, 2009
Monday, August 3, 2009
Rewarding Bad Actors
If you aren’t outraged, you haven’t been paying attention.
Americans are angry at Wall Street, and rightly so. First the financial industry plunged us into economic crisis, then it was bailed out at taxpayer expense. And now, with the economy still deeply depressed, the industry is paying itself gigantic bonuses. If you aren’t outraged, you haven’t been paying attention.
But crashing the economy and fleecing the taxpayer aren’t Wall Street’s only sins. Even before the crisis and the bailouts, many financial-industry high-fliers made fortunes through activities that were worthless if not destructive from a social point of view. And they’re still at it. Consider two recent news stories.
One involves the rise of high-speed trading: some institutions, including Goldman Sachs, have been using superfast computers to get the jump on other investors, buying or selling stocks a tiny fraction of a second before anyone else can react. Profits from high-frequency trading are one reason Goldman is earning record profits and likely to pay record bonuses.
On a seemingly different front, Sunday’s Times reported on the case of Andrew J. Hall, who leads an arm of Citigroup that speculates on oil and other commodities. His operation has made a lot of money recently, and according to his contract Mr. Hall is owed $100 million.
What do these stories have in common?
The politically salient answer, for now at least, is that in both cases we’re looking at huge payouts by firms that were major recipients of federal aid. Citi has received around $45 billion from taxpayers; Goldman has repaid the $10 billion it received in direct aid, but it has benefited enormously both from federal guarantees and from bailouts of other financial institutions. What are taxpayers supposed to think when these welfare cases cut nine-figure paychecks?
But suppose we grant that both Goldman and Mr. Hall are very good at what they do, and might have earned huge profits even without all that aid. Even so, what they do is bad for America.
Just to be clear: financial speculation can serve a useful purpose. It’s good, for example, that futures markets provide an incentive to stockpile heating oil before the weather gets cold and stockpile gasoline ahead of the summer driving season.
But speculation based on information not available to the public at large is a very different matter. As the U.C.L.A. economist Jack Hirshleifer showed back in 1971, such speculation often combines “private profitability” with “social uselessness.”
It’s hard to imagine a better illustration than high-frequency trading. The stock market is supposed to allocate capital to its most productive uses, for example by helping companies with good ideas raise money. But it’s hard to see how traders who place their orders one-thirtieth of a second faster than anyone else do anything to improve that social function.
What about Mr. Hall? The Times report suggests that he makes money mainly by outsmarting other investors, rather than by directing resources to where they’re needed. Again, it’s hard to see the social value of what he does.
And there’s a good case that such activities are actually harmful. For example, high-frequency trading probably degrades the stock market’s function, because it’s a kind of tax on investors who lack access to those superfast computers — which means that the money Goldman spends on those computers has a negative effect on national wealth. As the great Stanford economist Kenneth Arrow put it in 1973, speculation based on private information imposes a “double social loss”: it uses up resources and undermines markets.
Now, you might be tempted to dismiss destructive speculation as a minor issue — and 30 years ago you would have been right. Since then, however, high finance — securities and commodity trading, as opposed to run-of-the-mill banking — has become a vastly more important part of our economy, increasing its share of G.D.P. by a factor of six. And soaring incomes in the financial industry have played a large role in sharply rising income inequality.
What should be done? Last week the House passed a bill setting rules for pay packages at a wide range of financial institutions. That would be a step in the right direction. But it really should be accompanied by much broader regulation of financial practices — and, I would argue, by higher tax rates on supersized incomes.
Unfortunately, the House measure is opposed by the Obama administration, which still seems to operate on the principle that what’s good for Wall Street is good for America.
Neither the administration, nor our political system in general, is ready to face up to the fact that we’ve become a society in which the big bucks go to bad actors, a society that lavishly rewards those who make us poorer.
Why Do Health Insurance Companies and Republicans Want to Kill Health Care Reform?
Want Health Care? Just Be Rich!!!
Book: "That's Why We Don't Eat Animals"
Author and Illustrator Ruby Roth describes her vegan and vegetarian children's book "That's Why We Don't Eat Animals" and the ideas that inspired her to write it.
More info at http://www.WeDontEatAnimals.com
More info at http://www.WeDontEatAnimals.com
Sunday, August 2, 2009
Daily Kos: Uniformly Catastrophic
by Devilstower
Sun Aug 02, 2009 at 08:00:03 AM PDT
Sun Aug 02, 2009 at 08:00:03 AM PDT
In the first week of October, 1836, Captain Robert Fitzroy married Mary Henrietta O'Brien, the daughter of a prominent army general. Within a few years, the respected naval officer would become a Member of Parliment, then the governor of the British colony of New Zealand — a post he would lose by being so impolitic as to treat with the Maori on a basis of equality. In his public career, Fitzroy would become the head of the British Meteorological Department and be heralded as the father of modern weather forecasting. He would invent a better, cheaper form of barometer and devise the first system of storm warnings. He would be the commander of one of the first steam vessels in the British Navy and the master of the dockyard at which the most innovative ships of the day were constructed. He would invent new techniques of cartography, explore distant lands, and lead some of the most celebrated expeditions in history.
And his fame would be completely overwhelmed by that of a man he took as a passenger on one of his voyages. A man who had recently finished off a bachelor's degree, and who a friend recommended to Fitzroy as a good conversational companion. A young fellow named Charles Darwin.
Even the book we know today as The Voyage of the Beagle was originally the third volume of a set commissioned to record the expeditions led by Fitzroy. Captain Fitzroy himself wrote the first two volumes. Darwin, again at Fitzroy's invitation, wrote the third. It's that third volume that's still in print more than a century and a half later.
Both men were adventurous, intelligent, innovative and well connected. Both were very young (Fitzroy was only 26 when he wrote seeking someone with more knowledge of the natural world to come along on his next journey. Darwin was 22). Over the course of a journey that took almost five years the two men talked, argued, and used each other as sounding boards. They suffered through periods of cold silence and enjoyed occassions of warm friendship. Fitzroy — not only a ship's captain but the nephew of a duke — could be high-handed, officious, and prone to fits of rage his crew nicknamed "hot coffee." More than once he banished Darwin from his sight (as when the two argued over slavery, which Darwin opposed) only to apologize sincerely only a few hours later.
Darwin escaped to the land for over three years of their journey, leaving Fitzroy to carry out the expedition's real purpose: creating detailed maps of the coasts and harbors. But on many occasions Fitzroy delayed the progress of the ship to allow Darwin his observations and excavations, and when possible the two men went off together to share adventures. They were friends.
Both men used the other in working through feelings on theology and on scientific theories to explain the features of the world they observed together. It was during one of these discussions that Fitzroy and Darwin came to an agreement: the world around them could not have been formed in the short time allowed by a traditional interpretation of biblical events. In particular, the placement of fossils and the structure of the land could not have been the result of the single great flood relayed in the story of Noah.
But that was before the wedding.
All during their long journey, Fitzroy held one personal secret that he never shared with Darwin — he was engaged. Within days of the Beagle's return to England, Fitzroy married the general's daughter in a wedding that was a complete surprise to Darwin. As it happened, Fitzroy's new bride was a devout churchgoer, and lest he offend her, the captain censored the "progressive" ideas he had discussed during the journey. So, despite what he had told Darwin, Fitzroy's volumes recording the voyages of the Beagle were careful to present the results of landforms they had seen in terms of how they might have been gouged out by the waters of a universal flood. Even seashells found on the highest peaks were explained in terms of Noah's deluge.
This school of geologic thinking came to be known as Catastrophism — the idea that the world was primarily formed by a series of massive, unique events. Though catastrophism originated among those who traced natural history through biblical stories of creation, it wasn't restricted to only to those who expected the world to reflect their beliefs. In fact, the best known proponent of catastrophism at the time was also the best known scientist, period — Georges Cuvier. Unlike Fitzroy, Cuvier had no ancestral wealth or position in the peerage. A polymath genius whose ideas were shaped by the Enlightenment, Cuvier didn't come to catastrophism as a means of explaining what he had read in the Bible. He was looking for an answer to what he found in the rocks. In particular, Cuvier was looking for an explanation for something that was only then becoming widely accepted — extinction.
Meanwhile, the man who had just finished collecting some of the best evidence in support of extinction's worldwide reach was a follower of a diametrically opposed idea of how the Earth had been made. The biggest influence on Charles Darwin's geologic thinking was another unlikely character — a former lawyer who had taken to studying rocks when his failing eyesight made it too difficult for him to read the intricate text of legal documents. Charles Lyell's, Principles of Geology would not only shape much of Darwin's thoughts, but dominate geology for the next... ever. In this three volume set, Lyell laid out rules that seem simple (and are), but which are also as essential to geology as a number system is to mathematics.
What Lyell taught can be boiled into a single, intensely profound statement: the present is the key to the past.
Want to understand how ripples were formed in the sands of ancient stones? Look for the places where those same kind of ripples are being formed on sands today. The world of the past wasn't shaped by extraordinary events, but by extremely ordinary events. What to see what made the world? Look at wind. Look at rain. Look at streams. Look at the sea. The only difference between what happened then and what's happening now is time, lots and lots and lots of time in which those streams and oceans had the chance to carry out their actions. Our world was formed by the slow, steady accumulation of tiny features that led to large changes only over the course of millennia. It was a theory that was called Gradualism.
The attraction of gradualism was great, and completely understandable. Gradualism turned natural history into a testable, predictable endeavor. In short, it makes geology into a science. A world built completely around catastrophism would be a world of nightmarish, unpredictable events whose record can only be puzzled over — like a film made up of random clips. Gradualism is a system, a tool, a lens by which past events can be interpreted sensibly. It became the foundation for geology and paleontology, and the basis of Darwin's theories.
The idea that both stones and bones are shaped by step-by-step change became such a primary feature of Darwin's thinking that he defended gradualism against those who proposed more abrupt changes among species.
Mr. Mivart is further inclined to believe, and some naturalists agree with him, that new species manifest themselves "with suddenness and by modifications appearing at once." For instance, he supposes that the differences between the extinct three-toed Hipparion and the horse arose suddenly. He thinks it difficult to believe that the wing of a bird "was developed in any other way than by a comparatively sudden modification of a marked and important kind;" and apparently he would extend the same view to the wings of bats and pterodactyles. This conclusion, which implies great breaks or discontinuity in the series, appears to me improbable in the highest degree.
When Cuvier died in 1832 (in the midst of the Darwin's prolonged trip on the Beagle) catastrophism ruled the day. For years after, respect for Cuvier's genius, and the support of the church, helped to keep the theory at the forefront of scientific thought. (The cult of Cuvier strengthened after his death. When it was discovered that his brain was found to be extraordinarily large, this fact was often cited by those who wanted to make direct connection between brain size and intelligence, including those who misused Darwin's theories to promote ideas of race).
But the attraction of gradualism, and a mass of scientific evidence that accumulated around the idea as steadily as the processes the theory predicted, won the day. So much so that within a matter of decades gradualism had completely supplanted the theory of catastrophism. In both biology and geology, the past was seen the same way: a series of small, minute actions that produced measurable change only over deep time. Gradualism was predictable, measurable, comprehensible — comfortable.
That same love of comfort often pervades economic systems. When economists look at the behavior of markets, consumers, and systems, they don't look at each event as a unique occurrence. They, quite rightly, look for guidance in past events, using the failures and successes of previous cycles to guide actions in the current situation. In doing so, economists are expressing that same connection between past and present that Lyell formulated in 1830 (though they're looking through the other end of the scope — hoping to gain insight into the present by looking at the past, rather than peering at the present for clues to what went before).
It's this kind of steady predictability that was used as a means to replace defined benefit pension plans with that most ubiquitous new instrument: the 401k plan. Within three years of its inception in 1980, more than half of American corporations were offering 401k plan either as a supplement or replacement for defined benefit pension plans. Even though the original legislation targeted executive compensation, by 1993, most corporations offered only these kind of contribution-based plans for all employees. And why not? Seen over the span of decades, the value of stocks increased more quickly than the value of benefits held in pensions. Moving to contribution-based plans saved corporations billions, and employees enrolled in these plans were shown charts demonstrating that they would one day be millionaires... all thanks to that slow, steady accumulation of wealth. Though the basis of the 401k shift was the steady predictability of financial markets, the shift away form pensions itself was so abrupt as to represent an enormous "catastrophic" change. It can be argued that the whole of the economic boom experienced in the 1990s was due to corporations removing the cost of defined pension plans from their books and placing that risk on average workers.
The trouble is, they were all wrong. Lyell was wrong. Darwin was wrong. Cuvier was wrong. Fitzroy was wrong. And the guy who sold you that 401k plan was wrong. They were all wrong because, while they stood on opposite sides of the line of gradualism vs. catastrophism, they were united (to varying degrees) in a philosophy of absolutism.
The truth is that the world is formed both by gradual processes and by disaster. Anyone who adhered too strongly to either theory was likely to miss the evidence that the other was also at work. The affection for gradualism among geologists became so strong that when a physicist named Luis Alvarez suggested that (shades of Georges Cuvier) the extinction event at the end of the Cretaceous Period might have been caused by an object striking the Earth, it took years before geologists would accept the evidence. Biologists had become so wedded to the idea of gradual change that when Niles Eldredge and Stephen Jay Gould introduced the idea of "punctuated equilibria" in 1972, it was seen by some as an attempt to return to the pre-Lyell chaotic unpredictability of catastrophism. Market watchers were still predicting ever higher peaks even as the "comet" of the coming disaster hung in the sky.
Lyell was absolutely right on the central point of his great book — the same processes that shape the past also shape the present. But the present isn't only shaped by the drip-drip-drip of gradual change. It's also formed by asteroids, and eruptions, and floods. The fossil record reveals that the kind of slow, steady change of species that Darwin originally proposed does occur, but periods of stability interrupted by times of accelerated transformation is a more typical pattern. Not every change is predictable. Not every change is gradual. And steady contributions to a 401k plan are not a guarantee of eventual wealth.
We all live in a "punctuated" world, one in which gradual processes are occasionally replaced by more momentous actions. To Darwin's great credit, he recognized that the difference between gradualism and catastrophism was often little more than a difference in degree. Bird wings might not appear fully-formed, but he did accept that "everyone who believes in slow and gradual evolution, will of course admit that specific changes may have been as abrupt and as great as any single variation which we meet with under nature." Though his tendency was toward gradualism, Darwin was much less rigid in applying his theory than many of those who would come after him.
But if Darwin was willing to leaven his steadiness with a bit of abrupt change, Fitzroy never again seemed ready to make the move toward accepting gradualism as he had during that long voyage on the Beagle. After Darwin revised his volume on the natural history of the expedition in 1845, Fitzroy wanted no part of Darwin's growing insistence on deep time and gradual change. Instead, Fitzroy expressed great concern that such ideas might influence the next generation of young men, and devoted himself to a defense of literal interpretation of the Bible. In 1860, when The Origin of Species was published, FitzRoy felt crushed by guilt for the role he had played in helping bring natural selection to the world.
Though he was only fifty-five at the time, care and a lifelong struggle with depression had made Fitzroy frail and elderly. He appeared at public meetings holding aloft a huge Bible and calling on people to believe "God, not man." For the most part, he was treated as a kook. Even then, few people seemed to recognize that this was the man who had carried Darwin around the world, the inventor of the storm glass, the former governor, former MP, and vice-admiral of the navy. He had become another face in the crowd, another voice lost in the storm brought about by Darwin's theory.
Perhaps that was on Robert Fitzroy's mind in 1865, when he rose from bed one morning, passed his wife, and took his own life with a straight razor. Or perhaps he was haunted by the fact that his family fortune was exhausted. Vice-admiral Fitzroy, always the good public servant, had taken no money for his inventions and innovations. As governor, he had made no land deals to assure his family's wealth. As MP he had made no arrangements to secure his financial future. As harbormaster, he had taken no bribes when it came to supplying the Navy. In fact, most of his money had gone for public expenses that the government was supposed to repay, but never had.
He died penniless. A personal catastrophe to be sure, and one not softened by any form of pension.
However, following his death, a testimonial fund was established by sailors who had served with Fitzroy. At their urging, the government repaid the equivalent of $330,000 (half of what was owed) to keep Fitzroy's widow and children out of poverty. Another $11,000 came by way of a donation from an old friend of the family — Charles Darwin.
Single-payer Reduces Waste Dramatically
By Jeremy B. Stern
SouthCoastToday.com
July 07, 2009
I am an orthopedic surgeon who has been practicing in this community over the past 16 years and may be familiar to many of your readers. As our Congress debates the future of our health-care system, I am writing to urge my fellow citizens to get involved in the process. The debate in Congress is being framed largely by the insurance companies. This is problematic because of the large sums of money donated by the insurance lobby to the same senators who are crafting the reform.
What is not being considered fairly is H.R. 676, a single-payer health-care system.
In the U.S. today we spend approximately two times as much as other industrialized nations, over $7,000 per person per year, yet have nearly 50 million uninsured residents. What causes this waste of health-care dollars? We are the only industrialized nation that does not have a single-payer system. Instead our system is based on privately owned for-profit insurance companies.
In the average private health insurance company, one-third of the money paid in premiums is used for "administrative costs." That means that one-third of all the money you and I now pay for our insurance is used to pay for things like salaries, marketing, overhead and, of course, profits and bonuses. Not to provide health care.
In addition, hospitals, nursing homes and physicians need to employ large staffs just to negotiate the maze of rules and regulations from multiple insurance companies. By eliminating these multiple insurance companies, the cost savings to the system would be more than a staggering $350 billion each year.
Many people are scared to have a single-payer system run by the federal government for two main reasons. First, there is a general impression that the government is inefficient and will be unable to manage the system well, and second, people fear that the government would limit their choice of providers. Most people don't realize that the government plan we all know best, Medicare, runs at about 3 percent overhead while most HMOs run 15 to 20 percent overhead, and the Canadian system has 1 percent overhead. The government, then, is more efficient than the private sector.
As to the second fear, lack of choice, in the single-payer plan being talked about for the United States, the majority of the health-care system would run just as it does today. That means that most people would have greater choice of providers because they would no longer have an HMO telling them who they could see. Unlike the VA or Army system where the doctors and hospitals are run directly by the government, in a single-payer system here in the United States there would be no change in the providers; only the payers would change.
What would happen is that we and our employers would all pay taxes instead of premiums. These taxes would amount to a fraction of what we used to pay in insurance premiums. For those taxes we would have insurance that would pay for literally all of our health needs, from glasses to dental care to medical and surgical care.
The large cost savings of a single-payer system would come in various ways. By buying in bulk and demanding volume discounts, the single-payer plan would greatly decrease the cost of medication. The VA system in the United States gets a 40 percent reduction in medicine costs over what we all pay. A single-payer system would also greatly increase the country's access to preventative care. This in turn would reduce the inappropriate overuse of highly costly emergency rooms. Having diseases diagnosed earlier and treated appropriately vastly decreases the overall cost of treatment of that disease. For example, by treating high cholesterol early with medicine, you may well eliminate the need for a very costly coronary artery bypass later in life.
While doctors and hospitals would be paid somewhat less, their costs of doing business would be drastically reduced since there would be a very low cost to billing and administration, and providers would get paid more quickly and reliably.
Lastly, but perhaps most importantly, there would be improvements to our actual patient care with a single-payer system. Having only one payer would allow us to use a unified computer system. With this single computer system, whenever you went for health care of any kind, the health-care provider would have all the information needed to treat you safely, such as the medications you take and the allergies you have. There would be fewer medical errors and a greater awareness of interrelated medical problems.
I strongly encourage you all to call, write, text or otherwise contact your congressmen and senators, and encourage them to strongly consider H.R. 676, the single-payer system that will fundamentally eliminate a huge waste of health-care dollars and restore our health-care system.
Dr. Jeremy B. Stern is an orthopedic surgeon. He lives in Marion, Mass.
SouthCoastToday.com
July 07, 2009
I am an orthopedic surgeon who has been practicing in this community over the past 16 years and may be familiar to many of your readers. As our Congress debates the future of our health-care system, I am writing to urge my fellow citizens to get involved in the process. The debate in Congress is being framed largely by the insurance companies. This is problematic because of the large sums of money donated by the insurance lobby to the same senators who are crafting the reform.
What is not being considered fairly is H.R. 676, a single-payer health-care system.
In the U.S. today we spend approximately two times as much as other industrialized nations, over $7,000 per person per year, yet have nearly 50 million uninsured residents. What causes this waste of health-care dollars? We are the only industrialized nation that does not have a single-payer system. Instead our system is based on privately owned for-profit insurance companies.
In the average private health insurance company, one-third of the money paid in premiums is used for "administrative costs." That means that one-third of all the money you and I now pay for our insurance is used to pay for things like salaries, marketing, overhead and, of course, profits and bonuses. Not to provide health care.
In addition, hospitals, nursing homes and physicians need to employ large staffs just to negotiate the maze of rules and regulations from multiple insurance companies. By eliminating these multiple insurance companies, the cost savings to the system would be more than a staggering $350 billion each year.
Many people are scared to have a single-payer system run by the federal government for two main reasons. First, there is a general impression that the government is inefficient and will be unable to manage the system well, and second, people fear that the government would limit their choice of providers. Most people don't realize that the government plan we all know best, Medicare, runs at about 3 percent overhead while most HMOs run 15 to 20 percent overhead, and the Canadian system has 1 percent overhead. The government, then, is more efficient than the private sector.
As to the second fear, lack of choice, in the single-payer plan being talked about for the United States, the majority of the health-care system would run just as it does today. That means that most people would have greater choice of providers because they would no longer have an HMO telling them who they could see. Unlike the VA or Army system where the doctors and hospitals are run directly by the government, in a single-payer system here in the United States there would be no change in the providers; only the payers would change.
What would happen is that we and our employers would all pay taxes instead of premiums. These taxes would amount to a fraction of what we used to pay in insurance premiums. For those taxes we would have insurance that would pay for literally all of our health needs, from glasses to dental care to medical and surgical care.
The large cost savings of a single-payer system would come in various ways. By buying in bulk and demanding volume discounts, the single-payer plan would greatly decrease the cost of medication. The VA system in the United States gets a 40 percent reduction in medicine costs over what we all pay. A single-payer system would also greatly increase the country's access to preventative care. This in turn would reduce the inappropriate overuse of highly costly emergency rooms. Having diseases diagnosed earlier and treated appropriately vastly decreases the overall cost of treatment of that disease. For example, by treating high cholesterol early with medicine, you may well eliminate the need for a very costly coronary artery bypass later in life.
While doctors and hospitals would be paid somewhat less, their costs of doing business would be drastically reduced since there would be a very low cost to billing and administration, and providers would get paid more quickly and reliably.
Lastly, but perhaps most importantly, there would be improvements to our actual patient care with a single-payer system. Having only one payer would allow us to use a unified computer system. With this single computer system, whenever you went for health care of any kind, the health-care provider would have all the information needed to treat you safely, such as the medications you take and the allergies you have. There would be fewer medical errors and a greater awareness of interrelated medical problems.
I strongly encourage you all to call, write, text or otherwise contact your congressmen and senators, and encourage them to strongly consider H.R. 676, the single-payer system that will fundamentally eliminate a huge waste of health-care dollars and restore our health-care system.
Dr. Jeremy B. Stern is an orthopedic surgeon. He lives in Marion, Mass.
Saturday, August 1, 2009
What’s Not to Like?
by Jonathan Alter | Newsweek
Jul 31, 2009
Reform? Why do we need health-care reform? Everything is just fine the way it is.
Go ahead, shoot me. I like the status quo on health care in the United States. I've got health insurance and I don't give a damn about the 47 million suckers who don't. Obama and Congress must be stopped. No bill! I'm better off the way things are.
I'm with that woman who wrote the president complaining about "socialized medicine" and added: "Now keep your hands off my Medicare." That's the spirit!
Why should I be entitled to the same insurance that members of Congress get? Blue Dogs need a lot of medical attention to treat their blueness. I'm just a regular guy and definitely deserve less.
I had cancer a few years ago. I like the fact that if I lose my job, I won't be able to get any insurance because of my illness. It reminds me of my homeowners' insurance, which gets canceled after a break-in. I like the choice I'd face if, God forbid, the cancer recurs—sell my house to pay for the hundreds of thousands of dollars in treatment, or die. That's what you call a "post-existing condition."
I like the absence of catastrophic insurance today. It meant that my health-insurance plan (one of the better ones, by the way) only covered about 75 percent of the cost of my cutting-edge treatment. That's as it should be—face cancer and shell out huge amounts of money at the same time. Nice.
I like the "lifetime limits" that many policies have today. Missed the fine print on that one, did you? It means that after you exceed a certain amount of reimbursement, you don't get anything more from the insurance company. That's fair.
Speaking of fair, it seems fair to me that cost-cutting bureaucrats at the insurance companies—not doctors—decide what's reimbursable. After all, the insurance companies know best.
Yes, the insurance company status quo rocks. I learned recently about something called the "loading fees" of insurance companies. That's how much of every health-care dollar gets spent by insurance companies on things other than the medical care—paperwork, marketing, profits, etc. According to a University of Minnesota study, up to 47 percent of all the money going into the health-insurance system is consumed in "loading fees." Even good insurance companies spend close to 30 percent on nonmedical stuff. Sweet.
The good news is that the $8,000 a year per family that Americans pay for their employer-based health insurance is heading up! According to the Council of Economic Advisers, it will hit $25,000 per family by 2025. The sourpusses who want health-care reform say that's "unsustainable." Au contraire.
And how could the supporters of these reform bills believe in anything as stupid as a "public option"? Do they really believe that the health-insurance cartel deserves a little competition to keep them honest? Back in the day, they had a word for competition. A bad word. They called it capitalism. FedEx versus the U.S. Postal Service, CNN versus PBS—just because it's government-backed doesn't mean you can't compete against it. If they believed in capitalism, the insurance companies would join the fray and compete.
Jul 31, 2009
Reform? Why do we need health-care reform? Everything is just fine the way it is.
Go ahead, shoot me. I like the status quo on health care in the United States. I've got health insurance and I don't give a damn about the 47 million suckers who don't. Obama and Congress must be stopped. No bill! I'm better off the way things are.I'm with that woman who wrote the president complaining about "socialized medicine" and added: "Now keep your hands off my Medicare." That's the spirit!
Why should I be entitled to the same insurance that members of Congress get? Blue Dogs need a lot of medical attention to treat their blueness. I'm just a regular guy and definitely deserve less.
I had cancer a few years ago. I like the fact that if I lose my job, I won't be able to get any insurance because of my illness. It reminds me of my homeowners' insurance, which gets canceled after a break-in. I like the choice I'd face if, God forbid, the cancer recurs—sell my house to pay for the hundreds of thousands of dollars in treatment, or die. That's what you call a "post-existing condition."
I like the absence of catastrophic insurance today. It meant that my health-insurance plan (one of the better ones, by the way) only covered about 75 percent of the cost of my cutting-edge treatment. That's as it should be—face cancer and shell out huge amounts of money at the same time. Nice.
I like the "lifetime limits" that many policies have today. Missed the fine print on that one, did you? It means that after you exceed a certain amount of reimbursement, you don't get anything more from the insurance company. That's fair.
Speaking of fair, it seems fair to me that cost-cutting bureaucrats at the insurance companies—not doctors—decide what's reimbursable. After all, the insurance companies know best.
Yes, the insurance company status quo rocks. I learned recently about something called the "loading fees" of insurance companies. That's how much of every health-care dollar gets spent by insurance companies on things other than the medical care—paperwork, marketing, profits, etc. According to a University of Minnesota study, up to 47 percent of all the money going into the health-insurance system is consumed in "loading fees." Even good insurance companies spend close to 30 percent on nonmedical stuff. Sweet.
The good news is that the $8,000 a year per family that Americans pay for their employer-based health insurance is heading up! According to the Council of Economic Advisers, it will hit $25,000 per family by 2025. The sourpusses who want health-care reform say that's "unsustainable." Au contraire.
And how could the supporters of these reform bills believe in anything as stupid as a "public option"? Do they really believe that the health-insurance cartel deserves a little competition to keep them honest? Back in the day, they had a word for competition. A bad word. They called it capitalism. FedEx versus the U.S. Postal Service, CNN versus PBS—just because it's government-backed doesn't mean you can't compete against it. If they believed in capitalism, the insurance companies would join the fray and compete.
I'm glad they don't. I prefer the status quo, where the for-profit insurance companies suck at the teat of the federal government. Corporate welfare's what we've got, and it's a damn good system. Through a wonderful program called Medicare Advantage, the insurance companies receive hundreds of billions of dollars in fees to administer a program that the government is already running. Don't touch that baby. You'd be messing with the handiwork of some fine lobbyists.
You know what part of the status quo I like best? It's a longstanding system for paying doctors called "fee for service." That's where doctors get paid for each procedure they perform, as if my auto dealer got paid separately for the steering wheel, brakes, and horn instead of for the car. Fee-for-service is why the medical care at that doc-in-a-box at my mall is so superior to the Mayo Clinic or Memorial Sloan-Kettering Cancer Center, where the doctors are on salary. Who would want to mess with that?
OK, if you really press me, I'm for one change. It's the one that Republicans trot out to prove they're "reformers," too. We could save our whole system if we just capped malpractice awards. Two of our biggest states—California and Texas—did it a few years ago and nothing has changed there, but who cares? It sounds good.
So tell your congressmen and senators when they're home for the summer recess that it's too soon to address this issue. We've only been debating it for 97 years, since Theodore Roosevelt put national health insurance in the Bull Moose Party platform of 1912. We've only had 745 congressional hearings on the subject (I made that number up, but it's got to be close). That's not enough! Let's study this problem more before we do anything about it.
Did I say "problem"? Who said there was a problem? Not me. I like the status quo.
Subscribe to:
Posts (Atom)
