Posts Tagged ‘government health plan’

As the Senate prepares to take up the issue of health care reform, the Republican Party is gearing up for a fight to the finish, a fight to defeat any attempt at improving our health care system.  It is a desperate struggle the Republicans are waging, desperate because it is about money – lots of money.  It’s also a sad struggle because it shows so clearly how corrupt our government is. Granted, our government has been corrupt for a long time. Slipping a wad of money into a Congressman’s pocket is an old tradition on Capitol Hill. It’s the best way to assure that you can either get the legislation you want or to prevent legislation you don’t want from being passed.  Today, this “passing of bucks” is accomplished by middlemen, called lobbyists. It seems that just about every Congressman and Senator has his price. There are precious few who cannot be bought.

Money is where the health industry comes in. It is, of course where Republicans come in as well.  After all, they are the Party of business, of Capitalism, of profit. That is their constituency.  One is tempted to say, “OK, that’s alright. Let the Republicans represent the sellers of goods and the Democrats represent the buyers of goods.” Of course, it’s not that simple because the Democrats also represent the ordinary workers, while the Republicans represent the employers.  But one would hope at least that there could be an honest debate.  One could hope that there would be a rational discussion of the facts – all in the national interest.  It would be a debate about what is best for the American people – after all, isn’t that ultimately the purpose of Congress – to do what is best for Americans?

Unfortunately, the Republican Party has chosen not to have a debate on the merits of health care reform.  Instead they have launched campaigns of outright lies about reform. They have tried mightily to steer the debate into discussions about Death Panels and Nazi medical experiments and the rationing of health care.  Any reasonable person can tell that these Republican tactics are nothing but lies and because they are lies and not real issues that should be discussed, the Republican Party has done a disservice to America – in brief, they have become un-American in their zeal to protect the profitability of medicine.

There is a danger here in all of this distortion, in all of these attempts to steer the discussion away from the real issues and to focus on trumped-up concerns that have no basis in reality.  The danger is that we will fail to ever discuss the actual dangers that are inherent in our current way of going about the health business.  Here is one excellent example that, as far as I can tell, is being completely ignored: we have a vastly insufficient supply of H1N1 vaccine because we have a for-profit health system.

The simple fact is that not everyone gets a flu shot every year. Most people do not get routine flu shots and because of this our vaccine industry, ever intent on making a profit, has sized itself according to the yearly demand for flu shots.  Our commercial vaccine production industry simply does not have the capability of making enough H1N1 vaccine to protect everyone man, woman, and child in this country. It simply cannot be done.

So, I would ask our imaginative friends in the Republican Party, the ones whose vivid imaginations can conjure up images of Death Panels and Nazi medicine being practiced on Americans, and the limiting of health care to only those who are connected with someone in government, to think about something else. Consider this: suppose the H1N1 flu strain that is making the rounds this year was different. Suppose instead that it was the same H1N1 strain that made the rounds in 1918. How many people would die in America? One hundred million? Two hundred million? How many would die in the entire world? A billion? Two billion? What could be done stop that strain of flu?  Nothing. Nothing could be done in 1918 and nothing could be done now.

The question I would put to the Republican members of Congress is this: is there any way you could think of that we might be able to make enough vaccine for everyone in a case like this?  There is only one answer: the government has to create this capability in advance – it’s not a last-minute sort of thing.  Why? Because it’s a money loser. Big business would hate it – it’s a gigantic capacity that would only be used once in a lifetime.  You can’t make money from that. Which is why there is a natural role for government in health care. The government spends about half of our national budget on defense – i.e. defending us from other people in other countries. How long will it take until we understand that it is also the role of government to defend us from other foreign attackers, things like viruses and bacteria. It might seem strange at first to look at it that way, but think about this: suppose – just suppose – that there really were aliens from Mars attacking us – would it be the role of government to defend us? What if instead of the Martians being little green men they were little green bugs?  What if these little green bugs were actually microscopic invaders? How is that different from deadly Earth-based viruses attacking us?

The simple fact is that the government has a duty to protect its citizens. This duty extends to protecting the citizen’s health. Health care should not be a profit-making business.  It should be more like a utility, available to everyone and dispensed by the government. That doesn’t mean that businesses can’t play. People are certainly free to purchase health related things, but the government has to understand that it has a responsibility for the health of its citizens – a responsibility that cannot be dodged and delegated to the profit-making business community.  We missed a bullet this time with the H1N1 flu; however, it is virtually certain that a time will come in the future when a very deadly viral pandemic will sweep over the Earth.  The steps our Congress takes in the next couple of months may well determine whether America survives that inevitable pandemic; it may well determine whether the population of our country is obliterated or if it survives.  It would be a shame if hundreds of millions of Americans died in the future all because the Republicans wanted to help their friends in the health business make a buck.

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As the health care reform legislation wends its way through Congress, it appears that some sort of Public Option may be included in the bill.  The latest talk is that it will only be available to those who have no health insurance. If you already have health insurance through your employer you won’t be able to get it.  It also seems that individual states will be able to opt out of the program, thus denying residents of those state the opportunity to purchase the Public Option.  Meanwhile it appears that the vast majority of the American public are in favor of the Public Option – an option that most of them won’t be able to exercise.

Is there a message here? You bet there is. The American people are fed up with private health insurance.  It costs too much and provides too little.  The American people have seen the excellent quality of health care in Canada and much of Europe- all provided by national health care systems and most of the people seem to be saying that they would rather have something like that. The primary opposition to some sort of national health care comes from the hard core Republicans who are held in thrall to the insurance companies and the banks of America.  The thing to remember is that while the Republicans are a very loud voice they are at the same time a very small voice. Only 20% of Americans now consider themselves to be Republicans. That is a pretty small minority and it shouldn’t have the power to dictate national priorities. Actually the previous election that booted them out of office sort of says the same thing.

So, is there a solution for this upside down manner of thinking? Is there some sort of compromise that can worked out with the party of the politically flirtatious Olympia Snow that would make the majority of Americans happy and yet satisfy the cravings of Republicans to pay a lot of money for very little insurance? You betcha!

The solution is really remarkably simple. Create a national health care system and use Canada or another country that has a very successful national health care system as a model.  We don’t have to just make it an expanded version of Medicare. Make the national health care system such that it covers everyone by default.  You don’t have to be employed or live in a certain state or have no preexisting conditions. If you are alive, you are covered. However, knowing the extreme disappointment the Republicans are sure to feel about being covered by the government, we should provide them with the option of buying expensive insurance that doesn’t necessarily cover all possible ailments and might be revoked at any time for any reason. We will call that the Private Option.

If you ask me that is a compromise worthy of Solomon himself.  Everybody will be happy, everybody will get their way and we will all be healthier in the process.  I would bet even Sarah Palin and Rush Limbaugh would go for it.  I mean they would run right out and buy the Private Option. Right? Wouldn’t they?

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It’s been a long time since I’ve seen the American people so fired up – at least a significant portion anyway.  The town hall meetings that are being conducted are being invaded by coordinated groups of Republican protesters who clearly, desperately, believe that health care reform will bring about the destruction of the American way of life.  I don’t think I’ve have seen this much emotion from the American public since the Vietnam War protests many years ago.  Somehow though, I think this is a different crowd.  This time it is the people we usually call “conservatives” who are ranting and raving in the streets.  The question we should be asking ourselves is: why?  Why this huge disconnect among the citizens of the same country?  Is it that one group just doesn’t have the power of deductive reasoning?  Is it because one group has swallowed a bucket load of disinformation while the other group is totally well informed? Or is it just a fundamental difference in philosophy and  beliefs?

There are few Americans who would claim that citizens of this country are not entitled to life, liberty, and the pursuit of happiness.  These words are embodied in our Declaration of Independence and provide part of our fundamental understanding of who we are, even though they are not incorporated in the Constitution.  So, from the standpoint of philosophy, doesn’t it make sense to say that if we have a right to life, then we also have a right to health care?  Because in order to live, everyone needs health care at some time in their lives.  To deny health care is to deny life, and to deny someone the right to life, by definition, makes one un-American.  Simple, right?  Apparently not.

The fundamental issue that is at the bottom of all this is the burning question: who is going to pay?  Do you really expect me to pay for your health care – from my tax dollars?  Hell no – I want a system where I don’t pay for your health care – I want private insurance.  You pay for your own health care.  That’s what the opponents say.  Uh…wait a minute. Isn’t insurance effectively the same thing as taxes? I mean we all put money in a pot – either a public or a private pot – and then those who need the money for health care get it from that pot. If you don’t get sick, you don’t get the money.  Isn’t it, from the financial viewpoint anyway, pretty much the same whether you buy insurance or use tax dollars to pay your medical bills? Either way, you are going to pay.

Oh, OK.  But what about being treated by the doctor you trust?  Doesn’t insurance mean you can choose your own doctor while using tax dollars means that some civil servant is going to decide on your health care treatment?  It seems to me that this is a major sticking point. And I can understand that.  I’ve had more than enough contact with civil servants and, like most Americans, I hold the vast majority of them in very low esteem.  I think my dog has more brains than most of them, particularly the ones employed by the Federal government, – but don’t get me started.   On the other hand, the major insurance companies also make decisions on heath care treatments, and these decisions are made by the bean counters and administrative people at those for-profit companies, so even though your doctor might recommend a certain treatment, your insurance company might say they won’t pay for it.  It’s not so much that the insurance company execs are dumb (like the civil servants) it’s rather that they are out to make a buck (yours that is) and they are not in business to simply use your premiums to pay for your medical needs – after all they do need to make a fat profit, you know.

It now seems that we have moved beyond rational discussion of the actual issues into those that are much more fun to talk about – if not actually relevant. So we have ex-Gov Sarah Palin decrying government “death panels”, and the Republicans have called in their squads of crazies and told the lunatic fringe to be ready on standby.  Rush Limbaugh is desperately trying to convince his listeners that President Obama is the second coming of Adolph Hitler, while Glenn Beck is content to simply call President Obama a racist and a fascist.

It seems that the Republican Party and their minions are now desperately throwing everything but the kitchen sink at the health care bill that is looming in Congress.  But why? Why is the Party desperately stirring up mobs of people and baiting them with misinformation? Is it because we have moved beyond rational debate about the pros and cons of health care reform?  Apparently so.  The Republican Party has apparently decided that rational debate is useless and has decided to unleash mobs of irrational, ill-informed, emotional people in a last ditch effort to derail the Congressional bill.  The key concept here is desperation  – so evident among the mobs of mislead people who are showing up in carefully orchestrated groups at the town hall meetings across the country.  As demagogues, like Sarah Palin, add fuel to the flames, the “masterminds??” of the Republican Party have unleashed their final solution to the health care issue upon the country: Helter Skelter.

Ultimately though, the Republicans just don’t have the votes.  Despite all the lies and distortions, the name calling, the character assassinations, the idiocy that spews from the lips of Limbaugh and Beck, the wheels are not coming off.  Health care reform will be passed, and all Americans will benefit.

And before you can say Abe Lincoln, the Republicans will be taking credit for all the good things it does for the people of America.

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The fundamental problem with the President’s health insurance plan is that it is an insurance plan. So what’s wrong with that?  Shouldn’t everyone be insured?  Maybe, maybe not. Everyone should be able to get their medical needs attended to in a way that they can afford, but that doesn’t necessarily equate to giving everyone an insurance card.  The problem comes down eventually to resources, both physical and financial, and whether an insurance plan can really provide the answer for health care in our country.  The problem is the nature of insurance itself.

At the present time, about 47 million people have no health insurance in the United States.  That’s about 16% of the population.  I am willing to bet that the majority of these are people who can’t afford health insurance and who do not receive routine medical care and checkups.  It is therefore likely that this segment of the population has more medical needs than the remainder of the population on a per capita basis.  So what happens when we give everybody a medical insurance card, particularly people who have never had one before?  I expect that the number of people seeking medical care will increase by 16% compared to what we have today. Actually, because I expect these new people in the system will be less healthy, let’s make that a 20% increase in people seeking access to doctors, nurses, hospitals, and medicine.  Do we really have 20% excess capacity in our health care system? Can we instantly accommodate 20% more people in our hospitals?  Can our doctors accept 20% more new patients tomorrow?  Will we have 20% more flu vaccine on hand than we usually do?  I suspect the answer is “no” in all cases.  The turn on of health care for all will result in a very large increase in demand for health care, and I don’t believe we have made the slightest preparation for it.  I don’t seem to recall hearing that we have even thought about it.

The thing that’s wrong with the President’s medical health insurance plan is that it’s an insurance plan.  Insurance is a funny thing – it’s sort of like a reverse lottery where you put your money in the pot, but you really don’t want to win.  The thing about lotteries is that while you can have a big winner or several big winners, everybody can’t win big.  That’s because everybody only puts in a dollar or two and after a while it all adds up to a million dollars – for one person that is.  It’s the same with insurance – it’s just a sort of lottery that falls apart if everybody strikes a winning number.  Like with Hurricane Andrew or Hurricane Katrina, the insurance companies just fold up and go away when everybody files a claim.  They simply can’t pay when everybody needs their help.  It’s the same with medical insurance – the insurance companies don’t expect everyone to break a leg on the same day.  But what if the swine flu turns into a deadly pandemic?  What if a major water supply becomes contaminated?  What if a major population center suffers a devastating earthquake?  What if a new disease, like AIDS or worse, begins spreading through the population?  Will our insurance program protect everybody? No.  It can’t.  It’s an insurance program and by its nature it is intended to only help a small segment of the population at any one time.  It cannot cope with medical disasters.

But what if the program is a great success and everybody gets all their recommended exams and inoculations and they all get very healthy?  That’s bad too.  Why? Because then everybody will live to be a hundred years old, exactly what happened in Japan, and the health care system won’t be able to cope with the much larger population and all the old people who have all sorts of geriatric diseases but don’t contribute a dime to the program because they are retired.

So does this mean that we can’t have a working government health plan? No.  We can indeed have a government health plan that works – it just can’t be an insurance plan.  The only government health plan that could work for everyone under all circumstances is one that is based upon the government’s wealth -like all the gold in Fort Knox for example, or something else of value that the government owns in very large quantities.  Then the government would have the means to build the necessary hospitals and hire the necessary doctors and so forth in any eventuality.  A guaranteed health plan cannot depend upon probability calculations done by an insurance company.  We have already seen, too many times, that insurance companies, like AIG, go belly up just when you need them. Government insurance would be the same.

The question is: do we have the wealth to create a solid health plan for everyone?  I suspect we do, but we would probably have to slash our wasteful military budget and use the money saved to back health care.  Maybe we could fund our future military adventures with some sort of military insurance plan! It could be a plan that could fund the occasional war, but not constant war forever and ever. Hmmm…

Ultimately, whether we actually get a workable government health plan really depends a lot on our priorities as a people  – which, I suspect, is another problem with the President’s health plan.

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