Archive for the 'Alternatives to Corporate Models' Category
1 Comment January 28th, 2010 by Claudia Chaufan
By Margaret Flowers, M.D.
January 28, 2010
President Barack Obama|
1600 Pennsylvania Avenue
Washington, D.C. 20500
Dear President Obama,
I was overjoyed to hear you say in your State of the Union address last night:
“But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.”
My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.
I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/ National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare-for-All health system.
I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:
“I happen to be a proponent of a single-payer universal health care program.” [applause] “I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”
And that is why I was so surprised when the voices of those who support a national single-payer plan/Medicare for All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.
There was an opportunity this past year to create universal and financially sustainable health care reform rather than expensive health insurance reform. As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.
The good news is that it doesn’t have to be this way. You said that you wanted to “keep what works” and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.
Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.
I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare-for-All national health system. We can implement it within a year of designing such a system.
What are the benefits of doing this?
* It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.
* It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.
* It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market.
* It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.
* It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.
* It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.
* It will allow our people in our nation to be healthy and productive and able to support themselves and their families.
* It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.
Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare-for-All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.
With great anticipation and deep respect,
Margaret Flowers, M.D.
Congressional Fellow, Physicians for a National Health Program
Please join Dr. Flowers in urging the President to meet with advocates of real reform (improved Medicare for all) by calling the White House at 202-456-1111.
Tell them, “I’m letting you know that improved Medicare for all (HR 676) is better than the health bill proposed by Congress. Meet with Dr. Flowers and the Leadership Conference for Guaranteed Health Care about why.”
For more information relevant to President Obama’s health care related comments in his first State of the Union:
Going Down the Same Old Tunnel, By Steffie Woolhandler and David Himmelstein
Add a comment January 4th, 2010 by Claudia Chaufan
With all the respect that Professor Reinhardt deserves, the question he poses in the New York Times’ Economix blogpost, “Is ‘Community Rating in Health Care Fair”?, is bogus – perfect economic nonsense, morality aside.
His own 2003 paper, “It’s the prices, stupid”, lay out why we have the highest health care costs in the world: it is, critically, because we pay the highest prices on the planet for services and goods that cost a fraction elsewhere. Additionally, as the professor surely knows, another big chunk is wasted by for-profit insurers’ pushing paper around to make sure that they can get away with paying as little for our medical needs as their campaign contributions will afford.
Not to mention the fact that because we are hopelessly divided as a nation into a gazillion pools and plans, we fail to cross-subsidize in publicly useful ways, namely, very broadly and randomly, so that the system can be financially sustainable. Even for-profit insurers cross-subsidize, but in their case they do so to make sure that they enroll the healthier (and cheaper) “customers”, so that they can bring increasingly handsome profits to shareholders. And they dump the sicker and poorer on increasingly strained public plans (and then blame Medicare or Medicaid for their “financial unsustainability”).
So if rather than insisting on “uniquely American solutions”, such as leaving to for-profit insurance the task of financing health care for the majority of Americans, we did what every industrialized nation in the world has done, namely, ban profit from the financing of medically necessary services (yes, even the Swiss, as of 1996, have concluded that “it’s the profit, stupid”), and move to a social insurance system, the scenario, indeed the prices, painted by professor Reinhardt would never occur, so the question would be moot: both group A and B members in his thought experiment would be very happy, I suspect, cross-subsidizing whoever happens to be sick at any given moment, at dirt prices (compared to what we Americans pay), and both groups would likely feel this is fairer than subsidizing health insurance shareholders and CEO’s fat paychecks. No less importantly, they would know that we (or our children) can follow the jobs of our dreams (or even start a business!), rather than limit ourselves to those that include “health benefits” (whose numbers are decreasing as we speak).
Put another way, everybody would benefit from substantially lower health care prices, none of us would see our health care money go to financing wasteful paper-pushing, and cross-subsidization would occur for the benefit of the overall public good, in the same way that it does for any number of other things, such as Fire Departments, public schools, or National Defense. And what is more, we would finally enjoy the freedom to choose what really matters: our doctors or medical establishments, rather than from within those euphemistic lists of “preferred providers”.
Everybody would benefit, that is, except from those who make a living either at the expense of Americans’ health or by sponsoring Orwellian health care debates tantamount to those in the Middle Ages attempting to establish the number of angels that can dance on the tip of a pin.
And do not believe those who tell you that it is your fault because of your unhealthy lifestyles: Britons spend a fraction of what we do — 95% of them never see a medical bill in their lives – yet there isn’t a shred of evidence that they go more often to the gym or eat more broccoli than we do (however recommendable broccoli and exercise might otherwise be). And neither can “technology” or “aging population” be the whole story: if not, ask the Japanese, who use far more technology than we do, visit doctors substantially more often, and are substantially older than we are, yet pay 50% of what we pay.
Finally, don’t believe in those who tell you that social insurance is “politically unfeasible” either: when Otto von Bismarck started social insurance in Germany back in 1883, he did not do so because he was a socialist, but rather to defeat socialism, because he believed that “the social insecurity of the workers makes them a peril to the state”.
We can’t expect meaningful change from politicians or experts:
It’s really up to us.
Add a comment January 4th, 2010 by Claudia Chaufan
Last day to register for Lobby Day 2010
Location: Sacramento State University and California Capitol Building, Sacramento, CA
All – Inclusive in Registration Fee:
Registrants from Southern California:
- Roundtrip Luxury Cruiser Bus to Sacramento event
ALL Registered Participants:
- Hotel Suites in Embassy Suites, Sacramento
- Meals (Sunday Lunch; Monday Breakfast and Lunch) — all except Saturday night on the town
- Training Materials and Expert Training in Lobbying and Health Advocacy Skills
- Networking with Health Professional Students from all over CA
- Hearing Exciting Guest Speakers from Health Professional, Medical, Legislative Spheres
- And More!
Relevance to Your Healthcare Career
- This timely event will bring together about 600 health professional students from California to become involved in current healthcare reform and advocate for the coverage of all Californians, directly with our elected legislators in Sacramento, for the fifth year in a row.
- The two-day event includes: Training Day featuring collaboration between health professional student leaders, physicians, public officials and health policy experts to work towards a future of an effective and just health delivery system. On day two, pre-arranged Lobby Day legislative visits put it all into action!
- Enjoy this exciting conference to learn about Single Payer Healthcare and the California Universal Healthcare Act, CA Senate Bill 810 (SB 810).
- See and discuss what SB 810 will do for our future patients and how it will improve the health and financial health for all Californians and us as future healthcare providers.
- We will also educate about current national reform bills, and how SB 810 is relevant within those frameworks. More details to come from our confirmed speakers.
Goals of the Day
- This will prepare you for active participation and leadership of a legislative visit team.
- You will emerge from this CAHPSA Lobby Day weekend as an advocate who is able to do outreach and head advocacy in your community to promote support for Single-Payer Healthcare among your colleagues in your health professional or pre-health professional academic institution, on campus in general, and in your network and community.
- You’ll be prepared to present the facts in the face of organized political opposition to meaningful healthcare reform
Conference Programming
TRAINING DAY: Sunday, January 10, 2010, Sacramento State University, CSUS Union
11:00 – 12:00 Registration and Box Lunch (included in Registration Fee).
12:00 – 12:10 Welcome by Lobby Day Team.
12:10 – 12:20 Martha Penry, CSEA Area Director, “Welcome to Lobby Day”
12:30 - 1:20 Wendell Potter, Former health Insurance Executive, Senior fellow on Health Policy, The Center for Media and Democracy.
1:30 - 2:20 Richard Quint, MD, MPH, Board of Directors for California Physicians’ Alliance, UCSF Emeritus health Sciences Clinical Professor, “Single Payer 101″
2:30 - 3:20 Sara Rogers, Senior Health Policy Staffer to Senator Leno, “All about SB 810″
3:30 - 4:20 William Skeen, MD, MPH, Legislative Advocacy Consultant and Expert, “How to Frame your Argument and Talk to your Legislator”
4:40 - 5:50 Breakut Sessions – “Arguments for and Against SB 810, Planning your legislative Visit”
6:00 – 6:45 Michael Wilkes, MD, Director of global Health and Professor of Medicine, former Vice Dean of Medical Education at UC Davis, Reviewer of JAMA, Lancet, NEJM, “Our Role as Healthcare Providers and Social Responsibility”
7:00pm Dinner at River City and Hardrock Cafe (not included in Registration Fee)
LOBBY DAY: Monday, January 11, 2010, Embassy Suites, and Capitol Building, North Steps
7:00 - 9:00 Sumptuous Breakfast (included in Registration Fee)
9:00 - 10:00 Lobby Day Teams meet for final practice of Legislative Visits.
10:00 – 10:45 Box Lunch (included in Registration Fee)
10:45 – 11:00 Gather outside Embassy Suites for march
11:00 – 12:00 March through Downtown Sacramento to CA Capitol Building Rally
. 12:00 - 1:00 Giant Rally on NORTH steps of California Capitol Building
. 1:00 - 4:30 Legislative Visits with your Senator or Assemblymember in Capitol Building
5:00 Return Home: Buses to Southern California depart from Capitol Building area
Registration Fee: All this for the low fee of only $45.
Registration is open to all Healthcare Professional Students of all disciplines and degree programs, including pre-Health Professional Students, graduates, friends and supporters of CAHPSA and Single-Payer Healthcare Reform.
Locations
Travel arrangements
- Charter Bus from Southern California to Sacramento and return. (included in Registration Fee)
- Carpoolers will have parking on the Sacramento State University campus.
- The closest airport is Sacramento.
- Charter Bus service to all activities within Sacramento area: Night on the Town, March, and return from Legislative Visits. (included in Registration Fee)
Housing
Shared hotel rooms and suites for all at the Embassy Suites Hotel, downtown Sacramento (included in Registration Fee)
Additional Events: Sunday, January 10, 2010 (Optional, not included in Registration Fee):
- Night On the Town in the Capital, including dinner. Please join us for a Capital Special Social at River City and Hardrock Cafe (not included in registration fee) on the evening of Sunday, January 10th. Details to follow.
- Limited scholarships available. If you need financial assistance, please contact CaPA.Fellow@PNHP.org with the following information: name, school, educational program, reason for need and amount you are able to pay.
Questions? Contact the planning team for this conference:
Add a comment January 2nd, 2010 by Claudia Chaufan
In closing 2009, the editors at the New York Times make a “case for (health care) reform”. They build their case on the well documented fact that millions in America are uninsured, that the for profit insurance sector is getting richer as more and more Americans go bankrupt because they cannot pay their medical bills, and that the “political timing is right” because the Democrats have the House, the Senate and the White House.
But the question remains, will “reform” Democrats-style save the day? And how exactly will it do it, and on the back of whom?
The best rebuttal of the New York Times position (which in this case reflects the position of the Democrat majority and the White House) that I could find was written by Dr. Don McCanne, senior policy analyst at Physicians for a National Health Program. Dr. McCanne argues compellingly that “the Times doesn’t get it”. It is well worth reading in its entirety.
The only point I can add to this otherwise brilliant analysis of the bill is that it is important to not lump “opponents of reform” in the same bag. And one should be weary of those who talk about “enemies of reform”, using emotionally loaded terms to substitute for good arguments and relevant evidence.
After all, there could be disagreements about whether administering aspirin to a patient is the right thing to do or not, but one person may argue that aspirin is the wrong thing to do because aspirin is never useful, and they would be wrong – it is very useful for some things — while another may argue that aspirin is useless because the patient has cancer, and they would be right – aspirin is useless in the treatment of cancer.
So while Radical conservatives argue that reform Obama/Congress style is bad because it would get “big government” between patients and doctors, the Medicare for All, single payer community argues that the House and Senate bills are bad because they will lock us in the grip of for-profit health insurers for years to come, by making it a federal crime not to buy their products (and even subsidizing with taxpayer money the buying of their products), while failing to control costs, and leaving millions uninsured or underinsured.
So is there another way to think about reform? Of course there is. It is called social insurance and it has been adopted beginning in the late 19th century by every other industrialized economy with the glaring exception of us (yes, U.S.!).
The time to demand real change and to increase the cost on our representatives of not listening to ordinary Americans has come, and it is now.
Health care students in California can still join single payer advocates in Lobby Day, on Monday January 11. For more information and to sign-up for the two-day event click here.
1 Comment December 1st, 2009 by bronxdoc
Our colleagues at THE POINT, a South Bronx Community Development Corporation, sent us the following flyer for the South Bronx Food & Film Expo, this Saturday, December 5th (noon to 5PM).
Their announcement reads:
If you are interested in growing your own food, or having better access to healthy food, or getting involved with changing current food policies, this is the event for you! Our expo features groups that can help you do all this and more. Or if you simply want to come sample free local healthy foods, maybe learn a thing or two, and watch a few great films, you are welcome as well!
Rethinking the way we eat
This event will showcase some of the activism around rethinking the way we produce and consume food.
- Urban Farming, one of the sponsors, is an organization that promotes the use of urban spaces to plant gardens. They have developed the concept of vertical farming - “edible” food-producing wall panels mounted on walls of buildings, growing fresh produce (without the use of pesticides).”
- Bascom Catering will be providing free, locally-sourced Vegan lunches.
- Short films from the Bronx will be showcased. As an example, this link shows a shortened version of an urban farming video made at the Point.
- Two feature films will be shown. What’s on Your Plate? and FRESH! What’s on Your Plate? is a documentary that follows two eleven year old NYC girls as they try to figure out how food gets onto their plates. FRESH! focuses on the efforts of activists across the country to “reinvent the food system.”
- An interactive expo will feature groups from the South Bronx and beyond that grow and supply healthy local food, and fight for change in food policy.
Details: This event is free, but there is a $10 suggested contribution. Food/clothing donations are encouraged. Childcare will be provided. For more information, contact: Adam, actionatthepoint@yahoo.com
For more information on local food activism, consult some of our earlier posts on food and nutrition.
posted by Matt Anderson, MD
2 Comments May 15th, 2009 by Claudia Chaufan
The following news (brought to my attention by my dear friend Cristina), from today’s Amy Goodman’s Democracy Now radio show, provides a good exercise in critical thinking: finding the flaws in president Obama’s argument (invalid inferences, false assumptions, etc) that ” it is best to build on the health care system we have”, rather than presumably adopt too radical solutions like single payer (I myself could find four flaws in two minutes! For a fuller argument for why it is misguided at best to build on “the health care system we have” read “Not Change We Can Believe In“).
According to the president, “the vast majority” of Americans get coverage from their jobs, and presumably are satisfied with it.
Another interesting accompanying headline is “Health Industry Says Obama Overstated Pledge to Cut Costs” (surprise surprise!). It looks like, after all, companies “never agreed to specific yearly cuts, but only vague voluntary goals”.
For both clips, click here.
Obama Questioned on Single Payer
At a town hall-style event in Rio Rancho, New Mexico, Thursday, local resident Linda Allison asked President Obama why the White House and the Democratic-led Congress have ruled out single payer.
Linda Allison: “My question is, so many people go bankrupt using their credit cards to pay for healthcare. Why have they taken single payer off the plate? And why is Senator Baucus on the Finance Committee discussing healthcare, when he has received so much money from the pharmaceutical companies? Isn’t it a conflict of interest?”
President Obama: “If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world. The only problem is that we’re not starting from scratch. We have historically a tradition of employer-based healthcare. And although there are a lot of people who are not satisfied with their healthcare, the truth is, is that the vast majority of people currently get healthcare from their employers, and you’ve got this system that’s already in place. We don’t want a huge disruption as we go into healthcare reform, where suddenly we’re trying to completely reinvent one-sixth of the economy.”
Obama did not address the second part of Linda Allison’s question about Democratic Senator Max Baucus, who has excluded single-payer advocates from Senate Finance Committee hearings. Allison says she was partly inspired to ask the question after viewing Democracy Now!’s coverage on Wednesday of single-payer advocates who disrupted Baucus’s hearing.
Add a comment May 13th, 2009 by Claudia Chaufan
Advocates of single-payer universal healthcare-the system favored by most Americans-continue to protest their exclusion from discussions on healthcare reform. On Tuesday, five doctors, nurses and single-payer advocates were arrested at a Senate Finance Committee hearing, bringing the total number of arrests in less than a week to thirteen. We speak with two of those arrested: Single Payer Action founder Russell Mokhiber and Dr. Margaret Flowers of Physicians for a National Health Program.
Click here to watch the video [includes rush transcript]
Add a comment May 12th, 2009 by Claudia Chaufan
Click here to read the Canadian Health Coalition’s letter to President Obama. It is worth every word of it.
It debunks an advertising campaign where Brian Day, past Canadian Medical Association president, talks about the “evils” of Canadian Medicare, a universal, single payer system, that, according to Dr. Day, leaves patients “languishing and suffering in waiting lists”.
What the campaign does not say is that while Dr. Day may have complained about Canadian health care, he has also said that “the US system is a poor system to emulate”.
It also fails to say that Dr. Day’s private surgical clinic is under investigation for illegal billing and, according to the Coalition “does not represent the values of Canada”.
The Canadian Health Coalition is “a not-for-profit, non-partisan organization dedicated to protecting and expanding Canada’s public health system for the benefit of all Canadians. The CHC was founded in 1979 at the Canadian Labour Congress-sponsored S.O.S. Medicare conference attended by Tommy Douglas, Justice Emmett Hall and Monique Begin. The coalition includes organizations representing seniors, women, churches, nurses, health care workers and anti-poverty activists from across Canada”.
Its goals include “creating good health, preserving and strengthening the Canada Health Act (the foundation of Medicare), making the health care system democratic, accountable and representative, providing a continuum of care from large institutions to the home, and eliminating profit-making from illness”. (For a full listing and description of all goals click here).
2 Comments May 12th, 2009 by Claudia Chaufan
May 12, 2009 · Posted By Dr. Claudia Chaufan,· Filed Under Covering the Uninsured
(In Healthy Ideas: Californians Weigh In On Health Care Reform – to join the discussion click here)
In this second posting, I wish to elaborate on the question: “Is the public option model change we can believe in?”
I wish I could, but sadly I see no reason or evidence to do so. But before readers who may be excited about this approach conclude that I am a “spoiler,” let me lay out my case, making educated guesses about what assumptions underlie the “public option theory.”
During his election campaign, President Obama said he believed that health care is a right, so I assume that whatever he does, granting this universal right must be a high priority. So to secure this right he has promised to “overhaul” health care.
Very well. What may he and his supporters (like Kennedy, Baucus, etc.) have in mind? They have called their approach “uniquely American,” and modeled it after Berkeley professor Jacob Hacker’s proposal of a “public option” competing with private plans within a “highly regulated health care market.”
I call them all “hope it works” health care policy.
The fundamental problem is that, because supporters of this policy hold false assumptions about health insurance – that it is something you can comparative shop for with the same ease you comparative shop for designer shoes – they send you comparative shopping for it. But you do not comparative shop for rights; you are entitled to them.
“But,” says the public option crowd, “we have to send you comparative shopping because this will control costs and make health care affordable to everybody!” But what if I still cannot afford meaningful coverage that will protect me financially if I get sick? They might answer, “don’t worry; the health care marketplace will be highly regulated.”
What would they mean by that? Let me lay it out schematically:
First, they mean that private insurers will be legally bound to sell policies to everybody, regardless of past or present health status, and at prices people can afford. (Note: we are not told how this regulatory machinery will be enforced, or who will pay for it, but we can infer that taxpayers will foot the bill and, given the history of private insurance business practices, it won’t be cheap).
Second, employers will either provide insurance or contribute to a public fund. Discussions are also now moving from Obama’s initial demand for a mandate for children to a “universal individual mandate” that will legally compel all Americans to buy insurance.
Third, public programs for “vulnerable (i.e. expensive or poor) populations” will be expanded (Note: again, we are not told who will foot the bill of the machinery to divide people up according to “vulnerable” or not, or who will pay for the public programs, but we can safely infer it will be all taxpayers).
Fourth, there will be subsidies for those who cannot afford market prices, yet who are not “poor enough” to qualify for public programs (Note: again, criteria for “poor enough” remain a mystery, and once more we can infer that taxpayers will pay for subsidies, whether or not they qualify for them themselves).
Fifth, and here is where the theme of this second posting comes into play, there will be a “public option” good enough to set high standards – assuming, that is, that private insurers do not kill this option or water it down enough to make it worthless. The high standards of the public option – presumed by Hacker, based on Medicare’s indicators of performance, to provide excellent services and fair prices – will force insurers to compete or drop out of the market.
Finally, the plan will encourage providers to use electronic medical records, emphasize preventive medicine and fund research on comparative efficacy of treatment options.
Then we will all hold our breath, and hope that all this works, somehow.
Don’t get me wrong. I am not against electronic medical records, preventive medicine, eating your broccoli and not smoking, or researching what really works in medicine. All else equal, they are wonderful things. But is there any reason to believe that all or any of these things will, for instance, increase our purchasing power so that health care becomes affordable and can be universally guaranteed, as it is everywhere else in the industrialized world?
Well, there is not, because as I discussed in my previous posting, purchasing power comes from bulk purchasing, and all of the above are irrelevant to it.
Nor do electronic medical records or healthy lifestyles have any connection whatsoever with the other big “cancer” of our system: the administrative overhead that comes from dividing people up according to a mind boggling number of policies or eligibility criteria. (Britons spend half of what we do, while providing comprehensive and universal coverage, since they created the National Health Services. And there is no evidence whatsoever that their costs are lower because they eat more broccoli or use computerized records).
“But,” you might still insist, “what about the public option?” Well, in the absolutely best case scenario, it will end up with all the “bad customers” (i.e. the sicker, the poorer and the “not so poor for public programs yet not poor enough to qualify for a subsidy”, etc.).
And of course the public option, by being just an option, will be deprived of the greatest strengths of social insurance: 1. risk pooling, which assures sustainability and lowest costs, and 2) cooperative compulsory contributions, which secures an economically and politically sustainable source of money to pay for health care for all.
“But”, you may still argue, “can we not hope that this time a hybrid “private-public” insurance model will work?” You can, but you can’t rely on any past evidence of success – quite the contrary. Similar “hybrids” giving a central role to private insurance have been tried, touted repeatedly as “ground-braking” by a complacent, misinforming mainstream media, and have failed, repeatedly. There were tried in Massachusetts in 1988; Oregon in 1989; Minnesota, Tennessee and Vermont in 1992; Washington State in 1993; Maine in 2003; and again in Massachusetts in 2006. (For excellent analysis of these attempts, see “State Health Reform Flatlines” [PDF].)
Now, I recognize that the picture I have given you is grim. But let me tell you about the change I, at least, can believe in. It is the change that grassroots, truly popular social movements are able to bring about. One such movement is the single-payer movement.
If all those who believe that health care is a right – and evidence indicates that it is the majority of the population – drop the self-defeating belief that a true right to health care is not “politically feasible” and join in this movement, its collective strength will move mountains. After all, during the civil rights movements, Americans did not say, “let us just negotiate that black people be able to sit in the rear half of buses and hope this will lead to a universal right to sit in the whole bus.” They settled for no less than full equal rights.
Single payer legislation has already passed twice in our state, and was vetoed, twice, by Governor Schwarzenegger and his fellow Republicans. It has recently been reintroduced by Senator Mark Leno. At the federal level, many brave Americans are being dragged out of Washington-sponsored meetings and thrown in jail for demanding single payer (see video clips in my reply to a reader’s comment on my previous post). And as more people continue falling into debt or suffering unnecessarily, many more will join the ranks of these brave Americans. There are only so many jails to throw the increasing number who fight for health care equity. And they – we – cannot be silenced forever.
This growing grassroots movement gives me real hope that meaningful change is on the horizon and that politicians will eventually have to listen.
Because it is ordinary people who hold the vote.
Add a comment March 3rd, 2009 by bronxdoc
We have just published the 12th edition of Social Medicine/Medicina Social, our bilingual, online journal. It is available in both English and Spanish. Our 12th issue captures the stories and struggles of diverse health activists, among them Dr. Walter Lear (shown below):
US Health Activism Collection
Last summer we had an opportunity to interview Dr. Lear (now 85 years old), founder of the US Health Activism Collection. In a wide-ranging interview in his home Dr. Lear discussed his personal background, the origins and purpose of the collection, the impact of the McCarthy period on the US health left, as well as his vision for the future (available at this link). Dr. Lear later added copious footnotes to his interview creating a virtual “Who’s Who” of the mid-20th century US health left.
Dr. Lear also allowed us to make PDF copies of two of the pamphlets in his collection. These are Autopsy on the AMA: An Analysis of Healthcare Delivery Systems in America [1970] published by the Student Research Facility and Your Health Care in Crisis: A HEALTH/PAC Special Report [1972] [Both documents are a bit long and may take some time to download.] Although HEALTH/PAC no longer exists as an organization, there is a HEALTH/PAC website.
Seize the Hospital to Serve the People
We are also publishing a video of Cleo Silvers, a remarkable Bronx health activist who was involved in the takeover of Lincoln Hospital. (For more on this take over see our spring 2007 journal) The video of Ms. Silvers can be seen at our Audio/Visual tab.
Should India Use Commercial Ready To Use Therapeutic Foods (RUTF) For Severe Acute Malnutrition (SAM) ?
Indian Activists associated with Jan Swasthya Abhiyan (People’s Health Movement – India) and the Right to Food Campaign question the value of Plumpy Nut, an Ready to Use Therapeutic Food (RUTF). They argue that locally produced alternatives are cheaper, more acceptable, and serve to strengthen communities. At the very least Plumpy Nut should have been compared to local supplements before being adopted by the government. Available at this link.
Combatting Organ Tafficking
Activists Debra A. Budiani and Kabir Karim of the Coalition for Organ-Failure Solutions discuss the social roots of organ trafficking and consider the implications of a 2008 WHO resolution and the Istanbul Declaration. Available at this link.
posted by Matt Anderson, MD
