Sunrise: Health Care For All Rises Above the Horizon

The Sun has Risen for Health Care in America. Photo Courtesy: Bolte Medical

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Now is the time for health care to be added to those moments of sublime national change, to join those great reforms, cast as the finest, hardest steel into our Nation of Laws as an inalienable right and an eternal Blessing of Liberty.  D. Waggoner, Phd, 2009.

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Oregon Health & Science University: Oregon's Premier Medical School and Research University. Photo Courtesy OregonLive.com

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President Barack Obama:  Our presence here today is remarkable and improbable.  With all the punditry, all of the lobbying, all of the game-playing that passes for governing in Washington, it’s been easy at times to doubt our ability to do such a big thing, such a complicated thing; to wonder if there are limits to what we, as a people, can still achieve.  It’s easy to succumb to the sense of cynicism about what’s possible in this country.

But today, we are affirming that essential truth -– a truth every generation is called to rediscover for itself –- that we are not a nation that scales back its aspirations. We are not a nation that falls prey to doubt or mistrust.  We don’t fall prey to fear.  We are not a nation that does what’s easy.  That’s not who we are.  That’s not how we got here.

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Pres. Obama Signs Health Care Reform Act into Law. Photo Courtesy: Saul Loeb, AFP/Getty Images.

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We are a nation that faces its challenges and accepts its responsibilities.  We are a nation that does what is hard.  What is necessary.  What is right.  Here, in this country, we shape our own destiny.  That is what we do.  That is who we are.  That is what makes us the United States of America.

And we have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.  And it is an extraordinary achievement that has happened because of all of you and all the advocates all across the country.

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A Promise Fulfilled.

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There Will Never Be Another Tax Cut

Huh??  What do you mean there will never be another tax cut? Congress can vote to cut taxes anytime it wants.  Have you lost your mind, Waggoner?

Consider this statement:

Using tax levels consistent with the past half century in America, then subtracting entitlement payments as currently promised for Social Security, Medicare and Medicaid, The Heritage Foundation (another conservative think tank) estimates that sometime just before 2020, there won’t be enough money in the federal treasury for anything but the entitlement programs.

It was written by Bruce Brattain, owner of Wisdom River Partners, who, among his many talents, is an elder care consultant.  Now, don’t roll your eyes over the word “consultant.”  Start reading a few of the pieces in his blog, aninconvenientbruce, and you’ll instantly realize, this is one very astute observer who has his finger on the pulse of a number of national issues.

And, just to entice you more to go read the entire article from which this quote was taken; it’s not what you think it is.

Now.  Please. Go read what Bruce has to say.  Oh, and be prepared to not only to have your assumptions challenged in a classic Extreme Thinkover manner, get ready to be entertained by a guy with one wicked wit!  Click here.

Then come back to my post for this:

Post Script:  I just watched PBS’s The News Hour:

In an ongoing series of conversations on health reform, Jeffrey Brown speaks with Robert Laszewski, a former insurance executive and skeptic of a public insurance option.

Laszewski, in this interview, lays out the manifesto for Big Medicine’s opposition to health care reform.  He is articulate, clearly believes in his cause, and goes over their case against the public plan point by point.

And proves the argument for implementing a public option in the health care reform legislation so beautifully, I almost jumped up from the couch to give him a standing ovation.

Huh?   Two times in one post?  Read the interview of Robert Laszewski, former insurance executive and Big Medicine consultant by Jeffrey Brown.  Click Here.

1,935,960 Minutes Later: The Free Market’s Failure to Uphold the Right to Health From Day One

Correction: Bad math strikes again.  Please read the comment  submitted by Tyler, he correctly points out that my math in the title is wrong.  The number of minutes should be 116,157,600.  I decided to leave the post title as is (so this correction comment will make sense), but change it in the text.  And I have to admit, 116 million minutes is way more dramatic to the point! Now, on to this serious topic:

The United States Constitution will celebrate its 221st Anniversary on June 21, 2009.  It was ratified on June 21, 1788.

The Preamble of the Constitution declares,

We the People of the United States, in Order to form a more perfect Union, establish Justice, ensure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

On June 21st, 116,157,600 minutes will have passed since it became the law of the land.  That is how long the Free Market System has had to figure out how to create a health care system so that every single American can live the healthiest life possible, out of which directly flows “the general Welfare, secure the Blessings of Liberty to ourselves and our Posterity” for each individual citizen.

At the time of the official first census in 1790, the population of the United States was 3.9 million people, of course, not counting all the people they didn’t count.  Health insurance did not exist, although it had been conceived by an English doctor in 1694. Health care, prior to the modern age had been almost exclusively fee-for-service.  Today, after 221 years, the Free Market System has sucked up such huge chunks of the health care market into its for-profit maw, 50 million Americans cannot only not afford the fee-for-service for a visit to the doctor, they can’t afford insurance either.  And that appears to suit the aims of the Free Market System just fine.

In their minds they have succeeded.  They are the American Disease Industry.  Pain, suffering, disease, chronic medical conditions, a public clamoring for relief.  Pills, pills, procedures, tests, pills.  Newer, always newer.  Cutting edge–procedures must always be cutting edge.  Americans grows unhealthier by the year.  That’s the growth part of the plan.  It makes no difference that millions can’t afford care.  That’s a problem for the non-profits to handle.  How they must smirk in their Board Rooms at the not-for-profits.  Unfettered by any meaningful regulation of their industrial juggernaut, they know they are the medical messiahs of the modern age.  They have the advertising campaigns to prove it.  The drugs must flow.  All hail the Free Market System.

So, 116 million minutes later this system is anything but free.  It is an engine for unfettered greed exercised by a few, distorting every good potential of free enterprise into power for themselves, privilege for themselves, and domination over all others.

It is a great business plan.  With one exception.  The American Disease Industry made one critical error.  They cured too many diseases.  And over the past forty thousand days or so, here and there, now and then, individuals realized they could be healthier.  And Americans have this thing about talking to each other.  Freedom of speech and all that.  But more importantly communications technology, advancing at a rate unprecedented in history.  Radio.  Television, Telecommunications, Satellites, computers, cell phones, fiber optics.  The Internet.  All over the world, people just like us were figuring this out.  They got healthier as we got sicker.  That had to change.  It’s not the American way.

We the People figured it out.  We could be healthier.  We wanted to be healthier.  And we didn’t want to continue to be the serfs of the American Disease Industry.  And we realized:

The Unfettered Market System, led by those who duplicitously espouse it as the purest manifestation of the Ideals of this Preamble, has failed utterly to fulfill its demands, to ensure without exception the rights it promises to every citizen to live in this “more perfect Union.”   These rights are not mere constructs of a clash of cultures in which Capitalism and Socialism battle for supremacy to the destruction of the other.  These rights are virtually what define us as human.

The Unfettered Market System has driven us back to the epoch of tyranny, to that moment before the Constitutional Clock began, not for the blessings of Capitalism, where profit flows like a great current feeding the abundant life in the ocean of time, but to a new and insidious feudalism, crushing the very People for whom that Preamble was written, the ones whose blood was shed in sacrifice for the Blessings of Liberty, under an economic millstone of debt, disease, subservience and corruption.

The Constitutional Clock still runs, no longer the notch of gears, but with the seething quantum foam of Cesium atoms.  So, too, We the People no longer will tolerate our rights being ground away by the Houses of Greed, old and festering, oppressing us as they did to untold generations for under the banner of the Divine Right of Kings, Robber Barons or faceless Global Megacorps.

We are people of the Light, riding the very photons that power the universe, shrinking our globe’s girth to micronic seconds, a web of bioluminescence that no tyrant of institution or government can control.  We the People, knowing we are the stuff of stars, knowing we are of a Most Splendid Spark, knowing within our minds is the brilliance of a pulsar, knowing within the form that makes me, me, and you, you, that our right to Life is the right to Health.

116,157,600 minutes into this great constitutional experiment called the United States of America, we claim our right to health.  And this minute is as great a victory over tyranny as the very first one!

The Fight of Our Lives for the Fight For Our Lives

Here it comes: the fight of our lives for the fight for our lives:  Universal health care.

Despite the incredible amount of evidence that health care in America is a disaster, a terminal disease on a social scale unprecedented in history, that annually millions of lives are ruined, physically and financially by lack of access or restricted access to health care, what I call the Hegemony of Profit Before Health is preparing to attack without mercy.

Listen carefully to the rhetoric that the Hegemony will blast at you in the coming days and weeks.  It will not be about health.  It will not be about solutions for the common good.  It will not be how to create the healthiest America possible within a generation.

No.  The rhetoric will be  about frightening you into resisting changing the status quo.  The rhetoric will be about confusing you what the real issue is:  denying your inalienable right to be as healthy as possible.  The rhetoric will be about preserving a diseased system that holds you in its grip to the enrichment of a few–and sustains a diseased population to guarantee that enrichment flows in perpetua.

This is the fight of our lives.  This is the fight for our lives.  This fight will likely determine if America remains pre-eminent among the nations: more important than the fight against terrorism, more important than saving the economy, and just as important as protecting the environment.

The fight for universal health care will determine whether or not you, your children, and your children’s children will be among the healthiest people in the world with America as its strong and sure leader, or relegated to third world status, of ever declining health, a land held hostage like cattle in a factory farm, weakened by design to sustain the Hegemony of Profit Before Health.

My life is at stake.  Your life is at stake.  I choose life.  I choose a healthy America, strong into the future, the standard for health care in the World.  I choose universal health care.

Health Care Now–Paul Krugman, NYT. A Reply

If you are a regular reader of Extreme Thinkover (here’s a shoutout to Eddie and Micki, two of my colleagues), you know one of my passions is health care reform and universal health care insurance.  We need it and we need it now!

This week Paul Krugman, who writes for the New York Times published, in his January 29th column, “Health Care Now.”

It’s a good piece, not only because he agrees with me, but that he presents a concise description of what is holding up getting started on the health care reform legislation in the new Obama administration, and then gives a Nobel-winning prize economist’s perspective why sooner is really necessary.

There is a bit of a mystery, though.  When the column was published over 350 people, including me, posted a reply.  After so many hours, the comment section was closed, which is standard NYT practice.  But then by the evening of the next day, the comments link was taken off-line.  Nothing from Krugman or the NYT as to why.  However, since I back up all my posts, and planned to put it on Extreme Thinkover, what follows is my reply to Dr. Krugman’s column.

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Paul–For some of us in the medical industry, the tsunami you call the looming health care disaster has already crested.  The hospital I work for, part of a Catholic health care system, incurred $66 million in uncompensated care last year (FY08).  That’s not waste or bad management.  That’s the amount of money we spent to treat every person who came to us, for which we could not recover a single dollar.  There are no golden parachutes or corporate jets in our health system.  And the administration says we are already $3 million ahead of last year.

Our mission is to treat the sick.  Anyone who thinks that not having access to health insurance or basic health care is overblown rhetoric or too expensive just needs to spend one day with me.

I cannot urge the Obama administration strongly enough to initiate their health reform legislation.  Nothing short of universal health care will work in the short or long run.  During the election I studied the various plans being touted (AARP, AMA, both candidates, the Catholic Health Association), as well as the legislation being introduced by various politicians.  I support the plan by Sen. Max Baucus (D-MT). Be assured, I have written him several times, urging him to act quickly.

I know the financial crisis needs immediate attention, but there is no reason for the groundwork not to be laid now to push hard for health care reform and universal health insurance in Congress as soon as possible.

We need it now.  We needed it for all those patients who came to us last year, requiring  immediate medical care, but who had no way to pay for what collectively amounted to $66 million to just one hospital.  They got the care they needed, anyway.  That’s what can happen when you believe that health care is a human right.  It would just be nice for those people to have insurance so they are not prohibited from exercising that right.  It wouldn’t be bad to get compensated for that care either.

Go Max Go! Sen. Baucus’ Health Plan for Universal Coverage

Sen. Max Baucus (D-MT) has recently announced that he is moving to sponsor legislation that would create a universal health care program for all Americans.  And to get it implemented within a year!  Thank you, Senator!  Although the full text of the proposal has not been released, here is the statement presented on his website (http://baucus.senate.gov/issues/healthcare.cfm):

Health Care

Quality, Affordable Health Insurance for All

Our health care system is in trouble: costs are rising at an unsustainable rate, too many Americans are uninsured, and quality of care isn’t up to par. High costs are making it increasingly difficult for Montana’s families and businesses to afford comprehensive health insurance, which means that Montana’s rate of uninsured is growing rapidly.  Although the United States spends twice as much on health care as any other country, we clearly don’t have twice as much health care.

Charting a Course for Health Care Reform

So how do we fix our health care system?  I see five broad principles of reform. As Chairman of the Finance Committee, with jurisdiction over the major public health insurance programs, I have begun a series of hearings to explore each principle in greater depth. By having an open and honest dialogue, I am confident that we can build momentum, find consensus, and bring about reform.

Universal Coverage: The first principle is universal coverage, every Montanan and American has a right to affordable health coverage. Universal coverage is essential if we are to make meaningful progress on the other four principles. We cannot address the health care system, if we leave a growing portion of the country behind. The solution, however, must build on the current system and must involve a public and private sector mix.

Sharing the Burden: The second principle is sharing the burden. Neither the employer-based system nor the individual market can fulfill the demand for affordable, portable, quality coverage. One way to ensure affordable coverage is to create “pooling” arrangements, which allow individuals and businesses alike to take advantage of their collective purchasing power and save in administrative costs.

Controlling Costs: The third principle is controlling costs. Health care costs are rising at four times the rate of inflation. America cannot sustain its current rate of growth in health care spending. Any serious proposal must slow the rate of growth of health care costs. Our economy and nation’s competitiveness depend upon it.

Prevention: The fourth principle is prevention. American health care tends to address what happens when you are sick. By making prevention the foundation of our health care system, we can spare patients needless suffering. We can avoid the high costs of treating an illness that has been allowed to progress.

Shared Responsibility: The fifth principle is shared responsibility. We want universal coverage. But the question is: Who will bear the burden of a new system? In my view, everybody must shoulder the burden together. Health coverage is a shared responsibility and all should contribute. That means individuals, employers and the government.

I believe we can reduce the number of the uninsured by building on existing programs, and we must protect and strengthen these programs as we work towards broader reform.

Sen Baucus’ plan closely follows the principles I endorse that have been articulated by the Catholic Health Association (see my blog posted 4 Nov ’08 ).  My one suggestion to him is that “Prevention” necessarily needs to be priority #2, because, as I have explained in earlier posts, clear goals for prevention provides a foundation on which costs have to be based.  I’m aware that Business believes that costs must be addressed first, but based on my theoretical assessment, that approach will not work.

Thanks, Max.  We look forward to seeing the full text of your proposal very soon!

Getting Ready for the Real Work: Health Care After the Election

Twenty-four hours from now we will know who the next President of the United States will be.  That will be the moment the real work for bringing health care to all Americans begins.  Obama’s plan or McCain’s?  The AMA’s “Voice for the Uninsured” or AARP’s “Divided We Fail?”

If you have been a regular reader of my blog you know that I have reservations about all of the above.  All of them have a fundamental policy flaw: they begin with trying to control the cost of health insurance, but without a clear strategy for how to first establish national goals for a healthy America.  As a result, I am convinced that these plans will never work as promised, and in the end, cost us billions of dollars as well as come nowhere close to the medical and health needs for a healthy America across generations.

One nationally-based organization has designed a plan that parallels my primary assumptions for health care.   That organization is the Catholic Health Association, which is the voice for most Catholic-related hospitals and other health care facilities.  Now, don’t go squeamish on me, just because you might not agree with Roman Catholic theology and doctrines relating to contraception and abortion (or even if you do).  Instead, I invite my readers to thoughtfully consider the principles put forth in what they call the “CHA Vision.”

Disclosure: I work for a Catholic hospital that supports CHA principles, but is not a CHA-system hospital.  I am a member of a Protestant denomination.

Here is CHA’s promotional PowerPoint.  (Of course, you’ll need at least PowerPoint viewer to open this)  (CHA Vision courtesy of Catholic Health Association).

chavisionpowerpoint1

As always, I invite your comments.

And be sure you vote!