Kyle Brady: Blog » Insurance

Real Healthcare Reform Now – Not Later [OpEd]

Kyle Brady — Thu, 25 Feb 2010 08:05:50 +0000

It’s been over a year since the start of the healthcare debate, and for all the progress made there is little to yet show for it; however, President Obama released an outline for what he expects from a healthcare overhaul bill and while his direct intervention, however late, is welcome, it is not without problems. The two glaring omissions of this entire process, President Obama’s efforts included, are that this reform process is not healthcare reform, but rather insurance reform, and that there is sill no public option or extension of Medicare.

President Obama’s outlines for a bill include a requirement for all citizens to purchase insurance plans, or receive a penalty – this is, to bastardize a phrase, feeding the hand that bites you. One of the very reasons that the United States is in its current position of poor healthcare is the insurance companies that are more interested in profit than they are fulfilling the sole reason for their existence. Besides argument of reactive vs. preventative care, insurance companies have continued to raise the financial bar for individuals to simply be able to see a doctor, have a broken bone addressed, or even visit a hospital in an emergency. More importantly, in the event that an individual or family can afford to pay the absurd amounts demanded of them, their coverage is denied for a variety of obscure and self-serving reasons.

The entire process has focused almost solely on insurance, but from the substantially wrong perspective: to provide insurance for the whole country, not to remove or, at minimum, fix the insurance system itself. Rather than provide a Medicare-for-all package, public option, or the easy answer that would be socialized medicine, it has been deemed better to force some small, token amount of regulation on the insurance companies and require that their services be purchased. Quite honestly, rewarding such abhorrent behavior with millions of new, coerced customers is not the rebuke of business and ethics practices that the insurance industry deserves, but is instead a twisted validation.

There is surprising growth of Congressional support for the public option, when it has been thought dead for months, that could be accomplished during the process of reconciliation between the House and Senate bills. No matter that a public option, defined as the ability to purchase into a government-run healthcare plan, is not even close to socialized medicine does not seem to phase the screaming masses that can be found both inside and outside of the halls of Congress. One of the typical arguments is that while Americans may go to Canada or Mexico for medicine, the citizens of those countries come to America for surgical procedures, but, like most of these talking points, it is a false and invalid comparison: America has the best doctors not because of a better healthcare system or medical law, neither of which are true, but rather the simple truth that American doctors have substantially higher incomes and public visibility than any other nation in the world.

While a public option would not solve all the needs of true healthcare reform, where the system would be tightly regulated and converted into that of preventative medicine, it would be a substantial start. A public option, essentially no different than paid-for Medicare, would provide the competition to the insurance industry that is sorely needed in order to stop their disturbing behaviors and insane price hikes. Furthermore, the public option, if proven successful, could eventually be a gateway to a true nationalized healthcare system – one of the few talking points that the reform bill’s detractors have gotten correct.

If healthcare reform is to happen, it must happen now, in the immediate present – but healthcare reform without a public option, tighter industry regulation, or any substantial action against the predatory practices of those who latch on to the pockets of all Americans is not reform and should not, in any fashion, be passed into law. For Congress, and ultimately President Obama, to approve such toothless and ineffective legislation is nothing less than political theater that will inevitably produce results only worse than those that currently exist – especially if the process takes another six months under the guise of false bipartisanship, consideration of a public option, or various other carrots to the American people that are truly just billyclubs.

Real healthcare reform must be passed now, not later, in order for both the American people’s faith to be restored in the political process and their health retained before another medicine, procedure, or facet of care is denied to them under false pretenses.

Democrats Finally Exert Control [OpEd]

Kyle Brady — Mon, 26 Oct 2009 07:05:13 +0000

It seems as though the Democrats in Congress may have finally realized what the thinking-person’s America has known for months: if President Obama was elected on certain ideals, and Democrats have the requisite majority to accomplish these items by themselves, then concessions to Republicans are not necessary when they’re not interested in participating on any logical or coherent level. The evidence in this can be found in any news source, excluding those that include the word “FOX” in their trademark, over the end of last week.

This long overdue exertion of control has manifested itself in the regulation of Wall Street pay for institutions still under government financing, and is likely a prelude to overall Wall Street regulation; the Consumer Financial Protection Agency, intended, among other issues, to prevent banks from overexploiting American citizens, has taken a substantial step closer to being realized; equal rights for LGBT individuals has taken its first federal step in the form of hatecrime legislation; and, most importantly, the public option has suddenly become a viable legislative option once more, after a few weeks of resounding political depression across the nation.

What has inspired the more rationally-minded portion of Congress to suddenly take such control is unknown, but their decision to do so is apparent in their actions. In these four recent issues, it could be argued that the voices of the American public have not only reached the halls of the Capitol after long being ignored, but that they’ve become too strong to ignore. Momentarily disregarding healthcare reform, it would seem that so-called populist outrage over the behavior of banks, exorbitant bonus of still-failing institutions, and continued inequality became such a politicized and discussed issue that there was no choice but to act, for fear of not being re-elected come time for midterms.

Healthcare reform is, in and of itself, a large beast – especially when the issue of a public option, Medicare-E, or any of its other names arises. Recently, however, the insurance industry may have ruined their chances at receiving government subsides as a pretend reform measure by releasing what essentially amounted to a promise to increase healthcare costs by unacceptable amounts in the near future. This report was then followed by a number of polls from mainstream organizations that showed upwards of 60%, depending on source, of the American people support a public option – not a fake public option, or a public option through subsidies, but a real, robust, legitimate federal option for healthcare.

The coming weeks will show what is truly occurring with Congressional Democrats, and just how strong their political will to accomplish true change is – change that their President has demanded. If all is for the best, the last six months of extreme minority manufactured outrage by Republicans on behalf of the insurance companies will have been all for naught, proving that even the most astroturf-laden campaigns are often ineffective.

Something that is worth analyzing in the weeks and months to come is slowly revealing itself: were the summer months of unintelligible screaming part of the Democratic plan? Was President Obama’s occasional public option ambiguity part of the ploy to manipulate the Republican Party into destroying itself? Did Sarah Palin, Glenn Beck, and Joe Wilson play right into the arms of a grand political scheme?

Only time will tell, but if this is the case, the Republican Party should be scared – President Obama may be an even greater politician than America already believes.

The Secret Way To Achieve True Healthcare Reform [OpEd]

Kyle Brady — Mon, 19 Oct 2009 07:05:53 +0000

There’s been much debate, blathering, and false outrage by Congressmen over the issue of healthcare reform, most especially for the concept of a public option. The insurance industries have exerted extreme control over those campaigns that they helped finance, and true healthcare reform is fast approaching the point of no return, where a bill is passed that will either be irrelevant or do more harm than good. But there’s a way, a secret way, to achieve the kind of healthcare reform that the overwhelming majority of the country wants, including a public option: force all of those in Congress to relinquish their federally funded healthcare, and join the ranks of America.

The livelihood of Congressmen is largely separate from the majority of America, let alone the average, thanks to their large, built-in salaries (officially $165,200/yr), their own pension plan through the FERS, and a sometimes-free healthcare system through FEHBR. Congress has not been overly concerned with fixing the broken Social Security system that’s predicted to fail some time near 2016, because they are not effected by it – the FERS is an entirely different system with a separate set of rules that is not in danger of failing. Given the inaction on Social Security, should it be any surprise that their fundamental lack of understanding of the modern healthcare system is due to being outside of it?

Besides the influence of the insurance cartel, astute Congressmen have had to study hard to grasp the current healthcare situation in America, despite the ability of an average citizen to easily speak about it for great length. If Congressmen are inside the Capitol, they can receive substantial diagnosis, treatment, lab work, and prescription filling, all free of cost; however, if they’re outside of those illustrious walls, they participate in a federally managed group of insurance providers, which is not subject to the same level of megalomaniac freedom or profiteering so often seen outside the grasp of federal control.

Any reforms that Congress enacts on healthcare - the regulation of insurance industries, forced non-profit status of healthcare companies, public option, or other facets - will not effect their life in any noticeable fashion. If, however, members of Congress were forced to participate in the same insurance scams that the rest of America does, they would very quickly discover that which needs to be desperately rectified, and would likely pass definitive and progressive legislation within a short period of time without any further or inane squabbling.

This preeminent solution has been proposed for Social Security, for the same principle reasons and with similar predicted outcomes, and there is no valid reason why it cannot serve as a similar point for healthcare reform. Until the members of Congress are more akin to the average American citizen, legislation will continue to be slanted in favor of powerful corporate interests and those with extreme quantities of money, which was most definitively not the intention of the Founding Fathers. Perhaps a forced Congressional joining of Social Security and common insurance, along with paycuts and campaign finance reform, could produce a Congress that is more representative of the nation.

After all, Congress’ sole purpose is to emulate, protect, and act in favor of their constituents – the People of the United States of America.

Legitimate Healthcare Reform Is Fading Fast [OpEd]

Kyle Brady — Mon, 12 Oct 2009 07:05:18 +0000

Senator Max Baucus produced a bill from the Senate Finance Committee not long ago that has since been lauded as “revolutionary”, a “win” for the American people, and, most importantly, as the bill that will likely form the basis of what Congress will actually pass as so-called healthcare reform. Not only is this ethically wrong, it’s a farce that’s been handed to the American people in the hopes that they accept its very minimal reforms as truly revolutionary and placate the 70+% of the country that is pining for change within the medical, insurance, and otherwise healthcare sectors.

The “Baucus Bill” does a number of things, but there are two central pieces to it: forcing every American, under penalty, to have some form of health insurance, and providing subsidies to private insurance companies to make it more affordable to citizens. There is no public option, or any semblance of a government-run healthcare plan. There is no extension of Medicare to younger crowds. There is no tax to pay for these subsidies. There is no forced transformation from healthcare corporations to non-profits.

Rather than put together an intelligent bill, Max Baucus chose to give in to the current Republican ideal of not instituting progress for the average American citizen, as well as not increasing the size of federal government, and this has resulted in a mashup of horrible ideas with even worse implementations. Take, for example, the way the bill is paid for: rather than having a relatively low and inexpensive federal-level tax, individuals or families with extensive healthcare plans are taxed. This means that people who prefer to have substantial coverage for themselves, essentially those who are able to afford the best care/plan in the unnecessarily expensive world of health insurance, are now being taxed on their free-market expenditures.

Somehow, those behind this bill imagine that the federal government providing money to already corrupt and money-hungry insurance companies will help solve the situation, even without any actual regulation of the healthcare system or a legitimate nation-wide option for health insurance. The bill does nothing about pre-existing conditions, those truly unable to afford healthcare, regulating the health insurance companies, or even addressing the skyrocketing cost of healthcare in America, and yet the American people are expected to support a large cashflow of their money to the companies that have caused these very problems.

Is this what American politics have become? A system so entrenched in its fundraising process that it can no longer make intelligent policy decisions that have an effect on large corporate entities?

There are rumors that some Democrats, including President Obama, are supporting this bill merely to get something on the Senate floor, in order to pull a trick in the process of Reconciliation: sticking the public option in at the last minute, while removing the pocket-lining of insurance companies. This is a risky strategy, at best, because its failiure would obviously result in millions of dollars being freely given to an industry that has already proven itself as both irresponsible and unable to behave properly. To this end, there is a growing number of Democrats that are looking at the public option as the only solution, no matter its inherent partisan nature, something that should have occurred months ago, and Alan Grayson has become the focal point of this movement by publicly decrying the “Republican plan” of denial while calling out his fellow Democrats that have thus far failed miserably.

In response to the Baucus Bill, hundreds of amendments have been proposed, most of them as inane, or worse, than the bill itself - not the least of which is the ability of states to “opt-in” or “opt-out”, depending on the proposal, from a federal public option. Among proposals such as the public option becoming a state-level enterprise, the lack of backbone by many Democratic Congressmen has been shown, since the country’s citizens overwhelming want not only healthcare reform and industry regulation, but a federally run public option - this cannot, and should not, be accomplished at the state-level or with a provision for objecting states to remove themselves from federal law. Why is this so difficult to comprehend?

As the days and weeks pass, the hopes that many Americans had for a decline in healthcare costs and the de-emphasizing of grossly self-indulgent corporations is fading. Short of a coup in the Reconciliation process or a magical unity of Democrats, which would include the self-labeled “Blue Dogs” that masquerade as liberals, the American people have lost. Not only have the American people lost, but Congress has lost – the people’s faith in not only Congress but the government itself has been visibly shaken by the recent public display of corporate influence on the future, fate, and form of this very nation.

Health Care Reform: Saving American Lives [OpEd]

Kyle Brady — Thu, 08 Oct 2009 07:05:13 +0000

Editorial Note: I was going to write about the Senate and the current disastrous state of healthcare reform, with the outlook worsening even as the end nears, happening in large part thanks to Max Baucus.

But that can wait until Monday.

Keith Olbermann had an hour-long "Special Comment" show last night (10/7/2009) on his MSNBC show regarding healthcare reform, its immediacy, the joke that has become the American Congress, and more - a point that I've been making in various forms for months that he manages to effectively communicate with grace and poise.

So rather than the usual OpEd piece, the following audio, video, and transcript from that show is presented as a tribute to Keith Olbermann's spot-on brilliance, as an act of solidarity with his realistic and moving viewpoint.

All of the following content is property of Keith Olbermann and MSNBC.

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Official Podcast Audio:

[file link]

Official Video:

[file link]

Official Transcript:

Healthcare Reform: Saving American Lives

Since August 23rd of this year I have interacted daily with our American Health Care system and often done so to the exclusion of virtually all other business. It is not undercover reporting, and it is not an expert study of the field, but since that day, when my father slid, seemingly benignly, out of his bed and onto the floor of his home, I have experienced with growing amazement and with multiplying anger, the true state of our hospitals, our doctor's offices, our insurance businesses, our pharmacies.

My father's story as a patient and mine as a secondary participant and a primary witness has been eye-opening and jaw-dropping. And we are among the utterly lucky ones, a fact that, by itself, is terrifying and infuriating.

And thus tonight, for all those who we have met along the way, those with whom we have shared the last two months inside the belly of the beast, and for everyone in this country who will be here and right soon tonight, Countdown will be devoted entirely to a Special Comment on the subject of health care reform in this country.

I do not want to yell. I feel like screaming but everybody is screaming, everybody is screaming that this is about rights or freedom or socialism or the president or the future or the past or a political failure or a political success. We have all been screaming, I have been screaming.

And we have all been screaming because we do not want to face, we cannot face, what is at the heart of all of this, what is the unspoken essence of every moment of this debate; what, about which, we are truly driven to such intense ineffable inchoate emotions. Because ultimately, in screaming about health care reform, pro or con, we are screaming about death.
This, ultimately, is about death.

About preventing it. About fighting it. About resisting it. About grabbing hold of anything and everything to forestall it and postpone it, even though we know that the force will overcome us all - always will, always has. Health care is, at its core, about improving the odds of life in its struggle against death. Of extending that game which we will all lose, each and every one of us unto eternity, extending it another year or month or second.

This is the primary directive of life, the essence of our will as human beings, all perhaps that is measurable of our souls, the will to live. And when we go to a doctor's office or a hospital or a storefront clinic in a ghetto we are expressing this fundamental cry of humanity: I want to live! I want my child to live! I want my wife to live! I want my father to live! I want my neighbor to live! I want this stranger I do not know and never will know to live! This is elemental stuff — our atoms in action, our survival mode in charge. Tamper with this and you are tampering with us.

And so we yell and scream and try to put it all in a political context or expand it to some great issue of societal freedom or dress it up in something that would be otherwise farcical, like a death panel. But this issue needs no expansion and no dressing up. The Democrats need draw no line in the sand, and the Republicans need calculate no seats to be gained, and the Blue

Dogs need anticipate no campaign contributions lost. This issue is big enough as it is. This is already life and death. Of all the politicians of the previous century, none fought harder to prevent an administration that promised to involve itself in health care, from ever gaining power, than did England's Winston Churchill.

He equated his opponents, the party that sought to introduce "The National Health," to the Gestapo of the Germans that he and we had just beaten just as those opposing reform now have invoked Nazis as frequently and falsely as if they were invoking Zombies. Churchill cost himself the election because he didn't realize he was overplaying an issue that people were already damned serious about. Irony — this.

Because, a decade earlier, Churchill had made the greatest argument ever for government intervention in health care only he did not realize it. He was debating in Parliament the notion that the British government could not increase expenditures on military defense unless the voters specifically authorized it, just as today's opponents of reform are now claiming they speak for the voters of today, even though those voters spoke for themselves eleven months ago.

Churchill's argument was this"I have heard it said that the government had no mandate such a doctrine is wholly inadmissible. The responsibility for the public safety is absolute and requires no mandate!"

And there is the essence of what this is. What, on the eternal list of priorities, precedes health? What more obvious role could government have than the defense of the life, of each citizen? We cannot stop every germ that seeks to harm us any more than we can stop every person who seeks to harm us. But we can try dammit and government's essential role in that effort facilitate it, reduce its cost, broaden its availability, improve my health and yours, seems, ultimately, self-explanatory.

We want to live. What is government for if not to help us do so? Indeed Mr. Churchill, the responsibility for the public safety is absolute and requires no mandate! And yet today, at this hour, somebody somewhere in this country is arguing against, or protesting against, or yelling against health care reform, because the subject is really life and death, and they're scared, and they have been scared, and they have been mis-led by the overly-simple words of one side, and misinformed by the overly-complex words of the other side.

And that one person, at least that one person, who is tonight so scared that somehow sickness and pain and death will come sooner to them because of reform they do not understand - that one person, if his or her argument is successful and reform is again quoshed, that one person arguing against health care reform will die sooner, because they argued against health care reform.

Just as you and I have largely failed to understand the terror, the fear of death, that underlies this debate in the minds of so many, the leadership of the reform effort has also failed to understand it, and failed to lead not just in practical terms, but in rhetorical ones. If you did not know what something called "The Public Option" was, you might instinctively oppose it.

Option? My health care is now optional? Doesn't that mean it can go away somehow? Doesn't that mean that when I need it, it won't be there? Doesn't that mean somebody is trying to take it away from me? And this insurance that might go away is public? I'm giving control to the government somehow? No "private?" Just "public?"

And so, in seconds, with mental reflexes as acute and natural as any mechanism of "fight-or-flight", something that will expand health care and reduce its cost, something that will help fight death and pain becomes misunderstood as exactly the opposite. You can blame the one doing the misunderstanding all you want. But the essence of communication is reducing the chance of misunderstanding. And the term "The Public Option" has been as useless and as full of holes and as self-defeating as has been the term "Global Warming." It is political-speak. It is legalese. It is designed not for the recipient but for the speaker. It is the ego of the informed, strutting down the street and saying "look at me, I talk smart."

Just as "global warming" is really "bad climate change," "The Public Option" is in broad essence "Medicare For Everybody." Frame it that way, sell it that way, and suddenly it doesn't sound like a threat, turning the seemingly solid insurance which people have now, into something "optional" and turning anything "private" into everything "public."

Once you said "Medicare For Everybody," there would be just as much to explain. If you were under 65 you'd be paying for it. You wouldn't have to buy it. You wouldn't have to change from whatever you have now. There are just as many caveats.

Still, the intent of all this would be clearer. Much of the criticism of health care reform is coming from those who have or are about to get Medicare and, in confusion, in fear, in the kind of indescribable realization that we are far closer to the end than to the beginning, they are suddenly mortally afraid that health care reform will take it away from them. "Medicare For Everybody," might not be literally true, but instead of terrifying, it would be reassuring. And the explanations and the caveats would be listened to, and not shouted down, as anger and fear -- fear, remember, of death - swell up inside.

This rhetorical ship, of course, has sailed, and frankly, those leading the effort to reform health care have been so out-flanked, out-argued, out-terrorized by its opponents, that their reflexes seem shot. They are, to use Mr. Lincoln's words about General Rosecrans, frozen in place, "like a duck hit on the head."

And yet even from the most insurrectionary of the infamous Town Halls of August, there came report after report of proponents of Health Care reform, responding to the tea-baggers and the genuinely confused, in voices calm, with genuine empathy and honest inquiry, by asking "what are you afraid of? What do you think we can do to improve health care?"

Setting aside the professional protestors, the shameless mercenaries of the equation, the LaRouchebags and the hired guns, the results were uniform and productive. Dialogue. Conversation. Admission of fear. Admission that we are indeed talking about pain and sickness, and life and death. Admission that we are seeking the same things and that this should not be left to the politicians who almost to a man reek of the corruption of campaign contributions from the very monopolies they are supposedly trying to control.

And something else would come up. Something that you never hear included in the debate over reform, in the debate about insurance and bankruptcy and even in the debate over the remorseless rapaciousness of companies that are forever increasing premiums and deductibles while reducing what they give back to the person who is sick. What you never hear about is the person who is sick.

Have you ever stayed overnight in a hospital? All data suggests that in a given year, only about one in ten of us do so it's not a universal experience. Could you sleep in a hospital? With constant noise, with sharing a room with strangers, with contemplating mortality and more immediately the fog of germs in the place? With staph infections and MRSA and nursing staffs cut to the minimum, and overworked doctors, and medical record-keeping so primitive it might as well be done on blackboards?

And the bills? What about the person who is sick and the bills? How are they supposed to get better, while they are sitting there inside a giant cash register? How do you heal, how do you kill a cancer, when the meter is running so loudly you can hear it?

When a system of health care has been so refined, so perfected, as to find a way to charge for almost everything, and to reimburse for almost nothing, how does the person who is sick, not worry, always, always, about where he is going to get the money?

And how is somebody worrying always about where he is going to get the money, supposed to also get better? Yet our neighbor, in that hospital bed, hoping half for health and half for the money to pay for it, is still in better shape than at least 122 Americans who might be watching this right now, and who will not be with us tomorrow, because they will die, because they do not have insurance. I will pick it up there and then move on to the question of whether, if health care is not reformed, we should force the issue, by bailing out of this stylized blackmail that is insurance.

Some time around one o'clock in the morning on Saturday the 22nd of August of this year, my father, struggling with knee problems, some generalized weakness, lack of appetite, and lethargy, tried to use the portable urinal he kept by his bed to limit those middle-of-the-night trips to the toilet. Sounds a little gross, but certainly not when the alternative is a 20-minute ordeal of struggling to the bathroom and wondering what in the hell you're going to do if you don't make it there in time.

But that night there was an additional problem. He was having trouble going. He tried to adjust his position sitting on the edge of the bed. Suddenly the mattress shifted underneath him and deposited him gently on the floor. He might have been in nothing more threatening than a seated position there, but with his knees as bad as they are, there was almost no chance he was going to get out of it without help. For reasons that would later become apparent, my father would pretend to himself that that wasn't true. He decided to believe that soon he'd feel better and be able to get up, on his own.

He thinks he dozed much of the night. As it got light, he realized his cell phone was within grasp and he called me, not to say he was in trouble, but only about the move we were planning for him, to his own place closer to me. He never mentioned the precariousness of his position. He had now been stuck on the floor around seven hours.

Some time in the afternoon, between the dehydration and the exhaustion, the hallucinations started. He heard my sister and her family in the hallway outside his bedroom. He could feel the vibration of the footsteps of his grand-kids running up and down. In a startling tribute to the imagination's ability to make a hallucination like this one completely self-contained and impervious, he heard his daughter say "don't bother Grandpa, he's resting." He thinks he smelled cooking. My sister and her kids were, in fact, in Rochester, New York at the time.

My Dad found himself increasingly angry and finally, sometime after midnight on the morning of Sunday August 23rd, he phoned her and demanded to know why she had been in the house without so much as giving him the courtesy of peeking her head in to see if he was all right. Only after her repeated insistences that she was 330 miles away and had been, all day, did reality regain control. My father apologized. My sister called his neighbor. The neighbor called the cops.

There was never an official diagnosis of just the one incident that night, but I have gone into such excruciating detail because of what I was told that night by the doctors at the ER at which I joined my father, and what I've been told by other health professionals since. The hallucinations almost certainly were provoked by dehydration and if not renal failure per se, then certainly a kind of temporary shut down. By the time he got there, it had been more than 24 hours since he had triggered this cascade of problems by trying to adjust the position of his body so he could urinate. And he still had not done so.

My father's kidneys were in trouble. Considering kidney disease was what killed his father, this was very bad news. We heard just yesterday about kidneys and insurance. The Waddington brothers, Travis of New York; Michael of Santa Fe. As the New York Times reported, their Dad, David, needed a kidney transplant because of a congenital renal disease.

Each of his sons was ready to donate. But they were warned not even to get tested to see if they matched. For if they did transplant or no they would conceivably be denied insurance for the rest of their lives, because they might test positive for that same congenital renal disease that threatened their father. And thus would they have a pre-existing condition.

And still the Waddingtons and their Dad and my Dad were all luckier than at least 45,000 Americans. Because as discovered in a new study conducted by Harvard University and the Cambridge Health Alliance, that's how many of us are dying, each year, because we don't have insurance.

The number is horrible. But when it is contrasted to what faced my father that night, it is unforgivable. Because as Cambridge's summary of the findings put it: "Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease." My father had less to fear that night from bad kidneys than he would have if he hadn't had insurance!

And yet we let this continue.You and I. This society. Our country. Democrats and Republicans.
This is the study Congressman Grayson of Florida quoted, about which the Republicans demanded an apology when they should have been standing there shrieking, demanding we fix this. "Uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts."

People, in short, are dying for the lack… of money.Dying as surely as they did when Charles Dickens wrote about the exact same problem. Of a boy who couldn't get sufficient medical care for his affliction. Of the underprivileged, suffering not just privation but death, as the comfortable, moved silently and unseeingly through the streets of London.

The book was called "A Christmas Carol" and the boy Dickens imagined was called "Tiny Tim" and it was published on the 19th of December, 1843, and it is 166 years later and the problem is not only still with us, it is getting worse. The mortality rate among Americans under the age of 65 who are uninsured, is 40 percent higher than among those with insurance. In 1993 a similar study found the difference was only 25 percent.

We are moving backwards! We are letting people die because they do not have insurance.
What's worse is that barring meaningful health care reform, this will only grow. The difference between the surveys from 1993 and now suggest this fatal insurance gap is growing by about one percent, per year. Your chances of dying because you don't have insurance are now 40 percent higher than those who have it.

By extrapolation, three years from now your chances will be 43 percent higher. Your chances of dying because you used to smoke, compared to those who never smoked, only 42 percent higher. You heard that right. At the current rate, in 2012, you will be more fortunate, more secure, more long-lived, if you used to smoke, than if you don't have insurance. It is mind-boggling, and mind-less. This is the country you want? This is the country you will accept?

Do those other people in this country have meaning to you, or are they just extras in your movie, backgrounds in your painting, choruses in your solo? Without access to insurance for all of us and the only way we get it is with the government supplying the gaps, just like it does in flood insurance for God's sake that fatal gap will just keep growing.

A 45 percent higher likelihood of death for the uninsured compared to the insured by 2014.
By 2022, the figure will be 53 percent higher. Fifty-three percent! In the 1840s, as Dickens wrote a "Christmas Carol" - in a time at which we now look back with horror, the city of Manchester in England commissioned a crude study of mortality among its residents. A Doctor P.N. Holland categorized the sanitary conditions of the houses and streets of Manchester into three classes.

And when he compared the death rate in the First Class Houses in the First Class Streets, to the death rate in the Second Class Houses in the Third Class Streets, he found mortality in those worst locations was 53 percent higher. If we do not reverse this trend, in fourteen years' time we will not be living in the America of 2022. The shadows of the things that may be, tell us, that we will instead be living in an insurance-driven version, of the Dickensian England of 1843!

God Bless Us, everyone.

I told my father the other night that the insurance I really want to get for him and me is called Corporate-Owned-Life-Insurance. "COLI" — like in E. Coli. How fitting. With or without your consent, your employer is permitted by law to take out life insurance on you. It can, in fact, take out life insurance on everybody who works for it. Who gets the money when you die? Your employer does.

Dad pointed out that theoretically this would give them motivation to kill you. That, of course, would be for the same reason, as Michael Moore points out in his new movie "Capitalism: A Love Story," that you can't buy fire insurance on the house of the guy who lives next door to you. Golly gee, that's right, suddenly you'd have a motive to burn down his house and the world is already too much like that symbolically to make it like that in reality.

No, it's really unlikely that even the most evil corporation would think of killing you to get a payout from the COLI insurance plan. This exists for a much more mundane and passive reason. You're going to die anyway, and the tax laws of this country are such that if your company has a hundred thousand employees, it can take out small whole-life policies on everybody and just let the actuarial tables do the work for it. Ten thousand dollars here, $20,000 there, maybe $50,000 back here and all of it tax-exempt.

Oh and your employer can borrow the money to pay the premiums on the secret insurance it has on you. And the interest on that loan is tax-deductible. And your employer can, in essence, over-pay the premium it has on you and your fellow drones, and the extra money in the kitty is called "Cash Value," and it can be stuck into a pension-benefit plan or other product of the mad world of accounting. And "Cash Value" is also tax-deferred. It can be returned to your employer as a tax-free loan. And if your employer goes bankrupt, the Cash Value of those insurance policies is protected by the tax-laws - from creditors!

In short, your employer can get a tax-deductible loan to buy insurance on you that until this past June he didn't even have to tell you about, and the money is first tax-deferred and then tax-free, and when you die, the payoff it gets is tax-exempt, and when the company dies, the boss still gets to keep the money away from the creditors even if somehow you, the guy on whom your boss has surreptitiously taken an insurance policy - happen to be one of the creditors.

And even though it's based on insurance on your health and your life, all of that tax-free, tax-exempt, tax-deferred money not only doesn't go to you, it also doesn't go to the government. And so if we really are ever going to do anything about federally-supported health care as an alternative to these private insurers, there's that much less tax money to do it with.
And some of the money that isn't going to you, and isn't going to the government, is going to strengthen the already monolithic insurance companies!

And just in case this isn't a sweet enough deal, the government is almost silent about telling that employer of yours about what kind of health insurance it must give you. And year after year, the companies get smarter and more audacious about either cutting what your health insurance covers, or cutting the number of employees the health insurance covers, or both.
And if that still isn't enough, there is something called the National Association of Insurance and Financial Advisors. And it has a Political Action Committee, IFAPAC, and last year IFAPAC had one million, $492,000 worth of campaign money with which to buy politicians.
And you'd be amazed how many of them you can buy with even one million, $492,000.

And these are the same people who are not only influencing the health care debate, spending more than a million dollars a day to defeat reform, they are also the same people, who by raising your premiums and cutting your reimbursements, who by manipulating prices at hospitals and doctor's offices for everything from tongue depressors to enemas, who by influencing health care in this country more effectively and more selfishly than a dictator could ever do these are the people who decide what kind of health care you get, how much you pay for it, and whether or not they'd rather not see you get it.

It is your skin. Literally. And it is in the hands of people, insurance companies, who can still make money by betting against your good health. There is only one comfort here and it is cold indeed. Profit while you can, insurers. Sickness and death wait not just for your customer. They also wait for you. And they are double-parked. The doctor who treats you and the pharmacist who makes you pay through your nose are not your enemies in this. It proves they are as much victims as you and I are. And the time has come to realign the battle here, so that it is not just us versus the entire medical and health care establishment, it is us, and the doctors, and the nurses, and the pharmacists, and maybe even some of the hospitals, against the real enemy: The insurance companies... the Insurance companies who are right now at war against America! That's where I'll pick it up when this Special Comment continues.

Dr. Albert Sabin was by his own description, pretty full of himself when he managed to temporarily stop the testing of the Salk Polio Vaccine after a bad batch sickened and killed some children early in the first tests in the 1950s. Sabin recounted this in a television interview in the '80s. He was weeping. He had believed he was doing right. He had convinced himself that the fact that Salk's vaccine, the so-called "inactivated polio vaccine," had been chosen for use instead of Sabin's own "live polio vaccine," was irrelevant to his efforts.

He was weeping as he recounted this, too. Ultimately there proved nothing wrong with Salk's vaccine, the one batch had been improperly handled and manufactured. But Sabin and others, delayed all further testing for weeks. Sabin was weeping as he remembered. In 1983, Sabin had contracted a rare disease of his own. Surgeons operated, relieved the intense pain and muscle weakness, and then ten days later it came back, ten times worse, enough for him to be yelling and crying, virtually all the time.

The pain, he said, "made me want to die." And Dr. Albert Sabin suddenly remembered that the stopping of the Salk Vaccine experiments had led to death. Death of children. More immediately, it had led to pain, physical and emotional, for the children, and the parents.
He said it had not occurred to him that the first thing doctors must do, the first thing a health care system must do, is stop pain. He vowed to spend the rest of his life relieving pain.

His own searing agony, and paralysis, gradually, inexplicably, faded. They moved my father this afternoon. I don't mean they moved him to another hospital. They moved him. In his bed. Into a different position. It was agony for him. Agony enough that he could barely see us.
Agony enough that they had to give him all the pain-killer he could handle. Then he couldn't talk any more. Another moment when somebody like me wonders about what it would be like if he was going through that, and I was watching it, worrying about whether we could afford the pain-killers.

Or the doctors. Or that hospital. Or any treatment at all. And what kind of society we live in, where millions of us face questions like that, and politicians glibly talk about incremental improvements while they slowly re-shape new laws that are supposed to reduce the number of us faced with pain untreated due to money, into laws that take more money out of our pockets and give it to the corporations who are profiting off health care without contributing one second to the relief of pain or the curing of disease, the pimps of the equation, taking their 20 percent off the top the health insurance cartels.

How would our politicians react if there were millions Americans in pain, getting insufficient care to relieve that pain, because of interference from insurance corporations and those millions had just been injured in a natural disaster, or an attack on this country? How fast would they rush their portable podiums to the driveways outside the emergency rooms?
How quickly would the money come?

You know the answer. And you know what the answer has been about rushing to help those millions of Americans in pain tonight attacked not by another country or a terrorist or even a flood but attacked merely by life. Half of the politicians are dedicated to protecting the corporations against having to help our relatives and neighbors in pain.

The other half are calculating how far they can anger our Insurance Over-lords before our Insurance Over-lords stop contributing to their campaigns. Might all their CEOs, might all the wavering political frauds, get ten minutes of Dr. Sabin's pain. Or my father's. That's another part of this story I just haven't seen. The doctors.

For all the jokes over all the years, these guys really are on our side in this, especially the ones in the hospitals, especially the ones without whose skills you'd heal up just as fast in a bowling alley as in the best of the medical centers. The man who took my appendix out two years ago, a messy, dangerous job that took more than two hours, from which I recovered fast enough that I only missed four days of work, and who left three little scars one of which I can't find any more, I wrote all the checks. I know how much he got out of the whole price. About ten percent.

A very good friend of mine is a doctor in California. He wrote me the other day. "You can see why doctors, who want to make a living or cover increasing costs, labor, overhead, etc., have only one choice: see more patients, spend less time, answer fewer calls, because there is no other way to increase revenue.

"Plus," he wrote, "if you order tests, patients think they are getting better care (and) doctors thinking that testing, saves them time in thinking or talking with people. 'You have chest pain?' Instead of asking you questions, why don't we go ahead and do this stress test - that I get paid much more than some little office visit to do - and make sure it's not your heart.'"

And so like us the doctors are slaves to insurance. And that's not even talking about malpractice. We have to help them on that. Maybe we do need to cap damages. But do it where everybody benefits. Set the cap wherever it works out to be now, then lower it each year by exactly how much the entire cost of a patient's health care is lowered in this country. Incentivize doctors to help make health care available to everybody.

We patients and the doctors have to be on the same side again to stop pain, to heal disease, not to be customers and salesmen. And to help, thinking long-term. "People do want to discuss their end-of-life preferences prospectively," my friend the doc says, "and doctors should be paid to have these discussions." And then he wrote something that hadn't occurred to me. "We spend a lot of money on doing things that people would not have wanted us... to do to them."

Oh, that hit home. My mother died in the spring. Bless her, she lived without symptoms till nearly two weeks before she went. And we had all talked about what to do, and when to do it, and what not to do. And so when they said there's breast cancer, and there's five lesions in her brain, and there's nothing we can do that will wake her, but we can do a lot to lessen her pain or we can do things that might extend her life but also won't cure her and also won't wake her, but might be hurting her, we can't tell.

It took five seconds to decide. And then I thought of all the people who never had that discussion with their mother or father, who don't know that those are the choices they might face. And how it might help to have a doctor who says, here it all is. And you say: Doc thanks, I've decided I still want you to keep me alive forever even if I'm suffering and comatose, and he says, you got it.

Only now he could send you a bill and you could have insurance pay you back for it, so your mother and you will know, when the time comes, exactly what each choice would bring.
And some buffoon decided to call that a "death panel." On the list of preventable deaths diabetes, stroke, ulcers, appendix, pneumonia we are 19th. Canada is 6th, England 16th, we're 19th. Portugal is 18th. You're better off in Portugal.

Death panels? We have them now. They're called WellPoint and Cigna and United Health Care and all the rest. Ask not for whom the insurance company's cash register bell tolls. It tolls for thee. What you and I might able to do about all this, when my Special Comment continues.

So far we've covered our collective unwillingness to admit that this isn't a health care debate. We are talking, ultimately, about pain, and life and death. I've recapped my own father's trip through our health care system. And we've looked at the horrible statistics that this country is 19th world-wide in preventable deaths, worse than Portugal. And how, if the current gap between the insured and the uninsured continues to grow, at this pace, by the year 2020, the uninsured will be 53 percent more likely to die than will the insured, a number that matches exactly, the increased mortality rate for the poor in the England of Charles Dickens.

What do we do?

I do not know who the two women were, yet they are indelibly burned into my memory.
They stood outside, on a crisp New York morning last week, middle-aged, short, looking more than a little weary. They were wearing lab coats, and they were leaning against what those coats told me was their place of employment, the Mortimer B. Zuckerman Research Center at Memorial Sloan-Kettering Cancer Center.

The women in the cancer researcher's lab coats were smoking cigarettes. I have seen a lot of startling things in my more-than-40 days and 40 nights alongside my ailing father inside this nation's fractured health care system, but nothing seemed to better symbolize the futility, the ram-your-head-against-a-wall futility, of this gigantic medical entity that we have created, that seems to have not only broken free from human control, but has, to some great measure, enslaved us.

Twenty-three stories tall, built partly with a 100-million dollar gift from the publisher of the New York Daily News, and U-S News Magazine, and two of the cancer researchers are standing in front smoking. That isn't the only picture that haunts my dreams.

A man walking out of another hospital, casual, purposeful, in control. The red stitches on the left side of his shaved head outlining a space as big as a large potato and at least an inch higher than the rest of his skull. I don't know if he was getting better or he was getting worse. I don't know if he had gotten good news or bad. I don't know if tonight he's healthy, or he's dead.

Months ago I got in a line at a drug store here. A woman ahead of me, obviously a familiar figure to the young pharmacist behind the counter, trying with mixed success to take in the gentle explanation. "You've maxed out your prescriptions on that insurance," the professional said slowly, "I can't give it to you." The customer shook her head in resignation.

It was like the Medieval Courts of Chancery, where if you were poor, you could take your lawsuit against the rich or the government, and hope when they picked the handful of cases to be heard, they'd somehow pick yours. If they didn't, you could try again next year, or, in some cases, every year for twenty next years.

The woman who needed the prescription spoke even more slowly than the pharmacist had. She had almost no hope in her voice. "Try the Cigna. Please." Another drug store, late at night. The pharmacist was a friend of mine. "You have to do something about this," he said as he handed me my refill and then reached for somebody else's prescription. "You see this? Anti-fungal cream. I just filled this. You know what this costs wholesale? Four dollars. You know what I have to sell it for? Two hundred and sixty-three dollars. I sell it for less and I get fired and maybe we lose our license."

And last Saturday, I leave my father, 24 hours after serious surgery that probably saved his life, serious enough that he's still under sedation and it'd be another 24 hours before he knew where he was or who I was, and yet I know he's okay because I've gotten him the best care in the world.

Literally, his surgeon is considered one of the top five guys in his field alive today and even I can tell he absolutely nailed the operation. And I know that after my father wakes up, when post-operative fluids get into his lungs, and he has trouble breathing, and he has to inhale after every word, they have a drug called Lasix that will start to drain the fluids and within five minutes he'll be breathing easier and within fifteen it'll be like nothing was ever wrong and this is just one of twenty drugs they can use on him not just to make him better long-term, but just as importantly and twice as imperatively, to stop his pain short-term.

And I marvel that we have come so far that you can barely take care of your health, like he has for 80 years, you can even be as dumb as those two women outside the cancer research center, smoking away and there is still a kaleidoscope of drugs and therapies and nurses and diagnosticians and psychiatrists and x-ray techs and surgeons, and all of them are capable of undoing the pain and curing the sickness and forestalling death.

And as I walk down the hallway from my Dad's room I allow myself a brief moment of selfishness. I'm sorry. I'm sorry I'm happy that I can spend whatever it takes to help my Dad get better, to keep him around, but maybe I can atone for that selfishness by making this case, tonight, to you, to whoever sees this, that we have to make these wonders of life and health and peace of mind and the control of pain available to everybody. And this is boiling in my brain and I take the shortcut out to the street, through the Emergency Room, and that's when I hear my name called.

And it's a man, roughly my age, and he looks worried to death. And I haven't seen him in 32 years. He was the nephew of the two brothers from Brooklyn who used to run the baseball card shows when we were both kids, and his uncles were the businessmen but he, like me, collected mostly for the fun of it, and it's amazing to see him again, joyous almost, for the sake of the continuity that the accident of us running into each other provides to us both. And he asks what I'm doing there and I tell him and he smiles because my father used to go to those card shows with me and Mike remembers him. And then I ask Mike why he's there.

"My daughter's in ICU," he says. "Three weeks now." The worried look returns to his face. "Lyme Disease. It's one thing, they knock it down, then it's another." There's a brief pause.

"Tomorrow I have to sell my farm. Did you know I had a farm?" I don't have to ask him why he's selling it. He then goes the next step. "Hey, you wanna buy my card collection? I've got some great stuff."

We must reform a system that lets my father get better care than yours does, or better care than Mike's daughter does, because by the accident of life, I make more money than he does, or my checkbook can hold out longer than his does, or yours does, as the bills come endlessly like some evil version of the enchanted water buckets in Fantasia.

The resources exist for your father and mine to get the same treatment to have the same chance and to both not have to lie there worried about whether or not they can afford to live!

Afford to live? Are we at that point? Are we so heartless that we let the rich live and the poor die and everybody in between become wracked with fear — fear not of disease but of Deductibles? Right now, right now, somebody's father is dying because they don't have that dollar to spend. And the means by which the playing field is leveled, and the costs that are just as inflated to me as they are to you are reduced, and the money that I don't have to spend any more on saving my father can go instead to saving your father that's called health care reform!

Death is the issue! How can we not be unified against death? I want my government helping my father to fight death! I want my government to spend taxpayer money to help my father fight to live and I want my government to spend taxpayer money to help your father fight to live! I want it to spend my money first on fighting death. Not on war! Not on banks! Not on high speed rail!

Spend our money, spend my money, first: on the chance to live!

And we must be unanimous in this, not to achieve some political triumph for one side against the other, but to save the man or the woman or the child who will be dead by morning, in this country, in this century, on our watch, because we are not spending that money tonight. I will not settle for a compromise bill and I will extend my hand to those who are scared of the inevitability of death but have been told they are scared of reform, those who have been exploited by the others, paid, or forced, to defend the status quo.

And we must recognize the enemy here: an enemy capable of perverting reform meant for you and me, into its own ATM that mandates only that more of us become the slaves to the insurance companies. The monied interests that have bled their customers white, and used their customers' money to buy the system, to buy the politicians, to buy the press, cannot now even be checked by the government.

Ordinarily the solution would be obvious: we would have to do it for the government. We would have to bring the insurance companies to their knees to organize, to pick a date, to say enough to, at a given hour, on a given day, to stop paying the premiums. An insurance strike.

But the insurance companies' stranglehold on us is so complete that lives would be risked, lives would be lost by the very act of protest. What parent could risk the cancellation of their child's insurance? What adult could risk giving his insurer the chance to claim that everything wrong with him on the day of an Insurance Strike was suddenly a pre-existing condition?

Even as the pay-outs move inexorably downwards, to being less than what you have paid in over the years, we are such serfs to the insurance companies that just to invoke the true spirit of the founding of this nation, is to give them more power, not less.

So I propose tonight one act with two purposes. I propose we, all of us, embrace the selfless individuals at the National Association of Free Clinics. You know them, they conducted the mass health care free clinic in Houston that served 1,500 people. I want a mass health care free clinic every week in the principle cities of the states of the six senators key to defeating a filibuster against health care reform in the Senate.

I want Sens. Lincoln and Pryor to see what health care poverty is really like in Little Rock. I want Sen. Baucus to see it in Butte. I want Sen. Ben Nelson to see it in Lincoln. I want Sen. Landro to see it in Baton Rouge. I want Sen. Reid to see it in Las Vegas.

I'll donate. How much will you donate? We enable thousands of our neighbors to have just a portion of the bounty of good health, and we make a statement to the politicians, forgive me, William Jennings Bryan, "you shall not press down upon the brow of America this crown of insurance, you shall not crucify mankind upon a cross of blue."

We think these events will be firmed up presently. You will be able to link from our website.
Trust me, I'll remind you. Because in one party, in one demographic, in one protest movement, we are all brothers and sisters. We are united in membership in the party that insists that every chance at life be afforded to every American seeking that chance.

We are united in membership in the party that insists on the right of everyone to the startling, transcendent blessings of the technological advance of medical science. We are united in membership in the party that is for life, that is against death, that is for lower premiums, that is against higher deductibles, that is for the peace of mind that can be provided only by the elimination of the fear that cost will decide whether we live or we die!

Because that's the point, isn't it? It is hard enough to recover, to fight past pain and to stave off death, if just for a season or a week or a day. It is so hard, that eventually for you, for me, for this president, for these blue dogs, for these protestors it is so hard to recover, that for all of us there will come a time when we will not recover. So, why are we making it harder?

Financing a Healthcare Public Option [OpEd]

Kyle Brady — Mon, 24 Aug 2009 07:05:30 +0000

One of the concerns regarding the proposed healthcare reform, from both general critics and the ardent opposition, is the financing of an actual government-run insurance plan for millions of people - known as the "public option". One on-the-table solution is taxing those who are considered to be the elite rich of America, but this obviously does not sit well with some of the most vocal and influential constituents for Congressmen of any political party. There is, however, a better way.

The detrimental effect of not having a public option has been made clear elsewhere, but the actual projected cost of such a plan is approximately $1 trillion over the next ten years – that’s $100 billion each year for ten years. While the proposals circle around the idea of taxing a small segment of the population, in addition to having minimal co-payments by those who use the plan, the simple fact is that this large potential expenditure does not have the fiduciary stability it needs – and yet the country is in desperate need of a public option for healthcare.

The Federal Government spends a considerable amount of money each year, and the general public has only the the faintest idea of where it goes, how it is used, or even whether it is spent effectively. One such case is the yearly aid sent to Israel by American taxpayers, currently at the rate of $3 billion. The typical, and only, argument for this large sum of money is that they are American allies - yet they are not, nor have recently been, involved in any of the American armed conflicts which other allies have participated in, and they oppose the logical, and American-supported, two-state solution with Palestinians. Does America send billions in unrestricted funds yearly to England as an ally? Or perhaps to Canada, Australia, Egypt, or Japan, all of which are other allies? No. The necessary funds to make such a piece of legislation more politically attractive can therefore begun to be found in a convenient location: Israel.

This indefensible expense must obviously be put to an end, immediately, and the resultant savings can be usefully repurposed: a healthcare public option. If the costs of the public option are only 10% of the projections, entirely possible given the Congressional penchant for not understanding the number system and grossly overestimating costs, the cost is quickly reduced to $10 billion per year - a third of which can be financed by the amount formerly allocated to Israel. Suddenly the public option seems less expensive than at first glance, especially when a single reallocation of funds can have such a large effect.

Other big-ticket expenses approved by Congress could be repurposed, just like the aid to Israel, for the benefit of the country. It shouldn’t be entirely difficult, since close scrutiny of Congress’ spending habits reveals unnecessary expenses to the tune of millions, sometimes even billions, of American taxpayer dollars. If there ever was evidence of their greed and check-writing abilities, the recent public embarrassment over wanting to spend $550 million on passenger planes for themselves is it – the plan was scrapped when the story went public.

Large numbers are notoriously difficult for the American people to comprehend, but this should be neither prohibit nor excuse not creating a government healthcare option to control the skyrocketing costs of the insurance industry. If the Federal Government can spend $700 billion dollars, that they don’t have, on extremely risky bank bailout loans that may not ever be repaid in full, they should be able to find the money for the health and future of the American people.

It’s commonly known as pork barrel funding, unnecessary expenditures, and Congressional gluttony.

--- --- ---

Update (8/24/2009 2:25pm PST): It's come to my attention that I may have mislabeled this piece - it's not the "public option" that costs so much, but rather the reform package itself, with the option as a part of that.

Even though it's mistitled, this doesn't distract or change from the basic principle of relocating exorbitant and unnecessary spending to finance the healthcare reform proposal, in addition to using co-payments and premiums.

Update (9/6/2009 12:30pm PST): This piece has been plagued with number problems, all stemming from my indecision on how to represent such large numbers: full decimals, word descriptions, or abbreviated decimals? Thanks to alexanderevodicka, the 10% bit has been restated to what I originally intended - not that the projections were overshot by 10%, but rather that "if the real costs were 10% of the projections..."

Healthcare Revisions: Why It’s Important [OpEd]

Kyle Brady — Thu, 18 Jun 2009 07:05:00 +0000

The topic du jour in American politics / media is a revision of the healthcare system, and depending on who is spinning the data, it’s easy to believe that the eradication of a private healthcare system is near, free government-funded healthcare is coming, and the poor, poor insurance companies are going to be forced out of business. Not only is this not true, but a revision of the healthcare system, provided it reaches a certain level of competence, is important and necessary.

Anyone who’s been to a hospital, a general practitioner doctor, or dealt with insurance policy billing knows that the system is broken – not just the insurance companies, but the system as a whole. Insurance companies undercut payments to doctors, so the doctors overcharge (and overbook) their services, which results in the uninsured being unable to make regular visits; patients wait three hours at a hospital Emergency Room, only to be told their insurance won’t cover what they need, or to see a specialist instead; insurance itself prevents many from getting the care (especially surgeries) they need, claiming treatments, medicines, and certain doctor specializations are unnecessary and not essential to the patient’s overall health. Not to mention many patients are removed from their insurance policies for actually using them when they get sick – cancer patients are a common example.

One of the central problems is the idea of a corporation itself – an organization that is more interested in its profits and shareholders than those providing it with profits is incapable of being the foundation of a healthcare system. Insurance companies are for-profit corporations, and hospitals, if not the same, are still pressed by investors for a level of financial stability. Doctors are understandably interested in their income, as many are independent and therefore necessarily profit-minded. But why are the insurance companies and hospitals for-profit? Why are they not, instead, non-profits or not-for-profit? “Breaking even” makes more financial sense in this situation.

President Obama is touting a details-still-unclear plan to provide a “public option” for insurance, which could be a smart move. In the current system, students, poor/underprivileged individuals, and many lower-middle class families can’t afford the insurance coverage they need, and instead settle for what’s financially possible – often, nothing. However, if there were a cheaper (subsidized?) public option, these people could have coverage – not enough to get braces or have elective surgeries, but enough to be healthy. Providing free healthcare for all people within our borders, including the homeless, illegal immigrants, and other similar categories of people, is an entirely different, and infeasible, option.

By creating a public option, capitalism is not being ignored or disrupted, because the insurance companies are not being forced out of business or otherwise unfairly disrupted – something many knee-jerk Republicans are failing to recognize. Advocating an additional option in a pre-existing system is not the same as replacing the said system, and, more explicitly, socialism is not rising from the ashes of our American capitalism.

While Obama moves legislation towards this public option insurance, consideration needs to be given to reforming the system as well – not just providing more options, but regulating the industry as a means of it becoming more stable, patient-dependent, and rational. If insurance companies and hospitals were forced to become non-profit or not-for-profit organizations, squabbling over “elective” procedures and “unnecessary” medicines would immediately lessen, as a simple byproduct of not being singularly interested in profit margins.

America needs healthcare reform, and soon. If the industry companies are closely examined, their ethics and operations are strikingly similar to those of the banks that recently failed – do the American people want to, once again, spend billions of dollars to support companies they never wanted to fund in the first place? Tax dollars can be better spent on reforming the system prior to its collapse, rather than irrationally fighting reforms and being forced into action a few years later.