Dr. King once said, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
In a 2006 op-ed in the Charlotte News & Observer, Richard Payne wrote, "Is there any doubt that King would have been on the forefront of arguments for payment of a living wage to the working poor, and that he would have advocated for universal health care?"
Probably the top priorities at 'America's Future Now' conference (formerly Take Back America) is getting universal health care adopted this year.
Progressive groups announced plans to spend $82 million to press for adoption of Obama's health care plan. The coalition, made up of MoveOn.org, Americans United for Change, USAction, Campaign for Community Change, Rock the Vote, AFL-CIO, SEIU, the Children's Defense Fund, and others, together represent 30 million Americans.
Making sure the 'public option' is contained in health care legislation is a top priority of the coalition. Likewise for the congressional Progressive Caucus and the Black, Hispanic, and Asia Pacific American caucuses, which recently sent joint letters to President Obama and House and Senate leadership emphasizing that they would only support health care reform if it contains the public option.
Since there's suddenly a lot of talk about the long waits for treatment in Canada--and how reform will supposedly produce similarly long waits here--this seems like a fine time to remind people that long waits for treatment already exist here.
From Business Week, in July 2007:
both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. ...
If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. ...
There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.
The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.
"The usual complaints levied against the universal systems are that they will ration care, you have long waiting times for doctors, and quality of care then suffers. It seems to be a given that in the United States with our private system that we have better access, better quality, and fewer mistakes. But what do the data show?"
Today, surveys reveal overwhelming numbers of physicians resentful towards the current crazy patchwork health care system, which fixes their reimbursements, regulates and too often denies patient care, and piles physicians with paperwork so unending and from so many directions the average doctor has little time leftover to challenge the status quo.
Add to all this the frustration felt at working for no pay coordinating care and providing care after hours, at struggling with the cost of health care insurance for their own employees, and at seeing their uninsured and underinsured patients go without recommended care, and what emerges is a prescription for widespread physician support of radical reform.
Over four-fifths of physicians now agree that either fundamental changes are needed in our health care system, or that it needs completely rebuilt.
On April 27th, forty-four national physician organizations wrote to Senate Majority Leader Harry Reid to outline their common goals and strategies "for improving health care delivery and making affordable, high-quality care available to all Americans." The co-signatories included the largest groups representing America’s family physicians, internists, obstetricians and gynecologists, and surgeons.
The letter’s sentiments mirror the results of a national survey of physicians published in January by the Journal of General Internal Medicine, which found that only a small fraction of U.S. physicians supported leaving the U.S. health care financing system as it is. Nearly half favored either tax incentives or penalties to encourage the purchase of medical insurance, and four in ten preferred a government-run, single-payor, taxpayer-financed national health insurance program.
Just six years ago, similar polling found only 1 in 4 physicians supporting a single-payor system.
These findings challenge the public perception that American doctors are by and large unsympathetic to growing call for an overhaul of our costly and deeply unequal current health care system. Nine in ten physicians in fact agreed that every American should receive needed medical care regardless of ability to pay. Physician attitudes have undergone a marked turnabout in the last four decades.
The American College of Physicians, a national association representing 124,000 internists and internal medicine subspecialists, has been the medical organization perhaps most vocal in support of universal health care coverage. The ACP takes the position that "health insurance coverage and benefits should be continuous and not dependent on place of residence or employment status."
In December 2007, the organization became the first and thus far only medical association to endorse a single-payor national health insurance system as a viable option to achieve universal health care. The only alternative option the ACP recommends is a private/public model, much like what the Obama administration proposes. The ACP warns, however, that this health care model will likely result in inequities in coverage, and higher costs when compared to a single-payor system.
Every other national primary care organization likewise strongly favors universal health care coverage. The American Academy of Family Physicians, a national association representing 94,000 family doctors, crafted a health care reform proposal in 2001 which advocates for "a national health system with a basic set of benefits offered to all individuals."
The American Academy of Pediatrics, representing over 60,000 pediatricians nationwide, endorses the idea that "quality health insurance should be a right, regardless of income, for every child, pregnant woman, their families, and ultimately all individuals." Nine in ten pediatricians recently surveyed said they wanted a health insurance program that would cover all children in this country.
Universal coverage could help "significantly" reduce health disparities, according to a Commonwealth Fund-supported study published in the Annals of Internal Medicine.
The study, by J. Michael McWilliams, MD, Ph.D., and colleagues at Harvard University, found that Medicare coverage makes a difference in the health of racial, ethnic and challenged socio-economic populations for patients with diabetes and cardiovascular disease. Based on the study, the authors believe that universal coverage may reduce these types of health disparities in the general population.
The authors reviewed health data from more than 6,000 people aged 40 to 85 with at least one of the following conditions: diabetes, hypertension, coronary heart disease or stroke. They found that while overall improvements have been made in controlling the diseases, racial, ethnic and socioeconomic differences have remained the same or in some cases worsened in the pre-Medicare population.
However, at age 65, when people become eligible for healthcare coverage under the Medicare program, those differences were reduced significantly. The study found that for blood sugar levels with diabetes, educational disparities decreased by 83 percent, while racial and ethnic disparities fell by 78 percent. For total cholesterol levels, educational disparities disappeared altogether. And, for systolic blood pressure, racial disparities decreased by 60 percent.
"The results of this study make it clear that guaranteeing access to affordable insurance for all Americans is the essential first step toward a high performing healthcare system and a healthier America," said Commonwealth Fund President Karen Davis. "As our leaders look toward health reform it is critical that they take into account the value of healthcare coverage for everyone and ensure that all Americans have the ability to obtain insurance."
Putting Bill Maher’s recent words into action, “Health insurance is like a hospital gown, chances are your ass isn’t covered,” bare-bottom protesters wore hospital gowns and dressed as Insurance Executives. The protesters jumped through hoops held by the insurance executives symbolizing the proverbial hoops that doctors, nurses, and patients have to go through in the current corporatized health insurance system.
PHIMG, Healthcare-NOW!, Progressive Democrats of America, and Act Up! marched in lock step on Saturday, April 4th with United for Peace and Justice and Bail Out the People through Wall St. to support strengthening the workforce by urging Congress to pass HR676, expanding Medicare into a single-payer system, to provide true universal health care to all.
On the following Monday, PHIMG brought the Not Covered Campaign to Congressman Charles Rangel’s office, whose 2008 campaign received three times the amount of campaign contributions from health insurance and pharmaceutical companies as his last run in ‘04, while conveniently not cosponsoring HR 676 for single-payer health care, as he has in the past.
The group also had a list of demands including meeting with him, cosponsoring the bill, using his power as the Chair of the Ways and Means Committee to hold single-payer health care hearings, and including single-payer advocates - not just the health insurance corporations in the national health care dialog Obama’s administration is so open to having. Barack Obama also supported single-payer health care before his run for President made his campaign the top recipient of contributions from the health insurance and pharmaceutical industry.
The group received confirmation that Rangel does support HR 676, and just hasn't signed on yet. Advocates and constituents look forward to a long sought meeting with Rangel's staff next week.
The Not Covered Campaign will be in full swing all summer long calling out the Congresspersons that let campaign contributions stand in the way of providing all citizens with single-payer health care - one by one. It’s critical that citizens act now and push Congress to pass HR 676 before inadequate reform maintaining corporate interests over patients passes. Join the fight for single-payer health care now!
TNRtv:
At the 2009 World Health Care Congress, TNR senior editor Jonathan Cohn sat down with Dr. Michael Chen, Vice President and CFO of Taiwan's National Health Insurance Bureau, to discuss the results of Taiwan's switch to a universal health care system.
Symbolism counts in Washington, and Obama's request that his Cabinet officers come up with $100 million in spending cuts will be played up by the White House as the beginning of a major effort to trim unnecessary government spending. It's part of the president's effort to reach out to Republicans (and calm the nerves of "blue-dog" Democrats) worried about all the money the administration has spent and still wants to spend -- $787 billion on the stimulus, $700 billion committed to the bank and auto bailouts, and, most important, $3.5 trillion for the next 10 years, including universal healthcare. Throw in the cost of a cap-and-trade system to control climate change and you're talking big money.
Over the longer term, Obama must be careful not to put entitlement programs on the chopping block as part of a "grand bargain" to elicit Republican support for healthcare and cap-and-trade. Social Security is not in dire straits; it can be made flush for the next 75 years by ever-so-slightly lifting the ceiling on the portion of income subject to Social Security payroll taxes (and if Democrats are reluctant to do that on incomes over $100,000, then they could do so on incomes over $250,000).
Medicaid and Medicare are in trouble because healthcare costs are rising so fast, which argues for healthcare reform rather than cuts in these important programs. Yet if healthcare reform has any prayer of controlling the rising tide of healthcare costs, the plan must allow beneficiaries to opt into a public insurance plan -- something Republicans and the healthcare establishment are determined to fight. So it's critically important that the Senate wrap healthcare into a reconciliation bill that can be enacted by a majority vote in the Senate.
Obama should fast-track healthcare and stop trying to court Republicans. Every House Republican and all but three Senate Republicans voted against the stimulus; all Republicans in both houses voted against the budget. During the recess they hosted "tea parties" claiming that Americans are overtaxed. Over the weekend, House Minority Leader John Boehner called the idea of carbon-induced climate change "almost comical."
The free-market system, or capitalism, is the best way to produce most services and goods. However, it is not an all-encompassing way to manage a society where different people have different needs and some will always be unable to meet the challenges of life. The word is unable, not unwilling. The woman who cuts my hair has chronic lung problems that go untreated because she does not have medical coverage.At the same time,I watched too many faces, including Nancy Pelosi,,where the skin has pulled tight after numerous plastic surgeries and the effect is to give them a frozen smile. We've got to get our priorities right.
"BEIJING (AP) — China announced Monday it will make improved health care services available to all its citizens by 2020, taking aim at a system long derided as creaking and inadequate."
In the early decades after the 1949 founding of the communist state, China's soviet-style centralized public health system was credited with making huge inroads against infectious diseases and providing basic free care to most citizens.
In the 1980s, however, the system was largely dismantled amid economic reforms and a growing taste for privatization. Seeing a doctor became far more expensive and the gap between rural and urban health care began to grow, undercutting attempts to boost rural incomes.
"In the United States today, we can use our belief in numbers, which borders on the religious, to rationalize any amount of inequity. We can tell ourselves that we can’t have a system that guarantees health care to every American because such a system would be “inefficient.” We can tell ourselves that we must accept a world in which children suffering from post-traumatic stress don’t get any help because the numbers don’t support it. We can tell ourselves that we must trust our health to insurance companies, that markets are wiser than doctors, that we can afford every technology. We tell ourselves stories and we rationalize our prejudices, and, unless we are willing to more specifically address the “social determinants of health,” as Dr. Tsou said, we will continue to drift toward a change far more substantive than anything currently under consideration in Congress, a change suited to the few who care to exert their will. It may be a revolutionary system of corporate medical control, or a catastrophic financial collapse resulting from hubristic overtreatment, or a medical crisis stemming from some seemingly minor flaw in the heuristics of the integrated delivery network, or just a further increase in the massive inequities that already disgrace our current system. Whatever that change is, though, it will in the end be defined by the passivity of a people that has sacrificed its own, dem ocratic power of large numbers on the altar of strange and unstated beliefs."
The insurance industry already recognizes that it will lose out in this sort of competition. A government-run plan will be more efficient. We already know this based on the experience with Medicare. When private insurers have competed side by side with the traditional government Medicare plan, in the absence of government subsidies, the overwhelming majority of beneficiaries opted to go with the traditional Medicare plan.
This is why the insurers are yelling that they don't want to face 'unfair' competition from a government plan. But, their complaint should be all the endorsement that the public needs to support a public Medicare-type plan. The public plan will be cheaper and better than what the private insurers have to offer. Why shouldn't the public then have this option?
"Kiefer knows. When asked about the burden of being Donald Sutherland's son, he answers, no, the burden is living up to the legacy of Tommy Douglas, his maternal grandfather. He is a man who changed the world.
Who was Tommy Douglas? He was the social democratic premier of Saskatchewan, an ordained minister partly educated in the social gospel, and partly educated at the University of Chicago, who avoided losing his leg as a young man because a doctor agreed to treat him for free. Douglas pushed through what the Canadians called Medicare - universal, free health insurance - in Saskatchewan, which was later adopted by the national government in 1966.
You think it was easy? Check the clips. The doctors in Saskatchewan went on strike for 23 days, refusing to treat patients. Their arguments were the ones we have been hearing here for decades: Most people already have health insurance, the government has no business regulating the private marketplace, and so on. The doctors lost, and the rest is history. Canada has free medical care. It's not a perfect system - show me one that is - but it must look attractive to the tens of millions of Americans who have no health coverage at all.
Is there a Tommy Douglas for America? President Obama was grooming former Senator Tom Daschle for the role, but that came a cropper. Harvard Business School health policy expert Regina Herzlinger doubts Daschle was up to the job, anyway: "He was defeated for reelection, and he never got any major legislation through." She's doesn't think his two stand-ins at Health and Human Services and inside the White House are world beaters, either: "They are not going to go down in history the way Tommy Douglas did."
"Ted Kennedy might have been able to champion some serious health care reform," Herzlinger adds. "Maybe the Senate will enact all or part of Obama's legislation as a tribute to him."
Is there an appetite for Canadian-style health coverage in the United States? I was told no. "That's a simplistic question," says James Burgess of Boston University's School of Public Health, "but the simple answer is no. In Canada they have a certain number of doctors working off a global budget. Here we have more doctors and more highly paid specialists. To control costs, we're going to have to take away somebody's income, and that will be hard.
"Politically, it's still the case that most people are happy with their coverage in the US," Burgess says. "A small number of people are really harmed by the system, but it's hard to build a populist movement around them."
Even Jon Kingsdale, executive director of our state's modestly socialized Commonwealth Health Insurance Connector Authority, thinks it is "very, very, very, very unlikely" that Canadian-style coverage will come to the United States. "It's very popular in Canada, it's cheaper, and it's simple to administer," he says of Canadian Medicare. But "it would be less well received here," Kingsdale thinks. "In other countries, people trust the government to make their lives better, but you don't get that feeling here. The premise is that the government can't be trusted to run the health care system.""
"With the U.S. economy’s downward spiral still accelerating and the federal government looking at its largest budget deficits since World War II, some are saying that this is not the time to expand health care coverage to all Americans.
But this is exactly the time for the Obama administration to move boldly on its campaign promise to implement a universal health care system.
Obama wants spending that stimulates the economy in the short term, but he also wants to reduce the long-term deficit problem after the economy recovers. This is exactly what health care reform will do.
In the short run, health care spending, like other government spending on goods and services, creates jobs and generates income. This will help arrest the economy’s downward spiral.
With the collapse of private spending, the federal government must act as the consumer of last resort – hence the vital importance of the $787 billion stimulus package that Congress passed last week. Fortunately this package did contain at least some health care stimulus. In included $87 billion for Medicaid payments to the state governments, $25 billion towards helping unemployed workers extend their employment-based health insurance after being laid off, and $19 billion for health information technology.
But health care reform would do vastly more. President Obama has proposed a reform that would, while keeping the employer-based health insurance that covers most Americans, create a public health insurance system for the 46 million that do not have insurance. Large employers would be required to either pay into this system or provide their employees with insurance that is at least as good as the federal system. Individuals without insurance could buy into the public system, and the federal government would subsidize these payments so that they would be affordable for low-income households and those without ties to the labor force.
The White House estimates that their plan would cost $50-65 billion annually, but it would be better to spend much more than this, with more federal subsidies to employers to cover uninsured workers and improve existing coverage. As big as it may seem, the $787 billion stimulus bill passed by Congress amounts to less than 2.7 percent of GDP. This is not nearly enough to counteract our deep recession: the Congressional Budget Office estimates the output gap (i.e., how much output is below the economy’s potential) at $2.9 trillion over the next three years.
Besides saving thousands of lives by providing health care to the uninsured, and supplementing the fiscal stimulus, health care reform has another huge advantage: it can drastically reduce future federal budget deficits. The vast majority of our government’s long-term shortfall is due to exploding health care costs in the private sector. These spill over to the public sector, which currently finances about half the nation’s health care costs. The United States spends about twice as much per person on health care as other high-income countries, and yet has worse health outcomes, including life expectancy and infant mortality.
The main economic reason for this colossal failure is that our system of private insurance and powerful monopolies is vastly more wasteful and inefficient than the health care systems of other developed countries. Insurance companies spend tens of billions trying to insure the healthy, avoid the sick, and deny payment for claims. Pharmaceutical companies take $350 billion of our health care dollars for drugs that cost a small fraction of that sum to produce.
The Obama health care plan won’t eliminate most of these perverse incentives and waste – eventually we will need a truly national, single-payer system like Medicare to accomplish that. But it would be a big step in that direction, creating a nearly universal insurance system and laying the foundation for a sustainable system that can contain costs.
-------------------- Mark Weisbrot is co-director of the Center for Economic and Policy Research, in Washington, D.C. He received his Ph.D. in economics from the University of Michigan. He is co-author, with Dean Baker, of Social Security: The Phony Crisis (University of Chicago Press, 2000), and has written numerous research papers on economic policy. He is also president of Just Foreign Policy. "
