THIS IS NOW THE ONLY WEBSITE AVAILABLE ON THE ENTIRE WEB WHERE YOU CAN FIND A COMPLETE HISTORY OF THE HISTORIC HEALTH CARE DEBATE WITH ARTICLES FROM MAJOR NEWS SOURCES, LINKS TO ALL PROPOSALS & AMENDMENTS ALONG THE WAY, AND COMMENTARY FROM 100s OF SOURCES DOCUMENTING THE DEBATE, PROPOSALS, NEGOTIATIONS & VOTES FROM START TO FINISH!!!
About me: I'm a civil rights attorney with several landmark decisions improving the rights & lives of working people to my credit, a freelance writer, and a singer-songwriter (to check out my music, click here ... http://www.studioeight.tv/phpbb/viewtopic.php?t=16212 ) ... but the bottom line here is that having seen and experienced American health care at it's best and it's worst, I strongly believe that meaningful reform is absolutely necessary. Personally, I favor a single payer system to insure care for all Americans, but short of that, I find that a meaningful public option is a must for the reasons that follow. Thanks for reading! Beth Isbell
Health Care Reform & the Seven Deadly Sins
©2009 Beth Isbell
Definition: "Those who are proud of their greed and gluttony for extravagant luxuries which cause discouragement and envy in their fellow men, and are angry if their lust for such extravagance is ever questioned or threatened."
Answer: Wall Street & Health Care industry CEOs
You might recognize these as the seven deadly sins per part II of Dante's Inferno: Extravagence, Gluttony, Greed, Discouragement, Wrath, Envy & Pride. (Note, the Catholic church subsequently substituted Lust for Luxury or Extravagence, and substituted Sloth for Acedia or Discouragement). Source: Wikipedia - Seven Deadly Sins http://en.wikipedia.org/wiki/Seven_deadly_sins
Which makes you wonder why the right wing fundamentalists in our society would rather oppose health care for all & capping executive salaries on Wall Street (despite trillions in taxpayer bailouts) by supporting persons who commit these seven deadly sins as per church doctrine. What God are these fundamentalists actually supporting?
President Obama has clearly laid out some noble goals for health care reform:
Per the White House, this is what health care reform will mean to you:President Obama is committed to working with Congress to pass comprehensive health reform in his first year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans. The Administration believes that comprehensive health reform should:
• Reduce long-term growth of health care costs for businesses and government
• Protect families from bankruptcy or debt because of health care costs
• Guarantee choice of doctors and health plans
• Invest in prevention and wellness
• Improve patient safety and quality of care
• Assure affordable, quality health coverage for all Americans
• Maintain coverage when you change or lose your job
• End barriers to coverage for people with pre-existing medical conditions
Source: http://www.whitehouse.gov/issues/health_care/
Who in their right mind would not want such protections? What decent American would not want to provide this blanket of health care security to their family or make it available to their neighbor's family? So why then is there so much opposition to the President's plan?• No Discrimination for Pre-Existing Conditions
Insurance companies will be prohibited from refusing you coverage because of your medical history.
• No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays
Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
• No Cost-Sharing for Preventive Care
Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
• No Dropping of Coverage for Seriously Ill
Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
• No Gender Discrimination
Insurance companies will be prohibited from charging you more because of your gender.
• No Annual or Lifetime Caps on Coverage
Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
• Extended Coverage for Young Adults
Children would continue to be eligible for family coverage through the age of 26.
• Guaranteed Insurance Renewal
Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
Source: http://www.whitehouse.gov/health-insura ... otections/
It seems to me that all opposition stems from two factors: (1) cost, and (2) fear. And, if we're honest about it, most of the cost objections voiced by opponents so far, are at least in part, also based in fear.
If cost is only measured by increased governmental expenditures in the short term to cover subsidies to help poor and middle income families obtain coverage, then the critics may have a point. But it seems that costs, from my perspective, and likely yours, should consider that with a public option in place individuals and families will have to spend the same or likely less out of pocket to obtain satisfactory health care. President Obama has promised "We'll cut the cost of a typical family's health care by up to $2,500 per year." That's you and me, our pockets, our costs. When considered from the family perspective, rather than solely that of government expenditures, each family wins.
Per NPR, 34 million people who are currently without insurance will also be able to obtain decent coverage (unless health insurance lobbyists succeed in gutting the bill by putting in ridiculously high deductibles or exclusions for coverage to lower pubic costs by jeopardizing public health). The reality is that if you are insured, or if you pay taxes, you pay to fund emergency room programs and clinics that provide these uninsured Americans health care right now through higher premiums or higher taxes, or perhaps through charitable contributions you choose to make. It's obvious by their massive profits and mega-seven figure CEO salaries that the health insurance and drug company executives are not absorbing all this free uninsured emergency health care under their current system. They find ways now to push these costs off on the government or to have you or I or our neighbors foot the entire bill.
Importantly, the current system is emergency based. Unless you are lucky enough to be able to afford comprehensive health care, you don't seek health care except for emergencies and the most serious issues. Under the Obama plan, the focus would shift to preventative health care. By allowing families and individuals to have routine check-ups covered, encouraging pro-active follow-up by medical providers, and affording care at the earliest onset of a problem, long-term medical costs will be drastically reduced. The incidences of terminal cancer, and other terminal or life-threatening or major medical conditions, which are by far the most expensive to treat will be substantially reduced. If you're grandmother suspects that the mole on her face is cancerous, she would be able to get it checked out and treated early, rather than having to wait for her face to fall off & have the cancer spread through her system before even seeking treatment in the emergency room. Which option do you think costs you or society in general more? These same Americans will also be able to continue working and thus, continuing to pay taxes, rather than draining resources to pay for catastrophic care. So prevention will have the direct effect of ultimately lowering average healthcare costs and increasing future tax revenues, factors which the insurance lobbyists, & even the CBO's report, ignore.
Further, in his recent speech to the American Medical Association (AMA), President Obama said he had spelled out $950 billion worth of budget cuts and tax increases over the next 10 years -- an amount, he said, that takes "us almost all the way to covering the full cost of health-care reform." Even if the estimated costs of of subsidies under the plan turn out to be more, this is still a significant payment toward the overall projected costs of his plan. Long-term, as discussed above, prevention will save lives and money, and improve our overall health.
We should also consider that the cost of doing nothing and keeping the current system in place is considerable. Medical costs are skyrocketing. Many families and individuals are being denied or dropped from coverage. Per NPR, premiums to keep the same medical insurance plan in place have increased 3-4 times faster than wages annually. In a recent interview on Bill Moyers' journal, a former high ranking executive from the health care insurance industry, said that one thing is responsible for these increased consumer costs: greed. He said these companies are not driven by the need to help patients (i.e. you and me), but the need to line shareholders and executives pockets with increased dividends and excessive revenues. (Interview with Wendell Potter, http://www.pbs.org/moyers/journal/07312009/watch.html)
Moyers recently interviewed Marcia Angell, who was the first female physician ever to be named editor-in-chief of the New England Journal of Medicine and currently a professor at Harvard Medical School, and Trudy Lieberman director of the health and medical reporting program at the Columbia School of Journalism was particularly poignant. Their discussion was fascinating and so I have included most of it below, and you can watch the original interview here: http://www.pbs.org/moyers/journal/07242009/watch.html
As Potter, LIeberman and Angell discuss the strategy of the health care insurance industry is to bread fear. Fear of that under a public option care would be rationed, fear that government interference will restrict the cures and treatments you can receive, and which doctor you can see. (Fears that, by the way, have not borne out under medicare or medicaid, which are also run by the government). These "fears" are all written word for word by insurance lobbyists and handed to Senators, Congressman and Republican party officials who are being fed millions and millions in contributions by the health care industry because they fear what a public option might do to their profits. Not how it might improve your health, but only how it might affect their bottom line. Industry lobbying reports consistently show that the health care industry lobbyists are spending $1.5 million per day to prevent the public option and essentially gut any meaningful reforms.MARCIA ANGELL - [President Obama] was right in his press conference, when he talked about cost as the central issue. And he said, if we don't control cost, not only will the health system continue to disintegrate, but it'll drag the whole economy down with it. What he has essentially advocated is throwing more money into the current system. He's treating the symptom and he's not treating the underlying cause of our problem. Our problem is that we spend two and a half times as much per person on health care as other advanced countries, the average of other advanced countries. And we don't get our money's worth.
* * *
TRUDY LIEBERMAN - I feel the American people need to know what is in that bill. And what's in the bill is an individual mandate that is going to require all Americans with a few exceptions, to carry health insurance. And that means if you do not get insurance from Medicare or Medicaid or your employer. You're going to have to go out and buy health insurance. And that is a lot of money for most people because most of them would buy it now if they could afford it. About 85 percent of the uninsured require subsidies, because they can't afford it. And I think this is going to come up as a big surprise to people to realize they're going to have to buy insurance from private insurance companies or face a tax penalty.
* * *
MARCIA ANGELL - Well, that goes to the cause of the problem. We are the only advanced country in the world that has chosen to leave health care to the tender mercies of a panoply of for-profit businesses, whose purpose is to maximize income and not to provide health. And that's exactly what they do. So, now he says, okay, this is a terribly inefficient, wasteful system. Let's throw some money into it.
* * *
MARCIA ANGELL: [The current proposed bills] Delivers to the private insurance industry a captive market.
BILL MOYERS: By the mandate.
MARCIA ANGELL: By the mandate.
BILL MOYERS: It says "Marcia Angell, you've got to--"
MARCIA ANGELL: For whatever price they want to charge. Right. And so, this will increase costs. And let me tell you what he's running into, and he'd like to be able to pull a rabbit out of the hat, but he won't be able to. If you leave this profit-oriented system in place, you can't both control costs and increase coverage. You inevitably, if you try to increase coverage, increase costs. The only answer, the only answer, and he said it at the beginning of his press conference, is a single payer system. In his first sentence, he said, that is the only way to cover everyone.
BILL MOYERS: But he's also said, if we were starting the system from scratch, we could have single payer. But we're not starting this system from scratch.
MARCIA ANGELL: You know, you don't pour more money into a failing system. You convert.
TRUDY LIEBERMAN: It will be a bonanza for the health insurance industry. And a bonanza for the pharmaceutical industry. And for the doctors, too. Because the doctors are going to get more paying patients, because people will now have this ticket, this insurance card, that they can whip out when they need medical services.
MARCIA ANGELL: Well, they can charge whatever they want. That there will be no bargaining. That--
TRUDY LIEBERMAN: Medicare.
MARCIA ANGELL: That Medicare Part D will not bargain for lower prices. There'll be no formularies. You know, even this thing about the pharmaceutical industry is going to kick in $80 billion over ten--
BILL MOYERS: Have we heard--
MARCIA ANGELL: --years. That the President mentioned in the press conference.
TRUDY LIEBERMAN: Only if health care passes. So.
MARCIA ANGELL: First this is $8 billion a year for the pharmaceutical industry. This is chump change. And second, it's only for brand-name drugs. So, in a sense, it's a subsidy for the most expensive drugs.
BILL MOYERS: Do you believe the health care industry when it tells President Obama that "we will voluntarily cut costs"?
MARCIA ANGELL: No. I mean, these are investor owned businesses. If they behave like charities, heads would roll in the executive suites. They are there to maximize profits. And that's exactly what they do.
TRUDY LIEBERMAN: What's happened now is that the industries have gotten pretty much what they want out of the bills that are going forward.
And so, they need to build public support. They need to make everybody in the public realize that they actually are wearing white hats in this one. But behind the scenes, they are lobbying ferociously against the public plan, against cuts in doctors fees, against all kinds of things that they don't want. And for that they're using a different sort of lobbying tactic. All of these are communications or lobbying strategies that they know how to do and they are very excellent at doing them.
MARCIA ANGELL: It's clear that they can turn it to their advantage.
TRUDY LIEBERMAN: Right.
MARCIA ANGELL: That nobody is really trying to break their-- except the single payer people -- their death grip on the system. And here you have hundreds of for profit insurance companies that maximize their income by denying care to the people who need it most. And that's the insurance system. That's how we pay for health care.
But you also have to look at how we deliver health care. And we deliver that, primarily or largely, in for-profit facilities -- businesses, hospitals -- whose interest is in delivering only profitable care. So, we have a system that's through and through, in both the payment system and the delivery system, is oriented toward profits. Neither the Senate nor the House is doing anything to change that.
BILL MOYERS: The President says there will be a public option in my bill that will compete with the private insurance. To bring the cost down.
TRUDY LIEBERMAN: That's--
BILL MOYERS: That's what he said.
TRUDY LIEBERMAN: That's what he says. Again, we get back to the detail question and the particulars, which are so absent in this whole discussion. We don't know what a public plan will look like. And even if there's going to be a public plan. The insurers don't want it. It's not clear that the doctors want it. And the pharmaceutical companies don't want it.
So my question is, are they working behind the scenes to make sure this doesn't happen? My guess is-- my answer is, they probably are.
MARCIA ANGELL: A lot is said about how the public wants to cling to what it has. What I'm finding is something that confirms the polls that have been done. Showing that something like two-thirds of the public would favor a Canadian style or a Medicare for all style single payer system.
The same is true of physicians, now. About 60 percent of physicians favor Medicare for all, or a single payer system. So, what is against it? The pharmaceutical and the insurance industries are the biggest lobbies in Washington. They spend millions and millions on influential members of Congress. And the amount that they are spending now to the Chairman of the relevant health committees has increased enormously in the past few months.
BILL MOYERS: Just the other day the Chamber of Commerce began running an advertising campaign. And the Chamber says a new government run plan will undermine employer sponsored coverage and eventually lead to a government takeover of the health care system.
MARCIA ANGELL: Like Medicare.
BILL MOYERS: Alright. That will limit--
MARCIA ANGELL: That's scary.
BILL MOYERS: That will limit patients' choices. I mean, isn't that proving to be a convincing argument with the public? That seems to be--
MARCIA ANGELL: Well, it's phony, of course.
BILL MOYERS: Phony?
MARCIA ANGELL: It's phony, in the sense that Medicare is a single payer system, embedded within our larger market-based system. You have totally free choice of a physician in Medicare. You don't in most employer-sponsored private plans. Canada, totally free choice of doctors. So, this is simply not true.
BILL MOYERS: Let me show you both a couple of clips from the House floor recently. And get your comments on them. These are two Congressmen who are opposed to any kind of national insurance or general coverage. Look at this.
REP. STEVE KING: They're going to save money by rationing care, getting you in a long line, places like Canada and the United Kingdom and Europe. People die when they're in line.
REP LOUIE GOHMERT: One in five people have to die because they went to socialized medicine! Now I've got three daughters and a wife. I would hate to think that among five women, one of them is going to die because we go to socialized care and we have to have these long lists to get a mammogram. Once you find it to get treatment. It's insane.
TRUDY LIEBERMAN: We've heard these arguments since 1948. And what amazes me -- they opposed a national health system under President Truman. So, that notion, that conventional wisdom in America is pretty ingrained and pretty deep. What they fail to say here is that people are waiting in line in America. We ration care in America. We do it by income. People who don't have money and the ticket to health care, do not get the care.
So that rationing is taking place. But even people who do have insurance are waiting months for mammograms. In Florida, there's been a horrible shortage of places where women can go and get mammograms. And most people have to wait a long time to get an appointment with a doctor for an annual physical.
MARCIA ANGELL: If we continue to spend what we do, right now, on health care, but had a system that distributed it according to medical need, there would be no rationing. And if we held it at that cost, there would never be any rationing. So, it's simply not right. The problem is not the money, it's the system. There is more than enough in the system already. And that's why I don't think it's a good idea to pour more money into a dysfunctional system.
Obama said, in his press conference, the worst thing we can do is nothing. The most costly thing we can do is nothing. Now, I disagree with that. You can throw more money into this system and make it even more costly. But in a sense, we are at a point now, where we have to act. And we have to confront the private insurance industry directly.
BILL MOYERS: Do you see any evidence that the President wants to do that?
MARCIA ANGELL: No, no. But--
BILL MOYERS: Is willing to do that?
MARCIA ANGELL: But what I would say this time around, and now I am going to be very pessimistic, Bill. This time around, I don't think it's going to happen because of the power the pharmaceutical and insurance lobbies. I don't think it's going to happen. But I would rather see Obama go down fighting for something coherent and practical that the public could mobilize behind, than go down fighting for this amorphous plan that tries to keep these private insurance industry in place.
BILL MOYERS: It seems to me like they're more finessing than fighting.
MARCIA ANGELL: Well, he will have to fight. But I think he'll go down.
TRUDY LIEBERMAN: They've been finessing since the very beginning. They've been finessing since the campaign. During the campaign, he was not even willing to be pinned down. He had a whole list of things that he would like to do. But so did Hillary Clinton and John McCain. And in some ways, they really weren't all that far apart, except on the issue of long term care.
That is another time bomb that is awaiting America and nobody has talked about it. But aside from that, I see an Administration that is trying to keep this playbook going as long as possible. And to commit as little as possible until the 11th hour. And by then, it's going to be too late for the American people to know what's going to await them. And as a journalist, whose job it is to explain to the average person on the street what all of this means to them-- that's not happening. And as a journalist, that troubles me. The press has not dealt with the issue of how this is going to affect the auto mechanic on Main Street. Or the babysitter. Or--
MARCIA ANGELL: We don't know what this is.
TRUDY LIEBERMAN: But we know the outlines enough. We know about the individual mandate. We sort of know that if there's a public plan, it might be this tiering arrangement that has a bronze, silver, and gold kind of arrangement. And you can pay more if you have more. Which still perpetuates the problem that we have. We know enough so that journalists can write the story.
BILL MOYERS: Do I hear you both saying, in effect, what Bill Kristol, the Republican strategist said this week? "Kill this bill. Kill this proposal that Obama is pressing and start over?"
TRUDY LIEBERMAN: Well, not in fact.
MARCIA ANGELL: Not exactly.
BILL MOYERS: You're hesitating.
MARCIA ANGELL: I'm hesitating. Because I don't think he's grasped the nettle. And I don't think that even the best of the proposals that he is considering are going to be effective. And I worry about even the public option, because--
BILL MOYERS: You've been skeptical of the public option.
MARCIA ANGELL: I'm skeptical of that, because the power of the insurance industry is so great that I believe that they would use their clout in Congress to hobble the public option in some way. And have it become a dumping ground for the sickest patients, and then cream off the profitable ones for themselves. And then what people would decide is that the public option was no good. That the public couldn't do any-- the government couldn't do anything right. And that would be the wrong lesson to dwell on.
TRUDY LIEBERMAN: That's what some people fear will happen to Medicare. That it will be privatized in some way, to deal with--
MARCIA ANGELL: Well, Part D.
BILL MOYERS: Part D is...
TRUDY LIEBERMAN: --and only the sickest people will remain in the Medicare pool of people, who get benefits. I want to go back to Kristol's argument. And what he well, we sort of know what the conservative plan might look like. It's basically a market-based approach that would rely on private insurance but also on what is a relatively new kind of insurance arrangement called "consumer-driven health care."
And by that we mean policies that have very high deductibles. I've seen some being sold, by some of the Blue Cross plans, as being $20 thousand deductibles. And $40 thousand if you go out of network. So, is that really insurance? And are people going to be buying these, because they will be affordable, because the higher the deductible, the cheaper the policy. And so then what's going to happen to them when a serious illness strikes, and they have to cough up the money? They're not going to have it. So, this whole issue of underinsurance, which is kind of tied in with the conservative approach, hasn't even been discussed.
BILL MOYERS: Given what you've said, why the rush? Why not slow this down and give this very big issue more due deliberation?
TRUDY LIEBERMAN: It's really a political calculation. And I think that they believe that they have to act quickly, because it might not happen. Because the sooner you have the special interests going back home, during the August recess and holding town hall meetings and talking to people in coffee shops, they're going to find that maybe this isn't something that people really want or have doubts about.
MARCIA ANGELL: Well, I think we are in a hurry. I think that President Obama's worried, that what happened with the Clinton plan can happen with him. And I do have a feeling of déjà vu all over again. That this is like 1993. That the opposition is having a chance to mobilize. To march out these Canadians who say they had brain tumors and had to die. Or these ads that say 20 percent of Europeans drop dead.
TRUDY LIEBERMAN: And Harry and Louise are back
MARCIA ANGELL: And I think he does. He is right to worry about that. And he is right to want to do it in a hurry. The problem is he is not doing the right thing.
BILL MOYERS: Because?
MARCIA ANGELL: Well, the plan is not for all the reasons we've said. It leaves the bad guys in place. And it tries to kind of make concessions. And what the Clintons found out is they too wanted to keep the private insurance industry at the table. And maybe regulate them a little. And what the private insurance industry decided was, "Why should we take half a loaf when we can have the whole thing?" And that's what I'm seeing happen. Happening now.
TRUDY LIEBERMAN: We are having the same debate, almost, that we had in '93-'94. And it's something I've written about for the Columbia Journalism Review. It's actually the same debate we've had decades before. And it's the unwillingness to look at what we could learn from other systems. Single payer, multiple payers, as they have in Germany and Japan. Or even in the Netherlands, where there are private payers. What's really happening there?
So, I think there's an unwillingness on the part of politicians-- on the part of advocacy groups, some advocacy groups, to really educate Americans on what the possibilities are. And we at C.J.R. have been saying we really have not had a vibrant discussion about other possibilities.
MARCIA ANGELL: I think we have to start all over on this. I really do. I think we have to go for a single payer system. You could institute that gradually. You could do it state by state. You could do it decade by decade. You could improve Medicare. That is, make it nonprofit. But extend it down to age 55 and age 45 and age 35. It would give the private insurance industry a chance to go into hurricanes, earthquakes or something. To get out of the health business. It could be done gradually. I think that has to be done. And it's the only thing that can be done.
Source: Bill Moyers' Journal, Transcript of July 24, 2009 show http://www.pbs.org/moyers/journal/07242009/watch.html
We cannot continue, for our sake or the sake of our children and their children, to let these greed driven monied interests hold the health of American citizens hostage. We should be ashamed as Americans that other countries provide better care for all their citizens for less money. If other countries can enact viable cost effective solutions to provide preventative and meaningful health care, why can't our government? The answer is greed. Profit driven companies that have a death grip on the system and will spend billions to make sure that it stays that way.
Author's note: This article was too big to post in it's entirety, so it is continued in the Replies below
) is available the public system of dispensarios and hospitals (some admistrated by the city and others by the province govermnent).
