Number 1. Let’s begin with the easiest first (at least as a topic): Healthcare reform. When it comes to the delivery of healthcare, of every industrialized country on earth, the US leads in only one category: COST. Save only Switzerland, minimally we spend more than twice as much per capita on healthcare than any other nation. We still well outspend Switzerland, just not twice as much. Yet, harkening to the third word in the preceding sentence, we are not “well” thereby. If anything, we are unwell; 21st is the highest ranking we achieve according to UN and World Health Organization stats.
From one and all who champion our for-profit health insurance scheme and excoriate notions of a single-payor system comes the cliché, “Medical decisions should be between the doctor and the patient.” Only in some Peter Pan world where happy thoughts are the only ones thought does this paradigm exist.
I’ve been very lucky. It’s been eight and one-half years since I last repaired to El Camino Hospital in Mountain View, California. But from August 1st, 1974 through the spring of 1998, on the average of every three years I’d have to hit the ER with a small intestine blockage. That the same surgeon treated me each time was why his name on my health insurance forms was listed as my primary care physician. We came to be on a first name basis. He once told me he’d strongly counseled his two sons to steer clear of the medical profession, when contemplating career choices. “Do you know how many hours I have to spend every day, just fighting with some insurance company clerk, for permission to treat a patient the way my training and experience recommend?”
So let’s cut the bovine excreta about physician and patient decisions, okay, and let’s get real and honest, and never, ever overlook the fact that, for insurance companies, they’ve a very vested interest in denying care whenever possible: PROFIT!
Prior to my retirement last year, for the preceding nearly 15, I was a licensed and appointed representative of all the major health insurance companies. I’m here to slap the rose-colored glasses from the faces of all the for-profit advocates. First off, 30% of every premium dollar paid by either the individual or his or her employer or shared between them buys not a single cent of healthcare. It goes directly to profit and overhead, it doesn’t even stop to say hello to the consumer. And those premiums are ghastly exorbitant: around $3,000 per person; per person, not per family. And they’re growing, and growing, and growing. Not only are they high, individual subscribers are cherry-picked. If the applicant has had a relatively serious medical condition within the past 10 years; either denied outright, or the condition is excluded from coverage. Regardless whether it’s denial or exclusion, the net effect is that that consumer — and that ranges from 25 – 50% of applicants! — hasn’t the coverage he or she needs most.
The strident wailing against a federal single-payor system, “That’s socialized medicine,” is such a simple-minded smokescreen that it shouldn’t need comment. But because we’ve all heard it ad nauseam I’m going to offer a just few “socialized” examples: the US Army, the Navy, the Marines, the Air Force, the Coast Guard, our National Parks, our entire network of streets, roads and freeways and bridges, your police department, and your fire department. Pick the very worst example of a government run service, then ponder Enron, Halliburton, KBR, Bernard Madoff, Merrill Lynch, Bank of America . . . Wall Street. Now, which costs society more while returning less, and, given that it’s going to be to a clerk no matter that it’s to a for-profit corporation or a government agency, which would you feel less comfortable appealing a medical decision to, and might there be some cost reduction if the profit element were removed?
Just my opinion, but as one who was in the industry, no system could possibly be worse than the for-profit one we’re stuck with now.
Number 2. Picture this: You’re in your 40s or 50s, you’re married or single, with three kids, all of whom depend on you for food, shelter, clothing, etc. You’ve worked for the same employer for 10, 15, maybe 20 years, and you’ve always paid your bills and your taxes. You take pride in the way you try to be responsible. But, through absolutely no fault of your own, six months ago you were laid off. Your unemployment compensation is running out, and your savings have shrunk.
Day and night you’re scared because you simply do not know what you’re going to do. You’ve applied to every place in the area for work. You’ve even looked out-of-state, and no one is hiring, everyone is laying off, cutting back the workforce they have. And not a one of your obligations — not the food or clothing for the kids, not to the institution that holds the title to your car (“Oh, my god! If they take that . . .”), not your landlord or the financial service you send your mortgage payment to — will forever forgive and forget.
You heard that the administration and congress have passed a “stimulus package,” and that within it are funds to help your state continue to provide the unemployment compensation you and your family absolutely depend on. But you live in Mississippi (or, Louisiana, or Texas, or Georgia, or Alabama, or South Carolina, or Tennessee, or Alaska, or Idaho), and your governor has said “Thanks, but no thanks” to the federal government. “It’s wasteful spending.” “It only promotes indolence.” “It will put us on the hook where we might, at some time in the future, have to raise taxes.”
Next, someone who you know is a conservative, a Republican, and you know he or she voted for your governor (TX: Perry, GA: Perdue, LA: Jindal, ID: Otter, AL: Riley, SC: Sanford, MS: Barbour, TN: Bredesen, AK: Palin). And in a conversation, that person says, “My heart goes out to you, but you know, I agree with Barbour, we can’t borrow or spend our way out of this mess. The only way we’ll solve the problem is for government to cut out all that wasteful spending, and to cut taxes.”
What thoughts do you think would be running through your mind?
Number 3. “Were it left to me to decide whether we should have a government without newspapers, or newspapers without government, I should not hesitate a moment to prefer the latter.” — Thomas Jefferson, Letter to Col. Edward Carrington, 1787.
When Madison presented his draft of the Constitution to Jefferson, to review, Jefferson told Madison that he would fight the document’s passage, unless it was accompanied by a Bill or Rights, and within said bill, the first rights would be the guarantee of “freedom of the press.” The press, so sacred to this country’s framers, was called the “Fourth Estate.”
In his novel, The Fourth Estate, Jeffrey Archer write: “In May, 1789, Louis XVI summoned to Versailles a full meeting of the ‘Estates General.’ The First Estate consisted of three hundred clergy. The Second Estate, three hundred nobles. The Third Estate, six hundred commoners. Some years later, after the French Revolution, Edmund Burke, looking up at the Press Gallery of the House of Commons, said, ‘Yonder sits the Fourth Estate, and they are more important than them all.”
As far as anyone can now tell, regardless the quote is contained in a novel, Sir Edmund Burke did indeed make the remark, and did intend it as a genuine reflection on the essential need all democracies have for a free and open press.
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