Here's are two short excerpts. The finance sector's increasing concentration and growing political muscle have undermined the traditional American understanding of the difference between free markets and big business. This means not only that the interests of finance now dominate the economic understanding of policymakers, but also — and perhaps more important — that the public's perception of the economic system's legitimacy is at risk.
... It is no coincidence that shortly after bashing Wall Street executives for their greed, the administration set up the most generous form of subsidy ever invented for Wall Street. The Public-Private Investment Program, announced in March by Treasury Secretary Timothy Geithner, provides $84 of government-subsidized loans and $7 of government equity for every $7 of private equity invested in the purchase of toxic assets. The terms are so generous that the private investors essentially receive a subsidy of $2 for every dollar they put in.
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Humans clearly attend closely to status, an important part of status is dominance, and a key way we show dominance is to tell others what to do. Whoever gets to tell someone else what to do is dominating, and affirming their own status. But we are also clearly built to not notice most of our status moves, and so we attribute them to other motives. And as long as we are making up motives, we might as well make up the most admired of motives, altruism. --Robin Hanson
Let me begin by saying that I don't have any desire to be arrested. I am a pediatrician with 3 teenagers and a husband who would prefer that I do not spend time in jail. I have never actually spent the night in jail and I imagine it’s not very pleasant. To be honest, I am a bit frightened. But, I expect that these are normal feelings and I am dedicated to act despite my reservations because there comes a time when our conscience dictates that we act. That time is now (or "way past now" as doctors and patients whom I've met in my travels have told me).
In short, I am going to be arrested because I believe that it is my professional responsibility to advocate on behalf of those patients who are suffering and because it is clear that traditional advocacy tools are not working. The phrase that runs continuously through my mind is "To be silent is to be complicit." I cannot be complicit in the face of an industry that profits at the cost of human lives and in the face of an administration and Congress that are too dysfunctional to stop this practice.
I left practice more than 2 years ago to advocate for health reform. This year I traveled on a particularly unexpected and eye-opening journey. In January, I celebrated the inauguration of a new President who I hoped would be the agent to create real change in America I hoped we would see changes that benefited the people of America (more than the corporations). I joined the steering committee of the Leadership Conference for Guaranteed Health Care because I believed that if we built the grassroots movement for real health care reform: a national publicly-financed health system that was truly universal and accountable, Medicare for all, then we would provide the political cover so that the new administration and the Congress could pass it, or at the very least discuss it. I believed when the administration said that it wanted to hear from the Americans, that we would actually have a debate about how to improve health care in this nation.
Early in the year, I lobbied with many other members of the LCGHC who represented health professionals, patients, labor and faith groups. We had two simple requests: include advocates of single payer Medicare for all in the hearings and do an economic study of single payer legislation so that it could be compared to the plans being put together in Congress. We were assured by members, such as Majority Leader Steny Hoyer, that this would happen. However, before long, we saw quotes from the leadership that essentially said all options were on the table except single payer. Ever the optimist, I thought this was simply a signal to work harder. "OK," I told myself, "they aren't going to make this easy. No surprise there."
We continued to meet with members, we pressured the White House to invite single payer representatives to the Health Summit in March (which they did) and we continued to reach out to organizations to join our movement.
We thought the health care debate would include the stakeholders (health providers and patients), but found that only the stockholders were invited to the table. When it came time for the first series of public hearings on health care, which were held in the Senate Finance Committee, we requested that one single payer advocate be included with the 41 other witnesses (many of whom represented the private insurance industry, pharmaceutical corporations and big business). Despite thousands of calls and emails from across the country, our request was denied. That is when it became clear that we would have to use stronger tools. On the day of the second hearing, May 5th, 8 of us traveled to Washington to attend the hearing. As it began, we stood up one by one and requested a seat at the table. And one by one we were arrested to the sounds of nervous laughter from the members of the committee and audience. It reminded me of a quote from Gandhi, something like "first they ignore you, then they laugh at you, then they fight you and then you win." We returned the following week with nurses and more people were arrested in the committee. This time there was no laughter. I guess that meant we were on to phase three: the fight.
I was invited shortly afterwards to testify before the Senate Health, Education, Labor and Pensions Committee. In fact, I was the first of 24 people to testify there. I was shocked to hear other members of the panel give poor or misleading information to the committee. I wondered why we weren’t required to testify under oath.
For decades, I and other health providers have found it more and more difficult to provide quality health care. The private insurance industry has placed more and more obstacles in the way of providers and patients in the forms of co-pays, deductibles, networks, uncovered services, the need for authorization, pre-existing conditions, rescissions, rapidly rising health insurance premiums, etc. And we, the doctors and patients, have done our best to comply with the complex and confusing maze of requirements. We’ve seen medicine turned into a business rather than a healing art. Patients have become consumers and health care has become available only to those who could afford it or were eligible for government programs. Doctors have become frustrated and started leaving practice or opening "boutique" practices.
I traveled with a group of physicians this summer who drove across the country to speak about health reform (see www.madashelldoctorsvideo.com). The level of desperation we encountered was tremendous. Many of the doctors I spoke with said things like, "well, up until about five years ago I could still get care for my patients, but now, I can't." We heard stories of people fired because they or a family member became ill, people who delayed tests or medications due to costs who subsequently died of preventable causes or ended up in the intensive care unit and people leaving the country to have surgery or treatment done in Mexico or Canada where they could afford it.
For decades, legislators at the state and federal levels have tried incremental health reform. I have heard legislators and health advocates say that they are "diehard incrementalists" or "political pragmatists". Despite patchwork efforts to expand Medicaid, provide tax credits or subsidies towards the purchase of private insurance or to provide competing public insurances, the number of uninsured and underinsured has continued to grow. The cost of health care in this country has increased faster than wages, inflation and the GDP. How practical is it to keep trying the same thing and expecting a different result?
We, as a nation, have put off the fight we know we will have to wage if we want real health reform. The fight is against the market model of health care and the foe is formidable. The medical-industrial complex has billions of dollars and strong influence over the politicians. The revolving door between the M-I complex and the Congressional staffers is spinning so fast that it is hard to keep track. For instance, Liz Fowler worked for Sen. Baucus, then became Vice President of Public Policy for Wellpoint (one of the largest health insurers) and then returned to the Senate Finance Committee this year to oversee the legislative process for the health bill. There are 6 health insurance lobbyists for each member of Congress and at least 350 of these lobbyists were former staffers. The industry is spending around $1.4 million each day on lobbying.
We are the only industrialized nation to use this market model for health care and it has failed to be either universal or affordable for a very simple reason: the business of private health insurers is to make a profit for their investors, which is done by charging high premiums, avoiding the sick and restricting and denying payment for care. Decisions are made based on what is best for the bottom line, not the health of the patient.
The United States ranks at the top in only one area when it comes to health care and that is for how much we spend. We spend twice as much or more per person than any other industrialized nation and for that we are ranked 37th in the world on health outcomes. We have high infant and maternal mortalities, growing health disparities and low life expectancy. The other industrialized nations guarantee health care to almost everybody living on their soil. We leave at least 46 million out entirely and have millions more who are insured but unprotected and so they lose their home or go bankrupt trying to pay for needed health care. We rank the highest of the top 19 industrialized nations for the number of preventable deaths, estimated at 110,000 per year in 2007.
It doesn't have to be this way. We have a model that does work for the population it serves, those 65 years of age and over and the disabled. It is traditional Medicare. Medicare is already nationwide. It finances health care with a very low overhead (3% instead of the 31% spent on private insurance) and allows doctors and patients to make medical decisions without jumping through numerous hoops (like private insurers do). The politicians know this, but they try to shut it out because adopting Medicare for all means giving up those generous campaign contributions.
There comes a time when we must ask ourselves if we can continue to delay doing what we know is right. Can we be silent and allow thousands of our fellow Americans to die each year? Is it acceptable to close our eyes and pretend we don't see because we may believe that we have "good insurance"?
A dear friend recently wrote a song about the health care situation that contains the question "Isn't this America?" And I ask the same question. If we are spending the most, why aren't we trying to be the best? Or at least in the top ten? Why aren’t fiscal conservatives demanding that we spend our health care dollars wisely to get the most health for our dollars? A national single payer health system, such as Medicare for All, is civilized medicine. It is what civilized societies do for their people. It allows people the freedom to go to school, change jobs, open their own businesses, and provide for their families without the stress of worrying about losing everything if they become ill.
I have decided to join other doctors and citizens in the mobilization for health care reform - a nationwide coordinated nonviolent civil disobedience campaign for Medicare for all. As we saw in other social justice movements such as women's suffrage and civil rights in the 1960's, change will not come unless we take a stand. There are some who disagree with or do not understand the purpose of nonviolent civil disobedience. To me, it is clear that this is the path we must take in order to overcome the stranglehold the medical-industrial complex has on our nation. Other methods have failed. We cannot wait. The number of people suffering and dying in this nation every day is unacceptable.
I do this reluctantly but with resolve for those who would like to act but cannot. We will ask to speak with insurance company CEOs and we will demand that they stop denying care and influencing members of Congress. We will spread the message of Medicare for all to the public. I hope that others will join and support the campaign in whatever way they can. The website is www.mobilizeforhealthcare.org. There is still an opportunity to get real health reform if enough of us take action.
Margaret Flowers, M.D., Congressional Fellow, Physicians for a National Health Program.
Originally published at AfterDowningStreet.org
The United States ranks at the top in only one area when it comes to health care and that is for how much we spend. We spend twice as much or more per person than any other industrialized nation and for that we are ranked 37th in the world on health outcomes. We have high infant and maternal mortalities, growing health disparities and low life expectancy. The other industrialized nations guarantee health care to almost everybody living on their soil. We leave at least 46 million out entirely and have millions more who are insured but unprotected and so they lose their home or go bankrupt trying to pay for needed health care. We rank the highest of the top 19 industrialized nations for the number of preventable deaths, estimated at 110,000 per year in 2007.
I don't see how that could be right, Rollie! Cripes, a large and important industry group just today reported that gov't health insurance would be more expensive for policyholders, and give less money to providers, thus worsening care.
I mean, who are you going to believe, anyhow? Patriotic supporters of freedom or anti-Constitution, wasteful, power-hungry bureaucrats?
Last edited by walto; October-29th-2009 at 05:25 PM.
You are right, Walto. Margaret Flowers is the Cindy Sheehan of the health care debate. You can't believe a word she says. And deserves all the derision she receives for her position on single payer.
A national single payer health system, such as Medicare for All, is civilized medicine. It is what civilized societies do for their people. It allows people the freedom to go to school, change jobs, open their own businesses, and provide for their families without the stress of worrying about losing everything if they become ill.
This is one heroic woman! I totally agree with what she's implying here - i.e. that in many respects the U.S. is not a civilized society. The Dog Eat Dog mentality that prevails there would be laughable were it not so tragic.
Frankly, the nations of Europe look on helplessly, torn between scorn, amusement and pity, at shit like this.
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‘Perhaps it doesn’t understand English,’ thought Alice; ‘I daresay it’s a French mouse, come over with William the Conqueror.’
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
Reproducing the whole thing because the ads are brutal. I hope AP doesn't embed any here; I tried to strip them out.
The headline refers to the House bill, which could be voted on "as early as this weekend."
November 4, 2009 [about 7:30 P.M. ET]
AP Sources: Dem Health bill to get AARP backing
By ERICA WERNER and RICARDO ALONSO-ZALDIVAR
Associated Press Writers
In a coup for House Democrats, AARP will endorse sweeping health care overhaul legislation headed for a history-making floor vote, officials told The Associated Press on Wednesday.
An endorsement from the seniors' lobby was critical when then-President George W. Bush pushed the Medicare prescription drug benefit through a closely divided Congress in 2003. House Democratic leaders are hoping it will work the same political magic for them as they strive to deliver on President Barack Obama's signature issue.
An announcement from the 40-million member group is expected Thursday, said officials with knowledge of the group's decision. They spoke on condition of anonymity because the endorsement is not official yet.
Backing the 10-year, $1.2 trillion House bill is a tricky move for AARP. Many retirees are concerned about cuts in Medicare payments to medical providers, which will be used to finance an expansion of health insurance coverage to millions of working families who now lack it. Also, AARP says its membership is about evenly divided among Democrats, Republicans and independents, meaning its endorsement in today's highly politicized atmosphere could anger many members.
Floor votes on the House bill could come as early as this weekend. Obama planned to visit the Capitol on Friday, according to congressional officials. They spoke on condition of anonymity because the meetings have not been announced.
Asked Wednesday if Democratic leaders had the 218 needed for passage, House Majority Leader Steny Hoyer, D-Md., responded: "We're counting. We're counting."
House leaders moved on Wednesday to shore up support for the measure among the Democratic rank-and-file, even as they sharpened their fight with the health insurance industry.
Last-minute changes to the legislation, released late Tuesday night, started a 72-hour legislative clock and cleared the way for votes as early as Saturday.
In a move aimed directly at health insurance companies, the revised House bill would launch a federal-state crackdown on what it terms "unjustified premium increases." Insurers have sought above all to block creation of a government insurance plan, which happens to be the top legislative goal for liberals.
Under the bill, insurance companies would have to publicly disclose the justification for premium increases before they go into effect. The federal Health and Human Services department would monitor patterns of premium increases, and could take action if the price hikes are out of line. The bill would also provide $1 billion to state insurance commissioners, allowing them to ramp up their own enforcement.
Democrats also strengthened a provision that would strip the industry of its decades-old exemption from federal antitrust laws.
Supporters said the tougher approach is needed to keep insurance companies from artificially boosting premiums in advance of the major reforms taking effect in 2013.
Other late changes to the bill, such as enhanced status for the government's office of minority health, were intended as sweeteners for supportive lawmakers, including members of the Congressional Black Caucus.
With no Republican backing for the measure, Democrats will need overwhelming support from their own. A festering intra-party disagreement over how to prevent federal funds from being used to pay for abortion remained unresolved Wednesday morning.
The House bill is estimated to expand coverage to about 96 percent of eligible Americans. Beginning in 2013, it would provide government subsidies to extend coverage to tens of millions who now lack it, and ban insurance company practices such as denying coverage to people with pre-existing medical problems.
For the three years before the federal aid starts flowing, the bill would set up a temporary "high-risk pool" through which people who have been denied coverage because of poor health could obtain a government-subsidized policy.
The bill would set up health insurance "exchanges" through which self-employed people and small businesses could buy coverage, either from a private insurer or a new government plan that would compete. All the plans sold through the exchange would have to follow basic consumer protection rules, making it easier to shop and compare among them.
The majority of middle-class Americans covered under big employer plans would not see dramatic changes. But coverage for the poor through Medicaid would be significantly expanded.
Seniors in traditional Medicare would get improved preventive benefits. Also, the prescription coverage gap known as the "doughnut hole" would be gradually closed. However, seniors signed up for private insurance plans through Medicare could lose some benefits, as the bill scales back extra payments that the plans have been getting.
In addition to raising money by cutting payments to hospitals and other medical providers, the House bill boosts taxes on upper-income earners. Democrats also moved Tuesday to close a biofuel tax credit loophole, raising about $23 billion to help pay for the legislation.
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Associated Press writers David Espo and Alan Fram contributed to this story.
Last edited by bluenoter; November-4th-2009 at 11:07 PM.
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
November 5, 2009
Op-Ed Columnist
Unhealthy America
By NICHOLAS D. KRISTOF
The moment of truth for health care is at hand, and the distortion that perhaps gets the most traction is this:
We have the greatest health care system in the world. Sure, it has flaws, but it saves lives in ways that other countries can only dream of. Abroad, people sit on waiting lists for months, so why should we squander billions of dollars to mess with a system that is the envy of the world? As Senator Richard Shelby of Alabama puts it, President Obama’s plans amount to “the first step in destroying the best health care system the world has ever known.”
That self-aggrandizing delusion may be the single greatest myth in the health care debate. In fact, America’s health care system is worse than Slov—er, oops, more on that later.
The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland.
The Health Care Disaster in Canada
Dick Morris and Eileen McGann
Wednesday, November 04, 2009
After more than a decade of public health care with mandatory coverage, so many Canadian doctors have left the practice and so many young people have entered other fields that Canada ranks 26th of 28 developed nations in its ratio of physicians to population. Once, Canada ranked among the leaders in the number of physicians -- but that was before government health care drove doctors out of the practice in droves.
The fundamental fact is that we cannot cover 36 million new patients without more doctors and nurses, much less with the declining census of medical professionals the Canadian experience points to.
A recent survey of doctors by the Pew Institute found that 45 percent of all practicing doctors would consider retiring or closing their practices if the Barack Obama health care bill passes. This scarcity of medical personnel heightens the likelihood of draconian rationing, lengthy waiting lists and lower quality medical care for all of us, particularly for the elderly.
This physician shortage leads to massive and never-ending waiting lists. In 1993, for example, there was an average wait of 9.3 weeks from the time a patient got a referral from a general practitioner to the time he could see a specialist in Canada. By 1997, the wait was up to 11.7 weeks. Now it's 17.3 weeks -- over four months just to see a specialist!
In Canada, unions control the entire health care process. In Manitoba, for example, there is an eight-month wait for colonoscopies, yet the unions do not permit weekend or evening procedures, thereby extending the waiting lists.
The unions are doing to health care in Canada what they have done to education in America -- stifling creativity, reinforcing bureaucracy and extending waiting times.
Because of these long waits for colonoscopies, there is now a 25 percent higher incidence of colon cancer in Canada than in the United States. And, because the leading drugs that we routinely use to treat the malady in the U.S. are banned in Canada because of their high cost, 41 percent of Canadians who get the cancer die of it, compared with only 32 percent in the United States. Overall, the cancer death rate in Canada runs 16 percent higher than in the United States. Cancer does not wait for waiting lists to clear.
The potential of health care changes to shrink the doctor population, exacerbating scarcity and extending waits, is even worse now that it is apparent that we have overestimated the number of doctors in the U.S. Where we once thought there were 840,000 doctors, the total is now estimated to be only 760,000.
The proposed $400 billion cut in Medicare raises the probability that more and more of those doctors who do practice will refuse to accept Medicare patients, aggravating the doctor shortage among the elderly, the population that needs them the most.
As Obama's program moves through Congress, despite the fierce opposition of a majority of American voters in virtually all the polls, it becomes clear that those moderates who vote for it will face harsh retribution at the polls from their outraged constituents. A kind of suicide-pact mentality is gripping the Democratic majorities in Congress, akin to that which came over it when Congress passed President Clinton's tax package in 1993.
This disregard for the will of the marginal voter may make sense for those who come from safe districts -- it makes none for those who come from swing districts. For them, suicidal conduct leads to political demise.
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
The Pelosi Health Care bill has 1,990 pages + a 42 page manager's amendment making it a 2,032 page bill.
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Humans clearly attend closely to status, an important part of status is dominance, and a key way we show dominance is to tell others what to do. Whoever gets to tell someone else what to do is dominating, and affirming their own status. But we are also clearly built to not notice most of our status moves, and so we attribute them to other motives. And as long as we are making up motives, we might as well make up the most admired of motives, altruism. --Robin Hanson
__________________
"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
The Pelosi Health Care bill has 1,990 pages + a 42 page manager's amendment making it a 2,032 page bill.
I'm curious why that fact, in and of itself, makes any difference one way or the other. It's an empty argument, aimed at morons who are intimidated by reading anything more complicated than the label of a Budweiser can, IMHO.
I'm curious why that fact, in and of itself, makes any difference one way or the other. It's an empty argument, aimed at morons who are intimidated by reading anything more complicated than the label of a Budweiser can, IMHO.
We had a similar issue in Ireland recently re the second Lisbon Treaty referendum. It's very, very foolish and inflammatory to casually state that anyone who can't 'get down' with a 2000+ page government document is functionally illiterate, and only fit to read the TV listings, and the labels on bottles and tins (I'm extrapolating from the gist of your inane post).
The point is that quite apart from weighty issues such as length and access, the wording of gov. docs. is virtually impenetrable, 'lessen you're a trained legalese person.
Stop giving us crap jmj! (unless you were taking the piss, in which case - Snrf! Snrf! )
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‘Perhaps it doesn’t understand English,’ thought Alice; ‘I daresay it’s a French mouse, come over with William the Conqueror.’
I'm curious why that fact, in and of itself, makes any difference one way or the other. It's an empty argument, aimed at morons who are intimidated by reading anything more complicated than the label of a Budweiser can, IMHO.
I doubt that anybody has absorbed what's in the entire 2000+ page bill. It's likely that nobody has even read it. The bill should be short enough that the provisions that are pernicious carve outs to special interests are exposed for being that and expunged. You aren't curious who has gotten away with what? Health care is important enough that those voting on it should really know what's in the bill and the public should know as well. Pelosi pledged back in September to put the bill online for 72 hours (not very long), so that the public would have access to it but has now changed her mind about that.
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Humans clearly attend closely to status, an important part of status is dominance, and a key way we show dominance is to tell others what to do. Whoever gets to tell someone else what to do is dominating, and affirming their own status. But we are also clearly built to not notice most of our status moves, and so we attribute them to other motives. And as long as we are making up motives, we might as well make up the most admired of motives, altruism. --Robin Hanson
Pelosi pledged back in September to put the bill online for 72 hours (not very long), so that the public would have access to it but has now changed her mind about that.
Big surprise there.
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
I doubt that anybody has absorbed what's in the entire 2000+ page bill. It's likely that nobody has even read it. The bill should be short enough that the provisions that are pernicious carve outs to special interests are exposed for being that and expunged. You aren't curious who has gotten away with what? Health care is important enough that those voting on it should really know what's in the bill and the public should know as well. Pelosi pledged back in September to put the bill online for 72 hours (not very long), so that the public would have access to it but has now changed her mind about that.
With the Lisbon Treaty campaign in Ireland, the government made it available in truncated form on a 'for general consumption' website, and in full form elsewhere. It's all about transparency people! I'm horrified that U.S. citizens have no idea about the specific details of this Health Care bill, and are being treated like mushrooms essentially. (keep 'em in the dark, and feed 'em shit)
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‘Perhaps it doesn’t understand English,’ thought Alice; ‘I daresay it’s a French mouse, come over with William the Conqueror.’
I'm horrified that U.S. citizens have no idea about the specific details of this Health Care bill, and are being treated like mushrooms essentially. (keep 'em in the dark, and feed 'em shit)
And the public bows and chants "Obama, Obama, Obama"...
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
And the public bows and chants "Obama, Obama, Obama"...
I had gotten the impression rather that they were waving pitchforks and torches and screaming 'Obama! Obama!'. Poor guy's gonna be a scapegoat if ever there was one.
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‘Perhaps it doesn’t understand English,’ thought Alice; ‘I daresay it’s a French mouse, come over with William the Conqueror.’
I was referring to the die-hard left that are still kissing his rear end and think he is God.
As for being a scapegoat that's the way it goes with Presidents in the US: If things go well he is praised. If not, it's all his fault.
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"The main vice of capitalism is the uneven distribution of prosperity. The main vice of socialism is the even distribution of misery." --Winston Churchill
Last edited by Jeffrey Wozniak; November-6th-2009 at 08:39 AM.
Cripes, a large and important industry group just today reported that gov't health insurance would be more expensive for policyholders, and give less money to providers, thus worsening care. 
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