Doctors Criticize Obama’s Health Plan
A group of over 15,000 U.S. physicians has called on President-elect Barack Obama and the new Congress to “do the right thing” and enact a single-payer national health insurance plan, a system of public health care financing frequently characterized as “an improved Medicare for all.”
“Our country is hailing the remarkable and historic victory of Barack Obama and the mandate for change the electorate has awarded him,” said Dr. Quentin Young, national coordinator of Physicians for a National Health Program.
“In large measure Sen. Obama’s victory and the victories of his allies in the House and Senate were propelled by mounting public worries about health care,” he said. “Yet the prescription offered during the campaign by the president-elect and most Democratic policy makers – a hybrid of private health insurance plans and government subsidies – will not resolve the problems of our dangerously dysfunctional system.
“We’ve seen such hybrids repeatedly fail in state-based experiments over the past 20 years in Oregon, Minnesota, Washington and several other states, including Massachusetts, whose second go-round at incremental reform is already faltering,” Young said.
“The only effective cure for our health care woes is to establish a single, publicly financed system, one that removes the inefficient, wasteful, for-profit private health insurance industry from the picture,” he said. “Single payer has a proven track record of success – Medicare being just one example – and is the only medically and fiscally responsible course of action to take.”
(Full Article at Political Affairs Magazine)
Despite what many of his supporters allege, and despite what the McCain campaign tried to depict, Obama has never supported single-payer healthcare—a system which a majority of American physicians and a majority of American citizens support. Instead, he supports costly, inefficient, and minuscule reforms to the current pay or die system. And it is indeed pay or die for the nearly 18,000 Americans who die each year from lack of healthcare and the countless more who go untreated or even undiagnosed.
For those who claim that there’s no support for this, I would direct them to HR 676 in the House (a proposal Obama, for all his rhetoric, has never introduced or even endorsed in the Senate), as well as the link in the previous paragraph showing a majority of American patients and physicians want a universal system.
For those who claim single-payer is expensive and/or less effective than the current for-profit system, it’s worth noting that the US currently pays twice as much as any other industrialized nation for healthcare (over $7,000 per capita) and that over one third of all healthcare dollars are spent in needless bureaucracy generated by the “efficient” private sector (source). In spite of all this the US still lags far behind countries like Canada and the UK (which have national care systems) when it comes to health issues such as life expectancy, equity and evenness of care, information technology, and overall quality of healthcare. And don’t even start with that long-discredited canard about “waiting times in Canada“. Recent studies show we have longer wait times, too.
For those who are still stuck in the McCarthy era and tremble at the very mention of “socialized” medicine, I would point out that single-payer is actually not “socialized” at all. “Single-payer” means public funding but private delievery. In other words, you get all the efficiency of the free market but the government picks up the tab (hence the label, “single-payer”). Really, it’s the best of both worlds.
For those who claim we can’t afford it, here’s a simple yet elegant solution: cut our defense spending (which currently is greater than the rest of the world combined) in half. Redirect that money into healthcare. It’s not like the obscene military budget is helping us “win” our multiple wars around the globe, and given whom our purported enemies are, there’s little use in boondoggles like the $2.5 billion Virginia class subarmine. Thanks to the mentality of the military-industrial complex, defense budget is designed to combat an enemy who has quite literally ceased to exist. We can re-direct this money toward the health of our own citizens without even needing to raise taxes.
Lastly, for those who are wondering what they can do about it, here are some basic steps you can take for healthcare equality:
* Talk to your Congressional Represenative(s). If they haven’t endorsed HR 676, let them know this is a serious issue.
* Join the November 5 Movement, which has taken the implementation of single-payer healthcare a primary concern.
~ by Kimchi on November 12, 2008.
Posted in Barack Obama, democracy, Fact Checking, Healthcare, Hope, politics, Progressives, Social Justice, working class
Tags: democracy, Healthcare, HR 676, Obama, politics, Single-Payer Healthcare, Social Justice
Kimchurry: Spicy Hot Political Commentary 
The following 9 steps will simply suggest how, without the inefficiencies and burden to productivity of private insurance corporations, we can deliver efficient and effective comprehensive health care with great savings and no sacrifice of jobs. In fact, we may be able to decrease morbidity and mortality in this Country with one coordinated system which cares for all Americans, and concurrently analyzes optimal diagnoses and treatment modalities through its integrated computerized billing system. The savings incurred insuring all Americans through the more efficient Medicare system will benefit all citizens of our Country.
9 Steps to Comprehensive Quality Health Care in America
1) Shut down the private health insurance corporations.
2) Enroll all Americans (including Veterans) and the 40 million uninsured citizens into the Medicare Health Insurance Corporation. Since the current functioning Medicare Insurance Company is already accepted by almost all physicians, Hospitals and clinics in the Country, hardly any infrastructure investments on the health care delivery end will be necessary. Have all private businesses pay a Medicare premium for their employees instead of private health insurance premiums. Let employees as well as businesses contribute a fixed premium amount based on their age up until 65 for their Medicare services and drugs. Freeze current premiums for all Americans over 65 and adjust in the future according to the cost of living index. These premiums paid by businesses to Medicare for their employees should be less than that paid to current private insurance companies because of the lower overhead costs of the Medicare Corporation and improved risk distribution.
3) Hire the now unemployed former private health insurance corporate bureaucrats to actually deliver and not inhibit health care by working in hospitals, doctors’ offices, clinics and nursing homes around our Country. Demographically, the percentage of elderly Americans is rapidly increasing. With every American now insured through Universal Medicare Insurance, real health care workers will be in desperate need. For the first time in the brief but bloody history of managed care, these former private insurance corporation employees will actually touch and improve care for patients by working in physical therapy, nursing, home health care and other ancillary patient care capacities.
4) Obtain by eminent domain (for the public good) the best of the intellectual property protected computer codes which the closed private insurance businesses previously used to monitor patient care and doctors utilization and performance. Private health insurance companies have used these computer programs exclusively for the purpose of strong-arming their contracted health care providers into doing less for their patients and increasing the premium costs for sicker patients in order to achieve higher corporate profits. Medicare on the other hand can use these same computer programs for the common good; to monitor, collect data and eventually improve the efficacy of diagnoses and the treatment of diseases and medical outcomes every time a doctor submits a bill. For example, wouldn’t it be nice to know as a medical consumer (patient) which oncology groups in Boston, New York or Houston have the highest cure rates for stage III breast cancer or Stage II prostate cancer? All those numbers currently exist in cancer registries nation wide and just need to be collected and honestly disseminated. Currently, instead of solid medical data which delineates morbidity and mortality and performance, the medical consumer when choosing an oncologist must rely on word of mouth, physician referrals or advertisements in the local papers which show photographs of smiling doctors in white coats who claim to be the ‘best’ doctors in town. In addition to garnering invaluable instantaneous epidemiologic data on diagnoses and treatment of diseases based on severity and other variables, a strong Medicare based utilization review computer code would also allow Medicare to monitor doctors and hospitals who abuse a fee-for-service billing system. Any physician, institution or service found to abuse the Medicare fee for service billing system after proper review and appeal should be dealt with severely through stiff penalties and loss of their Universal Medicare provider contract.
5) Freeze Medicare physician, hospital and ancillary services reimbursements at current 2007-2008 levels. Adjust reimbursements for future services yearly by Cost of Living increases, or in the event of a deflationary economy a decreases in doctor and hospital payments. Ask any physician and they’ll tell you they would accept current reimbursement rates with COLA over the current mysterious illogical fee adjustment system of Medicare, or the physician population density reimbursement formula used by most private insurance corporations. Two tiered medical systems separating the “haves and have not’s” of society have and will always exist. Therefore, we must allow physicians to practice medicine without enrolling in or accepting the Universal Medicare reimbursement. With private medical insurance no longer available, and no performance based evidence for improved morbidity and mortality among their private for-pay patients, these extraordinarily expensive private ‘VIP’ practices will be limited.
6) Allow Medicare, much like the current Veterans Administration System and every private health insurance company and government health care system around the world, to bid on medications from pharmaceutical corporations for its Medicare drug formulary. Every physician recognizes that we don’t need a choice of a dozen redundant drugs in each pharmaceutical category. For example, we need only 2-3 statins for cholesterol, a handful of antibiotics for infections, 2 beta blockers for hypertension, and a few pain killers. Once the Government bids on pharmaceuticals for the Medicare Corporation formulary, macro economics will force prices to massively decrease to levels identical to that which all the other people of the world outside of America are paying for the same medicines. Since it has not effectively decreased morbidity or mortality in this Country, and only wastes money, we should also prohibit pharmaceutical companies and their workers from contributing to political campaigns or buying commercials on the public airways. We need to also prohibit the current practice whereby your local pharmacy and pharmacist sells your private medical diagnoses and your doctors private prescribing drug information to pharmaceutical companies so the pharmaceutical companies in-turn can directly pressure-market physicians. Prohibit pharmaceutical companies from contributing to organized medicine societies, colleges or associations because the doctors can’t rely on soft bribes or free lunches to prescribe what’s best for their patients. Prevent pharmaceutical representatives from visiting doctors’ offices or hospital pharmacies directly. Allow delivery of Medicare formulary approved sample medications for patients to physicians’ offices via post office mail only. Allow pharmaceutical companies to market products to physicians only via peer reviewed publications delivered by email or snail mail.
7) With the savings incurred from closing the private insurance corporations and paying less for drugs, have the American government fully fund the National Institutes of Health (NIH) and the National Cancer Institute (NCI) and Small Business Innovative Research (SBIR) programs. Emphasis should be placed on basic bench research carried out at not-for-profit American Institutions which employ or utilize a majority of American Citizens in their laboratories and clinics. Too often American Universities rely on free overseas labor to conduct bench research. Clinical trials should emphasize new drugs and devices which have promise to significantly decrease morbidity and mortality for any disease, including orphan diseases. Since a large percentage of private funding for drug and device studies will originate in the expanding financial liquidity and innovations and patients of the emerging developing world, we should allow the FDA to utilize research data obtained by reproduced laboratory and clinical studies performed overseas as well as in this Country.
Corruption of honest academics should be curtailed. Force all investigators to release reproduced publicly funded scientific data for all scientists to review on the internet via the Freedom of Information act (The Senator Shelby Amendment). Prohibit rights of first refusal on scientific data for private companies performing research in non-for profit institutions which receive public funding. Any rights to profits obtained from intellectual property and patents invented with combined funding from government and private sources should be split fairly among the contributing government institutions and any other private corporations funding the research, as well as with the individual inventor. Prevent organized medicine societies, associations or colleges from contributing to political campaigns since campaign donations have no relevance for physician performance or patient morbidity or mortality.
8) Offer physicians the same legal protection from malpractice lawsuits which have been established for commercial health insurance corporations during the last 3 decades.
9) The quality of current medical records software lags two decades behind business software. Therefore, we need to fund and challenge America’s best software corporations to finally develop standardized electronic medical records software for use in doctors’ offices and hospitals in order to increase the efficiency and productivity of physician charting, billing and prescribing. We should use the integrated medical records system to instantaneously and confidentially gather important epidemiologic data on physicians’ performance, patient diseases, and treatments. With new potent viruses and unsophisticated biomedical and nuclear warfare on the horizon, this system will be absolutely necessary for rapid National Security responses. Protect patient confidentiality at all costs to prevent the commercialization and abuse of patient data like that which the pharmacies trade today.
Lastly, some argue that Universal Government run health care in America will result in delays in diagnosis and treatment similar to those experienced in Britain and Canada. One can not simply compare the massive extremely functional Medicare insurance corporation based infrastructure which seamlessly delivers health care to tens of millions of people yearly in the USA to the government run westernized health care systems of Canada and Britain, France, Switzerland, Netherlands, Scandinavia, and Israel. America, for the last 40 years, thanks to the government run health insurance corporation-Medicare, has built an incredibly dense and fluid public insurance system involving almost all doctors’ offices, hospitals, clinics and ancillary services. The Medicare system dwarfs in breadth and actual practitioners and efficacy the lesser insurance systems established in all other countries. The billing and reimbursement bureaucracy for health care providers contracted with Medicare Insurance is already relatively streamlined and efficiently centralized in America thanks to 40 years of physician, hospitals and government cooperation.
We all know that the medically bankrupt private health insurance corporations and medical malpractice lawsuit threats have caused many disheartened physicians to quit practicing or downsize their practices in America. A continuation and technological upgrading of our most fair Universal Medicare based health insurance Corporation based on the concepts outlined above would undoubtedly motivate those disenfranchised physicians to return to the profession and bright younger physicians to invigorate the field. If patients, physicians and the Medicare Corporation continue to work together, without the deleterious interference of private for-profit health insurance corporations, malpractice threats and overt pharmaceutical marketing, the future for American health care will be healthy indeed.. A continuation of the status-quo mixture of a government subsidized private health maintenance insurance industry operating parallel to and within Medicare is wasteful, and will continue to provide no potential future health improvements for America.
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