To POTUS: We Are ALL Afraid
Dear Mr. President:
There are 'signs' everywhere: from violent town hall meetings to the passionate print media and fiery blogs. Your people are angry and as Spider Robinson wisely quipped, "Anger is always fear in disguise." The people are afraid ... of your plans for healthcare.
Please note. The anger is coming from both sides: for and against your health care bill. Reformers say that it does not go nearly far enough and those against it see it as ill conceived and a government take-over. BOTH are scared.
The people are not stupid. We know that the government cannot reduce true costs. We also know that the government cannot reduce expenditures at the same time that it expands insurance coverage to cover 46 million uninsured. You cannot spend and reduce spending at the same time.
Speaking of the uninsured: ten of that 46 million are eligible for already existing government insurance programs. They chose not to enroll. How are you going to deal with them?
The people are not stupid but we are scared. We are all acutely aware of our severe economic recession. Yet you promise to make it worse by increasing taxes, reducing payments, and pushing the deficit even higher. No wonder we are scared -- scared we will have no money for food, rent, gas or for the healthcare insurance premiums the public option will charge.
We are not stupid but we are confused. We hear that the uninsured will be covered "for free." We also hear that the public option will compete with private insurance. This means it will charge premiums. Otherwise how can one compete against "for free?" Must we remind you that millions of people could not afford the premiums in the first place? Which is it: premiums or for free? If health care is free, what incentive will people have to economize?
We are not stupid but we are dizzy. First you say that we must reduce healthcare costs; then you focus on the need to provide health insurance to the uninsured; and now we hear from Secretary of HHS Sebelius that the public option -- covering all the uninsured -- is "not the essential element" and may not even be in the final Bill. This merry-go-round of words is making our heads spin.
We are especially scared that what you are doing will reduce both our health and our health CARE. There is nothing in AAHCA about personal responsibility; you do not reconnect us with our money; nothing addresses the reasons for out-of-control healthcare costs; there are no incentives for a healthy lifestyle. There are, however, powerful incentives for hospitals to close and providers to quit.
Steal (okay borrow) a line from the film American President and announce, "I'm throwing AAHCA out and writing a bill that makes sense." Start an extended ground level national dialogue. Our country was founded on principles. Health care does not have any, certainly none on which we all agree. Help us create a consensus of principles upon which a new "uniquely American" health care system will be developed: one that we own and that we can accept without fear because WE will create it.
Respectfully,
Pretty much everyone outside the Beltway.
PS. If we sound angry, it is because we are scared.
Follow Deane Waldman on Twitter: www.twitter.com/systemmd
Loading comments…
Want to reply to a comment? Hint: Click "Reply" at the bottom of the comment; after being approved your comment will appear directly underneath the comment you replied to
WHEN WILL WE EVER LEARN?
The pathetic immorality of the current system has been obvious forever and is getting worse with each passing year.
The people who claim to be "religious" are the ones who refuse to provide access to their sisters and brothers.
Meanwhile the majority favors a single payer tax-funded system and is completely ignored because this option would harm the rapacious corporations that skim 30% of our healthcare dollars while providing only pain.
What a country.
suegar, the misinformation coming from the left is no better than misinformation coming from the right. Although majorities are in favor of both reform in general, and 100% coverage, they are decidedly NOT in favor of single payer. Only 32% support single payer.
http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/august_2009/32_favor_single_payer_health_care_57_oppose
from a know right wing poller? really? how was it presented? how were the people chosen, and they always are 20-40 points right of reality.
Single payer! Take it over!
Outlaw the insurance industry. It's legalized gambling out-of-control. The house always wins, even when it's done right, but this house is winning AND picking pockets AND mugging people in parking lots. Don't regulate them. They're beyond help. Cut them out, and bring the government in to take their place as single payer.
Spread the risk out among the entire population. Set some minimum standards, and then let there be as many or few providers as the "market forces" dictate and the payer (representatives of the American people) is willing to pay for.
If we don't push for the ultimate fix, which is single payer, then what we'll get is a barely perceptibly paler shade of the status quo, and it will be years before anyone addresses it again because it will wear the label of "fixed".
“Outlaw the insurance industry” Sure next we should outlaw the auto industry after all they are just money grubbing capitalist pigs who don’t deserve our money. Just let the “people” band together and run the car companies; ooops we are already starting that!
Well then next we should outlaw profit; after all isn’t that getting something for nothing? Profit just means you charged someone else more than you paid. But wait, why should you get more than the cost? That’s not fair - In fact let’s just outlaw money and allow everyone to got to stores and take whatever they want. Pffft.
Any mechanic will tell you that "you can't fix it if it aint broke."
Because your car may need a paint job is not a good reason to send it to the junkyard.
Or if your car gets dirty you don't trade it in.
We may need some maintenance on our insurance system like a car needs and oil change. But we surely shouldn't destroy those things which are the very essence of America: private property, life, liberty, freedom, etc.
regulate the insurance industry in general, take the profit motif OUT of health insurance because it is antithetical to offering care to the sick and unable to choose and sue.
There must be no motivation to withhold care for profit.
So the entire industrialized world except us provide free(or near free) health care for their citizens. But we cannot do that because it would put billionaires out of business. This is one SICK nation.
"Free( (or near free) health care? There's no such thing. And there's not enough money to be obsconded with from only the rich to cover the costs. Even in Europe, EVERYONE pays for health care with very significant taxes on everything that either moves or doesn't. We can only borrow and print so much before the economy implodes so expect even you to have to cough up for this so called "free (or near free) health care".
Right now we pay 12% of our GDP for the worst health care in the industrial world (measured in years of life).
France pays 7% for the best.
Your clam then, is that freeing up 5% of our GDP to provide new goods and services to people, while making us healthier and live longer, would be bad for the economy.
My question: How?
No, no one provides "free" health care. The industrialized world has developed a few different models for delivering (compared to the US) high quality and low cost health care and paying for it the way all government programs are paid for.
The USA stands alone as the exception and in a really not good way.
Actually, Canada is thinking of privatizing, as their system is "imploding" and "things are more precarious than perhaps Canadians realize".
http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw
Hear! Hear! Waldman nails it squarely on the head. The most insightful and rational response to this issue I've yet seen. Start from scrtatch, look at the world and where success has been achieved and begin to put together an American system that largely achieves all the outlined universal care goals deemed essential while proceeding honestly and at a pace that produces real public understanding. True reform is absolutely necessary. The status quo is just as financially debilitating downstream as what's being proposed now. Do this right and all of us will benefit. Do it wrong and we'll all surely suffer.
It appears that we are not going to get a Free, Universal, Single Payer, Not For Profit, Health Care System, in the near future. The polls say that more than 70% of the American people want a Single Payer System. The Congress, those who admit to being Republicans, and those who say that they are Democrats, together have sold us out to the Insurance, and Pharmecutical industries. Many people feel that anything this government gives us, will be better than what we have now. That does not necessarily follow. In fact with this crowd, that is presently in power, it's hard to believe that they will not make it worse. I know, it is hard to believe. Maybe we should vote it down, until they give us what we want. Isn't that how it is supposed to work, in a democracy ? "Medicare For All"
If more than 70% of the American people truly wanted Single Payer it would be under serious public consideration, no matter the number of powerful entities who opposed it. And your suggestion of 'Medicare for all' would simply break the bank.
Again, misinformation. 32% of Americans favor single payer. And NO healthcare system is free.
http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/august_2009/32_favor_single_payer_health_care_57_oppose
"We hear that the uninsured will be covered "for free." We also hear that the public option will compete with private insurance. This means it will charge premiums. "
HUH? Where did you get that idea from? Since when did "Free" have a value? You are intentionally trying to confuse an already confused populace with nonsense like that statement!
You don't speak for me, pal! I HATE the insurance industry! If it went toes up tomorrow, I'd want the day to become a national holiday! The poor have no voice in this issue and that is the most shameful thing about the health care debate. No one seems to care about those who have no money for insurance. The only choice we have with insurance today is whether or not we want it. I want the public option and private insurance can go play on the interstate in rush hour traffic!
I think perhaps it would be best if we all took these non-solution solutions followed them to their real conclusion. If we are not going to make any attempt to provide for 'the least of us' then perhaps we should invest in at least one more government program...voluntary euthanasia. The "Death Panel Lottery". Of course we are too high minded to provide anything like that. We believe morality dictates that we trap the disenfranchised (of which there are more every day) in a black hole of despair and death by neglect. After all, we are a Christian nation!
As radical as that sounds, isn't that where we're headed if we continue to protect the majority from any sacrifice for others? For now let's just admit that the protection of wealth is the most important thing in America. Tell the truth and be proud.
I have an answer for the ten million who are eligiable, but don't have health care. It's quite possible that they don't know, and thus should be educated. Not to mention it can be a duanting task to figure out which programs one qualifies for, and even more duanting sometimes is proving to the government you qualify. The biggest and best solution would be scap the system as it is now and rebuild it with everyone covered--with no need to sign up (or maybe you just fill out an extra form during your yearly taxes). Yes, this would make those protestor's heads explode, and yes, this would be socialism--but that's not a bad thing. Socialism is meant to preserve the common good, and I'd say a populace properly taken care of in a medical sense is good for everyone. (From an economic to an overall people just don't want to be around other sick people point of view.)
The inmates who rule the our asylum will never allow it.
If such a number existed, do we really believe that the government would actually WANT to add them to the Medicaid rolls? Right now they supposedly represent 10 million people they don't have to provide care for.
Let's close our eyes and damn the financial torpedos. Full steam ahead!
Thank you for this! I had to apply my son 4 times for the medicaid he was eligible for because our social services dept is so messed up. They can't keep people on the job there - they kept losing my paperwork - and apparently they don't retain files....it can be a nightmare.
Dr. Waldman
You've been a doctor for 45 years. You wrote in your bio that you've also been and administrator and a researcher and gotten grants. This article is the best you can do? What are you afraid of and where have you been for all of your career? Why haven't you offered yourself to all the past presidents to spearhead heath care and health insurance reform?
I'm not afraid. You don't speak for me (or many others). Since Clinton tried to do this NO ONE HAS TAKEN THE INITIATIVE TO DO ANYTHING.
So stop plying the fear meme and contribute something worthwhile.
BTW - what do you say about 8000 people, yes 8000, turning up in LA to see a doctor? How's that for a great health care system?
He's not suggesting nothing be done. His point is to do it and to do it right. That doesn't make sense to you?
The author is totally correct.
Except the solution is not to start over.
The solution is to address only the problems instead of trying to also fix things which are fine.
Fix things that are 'fine'????? Exactly who are these fictional people that feel that 'things are fine"??? I suppose if you are a CEO of an insurance company you could consider things to be 'fine', as you stuff your pockets full of money you have taken from people that are going broke trying to keep their health and their families acess to health care. Or maybe a lobbiest that is out there paying for people to demonstrate for your cause.. I guess things could be fine for you too. In the case of the rest of America, things are not fine and the problem that exists is that the insurance companies have gotten to the point where they are not held accountable for anything that they do. I know, the old 'bait and switch' technique is working quite well with the Fox news loyalists.... tell them that it is the 'welfare queens' or the 'illegal immigrants' that are causing all the problems... oh, yeah, that's right, you have changed the wording. Now it is the 'obese people' and the 'smokers' that are causing all of the problems, and if we keep things the same and start charging people who don't live like you say they should extra money, yeah, that will fix it all
Things are fine for 85% (+ or -) of Americans who have health insurance. What about them? Is it OK to take their insurance away? And don’t tell me about the Obama “if you like what you have you can keep it” mantra because we all know now that is false.
Insurance companies are held accountable by the free market. What we should “fix” is what is actually a problem not the 85%.
Let’s fix the pre-existing conditions issue. Let’s open up our choices so we can buy insurance from anywhere in any state no matter where we live. Those two simple things would be a great start.
Getting everyone covered? I don’t think so. The minute you make it mandatory you steal our freedom. Where will that end? Does everyone have a right to own a car or a house? After all they need them to earn a living and a place to stay!
We can make it easier to obtain coverage by eliminating pre-existing conditions as a barrier. We can provide more choices. But making it mandatory? We already have enough “mandatory” things which limit our freedoms and take away our resources. America was not set up to be a commune or socialist haven. Americans can put up with much but this time our limits have been reached.
Unfortunately i disagree with one of your central suppositions...
The American people are quite often very stupid.
I don't know if it's our educational system, genetics, too much telivision, or something in the water but the average American I encounter acts dimmer than a 2 watt bulb...
How the heck else do you explain the popularity of Nascar, Professional Wrestling, Fox news, 6 dollar cups of coffee, the Birther movement, and twitter?
Maybe it's not just americans and people are stupid everywhere... I don't travel abroad so i don't know...
but they are certainly stupid here.
I am guessing that you are blind to your own bias.
Perhaps the American people are stupid - probably not. Time will tell.
The Left has really stepped in it by attacking the health care reform protesters - here are some of my observations on the issue:
1 - "Astroturfing" - too many people are independently concerned to believe the claim, and either big Pharma hired the world's best cast of unknown actors, or these are real people, and really ticked off. The American people are not stupid enough to fall for this falsehood. Look for the impact on opinion polls to see if I am right. Pushing this meme doesn't help.
2 - Painting all of the protesters and opponents with a broad brush dipped in the vitriol of a few. This is a classical logical fallacy http://www.nizkor.org/features/fallacies/guilt-by-association.html and I think people see through it. The Left has not always been civil in their demonstrations. Criticism reeks of hypocrisy. It makes the perpetrators (Pelosi, Reid) look out of touch with reality. 2010 will tell.
3 - "No Obamacare - and keep your hands off my Medicare" Sounds stupid. But the response "If they don't want Government health care we should take away their Medicare" (I have seen it!) reveals some real fears of a governernment controlled health care system. It may feel satisfying to screw the old, stupid conservatives, but it shows the face of real tyranny.
4 - All Racists and Haters - See ad hominem attack, also the schoolyard wisdom "takes one to know one" ;) enough said.
Oh, don't forget wee-hour a.m. and shortwave radio talk shows like "Coast to Coast" and "Alex Jones Prison Planet". Next time you can't sleep or have to get up super early to catch a plane (or go fishing...) and want to be shocked at how bizarre some presumably un-hospitalized Americans' world views really are, just turn on your radio. I shudder to think that the listeners who call in to the show might also vote.
This is just plain silly! There is no way one piece of legislation is going to incorporate personal responsibility and preventative medicine. Right now it is very common for a physician to be personally charged by HMO's for sending a patient out for an MRI or a CT scan. Te financial incentive and health care model revolves around denying care with financial incentives to do so. In Britain physicians are financially rewarded for things like getting patients to quit smoking, or lose weight. They get a bonus for RESULTS!
How do we get there? By passing reform with a public option that models the same way as the UK.
As for being afraid, if your lucky enough to have insurance call your doctor, get a script for Xanax and take one. The cost for doing that isn't high enough for your insurance company to wrongfully deny.
What you are suggesting is social engineering; it is not "health care."
It is a form of socialism.
Britain beats us by all metrics in health care. We lead the world in health care related bankruptcies, We have one of the lowest life expectancies of any industrialized country. We have the highest per person health care costs in the world. We globalize trade and expect our companies to provide employee health insurance when foreign competitors need not. (and we wonder why our auto makers fail).
You may be ok with American mediocrity. You may believe there is no way we can compete in this area with the likes of the UK and France. You may be ok with allowing our companies to compete on unlevel playing fields. I am not!
I suggest your label of "socialism" is total acceptance of our current mediocrity and acceptance of defeat in our ability to beat France, Canada, UK and Jordan in life expectancy and health care costs. Perhaps you are alright with that because the insurance companies can make a buck and allow you to say "at least we are capitalists!"
I care about results, not labels.
Health care and mortality are not related. This is like blaming your car mechanic for front end breakdowns when you insist on damaging your car by driving over curbs. Mortality is driven by personal lifestyles.
We may have the most expensive health care on the planet. Our high costs are because we have the best technologies and the most skilled doctors.
These are old self delusional arguments and not correct. They only succeed in tricking yourself. If you really care about results you need to examine your logic processes.
Yeah.....so? Who's afraid of a little socialism? You depend on it 24-7. You want to get rid of all elements of socialism in America, Oldsop, then see how well Libertarians and Conservatives can:
Field a military. Maybe you just think you can fend off the Russians or the Chinese invaders with your family shotgun, case of shells and a wire with tin cans strung over your driveway.
Stay warm and get around after we Libertarian Louisianians left to fend for ourselves best we can (isn't that what you told us when we begged for help after Hurricane Katrina?) cut off your gas and oil because you can't pay its true cost, which after totaling all hidden costs, comes to at least $200 a barrel. That translates to $10 a gallon gasoline, Oldsop. And freezing your butt off all winter, unless you're in the 1% living south of us.
Get enough water to drink if you have to drill your own wells or catch your own rainwater, because the water company is government -owned and tax-supported and you got rid of it because it's... socialist.
As far as I'm concerned anything called healthcare reform that doesn't allow medicare to negotiate drug prices is baloney. To me, that says it all. The same is true for the banking bail-out. Anything that happened short of busting up the big institutions so that they could never pose a threat to the country again is baloney. Pres. Clinton's KISS (Keep It Simple, Stupid) logic is all that is needed to fix this countries problems in every industry, yet we end up with pretty words on thousands of pages of legislation that in effect, do nothing. Our legislatures and, unfortunately, our President, are products of an incredible corrupt political/corporate system and do not have the guts or ability to break that bond.
"The people" are not afraid. You and your like minded group may be afraid, but the vast majority of "the people" -- who are civil and don't go to town halls with guns to threaten our representatives -- are behind president Obama in his effort to bring sanity to an out-of-control, profiteering health insurance industry.
we're living right now with "death panels" and "health care rationing" at the hands of greedy,overpaid insurance executives. get it?
If we currently cover 300 million Americans, and the cost for profit, billing, etc., is 30%, that means that we can eliminate the profit and billing, and cover 100 million more Americans for free. Since there are only 47 million uninsured, that means that we would actually make a profit off those 53 million people that don't exist :)
Do you realize that in other industrialized countries with organized healthcare, the hospital's entire billing department consists of one part-time person?
You must be logged in to comment. Log in or connect with
