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Dr. Quentin Young

Dr. Quentin Young

Posted: October 15, 2010 12:25 PM

As we approach Nov. 2, it's fair to say that in many ways the distortion of political discourse in our country has never been worse.

Extreme right-wing personalities - reincarnated Know-Nothings - are elbowing their way into the nightly airwaves via paid advertisements and Fox News. Billionaires are lavishly funding the Tea Party movement and an assortment of anti-government themes.

As our serious economic destabilization continues, and in the absence of vigorous progressive voices offering convincing, evidence-based solutions to our problems, our population is increasingly being abandoned to the clutches of ultra-right yahoos like Sharron Angle in Nevada, Pat Toomey in Pennsylvania, Ed Martin in Missouri and Christine O'Donnell in Delaware, to name just a few.

Pernicious ballot initiatives aiming to turn the clock back on health care and other social issues have been put on several state ballots, often the result of ultra-conservative stealth organizations deploying deliberately misleading language. Arizona's Proposition 106, which would proscribe a single-payer system (and prohibit various other federal health programs), is a case in point.

These developments are creating a perilous situation for the republic.

It must be said that the quality of political discourse in the run-up to the midterm elections has not been facilitated by the flawed health reform legislation that the administration squeaked through Congress this spring.

While there are some desirable parts of the Obama administration's new health law - the funding of community health centers, the expansion of Medicaid, the modest but not unimportant efforts to curb insurance company abuses - it is still widely viewed with unease by the public.

In fact, a recent AP/Stanford/Robert Wood Johnson Foundation poll showed twice as many Americans - 40 percent - believe that the law doesn't go far enough as believe the government should not have a role in health care, and four-fifths of the public favor "making sure that more Americans get the health care they need."

The recent spate of insurance company premium hikes and their pre-emptive dropping of whole classes of potentially unprofitable policies, such as those that cover individual children, by insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana, haven't helped build public confidence in the new law's ability to rein in these corporate profiteers.

Nor have reports that insurance companies and employers are successfully negotiating waivers to evade some of the modest requirements contained in the law.

As a result, skepticism in the law abounds. Polls suggest Republican calls to repeal or defund the new law have gotten some traction, even though their crude scare tactics - e.g. their charge that the administration's health law is "socialist" - are patently ridiculous.

Big insurers are giving large donations to the GOP again (after having given so generously to Democrats in the run-up to the new law), hoping to dictate the terms of the law's implementation in a way most favorable to their mercenary interests.

Meanwhile the health care situation in the U.S. is deteriorating at a more rapid pace. The Census Bureau data reported a few weeks ago indicated a startling 4.3 million increase in the number of uninsured since 2008, to 50.7 million people last year. This number would have been much larger if public insurance programs, in the first place Medicaid, hadn't enrolled an additional 6 million people. The new uninsured numbers represent enormous human suffering.

It's worth noting that the much vaunted public option, had it been incorporated into the new law, would have had a negligible affect on this number, according to a letter from the Congressional Budget Office. Besides inviting an insurer's field day of cherry picking, such a provision would have been anything but a step toward single payer, as some of its advocates claimed.

So what to do?

First, it's important to recognize there are a number of candidates running for office this November who support single-payer legislation, both incumbents and challengers. The candidacy of Dr. David Gill in Illinois' 15th congressional district is but one example. Building up a single-payer caucus in Congress is an important goal, as is the continuing enlistment of support for single-payer legislation like Rep. John Conyers' H.R. 676 and Sen. Bernie Sanders' S. 703.

Second, several state-based movements for single payer are pressing their agenda for local reform. These states include Vermont, where an important Legislature-funded study on state models for reform - including single payer - is well under way, where several candidates have been vying with each other as to who's more supportive of single payer, including gubernatorial candidate Peter Shumlin. Sen. Sanders has pledged to seek whatever federal waivers are needed should the people of his state declare their preference for a single-payer system.

Third, Medicare, Medicaid and Social Security are under a serious threat from the National Commission for Fiscal Responsibility and Reform. The commission is presumably going to make recommendations for changing these vital social insurance programs in its report to a lame-duck Congress by Dec. 1. Any cuts should be emphatically rejected. Medicare should be strengthened by improving it and expanding it to everyone. That's also one of the surest ways to control skyrocketing health costs, as a recent congressional briefing by PNHP leaders and others recently pointed out.

Finally, our educational work in support of an improved Medicare for all remains indispensable. There are good reasons to believe that the new health law will be subject to destabilizing pressures from several quarters, including from actions by incorrigible offenders like the insurance industry (which is already complaining about the law's minimal restraints), and the law may unravel sooner than many suspect. Single-payer Medicare for all needs to be ready to fill the gap when that happens, and a powerful people's movement needs to be ready to push it forward in a new, dramatic way.

 
 
 
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HUFFPOST SUPER USER
sknyjohn
04:06 PM on 10/15/2010
Make Obama & congress enact Medicare For All!
http://www.healthcare-now.org/
02:58 PM on 10/15/2010
FBI Arrests Gangsters Behind The Largest Ever Medicare Fraud Scheme
The newly-created interagency Health Care Fraud Prevention and Enforcement Action Team (HEAT) is focused on strengthening existing fraud prevention and detection systems and the application of modern computing technology to the analysis of Medicare transactions. That activity lead to the arrest on Wednesday of 73 members and associates of an Armenian-American organized crime scheme behind more than $163 million in fraudulent Medicare billing [...]

http://silverbuzzcafe.com/?p=14008
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HUFFPOST SUPER USER
Damiano Iocovozzi MSN NP
Director, CEO, the Thomas Edwin Walls Foundation
08:53 PM on 10/15/2010
Mr. Day77, The US wastes billions in medically futile labs, medicines, ICU stays, treatments, advanced diagnostic procedures, surgeries, disposibles, trips to the cath lab etc. on those well past all cures, or remissions or reprieves from old age or dementia, usually in terminal decline during the last six months of life. The documented weight loss over a period of time, the drop in albumin, pre-albumin and rise in CRP and insulin levels are mostly ignored but tell the truth about approaching end of life. No astute & ethical medical provider could not see this. The most money made today is back-ended in a fee-for-service scheme that encircles the beds of the dying. It is an insane waste of money and robs that person of any dignity, privacy, energy & time to prepare himself & loved ones for the journey ahead. The pursuit of a cure orientation makes for fraud, waste & abuse by many unethical providers and those industries swirling about that action. The reasons are many: a sense of entitlement by the family for the everything of medical futility, the mercenary nature of the pharmaco-medical industrial complex, the stigma of death & a misbegotten fear of a lawsuit. For someone with documented terminal decline, a lengthy ICU stay & a code blue are horrors for which few understand what a loved one will endure, for no achievable, honest medical goals. Visit me for free blogs about what really occurs during code blues & ICU. http://www.soonerorlaterbook.com
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HUFFPOST SUPER USER
Damiano Iocovozzi MSN NP
Director, CEO, the Thomas Edwin Walls Foundation
09:14 PM on 10/15/2010
Sorry, but I ran out of room, Mr. Day77. The cost of the ICU stay is about $10,000 per day for basic room & intensive care nursing. Many consultants rush in also & begin all the ordering which increases the amount of the daily bill. Most of the nation's ICUs have become warehouses for the dying as that's the only place to make $. A person with a life-threatening disease really needs just TLC at home while supervised by hospice personnel and costs between $100-450 per day until natural death. The over-riding goal of hospice is quality of time spent pursuing what's important: comfort-care, freedom from anxiety, pain, depression, feelings of suffocation & treatment of short-term goals like UTIs, bedsores etc: all cheap but helpful in the short term to maximize the time left. There's also time to prepare spiritually, to make a legacy and pursue one's bliss. The pursuit of an elusive cure or remission waste any energy & quality time left, sitting in waiting rooms, doing tests & more treatments that actually have no benefit but place a high burden. The cruel joke in the ICU is when death arrives, intubated, restrained, shocked, chest pounded upon & unable to say good bye. That is the current American way of death for many who have no idea what the "everything" of medical futility is. It also costs plenty- 1.2 trillion USD per annum. I have spent 23 years at the bedside in many roles. Sincerely, Damiano
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HUFFPOST SUPER USER
Damiano Iocovozzi MSN NP
Director, CEO, the Thomas Edwin Walls Foundation
02:31 PM on 10/15/2010
Wonderful article, Dr. Young! Eventually the US will go the way of enlightened Western countries like Britain, Canada & France in all things rational & cost-effective. On so many levels, the US lags behind the developed nations, usually trailing in the high 30's like we trail Turkey in maternal child health outcomes. Yet, the US pays the most for health care because of the fee-for-service scheme which places the health insurance carrier as a middleman which is driving the whole process.You mentioned that about 55 million US citizens still are without health care at all. Not surprising! Fee-for-service makes money selling goods & services, even when they are considered medically futile to the tune of 1.2 trillion USD spent per annum.I agree that in future years, the fee-for-service scheme will be replaced by the single payer system after we eject industry out of the driver's seat. Until then, it will be a long slog to rationality as it is for everything in the US. After enough Americans feel jilted by American corporatism which has ditched them at the side of the road to more impoverishment & untreated illness, many will get the picture. The newest threats to the republic are not just corporate, they are visceral reactions to the jilted feelings we have about our "no place at the table" in a more corporate environment. Thanks for writing! Visit me at http://www.soonerorlaterbook.com for more about medical futility.
01:33 PM on 10/15/2010
If the democratic party was not so beholden to corporate interests and had actually proposed an expansion of medicare instead of their dreadful remake of for-profit health care it is quite possible that they would be doing much better with the public than they are now. A massive program of job creation together with an expansion of medicare would not only have been good policy but also good politics but this is not the path they chose and instead the extreme right has been given new life.