Co-authored by Glenn W. Smith and Eric Haas
Real health care reform is within our grasp. President Obama and Congress can create an American plan that can provide health care to all Americans. However, Democrats are not yet doing very well at describing what they are proposing in the area of health care. This has left an opening for Republicans to lie about it. Frank Luntz's 10-point memo, which he presented yesterday, is a good example. We'll come back to Luntz in a moment.
First, let's look at ways Democrats can get their ideas out in public in a way that effectively tells the truth about what they intend to achieve. What they need are some guiding principles for effectively saying what they believe and what is true.
Principle 1. Health care is part of our economic system.
President Obama correctly sees the economy as an integrated system that includes more than just banking. The economy is a system that includes health care, education, jobs, energy, and the environment, as well as an effective, well-monitored banking system and stock market. Real health care is essential for our economy.
Principle 2. Health care is a moral issue.
America was founded on the most central of moral principles: empathy, on caring about and for each other. We are responsible for ourselves and for one another. That is why we have principles like freedom and fairness, for everyone not just the few who are powerful.
To care about our fellow Americans is to care about their health.
Principle 3. Health care is central to the moral mission of the American government.
The American government has twin moral missions: protection and empowerment of the individual - equally for everyone.
Protection includes not just the military and police, but also consumer protection, worker protection, environmental protection, safety nets, investor protection, and health care.
Empowerment is what enables Americans to make a living and have a good life if they work at it. It includes systems of public road and buildings, education, communication, energy, banking -- and health.
No one can make a dime in America or achieve their goals in life without protection and empowerment by America's government.
Principle 4. The President's plan is the American Plan: it fits our principles and serves our people. It represents patriotism at its finest.
The American Plan allows you the freedom to keep your current health plan or choose the American Plan. It is fair in that it allows everyone to afford excellent care. And it allows us to demonstrate in the most visceral way that Americans care about and for their fellow citizens.
Principle 5. The American Plan is a doctor-patient plan.
You and your doctor determine your treatment.
There is no HMO bureaucracy standing between you and the care you get.
Principle 6. The American Plan relieves oppressive HMO government.
Right now HMO's govern your life. Unaccountable HMO bureaucrats decide what treatments you can be "authorized" for and they function to say No to care whenever they can justify it. They make you wait too long, and limit your choice of doctors, clinics, and hospitals. HMO's are oppressive forms of government.
The American Plan diminishes bureaucrats' control over your life. Your American government could act only as a bursar, paying your bills and making sure there is no fraud. Your treatment is up to you and your doctor.
Principle 7. The American Plan provides care instead of denying it.
Why do HMO's have a high administrative cost - 15 to 20 percent or more? They spend money to justify denying you the care you need and all too often delaying care so much that you are harmed by the delay.
The American Plan is there to provide you care, not deny or delay it. Its administrative costs would be low, about 3 percent.
Principle 8. The American Plan costs less and does more.
HMO's are big spenders, not on your health, but on administrative costs, commercials to tout their plans, and profits to investors. As much as 20 to 30% of what you pay does not go to your care. In The American Plan, 97% of what you pay goes for your care. It's a better deal for you and for our country.
Principle 9. The American Plan helps primary care doctors.
HMO's put the squeeze on primary care doctors and have created assembly line medicine. HMO's require doctors to take too many patients per hour, more than they can effectively treat. And they pay doctors as little as possible per patient, so that the HMO's make greater profits, while your doctor loses out -- and you may lose your doctor.
As a result, many thousands of primary care doctors have left their profession. The American Plan will bring back the primary care doctors, paying them what they are worth, and letting them practice medicine instead working on an assembly line.
Principle 10. The American Plan will make prescription drugs cheaper.
Why? Because they can be purchased in greater volume and at a discount.
No longer will Americans have to go to Canada to buy their meds, or order them from other countries. No longer will the cost of medicine threaten to bankrupt older Americans on a fixed income.
The American Plan is America at its best. It fits our moral principles of empathy, freedom and fairness. It helps our economy. It allows freedom of choice. It links your health to you and your doctor. It removes the denial and delay of care. It provides an alternative to the oppressive HMO bureaucracy. It spends less on health and gives your more. And it keeps primary care doctors in business.
Using these principles we can tell the truth about our vision of health care in America. Notice that Frank Luntz recommends "humanizing" Republican rhetoric to avoid humanizing health care in America. Our principles give us the power of truth.
Lakoff, Smith, and Haas authored the Rockridge Institute's report on health care, "Don't Think of a Sick Child." The report can be found here. For policy details on the American Plan see "Healthy Competition," by Jacob S. Hacker here.
1) Merge Medicare with Medicade into a single "Income Based" system.
2) Allow insurance companies to offer "Medigap" coverage to all participants.
As for Funding...
1) Changing from an "Emergency Treatment" to a "Preventative Care" system will save local communities billions, maybe even trillions of taypayer dollars!
2) Small business will be able to compete globally and hire additional taxpaying employees!
3) Wealthy seniors will pay their fair share!
4) The tremendous burden on future generations will be greatly reduced!
In most other first world countries there is some variation of a single payer universal system in which access to care is considered a basic right of the public and a basic responsibility of government. The quality of care in these systems is high, as evidenced by good health statistics. The efficiency and relatively lower cost of single payer systems obviates most of the need to ration care. Access is universal. Preventive Medicine is accorded primary concern. The public in these countries seem to be generally satisfied with their systems of health care. Most doctors are satisfied with their ability to focus on medical care rather than business issues.
It would be irrational to ignore the more successful systems of other first world countries, and instead attempt to resuscitate our failing non system.
Last I heard, France is number one. I don't see how you get there with unhappy patients, and disgruntled doctors.
I can, however, see how our broken system keeps us in the high 20s.
But republicans wouldn't want that! Who's going to pay for their corporate welfare? Their no-bid contracts?
What is your solution?
You think because others finally get some health care, your health care would diminish? A
(going colbert again)
Indeed! All those sick people will get in the way of MY health care! How dare they stay alive!!!
Clearly this is about you and not your fellow citizens.
Yes, the British already do that.
Canadian Health Care emphasizes preventative care.
I know how they do it in the UK and Europe, but it would be pointless to say because you wouldn't believe me
Of coursse that's assuming we are still alive, because we are now currently terminally ill due to years of negligence and abuse at the hands of the FDA and BigPharma
The ideologues simply want "single payer" without any real understanding of what that means. This is very dangerous.
Reality #1: no such thing as a "safe" drug, all drugs have side effects, you use the drug with the most benefit with the least and/or most tolerable side effects, ALL treatments have a cost/benefit ratio; Reality #2: at this point in time, western medicine can't "cure" many conditions (high blood pressure, diabetes, heart failure, autoimmune conditions), but can only try to keep the condition under control, as a physician friend put it, "I can't cure anyone, I just help them tolerate their symptoms."; Reality #3: because of genetics, exposures, health status, etc., each body responds it's own way to a treatment, 99.9% may respond favorably but that 0.1% may not - of course, if that 0.1% includes you, its 100%. Reality #4: everyone wants cured. Reality #5: everyone dies.
Will evil rule the day or will we come out of the dark ages?
The anxiety around health care and dare I say, credit scores is disabling for many Americans. We have nightmares about those issues. In the long run, health care will pay for itself and keep a lot of use from lapsing into an early death spiral.
It will save lives and bring in more taxes from healthier Americans.
We can not let the insurance industry and republicans win on this one. Our very future is at stake.
The current private insurance model works for some, but the millions without insurance, the multiple lawsuits that have come and gone to force insurers to pay for treatment originally denied, the increasing costs to employers, that fact that individuals can't afford it, all indicate that it is not a model that really works for the country. Insurance plans as designed not to provide health coverage but to make money for the insurance company!
The government option of a gov't run insurance plan as an option to the private plans, although decried by the insurance industry as potentially running them out of business, would actually be to their advantage. They will do what they have done before, refuse to cover the high risk and expensive and dump those on the government plan for the tax payor to cover while they keep the private dollar. Would not be much different than the current welfare program now in place.
My neighbor just had two surgeries that cost 100 grand total. She's old enough to be on the "socialist" Medicare program, so she's okay.
Had she been on the typical insurance plan, she'd be in debt for 20 grand, and probably now dropped from coverage by her provider.
When folks start actually seeing the difference between for-profit and for patient coverage, the insurance companies will be toast. They know this, and that is why they'll pull every dirty trick in the book to get a government plan stopped.
Obama watched his mother fight with these insurance companies, as she was dying of cancer. We have a person who gets it in the White House for a change.
I've seen again and again how those opposed to affordable, accessible health care change their tune as soon as the hospital and other treatment bills start rolling in.
We spend more than any other industrialized nation for healthcare (actually sick care) and have the worst outcomes. The number one GOP scare tactic is rationing if health care. It's rationed NOW. You can only see the doctors on their approved list and get procedures with their OK and prescriptions are often not covered or covered minimally. People are cutting back an EVERTHING medical these days because they can't afford it.
Keep in mind that no Republican voted for Medicare. Imagine your grandparents without it.
Both Tawain and Sweden changed their healthcare system to one offering a form of universal coverage (it can be structured in a variety of way) and a recent polls showed that more than 95% of the citizens of each country were VERY satisified with the new system.
We will be too. We just need to get it put in place.
And the greedy sure aren't shy about making money off of human suffering.
When you've endured 1/10th of that, come back and talk to me about suffering
It's simple. Let private companies form police forces, and let the market decide who gets police protection.
A police insurance company, could write a policy for $500 a month, with a $200 deductable for dialing 911.
You'd only be liable for 15% of the cost of a police visit, after paying $100 co-pay. If the criminal goes to court, you only pay 20% of the court costs.
Should the criminal be convicted, your out of pocket cost for incarceration, would be a mere 20% per year for the sentence given.
Of course, if you've ever been the victim of a crime, you may not be insurable, but that's your problem. You probably asked for it by not being smart enough to get rich enough to live in a gated community.
Gosh, I can't imagine why more people aren't demanding police insurance, instead of our current "socialist" driven police force for all citizens.
Thank god we still have insurance companies controlling life and death health care decisions! I'd rather be bankrupt from lack of the ability to pay for treatment, and giving my last dollar to an insurance company, than to be part of a "socialist" pinko commie health care system devised by a Democrat!
Me, I propose education insurance, because I'm sick of paying taxes to educate people who might otherwise choose to be stupid and uneducated. I was smart enough to be born in an upper income family which valued education, so why should I have to pay for others bad choices.
It's simple. Let private companies form schools, and let the market decide who gets educated.
A school insurance company, could write a policy for $500 a month, with a $200 deductable for staying in high school.
You'd only be liable for 15% of the cost of a year of school, after paying $100 co-pay. If you fail, you only pay 20% of the cost of the school year.
Should you graduate, your out of pocket cost would be a mere 20% per year of income generated by your education.
Of course, if you are poor, or your parents are uneducated, you may not be insurable, but that's your problem. You probably asked for it by not being smart enough to be born on the right side of the tracks.
Gosh, I can't imagine why more people aren't demanding school insurance and private schools, instead of our current "socialist" single payer public education system.
Just imagine, insurance companies even richer (or asking for bigger bailouts), money flooding into big education business (or tax dollars, if they make looser business decisions), and teachers in Beverly Hills making 1 million or more per year like invasive cardiologists.
1. Many older physicians will retire. Many younger physicians will do something more productive with their time because the risk (needlesticks, med mal, etc), coupled with diminished decision making capacity, will not be worth the reward. Future MDs will no longer be the best and brightest but the merely mediocre.
2. Investment dollars currently funding new device research and medicines will go away. Adios medical innovation.
3. Rationing will occur because it will be the only way to control costs.
So you will have rationed, rapidly outdated delivered by disgruntled or incompetent people.
Enjoy.
You can deny til your dying day that it will happen, but not believing it will happen will not prevent it from happening so long as ANYONE is concerned with cost
If we really want to do something about the health of Americans, which can then drive down the cost of treatment, not just figuring out a different way to pay for it, then more needs to be done, some ideas:
1. Physical activity needs increased: put PE back into schools and fund it; when designing malls, downtowns, etc, make them pedestrian centered, not car centered; provide tax breaks for companies that set up fitness/wellness programs; increase green spaces for bikes, walking, sports; require bike paths; fund national parks to get more people back out there hiking, etc.; tax breaks for those that show a reduced use of cars;
2. Nutrition: fast food places fill a need that is still there, but reconfigure the portion sizes - a US Whopper doesn't need to be bigger than the Canadian one; get the junk food out of the schools;
3. Support peer pressure: when our taxes go up to pay for illness care, then when we see the guy over there chomping down on Big Mac #3 or coworkers that aren't trying to stay fit, then peer pressure is great to help get them into line
4+: safe work environments, clean up environment, stop pollution, encourage time to play, on and on.
hold on.......let me toss another log on the fire.......just doing my part.....
Real Health Care Reform is a COMPLEMENTARY -- MAINSTREAM and ALTERNATIVE -- 21st CENTURY HEALTH CARE SYSTEM, which will DECREASE costs enormously since preventative measures as well as alternative care will keep people healthy.
Of course mainstream health care agencies do not want complementary medicine because each agency is making billions of dollars. OZONE destroys CANCER but since it's a natural substance and cannot be patented, the FDA has refused to allow its use in the U.S., despite the fact that OZONE DESTROYS CANCER TUMORS and is used with great success in Canada, Europe, and especially in Germany.
HEALTH CARE IS A FOR-PROFIT SYSTEM IN THE UNITED STATES!!!
Just by switching to a Complementary System, the cost of health care will Decrease by the Billions.
Which means the entire mainstream medical establishment has to be overhauled, starting with the FDA - the police of U.S. health care.
Download for free 2008 Updates for my book "Innocent Casualties: The FDA's War Against Humanity" at www.fdainformation.com to learn the documented truth.
FDA is a criminal agency, allowing Vioxx -- an arthritic drug -- to be marketed when it knew how dangerous the side affects were: 100,000 people had heart attacks, with 50,000 dying. The FDA's NUMBER ONE JOB IS TO PROTECT AMERICANS, not own shares in the RX co.s it regulates.
Real Health Care Reform will only happen when the public learns the TRUTH.