Surgery, Please - A Look At Edwards On Health Care

The following piece is part of an ongoing series of OffTheBus reports by citizen policy experts critiquing different aspects of Campaign 08.

Read more OffTheBus coverage and get involved by clicking here.

The Kaiser Family Foundation this week launched a series of thoughty, chewy interviews with presidential candidates on our dysfunctional medical system, and John Edwards, who has been trying to get out front on the issue, was first up. But from the tone of the discussion so far, the candidates must think that to perform major surgery on this moribund patient, first we have to anaesthetize the voters.

The format, borrowed from the sedate, PBS-News Hour style where reporters and guests aren't allowed to thwack each other with rubber mallets, is supposed to elevate the debate but instead threatens to launch it into the ionosphere of Platonic Forms. It comes off nice, pat and perfectly incredible, in the original sense of 'not meriting belief.'

The interminable policy chatter about health in this presidential campaign makes me fantasize about how far a proposal to guarantee health care as a 'human right' as Brazil's constitution does would fly here. Not very, of course, but it's the sort of gut-wrenching, polemic-stirring underlying fairness issue that deserves a better hearing than the ultimately disingenuous blueprints for reform that are going to be trotted out from now until, well, your death.

Edwards has some good ideas about health system reform, but you also need a ripping political strategy to give any of these worthy schemes a snowball's chance. The collapse of Hillary C's plan a decade ago illustrated the smug selfishness of our social discourse dating back at least to the Reagan years and how easily the entrenched industrial interests will turn any threat into soundbite mincemeat. Edwards and the rest of the candidates seem unwilling to turn up the rhetorical heat to anywhere near the requisite levels to reverse this momentum.

A good example is his wimp-out on malpractice reform where he repeats the Hillary error from the 1990s. He proposes a prior review process for potential malpractice cases and a 'three-strikes-you're-out' punitive faculty to weed out lawyers bringing frivolous suits, a bland position that will convince no one and expose him, as a former trial lawyer, to a howitzer blast from doctors and insurance industry.

Our current malpractice procedures need to be dug up root and branch, not timidly tweaked. They're ostensibly designed to reduce error and compensate those harmed but do neither while terrifying practitioners and absorbing millions. The Swedish no-fault malpractice system, to cite one example, arguably does better on both counts for a fraction of the cost, and different states have led the way on innovating their malpractice laws in that direction. Edwards' proposal is the sort of fiddling around with a mess that he more astutely criticizes elsewhere.

He finesses the 'choice' issue that helped bury the reform attempts in the 1990s by proposing to allow people to keep their current policies while insisting that everyone have something. He was also right when he answered the inevitable whiner about 'our taxes' going up by saying that tinkering with a junker isn't the answer, junking it is. That way, you spend here and save there, but in the end you're better off.

So he's right as far as he goes, just as when all the Democratic candidates tut-tut Bush's threat to veto the expansion of SCHIP medical coverage for poor children, which alone should be giving the opposition a field day. But where's the moral outrage? Where's the challenge to individual self-interest (including those of the sainted 'middle class'), the call for the solidarity implicit in all insurance schemes--that people contribute when they don't need care to guarantee protection for those, including themselves, who eventually do?

If they don't stir up that hornet's nest, a lot of people, encouraged by the howling wolves of the industrial propaganda machine, will continue to react to the reform proposals by saying, I'm fine--it'll cost me money--I'm agin' it. Instead of pandering to this attitude, someone, somewhere, should be confronting it.

Edwards does call our current system immoral although he doesn't say people have a 'right' to be cared for when sick. But the current discussion is too politically disemboweled to build the momentum for actually achieving the profound change Edwards says we need. The soothing sounds coming from him and his competitors so far only show at best a Clintonian aptitude for obtaining power, not for actually changing the course of events once they get it.

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Comments

[splashy]

Kuchinich and Conyers have the best program out there, a universal health care system that cuts out the insurance companies completely. That is the only way to do it that will do the trick.

BTW, those malpractice suits will be far fewer if people weren't so worried about future medical bills killing their finances. Universal health care without insurance companies involved would fix that too.

[DottiAgingSafely]

I am an RN with forty years experience working in facilities and communities to place elders into long term care. Why is it that EVERY medical/nursing professional I have spoken with about this subject wants a single payer Universal Health System? Simply, we no longer have the best medical care in the world---not even close. Pockets of greatness, yes. The system is broken and needs to be rebuilt from scratch.

Dotti Snow, RN - www.AgingSafely.com

[FlowerGirl]

Q: Why don't we have a National Health Care system in America?
A: Are you kidding? We can't afford it.
Q: Do you know that Israel has a National Health Care system"
A: Yes, but they can afford one.
Q: Then why do we send them billions in aid every year?

[laurenc]

None of the "plans" matter until we get a Democrat in the White House who will listen to the people that matter. Those that matter to me are the hard-working regular folks of America, the community college families, blue and white collar workers. That's who Edwards cares about and will represent. That's who will vote for him and carry him into the White House. Shame on the writer for buying into the right-wing frame that he's a "wimp." He's brave and honest, and far more acceptable to the average joe or john than "hillary" or "barack." Ask them.

[mommamia526]

Today there was a young woman on the tube (Sanjay Gupta,CNN), who is broke at the beginning of her life. She will never be able, she thinks, to buy a house. She was insured, but is left with bills that keep coming, which she will never be able to buy a house. MEDICAL MALPRACTICE INSURANCE is a HUGE ISSUE for doctors and patients. It is also a fact that the malpractice insurance premiums doctors pay may be very different in adjacent states, which leads to outflow of doctors from the higher premium state to the lower one. It is NOT WORKING. It is unneeded overhead - i.e. costfactor - for both the doctor and the patient, as it must be prorated in the billing. Medical Malpractice also leads to practicing of defensive medicine, i.e. doctors either do not do specific procedures, or do not do the newest and best techniques. They may also elect to send patients to large centers for treatment, and patients may die in transit as a result. ABOVE ALL, please realize, patient and doctor alike, if patients are cancelled, or procedures are not done, either because insurance will not pay for it, or because the doctor will not take the risk, THE DOCTOR DOES NOT GET PAID AND THE PATIENT DOES NOT GET THE NEEDED TREATMENT, and the patient may die, or be disabled for life. Instead of Medical Malpractice Insurance doctors who are negligent, incapacitated, or criminal should lose their license to practice. That cuts out further damage they could possibly do. Anyone else who is negligent, incapacitated, or criminal loses his job as well, and so should doctors. Medicare works, for nurses and for Doctors too, and for patients. We have the infrastructure in place for Medicare, and we should increase the Medicare premium to make this idea viable. Let us keep it simple. It would still be much less than we pay for private insurance, and it would ensure healthcare for patients, and that doctors get paid for their work, rather than pushing paper, or not getting paid because procedures are denied.

[Rebelfriend]

For Edwards, his commitment to UNIVERSAL Health Care goes to the very heart of who he is. John Edwards and his wife Elizabeth have shown throughout their lives that they are honest, decent people who genuinely care, and want more than anything in life TO SERVE. This is not about politics as usual for Edwards. This is about, as President, having the power to make life better for the average working people of this country who struggle every day to make ends meet. The Edwards' are people of honor and decency, and they are people you can believe will do what they say. John Edwards is smart, hard-working, a tough fighter, and has the will to bring about the change that will make life better for all Americans and for the rest of the world. If you have any doubt about that you should read the speech he gave on how he would fight terrorism a few weeks ago at Pace Univ. in New York. It is powerful, strong, and intelligent; when you read that speech, you will know who should be our next President: John Edwards.

[janmB]

The public and media hounded the candidates to present changes they want to make for healthcare. We don't even KNOW who will win the nomination or the presidency.
The plans presented now will certainly be disembowled--cut up--and reassembled.
Why get all bent out of shape over it and base our reason to vote for a particular candidate just on this. The important thing is THEY ALL know they HAVE TO DO SOMETHING SIGNIFICANT about our crisis .
VOTE for the most intelligent and the best experienced and qualified. Hopefullt, they shall bring into their administration people with the same qualities.

[LeftCoastOracle]

I've listened to all of the Democratic candidates' health care proposals and find most of them to be pretty wimpy. Kucinich's single payer proposal is the most attractive but of the front runners I'll support Edwards because he vows to that if the Congress doesn't act on the health care mess in this country they will have to give up their own health care plan until they fix our health care system and provide adequate health care for all Americans.

[Robert59]

They're all treading lightly and with good reason. The AMA, the pharmaceutical industry, private hospitals, and let's not forget the insurance industry (meaning Wall Street has a vested interest) have lots of money to spend on ads where they will rip out the throat of anyone who sounds too radical.

You throw out Sweden's no fault malpractice as an example to follow, but it's the first time I've heard about it.

What we should do is after we get 2/3 majorities in both houses and a Democrat president is examine all the universal health care programs to include malpractice and use them to construct one even better.

And what will be the first thing Republicans point out; this is going to cost the taxpayer. Only one candidate, Edwards, has had the guts to tell citizens it will cost to have universal health care. There will also be savings as all those providers take a hefty cut in the services they provide.

And before we jump up and down about malpractice lawsuits have you ever heard anyone from the insurance industry who will stand up and tell you how much less doctors will pay for insurance if caps are imposed?

NO, because they are making a ton of money jacking up malpractice insurance costs. And they also don't advertise another fact; what they are paying out as a result of lawsuits hasn't gone up squat in the past two decades.

[Kendo Nagasaki]

In the UK they have had state run universal health care since 1947. It works quite well and everyone is covered including the unemployed.

Insurance companies (BUPA) also offer private plans for those who want them. UK National Health doctors are paid an average salary of $200,000 per annum for a forty hour, five day week. They can also work in private practice if they so wish.

No one in the UK goes bankrupt because of Medical bills.

UK citizens also live longer than those in the US. Which system do most people really want ?

[JusticiaParaTodos]

The only candidate with a viable solution to the injustice in our healthcare system is Dennis Kucinich! Dennis is a co-sponsor of House Resolution 676 a bill that would expand an improved upon Medicare system for ALL residents of the United States! 676 has provisions to cover chiropractic, dental,in patient treatment, home health, long term care, mental health, out patient procedures, substance abuse, vision care and will not require deductible or co-payments!

With the passage of this bill the role of private for profit HMO's and other health insurance corporations diminishes to zero! H.R. 676 even has provision for the re-training of private insurance company workers who will be laid off due to the private healthcare insurances becoming "obsolete"!

Over 318 labor organizations across the nation have endorsed 676 along with 82 members of Congress, Latinos For A National Health Insurance, Progressive Democrats of America, Michael Moore, Physicians For A National Health Program, and the Board of Church & Society of the United Methodist Church! As one can see 676 is "radical" in concept, but supported by all walks of life including some conservatives!

[linkunlovr]

Kucinich is the only candidate who finally gets the insurance companies out of health care. They contribute nothing to health care but they cotribute millions to Hillary, Edwards and Obama. Naturally Kucinich is dismissed by the corporate owned media who either ignore him or ridicule him. Its pathetic.

[Rebelfriend]

Where is your proof that Edwards receives money from the insurance companies? You are wrong. Don't go blithely tossing out such "facts" unless you know what you're talkiing about. Kucinich's plan is sincere and a good idea; the problem is he's unrealistic to think that they will just meekly fold up their tents and disappear. Edwards' plan is realistic, and offers people a choice of keeping their insurance co plan if they like it, or change to the medicare type coverage he is espousing. (Once that gets going, guess what choice most Americans will make?! Think about that.) Your last statement is absolutely correct. The corporate owned media either ignores or ridicules Kucinich. They do the same thing to an even greater extent with Edwards because they know he is highly electable, where Kucinich sadly, for various reasons, is not. If you like Kucinich, then you should consider getting behind Edwards because Edwards and Kucinich are the closest to each other on positions, but Edwards is shown, in all the general election matchups, as being the MOST ELECTABLE of all the Democrats against ALL of the Repubs.

[Cailleach]

Three times during my life I have health care coverage. I have had hospital bills twice, but have never seen a penny from my various policies, even when I got approval from the companies in advance. The second time drove me into bankruptcy. Health insurance is one big fraud. It's a scam perpetrated by the insurance companies. They should be prosecuted for it. I will never again buy private health insurance.

[wrabbitt]

we can debate it all day long! we need action people are losing everything they own and/or dieing waiting for a few of the select "usual suspects" to tell us what they will do if elected well, why do human lives have to enter into a debate? because, they all stand to lose money? because,the people are fed up with lack of action on anything having to do with congress or the senate we don't need republicans or democrats we need AMERICANS if you want to fight amongst yourselves go some where else.

[linkunlovr]

Im amazed that people talk about Hillary's plan or Edwards plan when they all have the same plan - "buy insurance!" Hillary has been bought and paid for by the industry and all the others except Dennis Kucinich keep thinkign we need health insurance. WHY? It contriubtes nothing and sucks up a third of
all the money spent on health care. No one has the courage to stand up to these powerful moneyed forces except for Dennis Kucinich, so the establishment ignores or ridicules him.

[cruzecon]

I know everyone seems to get tired of the "Canadian" model but that is exactly the way we need to go. We need to open Medicare up as THE National healthcare plan as someone else here has suggested. THEN we need to get the private insurers out of the game as policy makers and ONLY as semi governmental subcontractors in order to pacify while implementing the change if that is the ONLY way to move forward. Most people are already paying about 600-1200 a month for insurance. Straight tax deductions would be less than that. It is a plan that would work.