ELDER MUSIC: Singers and Actors. (Or Vice Versa)
Aging Out of a Blackberry World

The Health Care Reform Debate

category_bug_journal2.gif There are so many fibs, falsehoods, fabrications, fairy tales and outright lies being circulated in regard the health care reform debate in Washington that fact is already hopelessly entwined with self-serving fictions from the various stakeholders.

And the debate has only just begun. The country will be subjected to this barrage of misinformation, meant to confuse and frighten various constituencies, for many upcoming months.

It is going to take all our concentration and brainpower to sort the useful information from the flummery. Here are two points to keep uppermost in mind as you try to follow the debate:

• Insurance companies, big pharma and corporate medicine want to maintain the status quo. It has made them rich.

• Members of Congress receive their largest campaign donations from insurance companies, big pharma and corporate medicine.

Filter everything you read through those two facts. No one who has the power to influence health care legislation (with the possible exception of Senator Ted Kennedy) has the people's interest in mind; all are more concerned with the goals power or money. When the president signs the eventual health care reform bill, whatever benefit it contains for citizens will be as little change as possible from the present, private system that has served those twin goals at our expense.

That said, there should be some improvement because Congress cannot entirely ignore the skyrocketing costs of healthcare nor the 47 million uninsured. (That number, nearly one-sixth of the U.S. population, was established in 2005, and is undoubtedly much larger now due to the rate of unemployment and the many who cannot afford COBRA premiums. Also, it does not include the under-insured.)

First, let's get the vocabulary straight so we are all talking about the same thing:

Individual Health Insurance is coverage purchased by individuals or families from private companies usually subject to increased premiums for age, gender or pre-existing conditions. Coverage can be denied for any reason.

Group Health Insurance is similar to individual health insurance but provided through employers, unions and other affinity groups often at a reduced premium rate.

Universal Health Insurance or coverage is an umbrella phrase referring to any kind of system that ensures coverage to everyone.

Single Payer, a form of universal coverage, refers to a centralized system in which the government pays for every citizen's health care funded through taxes. Physicians and other medical professionals are not employees of the government.

Socialized Medicine, also a form a universal coverage, is a system where the government owns and runs health care facilities, and physicians are paid by the government.

Public Plan (promoted by President Obama) is a relatively new phrase referring to health insurance coverage that would be offered by the federal government to individuals and families to compete with private, individual insurance plans.

There are hundreds of health care reform plans in Congress right now, one for nearly every member. None proposes any kind of universal care. The Democrats recoil from universal or single-payer plans because Republicans squeal “socialized medicine” when the Democrats mention them.

(By the way, if I were king of the country, we would extend Medicare to everyone. It's not perfect, but no plan can be. Systems are already in place and it has worked well for more than 40 years. The necessary expanded administration would employ many of the experienced people who now work at private insurance companies and those companies could sell additional coverage for cosmetic surgery and other discretionary treatments to people who want it.)

Most of the plans in Congress are what Nobel Laureate Robert Fogel, speaking at the Age Boom Academy I recently attended, called “tinkering at the edges” of the current system. Dr. Diane Meier of Mt. Sinai School of Medicine, also speaking at the Academy, declared “single payer won't happen,” but Nancy LeaMond of AARP, who knows her way around the halls of Congress, at the same conference declared that health care reform (of some kind) “is going to happen.”

Dr. Robert N. Butler, who runs the Age Boom Academy, said he believes the plan from Senators Ted Kennedy and Max Baucus is good and as close as we can get in this Congress to a single-payer system. It exists only in draft form – 615 pages - at the moment. You can read some details of the draft here and here.

The universal rejection in Congress of any kind of universal coverage is at odds with the American public. In a new CBS News/New York Times poll released on Saturday,

50% of respondents believe the government would be better than insurance companies at providing medical coverage

59% believe the government would be better at holding down costs than private insurers

64% believe government should guarantee health insurance for all Americans

And, a large majority, 72 percent, back a government-sponsored health care plan to compete with private insurers. Additionally, 57 percent are willing to pay higher taxes for insurance for everyone.

So apparently, our Congressional representatives are completely out of touch with the people they represent, beholden instead to the money interests who support their election campaigns. It's going to be a contentious summer.

At The Elder Storytelling Place today, Joan Barber: You're Never Fully Dressed Without a Dress - and the Right Shoes.

Comments

I've all but quit trying to decipher and cobble together an accurate picture and understanding of the mess called health care in the USA. Your guidance through the forest of overblown speeches, grand standing, and temper tantrums keeps the sun shining on "we, the people" — some thirsting, many starving for essential requirements to live.

I can't make head nor tails of any of it. I haven't the patience.

The most deft summary I've seen of why we will get something and we won't get single payer or anything that rational came in a local newspaper column by Jon Carroll. Despite the dismal subject matter, this is one to enjoy.

Thanks Ronni for keeping attention on this as I believe as do many others that it is the key to a better future for all. On the personal side, having a son with Type 1 diabetes has brought it home. What happens when you can't get insulin or supplies? Do you run to the emergency room every time you have a problem? etc. And I also agree with you about Medicare. My husband and are both on it and have had no problems.

I am becoming so depressed by the fact that greed will stop any kind of meaningful reform. I read the Jon Carroll article mentioned by Janinsanfran and he has it right.

Anyone with a calculator knows that the single-payer system is the only one that will actually save money for individuals and the government. But that one word 'Socialized' stops it. Medicare, Medicaid, the insurance that covers those senators and congressmen and government employees is 'socialized'. Ask any representative if they want to stop being hypocritical to give up their excellent health insurance.

I believe that, if they thought it would win them elections, our elected officials would do what we want. All the money they get is important to them only because, with it, they can buy the advertising that keeps them in power.

So I'm going to write to my two senators and my representative in the House, over and over, urging them to do what I ask. I believe that if the 70-some percent of Americans who want a government-run health care program make their voices heard, we can in fact get it done...or at least started.

I am not willing to write it off as a hopeless cause.

Although I have been relentlessly emailing, phoning, and visiting the offices of my Congressional reps and I can't say they've seemed particularly interested, I still believe that if our reps aren't responding to us, it's up to us to change that. Obama seems like our last best hope to really change health care, and a public option -- at risk, unbelievably -- is the minimum necessary change. Are you making noise out there, my friends?!

My concern is who is doing it (Congress) and my lack of trust in them (both parties) to not watch the bottom-line for businesses more than individuals (lobbyist payola). I would be much happier if it was single payer, Congress also in it, and they raised taxes to pay for it. If they try and put it onto our national debt, it will crush this country. It won't be free. Nothing is and how they decide what premium, who pays, what it covers, and if it ends up mandatory which means a tax that is clearly spelled out what it is for, those are the unanswered questions right now. It could end up such a mishmash that it only makes our situation worse. My trust quotient is low.

I write about these issues in my day job. It should be pointed out that all of the lawmakers, mostly conservative Democrats and Republicans, who oppose a "public plan" already enjoy a PUBLIC plan. They can go to Walter Reed, Bethesda or the nurse and doctor on duty at the Capitol.

AMERICA’S NATIONAL HEALTHCARE EMERGENCY!

It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

Contact congress and your representatives NOW! AND SPREAD THE WORD!

God Bless You

Jacksmith – WORKING CLASS

IMHO it is time for the healthcare insurance industry to go the way of the dodo bird. It always seems to have enough money to employ people whose jobs are to make sure someone/anyone/no one gets health care.

When I was young, we didn't have healthcare insurance. Didn't know it existed. Our healthcare was not great, but no one was denied access to what was available. We paid what we could afford to pay. Where did we go astray? (Greed...greed...greed.)

Oh, I am just one of those old folks who don't even understand Medicare. In six days, if I understand this right, I will have no private insurance and need to do something. Cobra? I'm just hoping my laid off husband understands how to sign up for medical care.

I think we need to keep bombarding our elected folk with the demand we receive the same insurance plan they have, or they have to end up with the same plan the least of our citizens get with whatever plan they ultimately choose to pass.

A lot of people are going to need to send them this message and more, continuously.

Excellent simplification of terms, definitions and issues.
Thanks for the draft links.

Thanks for the clarity in your blog about this important issue. Just remember people, if you are currently working and stop for any reason, you pay top dollar for coverage that will only last 18 months then, you should pray to be covered.

Medicare is NOT free but Ronni is correct, it is working. Could it be better: you bet. But if the president puts forth a government backed health plan, we could consolidate Medicare in that plan. There should be NO Age discrimination in health coverage!


"With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry." That's a lovely, rose-view dream.

In actual "real life" the workers processing your Medicare claims, etc., at least in this state, are Indian as in India not American workers. They send the maxium American $$ they can back to India, contributing nothing to local economy. My daughter works with one of those Garlic Rooms, as they are called by her co-workers.

If there were a mandate of "American jobs for Amrican Citizens", this state would have 10% of its unemployed back on a payroll.

So, at this point in time, any argument that nationalization would provide paperwork-jobs totally ignores reality.

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