Pro-single-payer doctors: Health bill leaves 23 million uninsured

A false promise of reform

For Immediate Release

March 22, 2010     PNHP

Contact:

Oliver Fein, M.D.

Steffie Woolhandler, M.D., M.P.H.

David Himmelstein, M.D.

Margaret Flowers, M.D.

Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

The following statement was released today by leaders of Physicians for a National Health Program, www.pnhp.org. Their signatures appear below.

As much as we would like to join the celebration of the House’s passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem – the profit-driven, private health insurance industry – this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers’ defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:

• About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
• Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
• Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.
• The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
• People with employer-based coverage will be locked into their plan’s limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
• Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
• The much-vaunted insurance regulations – e.g. ending denials on the basis of pre-existing conditions – are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
• Women’s reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn’t have to be like this. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid – a woefully underfunded program that provides substandard care for the poor – could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers’ health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill’s passage reflects political considerations, not sound health policy. As physicians, we cannot accept this inversion of priorities. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That’s enough to cover all the uninsured and to upgrade everyone else’s coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.

Oliver Fein, M.D.

President

Garrett Adams, M.D.

President-elect

Claudia Fegan, M.D.

Past President

Margaret Flowers, M.D.

Congressional Fellow

David Himmelstein, M.D.

Co-founder

Steffie Woolhandler, M.D.

Co-founder

Quentin Young, M.D.

National Coordinator

Don McCanne, M.D.

Senior Health Policy Fellow

******

Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

[Via http://laudyms.wordpress.com]

Rounding up the 216 votes on Fed-Med: It’s not ABOUT abortion, it IS an abortion

Earlier today, House Democrat leaders predicted passage of the massive government takeover of the American health-care system, as they worked feverishly to nail down the 216 votes needed to approve the measure this evening. This afternoon they picked up the support of one lawmaker concerned about the abortion issue and another who had voted against last November’s health care measure, while losing the vote of Democrat Rep. Zack Space, a second-term lawmaker from a swing district in eastern Ohio, said he would vote “no” Sunday, a switch from his vote for health care in November.

The pro-life faction of Democrats led by Rep. Bart Stupak (D-MI) has been in talks with the White House, with reports a deal had been reached on language that they had previously said amounted to taxpayer funding of abortion.

Imagine the naiveté exhibited by these elected officials who would take the desperate and lifelong abortion supporter Obama at his word that federal money would not be used to fund abortions?

The Washington Post displays a chart showing how members voted on health-care legislation Nov. 7, where they stand now and who is still undecided. Previously 39 Democrats broke with their party.

If this monstrosity passes, every American would be required to obtain coverage or face a penalty of at least $695 a year. Employers would be  under a government mandate to offer coverage or face penalties of $2,000 per worker. The fraud being perpetrated is that this mega-plan would reduce costs, something that is beyond rational thinking.  It will limit care by rationing, of that you can be sure.

[Via http://seeingredaz.wordpress.com]

Reconsidering "Choice"

I just read an interesting review of a new behavioral psychology book, “Addiction: A Disorder of Choice,” by Gene Heyman.  As the review states, the key theme of the book is “that the idea [of] addiction [as] a disease has been based on a limited view of voluntary behavior.”  As a remedy to this limited view, the author draws out the distinction between addiction and diseases such as Alzheimer’s or multiple sclerosis, the course of which cannot be altered by voluntary behavior.  In contrast, he argues that the success of treatment programs which provide reinforcement for sobriety demonstrates that a key element of addiction is choice- if it were not, incentives just wouldn’t work.   Of course, this suggests that the move toward viewing addiction as a disease rather than a choice is problematic in light of what we normally mean by “disease.”  But, what’s far more interesting to me is the implication that the “disease of choice” thesis has for our concept of ”choice.”  This is the issue I will explore further.

The person snorting her first line of coke or dabbing a little bit of heroin does not want to become a hopeless crackwhore or junkie anymore than the person diagnosed with Alzheimer’s wants to lose her memory.   In this way addiction resembles a disease more than a choice.     Most rational people don’t want to destroy themselves, and most addicts start out as rational people who want to feel better.  Addiction is the sum of incremental choices made on an ever-sliding scale of rewards and negative consequences.  It feels good and doesn’t seem that bad the first time, it might seem worse the next time, but it feels even better, and so on and so forth until it is a serious, life-swallowing problem that you just can’t resist.  Except of course, you can resist it, and if and when you do resist it, the negative symptoms of addiction get better.  The same can’t be said of Alzheimer’s.

The possibility of resisting addictive behaviors is what makes addiction a “choice,” but no addict manages to resist indulging unless he has stronger incentives to refrain than to continue.  Of course, as anyone who has studied the philosophy of David Hume can tell you, this isn’t just the way choice works with addicts.  A choice is always determined by competing desires.  This is as true of the martyr debating whether a vow of silence is more important than a cry for help as it is for a junkie debating between one more hit and passing his court-appointed drug test.  We are all slaves to our desires, some of us just have crueler masters.

The fact that actions are determined by desires, and desires themselves are, on some basic level, unchosen, raises a serious question about ultimate moral responsibility.  I’m not going to offer an opinion on that question, but I mention it because this is clearly the issue that motivates the move toward viewing addiction as a disease rather than a choice.  If addiction is a choice and addicts do terrible things, then they are morally responsible for those terrible things.  If addiction is a disease, then addicts shouldn’t be blamed for the “symptoms” of their disease.   Intuitively, I think most of us want to carve out some sort of middle position in between these two extremes.  What’s troubling about addiction is not the content of the desire.   Wanting a line of coke is not like wanting to rape a child.  The problem is the overwhelming force of the desire:   Addicts privilege their fix over all other competing desires, including the desire to fulfill moral obligations to other people.  So, to preserve the intuition that addicts can be responsible for bad things but not be bad people, we are intentionally opaque in the use of terms like “disease”- which addiction really isn’t- and “choice” -which addiction really is, but which implies a level of freedom and self-determination that nobody really has.

I think Heynman is right to characterize addiction as a “choice,” but the word needs to be trimmed of its metaethical weight.  Addicts have a choice because their behavior is determined by one desire, and that behavior could be altered if competing desires become more powerful.   Treatment programs are designed to strengthen the motivational force of these competing desires by focusing the addict’s attention on all of the things that they can keep or get by staying sober and all of the things which they stand to lose if they don’t.  These programs also offer incentives that tip the balance of competing desires by making some desire-fulfillment much easier than other desire fulfillment.  All of this suggests that addiction- both the active problem, and the process of recovery- is not a singular, moral choice.   Choice is never-ending sequence of battles between competing desires.  The fact that treatment programs work by reinforcing certain desires and disincentivizing others should not suggest to us that addicts have much in the way of power or freedom to change on their own.  It simply means that, given the right support and opportunities, they can change. Of course, the same description of choice is equally applied to non-addicts as well.

[Via http://theappleeaters.wordpress.com]

A+ Tutorial: Economics- Technology

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1. How does technology affect an organization’s productivity and costs? How has your organization used technology? What was the effect on productivity and costs? How do technical and economically efficient concepts shape the long-run average total-cost curve (thinks generally, and drill down to specifics if possible)?

[Via http://mylittletutor.wordpress.com]

Lady Liberty's Last Days

Lady Liberty, that beacon of light and hope, has a potentially terminal disease, called Liberalism.

Tomorrow, likely, the Democrats will vote to end the Constitutional Republic that America has been since 1776.

But it’s for your own good.

The Government knows better.

Last Thursday, the California Occupational Safety and Health Standards Board voted to set up a committee to examine whether condoms should be required on all pornographic film shoots.

California has run out of money, but it hasn’t yet run out of things to regulate. (IBD)

A bill introduced this week by Brooklyn Assemblyman Felix Ortiz would ban use of salt in every dish, in every drink, on every plate, in every restaurant, in every single part of New York State.

“No owner or operator of a restaurant in this state shall use salt in any form in the preparation of any food for consumption by customers of such restaurant, including food prepared to be consumed on the premises of such restaurant or off of such premises,” the bill, A. 10129 , states in part.”

Violators would be hit with a $1,000 fine for each salty dish.

Ortiz says the ban is designed to save lives, and would save billions of dollars in health care costs.

And I just saw this guy on “America Live” yesterday on FOX and when the host joked about cutting, fat and cholesterol and other unhealthy things, he agreed that should happen to and this was just the start for him.

The government should regulate what you eat, because you’re not to be trusted.

And it’s for your own good.

Sony Pictures Entertainment Chief Executive Michael Lynton called on the nation’s biggest circuits to think about the waist lines of their customers, not just their own bottom lines.(LA Times)

He’s advocating doing away with Butter on popcorn.

The salt ban prompted my to post this on a message board:

Since the Liberals are so intent on the Government saving everyone from themselves I think

Obama needs to takeover the Grocery Stores and close all Convenience Stores and Fast Food.

They are after all, sell things that are bad for you.

Think of it, the government can make sure you eat healthy and nothing but healthy.

They could issue you a card that has all your “best for you” foods on it and then you won’t be allowed to buy anything that is bad for you.

Think what it could do for ObamaCare and Health Care costs.

The government will decide what’s good for you and you have to eat it.

Also, the government programs like Food Stamps can be expanded so no one goes hungry ever again.

They can make it Mandatory.

Then they take over the Restaurants  because you can’t be trusted.

And Fast Food will have to be outlawed because they are pure evil.

Utopia awaits.

And you’ll never have to think again about your health, the government has you covered.

Cooking Shows will have to be government controlled.

And We’ll have the Food Police to arrest black marketers selling products and to make sure all government regulations are enforced.

Embrace the Freedom from thought and stress.

**

Then after I write it I wonder about government subsidized Gym memberships, for all those unhealthy people who can’t afford it.

That’s unfair too.  (in the Liberal world).

You have a right to be healthy and those evil corporate bastards are making you fat and unhappy. It’s just wrong….

And with the Government eliminating every Student Loan in the country that is in Private hands and giving it all over to the Bank of North Dakota, a College Education as a right can’t be far off.

It’s for your own good.

We’ll have a “healthy”, “well-educated”, well-cared for, populace.

What could be wrong with that?

How about Freedom.

Overrated in the Liberal world.

You’re not smart enough to be free.

The government must protect you from yourself.

You will have the freedom to agree with them, or else.

And with Cap and Trade, Census gerrymandering, and Amnesty they will try and control everything and everyone else.

But it will be for your own good.

You can’t be trusted.

Meanwhile, ObamaCare will result in the creation of at least 16,500 new jobs. Doctors? Nurses? Ha! Dream on, suckers. That’s 16,500 new IRS agents, who’ll be needed to check whether you — yes, you, Mr. and Mrs. Hopendope of 27 Hopeychangey Gardens — comply with the 15 tax increases and dozens of new federal mandates about to be “deemed” into existence.

This will be the biggest expansion of the IRS since World War Two — and that’s change you can believe in. This is what “health” “care” “reform” boils down to: fewer doctors, longer wait times, but more bureaucrats.

So can the IRS Health Care Enforcement Division be far from reality?

The Food Police.

The Energy Police.

The Internet Police.

The TV police.

The Education Police.

Welcome to the new America of your God (and President for life when Liberal repeal the Constitutional Amendment on Term Limits) Barack Hussein Obama.

It’s not like  Liberals take the Constitution or the Consent of The Governed seriously.

That’s how dire it really is folks.

The Second American Revolution has to begin.

You have no choice.

Unless, you want to prostrate and kiss the Emperor’s ring.

Mark Steyn:  Obama is government, and government is Obama. That’s all he knows and all he’s ever known. You elected to the highest office in the land a man who’s never run a business or created wealth or made a payroll, and for his entire adult life has hung out with guys who’ve demonized such grubby activities. Obama’s Cabinet has less experience of private business than any in the last century. What it knows is government, and government’s default mode is to grow, and grow.

Look around you, take it all in. From now on, it gets worse. If you have kids, they’ll live in smaller homes, drive smaller cars, live smaller lives. If you don’t have kids, you better hope your neighbors do, because someone needs to spawn a working population large enough to pay for the unsustainable entitlements the Obama party has suckered you into thinking you’re entitled to.

The unfunded liabilities of current entitlements are $100 trillion. Try typing that onto your pocket calculator. You can’t. There isn’t enough room for all the zeroes.

$100,000,000,000,000

Obama and Pelosi are strong-arming swing-state congressmen into taking one for the deem. It’s appropriate that it should take banana-republic maneuvers to ram this through, because it’s about government so powerful it can make up the rules as it goes along. Maybe regulators should roll a giant condom over the Capitol before it fatally infects the rest of us.

“No people will tamely surrender their Liberties, nor can any be easily subdued, when knowledge is diffused and Virtue is preserved. On the Contrary, when People are universally ignorant, and debauched in their Manners, they will sink under their own weight without the Aid of foreign Invaders.”– Samuel Adams

“It does not require a majority to prevail, but rather an irate, tireless minority keen to set brush fires in people’s minds.”–Samuel Adams

“For in reason, all government without the consent of the governed is the very definition of slavery“.–Jonathan Swift

“2010 is not just a choice between Republicans and Democrats. 2010 is not just a choice between liberals and conservatives. 2010 is a referendum on the very identity of our nation.” –Florida Gubernatorial Candidate (and Tea Party Activist)

“When the people fear their government, there is tyranny; when the government fears the people, there is liberty.”–

Thomas Jefferson

“They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.“

Benjamin Franklin

“When men yield up the privilege of thinking, the last shadow of liberty quits the horizon.”

Thomas Paine

“The hate of men will pass, and dictators die, and the power they took from the people will return to the people. And so long as men die, liberty will never perish.”

Charlie Chaplin

So let us all hold the flame of liberty, so that one day it will live again.

[Via http://indyfromaz.wordpress.com]

An Alternative Statistical Look at the U.S. Economy

I’ve come across Shadow Government Statistics before but I was recently reminded of them again. The proprietor of the site, Walter J. “John” Williams provides this background:

Walter J. “John” Williams was born in 1949. He received an A.B. in Economics, cum laude, from Dartmouth College in 1971, and was awarded a M.B.A. from Dartmouth’s Amos Tuck School of Business Administration in 1972, where he was named an Edward Tuck Scholar. During his career as a consulting economist, John has worked with individuals as well as Fortune 500 companies.

Formally known as Walter J. Williams, my friends call me John. For more than 25 years, I have been a private consulting economist and, out of necessity, had to become a specialist in government economic reporting.

One of my early clients was a large manufacturer of commercial airplanes, who had developed an econometric model for predicting revenue passenger miles. The level of revenue passenger miles was their primary sales forecasting tool, and the model was heavily dependent on the GNP (now GDP) as reported by the Department of Commerce. Suddenly, their model stopped working, and they asked me if I could fix it. I realized the GNP numbers were faulty, corrected them for my client (official reporting was similarly revised a couple of years later) and the model worked again, at least for a while, until GNP methodological changes eventually made the underlying data worthless.

That began a lengthy process of exploring the history and nature of economic reporting and in interviewing key people involved in the process from the early days of government reporting through the present. For a number of years I conducted surveys among business economists as to the quality of government statistics (the vast majority thought it was pretty bad), and my results led to front page stories in the New York Times and Investors Business Daily, considerable coverage in the broadcast media and a joint meeting with representatives of all the government’s statistical agencies. Despite minor changes to the system, government reporting has deteriorated sharply in the last decade or so. — John Williams

Manipulating numbers is a very easy thing. The U.S. Government’s numbers may have as much plausibility as China’s GDP numbers. How correct John Williams statistics are I cannot testify. I doubt most economists can tell either seeing how well they’ve covered their profession in glory the past two years. Many economists were perhaps shocked temporarily out of their narrative in the immediate aftermath of the Global Financial Crisis but most have comfortably settled back into their existing worldview.

I present the Shadow Government Stats here as food for thought:

[Via http://committeeofpublicsafety.wordpress.com]

What's Wrong With This Brochure?

What’s wrong with this brochure? The front advertises the CrediAMIGO microfinance program run by the Banco do Nordeste, a Brazilian, state-run, development bank. CrediAMIGO is the largest microfinance program in South America in terms of numbers of clients. “Those who want to grow should remember one name: CrediAMIGO.”

The flip side of the brochure gives the details of the program and the interest rate charged on loans.

The fine print shrewdly explains that the incredibly low 1.32% monthly rate advertised will, when calculated on Effective Interest Rate terms (roughly equivalent to APR rates used in the US), result in annualized interest charges of between 33% and 62% (not taking into account fees charged for opening accounts not mentioned here but only on the CrediAMIGO website “Products Page”).

[Via http://martindonascimento.wordpress.com]