IT'S TIME FOR UNIVERSAL HEALTH CARE

It's tragic that politicians can be bought off for virtually peanuts. Where there is a pretty clear quid pro quo, the lobbyist and the politician should be severely sanctioned.

Krugman's piece today addresses the future of universal health care.


^4/16/07: Way Off Base

By PAUL KRUGMAN

Normally, politicians face a difficult tradeoff between taking positions
that satisfy their party's base and appealing to the broader public. You
can see that happening right now to the Republicans: to have a chance of
winning the party's nomination, Republican presidential hopefuls have to
take far-right positions on Iraq and social issues that will cost them a
lot of votes in the general election.

But a funny thing has happened on the Democratic side: the party's base
seems to be more in touch with the mood of the country than many of the
party's leaders. And the result is peculiar: on key issues, reluctant
Democratic politicians are being dragged by their base into taking
highly popular positions.

Iraq is the most dramatic example. Strange as it may seem, Democratic
strategists were initially reluctant to make Iraq a central issue in the
midterm election. Even after their stunning victory, which demonstrated
that the G.O.P.'s smear-and-fear tactics have stopped working, they were
afraid that any attempt to rein in the Bush administration's expansion
of the war would be successfully portrayed as a betrayal of the troops
and/or a treasonous undermining of the commander in chief.

Beltway insiders, who still don't seem to realize how overwhelmingly the
public has turned against President Bush, fed that fear. For example, as
Democrats began, nervously, to confront the administration over Iraq war
funding, David Broder declared that Mr. Bush was "poised for a political
comeback."

It took an angry base to push the Democrats into taking a tough line in
the midterm election. And it took further prodding from that base --
which was infuriated when Barack Obama seemed to say that he would
support a funding bill without a timeline -- to push them into
confronting Mr. Bush over war funding. (Mr. Obama says that he didn't
mean to suggest that the president be given "carte blanche.")

But the public hates this war, no longer has any trust in Mr. Bush's
leadership and doesn't believe anything the administration says. Iraq
was a big factor in the Democrats' midterm victory. And far from being a
risky political move, the confrontation over funding has overwhelming
popular support: according to a new CBS News poll, only 29 percent of
voters believe Congress should allow war funding without a time limit,
while 67 percent either want to cut off funding or impose a time limit.

Health care is another example of the base being more in touch with what
the country wants than the politicians. Except for John Edwards, who has
explicitly called for a universal health insurance system financed with
a rollback of high-income tax cuts, most leading Democratic politicians,
still intimidated by the failure of the Clinton health care plan, have
been cautious and cagey about presenting plans to cover the uninsured.

But the Democratic presidential candidates -- Mr. Obama in particular --
have been facing a lot of pressure from the base to get specific about
what they're proposing. And the base is doing them a favor.

The fact is that a long time has passed since the defeat of the Clinton
plan, and the public is now demanding that something be done. A recent
New York Times/CBS News poll showed overwhelming support for a
government guarantee of health insurance for all, even if that guarantee
required higher taxes. Even self-identified Republicans were almost
evenly split on the question!

If all this sounds like a setting in which Democrats could win big
victories in the years ahead, that's because it is.

Republicans will, for a while at least, be trapped in unpopular
positions by a base that's living in the past. Rudy Giuliani's surge
into front-runner status for the Republican nomination says more about
the party than about the candidate. As The Onion put it with deadly
accuracy, Mr. Giuliani is running for "President of 9/11."

Democrats don't have the same problem. There's no conflict between
catering to the Democratic base and staking out positions that can win
in the 2008 election, because the things the base wants -- an end to the
Iraq war, a guarantee of health insurance for all -- are also things that
the country as a whole supports. The only risk the party now faces is
excessive caution on the part of its politicians. Or, to coin a phrase,
the only thing Democrats have to fear is fear itself.
---------------------------------------------------------------

I'm not opposed in principle to the idea of nationalized health care (and let's be honest, that's what "universal insurance" will boil down to - if you're gonna insure everyone anyway, why not just chop the middlemen?)

Either way, you have individuals who don't get the health care they desire.

Currently, we have a very high standard of health care, with advances in many areas becoming almost routine. On the downside, it's rationed by affordability, so if you have a low income, you don't get the benefits.

Moving to a nationalized health care system would distribute the shortage from the poor to those with very expensive illnesses - not to say that the government wouldn't pay for anything expensive, but as in other socialized health care systems, expensive treatments will be rationed by fiat, waiting lists, and so on. The bottom of the system comes up a lot, but the top levels out.

Additionally, the rate of advances in medical care will slow quite a bit, as there won't be nearly as much money kicking around for the latest life-saving treatment (and yes, medication too). Nor can the US free-ride the state of the art off of other advanced countries... since they already went to socialized health care, it's been the other way around, and frankly, there ain't anybody else to take up the load. So if the US socializes medicine, there will inevitably be people who die from diseases or injuries that they might have survived under market-based health care.

On the other hand, leaving it entirely to the market doesn't work either - the health care market is pretty screwy, with very high demand involved, and patients often don't have the luxury of price-shopping. There's not another market in the world where you can wake up and discover that you've run up ten times your annual income in expenses without actually assenting to anything... (Then again, it beats NOT waking up, does it not?)

Avatar, I disagree on a number of points.

You seem to be saying that more people will be dying under a universal system. Now, we have about 100 million who have no insurance or have inadequate insurance (key exclusions, high deductibles, etc.). Many of these people get the message that they are entitled to drop dead. Under a universal plan, they would get adequate treatment.

I don't see research money drying up. Currently, about 50% of drug and other medical research is financed by the government, which makes grants to universities and firms. Usually, private firms get the benefits of the research for free, and then charge large amounts for the drugs, etc. There is no reason why this should change under a universal system.

Under a universal system, expensive procedures would be covered, but there would be further restrictions on elective procedures, and reimbursements would be somewhat lower. But all would be entitled to adequate care. This would be an anathema to conservatives.

Advocate, I don't make a judgment about numbers one way or the other. There will be -different- people dying under universal health care. And a good number of those people will die of things we don't know how to treat, as opposed to things we do know how to treat but which treatments they cannot afford.

This may not be a bad thing - it's more of a value call.

A universal system won't ration health care through exclusion, sure. However, that doesn't mean that we will suddenly be presented with unlimited access to health care; certainly that's not the lesson of other nations with socialized medicine, huh?

This argument that if we go to universal health care then we won't have the research for new treatments is pure horse puckey.

If you know anything about the health care industry you would know that many treatments are approved with overseas testing before they ever get US testing. RU-286 probably being the most famous one, but stents, pacemakers, drug pumps and many other devices were approved overseas long before they became available in the US.

There is a very factual study, discussed on another thread, that compares U.S. and Canadian healthcare systems. Canadians pay about 40 % of what we do and have slightly better health results.

At present, the drug industry has at least four lobbyists for every member of congress. God knows how many more lobbyists there are representing the health insurance, HMO, and AMA groups. You can imagine the cost of just this.

I have yet to read this thread, so I don't what has already been said. Moreover, I am not well informed on this subject, despite the fact that I consider it one of the most troubling our country has to resolve. My concern is more with the ethical than the technical considerations. It seems to me that, contrary to Phoenix's stated position (and I almost always agree with her), it is far more important that noone be left out than that we who are insured have the best possible plan.
It seems that a two-tiered plan is acceptable. But not characterized by those who have and those who have not. The two (or perhaps more) tiers should reflect levels of adequacy: For those who can afford it make available a boutique system of care, but for those less fortunate, provide an "adequate" plan (and anything is adequate compared to nothing). I know Canadians who would not exchange their system for that of the United States, even though they sometimes come here for more immediate care, just as our less able go there to buy drugs too expensive here.

by Michael Moore Page 1 of 1 page(s)

http://www.opednews.com


Here is Michael Moore's letter to the Treasury secretary concerning Moore's sicko movie.

crossposted from Dailykos

Hello Kossacks, Michael Moore, here. I know you all are aware of the controversy surrounding my recent trip to Cuba with a group of 9/11 heroes for my upcoming movie SiCKO and the subsequent letter I received from the Treasury Department letting me know I'm now being investigated. Well, I would like to take this opportunity to share with you my letter to Treasury Secretary Henry Paulson. I just put it in the mail this morning...


May 11, 2007

Secretary Paulson,

I am contacting you in light of the document sent to me dated May 2, 2007, which was received May 7, 2007 indicating that an investigation has been opened up with regards to a trip I took to Cuba with a group of Americans that included some 9/11 heroes in March 2007 related to the filming of my next documentary, on the American Healthcare system. SiCKO, which will be seen in theaters this summer, will expose the health care industry's greed and control over America's political processes.

I believe that the decision to conduct this investigation represents the latest example of the Bush Administration abusing the federal government for raw, crass, political purposes. Over the last seven years of the Bush Presidency, we have seen the abuse of government to promote a political agenda designed to benefit the conservative base of the Republican Party, special interests and major financial contributors. From holding secret meetings for the energy industry to re-writing science findings to cooking the books on intelligence to the firing of U.S. Attorneys, this Administration has shown time and time again that it will abuse its power and authority.

There are a number of specific facts that have led me to conclude that politics could very well be driving this Bush Administration investigation of me and my film.

First, the Bush Administration has been aware of this matter for months (since October 2006) and never took any action until less than two weeks before SiCKO is set to premiere at the Cannes Film Festival and a little more than a month before it is scheduled to open in the United States.

Second, the health care and insurance industry, which is exposed in the movie and has expressed concerns about the impact of the movie on their industries, is a major corporate underwriter of President George W. Bush and the Republican Party, having contributed over $13 million to the Bush presidential campaign in 2004 and more than $180 million to Republican candidates over the last two campaign cycles. It is well documented that the industry is very concerned about the impact of SiCKO. They have threatened their employees if they talk to me. They have set up special internal crises lines should I show up at their headquarters. Employees have been warned about the consequences of participating in SiCKO. Despite this, some employees, at great risk to themselves, have gone on camera to tell the American people the truth about the health care industry. I can understand why that industry's main recipient of its contributions -- President Bush -- would want to harass, intimidate and potentially prevent this film from having its widest possible audience.

And, third, this investigation is being opened in the wake of misleading attacks on the purpose of the Cuba trip from a possible leading Republican candidate for president, Fred Thompson, a major conservative newspaper, The New York Post, and various right wing blogs.

For five and a half years, the Bush administration has ignored and neglected the heroes of the 9/11 community. These heroic first responders have been left to fend for themselves, without coverage and without care. I understand why the Bush administration is coming after me -- I have tried to help the very people they refuse to help, but until George W. Bush outlaws helping your fellow man, I have broken no laws and I have nothing to hide.

I demand that the Bush Administration immediately end this investigation and spend its time and resources trying to support some of the real heroes of 9/11.

Sincerely,

Michael Moore

--Unfortunately, I won't be able to stick around to answer questions this time (SiCKO premieres at Cannes next Saturday and my schedule is crazy) but I want to be sure you know where I stand. I hope you will stand with me. Thank you for your support and I promise to return again soon for a more involved chat. MM

He forgot to mention that the Commonwealth Fund is a Universal Health Care Advocacy group and that they cherry pick their data to make it say what they want it to say.

Why did they use mortality data based on 1998 WHO numbers when every country in the survey has newer data in the WHO system?

A few other tidbits they neglected:

According to OECD data, overall health care costs rose in 2003/2004 at a rate of 4.1% in the U.S.. Australia rose at 5%, the UK rose at 6.8% and New Zealand rose at 7%. Only Canada (2.9% and Germany -.6%) had lower rates. Why didn't that get calculated into thier numbers?

Why didn't they mention that France, Australia and Germany have fewer doctors per 100,000 people?

Why don't they mention that the differences in life expectancy between the 6 countries have been the same every single year since 1960 and they've all increased at the same rate over the last 47 years?

Illinois Tax Implosion
The political limits of "universal" health care.

Monday, May 14, 2007 12:01 a.m. EDT

"Universal" government health care has once again returned as a political cause, with many Democrats believing it's the key to White House victory in 2008. They might want to study last week's news from Illinois, where Democratic Governor Rod Blagojevich's tax increase to finance health care became the political rout of the year.

The Democratic House in Springfield killed the proposal, 107-0, after Mr. Blagojevich came out against his own idea when it became clear he was going to be humiliated. Only a month earlier he had said he was prepared to wage "the fight of the century" in defense of his plan to impose a $7.6 billion "gross receipts tax" on Illinois businesses.

Easily re-elected in November, the Governor used every trick in the "progressive" political playbook to sell his proposal. Instead of a general tax increase, he claimed it would be "targeted" for universal health care and education. Instead of raising individual taxes, he aimed at business and even built in an exemption for smaller firms. "These corporate guys, they can't avoid this tax," declared the Governor, sounding one of the "populist" themes that liberal columnists are now recommending for national Democrats.

Mr. Blagojevich also pitched his plan as a moral imperative, unveiling it while standing in the Fourth Presbyterian Church in Chicago and saying it was necessary to force businesses to pay their "fair" share of the tax burden. He wanted to force most employers to offer health insurance or pay a 3% payroll tax. Liberal special interest groups--including the state AFL-CIO and the Illinois Education Association--initially supported him.

But a funny thing happened on this road to Canadian health care. The state's more rational Democrats revolted, arguing it would drive businesses out of Illinois. Chicago Mayor Richard Daley was an early opponent, and Democratic Lieutenant Governor Patrick Quinn was cool to it. House Speaker Michael Madigan very publicly withheld his support and last week came out against the tax hike.

As tax increases go, this was one of the worst. A "gross receipts tax" is popular with politicians because it applies to every dollar of company revenue, not merely on profits, or on final sales the way a retail sales tax does. But this means the tax tends to hit hardest those small and medium-sized businesses that have healthy sales volumes but narrow profit margins. The tax is a huge revenue-raiser but can also be a job killer.

Mr. Blagojevich tried to soften this impact by creating an exemption for business with annual revenues of less than $5 million. But even with that exemption, retailers would feel the squeeze from the higher cost of goods. And because the tax applies to all business transactions, it creates what economists call a "pyramiding" effect that has a damaging overall economic impact.

The Tax Foundation estimated that Mr. Blagojevich's proposal would have been the largest state tax hike in the last decade, as a share of state general fund revenue--at 27% nearly double the next closest, which was Nevada's 14% increase in 2004. In per capita terms, the tax hike would average about $550 per Illinois resident.

All of this piled on top of the $1.5 billion in new taxes and fees that the Governor imposed in his first term. State revenue has been rising at a respectable 5% annual pace, but spending is rising faster. Jonathan Williams of the Tax Foundation says the Governor's proposed budget this year calls for a 13.2% spending increase, which comes on top of a near double digit increase a year ago. The cumulative impact of this rising tax and spending burden has been to drive businesses out of the state.

"To describe every major CEO in Illinois as fat cats is a mistake," said Chicago Mayor Daley. "They don't have to be here. They can go to Wisconsin. They can go to Indiana. They can go to India. They can go to China. So if you want to beat up businesses, go beat 'em up, and when they leave, just wave to 'em and they're going to wave back to you." Even Jesse Jackson disowned the Governor's plan, noting that "We all want health care. But business closer is not good health."

One lesson here is that it is far easier to talk about "progressive" political causes than to pay for them without doing larger economic harm. In today's global economy, the margin for policy mistakes is smaller, even for individual states. Mr. Daley may appreciate this better than Mr. Blagojevich because he knows the consequences of bad policy will harm Chicago long after the Governor retires to private equity, or some other "fat cat" job.

As for national Democrats, Presidential candidate John Edwards has already proposed a huge tax increase to pay for national health care. At least he's honest about what such promises require, but we doubt it will help his Presidential prospects. Illinois Senator Barack Obama has been silent on his Governor's tax implosion, but someone should get him on the record. And Hillary Clinton, well, we can't wait to see how "universal" her promises will be.

WSJ

The ER has the legal responsiblity to stabilize an incoming patient . Nothing more.

In the case of both breast and ovarian cancer those 2-4 weeks of not receiving any treatment may mean the difference between life and death for you.

Legal immigrants? Are you serious? More than 90% of the US population is the result of legal immigration in one form or the other.

Not for me........but I see what you mean. I'm sure a system could be devised to fix this problem. And 2-4 weeks is a pretty extreme example.

If you had a kidney stone, you wouldn't want to endure that terrible pain for 2-4 weeks.

Again, 2-4 weeks is an extreme example. Obviously pain, likely hood of more dangerous ailments, family health history, etc would have to be taken into account to determine someone's place in line (if there even was a line, which there doesn't have to be). I believe ERs use something similar to this to determine what order a patient will be seen.

Fishin, Miller, so what are your personal views on this issue? I think the evidence is overwhelming that our current system is a loser. Just to name one monumental thing, about 50 M are uninsured, and another 50 M are underinsured (poor plans with high deductibles, exclusions, etc.).

I just heard that more and more businesses are pushing for universal. Many people don't go into business because they would lose their current coverage. Many die due to the lack of decent coverage.

I don't see any other "rich" countries rushing to dump their universal systems.