McCain's startling proposal

Some overworked and underpaid editor at something called "Newsoxy.com" managed to get nearly everything wrong in providing a synopsis of a well-written piece there. He or she wrote:

John McCain wants to bring healthcare costs under control by actively allowing companies to compete around the world.

While I wouldn't put it past McCain to suggest that U.S. companies be "actively allowed" to compete around the world (huh?), a read of the story reveals that this poor editor garbled the last paragraph here:

Other rich similar industrial nations that offer universal care spend only 11 to 12 percent of their gross domestic product on healthcare. Canada spends even less, a bit more than 9 percent of GDP, on a single-payer government insurance system for all its people.

Healthcare advocates say an ambitious change in the United States healthcare system has become an economic necessity, not just a social desire to offer the service to all Americans.

Regina Herzlinger, an expert at the Harvard Business School in Cambridge, Mass. says that the business community bears for 55 percent of the nation's total health costs, the government just 45 percent. Moreover, many businesses eventually want to get rid of their health costs altogether.

"Bringing costs under control is the only way," Sen. John Mccain said on his website, "allow our companies to effectively compete around the world."

Unfortunately, McCain thinks the way to get costs under control is via insurance companies competing with less regulation and more tax breaks. That's worked so well already, after all.

State-Based Health Care Reform Act

Talk about a buried lede. Or the mainstream media not paying attention to an important story. The Milwaukee Small Business Times reports that a bipartisan proposal would let states reform health care - "States could use single-payer systems, expansion of current programs, market-based reforms or adopt completely new ideas in their efforts to cover the uninsured."

U.S. Sen. Russ Feingold (D-Wis.) and Sen. Lindsey Graham (R-S.C.) are authors of the State-Based Health Care Reform Act. Sen. Susan Collins (R-Maine) signed on today.

You can read the bill at the Library of Congress's Thomas.

There's a longer article on the bill at Psychiatry Online from October 2007.

S 1169... would establish the Health Care Coverage Task Force to approve grants to states whose proposals mandate minimum requirements in coverage and quality measures and meet cost guidelines. The bill would provide about $40 billion for state matching grants to expand health care coverage, while mandating certain "cost-sharing" limits to keep the coverage affordable for beneficiaries...

Another state-based approach would authorize grants for states to create universal health care pilot programs that could become models for other states and the country. The legislation, sponsored by Sen. Bernie Sanders (I-Vt.) and known as the States' Right to Innovate in Health Care Act of 2007 (S 2031), would authorize five, five-year grants to states committed to developing plans for universal, comprehensive, cost-effective health care. The states would have to provide comprehensive benefits, including coverage for long-term care, diagnostic services, preventive care, prescription drugs, dental and vision services, and mental health treatment including that for substance abuse.

What's PNHP's position on these bills?

Maine paper pushes single-payer

This isn't quite an endorsement of single-payer, but it's pretty close. The Bangor Daily News evidently has a readership close enough to Canada that they're not fooled by the propaganda slurring Canada's system. The editorial reads:

Much of American health care is already run quite satisfactorily on a single payer basis: Medicare, Medicaid and the veterans’ health system.

Government run health plans, usually single payer plans, are good enough for Canada, Britain, France, Denmark, Sweden, Germany, Australia, New Zealand and most other developed countries. Why can’t they even be considered and debated by candidates for the U.S. presidency?

Stopping Reform: Public Thoughts

CNN Money has a piece with advice for health insurance companies and Pharma on what to do about all the talk of health reform. I'm wondering who the target readership is — perhaps mid-level management types?

Hard to say.

The advice boils down to this: Not to worry. Act reasonable, then after the elections lobby as usual.

Tidbits:

In a December report called "Beyond the Sound Bite," PricewaterhouseCoopers compared the health-related policies of seven major presidential candidates: ... Democrats Hillary Clinton, Barack Obama and John Edwards and Republicans Rudy Giuliani, Mitt Romney, John McCain and Fred Thompson. ...

The Democrats propose "broader and more immediate changes, with new mandates, programs and funding."

The Republicans want no new government programs, preferring "indirect approaches such as changes in tax incentives that could move insurance away from an employer-based model."

PWC boiled down the issues to these: covering the growing uninsured population, changing tax rules to support health system changes, controlling health costs, and improving quality of care....

[None of the] candidates propose a single-payer system along Canadian lines. All seven candidates tend to rely on expansion of the existing private insurance market.

But the report notes, "The Democrats say they would also create new public programs to offer more choice and compete with private insurers."

The PWC expert advised the insurance companies needed to devise a strategy to compete with the government, if Clinton's or Edward's plan goes through.

Even if the Democrats don't hold the Congress and/or take the White House, Republicans can't be expected to maintain the status quo, says John E. Calfee, a scholar at the American Enterprise Institute ...

That's because the momentum to do something to bring the 47 million uninsured into the system is too strong.

"You know there's going to be heavy action on the Hill over this even if the Democrats don't win," Calfee said.

He suggests that the insurance industry attack head-on the question of its efficiency. Some analysts put the cost of bureaucracy and paperwork at 30% of the $2.1 trillion (in 2006) spent on health care in the U.S.

As for Pharma, a USC professor of pharmaceutical economics says he expects that Medicare Part D will change, and receive the ability to negotiate drug prices. That could hold down prices and bring greater transparency to the market — a worrisome scenario for Pharma stockholders, no doubt.

The good professor's advice: "appear cooperative and happy to get along with a new regime. Then, after the election, lobby vigorously in Congress, as usual."

McCain's short circuit

John McCain's column on U.S. health care begins so well:

WE HAVE AN approaching perfect storm in health care, and no one seems to be watching the clouds gather.

More families are without health insurance as premiums increase beyond the affordability of our citizens and their employers. Our safety net programs of Medicare and Medicaid are headed to financial meltdown and draining dollars from critical programs such as education. Our companies cannot continue to compete outside the country because health care costs are so much higher in the United States.

Leave out that bit about Medicare and Medicaid, and you've got some truths (and of course, with the Big Pharma giveaway that is Medicare Part D — no negotiating with pharmaceutical companies over the cost of drugs for Medicare recipients — the Republicans did manage to make Medicare unsustainable). McCain then attacks the Democratic candidates for their "same old" solution of universal coverage, which really means, he writes, "massive tax increases, mandates and government regulation, and no solution to rising costs."

Fair enough, since that is indeed the truth to mandates — unless mandates are a back-door route to single-payer. That seems unlikely, given the dominance of the organized money behind insurance. What he calls instead is almost unintelligible. If I hadn't heard McCain's policy guy in D.C. earlier this month I would come away wondering if McCain might not be the Nixon to China conservative on single-payer.

Here's why. McCain writes:

I offer a genuinely conservative vision for health care reform, which preserves the most essential value of American lives -- freedom.

We should not attempt to substitute government coercion for the right of individuals to decide what is best for them. Our citizens should not pay for the collective sins of a failed health care system. We must use the tools that have served us so well in the past -- competition, American ingenuity and personal responsibility.

Exactly what we in the single-payer movement are calling for, and exactly what Canadians, the Japanese, French, Greeks, Brits, etc. all have: freedom (aka choice of physician and hospital; and the freedom to be treated for medical ailments), which leads to competition amongst the docs and hospitals, with a strong element of personal responsibility injected. We are each responsible for our health. It's our government's role to empower us to do that better, however, not to punish us for not doing it well enough.

What kind of society do we want to be, an empowering one or a punitive one?

McCain also sings the single-payer tune when he notes that we should all have to "pay for the collective sins of a failed health care system." So well put.

Unfortunately, he then turns to gobbledygook, advocating tax credits so that more people can pay premiums to the insurance industry protection racket. Too bad. Ideology and a long career in Washington have blinded McCain to the real way forward — the conservative solition, since it fosters freedom, competition and fiscal sanity.

p.s. McCain has taken a page from Bush, whose image guys have long stood him in front of graphics that make it appear as though he has a halo. McCain's is more like a victorious Roman general's armored head-dress. Appropriate — he's not depending on the Christian fundamentalists hoping for end-times.

Don't let them choose

Mort Kondracke, executive editor of the Capitol Hill newspaper Roll Call, offers up conventional beltway wisdom on healthcare reform in a piece decrying the idea that people should be able to choose a public plan.

The case against Clinton's health plan -- and it's applicable to Edwards and Obama as well -- is that by creating a Medicare-like government alternative to private insurance and heavily regulating private plans, people will flood to the government plan, leading to Canadian-style medicine.

As Joseph Antos, a scholar at the American Enterprise Institute put it, Clinton has designed "a reasonably clever way to prove that the private sector doesn't work and have the government swoop in on a white horse. ... [She's] not jumping immediately to a single-payer system -- politically, that's a smart move -- [but] indirectly."

Antos and others contend that Clinton's proposed requirements that insurance companies cover everyone who wants a policy ("guaranteed issue") and charge everyone the same premium regardless of health, age or pre-existing medical conditions ("community rating") will hugely raise the price of private insurance, giving an advantage to her government-run insurance plan.

At a forum last week sponsored by the Kaiser Family Foundation, Clinton said, "We're going to change the way insurance companies do business in America. Right now, [they] spend $50 billion a year trying to figure out how not to cover people. Well, I'm going to save them a fortune and a whole lot of time because the new policy is, no more discrimination, period."

Clinton's $50 billion figure seems to encompass all underwriting, marketing and administrative costs for the insurance industry. She said government programs were far more efficient, but neglected to note that insurance companies provide services like disease management that public plans don't.

Various studies show that several states that have imposed guaranteed-issue and community rating requirements in the past ultimately repealed them after insurance companies dropped coverage and quit selling in the states.

Other studies document that public satisfaction with Canada's single-payer system is low because of long waits for diagnostic tests and surgery. Canada's Supreme Court overruled the government's ban on private insurance.

Kondracke's got a couple things wrong. First of all, Canadians are more satisfied than Americans on their healthcare, and only 8 percent say they'd prefer to switch to the U.S. system.

Second of all, disease management? Disease management is something our private insurance system does well? What?

According to Wikipedia, disease management concerns itself with coronary heart disease, kidney failure, hypertension, heart Failure, obesity, diabetes, asthma, cancer, arthritis, depression, and other common ailments. Exactly the kinds of chronic conditions that American health plans cherry pick against.

Most if not all of these ailments are managed far better in Canada and other universal healthcare nations. Far too often an HMO's management consists of making insurance coverage unaffordable and then, once a person drops coverage, no other insurance plan being willing to take that person on. And in any case, disease management would of course be part of public plans — even today. Because they're a function of the providers. Whether it's the VA or a physician getting paid through Medicare — or even an HMO being paid through Medicare — providers either do a good job or not of disease management. Because there's continuity of care in, for instance, France, disease management is done better than we can manage.

I'm not a regular reader of Roll Call. Who knew it was funded by lobbyists? Makes sense, though. Someone's got to pay the bills.

Colorado's Perlmutter quotes old polical boss

By Donna Smith

DENVER -- Ed Perlmutter, the U.S. Representative for House District 7 in Colorado, spoke to a group of constituents in Lakewood, Colo., on Wednesday and quoted an old political powerhouse when I asked him about health care lobbyist money as an influence on the health care reform debate.

The quote, in its cleaned-up form, turns out to be well-known:

"If you can't take their money, drink their liquor, screw their women, and then come in here the next day and vote against them, you don't belong here." -- Jesse Unruh, Speaker, California State Assembly, 1961-1969.

Known as “Big Daddy Unruh,” he also was credited with saying that money is the mother’s milk of politics. He was a powerful force on the national political scene and his political life served as a case study on “machine politics.”

It was interesting to have Unruh’s name come up in today’s session.

During the questions and answer period of Perlmutter’s meeting, I asked the freshman Congressman about making meaningful changes in health policy law and about bringing debate on health care reform to Congress. He pointed out that Rep. Diana DeGette of Colorado’s 1st Congressional District is in a powerful position a vice chair on the Energy and Commerce Committee, where health care is a major focus.

I countered that I appreciated DeGette’s potential power, but that I had concerns about the fact that her second highest contributing group in terms of her campaign financing is from health care related lobbyists. I suggested that while that doesn’t unequivocally mean that her loyalty is to those lobbyists that it does and should raise a red flag for voters like me who are concerned about health care reform.

When Perlmutter came to her defense with the Unruh quote, I was a bit taken aback. He went on to explain that because he represents a diverse district with Republicans, Democrats and Independents, he receives campaign contributions from a wide variety of individuals and interests, but that does not mean he panders to individual contributing interests. “I have faith in Diana,” he added.
Audience members added their questions about why the U.S. is the only industrialized nation without universal health care.

Another woman echoed my concerns about why those approved for Social Security Disability must then wait two years for Medicare health benefits. That seems inherently unfair when a person has been determined to be too disabled to work but then languishes without insurance or burdens other insurance plans or is unable to secure coverage at any price in today’s health insurance environment.

I told Perlmutter that Rep. John Conyers of Michigan, chair of the House Judiciary Committee, told me he would look into that too and would work to change that. The lag time between my husband Larry’s approval for Social Security Disability and his eligibility for Medicare coverage was one of the financially devastating factors that led to our bankruptcy as he fought his artery disease and I fought cancer.

All-in-all, Perlmutter said he is anxious to read all the health care reform proposals selected by Colorado’s 208 Commission and learn about the provisions of each proposal before settling on his preferred position. He pointed out that health care issues drive nearly 20 percent of the national economy and it is a complicated problem. He did not offer much support for universal health care. He didn’t speak against it.

I thanked him for his attentiveness, gave his staffer a copy of my July 17, 2007, testimony before the House Judiciary sub-committee, and told him I looked forward to meeting with him in Washington, D.C., as scheduled for Sept. 26, before the vigil on the Lincoln Memorial steps on Sept. 28 at sundown.

Paul Wellstone and plane crashes

The Twin Cities Daily Planet has a nice quote from Jack Nelson-Pallmeyer, an activist professor considering running against Norm Coleman for Paul Wellstone's old Senate seat.

"The purpose of good government should be to make sure that the benefits of the economy are dispersed widely and that taxes are invested for the common good," said Pallmeyer. "The rules of the economic game are undermining the health of our families."

Pallmeyer supports single-payer universal healthcare.

I couldn't help but think of Wellstone as I watched John Perkins on Democracy Now last week. Perkins, the author of Confessions of an Economic Hit Man, talked in part about how he had viewed his work — corrupting foreign officials — as urgently necessary for the well being of those officials. If they weren't corruptible, they often died. Two South American presidents he worked with died in small plane crashes within weeks of each other after refusing Perkin's blandishments.

Perkins writes, "The book was to be dedicated to the presidents of two countries, men who had been his clients whom I respected and thought of as kindred spirits - Jaime Roldós, president of Ecuador, and Omar Torrijos, president of Panama. Both had just died in fiery crashes. Their deaths were not accidental. They were assassinated because they opposed that fraternity of corporate, government, and banking heads whose goal is global empire. We Economic Hit Men failed to bring Roldós and Torrijos around, and the other type of hit men, the CIA-sanctioned jackals who were always right behind us, stepped in."

WI single-payer proposal

A retired small business owner in Colgate, Wis., writes Single-payer system would bring windfall for businesses in the Small Business Times, a journal for Milwaukee and Southwestern Wisconsin small business news.

His charge is that the campaign contributions from healthcare and insurance industries — now joined by banking and credit card interests that benefit from health savings accounts — have corrupted politicians who can no longer see that the compromises they're making are killing Americans and American business.

He urges small business to support the single-payer bill before the Wisconsin Legislature:

Sometimes you have to spend money to make money, and that's exactly what Sen. Mark Miller (D-Monona) and Rep. Chuck Benedict (D-Beloit) do with the Health Security Act (SB51/AB94). A small additional payroll tax for employers eliminates the 10 to 15 percent they currently spend on health care benefits, and a small additional payroll tax for employees eliminates costs of co-pays, deductibles, dental, vision, and scores of other expenses...

If you are hung up over the government's involvement, get over it. There are some things best left to the government to fund. Fire and police protection, building public roads, and funding health care are just a few. Political campaigns are another, but that's a story for a different day...

Where are the non-healthcare business leaders on this? Many with their heads in the sand. They are trying to reduce costs in this so-called "free market" system, all while turning their heads when their fellow healthcare businesses pick their pocket.

Lohman can be reached at jlohman@execpc.com.

Morality: Two or Five Foundations?

I just linked from Onegoodmove.org to this New Yorker clip with cultural psychologist Jonathan Haidt talking about the difference between conservative and liberal moralities.

Not only is Haidt nice to watch — funny, entertaining, smart (oh, and handsome) — he's got some great insights here that explain some things that I became aware of while working for the Catholic Church. Haidt describes how liberals have primarily a two-foundational morality based on protecting the weak from harm and on fairness. Both of those values are intrinsic to a social species with vulnerable young and nursing mothers, and which has reciprocal social interactions that are damaged by cheating.

Those moralities are our American, Enlightenment values, and reflect the definition of morality that psychologists go by and that of a tolerant, diverse society.

However, traditional societies, as exemplified by Islamic society and fundamentalist, conservative and rural societies, have five foundations to their morality that liberals miss out on. Their additional moral foundations are based on:
• in-group thinking, that is, loyalty;
• authority, that is, respect; and
• purity, that is, temperance.

Haidt refers to studies that show religious and conservative people to be happier, and he explains that like this: "As society gets more modern and more free, the depression rate goes up and people get lost… if you simply measure how happy people are... conservatives are happier... and a lot of the reason for this is because conservatives participate in denser, more binding social structures. We think we want freedom but if you get freedom beyond a certain point it’s actually bad for you..."

Talking about the three Democratic candidates, Haidt says that Ds have spent way too long thinking that people will vote for the person with the best policies. He cites Malcolm Gladwell's book Blink, on rapid cognition — which happens in the blink of an eye, and how a lot of choices that we liberals believe we should be thinking through actually happen on that basis.

Haidt judges that Hillary isn't a natural at speaking to people in a way that inspires awe and makes people feel elevated — although she's getting better. He sees Edwards and Obama as naturals, with Edwards operating from that liberal, two-foundation morality and Obama able to also reach the five-foundation crowd.

The entire talk lasts a while but is completely worth the time.

Haidt left out the odd libertarian version of conservatism, which pretty much leaves out kindness, fairness, authority, and temperance, and leaves only in-group, with the in-group being basically just that one person or family and Ayn Rand — and she's dead.

He offered this analysis so liberals could understand where conservatives are coming from — in particular on gay rights and abortion. It also explains a lot about the Iraq war (authority and in-group values). It does not explain, however, the deadly American distrust of government that has played into the hands of those who have for so long successfully denied Americans the universal healthcare that is a right of citizenship in every other industrialized nation on earth.

At least we've got universal primary and secondary education. Keeps the kids off the streets.

Sicko at Cannes and HCAC on KRFC

Tomorrow night's "Imagine Action" program, 6 - 7 p.m. on Fort Collin’s KRFC (88.9 FM or online here), will focus on health care reform. Guests will be Health Care for All Colorado and Physicians for a National Health Program member Dr. Cory Carroll, a local family practitioner and president of the Larimer County Medical Society; Rudy Deutschmann, president of the State Association of Health Underwriters; and HCAC board member Eliza Carney, who will discuss the 208 Commission and the political process around health care reform.

The call-in number is 970-221-5065.

In more international single-payer news, take a look at Salon’s feature article on Michael Moore’s new film Sicko. It will do your heart good.

Author Andrew O’Hehir writes that Sicko is

both a more finely calibrated film and one with more far-reaching consequences than any he's made before. Moore is trying to rouse Americans to action on an issue most of us agree about, at least superficially. You may know people who will still defend the Iraq war (although they're less and less eager to talk about it). But who do you know who will defend the current method of healthcare delivery, administered by insurance companies whose central task is to minimize cost and maximize shareholder return? Americans of many different political stripes would probably share Moore's conclusions at the press conference: ‘It's wrong and it's immoral. We have to take the profit motive out of healthcare. It's as simple as that.’

Sicko purposefully does not focus on the 50 million or so Americans who don't have health insurance, as scandalous as that is, but on the horror stories of middle-class working folks who believed they were adequately covered. There are so many of these they begin to blur into each other: the woman in Los Angeles whose baby was denied treatment at an emergency room outside her HMO network, and died as it was being transferred hours later; the woman in Kansas City whose husband was repeatedly denied various drugs his physician prescribed for kidney cancer, and who in the last stage of life was denied a bone-marrow transplant that could have saved his life; the woman who was told her brain tumor was not a life-threatening illness, and died; the woman who was told her cancer must have been a preexisting condition, and died.

If the Salon article whetted your appetite for more reviews, here’s one from The Guardian:

His question: what has happened to the idea of universal healthcare in the United States?

In four tidy acts, Michael Moore spells out the facts. Act one: 50 million Americans have no health cover, and 250 million who think they do, through costly health insurance schemes ($2,000 per person a year), are often denied treatment when they need it….

Act two: when did it all start going wrong, asks Moore. The answer: in August 1971. President Richard Nixon and his adviser Edgar Kaiser plot to break the system. "The less care they give, the more money they make," says Nixon, caught on tape….

Meanwhile astute national publicity campaigns have demonised the concept of universal healthcare by associating it with "socialised medicine", which in American English translates as "Soviet medicine" - the kind such oppressive regimes as Canada, Britain and France have adopted for their citizens….

Act three: Moore pays these regimes a visit….

Act four, the most powerful: Moore decides to test the US administration's claim that Guantánamo Bay prisoners get the best free healthcare in the world. He takes 9/11 volunteer rescue workers, whose health problems were not covered by the state because they weren't on its payroll when they ran to help, to Guantánamo Bay in Cuba….

And lastly, the news, also in The Guardian, that the U.S. government is trying to impound Moore's film – a claim that’s hard to dismiss considering everything else in our country’s recent past. “Now, according to movie mogul Harvey Weinstein, whose Weinstein Company is behind the film, the US government is attempting to impound the negative.”

The pretext would be Cuba. Moore had applied for permission to travel there but received no reply until this month, when “the treasury department notified Moore that it was investigating him for unlicensed travel to Cuba.

Watch a trailer for Sicko and more on Moore's website.

Kick the bums out

This would be why Sen. Chris Dodd should not have a chance at the White House. He shamelessly pandered on the insurance industry's behalf for cash and cheap political points at the time of the Clinton reform attempt. We've got to grow longer memories so that politicians can't get away with crap like that.

Dennis Kucinich on healthcare

We're already paying for universal healthcare. We're just not getting it.

Ezra covers Edwards

Ezra Klein gives John Edwards' health plan a good grade in this crib sheet at the Prospect.

Here's how it works: On first blush, the plan is much like the Wyden initiative, though it puts the onus of the responsibility for funding health coverage on employers... The employers can satisfy that responsibility by either providing comprehensive care, or helping employees purchase from a menu of insurance options provided by newly formed, state-run "Health Markets."

As of now, the plan doesn't explain how much employers must provide towards health market coverage, but it's a safe bet to assume that it's somewhat less than the total cost of health care, and so the incentive will be for employers to encourage their employees to purchase from the HMs. And that's where things get interesting. The HMs will offer a menu of private options that are totally community rated. The plan "will require insurers to keep plans open to everyone and charge fair premiums, regardless of preexisting conditions, medical history, age, job, and other characteristics." These days, though, community rating is a common enough.

Where the Edwards' plan takes a big step forward is in mandating, along with the private options, that HMs offer "at least one plan [that] would be a public program based upon Medicare." And the intent is explicit: "Health Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan."

At his own site, Klein writes that the media coverage of John Edwards' health plan was bad — snarkily compared to Hillary's 1994 plan in the NYT and just given a mushy "it's a tree" description in WaPo: "Reading their coverage, you'd be hard-pressed to distinguish the plan from any other proposal ever offered," opines Klein.

Klein thinks Edwards' plan is a big step forward, because it will allow the public and private sectors to compete with each other. If that were to be the case, I'd feel better about this plan, even though it does seem to be a long way around to the right solution. However, why would the powerful medical insurance lobby ever allow the public sector to compete on a level playing field? Medicare would have to be adequately funded for that, and all the private sector would need to do is ensure that the people signed on to the public program were subsidizing people who couldn't afford insurance and voila — the public subscribers be getting a raw deal. There would also be the same stigma as riding the city bus in Denver.

Can't afford a car, eh?

Maggie Mahar, author of Money Driven Medicine (2006), writes, in a response to Klein at The Prospect:

We don't have the best healthcare system in the world — patient satisfaction is lower in the U.S. and hospital errors are higher — as are mortality rates for many diseases. End-of-life care in the U.S. is both extraordinarily expensive and cruel.

Yet we spend far more than any other country on health care ($2 trillion, of which about $600 billion is wasted) and that bill has been rising by 6% to 10% a year--more than twice as fast as wages or GDP.

By accepting runaway healthcare inflation we are caving in to the corporate interests now running our health care system: Big Pharma, device-makers, for-profit hospitals and lobbies created by some of the highest-paid specialists who do the largest number of unnecessary sometimes unproven procedures.

These are powerful interests, but unless we face them down, healthcare reform will simply mean universal access to unnecessary, sometimes unwanted care at a price that we cannot afford.

This is not a one-time waste of money (like Iraq)--it is a continuous, ever-escalating expense. We have to get a handle on cost if we have any hope for healthcare reform.

I would love to see the Edwards plan empower the public insurer (Medicare) to use its enormous clout to negotiate serious discounts on drugs and devices. Medicare also needs to stop paying doctors and hospitals for volume (fee-for-service).

On March 1, the Medicare Payment Advisory Commission (MedPac) will be releasing a report March 1 that talks about waste in the system--and alternatives to paying doctors for volume. It will be interesting reading.

Wes Clark is for single-payer

Wes Clark gets it.
He says after studying the issue, he doesn't see how we can achieve our healthcare goals without going to a single-payer system.
The real question is how can anyone, after studying the issue, not agree?

SOTU & Pelosi

The best part of 2007's State of the Union speech is already past. It was the standing ovation for Rep. Nancy Pelosi (D-CA), the first woman to serve as speaker of the house. It truly was an emotional moment.
And now, to see her there instead of Dennis Hastert — what a relief on the eyes and to the heart.