Eliza Carney lauded

Eliza Carney is a major force at Health Care for All Colorado. She's got an amazing stamina and the skills to organize — she's built a great team of healthcare activists in Fort Collins, Colo. She's also smart and funny. So bravo to Cherry Sokoloski, editor of the North Forty News, for this feature on Eliza.

Sokoloski writes:

Her opinions about health-care systems were forged partially in New Zealand, where she and her husband, Jim, lived for a time. New Zealand has universal health care, with the government paying the bills.

"It was much more personal care," with a greater emphasis on wellness, Carney recalled.

Also, doctors did not push for unnecessary surgeries. Her husband had problems with his back while in New Zealand, and his doctor prescribed a body cast instead of surgery. The approach worked.

"We use far too many drugs and surgeries in this country," Carney stated.

Go Eliza!

What's wrong with Medicare

Dennis Kucinich explains: "Medicare, essentially, is built to be efficient. And it has worked for many people... (But) the Bush administration's philosophy has been to move increasingly toward the privatization of Medicare. They don't want Medicare to work ... the (federal government) is trying to drive up the costs, (and) they're limiting reimbursements to physicians to discourage them from participating in the system."

Does your doc work for Cigna?

Warren Pease has a brilliant essay titled "So... what's this here single-payer health care thing all about anyway?" at the Online Journal. Here's his answer:

Well, surprise, surprise, it's not socialized medicine. The federal government won't set up shop in every doctor's office and medical facility. Unlike the current system, in which privatized pests occupy a permanent position overlooking every doc's shoulder, governmental bureaucrats won't be making harassing calls to doctors offices every five minutes to second-guess whether a patient actually needs that procedure, or that test, or that prescription.

Let's say your doc has his own small family practice, which he runs as an LLC. He probably accepts payment from a couple dozen different insurance carriers. Does that mean he works for, say, Blue Cross or Cigna or Aetna? Of course not.

Under single-payer, he would no more work for the government than he now works for an insurance company. He gets paid by the feds, but runs his own business exactly as he has for many years.

So docs and hospitals continue to operate as they always have, although for-profit facilities must convert to non-profits.

Pease begins with an intro to corporate law, and then moves quickly to a good analysis of what happened to 17-year-old Nataline Sarkisyan, and then to what will cure our "murderous system":

By law, the only obligation of a publicly owned, for-profit US corporation is maximizing return for its shareholders. That's it. Nothing about good corporate citizenship, the public good, saving lives or anything else that isn't related to jacking up the price per share and maintaining a reasonable price-earnings (P/E) ratio.

If Cigna had been operating outside the rules, perhaps we could simply discipline that one company, levy stiff fines, jail a couple of high-ranking execs and serve notice to the rest of the industry that such behavior won't be tolerated. But that's not the case. Cigna was following the rules. The problem is that the rules are insane. That's why this profit-driven disaster of a medical system must be replaced.

We need to dump this murderous system entirely. It's too far gone to tinker around the edges. We simply have to get rid of the profit motive as the driving factor in determining who lives and who dies. We need to decouple the idea of health care from the idea of health insurance, since the two have absolutely nothing in common.

He describes single-payer perfectly: "a national health care program, funded by a modest and progressive tax, and generically called 'single-payer,' meaning that the insurance industry's multiple payers are replaced by a single entity, usually a state or the federal government."

Pease also has an informative link to a (hmmm) "scholarly treatment" on single-payer and other "stupid liberal ideas."

The neo-conservative godfather Leo Strauss believed that the masses needed to be kept divided in order to keep a natural aristocracy (i.e., Cheney) on top. Along those same lines, Krugman believes racism is at the heart of why we don't have universal health care — Pease agrees, adding that of course pr has been masterfully used to prejudice us against the idea of a common cause. Nope, we're rugged individualists, all smoking Marlboros and driving SUVs because it might snow one day.

Pease writes,

The insurers have As one California psychologist who serves on several managed care rate negotiating teams in the Santa Cruz area told me a while ago, "They have become adept at providing the illusion of health care, while avoiding the messy and expensive reality of having to actually deliver it — to the extent legally possible. And you'd be amazed at what's legally possible. Most of the time you can't even sue them so, at some point, the consumer literally has no recourse but to beg for his or her life. Increasingly, those pleas fall on deaf ears as the race to maximize profits obliterates what's left of basic human kindness."

Obamass

Ezra Klein reminds me today why Obama might not be so bad. It all goes back to the idea that liberals want to be inspired, conservatives led. And Obama can inspire. From Klein:

Obama's finest speeches do not excite. They do not inform. They don't even really inspire. They elevate. They enmesh you in a grander moment, as if history has stopped flowing passively by, and, just for an instant, contracted around you, made you aware of its presence, and your role in it. He is not the Word made flesh, but the triumph of word over flesh, over color, over despair. The other great leaders I've heard guide us towards a better politics, but Obama is, at his best, able to call us back to our highest selves, to the place where America exists as a glittering ideal, and where we, its honored inhabitants, seem capable of achieving it, and thus of sharing in its meaning and transcendence.... a call to create something better, bigger, grander, and more just than the world we have. When that happens, as it did with Robert F. Kennedy, the inspired remember those moments for the rest of their lives.

It's about an Obamass.

Ezra's beautiful writing makes me wonder why I can't hear it — and maybe this is a facile answer, but it's the first that came and it won't leave. It's his wife.

To backtrack a bit, I am concerned about his lack of experience, what Paul Krugman today described as the idea that "among at least some of Barack Obama’s supporters there seems to be a belief that if their candidate is elected, the world’s problems will melt away in the face of his multicultural charisma."

This seems like a mirror image of why people voted for Bush. Sure, at an Obamass you get a chalice with communion wine rather than a spit-flecked plastic cup of beer, but it's the same idea that character and image are more important than competence and experience.

But that's not fair. A look at Obama's record and achievements show him to be competent and a man of good judgment. The folks who saw that in Bush were willfully ignorant.

Obama is the only one of the three front-running Dems who doesn't include mandates in his healthcare plan. That should be enough to have me supporting him right there — but then there's Michelle.

She's vice-president for external affairs for a hospital, making $275,000 a year. Hospitals should be on the side on single-payer and reform, but in my experience they're not. This is a strong woman who has made it in cut-throat capitalism, and may well buy into the idea that she deserves to stand on her side of the chasm that divides rich and poor in America — and that the poor deserve to be where they are.

Let's hear what Michelle has to say about healthcare reform.

Insurance Companies' Playbooks

A Cornell doc vents at the LA Times on Cigna's deadly tactics, denying care to its "consumers" until it's too late. This time it was leukemia patient Nataline Sarkisyan's liver transplant.

Nataline, who was 17 when she died, was buried 28 December.

UCLA doctors had put her on a list for a liver transplant earlier in December, and a liver became available four days later. Her doctors told Cigna that Nataline had a 65% chance of living six months if she received a liver transplant. Cigna deemed the transplant experimental and refused to pay for it.

The California Nurses Assn., the Armenian community and Daily Kos publicized the case — which resulted in a telephone and e-mail campaign to urge Cigna to reconsider. It did, but too late for Nataline.

Giuseppe Del Priore has some details I didn't know about, such as the fact that denial of coverage always come with "a sentence to the effect that the doctors must provide whatever care is necessary and that the payment is a separate issue."

I agonize over having to choose whether to wait one more day for approval or to go ahead with the surgery and potentially damn the patient, his family, and the institution, to assuming the financial consequences. If I do go ahead without approval, no one comes to my defense when administrators ask me why so many of my patients' insurers are not paying. No one rescues the bankrupted families.

Another nasty bit of work is calling procedures "experimental" in order to avoid paying for them. Nataline's procedure, he writes, wasn't experimental in any sense of the word.

Ironically, this puts the lie to the idea that American health care is so advanced. We predictably call procedures experimental that are routine in Europe.

Del Priore says the third insurance stall used to kill Nataline was the use of "expert" review — their bringing in what is little different than hired killers to deny care.

Insurers that review my denials define any has-been, retired, unemployed failure with a medical license an expert, paid to deny care. This is practicing medicine without examining the patient or seeing all the data. In effect, the licensed nurse or doctor working for an insurer is practicing medicine unprofessionally and criminally.

Respecting the right

It's hard to come up with a historical era in which right-wing conservatives were really admirable. But the most recent crop have outdone themselves on a global scale. Cheney has turned himself and America with him into something that can be compared to Darth Vadar and the Empire. The world has a healthy respect for his/our power, and a healthy understanding that the Empire itself isn't worth real respect.

(So how much do regular Americans deserve the government we have?)

On the other hand, individual thinkers on the right are certainly worthy of respect. Timothy Garton Ash is on that list. Here he has a thoughtful essay on who should be the most powerful person in the world. Who would it be if you had your druthers? The Dalai Lama? Yourself? An innocent child?

Not too many of us would choose the innocent child, which is his point. He thinks Obama isn't ready.

"I started 2007 as an enthusiastic Obamaite," he writes. "I go into 2008 a sober Clintonian. "I continue to believe that Barack Obama is the only candidate who could change the United States' image overnight. It is now consistently less popular across the globe than at any time since international polling began. Obama personifies those aspects of American society that even some of Washington's fiercest critics admire, and he has some good ideas too. The trouble is, the more I watched him last year, the more convinced I became that he is not yet ready for the job."

Mandates: Bad Solution

Good piece on Huffington Post from Larry Womack — he begins with a quote from Obama: "It would be extremely unfair to enact a mandate before we make health care affordable."

Here, in Womack's words, is the argument against mandates: "Seventy-six percent of these people [who filed for bankruptcy for medical reasons] had medical insurance. Many of those lost it when they became ill and therefore unable to work. For the rest, it just wasn't enough to cover the staggering costs of an out-of-control system of medicine. Researchers concluded that a national health insurance system could eliminate half of all bankruptcies, sparing about 2.2 million hard-working, bill-paying citizens from financial ruin every year."

Regarding the difference between Hillary's plan and Obama's: "They're both awful, and they're both a hell of a lot better than the big nothing we have now."

I don't know about that, but Womack's right about this:

It's been stated many times that virtually every essential public service is handled by the government, except health care. Rightly so, since it seems a rather absurd omission--the very purpose of government is, after all, to provide a basic level of safety. If you're mugged, beaten and set on fire, the government will hose you down and even punish the guy who did it. You're just on your own when it comes to those potentially-fatal burns....

As long as we allow them to, our leaders will offer us small solutions to big problems. Clinton got burned in 1993, and now makes no secret of the fact that she won't do anything until we've built "a national consensus." The US health care system has class IV hemorrhaging and our leaders are tossing us band-aids.

Womack links to a piece on mandates that ran in the Baltimore Sun the day after Christmas. Its writer, David Nitkin, goes to a Harvard health policy professor, Robert Blendon, who says that Switzerland and the Netherlands are the only two countries with anything like a mandate, and that their systems are quite different from those being proposed here.

Nitkin doesn't explain how they're different, nor does he point out that the Netherlands system is all of a year old, and, says David Himmelstein, the Swiss system isn't that much older.

I expect that the difference lies in the European systems being regulated to an extent that make them truly the counterparts of utilities — in it for public service, not profit.

Nitkin writes "Many voters, particularly Democrats, say the affordability and availability of health care is a top concern they want to see the next president address. But while voters tell pollsters that they want a presidential candidate who supports universal health care, far fewer say they want a Medicare-style government program that replaces private markets."

That may have been true 10 years ago, but no longer. Celinda Lake's survey numbers for the Hearndon Alliance show 67 percent of Americans in favor of expansion of health care — as Nitkin says, they want this addressed.

But nearly two-thirds of voters in an AP poll last week said explicitly that they favor an expanded Medicare for All. That is not "far fewer," as Nitkin claims.

What kind of people are we?

What kind of people are we?

When you think about whether you like a person, what's your criteria?

Me, I like smart, witty people. But although I'll laugh at a mean comic's jokes, I don't want to hang out with them. My brother Curtis knew comics who were awful people. Funny, awful people. He doesn't hang out with them any more, although, like me, I suspect he still laughs at their jokes.

Through my brother Paul, on the other hand, I met some self-consciously do-good types in the film industry. One of whom left me completely cold when it became apparent that he was a do-gooder in theory, but not so much when the opportunity presented itself.

Nobody's perfect.

But in general, we don't choose friends who care only for themselves, who hurt others, who see money as being more important than people, and who don't pause to take care of the lost old lady, the dog in traffic, the crying kid.

At least I don't. Fact is, I want systems in place that keep the dogs out of traffic, that protect the vulnerable, and don't leave it to the vagaries of private charity and someone else's personal responsibility.

That's just me, sure. I'd like to think, however, that with the exception of a few misguided and ideologically blinded libertarians, plus a few more hard-hearted conservatives without consciences, most Americans feel the same.

What do you think?

Who are we, we Americans?

Edwards knows the enemy

Michael Moore isn't endorsing anyone, but he likes Edwards:

It's hard to get past the hair, isn't it? But once you do -- and recently I have chosen to try -- you find a man who is out to take on the wealthy and powerful who have made life so miserable for so many. A candidate who says things like this: "I absolutely believe to my soul that this corporate greed and corporate power has an ironclad hold on our democracy." Whoa. We haven't heard anyone talk like that in a while, at least not anyone who is near the top of the polls. I suspect this is why Edwards is doing so well in Iowa, even though he has nowhere near the stash of cash the other two have. He won't take the big checks from the corporate PACs, and he is alone among the top three candidates in agreeing to limit his spending and be publicly funded. He has said, point-blank, that he's going after the drug companies and the oil companies and anyone else who is messing with the American worker. The media clearly find him to be a threat, probably because he will go after their monopolistic power, too. This is Roosevelt/Truman kind of talk...

And he voted for the war. But unlike Senator Clinton, he has stated quite forcefully that he was wrong. And he has remorse...

Edwards is the only one of the three front-runners who has a universal health care plan that will lead to the single-payer kind all other civilized countries have. His plan doesn't go as fast as I would like, but he is the only one who has correctly pointed out that the health insurance companies are the enemy and should not have a seat at the table.

Right.

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?