(For previous posts on the issue of health care, see here.)

The advantages of single-payer systems over the current US system are becoming increasingly obvious. Another pro-business publication BusinessWeek concedes the advantages of the single payer system as is practiced in France.

In fact, the French system is similar enough to the U.S. model that reforms based on France’s experience might work in America. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self-employed, are free to prescribe any care they deem medically necessary. “The French approach suggests it is possible to solve the problem of financing universal coverage…[without] reorganizing the entire system,” says Victor G. Rodwin, professor of health policy and management at New York University.
…
France also demonstrates that you can deliver stellar results with this mix of public and private financing. In a recent World Health Organization health-care ranking, France came in first, while the U.S. scored 37th, slightly better than Cuba and one notch above Slovenia. France’s infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S. (my italics)

PBS’s Frontline had a program Sick Around the World that looked at the health care systems in England, Taiwan, Germany, Switzerland, and Japan.

The private, profit-seeking health industry knows that their system is terrible compared to what single payer or socialized systems can offer and so they have to obscure and confuse things as much as possible. What has been amusing to watch has been the logical knots that the health industry has been tying itself up in to avoid even the minimal public option that has been proposed, saying that it would drive them out of business. Of course, if their claims that the government cannot run anything properly, that the private sector is far more efficient and will provide better health care at lower cost, then they should not have anything to fear from a public option. Even president Obama, who has been trying to placate the private health insurance industry, found this argument a bit much, saying, “Why would it drive private insurers out of business? If private insurers say that the marketplace provides the best quality healthcare, if they tell us that they’re offering a good deal, then why is it that the government — which they say can’t run anything — suddenly is going to drive them out of business? That’s not logical.”

The fact that they are trying to prevent a public option shows that the opposite is true. What they really fear is that once you take the profits, the huge salaries and bonuses of their top executives, and their exorbitant bureaucratic costs out of the system, the public system will be cheaper and more efficient and people will flock to it. Because of this fear, they and their lobbyists will first try to prevent any discussion at all of a meaningful public option, such as single payer.

If forced to concede one, they will try to hobble it by either limiting access to it or put in a lot of restrictions and rules in order to make is as inefficient and expensive and callous as the private system. “Opponents say private insurers could not compete with a public plan that didn’t have to make a profit. They argue that private health plans would end up going out of business, leaving only an entirely government-run health care system.”

I sincerely hope that this is true. Profit-making entities have no business being in the position of making health care decisions.

What the industry would really like is for the government to mandate that everyone have private insurance and pay for it, and at the same time reserve the right to deny coverage so that they make more profits. Because of this, we should be aware that the public plan that finally emerges from Congress may not be that good because of the amount of money that the health industry funnels to members of Congress. They may try to fob off on us some lousy system that they label the ‘public option’ that is designed to fail.

We should keep pushing for a single-payer, Medicare-for-all type system. The group Physicians for a National Health Program (PNHP) has done wonderful work in pushing for single payer and has created a comparison chart of public option vs. single payer. Single Payer Action Network in Ohio (SPAN Ohio) has come up with a plan just for the state that has the following features:

• Patients get free choice of health care providers and hospitals.
• When you go to your own personal physician for visits, there are NO premiums, NO co-payments, NO deductibles, NO one excluded. You pay nothing.
• When you get your prescription filled by your pharmacist, there are NO premiums, NO co-payments, NO deductibles, NO one excluded. You pay nothing.
• If you need hospitalization, there are NO premiums, NO co-payments, NO deductibles, NO one excluded. You pay nothing.

It beats me why anyone would prefer the current bureaucratic, service denying nightmare of the private, employer-based, profit-seeking system over such a plan.

POST SCRIPT: Tom Tomorrow on health care

One of my favorite cartoonists has been on a tear recently with three strips on health care: one, two, and three.

(For previous posts on the issue of health care, see here.)

The fact that the current US system is broken and needs a complete overhaul with government involvement is becoming increasingly apparent to almost anyone except for those who have some kind of visceral reaction to the government being involved in anything. It is because of the stark reality faced by ordinary people that, despite the incessant propaganda against single payer public plans by the health industry and its allies in Congress and the media, the polls are pretty clear that people favor a greater government involvement in the health care system.
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(For previous posts on the issue of health care, see here.)

It is important to realize that in the single payer or socialized systems, everyone is covered and no one is denied coverage for lack of employment, pre-existing conditions and the like. Does that mean that one will be able to have any treatment that one desires whenever one desires it? Of course not. Whenever there is greater demand than resources available, there will always have to be decisions made as to how those resources are to be utilized, and invariably some treatments may be denied or delayed for some people.

The point is that this occurs even now in the private health insurance system that we have in the US. The difference, and it is a huge one, is that the private health insurance decisions about whom and what to treat are made by bean counters who are driven by the insatiable drive to make profits for their companies and who seek every means to deny treatment. There is almost nothing that ordinary people can do when they get shafted by the companies, because they are expert at giving you the run-around.

In single-payer and socialized medicine, decisions about how to allocate resources are made by collectively by physicians, other health professionals, and public policy makers who try to maximize the benefits of the system with the resources they have. There is usually some kind of board that is responsible for the workings of the system, but unlike the boards of directors of private, profit-seeking health insurance companies, they do not personally benefit financially by limiting treatment. And if we do not like how the system is run, then we have power to change things in that we can either vote to give the system more resources (the way we vote levies for schools and libraries) or we can vote for a government that will make the changes we desire. The public ultimately controls the health care system, which is as it should be.

It is also important to realize that in both single payer and socialized systems that are in existence in other countries, people still have the option to buy private health insurance if they want extra services, so those people who want premium services can still have them.

Those who think that they have good insurance now in the US from the profit-seeking private health insurance companies and resist change towards a single-payer or socialized system might be in for a nasty shock when they actually get ill because the health insurance industry has entire teams of people whose sole job is to find ingenious ways to deny coverage. The US health care system is truly wonderful as long as you do not get sick. Reporter Lisa Girion of the Los Angeles Times of June 17, 2009 reports on how the insurance companies cancel the medical coverage of sick people after they are diagnosed, a practice known as ‘rescission’.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

Denial of coverage is mostly done by using the infamous ‘pre-existing conditions’ loophole. Insurance companies will go to great lengths to dig up something, anything, that can be used to deny claims and cancel coverage altogether. “A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne… One employee, for instance, received a perfect 5 for “exceptional performance” on an evaluation that noted the employee’s role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.”

Michael Moore’s film Sicko (see my review) interviewed people whose job was to do this and get rewarded for it by the insurance companies. This should be no surprise. After all, then president Richard Nixon approved of setting up the present employment based private health insurance system only after he was assured by his aide that “Edgar Kaiser is running his Permanente deal for profit… All the incentives are toward less medical care… the less care they give them, the more money they make… the incentives run the right way.” The present system is running exactly as they envisaged.

In May 2008 my younger daughter graduated from college so she immediately ceased to be on our health plan. But her job started only in August 2008 so we had to go through the dreary business of shopping around to get temporary coverage for the months of June and July before she got on her new company’s plan. That kind of irritation alone should be enough for people to want to ditch the present system in favor of one where coverage is decoupled from one’s employment status. For most people, the biggest nightmare about losing their job, or even changing it, is how to ensure health care for them and their families.

But that’s not all. When my daughter later went to the doctor for some minor treatment, the insurance company would not pay unless she could prove that it was not a ‘pre-existing condition’, which meant that we had to go back and get all the documentation about her two month temporary coverage. Even that was not enough and we had to get the paperwork of the coverage she had before that and submit that too. All this took a lot of time and the matter still has not been resolved. In the meantime she left that job and got a new one, so we don’t know what will happen now. But if she had not taken the precaution of getting temporary coverage for the two-month period of June and July 2008 (which happens to many people between jobs), and if we had not been conscientious about keeping all the paperwork, they would have simply denied her claims and she would have been on the hook for the entire amount. And there is nothing that we could have done about it.

Suzie Madrak relates an awful story about the hassle she went through when she injured her ankle. Because the injury occurred when she fell while getting down from a truck, her health insurance and auto insurance companies kept passing the buck to each other as being the party responsible for paying for treatment. This kind of thing simply would not happen in a single-payer or socialized system.

Anyone who has had to deal with the health insurance companies knows the aggravation that occurs routinely. The funny thing is that most Americans think this is normal because they have never known anything better. People in countries that have single-payer or socialized health systems never have to deal with an profit-making insurance bureaucracy that seeks to make money by denying treatment.

It is important to always bear in mind one undeniable fact: In the current system, it is that the primary mission of the private health insurance industry is to maximize the profits of their shareholders, not to provide good service to sick people.

The fact that finding ways to deny coverage is an important part of their profit-making strategy emerged once again when during congressional hearings last month, Rep. Bart Stupak, the chairman of the House Subcommittee on Oversight and Investigations asked each of the heads of the major health insurance companies whether he would at least commit his company to immediately stop rescissions except in cases where they could show intentional fraud. All of them said “No”, thus confirming that denying coverage to sick people by any means possible is a deliberate profit-seeking policy of these companies.

Unbelievable.

POST SCRIPT: Bill Maher makes a commercial for the American Medical Association

(For previous posts on the issue of health care, see here.)

In order to effectively combat the health industry propaganda that seeks to preserve the current terrible system, people need to have a clear idea of what the main issues are and get clear on what the various terms mean.

First of all, ‘universal’ coverage, by which is meant that everyone has access to some health care is not enough. It is possible to achieve this by demanding that everyone must purchase private health insurance (the way all drivers must purchase auto insurance) and then providing aid for those who cannot afford it. All this would do is put more victims in the clutches of the rapacious and inefficient private health insurance companies and increase their profits while not improving the system.
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(For previous posts on the issue of health care, see here.)

The late Walter Cronkite said, “America’s health care system is neither healthy, caring, nor a system.” And he was right. It is a rotten structure that has continued purely on the basis of its ability to fool people using smoke and mirrors into thinking it is better than it is. But the structure is so bad that the façade is crumbling and the need for reform cannot be hidden anymore.

As the health care reform debate gathers steam, those who benefit greatly from the current system (drug and health insurance companies, hospitals, and doctors) by making large amounts of money while delivering less than adequate care, and the members of Congress whom they effectively bribe to protect their interests, and the mainstream media which is always obsequious in advancing the interests of the business and political elite, are going flat out to preserve as much of their interests by either lying or fear-mongering or creating confusion. As all the various plans are debated, with their details, it is important to keep clear what the issues are, and the next series of posts will try to do that.
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