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We Need a "Can-Do" Attitude on Health Care

By Barbara Ehrenreich, AlterNet. Posted November 15, 2006.


Most Democrats say their hands are tied when it comes to fixing health care. But they've also said that about the minimum wage, and this election voters proved them wrong.
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After their roaring two-house victory, the Democrats are squeaking about micro-policies. There'll be no impeachment, we're told, though maybe a bit more oversight of Halliburton-style war profiteering. No withdrawal from Iraq, only a "phased redeployment." And, the New York Times assures us (11/12/06), that the Dems " have largely dropped ... talk of a Canadian-style national health insurance." Instead, they might try to reverse the Medicare drug plan's ban on bargaining for drug price discounts.

They've caught the can't-do spirit that hovers over that former malarial swamp, Washington D.C. Well, maybe they caught it long ago, when the Republican congressional sweep of '94 sent Bill Clinton into long policy ruminations on school uniforms and midnight basketball. Since then it's been non-stop can't-do, with the initial exception of war: Can't do Social Security, can't do universal health insurance, can't do hurricanes. Then it turned out that we couldn't do war either, at least if that meant whipping the Taliban or finding an honorable way out of Iraq.

Well, here's a "phased redeployment" plan: First, bus the troops to the nearest functioning airport in Saudi Arabia, then put them on regular commercial flights to the U.S. According to Travelocity, the airfare part would cost about $1500 a person (coach class), or $225 million for 150,000 troops. If the government won't come up with the ticket price, I'm sure thousands of ordinary citizens would happily dig into their own pockets. Hell, I'd spring for first class.

When it comes to health care, the more cautious Dems trace their can't-do spirit to the great Hillary health reform debacle of 1993. We tried, they say, and it didn't work. But what did they try? The Hill health plan would have created a vast new level of bureaucracy to contract for health insurance from the existing health insurance companies, thus tightening their evil grip over American health care. I described that plan in a 1993 essay in Time as "the ultimate medical nightmare:"

You slip under the anesthesia confident that your problem will be solved with some simple procedure -- a polyp excision, for example, or tubal ligation. But when you wake up you find your breasts are missing or your intestine now terminates in a plastic bag.

Look, millions of voters didn't swing toward the Democrats because they wanted a $15 discount on their statins and beta-blockers. They voted out the can't-do Republicans in part because health costs are an immediate threat to ordinary Americans' livelihoods and lives. They want a solution, and they want it now.

How could we do that? The cautious way would be to expand Medicare to cover everyone. No new program would have to be devised, and the fight over whether Medicare would lead to socialism was resolved over 40 years ago. Just extend it to everyone of any age.

The only problem with that is that Medicare is as full of holes as the Bush rationale for the Iraq war. It's not enough to have Medicare Parts A and B, you need supplementary health insurance to cover the co-payments. As for Part D, aka "Part Doughnut Hole," no one has as yet been able to comprehend it, though it seems to work fine for people who are willing to substitute shark cartilage and lemon grass tea for prescription drugs.

So the most sensible plan is the one put forward by Anna Burger, head of labor's Change to Win coalition. She proposes extending the health insurance plan that currently covers Congress to everyone. "If it's good enough for [congress]," she asks, "Why isn't it good enough for every American?''

Hey, we can do it, or at least something very similar. Recall that as of a week ago, raising the minimum wage was another "can't do" issue: Can't do it because it might lead to inflation or unemployment, might offend the Chamber of Commerce or, god knows, cause acne. But six states just raised their minimum wages and Nancy Pelosi has promised to raise the federal minimum in her first 100 hours as Speaker of the House.

If the Dems can do that, they can do health care. Just renounce the can't-do spirit and start echoing the little blue engine: "I think I can, I think I can, I think I can."

Digg!

See more stories tagged with: minimum wage, democrats, healthcare

Barbara Ehrenreich is the author of 13 books, most recently "Bait and Switch: The (Futile) Pursuit of the American Dream."

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healthcare usa what went wrong
Posted by: richviss on Nov 15, 2006 12:19 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
i am e retired dutchman living in Thailand. Healthcare here is basic free in your own municipality. But in Holland as well in the most of Europe everybody is insured. Why not in America.
What went wrong untill till 1965 you were ahead of Europe.
Why Australian and Canadian people have healthcare.
Why so many USAveterans live in Thailand because their pension in America condemns them into poverty????
Some rich Americans no have a patriotic sense of life but a fascistoide filosofy.

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» RE: healthcare usa what went wrong Posted by: albrechtkrausse
» RE: tell the truth for starters Posted by: richholland
» RE: tell the truth for starters Posted by: albrechtkrausse
boycott
Posted by: rsaxto on Nov 15, 2006 3:07 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
If the Democrats don't give us the sanity of single payer health care then we will have to vote out both the Rs and the Ds in 08 because there is no point in having a government that has gone insane.

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» and replace them with WHAT? Posted by: not_the_preferred_nomenclature
Can't do or won't do?
Posted by: JCR on Nov 15, 2006 5:06 AM   
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This "can't do" attitude has nothing to do with not having the capacity and everything to do with a shameful lack of willingness. Maybe we can't get it done because most politicians have a "I'm a corporate whore who doesn't dare bite the Big Rx/Healthcare hand that put me in office" attitude. When are we going to wake up and ban corporate campaign contributions so that politicians aren't beholden to Big Biz in this manner? We also need to ban high-power corporate lobbies that hand out Caribbean vacations and Cabo fishing trips for voting in a way that is beneficial to big business and harmful to mainstream America . .

We just don't get it do we? Now that we're all done patting ourselves on the back for voting in a bunch of Neocon Dems, let's get back to reality and remember that they accepted the campaign $$$'s just like Republicans and now those corporations expect results and they don't care what color you are. That means ultra-expensive Rx and no affordable healtchare.

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the democratic activist base won't push them on healthcare b/c the base don't care
Posted by: not_the_preferred_nomenclature on Nov 15, 2006 5:39 AM   
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the democratic activist base will not push them on healthcare because the base don't really care about much about it. They themselves are not generally in need of it. Also, the democratic-liberal platform is not focused on economics in general but inside on social issues like race and gender and sexuality, in large part because the nonprofits that form the main organ for democratic liberal philosophy is funded by large nonprofit set up by plutocrats and corporations. The upper class runs them. They diverted american leftism towards a social issues focus starting decades ago. THey stopped focusing on populist economics like healthcare and started focusing on social issues like race and gender and gay rights.
These nonprofits are funded by the overclass. Whose interests do you think they will look out for?
So this is why the democratic politiicians give only lip service to healthcare. Healthcare and populist economics are ideas that unite working class Americans across race and gender lines. That is BAD for the overclass--the upper income types and the corporations. THey prefer it when politics focuses on separate groups, which is what divides the populace.

The divisive liberal politics is helping the overclass, and no wonder--the overclass CREATED this new liberal politics via the nonprofits. Read Joan Roelofs' book THE MASK OF PLURALISM.

The democratic base is just like the GOP base. They are the types of humans that are very conformist and eager to follow the philosophies of those at the top. The liberal blogosophere helps reinforce this conformist aspect of the liberal base by banning those leftists who dissent from the dogma handed down from on high.

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Not a bad idea, I now fear the insurance lobby...
Posted by: medstudgeek on Nov 15, 2006 6:00 AM   
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The AMA's proved pretty toothless lately. Short of a doctors' strike (which has never really been pulled off, the one attempt in NJ flopped) they can't do anything. I would worry about the insurance companies more than anything else. I don't know if we can defeat them. They can just buy out everyone. The Democrats would need to build some political capital by doing something widely popular and could then try.

I think it will happen when the corporations get fed up with paying for benefits (that's why it's so hard to get a job with health insurance nowadays) and push the government to cover their scaly asses.

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Good Legislation Is Ready and Waiting
Posted by: michaeltwatson on Nov 15, 2006 7:24 AM   
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Hillary Clinton and Barack Obama, besides being possibly the two leading contenders for the Democratic presidential 2008 nomination, are authors of Senate Bill 1784, known as the National Medic Act, or the National Medical Disclosure and Compensation Act. Its aim is the require the disclosure of medical errors to the patients, the adequate and swift compensation of injured victims, and the improvement of medical systems to help bring down the injuries and death, and reinvest the savings into safety systems. With 1.5 million injuries every year due to drug error; 190,000 deaths every year from hospital error, and 90,000 deaths from hospital infectins every year, a substantial savings of lives and money can come from safety improvements. If the Dems can do this first, they will show the consumer that they have good ways of working in the healthcare system. That type of confidence will be necessary to get America behind a single-payer or other universal coverage plan. Michael Townes Watson, author of America's Tunnel Vision--How Insurance Companies' Propaganda Is Corrupting Medicine and Law. www.StopMedicalError.com.

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Scrapping our health care system should be off the table.
Posted by: ABetterFuture on Nov 15, 2006 8:36 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
The problems are that 15% of the population without health coverage, that 10% of children lack health coverage, and that prices for health coverage are ballooning.

Abandoning our system--with all the benefits it has brought our society--in order to manipulate costs and extend coverage to the remaining 15% of the population that lacks it is a non-starter, for anyone who appreciates the need for leading edge medicine and health sciences.

I'd much sooner expand medicaid to offer enrollment to all children and poor working families than expand medicare to cover people who'd rather not settle for it. I don't want the coverage my little Congresscritter decides I should get. I want to weigh my budget, my health status, and my other options and decide which health coverage plan is worth my money.

People, if the American healthcare system works for 85% of folks, "fix" the 15% that's broken, not the 85% that is performing.

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» Percentages are from... Posted by: ABetterFuture
» I don't buy it... Posted by: mjabele
Coming back to haunt us
Posted by: Mamarianne on Nov 15, 2006 8:37 AM   
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That old bugaboo from the don't-call-me-a-Commie scare days has come back to haunt us. Back when folks could still pay for a doctor's office visit and a trip to the pharmacy out of their LIVING wages, we were warned of the peril of something called "socialized medicine." Now we look at the outsourcing of union jobs and the burdens health care costs have put on our struggling domestic employers. Now we see a class of hard-striving people carrying the label of "working poor" while living just one illness away from bankruptcy. Now we see our national ranking in health care sliding ever downward. Now we see that we were duped by the special interests. Medical services are sold to a captive market. Would anyone NOT have little Sonny's broken arm set because it costs too much? We need to look at the examples of wiser nations that have successfully provided basic medical services to their people. The majority of these nations have thriving, capitalistic economies and governments that provide for justice and due process. Most of their citizens look upon the cash and carry medical care of the United States as backward, counterproductive, and unjust.

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Here here!
Posted by: SufiLizard on Nov 15, 2006 8:44 AM   
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We need national, single-payer healthcare and we need it now.

If the Dems can bring that (let Bush veto it) they will have a long and prosperous future.

If they try to water it down with some atrocious corproate appeasing plan like Hillary-care then they will go back to the political wilderness in 2008 and Republicans will have a free ride on the slide into fascism (too bad they'll drag us all along with them.)

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Expand FEHBP = Terrible Idea
Posted by: nskala on Nov 15, 2006 8:56 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Barbara Ehreneich's suggestion to let Americans buy-in to Federal Employees Health Benefit Program is a step backwards for the uninsured:

1. FEHBP is exorbitantly expensive for inadequate coverage: family coverage under FEHBP is about $3,000 and deductibles are $500 or more. Most of the uninsured, unlike Federal Employees, are low-income workers. We are already experiencing an epidemic of medical bankruptcies, and FEHBP coverage would not help these people get care.

2. Even those high costs would go up as expanding FEHBP would bring sicker people (its not a stretch of the imagination to see that the average uninsured person is not as healthy as the average congressional aide) into the risk pool. This would cause fewer insurers to participate and costs to skyrocket.

3. Expanding FEHBP preserves the private insurance system which already consumes one-third of our health dollars for administration.

4. Expanding FEHBP does nothing to control costs. Its no different than expanding any other federal program. As health care costs continue to grow, any gains in coverage will be offset.

Fortunately, there is a way to provide comprehensive coverage to everyone for no more than we are spending now, and control costs long-term so benefits are sustainable. Its called single-payer national health insurance. HR 676, the US National Health Insurance Act, has more congressional co-sponsors than any other reform. For more information visit www.pnhp.org

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Health Care is a Persoinal Liability
Posted by: edhowes on Nov 15, 2006 9:20 AM   
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There can be no rational debate in this country until we clarify terms. Health Care: The prevention of disease. Medicine: The amelioration od disease symptoms. It is time to cease calling medicine health care The obscene profitability of medicine is the testimony to the utter failure of personal efforts to prevent disease in a highly toxic environment which makes health difficult, but not impossible. Medicine only adds to the national toxemia and takes more lives than it saves, over time. People only think theuy want more and cheaper because they have no idea health is an option. Health care must teach and educate people about the helth option of preventing disease and failing that, natural and affordable remedies. Citizen heal thyself. Physician learn prevention and remedy. Government - educate.

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» RE: Health Care is a Persoinal Liability Posted by: albrechtkrausse
» RE: Health Care is a Persoinal Liability Posted by: albrechtkrausse
Corporations: bring it on
Posted by: albrechtkrausse on Nov 15, 2006 9:54 AM   
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I think the best thing we could do to get this passed is get the large corporations on our side. This CAN BE DONE if you show them, with numbers and presented in a professional manner, how the corporate-provider system is a big drain on their resource, costs them a lot, and doesn't help their competitiveness with other countries, like those in Europe. Also, this could/should be coupled with some kind of tort reform to limit these ridiculous lawsuits which would also help lower costs both of health care and running a business. If you look at the large companies healthcare, pensions, and the like have become huge burdens and often are leading to unprofitability and/or bankruptcy.

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» RE: Corporations: bring it on Posted by: albrechtkrausse
I wonder
Posted by: vangogh69 on Nov 15, 2006 11:09 AM   
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I wonder, how is it that there are so many differences between the US and say, the European model (using healthcare as an example, though there are many) and yet many in the US still maintain the illusion that somehow the US is the "best nation of earth?" Seriously, there is something rotten at the core of the USofA and I think we need to, on a national level, take a hard look at just what sort of society we have. I know I'm not the only one who feels this way, nor who notices that something is seriously wrong, yet this feeling of discontent seems to find little to no expression in the official political parties, nor our media. Have we, as a nation, come to love our abuse so much that we can no longer separate ourselves from the identity of our abuser? Seriously, what's it gonna take to wake up?

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» You are so right!! Posted by: zooeyhall
» RE: I wonder Posted by: richholland
Simple Question
Posted by: NoPCZone on Nov 15, 2006 11:31 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Do you want your House & Senate officials to be representatives or leaders?
If the answer is representatives, healthcare is a dead as Princess Di.
If the answer is leaders, start calling, writing and organizing.

The problem is, most voters punish elected officials when they try to step out front and lead these days. Whatever vested interest is offended spends $$, runs negative media dispatches paid spin-bots on talk radio/TV and generally pounds the idea and person into the ground. If you wish for members of Congress to lead you are going to have to provide them with grassroots cover.

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mdoino
Posted by: mdoino on Nov 15, 2006 11:37 AM   
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I am one of millions of americans on Social Security Disability for something that was treatable if I had access health care. I was misdiagnosed and denied treatment because I didn't have health insurance. At the time I was working a series of Low payng jobs and attending college. Because my condition remained undiagnosed and untreated it got worse, and the only way I can survive was to go on disability. My condition is getting worse, because even though i have Medicare, I still can't get the treatment I need to try to rejoin society. I have tried to work, but because of my disability I cannot get the suport I need to keep a job. My medications and treatments are much more expensive than the preventative medicine I didn't have access to because I had no Insurance. I would much rather be working, but I have to rely on Public assistance, because of the lack of access to health care I need. The system will pay thousands for innefective treatments, but will not pay for alternative treatments or job accomodations, in the meantime my health is deteriorating, because the good doctors don't take Medicare, because of the mind boggling time it takes to do the paperwork.
There was a recent study done that claimed that patients are misdiagnosed 50 percent of the time, unfortunately the system pays just as much for a misdiagnosis that costs the system more money. My condition would not have led to disability, if I had access to health care, now I don't know what I am costing the system. I have been routinely misdiagnosed and denied treatment by incompetant Doctors, while my condition deteriorates. I may have to have another surgery because my previous doctor ignored my symptoms.

I would rather be working, but I lack access to the healthcare and minimal support that would allow me to work.

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Payment In Kind Will Make A Comeback
Posted by: edith on Nov 15, 2006 1:48 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I like the suggestion to consider the congressional plan as a starter. Extension to hundreds of millions may or may not be feasible, I just dont know. We have to start somewhere, however.

I would ask Ms. Ehrenreich and other investigative journalists with experience in health care issues to take a close look not just at replacement of private insurors, but at the restraints on trade that medical societies, "board certified" specialists, and manufacturers of radiological and MRI type devices impose on a system that is built on fear.

Frankly, medical care isn't like buying a car. If my Toyota doesn't work, I'll sell it for another car that does. Eventually I can control costs by choosing not to drive so much, finding a more reliable or fuel efficient car, or carpooling.

because fear of death and pain drives our demand for health care,and because it is increasingly dominated by "specialists" who benefit from "referals" from primary providers who work off approved lists, there is lilttle or no competition in health care. I am not even speaking about the drug industry and its concentration and monopolistic practices.

At some point doctors need to be told that they are NOT going to get rich practicing medicine and that while they, like nurses, teachers and sanitation workers deserve good salaries and benefits, we would rather die that be gouged. Doctors are not gods.
We are blackmailed by them because they tell us they hold our lives in their hands. Of course we can hold their lives in our hands if we had community controlled health care that paid fair but not exhorbitant salaries to these "doctors" (memorizing anatomy is not necessarily a sign of applied intelligence.)

In other words, we have to say to doctors who will not work at reasonable rates: You are fired. And we will not allow you to open a practice in a wealthy area to get around reasonable rates in middle and working class areas. You may move to South Africa or Vietnam to treat truly poor patients, but if you practice in America you work for the community, not for your investment adviser. And forget the doctor- owned business centers and hospitals! You're so gone, "Dr." Bill Frist!

And all you foreign-born radiologists flocking here to take our photos at several thousand dollars per framer of an organ you look at many times a week: Don't stay on our account! There are kids in Bangladesh or Calcutta who you really want to help but the mean ol Americans forced you to accept $400,000 and up per year to take pictures of their fat capitalist rear ends.

Don't stay on our account, or if you do, welcome to the working class. After all, you're not any "better" than your patients, are you?

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» Street-corner capitalism Posted by: eddie torres
» Costs of things..... Posted by: mjabele
» Bingo! Posted by: edith
» Response to Edith, Part 1 Posted by: mjabele
» RE: esponse to Edith, Part 1 Posted by: dragonrider
» Response to Edith, Part 2 Posted by: mjabele
» RE: esponse to Edith, Part 2 Posted by: dragonrider
Profit-making and human rights incompatable
Posted by: BobbyGreyFriar on Nov 15, 2006 9:03 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Universal healthcare (as guarantied legally under article 25 of UD) cannot get off the ground until profit is taken out of the equation. Both parties (because of the nature of political power in this country) must form policies re: HC (or virtually anything else for that matter) in such a way that people can make money out of it. In the case of insurance companies it boils down to pure theft -- it would be vastly better if insurance were public; premiums would be cheaper and it work better. Ontario tried this with auto-insurance (i.e., to create a no-fault auto-insurance scheme), but were sued by the insurance companies and backed down because the province couldn't afford the legal costs.

The huge relative expense and the bureaucratic complications we have in this country are largely the result of the profit-making component. Forget Canada: look at Cuba's incredible healthcare system for an example of a guide we should follow.

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Vintagebetty, future Physician Assistant
Posted by: vintagebetty on Nov 19, 2006 2:20 PM   
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The trillion dollar question is, "how are we going to pay for this?" The $18 billion dollar answer: end the "war on drugs" and reallocate the funds to expand the health care plan that our politicians enjoy (on our dime). It's thst simple.

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