PNHP

Medicare for all is the best prescription for nation's health care woes

Medicare for all is the best prescription for nation's health care woes

By Dr. John Cavacece
Grand Rapids Press, Jan. 3, 2011

With the elections and the old year in the rearview mirror, debate will rage about whether to repeal the health care reform law. Some of the many opposed to the law will use the same misinformed scare tactics that got them elected, saying that we can’t afford it, that it puts too much control in the hands of the government, and that medical progress, like open heart surgery in every hospital in Grand Rapids, will be hindered.

All of these assertions will distract people from fixing the real tragedy of our health care system: 50 million people without access to health care, a health care industry that continues to make obscene profits at the expense of the health of all of us, and a misleading and false claim that we have the best quality health care in the world. The truth is we are last of 19 industrialized nations in quality measures such as preventable death at age 75 and infant mortality. This lack of quality exists despite the fact that we spend almost twice as much per capita as the next highest spending nation.

The new health care law is not perfect. It does offer coverage to previously uncovered young adults through their parents’ policies. It will force insurance companies to cover those with pre-existing conditions. It does expand Medicaid to cover those with very low incomes.

On the flip side, the law fails to go far enough. The mandate will give the insurance companies millions of new customers, but the insurers, having sold what amounts to a defective product to those customers, will be able to continue to increase their co-pays and deductibles, insuring that the insurers maintain their profit margins.

In 2019 there will still be 23 million Americans without insurance, and thus without access to quality health care.

The law doesn’t do enough to ensure that our health system focuses on the kind of care that is most needed, e.g. primary care. Primary care has proven not only to improve the quality of health care, but also to cut costs as well.

Most disturbing, the law allows the same profit-hungry, inefficient health care industry to keep a stranglehold on all decisions. This is only to be expected, since former health industry executives helped write the bill, the health industry supplied six lobbyists for each member of Congress who worked on it, and that same industry donated tens of millions to congressional campaigns in exchange for the lawmakers’ complicity.

The simple remedy lies in a tried and true system that has offered dependable, efficient health care to all of its patients for 45 years: Medicare. By simply improving and expanding Medicare to cover all of our citizens and appropriately funding its efforts, instead of portioning them out to private insurance companies who make sure they take their cut first, we would have one system, not a crazy quilt of hundreds of plans.

It would make the question “Will I be able to afford basic health care?” obsolete.

Doctors and nurses believe this is the best way to go. Doctors realize that they have more power to make decisions that benefit their patients under an improved and universal Medicare system than a restrictive, arbitrary private insurance system.

The people know this is the answer. Business owners should jump at the chance for such a system to relieve them of the burden of covering their employees in a simple, fair way.

It makes too much sense, which is why the health care industry doesn’t want you to hear about it and why Medicare-for-all advocates were not even allowed at the table when the bill was being formed.

It’s time that all should know about it. We need compassionate government that provides health care for all. What we don’t need is an insurance industry that continues to make profit at the expense of our citizen’s health. We need to preserve what’s good in the new law but move beyond it to an improved and expanded Medicare for all. We need to speak for those who cannot speak for themselves.

John Cavacece, D.O., practices family medicine in Grand Rapids. He is a member of Physicians for a National Health Program.

http://www.mlive.com/opinion/grand-rapids/index.ssf/2011/01/guest_commentary_medicare_for.html

How to eliminate insurance costs

Chicago Tribune, Jan. 3, 2011

Dr. Lisa A. Rone (Dec. 24), in response to PPO requirements for pre-authorization for psychiatric care, suggests that the Illinois Psychiatric Society work with insurance companies, including Blue Cross and Blue Shield of Illinois, to resolve coverage issues.

But Blue Cross and Blue Shield is only one of more than 1,000 insurance companies in the US, each offering many separate insurance plans; and requiring pre-authorization for psychiatric care is only one of hundreds of ways in which those insurance companies interfere with medical decisions.

We need to get rid of insurance companies, not negotiate with them. Under a single-payer health care system, Improved and Expanded Medicare for All, everyone would have access to mental health care, as well as to all other necessary care. Decisions about treatment of mental illness, like all other medical decisions, would be in the hands of patients and doctors, not in the hands of insurance company bureaucrats. We would save the money needed to make the system financially sustainable not by denying care, but by negotiating fair prices for all goods and services, and by greatly decreasing the bureaucracy – such as the bureaucracy created for pre-authorizations and their denial – that currently consumes more than 30 percent of all health care dollars.

Anne Scheetz, MD, FACP, Chicago

http://www.chicagotribune.com/news/opinion/letters/chi-110103scheetz_briefs,0,6576949.story

U.S. far from having finest health system

The Coloradoan, Jan. 3, 2011

I am writing in response to “U.S. has world’s best health-care system.” It was said that “we have, without a doubt, the finest health-care system in the world.”

In the United States, we do have the finest nurses, physicians and technology in the world. The system, however, is far from the finest. Each year in the United States, the system drives 700,000 families to bankruptcy from medical bills (the majority of whom have medical insurance). Every year, the system leaves 50 million people uninsured. Every year, the system allows 45,000 people to die from lack of access to basic medical care. Our system charges nearly twice as much per capita to accomplish these statistics. The system is neither fair nor fiscally sound. The good news is that the solution exists in a uniquely American proposal put forth by an organization endorsed by more than 18,000 medical providers in our country. Learn more about the proposal at Physicians for a National Health Program (www.pnhp.org).

Learn more about other successful health-care systems by reading T.R. Reid’s well-considered “The Healing of America.” We need to open our minds and hearts to a health-care system that provides access for all and promises our sons and daughters a fiscally sound and sustainable future.

Doug Whitman, M.D., pediatrician
Larimer County

http://www.coloradoan.com/article/20110103/OPINION03/101030309/1014/OPINION/U.S.+far+from+having+finest+health+system

California and New York lessons for Medicaid expansion under PPACA

Cuomo Targeting Medicaid Spending

By Jacob Gershman
The Wall Street Journal
January 4, 2011

Gov. Andrew Cuomo is aiming to reduce the state’s Medicaid spending by billions of dollars, exceeding the size of cuts to the program proposed in past years, according to individuals with knowledge of his budget.

The Cuomo administration is considering a cut of about $2.1 billion out of the state’s projected spending on Medicaid in the upcoming fiscal year. With federal matching funds, the cut comes to more than $4 billion.

http://online.wsj.com/article/SB10001424052748704111504576060280154691892.html

And…

Brown to propose broad list of budget cuts

By Kevin Yamamura
The Sacramento Bee
January 3, 2011

(Gov. Jerry Brown) will propose Medi-Cal (Medicaid) savings by requiring patients to provide co-payments for services, limiting doctor visits and reducing rates paid to health providers. In Healthy Families (CHIP), which provides subsidized care for low-income children, he wants participants to pay more in premiums and co-payments while eliminating vision care.

“These would be shocking cuts if we hadn’t seen them before, but we have seen them before,” said Anthony Wright, executive director of Health Access California. “This is what’s left to cut outside of the wholesale dismantling of core programs. These are bad cuts that will impact millions of Californians.”

http://www.sacbee.com/2011/01/03/3295079/brown-to-propose-broad-list-of.html

A substantial increase in eligibility qualification for the Medicaid program is a crucial measure in the Patient Protection and Affordable Care Act (PPACA), designed to decrease the numbers of Americans without insurance coverage. Now the newly-elected Democratic governors of the two most populous states in the nation intend to sharply reduce funding of their Medicaid programs. What does this say about the wisdom of the PPACA policy of using Medicaid to expand coverage?

Gov. Brown’s proposal to impose financial penalties for accessing care, placing caps on doctor visits, and further slashing payments in this already critically underfunded program can only be disastrous for the low-income patients enrolled.

Once again, this is not change we can believe in. We desperately need an improved Medicare that covers everyone.

Vermont: Creating a singular health system

Globe Editorial
The Boston Globe, Jan. 2, 2011

While Massachusetts grapples with its own health costs, the nation’s eyes will be on Vermont as it tries to do ObamaCare one better and switch to a single-payer health insurance system. The newly elected governor, Peter Shumlin, made single-payer a main campaign pledge. Now he has assembled a team of health officials grounded both in the realities of Vermont medical care and the pros and cons of comprehensive health reform. Shumlin’s special assistant for reform will be Anya Rader-Wallack, once an aide to former Vermont Governor Howard Dean and more recently deeply involved with the Massachusetts universal-coverage system.

Single payer, under which the government would take over all health insurance functions, has attracted many reform advocates because it simplifies health payments and reduces the overhead costs of a private insurance system that has to pay for marketing and, in some cases, shareholders’ dividends. Single-payer would also unlink insurance from employment, reducing a costly burden on companies and increasing workers’ flexibility in seeking new job opportunities. Hospitals and doctors have been wary of single-payer because two of the biggest payers in the current system — government-run Medicare and Medicaid — reimburse at rates that providers say are inadequate.

Any reform plan in Vermont will have to address that concern. More immediately, it will need waivers from the federal government to bring both Medicare and Medicaid into the one-payer system. The Obama administration should examine waiver requests closely to make sure they protect the needs of both patients and providers. But Vermont deserves the benefit of the doubt as it works its way toward becoming a laboratory of democracy on an issue — the unsustainably steep increase in health costs — that has proven intractable both for the nation at large and health-reform pioneer Massachusetts.

http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2011/01/02/vermont_creating_a_singular_health_system/

Drug firms providing kickbacks for co-pays and coinsurance

Coupons for Patients, but Higher Bills for Insurers

By Andrew Pollack
The New York Times
January 1, 2011

With drug prices rising and many people out of work, pharmaceutical companies are increasingly helping patients with their co-payments.

Drug companies say the plans help some patients afford medicines that they otherwise could not.

But health insurers and some consumer groups say that in many cases, the coupons are just marketing gimmicks that are leading to an overall increase in health care costs. That is because they circumvent the system of higher co-pays on costlier drugs that insurers use to encourage consumers to use less expensive products.

Any shift to brand-name drugs can have a big impact on health care costs.

At District Council 37, a union representing public employees in New York City, 59 percent of claims for statins in the year ended in June 2009 were for brand-name products that cost the plan $17.3 million. The other 41 percent of claims were for generic statins, which cost only $179,000. A year ago, the health plan eliminated the co-pay on generic statins to encourage more use of them.

For very expensive drugs, co-pay assistance is almost de rigueur, because in some cases co-payments can be up to 20 percent of the price of the drug. Novartis’s new pill for multiple sclerosis, Gilenya, costs $48,000 a year, compared with $30,000 to $40,000 for rival drugs, which are injected. Novartis is offering to cover the entire co-pay, up to $800 a month, which is 20 percent of the drug’s monthly cost.

Jazz Pharmaceuticals has quadrupled the price of its narcolepsy drug Xyrem, to about $30,000 a year, over the last five years, according to a recent report from the securities firm Jefferies & Company. To cushion patients, the company recently increased its co-pay assistance to as much as $1,200 a month.

Drug companies cannot offer co-payment assistance for patients in federal programs like Medicare because such offers are considered an inducement to use a drug and in violation of anti-kickback laws. Some companies have responded by contributing to, or even helping to set up, charitable foundations that can provide co-payment assistance legally.

Executives at insurers and pharmacy benefit management companies say they would like to counter the cards and coupons but are not sure exactly how to do so. One problem is that the information they receive from pharmacies does not specify whether the co-pay was made by the patient or by the drug company.

“The payer doesn’t know, and the P.B.M. doesn’t know,” said F. Everett Neville, chief trade relations officer at Express Scripts, a pharmacy benefits manager. “We have no ability to stop it and no ability to prohibit it.”

http://www.nytimes.com/2011/01/02/business/02coupon.html?_r=1&pagewanted=all

Comment: 

By Don McCanne, MD

Should a health care system be designed to ensure that patients receive appropriate medications that they should have to relieve symptoms or cure disease? Of course. Yet co-payments (a dollar amount) and coinsurance (a percentage of the cost) impose on the patient financial barriers to the medications – barriers which frequently are not surmounted, and thereby may result in impaired health outcomes.

With our fragmented system of financing health care those seeking greater profits will always find another way to achieve their goals. In this instance, the pharmaceutical manufacturers have found a way to reduce or eliminate these financial barriers to their products.

In providing cost-sharing assistance to the patient, the manufacturers are not specifically removing barriers to the most appropriate products, but rather are removing barriers to their most profitable products, irrespective of whether or not they are the best choice. Since these are more expensive products, that increases the drug costs of the private insurers. Those of us paying premiums to private insurers that cover drugs are paying for these excess costs.

These practices do not require collusion with the physicians and pharmacists since their marketing practices are effective in creating a demand for their products regardless of the appropriateness.

Note that these pharmaceutical industry subsidies of co-payments and coinsurance are illegal in federal programs such as Medicare because they are the equivalent of kickbacks. If we had a Medicare program that covered everyone and eliminated the private intermediaries such as the insurers and pharmacy benefit managers, then these kickbacks wouldn’t exist. Drugs would be prescribed based strictly on appropriateness, and would be priced to provide fair profits for the pharmaceutical firms and fair costs for Medicare.

Drug firms providing kickbacks for co-pays and coinsurance

Coupons for Patients, but Higher Bills for Insurers

By Andrew Pollack
The New York Times
January 1, 2011

With drug prices rising and many people out of work, pharmaceutical companies are increasingly helping patients with their co-payments.

Drug companies say the plans help some patients afford medicines that they otherwise could not.

But health insurers and some consumer groups say that in many cases, the coupons are just marketing gimmicks that are leading to an overall increase in health care costs. That is because they circumvent the system of higher co-pays on costlier drugs that insurers use to encourage consumers to use less expensive products.

Any shift to brand-name drugs can have a big impact on health care costs.

At District Council 37, a union representing public employees in New York City, 59 percent of claims for statins in the year ended in June 2009 were for brand-name products that cost the plan $17.3 million. The other 41 percent of claims were for generic statins, which cost only $179,000. A year ago, the health plan eliminated the co-pay on generic statins to encourage more use of them.

For very expensive drugs, co-pay assistance is almost de rigueur, because in some cases co-payments can be up to 20 percent of the price of the drug. Novartis’s new pill for multiple sclerosis, Gilenya, costs $48,000 a year, compared with $30,000 to $40,000 for rival drugs, which are injected. Novartis is offering to cover the entire co-pay, up to $800 a month, which is 20 percent of the drug’s monthly cost.

Jazz Pharmaceuticals has quadrupled the price of its narcolepsy drug Xyrem, to about $30,000 a year, over the last five years, according to a recent report from the securities firm Jefferies & Company. To cushion patients, the company recently increased its co-pay assistance to as much as $1,200 a month.

Drug companies cannot offer co-payment assistance for patients in federal programs like Medicare because such offers are considered an inducement to use a drug and in violation of anti-kickback laws. Some companies have responded by contributing to, or even helping to set up, charitable foundations that can provide co-payment assistance legally.

Executives at insurers and pharmacy benefit management companies say they would like to counter the cards and coupons but are not sure exactly how to do so. One problem is that the information they receive from pharmacies does not specify whether the co-pay was made by the patient or by the drug company.

“The payer doesn’t know, and the P.B.M. doesn’t know,” said F. Everett Neville, chief trade relations officer at Express Scripts, a pharmacy benefits manager. “We have no ability to stop it and no ability to prohibit it.”

http://www.nytimes.com/2011/01/02/business/02coupon.html?_r=1&pagewanted=all

Should a health care system be designed to ensure that patients receive appropriate medications that they should have to relieve symptoms or cure disease? Of course. Yet co-payments (a dollar amount) and coinsurance (a percentage of the cost) impose on the patient financial barriers to the medications – barriers which frequently are not surmounted, and thereby may result in impaired health outcomes.

With our fragmented system of financing health care those seeking greater profits will always find another way to achieve their goals. In this instance, the pharmaceutical manufacturers have found a way to reduce or eliminate these financial barriers to their products.

In providing cost-sharing assistance to the patient, the manufacturers are not specifically removing barriers to the most appropriate products, but rather are removing barriers to their most profitable products, irrespective of whether or not they are the best choice. Since these are more expensive products, that increases the drug costs of the private insurers. Those of us paying premiums to private insurers that cover drugs are paying for these excess costs.

These practices do not require collusion with the physicians and pharmacists since their marketing practices are effective in creating a demand for their products regardless of the appropriateness.

Note that these pharmaceutical industry subsidies of co-payments and coinsurance are illegal in federal programs such as Medicare because they are the equivalent of kickbacks. If we had a Medicare program that covered everyone and eliminated the private intermediaries such as the insurers and pharmacy benefit managers, then these kickbacks wouldn’t exist. Drugs would be prescribed based strictly on appropriateness, and would be priced to provide fair profits for the pharmaceutical firms and fair costs for Medicare.

Republican rules threaten health care

Deficit Hypocrisy

Editorial
The New York Times
December 29, 2010

On Dec. 22, just before they left town for the holidays, House Republican leaders released new budget rules that they intend to adopt when they assume the majority in January and will set the stage for even more budget-busting tax cuts.

The new Republican rules will gut pay-as-you-go because they require offsets only for entitlement increases, not for tax cuts.

It gets worse. The new rules mandate that entitlement-spending increases be offset by spending cuts only — and actually bar the House from raising taxes to pay for such spending.

Even worse, they direct the leader of the House Budget Committee to ignore several costs when computing the budget impact of future actions.

For example, the cost to make the Bush-era tax cuts permanent would be ignored, as would the fiscal effects of repealing the health reform law. At the same time, the new rules bar the renewal of aid for low-income working families — extended temporarily in the recent tax-cut deal — unless it is fully paid for.

http://www.nytimes.com/2010/12/30/opinion/30thu1.html

Rules draft (33 pages):
http://rules-republicans.house.gov/Media/PDF/112-Hres5-CP_xml.pdf

Comment: 

By Don McCanne, MD

Although long, the new Republican rules for the House of Representatives read somewhat like those jokes that are circulated around the Internet. When the fact sinks in that this is no joke but that these rules are very real, the inhumanity implicit in these new rules induces a feeling of despair.

Think of what these rules do for public funding of health care under the Patient Protection and Affordable Care Act. Because health insurance is too expensive and out-of-pocket costs are also unaffordable, government subsidies are necessary, but those called for in the act are inadequate. Many people who will need health care will face financial hardship unless the subsidies are increased.

Under the Republican rules, increases in these subsidies cannot be paid for by increasing taxes. Only reductions in other programs can be used. This is not unlike the prohibited act of cannibalizing one military vehicle to get another one up and running, when both vehicles are essential. Just as we have a responsibility to pay our taxes, our government has a responsibility to ensure that appropriate publicly-financed services will be there when needed, whether it’s maintaining our military vehicles, supporting transportation services in major snowstorms, or ensuring that everyone always has access to affordable health care.

Although the Republicans display a decidedly uncaring attitude toward the financing of important public services shared by most of us, they have an almost sacred devotion to protecting higher-income individuals from the need to pay their equitable share of the taxes to fund those services.

Any increases in spending for the public good must be offset by reductions in other services that would then no longer be available for the public good. Yet, under the new Republican rules, any tax reductions which would accrue primarily to the benefit of the wealthy do not have to be offset at all. Instead, those deficits are added to our debt burden and the debt burden passed on to our progeny.

Is the tax burden in the United States so great that we must sacrifice our public services while burdening ourselves with more debt simply to provide tax relief for the wealthy? The following chart provides that answer. The United States has one of the lowest tax burdens of all nations. The Republicans are catering to the rich at a great cost to the rest of us. What is really tragic is that it seems that, rather than electing representatives who care, the American voters would rather attend tea parties.

If the following OECD chart was not transmitted in this message, it can be accessed by scanning down to Chart A at this link:
http://www.oecd.org/document/35/0,3343,en_2649_37427_46661795_1_1_1_37427,00.html

Total tax ratio as percentage of GDP, 2008

Republican rules threaten health care

Deficit Hypocrisy

Editorial
The New York Times
December 29, 2010

On Dec. 22, just before they left town for the holidays, House Republican leaders released new budget rules that they intend to adopt when they assume the majority in January and will set the stage for even more budget-busting tax cuts.

The new Republican rules will gut pay-as-you-go because they require offsets only for entitlement increases, not for tax cuts.

It gets worse. The new rules mandate that entitlement-spending increases be offset by spending cuts only — and actually bar the House from raising taxes to pay for such spending.

Even worse, they direct the leader of the House Budget Committee to ignore several costs when computing the budget impact of future actions.

For example, the cost to make the Bush-era tax cuts permanent would be ignored, as would the fiscal effects of repealing the health reform law. At the same time, the new rules bar the renewal of aid for low-income working families — extended temporarily in the recent tax-cut deal — unless it is fully paid for.

http://www.nytimes.com/2010/12/30/opinion/30thu1.html

Rules draft (33 pages):
http://rules-republicans.house.gov/Media/PDF/112-Hres5-CP_xml.pdf

Although long, the new Republican rules for the House of Representatives read somewhat like those jokes that are circulated around the Internet. When the fact sinks in that this is no joke but that these rules are very real, the inhumanity implicit in these new rules induces a feeling of despair.

Think of what these rules do for public funding of health care under the Patient Protection and Affordable Care Act. Because health insurance is too expensive and out-of-pocket costs are also unaffordable, government subsidies are necessary, but those called for in the act are inadequate. Many people who will need health care will face financial hardship unless the subsidies are increased.

Under the Republican rules, increases in these subsidies cannot be paid for by increasing taxes. Only reductions in other programs can be used. This is not unlike the prohibited act of cannibalizing one military vehicle to get another one up and running, when both vehicles are essential. Just as we have a responsibility to pay our taxes, our government has a responsibility to ensure that appropriate publicly-financed services will be there when needed, whether it’s maintaining our military vehicles, supporting transportation services in major snowstorms, or ensuring that everyone always has access to affordable health care.

Although the Republicans display a decidedly uncaring attitude toward the financing of important public services shared by most of us, they have an almost sacred devotion to protecting higher-income individuals from the need to pay their equitable share of the taxes to fund those services.

Any increases in spending for the public good must be offset by reductions in other services that would then no longer be available for the public good. Yet, under the new Republican rules, any tax reductions which would accrue primarily to the benefit of the wealthy do not have to be offset at all. Instead, those deficits are added to our debt burden and the debt burden passed on to our progeny.

Is the tax burden in the United States so great that we must sacrifice our public services while burdening ourselves with more debt simply to provide tax relief for the wealthy? The following chart provides that answer. The United States has one of the lowest tax burdens of all nations. The Republicans are catering to the rich at a great cost to the rest of us. What is really tragic is that it seems that, rather than electing representatives who care, the American voters would rather attend tea parties.

If the following OECD chart was not transmitted in this message, it can be accessed by scanning down to Chart A at this link:
http://www.oecd.org/document/35/0,3343,en_2649_37427_46661795_1_1_1_3742…

Total tax ratio as percentage of GDP, 2008

Private insurers depending on Medicaid for growth

Insurers Bid for State Medicaid Plans

By Avery Johnson
The Wall Street Journal
December 29, 2010

Health insurers are preparing to capitalize on $40 billion of new opportunities to run privately managed Medicaid plans for the states, which would position insurers to benefit from the health overhaul’s expansion of Medicaid in 2014.

Medicaid is one of health insurers’ few bright spots, as their margins are pressed by regulatory crackdowns on premiums in their traditional policies. Gail Boudreaux, UnitedHealth’s executive vice president, told investors last month that: “The Medicaid space is a significant long-term growth opportunity for us. It’s a big market that’s getting even bigger.”

Budget crises mean cash-strapped states are more willing than ever to outsource their programs to private companies.

http://online.wsj.com/article/SB10001424052748704259704576033943934403286.html

Comment: 

By Don McCanne, MD

When you hear that the nation’s largest (in revenue) investor-owned insurer is looking at taxpayer-financed Medicaid as “a significant long-term growth opportunity,” be afraid. Be very afraid.

Private insurers depending on Medicaid for growth

Insurers Bid for State Medicaid Plans

By Avery Johnson
The Wall Street Journal
December 29, 2010

Health insurers are preparing to capitalize on $40 billion of new opportunities to run privately managed Medicaid plans for the states, which would position insurers to benefit from the health overhaul’s expansion of Medicaid in 2014.

Medicaid is one of health insurers’ few bright spots, as their margins are pressed by regulatory crackdowns on premiums in their traditional policies. Gail Boudreaux, UnitedHealth’s executive vice president, told investors last month that: “The Medicaid space is a significant long-term growth opportunity for us. It’s a big market that’s getting even bigger.”

Budget crises mean cash-strapped states are more willing than ever to outsource their programs to private companies.

http://online.wsj.com/article/SB10001424052748704259704576033943934403286.html

When you hear that the nation’s largest (in revenue) investor-owned insurer is looking at taxpayer-financed Medicaid as “a significant long-term growth opportunity,” be afraid. Be very afraid.

Reagan and Churchill – contrasting views on health care

Two Views of Health Law

Letters, The New York Times
December 27, 2010

To the Editor:

Re “In Health Law, Old Arguments Get New Airing,” by David Leonhardt (Economic Scene, front page, Dec. 15):

It is interesting to compare Ronald Reagan’s argument opposing Medicare as “socialized medicine,” a program that would take away the freedom of “our children and our children’s children,” with the words of one of his heroes.

In 1944 Winston Churchill, while still prime minister, said that “our policy is to create a national health service in order to ensure that everybody in the country irrespective of means, age, sex or occupation shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Humphrey Taylor
New York, Dec. 15, 2010

The writer is chairman of the Harris Poll.

http://www.nytimes.com/2010/12/28/opinion/lweb28health.html

“In Health Law, Old Arguments Get New Airing,” by David Leonhardt:
http://www.nytimes.com/2010/12/15/business/economy/15leonhardt.html

And…

Actually, Reagan Wasn’t So Proud of That 1965 Medicare Speech

By David Weigel
The Washington Independent
August 21, 2009

In the last month, there’s been a rediscovery of Ronald Reagan’s 1965 recording “Ronald Reagan Speaks Out Against Socialized Medicine.” Something that’s largely been forgotten, though, was that a much more famous Reagan quote — his “There you go again” dismissal of President Jimmy Carter in the 1980 presidential debates–came when Reagan denied that he really meant this, or that he was “opposing the principle of providing care for” seniors in 1965.

http://washingtonindependent.com/56004/actually-reagan-wasnt-so-proud-of-that-1965-medicare-speech

Comment: 

By Don McCanne, MD

Winston Churchill represented the view of most conservative politicians in recent history when he said that “everybody in the country irrespective of means, age, sex or occupation shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Even Ronald Reagan tried to erase his personal history of opposing Medicare by stating during the debate with President Carter, “I happened to favor the other piece of legislation and thought that it would be better for the senior citizens and provide better care than the one that was finally passed.”

So what has happened? Why are conservative politicians in the United States implicitly paying homage to the Chicago school of economics when their policies result in tens of millions of Americans being denied equal opportunities to benefit from the best and most up-to-date medical services that Winston Churchill spoke of? Does the faith in the abstraction of free market ideology really trump the actual health and welfare of the citizenry?

It would be too much of a stretch to classify this as a folie en masse. However the feigned obliviousness toward the unmet needs of fellow citizens can hardly be interpreted as anything other than heartless neglect driven by greed.

The conservatives and their moderate co-conspirators have updated Russell Long’s famous quotation: Don’t tax you, don’t tax me, and above all don’t even consider taxing that rich man behind the tree even if it means destroying social justice and common decency along with it.