PNHP

The reform that’s missing

The reform that’s missing

By Rhonda Swan
Palm Beach Post
Thursday, November 05, 2009

Perhaps “death panels” weren’t such a bad idea.

For private health insurance companies.

If ever there was a useless entity, it’s a business that earns profits for doing nothing.

Wait. I take that back. They do something. They decide who lives and who dies. Paper-pushers with no medical training choose what is and isn’t medically necessary for millions of people on whom they’ve never laid eyes. And for that, their employers rake it in.

United Health Group reported net income of nearly $3 billion in 2008; Aetna Inc. reported $1.3 billion, Humana Inc. came in at $647 million. Their CEOs had total compensation of $3.2 million, $24.3 million and $4.7 million, respectively. Their profits were down sharply compared with 2007 because of the recession. Still, it’s not a bad haul for being nothing more than middlemen.

“What product does this industry sell?” Dr. Howard A. Green, director of the dermatology division at St. Mary’s Medical Center in West Palm Beach, asked in an interview. “They don’t do health care, they don’t do access to health care because we have so many uninsured and underinsured. They remove too much money from health care, and therefore make it inefficient and ineffective.”

In an article for On Call: The Journal of Palm Beach County Medical Society, Dr. Green maintains that shutting down private health insurance corporations is the first step to creating comprehensive quality health care. “Without the inefficiencies and burden to productivity of private insurance corporations,” he wrote, “we can deliver efficient and effective comprehensive health care with great savings and no sacrifice of jobs.”

The U.S. House is expected today to take up the 2,032-page health reform bill proposed by Democrats. A national insurance plan is a key element, though this version is far from the single-payer Medicare for All program that Dr. Green and Physicians for a National Health Program endorse.

Such a plan, which eliminates private profits, would be real reform. Yet it hasn’t even come up for discussion, not this year or in 1994 under President Clinton, the last administration to attempt reform. No one in the White House or Congress has had the guts to take on private insurers, even though they clearly are the problem.

The major reform proposals focus more on private insurers than actual health care delivery. Forcing insurers to cover sick people. Getting insurers to compete and lower costs. Doling out subsidies to insurers so we can afford their high prices.

Why not just get rid of them? All they do is take our money and then show us the hand when we expect something in return like … medical treatment.

Opponents of the so-called public option say they fear a “government takeover” of health care that would put private insurers out of business. So what!

The fact that we are the very government that would “take over” our health care system under which doctors and hospitals would remain private gets lost.

As does the fact that we are a capitalist society where businesses that can’t compete go out of business every day. And for-profit insurers just can’t compete.

A Harvard Medical School and Public Citizen study found that health insurance bureaucracy – billing, sales and marketing, profits and executive pay, which have nothing to do with health care – costs $399.4 billion a year. Money that could insure every American.

Insurers also spend millions legally bribing Congress and the White House to protect their profits. But who is protecting us from them? Harvard researchers found that medical problems caused 62 percent of all personal bankruptcies in 2007. Of those, 60 percent had private medical insurance. “It’s unethical,” said Dr. Green. “It’s a crime to bankrupt someone because they’re sick.”

It should be. Private insurance companies are too big, too inefficient and too heartless not to fail.

Rhonda Swan is an editorial writer for The Palm Beach Post. Her e-mail address is rhonda_swan@pbpost.com

http://www.palmbeachpost.com/opinion/content/opinion/epaper/2009/11/05/a14a_swancol_1106.html

Harvard Professor William Hsiao on effective reform

Health Care Abroad: Taiwan

An interview of William Hsiao, Ph.D., Professor of Economics at the Harvard School of Public Health
The New York Times
November 3, 2009
Q. What’s the most important lesson that Americans can learn from the Taiwanese example?
A. You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.
http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/
William Hsiao, Ph.D.
http://www.hsph.harvard.edu/faculty/william-hsiao/

There is no person more qualified to discuss health system design than William Hsiao (see the link above for his qualifications).

Unhealthy America

By NICHOLAS D. KRISTOF
Op-Ed Columnist
New York Times
November 5, 2009

The moment of truth for health care is at hand, and the distortion that perhaps gets the most traction is this:

We have the greatest health care system in the world. Sure, it has flaws, but it saves lives in ways that other countries can only dream of. Abroad, people sit on waiting lists for months, so why should we squander billions of dollars to mess with a system that is the envy of the world? As Senator Richard Shelby of Alabama puts it, President Obama’s plans amount to “the first step in destroying the best health care system the world has ever known.”

That self-aggrandizing delusion may be the single greatest myth in the health care debate. In fact, America’s health care system is worse than Slov–er, oops, more on that later.

The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland.

Canadians live longer than Americans do after kidney transplants and after dialysis, and that may be typical of cross-border differences. One review examined 10 studies of how the American and Canadian systems dealt with various medical issues. The United States did better in two, Canada did better in five and in three they were similar or it was difficult to determine.

Yet another study, cited in a recent report by the Robert Wood Johnson Foundation and the Urban Institute, looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. What Senator Shelby called “the best health care system” ranked in last place.

The figures are even worse for members of minority groups. An African-American in New Orleans has a shorter life expectancy than the average person in Vietnam or Honduras.

I regularly receive heartbreaking e-mails from readers simultaneously combating the predations of disease and insurers. One correspondent, Linda, told me how she had been diagnosed earlier this year with abdominal and bladder cancer — leading to battles with her insurance company.

“I will never forget standing outside the chemo treatment room knowing that the medication needed to save my life was only a few feet away, but that because I had private insurance it wasn’t available to me,” Linda wrote. “I read a comment from someone saying that they didn’t want a faceless government bureaucrat deciding if they would or would not get treatment. Well, a faceless bureaucrat from my private insurance made the decision that I wouldn’t get treatment and that I wasn’t worth saving.”

It’s true that Americans have shorter waits to see medical specialists than in most countries, although waits in Germany are shorter than in the United States. But citizens of other countries get longer hospital stays and more medication than Americans do because our insurance companies evict people from hospitals as soon as they can stagger out of bed.

For example, in the United States, 90 percent of hernia surgery is performed on an outpatient basis. In Britain, only 40 percent is, according to a report by the McKinsey Global Institute.

Likewise, Americans take 10 percent fewer drugs than citizens in other countries — but pay 118 percent more per pill that they do take, McKinsey said.

Opponents of reform assert that the wretched statistics in the United States are simply a consequence of unhealthy lifestyles and a diverse population with pockets of poverty. It’s true that America suffers more from obesity than other countries. But McKinsey found that over all, the disease burden in Europe is higher than in the United States, probably because Americans smoke less and because the American population is younger.

Moreover, there is one American health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That’s because Americans above age 65 actually have universal health care coverage: Medicare. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

That brings me to an apology.

In several columns, I’ve noted indignantly that we have worse health statistics than Slovenia. For example, I noted that an American child is twice as likely to die in its first year as a Slovenian child. The tone — worse than Slovenia! — gravely offended Slovenians. They resent having their fine universal health coverage compared with the notoriously dysfunctional American system.

As far as I can tell, every Slovenian has written to me. Twice. So, to all you Slovenians, I apologize profusely for the invidious comparison of our health systems. Yet I still don’t see anything wrong with us Americans aspiring for health care every bit as good as yours.

Harvard Professor William Hsiao on effective reform

Health Care Abroad: Taiwan

An interview of William Hsiao, Ph.D., Professor of Economics at the Harvard School of Public Health
The New York Times
November 3, 2009

Q. What’s the most important lesson that Americans can learn from the Taiwanese example?

A. You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.

http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/

William Hsiao, Ph.D.
http://www.hsph.harvard.edu/faculty/william-hsiao/

Comment:

By Don McCanne, MD

There is no person more qualified to discuss health system design than William Hsiao (see the link above for his qualifications).

150 activists arrested coast-to-coast for Medicare for All

FOR IMMEDIATE RELEASE
Nov. 5, 2009

Contact:
Margaret Flowers, M.D., Washington, D.C., (410) 591-0892, mdpnhp@gmail.com
Matt Hendrickson, M.D., Santa Monica, Calif., (310) 383-4343
Eric Naumburg, M.D., Columbia, Md., (443) 562-6562
James Squire, M.D., Seattle, (206) 465-6340
Katie Robbins, Healthcare-NOW, New York, (330) 618-6379
Mark Almberg, PNHP, (312) 782-6006, cell: (312) 622-0996, mark@pnhp.org

In the past few weeks over 220 people in at least 28 cities have risked arrest by sitting-in at health insurance company offices and at the offices of national lawmakers to protest insurance company practices and to show their support for a single-payer national health insurance system, sometimes called an improved “Medicare for All.”

Over 150 of the participants, including a number of physicians and nurses, have been arrested in the lobbies of companies like UnitedHealth, WellPoint, Aetna, Cigna and Humana, and at offices of key legislators. Another nine were arrested today in the Capitol Hill office of Sen. Joseph Lieberman, who activists say is closely aligned with private, for-profit insurers.

“The mass arrests of single-payer activists signal the urgency of our movement,” said Dr. Margaret Flowers, congressional fellow for Physicians for a National Health Program. “With nearly 45,000 people dying annually due to lack of insurance, we are compelled to take action. A majority of Americans support a Medicare-for-All approach. We need congresspersons to heed the views of their constituents.”

Flowers continued: “I did not want to be arrested, but as a physician, I know the tragic state of our health care system. For too long, the health insurance industry has gotten away with its deadly practices of screening out the sick and denying care to increase their profits.”

Flowers, a Maryland pediatrician, joined dozens of others in protesting at CareFirst BlueCross BlueShield on Oct. 29 in Baltimore. She was arrested and detained for nearly 12 hours. Other physicians have been arrested at private insurance companies in California and Washington state.

Organizers say the sit-ins constitute one of the largest coordinated acts nonviolent civil disobedience in U.S. history. While the actions have taken place largely beneath the national radar, organizers credit them for helping to keep the Medicare-for-All alternative on the congressional agenda.

On Wednesday, for example, 12 activists were arrested at House Speaker Nancy Pelosi’s San Francisco office. The activists said that Pelosi was threatening to renege on her promise to allow a debate and floor vote on Rep. Anthony Weiner’s single-payer amendment to the Affordable Healthcare for America Act (H.R. 3962).

On Thursday, Pelosi said she would fulfill her promise, and Weiner’s single-payer amendment is expected to receive a floor vote — a historic first for this kind of legislation — on Friday or Saturday.

Leaders of the activists, most of whom have been organized by groups like Healthcare-NOW and the Mobilization for Health Care for All, say a single-payer program would recapture over $400 billion wasted annually on excessive bureaucracy and paperwork, enough to provide everyone with comprehensive, high-quality health care.

Sit-ins and other nonviolent direct actions have taken place in the following cities, among others:

Glendale, CA
Los Angeles, CA
San Francisco, CA
San Diego, CA
Denver, CO
Washington, DC
Sunrise, FL
Atlanta, GA
Augusta, GA
Chicago, IL
Louisville, KY
Boston, MA
Baltimore, MD
Detroit, MI
Newark, NJ
Albuquerque, NM
New York City, NY
Rochester, NY
Syracuse, NY
Cleveland, OH
Columbus, OH
Philadelphia, PA
Warwick, RI
Houston, TX
Va. Beach, VA
Seattle, WA

******
Physicians for a National Health Program is an organization of 17,000 doctors who support single-payer national health insurance. For more information, visit www.pnhp.org or call (312) 782-6006.

CBO on premiums and cost sharing of the House bill

Letter from CBO Director Douglas Elmendorf

Congressional Budget Office
November 2, 2009
This letter responds to questions about the subsidies that enrollees would receive for premiums and cost sharing and the amounts that they would have to pay, on average, if they purchased a relatively low cost plan in the new insurance exchanges to be established under H.R. 3962, the Affordable Health Care for America Act, as introduced in the House of Representatives on October 29, 2009.
The enclosed table focuses on enrollees who purchase a “reference” plan (the premiums for which equal the average of the three lowest-cost “basic” plans, as defined in the bill), because federal subsidies would be tied to that average. Such a plan would have an actuarial value of 70 percent, which represents the average share of costs for covered benefits that would be paid by the plan.
Although premiums under H.R. 3962 would vary by geographic area to reflect differences in average spending for health care and would also vary by age, the table shows the approximate national average for that lower-cost reference plan — about $5,300 for single policies and about $15,000 for family policies in 2016. Enrollees could purchase a more expensive plan or more extensive coverage for an additional, unsubsidized premium — and CBO anticipates that many enrollees would do that, so the average premiums actually paid in the exchanges would be higher (although average cost-sharing amounts could be lower than those shown in the table).
Estimate for “Reference Plan” in 2016 — Average of 3 Lowest-Cost Basic Plans:
Family Policy:
70% – Actuarial value
$15,000 – Average premium
$5,500 – Average cost sharing
One example – a family of four at a higher income level:
400-450% – Income relative to the federal poverty level
no cap – Premium cap as a share of income
$102,100 – Middle of income range
$15,000 – Enrollee premium in reference plan
0% – Premium subsidy (share of premium)
none – Average cost sharing subsidy
$5,500 – Average net cost sharing
$20,500 – Enrollee premium + average cost sharing
20% – Premium + cost sharing as a percent of income
http://www.cbo.gov/ftpdocs/106xx/doc10691/hr3962SubsidiesRangelLtr.pdf

Of the many flaws in the very expensive and highly inefficient model of health care reform that Congress has selected, one of the more important is the financial impact that it will have on middle- and upper-middle income individuals and families. Let’s look at the example of a family of four with a very good income: $102,100.
The premium ($15,000) and average cost sharing ($5,500) that that family would have to pay would leave them with a net income of $81,600. That is not bad, but it certainly falls short of the $100,000 plus income that no doubt the family believes they should have.
Also that family would likely want coverage beyond the average of the three lowest-cost basic plans. They would want coverage greater than an actuarial value of 70 percent, especially since employer-sponsored coverage now provides an average actuarial value of 80 percent. They would also want more protection should their out-of-pocket medical expenses exceed the $5,500 average net cost sharing. Even with caps on cost sharing, the family would still be responsible for non-benefit products and services and for often-unavoidable out-of-network health care. Take those costs out of the $81,600 balance and that one-hundred-thousand-dollar-income family is going to be very unhappy with this reform legislation.
Do you think that they know about this? Do you think that maybe we should tell them?

A doctor's view: escaping the maelstrom

By Samuel Metz
The Oregonian
Inside the Stump
November 03, 2009

Smoking kills. So does the health insurance industry.

In the 20th century our tobacco industry, threatened by associations between its product and a lung cancer epidemic, diverted public discussion to a multitude of highly charged and largely irrelevant issues. It succeeded so well that even now, 50 years later, it still freely markets its dangerous products with only minor packaging concessions.

In the 21st century our health insurance industry, with its product similarly wreaking havoc on public health, diverts debate away from health care to a variety of powerfully contentious (and distracting) issues. And with similar success — the health insurance industry still rides a crest of prosperity.

What’s the difference? Tobacco only affected the 40% of the population that smoked when the cigarette-cancer association began in the 1950s and the 20% of us who still do. The health insurance industry, on the other hand, affects every one of us. Its monopoly of health care financing extracts $500 annually from every citizen for its own administrative costs (not entirely devoted to lobbying and profit — let’s give the industry some credit), causes 45,000 annual deaths from inadequate access to health care (that’s as many as die in automobile accidents), and precipitates most bankruptcies in the U.S. The money spent by our health insurance industry on administration could extend essential health care to every American. But we don’t discuss that, do we?

Our health insurance industry succeeds as well in this century as the tobacco industry did in the last. Witness the congressional “reforms” — all variants on a theme: Make every citizen buy our insurance. And if our price is too high, make our government buy it for them. All hail this great victory for free enterprise. But what about our health?

American spending on health care outstrips every other nation on earth, yet we lead in not one significant measure of public health. Can it be that our doctors, nurses and hospitals are that bad? Or is that we pay for them through private insurance? Our health insurance industry would have us believe our problem stems from spending too little on their profitable insurance, not spending too much.

The most brutal evidence of the insurance industry’s success is the intensity with which all of us debate perennial unsolvable social challenges — the role of government in private lives, how America’s free enterprise system makes us special, whether tax dollars should fund abortion, whether people who work should provide free services to those who don’t, how illegal immigrants sap our country’s strength, the evil of socialist programs in foreign countries, the insidious threat of death panels, and the inherent inefficiency of any government to run anything. In short, the health insurance industry successfully diverts our attention from the root problem — that our method of financing health care through for-profit private insurance is driving our families and government into financial ruin.

So here we are, fighting not with the insurance industry but with each other: healthy against sick, insured against uninsured, libertarians against liberals, employed against jobless. Fear runs amok. Medicare recipients fear reduced benefits. Employers fear compulsory medical entitlements. Unions fear for their negotiated benefits. And everyone fears skyrocketing policy costs and decreasing access to physicians. We are paralyzed with terror.

Meanwhile, health insurance executives dab their collective brows, having successfully diverted us from realizing that their industry created and sustains our dilemma.

Can we escape this maelstrom?

Yes. With the health insurance industry spending $1.4 million daily on distractions, it takes grit to stay on target. But we must. We must demand our elected officials address the only three questions that matter: “What have you done to provide essential health care to all regardless of ability to pay, employment status or medical condition? What have you done to reduce costs? What have you done to improve our health? Everything else is irrelevant.

Can we stop the health insurance industry from killing Americans in this century faster than we stopped the tobacco industry in the last? Let’s hope we don’t have to wait another 50 years to find out.

Samuel Metz is a Portland physician.

http://www.oregonlive.com/opinion/index.ssf/2009/11/post_26.html

Lack of health insurance played a role in thousands of child deaths, researchers say

By Shari Roan
Los Angeles Times Blog
October 29, 2009

An analysis of 23 million hospital records from 37 states shows that a lack of health insurance likely played a role in the deaths of nearly 17,000 U.S. children over a 17-year period.

Researchers at Johns Hopkins Children’s Center examined records from 1988 to 2005. They compared the risk of death in hospitalized children who were covered by health insurance with those who did not, and found that uninsured kids were 60% more likely to die, regardless of their medical condition. This does not mean that the children received less aggressive care at the hospital but that they were probably in poorer health before the arrived, researchers said. Insurance status did not affect how long a child spent in the hospital, according to the study.

The study did not count children who died outside the hospital or after leaving the hospital, which means that deaths among uninsured children are probably even higher. The report will be published Friday in the Journal of Public Health.

“Can we say with absolute certainty that 17,000 children would have been saved if they had health insurance? Of course not,” a co-author of the study report, David Chang, said in a news release. “The point here is that a substantial number of children may be saved by health coverage. From a scientific perspective, we are confident in our findings that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance.”

As the healthcare reform debate reaches a critical stage in Washington, the study is a reminder of the human cost of healthcare inequality. About 7 million American children are uninsured.

“In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue,” Dr. Peter Pronovost, a co-author of the study, said in a news release.

CBO on premiums and cost sharing of the House bill

Letter from CBO Director Douglas Elmendorf

Congressional Budget Office
November 2, 2009

This letter responds to questions about the subsidies that enrollees would receive for premiums and cost sharing and the amounts that they would have to pay, on average, if they purchased a relatively low cost plan in the new insurance exchanges to be established under H.R. 3962, the Affordable Health Care for America Act, as introduced in the House of Representatives on October 29, 2009.

The enclosed table focuses on enrollees who purchase a “reference” plan (the premiums for which equal the average of the three lowest-cost “basic” plans, as defined in the bill), because federal subsidies would be tied to that average. Such a plan would have an actuarial value of 70 percent, which represents the average share of costs for covered benefits that would be paid by the plan.

Although premiums under H.R. 3962 would vary by geographic area to reflect differences in average spending for health care and would also vary by age, the table shows the approximate national average for that lower-cost reference plan — about $5,300 for single policies and about $15,000 for family policies in 2016. Enrollees could purchase a more expensive plan or more extensive coverage for an additional, unsubsidized premium — and CBO anticipates that many enrollees would do that, so the average premiums actually paid in the exchanges would be higher (although average cost-sharing amounts could be lower than those shown in the table).

Estimate for “Reference Plan” in 2016 — Average of 3 Lowest-Cost Basic Plans:
Family Policy:
70% – Actuarial value
$15,000 – Average premium
$5,500 – Average cost sharing

One example – a family of four at a higher income level:

400-450% – Income relative to the federal poverty level
no cap – Premium cap as a share of income
$102,100 – Middle of income range
$15,000 – Enrollee premium in reference plan
0% – Premium subsidy (share of premium)
none – Average cost sharing subsidy
$5,500 – Average net cost sharing
$20,500 – Enrollee premium + average cost sharing
20% – Premium + cost sharing as a percent of income

http://www.cbo.gov/ftpdocs/106xx/doc10691/hr3962SubsidiesRangelLtr.pdf

Comment:

By Don McCanne, MD

Of the many flaws in the very expensive and highly inefficient model of health care reform that Congress has selected, one of the more important is the financial impact that it will have on middle- and upper-middle income individuals and families. Let’s look at the example of a family of four with a very good income: $102,100.

The premium ($15,000) and average cost sharing ($5,500) that that family would have to pay would leave them with a net income of $81,600. That is not bad, but it certainly falls short of the $100,000 plus income that no doubt the family believes they should have.

Also that family would likely want coverage beyond the average of the three lowest-cost basic plans. They would want coverage greater than an actuarial value of 70 percent, especially since employer-sponsored coverage now provides an average actuarial value of 80 percent. They would also want more protection should their out-of-pocket medical expenses exceed the $5,500 average net cost sharing. Even with caps on cost sharing, the family would still be responsible for non-benefit products and services and for often-unavoidable out-of-network health care. Take those costs out of the $81,600 balance and that one-hundred-thousand-dollar-income family is going to be very unhappy with this reform legislation.

Do you think that they know about this? Do you think that maybe we should tell them?

A doctor’s view: escaping the maelstrom

By Samuel Metz
The Oregonian
Inside the Stump
November 03, 2009

Smoking kills. So does the health insurance industry.

In the 20th century our tobacco industry, threatened by associations between its product and a lung cancer epidemic, diverted public discussion to a multitude of highly charged and largely irrelevant issues. It succeeded so well that even now, 50 years later, it still freely markets its dangerous products with only minor packaging concessions.

In the 21st century our health insurance industry, with its product similarly wreaking havoc on public health, diverts debate away from health care to a variety of powerfully contentious (and distracting) issues. And with similar success — the health insurance industry still rides a crest of prosperity.

What’s the difference? Tobacco only affected the 40% of the population that smoked when the cigarette-cancer association began in the 1950s and the 20% of us who still do. The health insurance industry, on the other hand, affects every one of us. Its monopoly of health care financing extracts $500 annually from every citizen for its own administrative costs (not entirely devoted to lobbying and profit — let’s give the industry some credit), causes 45,000 annual deaths from inadequate access to health care (that’s as many as die in automobile accidents), and precipitates most bankruptcies in the U.S. The money spent by our health insurance industry on administration could extend essential health care to every American. But we don’t discuss that, do we?

Our health insurance industry succeeds as well in this century as the tobacco industry did in the last. Witness the congressional “reforms” — all variants on a theme: Make every citizen buy our insurance. And if our price is too high, make our government buy it for them. All hail this great victory for free enterprise. But what about our health?

American spending on health care outstrips every other nation on earth, yet we lead in not one significant measure of public health. Can it be that our doctors, nurses and hospitals are that bad? Or is that we pay for them through private insurance? Our health insurance industry would have us believe our problem stems from spending too little on their profitable insurance, not spending too much.

The most brutal evidence of the insurance industry’s success is the intensity with which all of us debate perennial unsolvable social challenges — the role of government in private lives, how America’s free enterprise system makes us special, whether tax dollars should fund abortion, whether people who work should provide free services to those who don’t, how illegal immigrants sap our country’s strength, the evil of socialist programs in foreign countries, the insidious threat of death panels, and the inherent inefficiency of any government to run anything. In short, the health insurance industry successfully diverts our attention from the root problem — that our method of financing health care through for-profit private insurance is driving our families and government into financial ruin.

So here we are, fighting not with the insurance industry but with each other: healthy against sick, insured against uninsured, libertarians against liberals, employed against jobless. Fear runs amok. Medicare recipients fear reduced benefits. Employers fear compulsory medical entitlements. Unions fear for their negotiated benefits. And everyone fears skyrocketing policy costs and decreasing access to physicians. We are paralyzed with terror.

Meanwhile, health insurance executives dab their collective brows, having successfully diverted us from realizing that their industry created and sustains our dilemma.

Can we escape this maelstrom?

Yes. With the health insurance industry spending $1.4 million daily on distractions, it takes grit to stay on target. But we must. We must demand our elected officials address the only three questions that matter: “What have you done to provide essential health care to all regardless of ability to pay, employment status or medical condition? What have you done to reduce costs? What have you done to improve our health? Everything else is irrelevant.

Can we stop the health insurance industry from killing Americans in this century faster than we stopped the tobacco industry in the last? Let’s hope we don’t have to wait another 50 years to find out.

Samuel Metz is a Portland physician.

http://www.oregonlive.com/opinion/index.ssf/2009/11/post_26.html

Hawaii Information

Contact Information

Email us for information on local activists

Media Contacts

Stephen Kemble, M.D.Stephen B. Kemble, M.D.
stephenbkemble@gmail.com

Dr. Steve Kemble attended medical school at the John A. Burns School of Medicine when it was a 2-year school, and completed medical school at Harvard. He trained in both internal medicine and psychiatry. He is a psychiatrist in private practice and also teaches psychiatric aspects of general medical care to internal medicine residents. He is an Assistant Clinical Professor of both Medicine and Psychiatry at the University of Hawaii School of Medicine. He is a past president of both the Hawaii Psychiatric Medical Association and the Hawaii Medical Association. Dr. Kemble has a longstanding interest in health care reform, and he has been appointed to the Hawaii Health Authority, charged with overall health planning for the State of Hawaii and with designing a universal health care system covering everyone in the State. He is also a longstanding member of PNHP and serves as a PNHP board adviser.

Leslie Hartley Gise, M.D.
(808) 878-3314
leslieg@maui.net

Dr. Gise is a Clinical Professor, Department of Psychiatry, John A Burns School of Medicine, University of Hawaiā€™i, She is the contact person for the PNHP Hawaii State Chapter.