Mon
Jul 9 2007
09:29 am

OK, so we've seen the movie and we're sufficiently outraged and we're starting to talk about our broken health care system.

What now? What can we actually do about it?

Read more...

There really isn't much any of us can do individually, other than to keep talking about it and raising awareness. We can start making healthier lifestyle choices, and that would help. But most of us have few if any choices in picking an insurance company. And complaints or activism directed at your insurance company probably aren't in your best interest given the current environment.

I've been trying to figure out what I personally, and we collectively, can do about it. I concluded that any reforms will have to be at the federal level. Local and state governments can't do it. Sure, local governments can fund more health clinics and indigent care. And the states are trying with Medicaid, but look at what a disaster TennCare has been. And what about the underinsured and even the insured who are not always getting adequate, affordable coverage?

Change has to come at the federal level, and there has to be pressure from grassroots, local and state governments, labor and business organizations, and people in the health care industry who are focused more on health care than on profits.

I was thinking we should demand that every candidate for political office, from County Commissioner on up to President, take a pledge to reform health care in the US. I was wondering, what should this pledge be? There are lots of ideas floating around, but I came up with:

• Support policies and legislation that guarantee every American affordable access to health care in the next ten years.

• Work to reduce the number of uninsured to zero within five years.

• Support policies and regulation that end "cherry picking", exclusions, and denials of claims by insurance companies.

• Support policies and legislation that promote wellness and preventive care.

• Support policies and regulation that control costs and improve quality of care and patient outcomes.

• Remain open to ideas and dialog and compromise towards reforms that accomplish all of this in the most open and accessible way to all Americans, whether it ends up being a single-payer system, a better regulated free market system, or a hybrid of some kind.

• Refuse to accept campaign contributions or any other financial support from health care and pharmaceutical industry interests.

I, like most Americans, have always been leery of "socialized medicine" such as they have in the UK. The French system is a hybrid that might be more politically feasible in the US. But the reality is that I don't know what would work best here, and neither do you unless your full-time job involves public health policy and a lifetime of studying other systems around the world. It's almost like we need a national plan of action similar to an "Apollo Program" or a "Manhattan Project" for health care reform.

Or maybe not. HR676, introduced by John Conyers four years ago, proposes something I've long thought might be a good solution: Open up Medicare for everybody. This bill would essentially accomplish every point in the above "pledge" with a single act of Congress. It's not quite an overnight solution, but almost.

When I first read it a couple of years ago, I thought it was crazy and had no chance at all of even being taken seriously. But the more I think about it, the more I think this is a solid foundation for a single-payer universal insurance program. The systems are in place, the funding mechanisms are in place, and the bill lays out an orderly transition.

It would eliminate for-profit health insurance, and consolidate all federal and state programs including Medicaid and VA into one National Health Insurance program based on the existing Medicare program. It would be funded by shifting resources already being spent along with some modest tax increases.

It's not perfect, there are some details that need to be fleshed out, and it will be met with vicious opposition by the insurance and pharmaceutical companies. But it's a good starting point and it's better than anything else that's been proposed in the last twelve years or so.

I believe that an open and legitimate debate with HR676 as the proposed basis for reform would get us to a solution within a couple of sessions of Congress. Say what you want about Michael Moore, but the movie SiCKO may have just ignited the political will to get it done, or at least get the debate started in Congress.

So what I would propose to do is to write your and Senators and Representative asking them to take this simplified pledge:

1. Pledge to not accept campaign contributions or any other financial support from any health care or pharmaceutical industry special interests, and

2) Pledge to a) Support HR676, or b) support at least a fair and open debate of the bill in Congress, or c) offer an alternative solution that accomplishes the same goals of providing affordable universal health insurance to all Americans.

You should also ask whatever candidate you support in the 2008 presidential election to pledge the same, and ask the same of your candidates in the 2008 congressional elections.

We should also demand that every candidate in every debate, local or national, be asked if they will pledge the same. Maybe we can ask the League of Women Voters to include these two points in their local candidate surveys and debates.

And while they wouldn't be directly involved in the debate, state and local candidates can be held to the same pledge. They can lend political support and apply pressure by raising awareness and educating the public about the benefits (and savings) to local public health and state Medicaid programs.

Contact everyone you can think of, and email this info to five or ten other people and ask them to do the same.

Here's some contact info to get you started:

Congressman John J. Duncan, Jr.
2207 Rayburn House Office Building
Washington, DC 20515
Phone: (202) 225-5435
Fax: (202) 225-6440
Web contact form

Senator Lamar Alexander
455 Dirksen Senate Office Building
Washington, DC 20510
Phone: (202) 224-4944
Fax: (202) 228-3398
Web contact info

Senator Bob Corker
Dirksen Senate Building
SD-185
Washington, D.C. 20510
Phone: (202) 224-3344
Fax: (202) 228-0566
Web contact form

(For you folks over in Memphis, Rep. Steve Cohen has already signed on as a co-sponsor of the bill, along with 74 others.)

120
like
Mello's picture

well...

While we are on the subject, check out what PBS has been researching.

(link...)

Carole Borges's picture

I really think a huge protest in Washington might work..

When people finally did get fed up with Viet Nam they showed up in Washington with numbers no politician could ignore. They demanded and they got an end to the war. In Sicko Moore mentioned how the French use public protest as a tool. People here simply "talk and write", hoping their elected officials will vote the way they want. We also leave it to the media to plead our causes. If we are to get national health care for all and an end to the war, it's time we start organizing public protests and teach-ins (ala the 60s). The Internet in someways has made us feel as if we are taking action, but I think all the emails, phone calls, and signed form-letters from MoveON type organizations in the world, can't do the job alone.

A huge protest in Washington organized by smart people with resources like buses and money and publicized like 6 months or a year ahead of time would, I think, be the only way to get free national healthcare for everyone who wants it.

Until then contacting the usual suspects is certainly far better better than doing nothing at all.

metulj's picture

Here's an idea to break the

Here's an idea to break the "Doctors won't have the choice to practice privately" bullshit argument under a national healthcare system: Accepted to medical school? Free tuition if you choose the national healthcare path which you must participate in for 10 years after residency and 1, 3 or 5 year contracts afterward. If you choose to opt out, then you can practice privately, but you don't get tuition remittance.

The key to national, universal healthcare is to give the doctor's incentive and a choice at the beginning and down the line.

Here's two scenarios:

1. Michelle gets accepted to medical school and chooses to do the national service. She does her residency in family medicine and joins the national plan afterward. She does her 10 years and is 38 years of age at that time. She decides to go into private practice then. She owes nothing in loans and has copious amounts of experience. That's a situation that would create great doctors.

2. Sarah gets accepted to medical school and chooses to pay to be a private doctor. She does her residency and specializes in orthopedics. She goes into practice. The option to go onto the national plan will always be open to her, so if she decides that she wants to be a mom or retires, she can come on the national plan later in life as a doctor for a year, for 3 years or for 5 years.

How do you bridge the two choices? It is obvious that people will want to specialize and go into private practice, but those residencies are really hard to get (especially good ones). Surgeons would be private practice in most cases, but referring PCPs would be nationalized. The payments that one would make to the national service via FICA like payments would go to nationalized doctors, admin of them, prescriptions and a nationwide pool insurance for catastrophic care that would pay the specialists.

Yeah, I know there are holes in there, but its my contribution that does not eliminate choice for the doctors.

True happiness is knowing you are a hypocrite. -- Ivor Cutler

Brian A.'s picture

Good discussion

I think a great deal of cost savings could be realized through this point:

Support policies and legislation that promote wellness and preventive care.

In SiCKO, I was intrigued by policy mentioned that gives doctors incentive pay for helping keep people healthy. I'm not familiar with how that works. It sounds like a really good idea. Unfortunately, it also seems like would be difficult to implement and effectively run.

Brian A.
I'd rather be cycling.

cooperhawk's picture

ideas

The Germans had national health care in the 1930's. It was a good way to persecute the Jewish doctors before the government started getting really nasty. Just don't pay the Jewish doctors & they're out of a job. I'm sure we are too civil to do that here though.

metulj's picture

Godwin's Law. You lose. True

Godwin's Law. You lose.

True happiness is knowing you are a hypocrite. -- Ivor Cutler

Andy Axel's picture

Apparently Michael Moore

Apparently Michael Moore didn't like the treatment he got on CNN, and takes Wolf Blitzer directly to task.

A thing of beauty.

____________________________

I'm a guy in a Reagan mask -- and I'm running for President!

Andy Axel's picture

And Lou Dobbs validates

And Lou Dobbs validates Moore's rant by calling Moore:

"...a bigger left wing promoter than Hugo Chavez."

...at the end of the program.

____________________________

I'm a guy in a Reagan mask -- and I'm running for President!

Brian A.'s picture

Germans

I understand the Germans also built some pretty good highways in the 1930s.

We better not ever try that here!

Brian A.
I'd rather be cycling.

MartyD's picture

health Care(?)

We need to do all the things outlined in your piece.There is something else I've been doing which makes me feel better. Go to petionsite.com and register for all the petitions concerning health care. They will be sent to your legislators.
Last year in the spring my husband was diagnosed with colon cancer.We are on Medicare and we have the supplement with the company that insured us while he was working in Oak Ridge. We encountered several people in waiting rooms who were paying premiums each pay period but couldn't afford the co pay ...One young man maxed out a credit card to get an MRI for his wife because they had not met the outrageous deductible on their policy. In essence they had no insurance either. Not only do we have a large portion of our people ininsured but we have a lot of what I call the "almost insured". These are people who go to work, pay their premiums and don't get squat for it.

Eleanor A's picture

The problem, IMO, is that

The problem, IMO, is that we've already given away the store vis a vis allowing corporations more or less unfettered abilities to sell whatever products they like through owning our legislators. Whatever small consumer protections we still have contain easy workarounds on the part of any corporation with a big bank account.

The problem is that organizing consumer boycotts on a large scale isn't all that easy to do. I'm just not sure the large Washington protest is an effective vehicle any more, because most folks aren't all that concerned about an armed uprising on the part of the populace.

First thing we have to do is make sure they don't get control of the Internet. I think it's pretty well our last best hope, in terms of organizing something for normal people the terms of which aren't dictated by the Big Corporate Government that runs everything these days.

talidapali's picture

"People should not be afraid of their government,

the Government should be afraid of the people" ~ V for Vendetta.
V
_________________________________________________________

"You can't fix stupid..." ~ Ron White"

"I never said I wasn't a brat..." ~ Talidapali

R. Neal's picture

That was mentioned in Sicko

That was mentioned in Sicko as one of the differences between France and the US, i.e. over there the gov. is afraid of the people and over here it's the other way around.

Maybe what we ought to remember and get back to is that here, the government IS the people. Or at least it's supposed to be.

It only works, though, if people get off their butts and vote. And then if those people, when they vote, hold these idiots in Washington and elsewhere accountable for not representing the people and the Constitution like they are supposed to.

MartyD's picture

I just noticed a misspelling

I just noticed a misspelling in my comments Go to petitionsite.com and sign up for matters of interest, i.e., health care, national parks etc. They will send only those petitions which interest you and the signed petitions will go to your legislators.

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