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Care Package 

Editor:

I enjoyed the Journal’s presentation of several varying views of President Obama’s health care reform package (“Reform!?,” Sept. 17). Kudos!

However, I have issues with a few of the points brought up by Ron Ross in his article, “Many Questions, Few Answers.” While I agree Pres. Obama is all over the place right now with the proposal’s specifics — to an annoying degree, at that — I see no real alternative presented in this article.

Ross calls for more analysis into overhauling our health care system and for bipartisanship, but the reality has been one of many hard-line Republican members of Congress offering little in alternative plans and much in heavy, at times hateful and absurd, rhetoric.

I’m also curious what position Ross takes on Social Security and Medicare, two burdensome and bludgeoning government-run health programs threatening to drain the coffers of the next several generations before those kids are even born. In fact, I see few calls from the opponents of Pres. Obama’s proposal to completely abolish those two programs — an action that would align with the statist fear-mongering swirling about these days by opponents.

Believe me, I have my issues with Pres. Obama’s proposal, being wary of bureaucracy and all. But the claim by Ross that our privatized system sees people as “individuals” instead of “categories,” as a government-run bureaucracy would, is absolutely absurd. Pre-existing condition, anyone?

John Osborne, Arcata  

  

Editor:

If you or I denied medical care to someone we were responsible for, we would be committing a crime as well as a sin. If that person died, we could be charged with manslaughter or even murder. If an insurance company denies or delays medical care and death or injury results, no charges are filed. If a mechanic billed us $7,000 for an oil change, or a restaurant $7,000 for the special, we would have them charged with extortion or profiteering. But when the health care system charges us $7,000 for a test that really only costs a few hundred dollars, again, no charges are filed.

A fine example of unconscionable profiteering is the anticancer drug which was discovered, tested and developed by the National Cancer Institute using our tax dollars. The drug industry, which normally won’t touch natural products (Taxol is extracted from yew trees) because they can’t patent them, smelled big money on this one and moved in. Some hospitals charge up to $12,000 for a 300mg dose of this drug. The real cost of the active ingredient is about $20 — 7 cents/milligram.

Alan Sanborn’s heart-wrenching story about his wife’s battle with cancer made me feel that the equal battle she was fighting with the insurance industry was a form of torture. Ron Ross’ article just bangs the government bad/business good drum. It does not address how the rest of the industrialized world gives its citizens universal health care, sometimes at half the cost we pay, because their governments regulate costs just like we do here with Medicare or the VA. These countries also avoid unnecessary diagnostics and questionable surgery. And you know what? These countries’ drug companies are doing just fine. Their doctors are not dressed in rags. Most importantly, their people are not dying of treatable diseases.

But there is one thing that these countries do not have that we have in abundance — fear. Fear that if we get sick or have a really bad accident we could lose everything. But these countries have waiting lists, some say. Most of these countries have private insurance, private doctors and private hospitals to solve this problem — if you want to pay for it — and it’s still cheaper than here. We have waiting lists, too. You could call them claim pending, claim denied, no insurance or not rich enough not poor enough. So, Ross, if you want to pay $12,000 for a $20 drug because you believe profit good/regulation bad, that’s OK with me, but pay it out of your own pocket. I don’t want my insurance premiums to pay for such nonsense.

The current medical industrial complex is godless, greedy, and corrupt. Some of the people who work in it are actual criminals. I worked in the drug industry. I met some of them.

Charles Davy, Bayside

  

Editor:

Ron Ross, arguing against President Obama’s effort to provide health care to all Americans, points out that FedEx is more efficient than the Post Office. Last I checked, FedEx does not deliver a letter from Alaska to Hawaii for half a buck. And there’s no requirement on FedEx to provide an office here in little Trinidad; if FedEx thought they could increase profits by declining to deliver to certain areas, I’m sure they’d hurry to do so. As free-market enthusiasts are fond of reminding us, management’s duty is to maximize shareholder profits.

Health care is not package delivery. As citizens of a wealthy and civilized nation, surely we don’t think sick people should be cared for only when it’s profitable to some insurance company. So it’s odd that we’ve developed this system where the gatekeepers’ duty is to maximize shareholder profits, rather than maximize “customer” health.

When any uninsured person in America gets critically sick, they can always go to an emergency room. Eventually the taxpayers will end up paying for their emergency care. The President would like all Americans to have access to health care before problems become critical (and expensive). His proposal is not to “take over” health care at all, but to offer Americans some alternative to the for-profit health insurance bureaucracies that now control access.

According to Physicians for a National Health Program, “[t]he Medicare program operates with just 3 percent overhead, compared to 15 percent to 25 percent overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1 percent.” A substantial part of that 15 percent to 25 percent overhead pays for insurance company efforts to avoid enrolling people who might need care. Another substantial part pays for efforts to avoid paying doctors for procedures the doctors think are necessary. It is precisely for achieving those goals that the corporate managers are rewarded with high salaries.

The goal of any private insurance company is to maximize the premiums it receives and to minimize the payouts it makes. That’s fine, it’s just a lousy way to deliver health care.

Mitch Trachtenberg, Trinidad

  

Editor:

What really bothers me about the current public discourse around health care reform are not the outright lies, misinformation and thug behavior of the extreme right. After all, these are all tactics that have been used historically by corporate rich and those that they own to fight every grassroots movement that has threatened their bottom-line profiteering. It was used in the past against workers’ rights and unionization as well as voter registration, to name two well-accepted improvements in American life. No, that is to be expected.

What really bothers me is the utter disregard for the facts by otherwise intelligent, articulate thinkers on the right, like Ron Ross, among many others. They seem too much in love with their now-discredited Reagan-era rhetoric to notice that every other Western democracy on earth has a better health care system than the U.S. They all spend less of their gross national product on health care than the U.S., cover a greater percentage of their people (100 percent covered in most of them) and get more quality in terms of many measures of health care outcome, such as life expectancy.

So to hear Ross and others rail on about how a “public option” or a single-payer system is untested, impossible, unreasonable, etc., etc. is so incredibly frustrating. When are they going to wake up, look around, come to terms with the facts and realize that while their theorizing and rhetoric sounds intelligent and reasonable, it is completely unsupported in reality? That, in fact, putting health care financing in the hands of large, not-for-profit or single-payer systems — i.e. the public option — has worked out so much better than the system that we have in the U.S.? It is not experimental, untried, theoretical, unreasonable, etc. etc. It is the proven norm.

Mark Twain once said something to the effect that he loved science because it gave such a large return of theory for such a little investment of data. I am not sure if economics can be said to be a science. Recent events suggest not. But the history of science is full of stories of otherwise accomplished people who hung on to their time-tested favorite theories in the face of all evidence to the contrary, way past the time when a reasonable, objective, dispassionate realist would have abandoned them. In the light of history they all just look ignorant.

History is much kinder to those who adjusted their theoretical rhetoric to incorporate proven factual information. We don’t expect that from those on, or beholden to, the corporate payroll, who are clearly paid to blind the public to information that could hurt profits. But we do expect that from anyone claiming to be a reasonably objective source of information. What about the facts, Mr. Ross? How do you account for the blatant success of all those other countries using a single-payer, not-for-profit system?

Could it possibly be that if you want to buy better health care for less money, then spreading the risk pool as large as possible and insisting that every health care dollar goes to providing better health care, rather than to executive compensation and shareholder profit, actually works? Well, this has been tried in many countries and the answer seems to be, over and over, a resounding yes.

Gerald Drucker, Trinidad

  

Editor:

I’m writing to point out a typesetting error in Ron Ross’s piece on health care reform in your current issue. It appears that you omitted the section in which Ross offers his ideas for providing affordable health care for all Americans, leaving one with the impression, surely mistaken, that he only wishes to criticize without offering any better ideas himself. Hasn’t the innovative and efficient American health insurance industry come up with a better plan? I’m eager to hear it.

I also wonder if Ross is a newcomer to this great nation of ours. Apparently he has not heard of our many wonderful government-run agencies. The post office, for example, will send someone over to my house to pick up my meager bank deposit, and personally deliver it to my bank within a day or two, for only 44 cents, saving me a half-hour drive across town. They have never once failed in this endeavor. I’m not aware of any private company that does such a good job for such a small fee.

And water! My husband and I pay less than one dollar per person per day to receive clean drinking water in our home and to have our sewage magically whisked away to some far-off place where we never have to so much as think about it again. I’ve been reading up on water and sewage-borne illnesses lately (don’t ask) and let me tell you, good sanitation is — oh, wait. You know what it is? One of the best government-run health care programs in the world. Hmmmm.

But wait, there’s more! Ross may not be aware that in this country, children go to school for free. And if your house catches on fire? (He’s going to love this part.) A crew of very brave men and women will come rushing over with very expensive and sophisticated equipment and will risk their lives to save you and your loved ones. Even if you’re poor! Even if your own stupidity caused the fire! Would Ross like to opt out of this system and instead find a private company willing to provide those services?

I’m sure that once Ross spends a little more time in America and familiarizes himself with the many government-run wonders we enjoy here — Good roads! Traffic lights! Police! Health and safety codes! Libraries! — he’ll come to realize the benefit of us all chipping in a little bit of money in taxes, and sometimes paying a modest amount in fees, to receive good, basic, decent services that are too important to be offered on the open market to only those who can afford it.

Oh, and if you wouldn’t mind letting Mr. Ross know — because it really is starting to seem as though he’s quite unfamiliar with our situation here in these United States — that last year, two pillars of American capitalism, the financial industry and the automotive industry, collapsed. This, in spite of all their innovation, ingenuity, and efficiency. Oddly, no private company came forward to bail them out. The government did that, too.

Amy Stewart, Eureka

  

Editor:

Ron Ross begins his argument against “Obamacare” by bashing the president for his failure to persuade conservatives such as Ross himself to accept Obamacare. This strikes me as a circular, inauspicious way to state a persuasive case. He even derided the way Obama keeps trying to forge a consensus by coming up with different ideas — health insurance co-op, public option trigger, insurance exchange — as “silly, desperate and floundering.” Yet a few paragraphs later we find out that the president is inflexible and has ridiculed anyone who doesn’t agree “with his own particular prescription for reform.”

Ross would have been a lot more persuasive himself if he’d stuck to the meat of his argument. Essentially, he has the conservative’s distrust of sweeping government intervention, and he has the economic background to foresee unexpected damaging side effects that well-intentioned legislation often has. These are exactly the valid reservations that conservative thinkers are supposed to raise. Yes, the government is notorious for its “one-size-fits-all character” that doesn’t treat people as “individuals but rather as categories.” But don’t insurance companies do the same? The question is: Whom do we distrust the least? The government bureaucracy that gave us Medicare and Social Security or the insurance companies with their flagrant and callous mandate to maximize profits no matter what?

If Ross hadn’t squandered his word count on senseless bashing, maybe he would have had room to outline some solutions to the current situation. Because if he’s right that a public option — added into the crazy mix of what we now have — will drive up costs and cause shortages, then he inadvertently made the case for single-payer insurance. But how to pay for it? Well, let’s take a look at that gargantuan military budget Alan Sanborn mentioned. Speaking of intrusive big government, I’ll bet it involves some of that waste and inefficiency we all hate to see. Maybe it’s just plain not necessary to spend almost as much money on our military as the rest of the world combined. Maybe we can take care of our health instead. Ooh, that’s radical.

Martha Walden, Westhaven

  

Editor:

I am a local pediatrician and I really enjoyed reading Alan Sanborn’s salient and entertaining article in favor of health reform. I, too, am an advocate of a single payer system because I can see no other way to improve care and contain costs. There is fat in the system, but it belongs to insurance companies (most of these companies keep about 20 percent of the premiums they take in for themselves in the form of administrative costs and profit), malpractice lawyers and pharmaceutical companies. Without fundamental reform, including tort reform, much of the money put into the system will not go toward health care essentials.

To rebut Ron Ross, the comparison between running health care and running a company is not a comparison that works, because there are fundamental differences between someone with cancer who needs treatment and someone who would like to mail a package. Health care is not an optional service, but a necessary one. Patients should not be expected to choose between having their breast cancer treated or dying.

Realistically, patients have limited or no options when it comes to health care coverage. In fact, many of those uninsured have no options. Even when the consumer does have options and can choose an insurance policy, it is impossible to understand what you are purchasing. Find me one person who understands the coverage that their insurance policy provides with all the deductibles, co-pays, caps, exclusions, preferred providers, in-network requirements, authorizations, pre-authorizations, prior authorizations, covered prescriptions, etc., and I’ll hire them immediately to work in my billing office.

As for the argument that government does not run things efficiently, if that is so then let’s improve our government. There are government programs that work well to serve as models, and too often they get ignored. Take, for example, the Rural Health Clinic program. This is a government program that helps fund rural clinics that care for the indigent. I think the government has done a great job of balancing oversight while allowing the clinics to function independently, in providing incentives to function efficiently while not interfering with effectiveness.

Another great federal program is the Vaccine For Children or VFC. They provide free vaccines to clinics and doctors’ offices for low income children. They oversee vaccine distribution and help us to maintain the proper quality and care of those vaccines. Again, here is a program that provides a great balance of support and oversight while encouraging independence and efficiency.

We should meditate on the disclaimer given to all subscribers of Blue Cross: “Verification of benefits or coverage is not a guarantee of eligibility or payment. Actual payment is based on the terms and conditions of the plan.”

Emily Dalton, Eureka

  

Sweet Spot: Essentially a seven-way tie for first. We ran a random number generator — no joke — and Gerald Drucker came out on top. He wins a Bon Boniere sundae for being the luckiest member of our deepest field in ages.

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