I've never seen this video, and it's one for the archive... let's hope it doesn't get deleted from You Tube. (hat tip Jon Bois)
It's got it all, a Sox-Cubs Exhibition Game matchup before interleague play in Major League Baseball. We have the legendary Sox and Cubs announcer Harry Carey interviewing Michael Jordan and later singing "Take Me Out to the Ballgame."
Also, note at the 4:30 mark: the White Sox line-up contains current Manager Ozzie Guillen and bench coach Joey Cora. The color commentator is none other than Cy Young Award winner Steve Stone who now does the same job for the White Sox. Jordan goes 2 for 5 with two RBI's.
Usually I eschew the dramatic and seek a more reasoned approach to any discussion. The passions of any theme will almost always lead away from a rational discussion... but this story is emblematic of the lunacy of our current health care "system", which really has no resemblance to a system at all. And as the Republicans and Blue Dog Democrats scream to "slow down" health care reform, this story is even more poignant.
Kimberly "Kimi" Young (at left), a healthy 22-year-old recent college graduate, got the flu. She was sick with fever and upper respiratory symptoms but delayed treatment because she lacked health insurance and was concerned about the cost. After two weeks her condition worsened to the point her roommate took her to the hospital, where she subsequently died. Died of suspected swine flu.
Okay this is one tragic case and no conclusion about any large population can be drawn from one tiny example in a society of 300 million people.
A recent federally funded Harvard study estimates 45,000 Americans die each year from lack of health insurance. Yes, detractors will say these numbers are spurious even by the most objective analysts, and sure many of those deaths may be people who are already infirm, and yes there are probably many other problems with such a study, but the number is out there.
Even if this number of deaths is inaccurate, the costs of caring for people who live is higher when treatment is delayed. Even if Kimi were to have lived, her delayed treatment was certainly more expensive than the week's worth of oral antiviral Tamiflu that may have mitigated the criticality of her illness had it been administered early.
Americans who have comprehensive insurance or who never get sick just have no idea the insanity of the current US health care "system." Even people with high deductible insurance will ponder what to do when they feel ill. Whenever someone gets sick they sit down and think about whether to get treatment. Why?
No matter how much time an individual takes to think about it, they will never acquire the expertise to triage their medical condition and render the proper care. One 10-minute visit with a doctor or nurse practitioner, or even a phone call to the office nurse, can allay fears and frustrations, or may save thousands of dollars-- and in Kimi's case, maybe even save a life. By constructing hurdles based on financing, we are adding to the extant hurdles we all struggle with in pursuing medical care. Nobody "wants" to go to the doctor: to sit in the waiting room, to talk about their personal issues, to get undressed, maybe get poked with a needle, etc. So why add yet another burden like payment to the mix?
Kimi is gone, and while I hesitate to get all dramatic over this one case, it is a tragedy which was avoidable. A waste... not only for this young woman and her family and friends, but for all of us. Thinking selfishly, we must consider that we will never benefit from the expertise of this college graduate, a seemingly wonderful and productive member of our society. She is gone forever, and all because of the relatively tiny cost of health insurance.
Usually with the White Sox mathematically eliminated I would be rifling through my bottom drawer for the old Bears shirts and hats, especially with a promising new QB and an honest chance to achieve something in Soldier Field this year. But I cannot turn away from the Sox just yet. Spoiling the Tigers in the final week would be a moral victory, especially if they were eliminated from the post-season now after leading the division from the very first day. The reasons this week matters:
White Sox Redemption
This year held a lot of promise with an highly touted bullpen, big bats, great young prospects, but from the very beginning of the season the team has sustained one disappointment after another. Quite a few players are on the bubble and their performance this final week may actually have significance. Aside from Thornton and Carrasco, nobody's bullpen job is safe. Bad performances from Dotel, Linebrink, Nunez, or Pena could find them on the trading block, or in a couple cases out of baseball altogether.
Peavey, after being absent during the crucial meltdown just when we needed him, could redeem himself in the fans' hearts with a couple strong outings such as last night's outstanding shutout. Buehrle would validate his perfect game by winning at least game since that stellar performance.
The quiet bats from Quentin, Rios and Dye have been disturbing. Only Beckham, Pierzynski and Podsednik have been playing up ton their potential and a few victories without Thome's power would do a lot for the confidence going into the off-season.
Playing a week without the appalling errors we have seen this year in the field would go a long way to instill some pride. A flawless week out of Ramirez could be significant in showing that he does not belong at second base for the Padres.
Tiger Punishment
Despite their huge payroll ( 3rd highest in baseball), the Tigers are only barely hanging onto the lead in the worst division. Sure, the White Sox have no room to gloat, but handing the Tigers a hugely ironic ticket home before the post-season after leading since April 10th would be quite comforting.
In recent history the Sox have owned the Tigers, and especially Tiger pitching, and continuing this dominance would be a nice boost going into next year. The Twins winning ways over the Sox should end when they move outside of the Baggy Dome next year, so proving that we still can beat the Tigers is important for our sentiment next year.
Andrew Reilly outlines other reasons to point our animosity at Detroit, including their over-hyped septuagenarian manager, their empty city and their unemployed fans... none of which will find any argument from me.
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Baseball season will be mercifully over this weekend and I can still have plenty of time to don the Blue and Orange for Sunday's big game against the Seahawks, one of the worst passing defenses in the league-- prediction Cutler throws for 400 yds and Knox scores two TD's. And then, the following week: the Lions come to Soldier!
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UPDATE 11:30 pm, 9-26-09
The Sox are terrible. After going ahead 5-0, Garcia and the bullpen gave up 11 runs before I turned it off. Stop. The. Pain.
The Democratic Senator from North Dakota has read a book! Go read it here.
Conrad, a consistent opponent of the public option, wanted liberals to know "government-run programs" aren't necessary to lower costs and expand access. He explained that he'd finished reading T.R. Reid's "The Healing of America" over the weekend, and learned Germany, Japan, Switzerland, France, and Belgium are doing just fine. "[A]ll of them contain costs, have universal coverage, have very high quality care and yet are not government-run systems."
What? After 22 years in the Senate this is the great paradigm-changing insight you give us? The upshot of this discussion seems to be that the "government option" will be an expansion of low reimbursement Medicaid to the lower working class while allowing private insurance companies will continue to cherry pick the health and wealthy
>> A boon to the insurance industry and the Senators and Congressmen who they own, and a disaster for medical practice, taxpayers, physicians and patients.... just my cynical hunch.
This is what lame libertarian ideology sounds like these days. Rep Eric Cantor never read his Ayn Rand back in college, or at least he won't reiterate here for the unwashed masses. Let's go to the video and I'll discuss afterward.
First of all, I'm going to take a couple Democratic sites to task. Think Progress dramatically summarized the exchange thusly: " Churchill told Cantor that her relative was dying of stomach tumors and needs an operation as soon as possible." Um, no. Ms. Churchill never said anyone was "dying." Similarly, over at Dissenting Justice, the headline reads "Eric Cantor says cancer patient should get help from "government program" or "charity."" Um, no again. Ms. Churchill never said anyone had "cancer." [emphasis mine].
Theatrics aside, what Ms. Churchill did say is that her relative was told that the "tumors" needed to be operated on "quickly." For the record, my presumptive diagnosis: uterine fibroids with dysfunctional uterine bleeding. This is a condition common among middle-aged African-American women, and is universally described as "tumors." While usually not life-threatening and rarely malignant, fibroids can lead to pain, heavy vaginal bleeding, anemia and other medical problems, and the treatment is usually surgical.
Regardless, let's presume the physician is accurate and the fibroids need to be operated upon "quickly", either for medical or lifestyle reasons. Rep. Cantor's answer is ridiculous. He recommends that this woman sign up for a government program (Medicaid) and if she does not qualify based on her income or wealth, then she must beg for charity care. And I have to ask, why would any citizen or physician need to be asked to give her charity? She is professed to be middle class and just down on her luck, so why didn't she prepare for the 'rainy day' prior to the storm clouds? Besides this one relative at the town hall, where is the unfortunate woman's family?
Let's pull this thread a bit further. Instances exactly like this woman's occur every single day in every single city. It's not a matter of if someone loses their insurance and needs surgery, it's when. There but for the grace of God goes every person in this country, and nobody seems to be saving for the rainy day. This unfortunate woman is guilty.... guilty of lacking independent wealth and in Ayn Rand's libertarian world, that is a damnable offense. And Eric Cantor, as GOP representative and small govt advocate, should speak up and, instead of advocating for government programs, tell her to nut-up and ask her relatives for some donations.
Eric Cantor needs to unravel this thought process and keep pursuing the "what ifs". Eventually you get to the point where you realize that a lot of otherwise healthy productive people are dying or becoming disabled by very treatable conditions, all because--either by circumstances out of their control or simple lack of personal responsibility-- they lack the immediate resources for treatment. Rep Cantor needs to be truthful and tell Ms Churchill, well, there's a good chance your relative may not get that surgery.
Frankly, I don't give a damn what health reform, if any, gets passed. The whole conversation has devolved into absurdity on both sides. I happen to know how health care works and I can see the debate is fatally flawed... so I can only assume that this happens with every debate of which I am ignorant, too. If this is how health care gets mangled, I can only just imagine how missile defense, terrorism, war financing, Israeli relations, banking reform, etc get twisted as well.
The Republicans seem to be behind most (but obviously not all) of the obfuscation in the current health care debate. The GOP rails against big government "because it doesn't work", and then the incompetence becomes a self-fulfilling prophecy when they take control and fuck everything up with Medicare Part D and Medicare Advantage. And then Eric Cantor recommends that an uninsured woman run to sign up for a government program for which she does not qualify. Silly.
Be truthful, Rep Cantor. Tell her she just has to live with bleeding fibroids or find her own damn way: sell her plasma TV or move to a smaller house. What's so freakin' hard about that? Are you afraid the town hallers will get violent?
The fact is that the predicament of Ms Churchill's relative is a common occurrence: someone who probably has paid tens of thousands of dollars in health insurance premiums in her life, tens of thousands of dollars in Medicare payroll taxes... and just when she needs health insurance most, it lapses. Aw, snap. Ms Churchill's relative has supported, with her payroll taxes, millionaires on Medicare, but now she is left to fend for herself.
The right answer, and one Eric Cantor will never support, is to provide every citizen with a health care card when they are born and finance the system with consumption taxes. If you can afford to have two kids, a new car, a steak dinner or tickets to a baseball game, then you should be paying for your health care, and if you won't save, then we'll have to tax all those consumables in order to pay for your care. Americans need to learn from our European and Canadian friends that personal responsibility needs to be mandated because we ain't doing it on our own.... and ass-hats like Eric Cantor are too chicken to tell people that they may have to do without.
The latest report of the ACORN "scandal" reveals that a worker who was a subject of the "sting" operation had contacted police within 2 days of the incident. Regardless, this worker, Juan Carlos Vera, was fired. Several news outlets including Fox news have reported this update.
This is exactly the problem with trial and conviction in the media: the facts are incomplete and now every side of the fiasco is dug in. The ACORN supervisor becomes defensive because he may be accused of wrongful termination, the employee is without a job, and the organization is tarnished.
Was Mr. Vera wrong in the way he handled the situation? We'll never know because he was fired before he was allowed to present his side of the incident. A couple of wealthy kids with too much time on their hands go around without any journalism expertise and entrap a bunch of workers and sell the edited videotape to Fox News. No rules of evidence are followed and no law enforcement is involved to ensure propriety... as for example was done with Chris Hansen's MSNBC series on internet child molesters.
Maybe the ACORN workers really are involved in trafficking child prostitutes, in which case they will unfortunately go free since proper procedures for a criminal investigation were not followed. More likely, however, the ACORN workers were going along with the silly ruse just to get these idiot kids out of the office, as evidenced by the lack of follow through by any of the participants. When crazy people come into your place of employment and say crazy things it's often better to go along with the insanity and hope they leave.
But now we have a major incident with people losing their jobs and an organization ruined that does community service in communities that sorely need such service... all because a couple knucklehead kids decided to be cute.
I have to admit that as a biologist (of sorts), there is something romantic about having one of the founders of your field hailed as an outlaw. Can geography or physics or calculus make such a boast? We're like the bad-asses of academia.
Now the British makers of a feature length Charles Darwin bio-pic (seen at left) are having difficulty finding someone to distribute the film here in the US because of the "controversy." Please. Listen, I know we have our share of dunderheads here, but come on folks... it's a movie.
My guess is that this is more a synthetic concern by movie distribution companies than any kind of real threat. More likely, it is some type of publicity stunt to get everyone lathered over a perceived slight. Maybe I'm being naive, but I cannot help but think that even the dumbest shit redneck would not really give a damn about a Darwin movie, and even if they did... who cares? Hollywood distributors would relish such a hub-bub.
While they fret over what is taught in schools, for the most part creationists seem to understand the difference between public education and entertainment. I think the Hollywood mogul types are just having fun with this in the hope of stirring up some controversy and thus publicity.
Or... it's not really that good a film (although it has won some awards.)
Besides, you want someone with real street cred? Man, that Enrico Fermi... now he was a real b-a-a--a-ad mo-fo.
Which would you prefer -- the current health care system or the health care
plan proposed by President Obama?
Current health care system: 46% (Dem 20%, Repub 79%)
President Obama’s proposed system: 37%
(Don’t know): 16%
This poll understandably is getting a lot of airtime on FoxNews. Just from this one question I can identify several problems.
1. How many of these folks who are satisfied with their health care plan are on Medicare? Asking this question is the most important part of any health care poll. Fox News lumps everyone together while likely half the satisfied 79% of Republicans are already on "government-run" health care. Why not asked how many on Medicare are satisfied? Because this is always a very high number. Or, ask how many people under 40 are satisfied with their health care... likely a much smaller number.
This is the only nation on earth where a a breadwinner for a family of four can live close to the poverty line, have no health insurance for his family, yet give payroll taxes to cover health care for retired millionaires. Unbelievable. And then, the people on Medicare say 'screw you I got mine.'
2. How old are the respondents? The poll is based on 900 respondents who were contacted by telephone, which means land line telephone, not cell phone, which means the sample is likely skewed to older folks who are more likely to have land lines. The demographics of age are not noted.
3. There currently is no plan "proposed by Obama." The House and Senate bills have different authors, none of whom are the president.
4. Alternatively, one could say most Americans (54%) cannot say that they prefer the current health care system.
Granted, there are problems with almost all polls, but on this particular topic the flaws with the Fox News poll are fatal and render it useless. Having endured this long introduction... cue the pretty ladies:
ACORN received $53 million in federal funds over fifteen years, about $3.5 million per year. If all the letters in the King James Bible represented federal funding, ACORN would be a “comma” somewhere in the Book of Maccabees. It means less than nothing. Heck, Dick Cheney has more than that in his sofa cushions that he likely stole via KBR Halliburton.
Community organizers do perform useful services for some folks: help with health care access, voter registration, day-care programs, landlord disputes, opening bank accounts, etc. If the wealthy have a problem they can just call the concierge. Nobody is excusing malfeasance, but let's keep it in perspective.
1)ACORN fired the staffers immediately and took corrective actions, which is more than Blackwater did when they took Billions (with a B) of your tax dollars and killed civilians in your name.
2)ACORN immediately lost all funding for their entire organization despite no laws being broken; the “investigation” was not conducted by law enforcement and did not follow proper rules of evidence.
3)ACORN has not been allowed to plead their case, which should be allowed even in the most egregious of cases– even Jeffrey Dahmer had a trial– yet ACORN is punished into non-existence within 72 hours due to the antics of 6 employees. A lot of good it did having their lawyer in White House!
Greenwald notes that:
Meanwhile, not millions, not billions, but trillions of dollars of public funds have been, in the last year alone, transferred to or otherwise used for the benefit of Wall Street. Billions of dollars in American taxpayer money vanished into thin air, eaten by private contractors in Iraq and Afghanistan, led by Halliburton subsidiary KBR. All of those corporate interests employ armies of lobbyists and bottomless donor activities that ensure they dominate our legislative and regulatory processes, and to be extra certain, the revolving door between industry and government is more prolific than ever, with key corporate officials constantly ending up occupying the government positions with the most influence over those industries.
Exactly as one would expect, the prime beneficiaries of all of that pillaging continue to grow. The banks that almost brought the world economy to collapse but then received massive public largesse because they were "too big to fail" are now bigger than ever... Everything involving the government turns out well for these "behemoths" because they own and control the U.S. Government.
So with this massive pillaging of America's economic security and the control of American government by its richest and most powerful factions growing by the day, to whom is America's intense economic anxiety being directed? To a non-profit group that devotes itself to providing minute benefits to people who live under America's poverty line, and which is so powerless in Washington that virtually the entire U.S. Senate just voted to cut off its funding at the first sign of real controversy -- could anyone imagine that happening to a key player in the banking or defense industry?
But if you watch Fox News, the coverage has been all-ACORN, all the time. The best part of the Greenwald piece is the UPDATE where he notes that we are now hearing:
...demands for a "Special Prosecutor"into Obama's so-called "relationship with ACORN" from the very same circles that vehemently objected to investigations into torture, illegal government spying, politicized prosecutions, military contractor theft, Lewis Libby's obstruction of justice, and virtually every other instance of Bush-era criminality. Those, of course, are the very same people who, before that, demanded endless inquiries into Whitewater and Vince Foster's "murder." There's nothing more valuable than petty, dramatic "scandals" to distract attention from what is actually taking place.
And a big heads up: The next meme will be “all the Medicare fraud”– it was trotted out on Greta Van Susteren’s Fox show tonight. I can hardly wait: Birthers, Deathers, Czar-ers, Teabaggers, ACORN-ers… and now Frauders.
Yawn. I suppose I could bang out a few hundred words about how Beck doesn't deserve the attention, it only feeds the beast, TIME has lost all respect... yada, yada, yada. But I'm not. Beck's an asshole, plain and simple, but there will always be Glenn Becks and Ann Coulters and Rush Limbaughs and Sean Hannitys and it's never going to change. Why? Because people for the most part are not much smarter than rocks and there is a need to have something, someone stoke some emotion-- any emotion-- into our boring work-a-day lives. These clowns do it.
This is capitalism, folks, and this emotion-infused vomit sells. TIME knows it and that's why Beck's the coverboy. Every shit-for-brains Becktard will buy a copy for the top of the commode, and the capitalists in charge of TIME plan on making their quarter this week.
That's not to say the story on Beck isn't informative and entertaining. The most entertaining item is when Glenn Beck, asked about the 1976 film Network which popularized the line, "I'm mad as hell and I'm not going to take it anyway", says damn right that's exactly how he feels. The funny thing-- if by funny you mean like an icepick twisted into my cerebrum-- is that Beck didn't get the reference, the fact that he's the punchline. In the movie, Beale, the character who invoked the angry tirade, was manipulated by the network's management and Beale was the lackey who merely did their bidding to get higher ratings ... to his eventual demise. Yup, we can only hope.
Beck is a loud, overbearing joke. He's the cacophony we must endure to be a part of a free and open society. Ass-hats exactly like Beck are what prompted Socrates to call for rule by philosopher-kings... presumably to decree that all loudmouth half-wit narcissists be crated off to Sicily.* We, however, are not so lucky and Beck is here to stay... at least until he burns himself out with one of his many self-loathing addictions.
Sure, there's a lot of criticism of TIME for this article, and you can read some here and here. But for me, what the heck... I'm okay with it. My copy of TIME will come in tomorrow's mail, and while it will find it's rightful place on top of my commode, the cover will be promptly removed and placed in it's rightful place-- in the commode.
(*which might help to explain some of my forebears, but I digress.)
Joe Wilson claims he was "provoked." I asked a conservative friend if he thought that Wilson's outburst was motivated to influence his home base voters (white Southerners) and he said that he was "not sure." I am. We should not only encourage South Carolina's secession, we should force it.
UPDATE: South Carolina Senator Jim Demint likewise supports the Congressman on this issue. It works, folks. Can't you just feel the love?
Don't throw interceptions. I know this sounds trite and self-explanatory, but you really need to understand this. If the Bears are going to win, it is the defense that will win the game. Rex Grossman never understood this fact and he lost the Super Bowl and is relegated to obscurity, his just sentence.
The offensive line is old and your receivers are too young (Knox), too inexperienced (Olsen), too short (Hester), or just plain suck (Des Clark). Deal with it and don't try to make something happen. Only bad things happen in that scenario. Hand off to Forte and if a pass play is called, throw it out of bounds and for godssakes, don't throw it it into coverage.
Three and out is fine; the defense will score the points, but when they are 10 or more points behind because you threw three interceptions, they can't win the fucking game. Don't be a goddam hero, Jay. Be a Bear: curl up and hibernate. Our division sucks, we can beat these rum-dums.
On CNBC this morning, Michael Leavitt, George W. Bush's HHS secretary and now proprietor of his own consulting firm, blatantly lies as the "journalists" at CNBC stare blankly into the monitor. At the 2:30 mark, Mr Leavitt says the we do not need a governemnt option and "that is what the American people have resoundingly said." Oh, really?
Poll after poll has shown that a majority of the American people prefer to have an option available from the federal government. The CBSNews poll from July says 72% want a public option. An NBC/Wall Street Journal poll (page 21 of this pdf) says that 76% of the American people rate a public option as "very important" or "quite important."
A few screamers in the town halls and-- voila!-- the reality is forgotten.
Despite three-quarters of the American people in favor of a public option, ass-hats can go on a major network and spout the opposite of this reality, completely unchallenged. Cute little Becky blinks into the camera and dry drunk Larry revs up for another anti-government harangue. So much for the fourth estate... our democracy is not in good hands, my friends.
Furthermore, no mention is made of any conflits of interest Mr. Leavitt's "consulting firm", which according to it's website has several "strategic partners" within the health care field, might have. One corporate beast (GE/CNBC-- liberal media? Ha!) washing the balls of other corporate beasts.
The one admirable thing about the Republican opposition is their ability to get the talking points out to the troops who follow in lock-step. They understand the power of a quip or one-liner and the value of repeating it until it becomes emotionally entwined into the discussion.
First we had death panels and socialism... the next fear-meme is the "long lines." From the Rude Pundit (not family safe, but his paragraph about Sarah Palin is worth the trip to the link):
Sen. Richard "My Forehead Is Too Big For My Face" Shelby: "I think rationing is underlying all of this. There's a lot of denial out there, but you look at the other plans -- you look at the Canadian plan, the British plan and so forth, and you have long lines. People decide who's going to get treatment and when. That's rationing health care. If you don't get health care when you need it, you know, ultimately it's going to affect your life."
Sean Hannity on government-run health insurance: "There's rationing, there's long lines."
Neil Cavuto on the same: "It is going to be spread between a lot of folks and there will be long lines and rationed care."
The threat of "long lines" is invoked by other members of Congress, like Representative John Fleming (R-LA) and the hilariously named Representative Bob Goodlatte (R-Starb...VA).
You get the idea. You've heard it all a million times over. Here's the problem: if you're afraid of "long lines" for health care, then you advocate rationing that care. Because what you're saying is that you don't want more people to be able to go to the doctor. In other words, you want to deny people medical treatment because you (mostly irrationally) fear there's a possibility you may not be next in line, that some impoverished woman on a public option might go before you.
They're crazy, they're selfish, they can't solve any problems, but goddam if they can't stay on message.
Nobody is looking forward to President Obama's speech on health care more than I am, but my expectations are not very high. The Republicans have put a major hurt on any effort for substantive reform and Obama's prerequisites: universal care, decreasing costs, etc., were never being realistically addressed anyway.
Sure, Republicans had one great point: that "governemnt-run" health care always costs more than anticipated. But I would add that the reason it always costs more is largely due to Republicans adding things like Medicare Advantage and Medicare Part D drug benefits. In the 1980's Reagan signed a Medicare reform package that was really just an addition to the trust fund without any cost containment. Any new entitlement, no matter how well it is instituted, will be expanded and mismanaged once Republicans regain control of government. What they are really saying is 'stop us before we kill again.'
So now we are left with a process in tatters. No existing bill fulfills the president's requirements and the partisan rancor is through the roof. Sure, some bill might be passed so that both sides will be able to claim vistory: new regulations for insurance companies, non-profit co-ops to replace the "public option", elimination of pre-exiting illnesses, token tort reform for the GOP... but the chance for real reform is lost.
And the Republicans, relishing their role as opposition party, are not done yet. Any attempt to control costs will be criticized as "rationing", roiling seniors. Every concrete piece of any proposal will be torn apart with individuals coming forward to bemoan some lack of coverage or some new tax penalty because of the "Democrat's health care reform bill."
The Democrats will gain nothing over this debacle, certainly health care will not be delivered more efficiently, and the Democrats may even lose control of the Senate by 2012. Daresay, there is enough angst among liberals that Obama's re-election may even be in jeopardy. And if that happens, no president will ever touch health care again.
Recent polls signal a significant dissatisfaction with the status quo among American physicians. Up to 81% of primary care providerswould prefer a single payer system, not just a public option.
The Annals of Internal Medicine last year reported that 59% of physicians wanted a single payer to alleviate the paperwork and authorization hassles. As the American Prospectarticle points out:
The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments.
Another survey shows that 64% of physicians prefer a single payer. From that same survey of Minnesotan doctors:
Physicians also were asked who should be responsible for providing access to health care. Nearly all (86%) believed it is the responsibility of society through government to ensure access to good medical care for all, regardless of ability to pay. Only 41% held that the private insurance industry should continue to play a major role in medical care financing and delivery.
Perhaps this may seem counter-intuitive, but not to me. On a day to day basis, the hassle in medicine comes from the plethora of arbitrary requirements and authorizations from the various payers. One insurance company will require one treatment first, and another will use only one visiting nurse company, while yet a third will change their pharmacy formulary every quarter.
A few years ago I decided to leave my long term hospital employer to scale back my practice from a patient mill to something more consistent with humanity. I consulted with various people and colleagues about the process. Unbelievable. Over 20 different payers with 20-30 page contracts and complicated reimbursement schedules, different billing forms, separate credentially processes, etc. Just to get started would have taken 3 months and a staff of five people and legal counsel. And as a solo practitioner, I had no bargaining power with any of the payers.
Needless to say, forget that bullshit. I went to work for another hospital which had the clerical and support staff to do all this crap. Eventually it got bought out by my original employer and I'm right back where I started. No complaints, they are an excellent employer, but the point is that the market place is stacked against the small guy and the pressure to be employed by a corporation is overwhelming. This plays into the corporatization scheme and leads to frustrations among some physicians and patients who might prefer a smaller setting.
Again, this might seem counter-intuitive, but if we had single payer we might actually see a resurgence of smaller, patient-centered practices. The hassle of dealing with different payers would be eliminated and the doctors would not feel that they need a huge hospital or medical group to do all the billing and negotiating of payments. One set of standards, one set of paperwork, one set of reimbursement rates.
Physicians will make a good salary regardless, and that salary will be based on market economics of supply and demand. If you're in demand, you'll be busy and make a good living.... but you will never be able to charge more than insurance pays for basic services.
Another fundament of physician labor economics is that if you provide a service that is necessary, then someone will find the money to pay you for your services. Hospitals want Trauma designation for various reasons: it brings in motor vehicle accidents that are all insured patients and it gives the hospital some cache within the community (and there are probably other reasons that I don't know.) But to keep this designation, the hospital must pay for 24 hour orthopedic, radiology, anesthesia and surgery coverage... not cheap, but that's the market.
Bottom-line... physicians care little about who pays the bill, the amount paid will be determined by the market anyway and the more pressing issues surround patient care: access, formularies, authorizations and paperwork.
First, the case for Single Payer. A little simplistic, sure... I know, I know... the cost of fraud, loss of innovation, rationing... yada, yada, yada. As means of introduction, most physicians back single payer for a variety of reasons that I'll go over in the next post.
The second video shows Sen Al Franken talking down an angry mob (as angry as it gets in Minnesota, I suppose). Note that he is not advocating single payer, but instead a regualated market of non-profit insurance companies. He states near the end of the video that Minnesota does not allow for-profit health insurance in the state, which helps explains their relative low cost... I did not know that.
I've always found it odd that conservatives are more trusting of big business than the government, but whatever. Philip Morris, General Electric and Exxon would have me dead tomorrow if they could 1) make nickel out it and 2) get away with it. Why should I believe that United Healthcare and Aetna are any different?
Bill Moyers interviews Dr. Marcia Angell and Trudy Lieberman on health care reform:
