Thursday, August 20, 2009

Medicare for All should be our goal

"Under the greatest adversity there exists the greatest potential for doing good, both for oneself and others." ~Dalai Lama

And one of Montana's Methodist Ministers, Joan Uda, wrote an editorial for the Great Falls Tribune this week, asking essentially, What would God think of this? Here's a small excerpt:

I'm startled by the frenzied opposition to health care reform. Are these good people Christians? Do they recall that Jesus will judge us not by how well we've kept our earnings for ourselves but by how we have cared for "the least of these"? Matthew 25:31-46. This is a matter of salvation.I don't believe God supports any particular solution for health care. But I do believe God wants everyone, even the least, included. And I believe Jesus Christ calls us to display our best Christian virtues in the debate on these issues.

Here's George Lakoff's perspective on how language influences the discussion on Health Care policies this season. Mr. Lakoff is a a cognitive scientist and linguistics professor at Berkeley University, and has written several books about how the choice of words can skew our intentions and our understandings. (My personal favorite is Don't Think of an Elephant: Know Your Values and Frame the Debate ) First of all, Lakoff reminds policy-makers, and citizens, to KEEP IT SIMPLE, and hold the vision of an overall, unifying principle. I interpret this as something as simple as Medicare-for-All. Everything else will come, as the bureaucrats are fond of administering the minutia. Our Health-care crisis is not "just" about the health insurance companies, or "just" about the un- and under-insured, or "just" about those poor insurance companies who might actually have to compete for sales.
Here is an excerpt from Lakoff's article:


As for language, the term "public option" is boring. Yes, it is public, and yes, it is an option, but it does not get to the moral and inspiring idea. Call it the American Plan, because that's what it really is.

The American Plan. Health care is a patriotic issue. It is what your countrymen are engaged in because Americans care about each other. The right wing understands this well. It's got conservative veterans at town hall meeting shouting things like, "I fought for this country in Vietnam and I'll fight for it here." Progressives should be stressing the patriotic nature of having our nation guaranteeing care for our people.

A Health Care Emergency. Americans are suffering and dying because of the failure of insurance company health care. Fifty million have no insurance at all, and millions of those who do are denied necessary care or lose their insurance. We can't wait any longer. It's an emergency. We have to act now to end the suffering and death.

Doctor-Patient Care. This is what the public plan is really about. Call it that. You have said it, buried in Policy Speak. Use the slogan. Repeat it. Have every spokesperson repeat it.

Coverage Is Not Care. You think you're insured. You very well may not be, because insurance companies make money by denying you care.

Deny You Care ... Use the words. That's what all the paperwork and administrative costs of insurance companies are about - denying you care if they can.

Insurance Company Profit-Based Plans. The bottom line is the bottom line for insurance companies. Say it.

Private Taxation. Insurance companies have the power to tax and they tax the public mightily. When 20 percent to 30 percent of payments do not go to health care, but to denying care and profiting from it, that constitutes a tax on the 96 percent of voters that have health care. But the tax does not go to benefit those who are taxed; it benefits managers and investors. And the people taxed have no representation. Insurance company health care is a huge example of taxation without representation. And you can't vote out the people who have taxed you. The American Plan offers an alternative to private taxation.

Is it time for progressive tea parties at insurance company offices?

Doctors Care; Insurance Companies Don't. A public plan aims to put care back into the hands of doctors.

Insurance Company Bureaucrats. Obama mentions them, but there is no consistent uproar about them. The term needs to come into common parlance.

Insurance Companies Ration Care. Say it and ask the right questions: Have you ever had to wait more than a week for an authorization? Have you ever had an authorization turned down? Have you had to wait months to see a specialist? Does your primary care physician have to rush you through? Have your out-of-pocket costs gone up? Ask these questions. You know the answers. It's because insurance companies have been rationing care. Say it.

Insurance Companies Are Inefficient and Wasteful. A large chunk of your health care dollar is not going for health care when you buy from insurance companies.

Insurance Companies Govern Your Lives. They have more power over you than even governments have. They make life and death decisions. And they are accountable only to profit, not to citizens.

Having worked for 10 years on the administrative side of a small health care clinic (1992-2002) I can state unequivocally that each year, insurance companies required more "documentation" (copies of records and chart notes) and that documentation often required repeated insistence from the doctor's office to get the insurance companies to consider paying a portion of the person's bill. Health Insurance companies, on average, keep 35 cents of every dollar as profit. This is more than casinos (who are notorious for tricking you into giving them all your money) !

Insurers' "case-managers" - sometimes medical professionals, but unfortunately, often entry-level employees trained to deny at every turn, in order to earn their own bonuses- decide whether your claim fits their company guidelines. The Insurance Company tells you which doctors you can see - they creat "networks" of doctors - if you go out side their network... too bad for you! You read your policy and believe that you are covered 80% for a simple procedure. Afterwards, the forms are submitted and you discover that your insurance company believes that your procedure is really only "worth" maybe 40% of what it actually cost you. HA! You're a fool, but you keep paying those premiums because of fear what "what if"....

True Example: after Jon left his job of 23 years, we shopped about for health insurance. . As self-employed -but healthy!- micro-business people, we pay what I think of as exorbitant premiums (no groups are available for us) for a very high deductible policy that covers NOTHING before that deductible. So, we pay our Insurance Company over $6,000/year, AND we pay out-of-pocket for EVERYTHING medical until we reach that $10,000 mark - and at that point, the Insurance Company claims that our costs are "beyond reasonable and customary" in order to deny paying out all but a dribble. And why do we capitulate and buy the insurance? Because we know what happens if, God forbid, an accident causes unmanageable & huge medical bills...bankruptcy.

My rant could could go on and on and on - and I'm guessing, so could yours!

The solution is as clear as this: We already have a system that works, that is government run, that is single payer (even though I think that compensation for docs should be improved!) and it's called MEDICARE. Medicare-for-All!! Expanding basic Medicare coverage to All Americans could be done incrementally (expanding age-groups first, until full coverage is achieved within say, 10 years). This allows Health Insurance companies to prey on us for "expanded coverage" policy options, and I admit, Jon & I would consider something more-than-Medicare-alone. However, it would provide a BASIC LEVEL of health care to everyone. Social Democracy at it's finest.

How simple is that? Mr. President - and all of congress - please pay attention, and do the right thing for ALL citizens of the US. this is our chance to begin becoming a "Great Nation" again.


Betty said...

Yes, Yes, Yes!!!

Darlene said...

This is one of the best blogs on health care reform I have read. The Lakoff piece was marvelous. Thank you for posting it.

janinsanfran said...

That's simple enough and I'd sure take it. Would that our pols would cut through the BS as you have!

lilalia said...

It is rather shocking to read about the costs of being insured with, more or less, no compensation for day-to-day illnesses, but only in case of horrible accidents. That is not what medical insurance should be. Your suggestion to extend Medicare sounds very simple. Do you hear anything like this happening in the politicians talk?

Gene said...

Sounds reasonable and workable.
Now to get congress to listen!

sopranospinner said...

I'm with you! Medicare for All! And a very good explanation.

I'm very tired of hearing all of these "pro-life" folks not caring at all if the already born suffer and die needlessly, which they do every day.

Cynthia Friedlob said...

The simple solution of a government-sponsored health insurance plan for everyone is too logical, too straightforward and too threatening to the status quo.

Too bad, isn't it?