Saturday, May 23, 2009

A statement in support of single payer health insurance

I am mailing a letter to the President and to my two senators, Claire McCaskill and Kit Bond. The issue seems critical for the future of the country. RLC

President Barak Obama
1600 Pennsylvania Ave NW
Washington, DC 20500

Dear President Obama,
In his May 22 program on PBS Bill Moyers and his guests described how the attempts to develop a useful health care reform bill have been subverted by the health insurance industry. [I append a list of some details from that program.]

I would like to express concern that what appears to be a good solution -- a “single payer” system – is being sidelined in the discussions about health care because of the influence of the insurance industry on the various senators considering health care reform.

Most terrifying in the Moyers report is the sense that what the public most wants is being ignored because of the power of big moneyed interests such as the health insurance industry. I am hearing in various ways, in various contexts, that the democratic process, which we take such pride in – by which elected officials represent the interests of those who elected them – has been subverted by large financial interests. The result has been, of course, an emasculation of the democratic process.

I do understand the problem of the elected official: these days one has to garner huge amounts of money to be elected, which in effect – despite all denials – effectively creates obligations that need somehow to be reciprocated. It is easy to suppose that every elected official is in the pocket of at least some wealthy interests. I am therefore writing to ask you what can be done to free public officials from such dependence on such large financial interests. A way needs to be found to ensure that elected officials will actually represent the interests of those who elected them, without the public interest being hijacked by the wealthiest industries in the country. Nothing reveals more clearly how seriously our government has become dependent on big moneyed interests than the Medicare bill that prohibits competitive bidding for the cost of medication.

I therefore urge you to
(a) help promote a single payer health system bill, following the model of Canada and Taiwan [mentioned in the transcript]; and
(b) pursue legislation that will enable those who run for office to be free from heavy obligations to wealthy donors and powerful corporate interests.


Robert L. Canfield

Some statements from the Bill Moyers PBS program of May 22, 2009.

• What [is being proposed] is single-payer health care -- a non-profit system that would remove the role of the insurance companies and unify the financing of the health care system under one entity, a government run organization, like Medicare, that would collect all health care fees, and pay out all health care costs.

• [These were] arbitrary decisions [by the insurance companies], which were not about people's health care. They were about profits: How can I get away with the least amount of care offered to this person, so that their premium is going to give me the most profit? That's not the way health care decisions should be made.

• [T]he process [has been] hijacked by the insurance industry.

• The money and the power that's exerted in Washington on them from the health insurance and health industry lobbies is very powerful. It's hard for them to break out of that loop.

• [D]octors have had to spend hours of every day not in patient care but on the phone, hassling with insurance companies, trying to negotiate to get a patient a treatment. It makes it very difficult to deliver the right kind of care.

• If you get sick, you find out just how inadequate that insurance may be. Not only did I have health insurance; I had Aflac disability insurance, and a health care savings account on top of that. So we were like the prime example of responsible people who try and keep ourselves covered. And yet when we got sick, there was no way the deductibles and out-of-pocket maximum exposure [could add up]; [they accumulated] so quickly that we were buried very quickly financially.

• [In] data where we just ask about a national health insurance system, . . . 60 percent of the American public say we've got to have a national health program.

• It's spun out of control. It's going to bury us financially. It's going to mortgage our children, and it kills people. It just is not working.

• So just who has been getting the chance to testify before Congress? . . . The Business Roundtable. The U.S. Chamber Of Commerce. The conservative Heritage Foundation. Representatives of the insurance industry, including Blue Cross Blue Shield - all in favor, more or less, of the status quo.

• The president asked representatives of the health care business to reason together with him at the White House. They came, listened and promised to cut health care costs voluntarily over the next ten years. . . . [But we have heard this before:]

o In the 1970's in response to a proposal by Jimmy Carter “the very industry that only a decade earlier had tried to strangle Medicare in the cradle, seemed uncharacteristically humble and cooperative. "You don't have to make us cut costs," they promised. "We'll do it voluntarily."

o [In the early 1990's,] . . . the health care industry . . . came after the Clinton reforms with one of the most expensive and deceitful public relations and advertising campaigns ever conceived.. . . [And] they said, "We'll cut costs voluntarily."

• [Now] the industry is pouring big money into lobbying, more than half a billion dollars last year alone, according to the non-partisan Center for Responsive Politics. They're also shelling out megabucks for a publicity blitz and ads attacking Obama's public plan or any health care reform that threatens to reduce the profits from sickness and disease.

• [A major problem is] the power of the health insurance industry. Only about one out of 14 people trust the insurance industry as being honest and trustworthy. On the other hand, in Washington, they're in bed with the health insurance industry.

• Half of the bankruptcies [in this country] are medical bankruptcies. And of those medical bankruptcies, three quarters of those people had insurance, at least when they first got sick. But people have insurance that goes away after they actually need it.

• The seats at the table, or the witnesses at the hearing are, in a sense, controlled by the health insurance industry.

• "We don't need a health insurance industry. We can do what most other countries in the world have done. Have the government collect the money and pay the bills and get rid of all these people who are wasting $400 billion a year on excessive administrative costs."

• [We now have] a fragmented health insurance industry. And it thrives on being fragmented. The pharmaceutical companies make much more money with the fragmentation, because there's no price control. The insurance companies make much more money, 'cause they can push away people who aren't going to be profitable. The only people that suffer are the patients.

• And there's big money being made. There are billions being made from the private health insurance industry, from the drug industry, and that gets spread around Washington.

• The biggest recipients of insurance money, of drug money, are the powerful people who chair the committees, who decide what witnesses testify.

• Senator Baucus [who is chair of the Senate hearings] is the third highest recipient of donations from the health insurance and health care industry in general.

• Over the last 30 plus years there have been maybe two and a half, three times more doctors and nurses. Pretty much in proportion with the growth in population. There are 30 times in the insurance industry. These people are not doctors. They're not nurses. They're not pharmacists. They're not providing care. Many of them are being paid to deny care. So, they are fighting with the doctors, with the hospitals to see how few bills can be paid. That's how the insurance industry thrives: by denying care, paying as little out as it can.

• In Canada, back in 1970 or so, they were spending the same percentage of their gross national product as we were on health. They had huge numbers of uninsured people. They had the same insurance companies. Blue Cross Blue Shield. They decided to just get rid of the health insurance industry. . . .

• Canadians [now] have better choice than we do. They spend half as much per person on health care as we do.

• We're really talking about social insurance, like Medicare is social insurance. But doctors and hospitals remaining privately owned.

• Medicare actually takes care of the sickest, most expensive parts of the system. So in a way, they subsidize the private insurers. They take the unprofitable patients off the private insurer's hands.

• Canada has been a very good model. It's been going on for 38 years. Canadians would revolt, literally, if someone said, "We're going to take away your health insurance system."

• [F]or the insurance industry, for people making $225 thousand a day as CEOs of insurance companies, [the single-payer system would be] disruptive for them.

• [S]urveys are showing that most doctors support national health insurance-

• Taiwan [recently] said, “We don't like the fact that 40 percent of our people are uninsured.” They passed, essentially, single-payer plan and within a few years 90-95 percent of the people were covered.

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