Medicine
.
The death of Senator Edward Kennedy this week was sad and sobering. Even this longest-lived of the Kennedy brothers, the only one to not die by a bullet in war or from an assassin’s gun, the one who served 47 years in the US Senate, still experienced tragedy at the end of his life. When someone dies, there is a natural tendency, in eulogies, to talk only about their positive attributes. In Senator Kennedy’s case, these are not only well-deserved, but important. I am not talking about his personal life, or things that happened long ago; I am talking about his public life as a leader.
On August 27, 2009, NPR Morning Edition ‘s Pam Fessler spoke with former Kennedy political advisor Bob Schrum http://www.npr.org/templates/story/story.php?storyId=112281174&ft=1&f=112268401.:
“FESSLER: Political consultant Bob Shrum recalls how he almost got his head bitten off during Kennedy's reelection campaign in 1994 against Republican Mitt Romney. Shrum had given this political advice: Don't oppose Romney's plan to stop welfare for women who have children out of wedlock.
Mr. BOB SHRUM (Political Consultant): And he said I'm not going to do that. I'm not going to get reelected by taking food out of the mouths of poor kids. I don't need the job that much. They need the food. He was genuinely angry.
FESSLER: Shrum says it was part of Kennedy's deep philosophical belief.
Mr. SHRUM: I think Ted Kennedy always had a very strong feeling that government existed for people who didn't have power and didn't have privilege and didn't have influence, that it somehow or other was a balancing mechanism to achieve a measure of social justice and opportunity and equality.”
I didn’t know this story, before, and I can’t say that I always thought that the Senator was doing everything I thought he could to advance healthcare for all, but I can say that this pretty much seems like the right definition of the purpose of government. And this should define what our government, representing our people, should be doing to reform health care.
Of course, not everyone believes that this is the purpose of government, but I do. I am not talking about the national defense, or the building of federal highways but in its core approach to domestic spending. Small business loans should help small businesses, people who are starting up or trying to get through hard times to achieve the American dream, not big companies. Farm support, to the extent we have it, should protect and help the family farmer, not giant agribusiness companies. We need to protect our nation’s natural resources and public lands so that they will be there for future generations, not destroy them to create more enormous wealth for multi-national corporations. Huge multinational corporations (and make no mistake, all of these large ventures from farming to mining to manufacturing to finance are controlled by large multinational corporations) and the extremely wealthy people who control them are doing just fine, thank you. If some of them are doing a little less fine than they were a year ago, that is fine also, and no one should shed a tear even if they are forced to move into public housing (hah!) – see my entry on the “Super Rich”, August 27.
But there are lots of people who do need help. They include the children that Senator Kennedy knew needed food, and who also need education. Nicholas Kristof, writing in the New York Times on August 19, 2009 (http://www.nytimes.com/2009/08/20/opinion/20kristof.html?scp=16&sq=&st=nyt), notes that while the Oakland, CA schools spend $8,000 per year to educate each of its students, the state of California spends $216,000 per year for each inmate in its juvenile justice system. If these children had a little more spent on their eduation, perhaps they won’t be in the same situation as another man described by Kristof, who, having had two minor convictions at 19, landed in jail for life for stealing a $2.50 pair of socks, under California’s 3 strikes law! Prison for life for stealing $2.50! While the bankers and financiers who were true bandits get government bailouts! Um, wrong use of taxpayer money.
And we need healthcare for all, which Senator Kennedy long fought for. By the end of his life, with the greatest possibility of achieving this goal on the horizon, he was unfortunately willing to give up on the plan he knew would work best, single payer, but would never give up on the need for a public plan, because he would not give up on the idea that everyone needed to be covered, and there are only 3 ways to do this: single payer, a public plan (more costly, as I have discussed previously), and a system using not-for-profit private insurance companies that are highly regulated, forcing them to cover everyone and not gouge them with his premiums (which has less chance of happening than single payer!) We need to do this he, and I, belive, because that should be the role of government: to be a balance, to help those who need the help to meet have the basic requirements for a good life, and to spend not a penny padding the accounts of the least needy in a manner that is often believed to be characteristic only of backward, corrupt, third-world dictatorships.
Not everyone agrees that government should be involved in health care reform. “The federal government has absolutely no business in any way, shape or form addressing health care,” an attendee at a town hall held by Sen Claire McCaskill of MO was quoted as saying by the Kansas City Star on August 24 (http://www.kansascity.com/news/politics/story/1403874.html). “Not pro, not con. Zero. Zip.” The article did not contain more information explaining this position, but I’m certain it was coherent as well as cogent. I'm sure that this person would be happy to eliminate the benefits offered by taxpayers not only for Medicare and Medicaid, but also the Veteran’s Administration, and the military and all federal employees. Not to mention the benefits supplied by all the state and local governments for their employees. Or the tax revenue foregone (thus a cost) by the federal government for making employer health contributions (perhaps including the employer of the person making this comment) tax-deductible. While the Center for Medicare and Medicaid Services (CMS) estimates the federal contribution to be 45% of healthcare spending, this doesn’t include the benefits for federal employees, state and local employees, or the tax breaks. When they are, appropriately, included, it brings the taxpayer-supported contribution to healthcare to nearly 60%.[1] In absolute per capita dollars, the US taxpayer spends more than the TOTAL per capita healthcare spending of every country save Switzerland, while having 47 million uninsured! We pay for national health care, but do not get it.
Go out, all of you covered by government funds, and get your own private health insurance!
Perhaps the commenter at the McCaskill event meant that he believed that he and everyone else should pay for their health insurance themselves in after-tax dollars. Or maybe he, or others who might be tempted to agree with him, are victims of the “Craig T. Nelson Fallacy”. This fallacy, of which “keep the government’s hands off my Medicare!” is an example, is named for the actor who, after an extensive anti-government rant on Fox’s Glenn Beck show, declared “I've been on food stamps and welfare. Anybody help me out? No. No.” (May 28, 2009, http://www.foxnews.com/story/0,2933,522939,00.html).
While many may dismiss Mr. Nelson as an ignorant blowhard who doesn’t know what he is talking about (which he is and is true), the real issue is that so many other people are missing the key point: how much they, personally, benefit from the government, and how helping them, and others in need, is a completely appropriate thing for the government to do. The “government” after all should be representing all of us, and helping us when we have need, not stuffing the pockets of the privileged (who, in turn, stuff the pockets of our representatives).
On MSNBC’s “The Morning Grind” on August 25, 2009, Rep. Anthony Weiner (D., NY), a single-payer advocate, left host Joe Scarborough “speechless” (many links all over the web; here is one:
http://click.icptrack.com/icp/relay.php?r=4798182&msgid=254377&act=0LH3&c=196437&admin=0&destination=http%3A%2F%2Fwww.pnhp.org%2Fmultimedia%2Fanthony_weiner_leaves_scarborogh_speechless.php) by his simple logic that said, essentially (paraphrase) “why should we pay insurance companies such a big cut of our health care dollar? When did an insurance company ever operate on someone or make a diagnosis?” Scarborough could not believe that the Congressman was urging that insurance companies be eliminated, but all he could basically say was “I believe in private enterprise, and you want the government to run healthcare!”, unable, of course, to respond to the content. Weiner noted that if private insurance companies could really do a better, more cost-effective job, they wouldn't be concerned about competing with a public option.
Apparently Joe Scarborough, and many others, have an ideological belief different from that of Senator Kennedy. They believe that government should support rich corporations rather than existing “…for people who didn't have power and didn't have privilege and didn't have influence,” and being “a balancing mechanism to achieve a measure of social justice and opportunity and equality.” I believe that it was largely in agreement with this purpose that so many people became activated in the campaign of Barack Obama and elected him President. The President would be doing us all a great favor if he could ignore the advice of the (pre-reconstructed) Bob Shrums who advise him to abandon that belief, and provide the leadership that he can to create a health reform that is truly reform, that will truly cover all the people of the United States, and that willing truly be a fitting tribute to Senator Kennedy.
[1] Woolhandler S and Himmelstein DU, “Paying for national health insurance – and not getting it!” Health Affairs, July-August 2002, pp. 88-98.
- Medicine And Social Justice – The First Year: An Index
. Thanksgiving weekend – today, November 28, specifically – marks the first anniversary of the Medicine and Social Justice blog. I thought I would review the topics I have covered, grouping them generally into several areas. This might enable anyone...
- Public / Private Funding: We're All In This Together
. I have written a great deal about the shortage of primary care physicians in the US, both at present and probably worsening in the future. One of the main reasons is that they make less (much less!) money than many other specialists. This has led to...
- The "super Rich" And Our Healthcare
. The New York Times, August 21, 2009, has a front-page article by David Leonhart and Geraldine Fabrikant titled “After 30-year run, rise of the super-rich hits a sobering wall” (http://www.nytimes.com/2009/08/21/business/economy/21inequality.html?_r=1&scp=1&sq=super%20rich&st=cse)....
- “no Single Payer”: Sebelius – Making Policy For The Powerful
. Item: The Kaiser Family Foundation survey again confirms the preference of the American people for a program that covers everyone. http://www.kff.org/kaiserpolls/upload/7892.pdf: Two-thirds to three-quarters of respondents support the following options:...
- The Massachusetts Avenue Of Health Reform
In contrast to the personality-driven path that Lyndon Johnson took to navigate legislative obstacles to Medicare and Medicaid, former management consultant Mitt Romney charted a decidedly different course to expanding health insurance when he became...
Medicine
Senator Ted Kennedy, Social Justice, and Healthcare for the People
.
The death of Senator Edward Kennedy this week was sad and sobering. Even this longest-lived of the Kennedy brothers, the only one to not die by a bullet in war or from an assassin’s gun, the one who served 47 years in the US Senate, still experienced tragedy at the end of his life. When someone dies, there is a natural tendency, in eulogies, to talk only about their positive attributes. In Senator Kennedy’s case, these are not only well-deserved, but important. I am not talking about his personal life, or things that happened long ago; I am talking about his public life as a leader.
On August 27, 2009, NPR Morning Edition ‘s Pam Fessler spoke with former Kennedy political advisor Bob Schrum http://www.npr.org/templates/story/story.php?storyId=112281174&ft=1&f=112268401.:
“FESSLER: Political consultant Bob Shrum recalls how he almost got his head bitten off during Kennedy's reelection campaign in 1994 against Republican Mitt Romney. Shrum had given this political advice: Don't oppose Romney's plan to stop welfare for women who have children out of wedlock.
Mr. BOB SHRUM (Political Consultant): And he said I'm not going to do that. I'm not going to get reelected by taking food out of the mouths of poor kids. I don't need the job that much. They need the food. He was genuinely angry.
FESSLER: Shrum says it was part of Kennedy's deep philosophical belief.
Mr. SHRUM: I think Ted Kennedy always had a very strong feeling that government existed for people who didn't have power and didn't have privilege and didn't have influence, that it somehow or other was a balancing mechanism to achieve a measure of social justice and opportunity and equality.”
I didn’t know this story, before, and I can’t say that I always thought that the Senator was doing everything I thought he could to advance healthcare for all, but I can say that this pretty much seems like the right definition of the purpose of government. And this should define what our government, representing our people, should be doing to reform health care.
Of course, not everyone believes that this is the purpose of government, but I do. I am not talking about the national defense, or the building of federal highways but in its core approach to domestic spending. Small business loans should help small businesses, people who are starting up or trying to get through hard times to achieve the American dream, not big companies. Farm support, to the extent we have it, should protect and help the family farmer, not giant agribusiness companies. We need to protect our nation’s natural resources and public lands so that they will be there for future generations, not destroy them to create more enormous wealth for multi-national corporations. Huge multinational corporations (and make no mistake, all of these large ventures from farming to mining to manufacturing to finance are controlled by large multinational corporations) and the extremely wealthy people who control them are doing just fine, thank you. If some of them are doing a little less fine than they were a year ago, that is fine also, and no one should shed a tear even if they are forced to move into public housing (hah!) – see my entry on the “Super Rich”, August 27.
But there are lots of people who do need help. They include the children that Senator Kennedy knew needed food, and who also need education. Nicholas Kristof, writing in the New York Times on August 19, 2009 (http://www.nytimes.com/2009/08/20/opinion/20kristof.html?scp=16&sq=&st=nyt), notes that while the Oakland, CA schools spend $8,000 per year to educate each of its students, the state of California spends $216,000 per year for each inmate in its juvenile justice system. If these children had a little more spent on their eduation, perhaps they won’t be in the same situation as another man described by Kristof, who, having had two minor convictions at 19, landed in jail for life for stealing a $2.50 pair of socks, under California’s 3 strikes law! Prison for life for stealing $2.50! While the bankers and financiers who were true bandits get government bailouts! Um, wrong use of taxpayer money.
And we need healthcare for all, which Senator Kennedy long fought for. By the end of his life, with the greatest possibility of achieving this goal on the horizon, he was unfortunately willing to give up on the plan he knew would work best, single payer, but would never give up on the need for a public plan, because he would not give up on the idea that everyone needed to be covered, and there are only 3 ways to do this: single payer, a public plan (more costly, as I have discussed previously), and a system using not-for-profit private insurance companies that are highly regulated, forcing them to cover everyone and not gouge them with his premiums (which has less chance of happening than single payer!) We need to do this he, and I, belive, because that should be the role of government: to be a balance, to help those who need the help to meet have the basic requirements for a good life, and to spend not a penny padding the accounts of the least needy in a manner that is often believed to be characteristic only of backward, corrupt, third-world dictatorships.
Not everyone agrees that government should be involved in health care reform. “The federal government has absolutely no business in any way, shape or form addressing health care,” an attendee at a town hall held by Sen Claire McCaskill of MO was quoted as saying by the Kansas City Star on August 24 (http://www.kansascity.com/news/politics/story/1403874.html). “Not pro, not con. Zero. Zip.” The article did not contain more information explaining this position, but I’m certain it was coherent as well as cogent. I'm sure that this person would be happy to eliminate the benefits offered by taxpayers not only for Medicare and Medicaid, but also the Veteran’s Administration, and the military and all federal employees. Not to mention the benefits supplied by all the state and local governments for their employees. Or the tax revenue foregone (thus a cost) by the federal government for making employer health contributions (perhaps including the employer of the person making this comment) tax-deductible. While the Center for Medicare and Medicaid Services (CMS) estimates the federal contribution to be 45% of healthcare spending, this doesn’t include the benefits for federal employees, state and local employees, or the tax breaks. When they are, appropriately, included, it brings the taxpayer-supported contribution to healthcare to nearly 60%.[1] In absolute per capita dollars, the US taxpayer spends more than the TOTAL per capita healthcare spending of every country save Switzerland, while having 47 million uninsured! We pay for national health care, but do not get it.
Go out, all of you covered by government funds, and get your own private health insurance!
Perhaps the commenter at the McCaskill event meant that he believed that he and everyone else should pay for their health insurance themselves in after-tax dollars. Or maybe he, or others who might be tempted to agree with him, are victims of the “Craig T. Nelson Fallacy”. This fallacy, of which “keep the government’s hands off my Medicare!” is an example, is named for the actor who, after an extensive anti-government rant on Fox’s Glenn Beck show, declared “I've been on food stamps and welfare. Anybody help me out? No. No.” (May 28, 2009, http://www.foxnews.com/story/0,2933,522939,00.html).
While many may dismiss Mr. Nelson as an ignorant blowhard who doesn’t know what he is talking about (which he is and is true), the real issue is that so many other people are missing the key point: how much they, personally, benefit from the government, and how helping them, and others in need, is a completely appropriate thing for the government to do. The “government” after all should be representing all of us, and helping us when we have need, not stuffing the pockets of the privileged (who, in turn, stuff the pockets of our representatives).
On MSNBC’s “The Morning Grind” on August 25, 2009, Rep. Anthony Weiner (D., NY), a single-payer advocate, left host Joe Scarborough “speechless” (many links all over the web; here is one:
http://click.icptrack.com/icp/relay.php?r=4798182&msgid=254377&act=0LH3&c=196437&admin=0&destination=http%3A%2F%2Fwww.pnhp.org%2Fmultimedia%2Fanthony_weiner_leaves_scarborogh_speechless.php) by his simple logic that said, essentially (paraphrase) “why should we pay insurance companies such a big cut of our health care dollar? When did an insurance company ever operate on someone or make a diagnosis?” Scarborough could not believe that the Congressman was urging that insurance companies be eliminated, but all he could basically say was “I believe in private enterprise, and you want the government to run healthcare!”, unable, of course, to respond to the content. Weiner noted that if private insurance companies could really do a better, more cost-effective job, they wouldn't be concerned about competing with a public option.
Apparently Joe Scarborough, and many others, have an ideological belief different from that of Senator Kennedy. They believe that government should support rich corporations rather than existing “…for people who didn't have power and didn't have privilege and didn't have influence,” and being “a balancing mechanism to achieve a measure of social justice and opportunity and equality.” I believe that it was largely in agreement with this purpose that so many people became activated in the campaign of Barack Obama and elected him President. The President would be doing us all a great favor if he could ignore the advice of the (pre-reconstructed) Bob Shrums who advise him to abandon that belief, and provide the leadership that he can to create a health reform that is truly reform, that will truly cover all the people of the United States, and that willing truly be a fitting tribute to Senator Kennedy.
[1] Woolhandler S and Himmelstein DU, “Paying for national health insurance – and not getting it!” Health Affairs, July-August 2002, pp. 88-98.
- Medicine And Social Justice – The First Year: An Index
. Thanksgiving weekend – today, November 28, specifically – marks the first anniversary of the Medicine and Social Justice blog. I thought I would review the topics I have covered, grouping them generally into several areas. This might enable anyone...
- Public / Private Funding: We're All In This Together
. I have written a great deal about the shortage of primary care physicians in the US, both at present and probably worsening in the future. One of the main reasons is that they make less (much less!) money than many other specialists. This has led to...
- The "super Rich" And Our Healthcare
. The New York Times, August 21, 2009, has a front-page article by David Leonhart and Geraldine Fabrikant titled “After 30-year run, rise of the super-rich hits a sobering wall” (http://www.nytimes.com/2009/08/21/business/economy/21inequality.html?_r=1&scp=1&sq=super%20rich&st=cse)....
- “no Single Payer”: Sebelius – Making Policy For The Powerful
. Item: The Kaiser Family Foundation survey again confirms the preference of the American people for a program that covers everyone. http://www.kff.org/kaiserpolls/upload/7892.pdf: Two-thirds to three-quarters of respondents support the following options:...
- The Massachusetts Avenue Of Health Reform
In contrast to the personality-driven path that Lyndon Johnson took to navigate legislative obstacles to Medicare and Medicaid, former management consultant Mitt Romney charted a decidedly different course to expanding health insurance when he became...