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August 24th, 2009
Freethought San Marcos: Denying quality health care insurance a senseless act of violence?

Freethought San Marcos: A column
by LAMAR W. HANKINS

It is a striking figure–at least 22,000 people a year die in the United States because they have no health insurance. The death figure comes from research by the Institute of Medicine (IOM), a nonprofit organization chartered in 1970 as a part of the National Academy of Sciences. The IOM works “outside the framework of government to ensure scientifically informed analysis and independent guidance. The IOM’s mission is to serve as adviser to the nation to improve health. The Institute provides unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society, and the public at large.”

The IOM report, “Uninsured and Dying Because of It,” was published in January 2008 by the Urban Institute. Its findings were summarized in the report:

The absence of health insurance creates a range of consequences, including lower quality of life, increased morbidity and mortality, and higher financial burdens…

In 2002, the Institute of Medicine (IOM) estimated that 18,000 Americans died in 2000 because they were uninsured. Since then, the number of uninsured has grown. Based on the IOM’s methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006.

Much subsequent research has continued to confirm the link between insurance and mortality risk described by IOM. In fact, subsequent studies and analysis suggest that, if anything, the IOM methodology may underestimate the number of deaths that result from a lack of insurance coverage.

As every American alive and cognizant in 2001 will remember, a bunch of politically-motivated and religiously-inspired men hijacked two planes and piloted them into the World Trade Center in New York City, killing nearly 3000 people. These men were immediately and widely termed terrorists for their actions. Americans and most of the world came together to condemn these senseless acts of violence.

Most people believe that it is simply unacceptable to kill people over political grievances, when those people do not threaten one’s own life. When Timothy McVeigh bombed the Alfred P. Murrah Federal Building in 1995, killing 168 people, he was motivated by political pay-back for the government’s actions at the Branch Davidian compound near Waco in 1993 and the FBI’s actions at Ruby Ridge in 1992. He was justly condemned and abhorred for his actions.

The opponents of health insurance reform, which is intended to make health insurance available to all Americans, are also motivated by political concerns, some by religious ones (“the poor you shall always have with you”). It may be that their notions about the role of government in the United States would be violated if that government provided health insurance for the nearly 50 million Americans who are unable to afford it today. And by their own admission, some people’s political motivation to thwart health care reform is to prevent President Obama’s promise of reform from becoming a reality in order to cripple his presidency.

John Mackey, the CEO of Whole Foods, headquartered in Austin, begins an article against health insurance reform in the Wall Street Journal (August 11, 2009) by arguing that it is nothing but socialism–the term used by many right-wing ideologues to oppose all government programs that don’t rely entirely on the so-called free market.

Mackey’s WSJ opinion piece almost completely ignores those millions of Americans who have no insurance, 22,000 of whom die each year because they lack coverage. For these Americans, he calls for tax-deductible donations from charitable tax-payers to help them out, a tepid idea to say the least. This is the last of his eight suggested reforms, most of which merely tinker with the present inadequate, failing private health insurance market. For me, covering these Americans is the first priority. If we can’t get every American who wants health insurance covered, whatever is proposed is of little value to the people who need health care.

But Mackey apparently does not believe in a right to life. He writes that he opposes any notions that people should have a right to food, shelter, and health care, though his feeble heart does ooze for them just a bit (or so he claims). From his previous writings, we know that he opposes the right of association if that means some employees want to form a union. Are we to conclude from what he writes that he wants to eliminate food stamps (I’m sure that not many food stamp recipients shop at his grocery store, given the high prices, e.g., a ten-cent, 21-ounce container of iced tea costs $2.99 plus tax), homeless shelters, federal housing assistance, public housing, Medicare, Medicaid, and VA health services, along with any other guarantees of food, shelter, and health care?

Mackey exhibits blind adherence to his political belief in the magic of the free market. The problem with magic, of course, is that it’s not real. It is an illusion or supernatural phenomenon. Real people need real solutions, not magic. To Mackey, health care is just another commodity to be peddled by businesses without regard to the human cost.

Mackey writes, without offering any proof, that there is rationed health care in those countries with universal systems, but he fails to recognize the rationing caused by the free market in the United States. One hundred million Americans have no health insurance or have such poor policies that they are unable to get the health care they need. That is extreme rationing for nearly one out of three Americans.

Among Mackey’s major concerns are the costs involved with providing health care insurance for all Americans. However, he fails to recognize that the US free market wastes enough money to cover the health care needs of all Americans not now covered. The World Health Organization (WHO) has found that the United States spends nearly twice as much of its Gross Domestic Product on health care as does England. Both countries have nearly the same number of nurses, doctors, and acute care hospital beds per capita, yet the United States spends nearly $7300 per person per year on health care, while England spends less than $3000 per year. And Brits enjoy a longer life expectancy (by two years–80 versus 78) and have an infant mortality rate of 4.8 per 1000 live births, while the US has a 6.7 infant mortality rate. It is sobering to realize that the WHO ranks the US health care system as 37th in the world. But for people like Mackey, who have excellent health insurance, it is easy to ignore the health care reality faced by nearly one-third of our citizens.

Mackey is concerned that providing health insurance to all Americans will be a cost that we can’t afford. Such a myopic view ignores the incredible waste of trillions of dollars being spent on the wars in Iraq and Afghanistan, along with the incredible loss of life in those two countries, but Mr. Mackey expresses no concerns for these costs, perhaps because his beloved corporations, the ones so anxious to protect the free market, are the major beneficiaries of the government’s treasure spent to wage war. Surely, if we can find the money to wage senseless wars, we can find the money to provide every American quality health care insurance.

I can’t be sure of Mr. Mackey’s motivations for opposing effective health care reform, but his ideas will not provide all Americans access to affordable, effective health care at least as good as Medicare, which is the standard by which all health care proposals should be judged. Not one of his eight propositions would affect my health insurance coverage in any beneficial way.

Mackey claims that in England and Canada citizens “are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them.” If he had bothered to do even minimal research about those health care systems, he would know that his statement is false. Health care decisions in both countries are decided by doctor and patient, not the government. In fact, in Canada, the government merely pays health care bills. It hires no doctors, nor does it have a system to approve certain procedures as is the case with free market insurance in the US. Mackey has become yet another voice in the right-wing propaganda machine, which opposes health insurance for all Americans.

When a person’s political and/or religious views excuse or ignore the premature and unnecessary deaths of 22,000 human beings each year because they don’t have access to adequate health care insurance, I believe it is time to renounce those beliefs. Otherwise, how are we to judge that killing 3,000 people in 2001 as a result of political and/or religious beliefs is a worse offense? If you know that the political act of denying nearly 50 million people adequate health insurance will result in 22,000 deaths per year, is that denial, in its own way, a senseless act of violence? Is it morally equivalent to flying planes into the World Trade Center?

Mr. Mackey, nearly all Republicans in the Congress, and many Democrats are politically (and perhaps religiously) opposed to universal coverage or a public option to provide health insurance to all Americans who do not have it. Not one of them has suggested any other way that will satisfy the health care needs of the 100 million who have no health insurance, or inadequate health insurance. Their failure to act to seek real solutions to health insurance for all Americans will result in 22,000 unnecessary and avoidable deaths during the next twelve months. They should be held accountable for those deaths. When political or religious views become more important than human life, our civilization is in peril.

© Freethought San Marcos, Lamar W. Hankins

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2 thoughts on “Freethought San Marcos: Denying quality health care insurance a senseless act of violence?

  1. Lamar is exactly right on each point that he makes.
    A few days ago, I replied to one of his other writings, but that article of his in the Mercury was considerably older than this one, so I will copy/paste from my previous reply into this reply.

    “Well, it’s been a few days since the last posting and it looks like the Obama team and Congress have caved on the Public Option. I said previously that I was afraid that compromise would remove the best of whatever healthcare reform might hope to offer, and it appears to me that two groups are well on their way to killing meaningful reform.

    The 1st group is the big healthcare business group, which includes Pharma and the big insurance companies like Cigna & Aetna. This group also includes key legislators that have for years taken huge sums of benefit from private healthcare related companies. That invested money is now bearing sweet fruit for big business.

    The 2nd group includes the uninformed who believe the lies they are being told about healthcare reform. They listen to the garbage (death panels???) – propagated by those who want no change or who want to manipulate reform to their own benefit. This group also includes the “citizen liars”. I believe that the citizen liars are usually folks who have healthcare either thru their employer or perhaps they are wealthy enough to self-insure. They don’t say this out loud, but I believe they feel that those who don’t already have insurance are “trailer trash” who have not done what they need to do to be insured.

    I suggest that we read 2 editorials that appeared in the Austin American-Statesman on Tuesday, August 18th.
    ARA DARZI and TOM KIBASI – “The Truth about British health care”
    PAUL KRUGMAN – “Swiss way better than our way”

    Also, let me please refer all to various “Wiki charts” (from the WHO World Health Org, etc.) that compare U.S. healthcare with healthcare in other countries. It’s clear from the charts that our free enterprise system of healthcare is not getting the job done for Americans. We keep hearing in TV soundbites that America has the “best system of healthcare in the world”. That statement is absolutely untrue. The American system of healthcare is far from the best. As I’ve said many times – we don’t need healthcare insurance. We need healthcare.
    The Taiwanese are not smarter than we are but they got the job started –
    http://www.npr.org/templates/story/story.php?storyId=89651916 .
    They are now a bit underfunded but if they fix that problem with additional taxation they will still be paying 1/2 of what Americans pay for healthcare. And they love their healthcare system.

    Yes, some people do come to America for certain remedies. But then again, many Americans are going to other countries for affordable treatments/surgeries. I believe (big time) in the free enterprise system, but I do believe that our for-profit system of healthcare is not good for the health of Americans – and it costs twice as much as it should.

  2. Theme : 6 Main Lies Have Nothing To Do With This Promising Reform.

    1. The contents of savings (below) in this reform ‘have nothing to do with’ limit to medical access, rationing, tax raise, and deficit etc.

    Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing, more tax raise, and more deficit etc than today.

    $1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).

    $583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility) + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).

    As lawmakers debate how to pay for an overhaul of the nation’s health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.

    “Health reform can help pay for itself, but both private and public insurance choices are critically important,” said Commonwealth Fund President Karen Davis, who coauthored the new report. “A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost.”

    Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class, the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.

    In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. Unnecessarily, hope should not be replaced with all forms of malign lies, fear, just like people don’t have to fear quitting drug.

    2. Greedy insurers with no competitors by consolidation have nothing to do with the law of price, demand & supply.

    Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options. In practice, runaway premiums with no competitors by consolidation drive the enrollees out, and 4C + 2R (canceling, capping, cherry-picking, cash for special lobby, rationing, rapid premium hike) guarantee multiple times as much profit. Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.

    3. The plans to stem inflation in the House have nothing to do with crowd-out.
    With the heartbreaking tears in mind (In no other industrialized country do 20,000 people die each year because they can’t afford to see doctor. Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
    And It can be said that fair competition starts with a fair, sustainable market value.

    However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment), some mandate code, ample capital, the reduced exorbitant ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services. Focus should be on the uninsured, the underinsured.

    In an attempt to avert innovation, moderation, and social responsibility, accusing essential affordability, citing take-over, will be a dirty play.

    — Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada —

    4. Profit-driven markets have nothing to do with affordable, sustainable public health.

    When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future (Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007).

    Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, about 50% of idle world’s best practices, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary, risk-carrying procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, incredible medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the comprehensive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.

    Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal.

    Please be ‘sure’ to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

    Today, another innovative, fundamental change in payment system, or patient’s outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

    5. Inflation-driven greedy allies backed by the insurers have nothing to do with deficit-neutral.

    When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too. In case somebody in the house gets ill, health will be put over house, in practice.

    6. The analyses of CBO have nothing to do with common sense and practice.

    Costs of Preventable Chronic Disease account for around 75% of the nation’s $2.4 trillion medical care costs. U.S. health care spending is also expected to double in the next 10 years. and they are largely preventable — 80 percent of the risk factors are behavior-related.

    Unlike the analyses of CBO, world-wide outstanding public programs put heavier emphasis on preventive program equally, and preventable swine flu pandemic is expected to cost about $2trillion dollars world-wide for the lack of prepared vaccines. (Genes included in the new swine flu have been circulating undetected in pigs for at least a decade, according to a team led by Rebecca Garten of the federal Centers for Disease Control and Prevention who have sequenced the genomes of more than 50 samples of the virus).

    If CBO asks the profit-driven interests about why they have hindered the budget request for preventive program in Medicare and Medicaid, they will say, ” just look at the health Catrina special lobbying has made, we are professional, and we are now obstructing this reform, too ” .

    7. Conclusion : The public health is a fundamental human right.

    As I said previously, patient-oriented value alone could be enough to meet the goal, and another innovative, fundamental change in payment system, or patient’s outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

    If At least, some media pay attention to this flower of reform, people will feel empty as the past and current discussion has been time-consuming for sure.

    Thank You !

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