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Tuesday, January 13, 2015

Health Care Reform Articles - January 13, 2015

The American Way over the Nordic Model? Are we crazy?

In my long nomadic life, I've been to both poles and most countries in between. I still remember when to be an American was to be envied. The country where I grew up after World War II seemed to be respected and admired around the world.
Today, as one of 1.6 million Americans living in Europe, I instead face hard questions about our nation. Wherever I travel, Europeans, Asians and Africans ask expatriates like me to explain everything odd or troubling about the conduct of the United States. Polite people, normally reluctant to risk offending a guest, ask pointedly about America's trigger-happiness, cutthroat free-marketeering, and "exceptionality."
Their questions share a single underlying theme: Have Americans gone over the edge? Are you crazy?


At the absolute top of the list: "Why would anyone oppose national healthcare?" Many countries have had some form of national healthcare since the 1930s, Germany since 1880. Some versions, as in France and Britain, have devolved into two-tier public and private systems. Yet even the privileged would not begrudge their fellow citizens government-funded comprehensive healthcare. That so many Americans do strikes Europeans as baffling, if not brutal.
In the Scandinavian countries, long considered to be the most socially progressive in the world, a national (physical and mental) health program is a big part — but only a part — of a more general social welfare system. In Norway, where I live, all citizens also have access to free education from age 6 through specialty training or university; low cost, subsidized preschool; unemployment benefits, job-placement and paid retraining; paid parental leave; old age pensions, and more. These benefits are not a "safety net" — that is, charitable payments grudgingly bestowed upon the needy. They are universal: equally available as a human right, promoting social harmony.
This is the Nordic Model: a balance of regulated capitalism, universal social welfare, political democracy and the highest levels of gender and economic equality on the planet. It's their system, begun in Sweden in the 1930s and developed across Scandinavia in the postwar period. Yes, they pay for it through high taxation. (Though compared with the U.S. tax code, Norway's progressive income tax is remarkably streamlined.) And despite the efforts of an occasional conservative government to muck it up, they maintain it. Why?
They like it. International rankings cite Norway as the best place to grow old, to be a woman and to raise a child. The title of "best" or "happiest" place to live on Earth comes down to a neighborly contest among Norway and the neighboring Nordic social democracies, Sweden, Denmark, Finland and Iceland.
All the Nordic countries broadly agree that only when people's basic needs are met — when they cease to worry about jobs, education, healthcare, transportation, etc. — can they truly be free to do as they like. While the U.S. settles for the fantasy that every kid has an equal shot at the American dream, Nordic social welfare systems lay the foundations for a more authentic equality and individualism.
These ideas are not novel. They are implied in the preamble to our own Constitution. You know, the part about "We the People" forming "a more perfect Union" to "promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity."


Knowing this, a Norwegian is appalled at what America is doing to its posterity today. That top chief executives are paid 300 to 400 times as much as an average employee. Or that Govs. Sam Brownback of Kansas and Chris Christie of New Jersey, having run up their state's debts by cutting taxes for the rich, now plan to cover the loss with money snatched from public pension funds. That two-thirds of American college students finish in the red, some owing $100,000 or more. That in the U.S., still the world's richest country, 1 in 3 children lives in poverty. Or that the multitrillion-dollar wars of Presidents George W. Bush and Obama were fought on a credit card, to be paid off by the kids.
Implications of America's uncivilized inhumanity lurk in the questions foreign observers ask me: Why can't you shut down that concentration camp in Cuba? Why can't you stop interfering with women's healthcare? What is it about science and climate change you can't understand?


And the most pressing question of all: Why do you send your military all over the world to stir up trouble for all of us?
Europeans often connect America's reckless conduct abroad to its refusal to put its own house in order. They've watched the United States unravel its flimsy safety net, fail to replace decaying infrastructure, weaken organized labor, bring its national legislature to a standstill and create the greatest degree of economic inequality in almost a century. As they see it, with ever less personal security and next to no social welfare system, Americans are bound to be anxious and fearful. They understand as well why so many Americans have lost trust in a national government that for three decades has done so little for them (save Obama's endlessly embattled modest healthcare effort).
In Norway's capital, where a statue of a contemplative President Franklin D. Roosevelt overlooks the harbor, many America-watchers think he may have been the last U.S. president who understood and could explain to the citizenry what government might do for all of them.
It's hard to pin down why America is as it is today, and — believe me — even harder to explain it to others. Some Europeans who interrogate me say that the U.S. is "crazy" — or "paranoid," "self-absorbed," or simply "behind the times." Others, more charitably, imply that Americans are merely "misguided" or "asleep" and may still recover sanity. But wherever I travel, the questions follow, each suggesting that the United States, if not exactly crazy, is decidedly a danger to itself and others.
Ann Jones is the author of "They Were Soldiers: How the Wounded Return From America's Wars — The Untold Story." A longer version of this piece appears at tomdispatch.com.

Steven Brill & 60 Minutes show why letting lobbyists write the ACA was an Enormous Blunder


In 2009 when the Affordable Care Act was being crafted together a calculation was made not to challenge the entrenched power of the big stakeholders in the American Health Care system no doubt to avoid provoking their opposition to the reforms in health care that would have probably prevented its passage. This Faustian bargain prevented any constraints being imposed on the revenue streams going to those powerful stakeholders like hospitals and Big Pharma. So  Democrats in the Congress Like Senator Max Baucus essentially let the stakeholders lobbyists like Liz Fowlerwrote protections for the inflated revenue streams for the powerful stakehilders into the A.C.A. Cost containment went by the wayside. Now we've got a reformed health care system that expands access to segments of the population that were being left out, but we still have a for profit healthcare system with its attendant very high costs.  
No one I know framed these problems with how the A.C.A. was crafted together largely by lobbyists to protect entrenched interests revenue streams better than Bill Moyers did back in the Fall of 2009.            
                     
So now we're saddled with this expensive for profit Rube Goldberg machine of a health care system instead of the single payer system many of us on the Left were clamoring for. The power of the entrenched interests has only grown since the Moyer piece described it in 2009. We now have a congress with Republican majorities in both houses looking for ways to dismember the A.C.A. as much as they can, threatening the reforms that are so desperately needed by millions of Americans. Its a predicament that's likely to get a lot worse the more Republicans meddle with the A.C.A.

Here is the link to the most recent 60 Minutes Obamacare show
-SPC

New Rules to Limit Tactics on Hospitals’ Fee Collections


With friends like these, who needed enemies in 2014?
In soccer it's called an "own goal," when a player inadvertently kicks the ball into his own net.
In politics, it's called being Jonathan Gruber.
Gruber, an economist at the Massachusetts Institute of Technology, did more than any other supporter of the 2010 healthcare law to increase its chances of being repealed. But he's hardly the only one whose words or deeds wound up hurting his own allies.
Here's a short list of the people whose actions in 2014 raised the question, "With friends like these, who needs enemies?"
Jonathan Gruber
As a consultant to the White House and congressional Democrats, Gruber developed the models that projected the positive economic effects of various provisions of the Patient Protection and Affordable Care Act. In particular, Gruber's work helped defend the individual mandate to buy insurance and the "Cadillac tax" on high-value health plans.
Then Gruber gave a series of speeches explaining the law, in which he called voters stupid, said the Cadillac tax provision was crafted in a way to mislead the public about its true intention, and declared that Congress intended to withhold subsidies from lower-income residents of states that did not set up their own insurance exchanges.
He has since backtracked vigorously from all those remarks and has apologized for holding himself out as more of an expert than he really was. Nevertheless, his comments have put defenders of the embattled Affordable Care Act in an even tougher position as Republicans, who bitterly oppose the law, assume control of both sides of the Capitol.

Don’t Look to States for New Ideas

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