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Wednesday, February 4, 2015

Health Care Reform Articles - February 4, 2015

The Super-Rich Can’t Hide From the Rest of Us

My friend Craig Zobel just premiered his new movie at the Sundance Film Festival. Z for Zachariah is based on a young adult novel from the seventies about a post-apocalyptic world and a woman who lives on a farm in a remote valley. A geographic anomaly, the valley has been isolated and protected from the nuclear radiation that devastated the rest of humanity. But then a man arrives and, a while later, another. You’ll have to see it.
Craig’s movie is the latest in a long line of such stories about faraway, idyllic places trying to fend off human wrongdoing – from Aristophanes’ Cloud Cuckoo Land and the pre-serpent-and-apple Garden of Eden to the Shangri-La of James Hilton’s novel, Lost Horizon. In the classic, 1937 movie version, Shangri-La’s High Lama says to the hero, a British diplomat, “Look at the world today. Is there anything more pitiful? What madness there is! What blindness! What unintelligent leadership! A scurrying mass of bewildered humanity, crashing headlong against each other, propelled by an orgy of greed and brutality.” Sounds like a typical night at Fox News.
Z for Zachariah was filmed on New Zealand’s South Island, about as close to a distant Paradise on Earth as I’ve ever been. Which apparently is part of the reason why, according to former hedge fund director Robert Johnson, “I know hedge fund managers all over the world who are buying airstrips and farms in places like New Zealand because they think they need a getaway.”
And not just a getaway for a couple of weeks of vacation fun. No, the British newspaper The Guardian reports, “With growing inequality and the civil unrest from Ferguson and the Occupy protests fresh in people’s mind, the world’s super rich are already preparing for the consequences.”

Martin Luther King Jr. -- Health Care as a Moral Crisis

By John Geyman, M.D.
The Huffington Post, Jan. 30, 2015
On this occasion honoring the anniversary of the birthday of Martin Luther King 86-years-ago, coinciding with the release of the movie Selma, it is fitting to recall his leadership on moral principles toward equity of health care in this country. Among his many classic quotes about health care, he had this to say in 1966 in a speech to the Medical Committee for Human Rights:
Of all the forms of inequality, injustice in health care is the most shocking and inhumane.
Were he here today, Martin Luther King, Jr. would be appalled to see what Americans are facing, even five years after the passage of the Affordable Care Act.
Here's one patient vignette that puts a human face on the outcomes facing patients unfortunate enough to live in states that opted out of Medicaid expansion, as more than twenty states have done.
Charlene Dill was a 32-year-old mother of three who earned $11,000 a year cleaning houses and babysitting in Florida. That was too much to qualify for Medicaid, and too little to afford health insurance. The ACA would have provided subsidies for health insurance if her income was more than $23,550. When she developed a heart condition, and later, abscess on her legs, she did go to emergency rooms, but couldn't afford those bills or any other care.
This is not an isolated anecdote, but more the rule for many millions of Americans. Access to care has improved for some, especially in states that expanded Medicaid, but there are still more than 30 million uninsured and tens of millions underinsured. Lacking any mechanisms to rein in markets and contain costs or prices, the ACA has unleashed increasing consolidation and control by hospital systems and insurers.
Wall Street is happy, and health care stocks are soaring. Yet one-third of insured Americans cannot afford to pay their medical bills, often leading to bankruptcy. Meanwhile, our safety net continues to deteriorate. We can expect that to worsen in the months and years ahead if Republican governors impose more restrictions on Medicaid, and if the Republican-controlled Congress cuts spending for critical programs.
As Martin Luther King knew full well, health care is a moral issue. Virtually all advanced countries around the world recognized long ago that health care is a human right, not a privilege based on ability to pay. Dr. Edmund Pellegrino, leading medical ethicist for many years at Georgetown University's Center for Clinical Bioethics, summed up the issue this way at the Annual Meeting of Academic Health Centers in 2000:
Access to health care is a moral obligation of a good society.

MLK's Vision and the Right to Healthcare

By James Besante, MS4
Common Dreams, Jan. 25, 2015
This past week the world celebrated the life of Dr. Martin Luther King Jr.
Marches of remembrance also served as painful reminders of unhealed wounds along the lines of race in America, particularly the failure to realize equal access to health care for all.
In 1966, while addressing the second convention of the Medical Committee for Human Rights, King declared, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
The true magnitude of race-based health inequality is staggering: In his seminal paper “What If We Were Equal,” former Surgeon General David Satcher calculated approximately 83,000 excess deaths per year among African Americans, also known as the “black-white mortality gap.”
Despite progress in civil rights, housing, education, and employment from 1960 to 2000, this gap has remained. Shockingly, it has widened for infants and African American men over the age of 35.
The King holiday was a sobering day of reflection, but it was also the crescendo to the very audible justice movement loosely organized under the banner Black Lives Matter.
Activists marched in cities across the nation to bring attention to numerous highly publicized incidents of police violence. More broadly, organizers sought to underline the subversive elements of racism still deeply etched in our nation’s subconscious, and no doubt represented in unequal health outcomes for African Americans.
As a nation, we do not provide universal access to even the most basic medical services. This is not likely to change anytime soon since the Congressional Budget Office estimates that 27 million people will remain uninsured after the full implementation of Obamacare.
The absence of universal health care coverage sets the U.S. apart from all other developed countries. It is the only member of the elite G7—a group of nations accounting for 66 percent of net global wealth—without universal health insurance for its citizens.
Dr. Satcher proposed national health insurance as the evidenced-based remedy to finally close the racial mortality gap and address persistent health injustice in America.
Polls show most Americans also support universal health care. In fact, the majority of physicians agree the private health insurance industry should be replaced with a streamlined, publicly accountable system, like “single-payer,” also known as “improved Medicare for all.”
What is single-payer? It simply means the government pays for health care costs without routing money through private insurers who manufacture paperwork, billing complexity and profits. This is how traditional Medicare insurance is able to operate with overhead costs of 2 percent, which is far more efficient than private health insurance plans, with overhead costs of 15 to 25 percent.
Harvard researchers recently calculated the administrative savings of single-payer’s simplified financing structure to be $375 billion annually, nearly 15 percent of total health spending. This would help to lower the sky-high cost of our current system, which is approaching 18 percent of the gross domestic product.
Single-payer would free patients from out-of-pocket expenses, like co-payments and deductibles—proven barriers to care that are administratively unwieldy and unnecessary for cost containment.
National health insurance would also give patients free choice of providers without the narrow networks that are commonly encountered by insured Americans.
The comprehensive, high-quality care that is equitably accessible in a single-payer national health program stands in stark contrast to our current market-based system in which health care is rationed based on an individual’s ability to pay.
http://www.pnhp.org/print/news/2015/january/mlks-vision-and-the-right-to-healthcare


Onward, Christian Health Care?

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