Sunday, September 06, 2009


I received a chain letter email today from a conservative friend opposing “Obamacare” and urging me to help defeat any proposed health care reform by donating to the League of American Voters.
I'm a retired Federal employee with over 41 years of service, and I have one of the many commercial health insurance policies available to every Federal employee, including congressmen.  I pay about $250 per month out of my pension for that policy.  Before turning 65 this past March and becoming eligible for Medicare (or "socialized medicine", as opponents prefer to call it), I did a lot of research to figure out if I should drop my commercial health insurance and just take Medicare part A and B.  (Or to add the new Medicare Part D prescription drug plan recently passed by a Republican president and congress (Bushcare?)). I kept the commercial policy, and subsequent spine surgery and four months of outpatient rehab have convinced me that was a good idea.  So I consider myself, and the hundreds of thousands of other retired Federal employees, vets and military retirees who continue to pay premiums for commercial health insurance despite having access to "free" insurance, to be living proof that a so-called "government option" plan will not drive commercial insurers out of business.

  There are a lot of legitimate concerns that both liberals and conservatives, Democrats, Republicans, Independents and Libertarians have with some of the proposed health plans.  I too am concerned about the costs of an expanded plan and its influence on our national debt. I think any proposed plan should limit malpractice awards if we want to control medical costs. I'm concerned about protecting my Medicare benefits. But we need to keep the discussion focused on facts, not fiction.  The United States does NOT have the world's best health care system.  In the rankings of the World Health Organization the US ranks #37 overall among the world's countries, behind Chile, Denmark, Domenica and Costa Rica. We rank #14 in preventable deaths, #24 in life expectancy,
and #46 in infant mortality.

In fact the only area in which the US is ranked number one in health care against every other nation in the world is in the cost per capita, where the US far and away exceeds the cost of any other country.

Let's talk about health care for the more than forty million Americans who do not have any health insurance. I know some of them. A friend's wife has a serious cancer and, unable to work, lost her employer-provided policy. Another good friend's son, who we've known since he was born, was laid off from his job when a local firm lost a government contract, leaving him, his wife and two kids without health insurance. Who do you think is paying for those uninsured folks' health care?

We are.

Let me tell you a story. This spring I fell and had to go to the local hospital with a bleeding cut on my head, which required a stitch. While I was sitting in the crowded emergency room holding a towel to my bloody head I noticed that many of the people waiting were not showing many of the symptoms of emergency. They had a fever, cough, runny nose, back ache, or other things for which you and I would probably visit our family practice physician during his normal office hours. But if you are uninsured in America, no doctor will see you in his private practice and free clinics are few and overcrowded. So every emergency room is loaded with patients who are receiving treatment for which they cannot pay. So how do you think these private hospitals make the profits they do? They simply pass on the treatment costs to those patients who can afford to pay. My one single staple cost over $1000.

So the issue is not whether you and I will pay for health care for the uninsured, it is how we will pay – in the form of taxes or increased healthcare insurance premiums or bigger bills for our own health care. This needs to be a dialog in congress, not a reason for fingerpointing and sloganeering and alarmist emails.

Let's talk about that League of American Voters commercial. First, it cites both Great Britain and Canada as examples of what will happen if the “Obamacare” plan is passed. Notice that in the overall country health care ranking I cited above, the United Kingdom is #18 and Canada is #30. The USA is #37. I have lived in both Germany (#26) and Japan (#10) for ten years each, used the hospitals and doctors in both and found them first-rate.

Second, the League's ad suggests that adding another 40 million uninsured Americans to the rolls of paying patients will overtax the supply of doctors, leaving the rest us inadequately served. Besides the fact that this argument ignores the usual conservative “free market” economic theories which predict that the supply of doctors will increase to meet demand, it also ignores the fact that I discussed in the emergency room example above – that in many cases uninsured people are already receiving emergency medical care, at the expense of paying patients. True, we may need more family practice physicians, and a plan which provides more benefits for preventive medicine rather than the current fee-for-service system, but better prevention is proven to lower overall medical costs. Again, we need a dialog, not slogans.

If you listen to Rush Limbaugh or Jim DeMint or many other Republican spokespersons, the defeat of ANY healthcare reform is considered essential to “get Obama.” The problem with that plan is, by not repairing the many things wrong with healthcare in America, that absence of action will also defeat most Americans, including the many seniors who will find our present Medicare and social security programs bankrupt within fifteen or twenty years, buried under a tide of retiring baby boomers who will outnumber the paying work force, and by medical costs that are increasing at twice the rate of inflation. That's why such “liberal” organizations as AARP support the need for healthcare reform now. If we are diverted from the course of reform by congressional inaction and the concerted efforts of over two thousand of the health care industry's registered lobbyists, we won't have to worry about remaining #38 in the world's healthcare statistics; America's health care situation will get much worse.

Let's quit pointing fingers, screaming and sloganeering at town meetings, and swapping viral videos and email propaganda, and start talking about compromises that will protect our common interests. That's how democracy is supposed to work.