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I'm mad as hell, so I'm going to lash out at everybody!

This seems to be the prevailing opinion in the country today. Everybody seems to be mad. Everyone seems to be on edge. The government is to blame. Conservatives are to blame. Independents are too fickle. Democrats are too liberal. We’ve heard every explanation under the sun. In my opinion, some of the explanations are simply outlandish and others miss the point entirely. The bottom line, as I see it, is that people are working hard and getting less and less in their take-home pay. Whatever monies they make cover less and less. This is the problem.

One of the more misguided efforts to fix our problems is an organization called Get Out Of Our House. Their plan is to simply replace every member of Congress. Of course, this idea has been embraced by FOX News (see video.)

It is hard to explain just how misguided this effort is. What makes every member of Congress inherently bad? Were they bad before they were elected to Congress? If so, how do we fix the election process so that we elect “good” people? On the other hand, could it be possible that “good people” were elected to Congress and then became bad after the election? None of these questions are asked by this organization. Of course, they don’t answer the questions either. It seems to me that you would need to at least investigate these questions before jumping to the conclusion that you need to replace everybody.

In my opinion, corporate influence over policy has increased over the last 30 years. If we look at the explosion in the number of lobbyists, this would suggest that corporations are paying more attention than individuals to what is going on in Congress. This may be the place to start. How do we decrease corporate influence over our political process? How do we make our elected representatives more responsible to the people instead of to our corporations? This is the fundamental question is facing America today. Let’s thoughtfully fix this problem. Lashing out in a fruitless effort to replaced everyone is foolhardy, to say the least.

By |2010-01-20T13:52:16-04:00January 20th, 2010|Business, Domestic Issues, Party Politics|Comments Off on I'm mad as hell, so I'm going to lash out at everybody!

Single-payer questions and answers (updated)

Thanks for stopping by C&L readers.

I posted a little something on my Facebook page which stated if we went with single-payer would you save anywhere between $3 – 4 trillion over 10 years. Some of my friends began to seize when they saw that number. So I thought that I would take some time to explain where that number came from and answer some of other questions.

Are you dreaming?

Although it is nice to dream, I don’t think I’ve ever dreamed about healthcare or healthcare reform. As a matter of fact, I’m really not looking forward to dreaming about healthcare. I like dreaming about Tyra BanksCindy Crawford and/or Stacy Williams. On the serious side, in 2007, we spent $2.2 trillion on health care. This averages out to be about $7200 per American. If we go to a single-payer system (government payer system) this would eliminate a price when $700 billion which currently goes to health insurance overhead and administration. We can use half of the $700 billion to cover the 46 million Americans who are currently without health care. This leaves approximately $350 billion left over. Now, it is true that the folks in Washington seem to be able to find things to do with money that is left over. That’s not the point. The point is we would end up with $350 billion. Multiply that by 10 years and you get $3.5 trillion. That’s a lot of savings.

Healthcare reform is about control?

While I will grant the critics of the America’s affordable health choices act of 2009 that there is a lot of garbage in this bill, I’m not sure that you can make the leap that healthcare reform is about control. Currently we spend of roughly 16% of our gross domestic product on health care. We’ve seen healthcare expenditures skyrocketed over the last 10-20 years. There are estimates, that are legitimate, that suggests that by the year 2025, at our current rate, would spend approximately 25% of our gross domestic product on health care. There’s no way that this is acceptable.

I’m not sure how anyone could leap to the conclusion that this is about control since you will be able to keep your same hospital and your same physician. Maybe, it is about controlling health care costs. If one of the goals of healthcare reform is to control costs and the simplest way is going with single-payer which frees up $700 billion. If, on the other hand, you want to jerryrig the current system then you need to put more money in the system in order to cover the 46 million Americans who are currently not covered.  How much money will be needed?  46 million x $7200 = $330 billion.  For those folks that don’t want single payer they will need to figure out how to raise over $300 billion per year.

Where does the number 46 million come from? How many economic refugees (illegal aliens) are in the 46 million who don’t have insurance?

The US Census Bureau published a document in August 2008 called Income, Poverty, and Health Insurance Coverage in the United States: 2007. According to this document, 45.7 million Americans do not have health insurance in 2007. (Page 19) According to the same document 9.7 million economic refugees do not have health insurance. (Table on page 22)

Update: I thought of a few more questions that I have been asked over the last several months.

Should we all invest in a hospice?

Many conservatives are trying to get seniors worked into a lather. They claim that there is provision in the bill America’s Affordable Health Choices Act of 2009 which basically kills off seniors. The ridiculousness of this claim cannot be understated. In section 1233 (page 424), the bill talks about an advance care planning consultation. The bill provides funds for Americans to sit down with a health professional and talk about end-of-life issues. It isn’t mandatory. It doesn’t stop your healthcare, nor does it tell doctors never to treat you again. As a physician, I think that Americans need to talk with their spouses and their primary care physicians about end-of-life issues. We don’t do this enough in this country. I see way too many trauma patients who have told their spouses or partners nothing about their end-of-life wishes. So, if you want to invest in a hospice, do as you wish with your money. I don’t foresee any signifiicant uptick in the death rate if this legislation passes.

Isn’t this the same thing that they have in England? Isn’t this socialized medicine?

Yesterday afternoon, I was a guest on health care forum on a local radio show called Take A Stand. I was representing both healthcare and a progressive point of view. A caller related a very long story in which a friend of his had to wait a couple months for a particular procedure. During this long time period, this friend remained in the hospital. Isn’t that the same type of medicine that we’re bringing here? No! In England, they have a socialized medicine system. The doctors, the nurses, all of the healthcare professionals are employees of the state. With a single-payer system, the government pays the bills and we pay the bills. The hospitals remain privately owned. Doctors continue to be in solo or group practices as they see fit.  Nurses would continue to be employed by the hospital or doctor or nursing home.

Many politicians have pointed out the fact that we spend twice as much on health care as other industrial countries. Some have pointed to this as a bad thing. I don’t know whether it is good or bad, but I can tell you that some of the differences in expenditures are because we, Americans, expect a certain type of service. We don’t expect to be waiting in the hospital for procedures. We expect to have access to whatever tests we need, in a timely fashion. That will not change under a single-payer system. As a matter fact, the speed may actually increase with a single-payer system because you don’t have to wait for your procedure to be certified by your insurance company.

A variation on the same theme is that a single-payer system (government payer) will turn hospitals all across the country into VAs. I’m sorry, I don’t follow this line of reasoning. A hospital that was run for profit yesterday would still be for profit under a single-payer system. If the hospital was efficient before single-payer, why would it be less efficient after the implementation of a single-payer system in which the hospitals billing apparatus could be streamlined because the hospital only has to bill the government? Hospitals wouldn’t have to bill 15 or 20 different insurance companies. Finally, I would say that the VA was designed to take care of relatively elderly men. Therefore, the VA is very good at taking care of heart attacks, strokes, diabetes, prostate cancer and colon cancer. The VA has had a hard time taking care of patients who are young, who are female or who have something out of the norm, because it wasn’t designed to take care of these patients.

By |2009-08-04T14:09:20-04:00August 4th, 2009|Healthcare|Comments Off on Single-payer questions and answers (updated)

The Top 43 Appointees Who Helped Make Bush The Worst President Ever

I wish I were smart enough to come up with a list like this. The good news is my friends at TP are smart enough.

From TP:

Next week, “change is coming to America,” as President George W. Bush wraps up his tenure as one of the worst American presidents ever. He wasn’t able to accomplish such an ignominious feat all by himself, however; he had a great deal of help along the way. The ThinkProgress team heralds the conclusion of the Bush 43 presidency by bringing you our list of the top 43 worst Bush appointees. Did we miss anyone? Who should have been ranked higher? Let us know what you think.

1. Dick Cheney — The worst Dick since Nixon. The man who shot his friend while in office. The “most powerful and controversial vice president.” Until he got the job, people used to actually think it was a bad thing that the vice presidency has historically been a do-nothing position. Asked by PBS’s Jim Lehrer about why people hate him, Cheney rejected the premise, saying, “I don’t buy that.” His top placement in our survey says otherwise.

2. Karl Rove — There wasn’t a scandal in the Bush administration that Rove didn’t have his fingerprints all over — see Plame, Iraq war deception, Gov. Don Siegelman, U.S. Attorney firings, missing e-mails, and more. As senior political adviser and later as deputy chief of staff, “The Architect” was responsible for politicizing nearly every agency of the federal government.

3. Alberto GonzalesFundamentally dishonest and woefully incompetent, Gonzales was involved in a series of scandals, first as White House counsel and then as Attorney General. Some of the most notable: pressuring a “feeble” and “barely articulate” Attorney General Ashcroft at his hospital bedside to sign off on Bush’s illegal wiretapping program; approving waterboarding and other torture techniques to be used against detainees; and leading the firing of U.S. Attorneys deemed not sufficiently loyal to Bush.

4. Donald Rumsfeld — After winning praise for leading the U.S. effort in ousting the Taliban from Afghanistan in 2001, the former Defense Secretary strongly advocated for the invasion of Iraq and then grossly misjudged and mishandled its aftermath. Rumsfeld is also responsible for authorizing the use of torture against terror detainees in U.S. custody; according to a bipartisan Senate report, Rumsfeld “conveyed the message that physical pressures and degradation were appropriate treatment for detainees.”

5. Michael Brown — This former commissioner of the International Arabian Horse Association was appointed by Bush to head FEMA in 2003. After Katrina made landfall as a Category 4 hurricane, Brownie promptly did a “heck of a jobbungling the government’s relief efforts, and was sent back to Washington a few days later. He was forced to resign shortly thereafter.

6. Paul Wolfowitz — As Deputy Secretary of Defense from 2001 to 2005, Wolfowitz was one of the primary architects of the Iraq war, arguing for the invasion as early as Sept. 15, 2001. Testifying before Congress in February 2003, Wolfowitz said that it was “hard to conceive that it would take more forces to provide stability in post-Saddam Iraq than it would take to conduct the war itself.” Wolfowitz eventually admitted that “for bureaucratic reasons, we settled on one issue, weapons of mass destruction,” as a justification for war, “because it was the one reason everyone [in the administration] could agree on.”

7. David Addington — “Cheney’s Cheney” was the “most powerful man you’ve never heard of.” As the leader of Bush’s legal team and Cheney’s chief of staff, Addington was the biggest proponent of some of Bush’s most notorious legal abuses, such as torture and warrantless surveillance, and is a loyal follower of the so-called unitary executive theory.

8. Stephen Johnson — The “Alberto Gonzales of the environment,” EPA Administrator Johnson subverted the agency’s mission at the behest of the White House and corporate interests, suppressing staff recommendations on pesticides, mercury, lead paint, smog, and global warming.

9. Douglas Feith — Undersecretary of Defense for Policy from 2001-2005, Feith headed up the notorious Office of Special Plans, an in-house Pentagon intelligence shop devised by Rumsfeld and Paul Wolfowitz to produce intelligence to justify the invasion of Iraq. A subsequent investigation by the Pentagon’s Inspector General found the OSP’s work produced “conclusions that were not fully supported by the available intelligence.”

10. John Bolton — As Undersecretary of State, Bolton offered a strong voice in favor of invading Iraq and pushed for the U.S. to disengage from the International Criminal Court and key international arms control agreements. A recess appointment landed Bolton the job of U.S. ambassador to the United Nations, despite his stringent animosity toward the world body. Today, he spends his time calling for war with Iran.

(more…)

By |2009-01-18T23:20:04-04:00January 18th, 2009|Bush Administration|Comments Off on The Top 43 Appointees Who Helped Make Bush The Worst President Ever
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