A
battle over health care is shaping up...again. It's overdue.
"Our
health care system is failing. It is expensive, bureaucratic,
and denies care to many in need. Americans die younger, get
less care, face greater restrictions, are less satisfied, and
spend at least $1,500 more per person on health care than Canadians
or Western Europeans - nations that have opted for non-profit
national health insurance."
~ David Himmelstein, MD, Harvard Medical School
Frontline:
High Price of Health, For Patients, Not For Profits:
Any
connection to campaign financing, Clean Elections? You bet!
"The
powerful interests that dominate the health care industry could
challenge even Mr. Obama's political deftness," writes Robert
Pear, health reporter, New
York Times, 3-1-09
If
we really want affordable health care for all, we have to curb
the influence of the health care industry — influence which
flows from their immense profits, reinvested as campaign contributions
and lobbying.
Extortion
or Bribery?
This mutual back-scratching is a racket - between Congress and the
profitable industries in America, including health care. Is it extortion?
- Congress says, if you want this political favor, attend my fund
raiser and contribute to my campaign! Or bribery? - Industry says,
we'll provide a lucrative job for your wife and send you golfing
in Ireland - and if you don't play along, we'll bankroll someone
to run against you!
Either
way, it's wrong, and it must be stopped.
Sadly,
it's also the reason why the United States spends nearly twice
as much as any other country, per person, on health care. And
for all that, we have millions uninsured, and health outcomes
that lag behind other countries that spend far less.
Joanna
Garritano, MD, Seattle Post-Intelligencer, 1-10-07
"We spend twice the cost per capita compared with other developed
nations, yet are ranked 37th in overall quality, according to
the World Health Organization. Americans face higher infant and
maternal mortality rates and a shorter life span than our counterparts
in other industrialized nations that offer comprehensive health
coverage for all their residents.
"Why
do we tolerate this unstable and unjust situation? The answer:
There is still profit to be made maintaining the status quo. However
dismal the health care situation has become for individuals and
families, the for-profit health care industry still churns out
billions in profits. In a democratic nation founded on principles
of "liberty and justice for all," the health and well-being
of the many should not come second to the financial benefit for
the few."
Health
care dollars for profit - Spending we can't afford
This
is not only unfair to our citizenry - it's also crippling our
economy. Why should we burden major industries and small employers
alike with providing health care coverage - when health care is
something everyone needs, from birth to death, regardless of employment?
And
why should we tolerate a system where over 30 cents of every health
care premium dollar is siphoned off for non-health expense, such
as lobbying, TV ads and marketing costs, investor profit, unconscionable
compensation to top executives, and investor profit? Equally costly
is the inefficiency and administrative overhead of a payment system
dominated by over 1500 separate insurance companies and health
care plans.
Where
does the health care dollar go:
-
Marketing
- TV ads, promoting Rx drugs, and competing health plans seeking
enrollment
-
Executive
compensation - top CEOs receive millions in salary and stock
options
Profit to investors - return on investment averaging 10-12%
-
Costs
of mergers and acquisitions - commissions, fees, legal expense
-
Excessive
administrative cost - (inefficiency of a multi-payer system
of some 1500 private insurers)
-
Excess
spending on high-cost of specialty care rather than primary
care
-
Extra
cost of emergency room intensive care, when persons without
coverage skip preventive care until they are really sick
This
non-system begs for major reform. But logic is not driving
the debate. Instead, it's our system of "pay-to-play"
politics - a Congress that's drunk with special-interest campaign
cash and manipulated by armies of corporate lobbyists.
Real
health care reform - like most major issues - is all about power.
We must put a stop to the illegitimate influence of the health
care industry in Congress.
But
it won't be easy.
First
of all, health care spending in America represents one-sixth of
the entire U.S. economy. That is a tremendous financial motherlode!
- and a huge industry to retool. It represents millions of employed
workers, some who need to be retrained and deployed elsewhere.
It represents millions of dollars in fees, commissions and overhead,
drug patents to protect, stocks on Wall Street - all this spending,
with opportunities aplenty for plunder and profit.
And,
it's an industrial complex similar to what Eisenhower warned about
in 1961, when he spoke of the military-industrial complex.
Of
course, let's realize also that as a nation, we certainly have
the health care professionals, the medical schools, and the infrastructure,
and the money to care for everyone in America, and likely for
much less cost. Doing so is a matter of political will, not availability
of resources.
Which
gets to the second reality. The guardians of the status quo are
well-funded and powerful. Who are they? At every level, commercial
interests fatten their pockets through the huge money stream that
is health care spending in America. And they lobby Congress to
keep it that way.
In
2008, $157 million was spent in campaign contributions, and
$473 million in lobbying, by the health care industry - consisting
of HMOs, pharmaceuticals and health products, health professionals,
and hospitals/nursing homes. These amounts surpassed 2006 contributions
of $96 million, and lobbying expenditures of $375 million. Data
compiled by OpenSecrets.Org.
And
they know that health care reform might challenge their profitability:
Kevin
Baker writes about ETFs
(Exchange-Traded Funds), March 2, 2009…"Health care
companies consider President Barack Obama's budget a potential
profit-killer. Investors agreed and dumped their shares last
week, dragging down exchange traded funds."
"The Medicare Advantage plans offered by private insurers
could lose as much as $175 billion. The Advantage program is
on the chopping block because it pays 14% more to providers
than Medicare would for the same services."
Consider:
In the 1990's no one could miss the TV ads - "Harry and Louise"
- blaring that government should not stand between you and your
doctor - ignoring the obvious reality that Wall Street-directed
HMOs and insurance providers are standing between just about everyone
and their health care provider. Who paid for those ads? The health
insurance industry - the same group that has been raking in profits
for years, and who will spare no expense to continue the gravy
train.
Kristen
Gerencher, article
in CBS.MarketWatch.com
May, 2004, five years ago: "Managed-care companies look
financially healthy lately: A sample of 528 found that profits
increased 52 percent during the first nine months of last year
from a year earlier on the strength of higher premiums, according
to a new study.
"Health
maintenance organizations' profits jumped to $6.7 billion in
the first three quarters of 2003, up from $4.4 billion in 2002,
according to a Weiss Ratings study of financial statements filed
with state insurance departments. The figure is the highest
for the period since Weiss began looking at HMOs' quarterly
statements in 1995, senior analyst Donna O'Rourke said."
"It's
all profits," Dr. Hillman said, adding that a group of
doctors can make an extra $500,000 to $1 million a year simply
by acquiring a scanner. ~Dr.
Bruce Hillman, a radiology professor at the University
of Virginia.
The
real debate is health care for people
or for profit...not public vs. private
Even
government spending is hijacked for additional profit - health care
delivered in part through government programs like Medicare, where
policy-direction and the public treasury have been hijacked by commercial
interests for their own gain!
Consider
this:
Who
is served?
When Medicare Part-D was enacted, a clause was demanded by Big Pharma,
forbidding the government from negotiating lower prices for prescription
drugs. The result is Americans paying hundreds of millions more
for Rx drugs, than might be necessary - producing extra profit for
the pharmaceutical industry.
Who
is served?
Through the Medicare Advantage program, the government pays HMO's
a per-capita sum to care for patients, but then looks the other
way when they "cherry pick" only healthy subscribers (who
cost very little) to enroll, in effect dumping the sick ones (who
cost more to care for) onto traditional fee-for-service Medicare.
This has been a financial bonanza to the HMOs - with the extra profit
in effect swindled from taxpayers.
What
we have is "industrialization" of health care in America.
Health care is no longer a service profession. Instead it's become
a commercial enterprise, and the bottom line is the dollar - not
the health of the people. Insurance coverage contracts are a commodity,
bought and sold like cattle or bushels of wheat. Claims are delayed
and denied, to meet quotas and fatten the net profit.
Want
change? Support public financing of campaigns!
Until
we break the chokehold of the health care industry over Congress,
we will not see real health care reform in America.
And
it's a fight we must engage. Our lives, our health, and a sustainable
economy depend on it.
~Craig
Salins, March 6, 2009
Salins is Executive
Director of Washington Public Campaigns, working for public financing
of campaigns at every level. washclean.org
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