Posts Tagged ‘healthcare reform’

Gaming the System

August 4, 2013

So-called Washington gridlock appears to work for the top one percent of America.  The economy is improving, and CEOs, top management, and professionals are raking it in.  Not so, for most others. That’s probably why it continues, and there is no end in sight.

The average American has seen his income decline over the past few decades, while the affluent American has seen his income dramatically increase.   The income gap between rich and poor is about as great as it was in the Gilded Age when the Robber Barons ran things.  After an anarchist assassinated President McKinley, his successor, President Theodore Roosevelt, became concerned about a revolution and started reforms, things like anti-trust laws to break up the monopolies.  The idea was to save American capitalism by reforming it.

President Franklin D. Roosevelt, who admired and wanted to emulate his cousin Teddy, took the same tact during the Great Depression, and for the same reason some historians report, to save American capitalism.   While the Russian revolution of 1917 brought on the communist state and the dictatorship of the murderous Joseph Stalin,  and the Great Depression set the stage for ruthless dictators Hitler and Mussolini to come into power in Germany and Italy,  the United States elected a president that promised it a New Deal. He is the only president in American history to  be elected four times to the office.

From about 1937 to 1947 income inequality dropped dramatically. This was brought about  by highly progressive taxation and the strengthening of unions, according to an article in Wikipedia. “And,,” the article says,”regulation of the National War Labor Board during World War II raised the income of the poor and working class and lowered that of top earners.” The middle class was at its peak and a “relatively low level of inequality remained fairly steady for about three decades ending in early 1970s.”

No doubt, the one percent leaders understand the lessons of those times.  When things get bad enough for the masses, they will revolt, maybe not violently in every case, but they will revolt.  There are ways to keep and increase the income gap while preventing revolt, and at the same time funnel tax dollars into their enterprises. They have figured out how to game the system.

Conservatives, including the American Medical Association, fought  the creation of Medicare with everything they had.  President Lyndon Johnson was a master at getting Congress to do what he wanted and he pushed through Medicare.  It was and is a very popular program and costs a lot less to administer – compare 3 percent to 20 percent – than private healthcare insurance. 

Recognizing this fact,  the healthcare industry’s leaders, for instance, obviously now understand that the majority of Americans want the government involved in providing healthcare.  Why not give them tax supported programs, but under the healthcare industry’s terms?

A good example is Congress passing of the Medicare “B” drug plan.   That plan doesn’t  allow Medicare to negotiate prices, which could lower them, but it does help senior Americans pay for their drugs, which means that billions in tax dollars are funneled into the coffers of the pharmaceutical companies. The CEO’s of the top eleven global pharmaceutical companies were paid  a total of $1.58 billion last year.  The top salary was $40 million.  Tax dollars paid a great deal of that.

Now, in spite of all the anti-Affordable Healthcare Act or “Obamacare” propaganda, guess who is not going to lose in that scenario?  The program calls for mandatory insurance for all Americans.  The lobbyists were successful in keeping out a government option healthcare insurance plan,  That was the one sure way of lowering premiums.  Only private healthcare providers will sell that mandatory insurance.  Do the math. 

Yes, the system can be gamed.

 

    

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What Does the Future Hold for Today’s Medical School Graduates?

June 22, 2009

That was certainly on the mind of medical school graduates at a graduation ceremony I attended at Sunrise, a Fort Lauderdale suburb. My grand-nephew, Dr. Gibson Gray, was one of the graduates from Nova Southeastern University.  Keynote speaker, Florida U.S. Rep. Debbie Wasserman Schultz, told them about the healthcare changes she supports.

Being a good Democrat, she made it clear that she supports President Obama’s initiative for Congress to come up with a new health care plan.  With costs going out of sight, and about 50 million Americans being uninsured, many believe something has to be done – not that everyone wants anything done, because some are making out like bandits with the system the way it is – but the sticking point is what will be done.

Rep. Debbie Wasserman Schultz, FL (D),  Nova medical college keynote speaker, Ft. Lauderdale, FL.

Rep. Debbie Wasserman Schultz, FL (D), Nova medical college keynote speaker, Ft. Lauderdale, FL.

 
Rep. Schultz says any new plan has to ensure that no one will be denied coverage, that no policy should deny coverage because of pre-existing conditions,  that no one can be excluded from coverage, and no one looses coverage because they changed jobs, and that the government offer an optional insurance plan.  The insurance companies will, no doubt, spend many millions of dollars to kill the government option part of the plan.  The government plan would provide competition by providing lower rates, and the private insurance companies would have to keep their rates down to sell any insurance.

This can and will be debated, but a lot of people believe that the plan will not really solve the problem because it will still rely on private insurers.  Among those who believe it won’t work and who are for single-payer is the organization  Physicians for a National Health Program.  They believe that only single-payer can actually cause the change needed.  They maintain the private insurance industry is the reason that  health care in America has reached this critical stage.  On their website, PNHP.org, Dr. Fred Silver of Florida says, “This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.”  Physicians for a National Health Program is a non-profit research and education organization of 16,000 physicians, medical students and health professionals who support single-payer national health insurance.

Naturally, health professionals are concerned about how healthcare reform will affect their careers, especially recent grads who owe hundreds of thousands of dollars in college loans.  Some believe that if the government plan does lower physician compensation, it should pay off those loans.  They have a good point. 

It appears there is little doubt that Congress will come up with some sort of healthcare reform legislation.  It also appears that the healthcare industry is going to cooperate, with health industry leaders pledging to reduce  healthcare spending by $2 trillion over the next ten years.  And the pharmaceutical  industry has agreed to spend $80 billion over the next decade to lower drug costs.  Reform is probably preferable to revolution,  and, no doubt, many drug industry leaders would consider a single-pay system a revolution.  It would be.  
 
 

The Graduate

May 31, 2009

This was a very special graduation season for me, and I attended a very special graduation and celebrated it in novel, and most enjoyable way.  I’ll get around to the celebration in another blog post, but for now we’ll concentrate of the graduation and what medical professionals face in the future. 

Nova Southeastern University Healthcare Professionals Division 2009 graduation, Ft. Lauderdale, Florida

Nova Southeastern University Health Professions Division 2009 graduation, Ft. Lauderdale, Florida

I said this was special graduation for me. It’s always special when a family member you have known from birth gets to put “Doctor” in front of his name.  I flew from Columbus, Georgia to Ft. Lauderdale, Florida to attend the graduation of my nephew Gibson Gray – well, he’s actually my grand nephew since he is the son of my niece Janet Sue Gray – from the medical college  of Nova Southeastern University.  

As I sat with Gibson’s mom and dad, Janet Sue and Gordon Gray, his brothers, Schafer and Taylor, and his wife Catherine, I felt, with them, a great sense of elation.  I mean,  doing what it takes to become a physician is quite an achievement – and who doesn’t want to be able to say, “my son, the doctor,” or in my case, ” my nephew, the doctor” ?

Gordon, Janet, Catherine, Schafer, and Taylor Gray, Nova Southeastern University Graduation, Fort Lauderdale, Florida

Gordon, Janet Sue, Catherine, Schafer, and Taylor Gray, Nova Southeastern University Graduation, Fort Lauderdale, Florida

It is a tremendous acheivement, considering all of the years of study, and the tremndous costs – the majority of medical students have to  get student loans running into the hundreds of thousands of dollars – that it takes to get a medical degree.

Dr. Gibson Gray, Uncle Richard (me)

Dr. Gibson Gray, Uncle Richard (me)

Well, by George, our Gibson did it, and we are all bursting with pride.  He is not through yet, though. Now he has to do three years of residency in a hospital.  He will get paid, but it is a very low salary, and he won’t be able to pay back any of the loan until he finishes that.  

Naturally, he and his family, and all of the medical graduates and their families, are keenly interested in what will happen to healthcare in the United States.  It’s for sure that something is going to happen.  The American people put it at the top of their list of concerns about the future.  Costs have gone out of sight. 

The issue was not ducked at the Nova Health Professions Division graduation ceremony. It was squarely faced by Florida Democratic Rep.  Debbie Wasserman Schultz, the keynote speaker.  We’ll look at that it in a future post.  Stay tuned.