HEALTH CARE REFORM by Dr. John Payne

The most pressing problem in the US today other than education is health care reform. Approximately 50 million people in the United States today are not covered by health insurance. 50 million more are covered by inadequate health insurance. No country spends as much of its gross national product as the United States . However, no country obtains less for its dollar then the United States . The longevity of life is less in the United States than in countries such as Cuba . This is in spite of the fact that many medications readily available in the United States are prohibited from being sent to Cuba . Also the infant mortality is less in Cuba than it is in the United States . Again Cuba has a very high black population and the problems with eclampsia that plague our black population during pregnancy. However, their survival rates are better than ours..

As an indication of the cost of medical care in the United States it has been found by corporations such as General Motors and Toyota that a midsized sedan can be manufactured in Canada for $1400 less than it can been made in the United States . The $1400 higher cost in the US is due to the higher health care costs in this country..

The employer based health insurance that exists in the United States is driven by the commercial insurance companies. The insurance companies realize that they will make their profits by covering primarily healthy people. The very people who need health care, the chronically and elderly, prohibited from being carried by the majority of commercial insurance companies in the United States . The corporations that make up the commercial insurance or insurers cannot make any excellent profit by covering site.

In the United States, approximately .30 to .33 out of every one dollar spent on medical care is involved in administrative costs rather than on actual care itself. In Canada , the administrative costs usually average approximately 3 to four cents out of every one dollar. In France , the costs are actually less than three cents. If the United States were to go to a single-payer system, there would be an immediate savings of approximately $300 billion. Administrative costs would be saved in hospitals, doctors’ offices, and in the elimination of insurance company offices.

The savings would also come about through more efficient billing in doctor’s offices. As doctors bill under different codes for various procedures, a different payment from each insurance company is made. There are multiple companies that do nothing, but coding for doctors in order to increase the fees which doctors will collect. There are also companies which go to doctors’ offices and instruct office personnel as well as doctors in the vagaries of coding. All of these procedures actually increase the amount of the health dollar, which is then involved in administrative costs. Instead of having just one code for a particular procedure, each little step in a procedure can be broken down and each step will be billed. This is called unbundling considered unethical, but most medical offices in the United States carry it out. A single payer system would eliminate unbundling and decrease costs. Single payer would give the government greater leverage in controlling costs and quality control

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During the past weeks the President and Vice President have behaved as petulant children defending their actions regarding the Iraq war. In his usual act of dressing up as a soldier or aviator, Mr. Bush, in front of his selected crowds at military bases, has stamped his feet as he attacked his critics. This testy child believed the ends (occupying Iraq ) justified the means (exaggerating the threat). The lies have led us to disaster. He knew that there were no significant weapons of mass destruction. In his speech to the National Press Club the impish Bush pranced about the Oval Office looking for the WMD’s while the sneering Cheney continued to lie about the contacts between Saddam and al Qeada. Hans Blix and elBarodelai, those discredited UN inspectors who have been nominated or won Nobel prizes, found no evidence of WMD’S. German intelligence had reported in 2001 that the reported contact between Saddam and al Qeada was a hoax. Boxed in by international sanctions, weapons inspectors, U.S. fighter jets patrolling two huge no-fly zones and powerful rivals on all his borders, Hussein in 2003 was decidedly not a threat to America. But the Bush White House wanted a war with Iraq, and it pulled out all the stops -- references to "a mushroom cloud" and calling Hussein an "ally" of al Qaeda -- to convince the rest of us “shock and awe” were necessary. The Bush spoiled scion flouted international law then and even now states his right to attack any country in the world preemptively. In the United States, he disregards his country’s laws to spy on its citizens while claiming dictatorial powers. As Huey Long said over seventy years ago, “We’ll have fascism in America only it will be called democracy.”

GOP attack dogs, even minor ones in small towns, must be loosed upon the Democrats and question their patriotism. This tactic has worked repeatedly for the Republicans for the last four years, but a number of us are tired of it. The disguised president wraps himself in the flag attacking all critics as “irresponsible”or “defeatist.” This tactic reeks of childish desperation. He claims victory is within our reach, but he never defines “total victory.” The facts are that food distribution for Iraqis, oil production, electricity generated, and potable water are less than they were during the last four months of Saddam’s government. Fact and reality have never concerned this administration. 60% of the people believe they have been misled and betrayed. As Rep. Murtha points out what this administration believes and what exists are totally divergent.

When we are rarely given the opportunity to view the coffins that are returned from Iraq, a giant Republican elephant is not stamped on any of them. The martyrs of this war are mainly small town Caucasians who have no champion like Martin Luther King to awaken the conscience of this country. The dressed up cowboy proclaims in the confines of the Rose Garden, “Bring ‘em on.” Making a mockery of his bravado, jihadists from across the Islamic world have poured into Iraq to kill our troops. The taunts from the boy king have placed targets on each American. Recently in one of his speeches while dressed in an aviator’s jacket, Bush proclaimed the cause in Iraq as a “noble one.” Ghosts arise from over 2150 coffins asking, “Why is it so noble to die when the people of Iraq do not want us there. Where was the Iraqi threat to America?” Every time an American kills wounds or arrests an Iraqi, three more insurgents are recruited from his relatives. Recent CIA reports show the insurgency is over twice as strong as it was one year ago.

Bush has won the war for Iran and is too obtuse to realize it. Already the leaders of the Iraqi provisional government are traveling to Tehran to sign agreements. The Shiite religious parties have won an overwhelming majority in the recent elections, and their mullahs are planning an Islamic republic similar to that in Iran.

Like a flippant teenager our president has been openly dismissive of the past. Glibly he says, "History. We don't know. We'll all be dead." His presidency is an effort to defy history. Now President Bush wants to erase memory of his actual record, substituting a counterfactual history. He has ignored history. After World War I, Churchill tried to establish an Iraqi state. That great defender of British Liberty, not Saddam, was the first one to gas both Arabs and Kurds. 50 years later, the British gave up, and eventually Saddam came to power. Only by ruthless terror was he able to hold Iraq as one nation because of the tribal origins and religious sects throughout the country. We, as a people, do not have the lack of integrity necessary to be an occupying power.

The decision by the Senate to investigate prewar White House propaganda has precipitated a wrathful response with the laddie claiming the questioners are rewriting history. The play general knew the intelligence was not faulty. The claims of the purchase of uranium and the Al Qaeda connections were false. Both the President and his henchmen spouted these fabrications before the Congress and the American people. The use of the intelligence was manipulated to justify the means of disposing of Saddam. Both the 9/11 commission and the commission appointed by the president were instructed not to evaluate the use of the gathered intelligence. The Republican Congress has blocked all attempts to evaluate the President’s use of intelligence. The Special Prosecutor’s indictment of the Vice-President’s Mafiosi may unloose the sack of deceptions that preceded the Iraq war. If that occurs then a true impeachment for high crimes and misdemeanors, rather than for a stain on a blue dress, will take place.

The petulant prince has reached the point that he is again frightening the nation predicting the calamities that would threaten the country if we left Iraq. Like Chicken Little, he can continue to shout the Big Lie to keep the country terrified so the right wing believes only he can save the US. Using this technique to manipulate a free press, he was able to obtain a second term. However, the moribund press is finally resurrecting its proper function in America.

Bush can no longer demand that a small percentage of the populace continue to shoulder the burden of this war. The military is becoming exhausted. If the war is winnable and worth fighting, the entire country should share in the sacrifices. This means raising taxes on the rich as well as instituting a draft to fill our depleted army. It is easy to be hawkish when someone else’s offspring are getting killed. If the Republican population will not support a true draft, then the president should know that the citizens do not believe the Iraq war is worth fighting. He should don his aviator’s suit, begin his Top Gun strut, and lead our troops home from the quagmire he created.

Like an immature boy our president brags that he never completed a book while at Andover, Yale, or Harvard (demonstrating that the correct name and money will get you a degree from our most prestigious universities regardless of achievement.) However, he must have started Melville’s masterpiece; for Bush has become a caricature of Captain Ahab-- chasing his own Moby Dick, Iraq. Hopefully the country will not follow him to his triumphant catastrophe as Ahab’s crew followed him, but will be the Ishmael of the 21st century.

But God bless George Bush. Iraq is in flames as civil war engulfs the country. How does he answer the call. He sneaks into the secret entrance of a deluxe hotel or resort and immediately joins a select few of the richest fatheads on his dad’s rolodex. He expounds his half ass policies quickly like a campus streaker, has his goons collect the campaign cash, then ducks back into his rabbit hole.

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Since the election of Ronald Reagan in 1980, there has been a definite turn where America has rewarded wealth, while taxing work and making it more difficult to fulfill the American dream. After the Second World War, and on into the 60s, the difference between the rich and the poor was not that great. Educational chances for the children of the poor or poor middle class to reach their dreams or beyond were great. Now, educational costs have become so exorbitant that only the upper middle class and beyond can easily fulfill their desires, Reagan though born into a poor family, became convinced he was a member of the aristocracy. As the late 1800’s witnessed the rise of a gilded age, the late 1900’s saw another attempt to define an aristocratic form of government in the US. This has culminated in the election of Bush and the Republicans and another attempt to destroy Jeffersonian meritocracy.
 

The last six years have proved that five wise men cannot select a decent president. Bush. along with the Republican Congress, has been the biggest failure our government has experienced in over 200 years. They have constantly awarded the richest individuals in the United States, along with corporations, excellent tax benefits. These have been to the detriment of the middle and lower classes. Only by changing the tax laws back to approximately those of the 70s will the government reward individual work again.

At present, corporations are trying to bring the cheapest wages in the world to the US. Labor unions, must be reestablished so the they will be able to fight the power of the corporations. Unions will be able to reestablish the dignity of the common man. Then, make sure he is again being paid an excellent wage.

From my point of view. my family was extremely poor. However, of five children, one is a lawyer, one is a CPA, one is they cardiac nurse, and another is an orthopedic surgeon. One of us raised five excellent sons.

I went to Yale on scholarship. I then went to medical school by working and borrowing money. My roommate at Yale, who was also on scholarship, became a chemical engineer. and entrepreneur. He put four sons through Yale and three through graduate programs at Harvard. A suite mate, who was the son of a New York cop, was also on scholarship. Later he made enough money he was able to donate $29 million to Yale.

The thing that I do not wish to see disappear from this country is the chance for someone to go from the bottom to the top regardless of their birth. The laws have changed so much in the US that multiple countries throughout the world have greater chances of upward mobility than in the United States today

As Harold Bloom has pointed out, as long as Americans vote moral values rather than economic self interests, the country will suffer debasement.

Kevin Phillips books, “Politics of Rich and Poor,” along with “Wealth and Democracy,” should be read by all voters.

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