Posts Tagged ‘Howard Dean’
Too often have I written about the endgame.¬† Shades of Mark Twain — reports of my death are exaggerated.¬† But this really is the ninth inning.¬† The problem is the president is looking for the long ball — the out of the park home run.¬† When he should have been hitting singles, or emulating the great Joe Montana — short yardage high percentage gains — not Hail Mary passes.
Ave, Imperator, morituri te salutant
The secret fate of all voting democratic House members.¬† The arm twisting in the house rises to epic proportions not seen since the days of the infamous Tom DeLay – the Hammer.
This will be a bad bill.¬† You are all unwitting pawns in this game.¬† It will solve nothing.¬† It cures nothing.¬† It has emboldened the insurance racketeers and Big Pharma.¬† It has only one potential good outcome — Rush Limbaugh has promised he will leave the country.
They have rolled Howard Dean and Dennis Kucinich.¬†¬† Other voices have been marginalized – Bernadine Healy, Robert Reich, Norman Goldman of Talk Left, Marcia Angell. And who will benefit from a fatally flawed passage?¬†¬† The rising unaffiliated — the independent vote.¬† This is a Greek tragedy.¬†¬† A Pyrrhic victory.
We are all too aware of the right wing echo chamber.¬† A well orchestrated score promoting stereotyped rat a tat answers.¬†¬† How do they do this?
The same may be true in on the left as well.¬† We hear platitudes and assertions over and over again without challenge.
1. United States ranks number 37 in the world in healthcare.
Why repeat this assertion over and over and over again?¬† Because it makes a false point.
This figure is derived from life expectancy in the OECD¬† (organization of economic cooperation and development) countries.¬† The spread is narrow – less than five years.
My friend Burton Goldberg, one of the most successful publishers of alternative medicine, constantly beseeched me on this issue — investigate life expectancy derivations.¬† Life expectancy is a highly complex mathematical formula that balances death with infant mortality.
A country with a high infant mortality has a lower life expectancy rate – at birth.
For the most perplexing reasons, the United States still has a relatively high infant mortality rate.¬† If the figures are adjusted for life expectancy after the age of 60 we rate number 5 in the world.¬†¬† If life expectancy figures are adjusted after the age of 80 we rate number 3 in the world.
In other words, as we advance in age, the effect of infant mortality is factored out and the real life expectancy becomes more apparent.¬† We are not number 37 in the world.¬† We are in the top three.¬† Life expectancy figures beg a revised definition.
Furthermore, life expectancy is a dreadfully¬† inadequate measure of the health of a nation.¬† It says nothing about the quality of life.¬† HDI, (Human Development Index) may be a better measure.]¬† It says nothing about vibrancy, activity, mental health, social health, sexual health, or productivity.¬†¬† It simply means that you crossed the finish line at a particular age.¬†¬† No matter whether you dashed across or fell across the finish line and died.
In Anti-Aging Medicine, we talk about “squaring the curve.”¬† Increased Health Span and not Life Span.¬† A healthy life until old age followed by sudden death.¬† Not a slow inexorable painful march to the end.
2. The medical system suffers from over utilization.
Not as I see it.¬†¬† Quite the opposite.¬† I see scores of patients who have pleaded for years for adequate and thorough lab testing only to needlessly suffer through unnecessary dysfunctional states¬†¬† This is a natural consequence of HMO and PPO medicine.¬†¬† Bottom-line cost-recovery medicine is a zero sum game.
3.¬† If you do not pass this bill everybody will end up in the emergency room.
There is such an appalling lack of medical input in this entire debate.¬†¬† Urgent care medicine had its roots in the 1980s.¬†¬† Originally funded and promulgated by astute entrepreneurs and ex-emergency physicians, these facilities answered the need for acute medicine outside of an emergency facility.¬†¬† There are more than 8700 Urgent centers visits vs. 4600 emergency departments.¬†¬†¬†¬† [And by the way, Emergency care represents less than 3 percent of the nation's $2.1 trillion in health care expenditures while covering 120 million people a year.]
This is market-oriented medicine.¬† A workable and elegant solution in response to a market demand for immediate care outside of exorbitant emergency rooms.¬†¬† They are successful and see all comers.¬†¬† In Atlanta alone, my good friend Jordan Rice, one of the leading Urgent Care entrepreneurs in the country boasts of the ability to see any and all comers — Medicaid and cash paying patients.
Even the original Medicare bill of a 1965 garnered 13 Republican votes in the Senate and 70 Republican votes in the House.¬† To pull every legislative trick in the book only underscores the thinness of support for this ill-conceived rewrite of our society.¬† To be honest, Michelle Obama’s anti-obesity campaign could have more far-reaching effects that all 2700+ pages of this legislative lunacy.
Half a loaf?¬† No, worse.¬† Here is your pre-Christmas present — a big lump of coal.¬†¬† Let me simplify and make clear my assertion.¬† You are ill, in need of medical care.¬†¬† You want the best. ¬† Whose wise counsel and help do you seek? ¬† You want someone who is sympathetic, skilled and competent.
This debate has never been about Health. ¬† Certainly not your health.¬† For the last six months I have steadfastly maintained the large insurance racketeers will not lose this one.¬†¬† They have thrown all their money into the ring.¬† It has paid off handsomely. Their paid surrogates have performed well.¬† Like their Wall Street kin, the pirates have won again.¬†¬† Robert Reich pulls no punches:
In other words, the private insurers are winning and the public is losing.
Pharmaceutical companies are winning as well.
Howard Dean at his most articulate and unambiguous self.¬†¬† The time has finally come. ¬†¬† There is nothing left to support.¬†¬† It’s now face saving time.¬†¬† It is not about Joe Lieberman.¬†¬† He’s just become the Mannie Ramirez of the Senate.
“It’s not health care reform … and it’s too bad it’s come this.”
“You are going to be forced to pay, on average, 27% of your money to pay CEOs $20 million a year…”
[starts at about 4:08 into this clip]
As I wrote many weeks ago, the health insurance industry will not lose this battle …¬† any more than the too-big-to-fail Banks have … all at immense public expense.
Max Baucus‘ political contributions from the health care and finance industry are well documented.¬† Now they have enlisted Tom Daschle and Bob Dole.¬†¬† What a pair — Tweedle Dee and Tweddle Dum.¬†¬† I have never understood what qualified Tom Daschle as a health care expert?¬†¬† His ties to the industry?¬† A deposed ex-Senate Majority Leader?
Joseph Campbell first offered this sage aphorism:
“If you want to change the world, you have to change the metaphor.” - Joseph Campbell
The president subtly changed the metaphor this morning in a major financial address.¬† Instead of the phrase health care reform he used the phrase health insurance reform.¬† Ah , now we are framing the right debate. Was this metaphorical or strategic?
We have argued for months now that this is not about health care reform.¬† Want real health care reform — you change the paradigm.¬† Read Deepak Chopra’s OpEd this morning in SFGate. Then read all our past and future posts.¬† The advent of the 21st century is quickly evolving.¬† Old paradigms, companies, and entire industries are vanishing.
The current debate is about economic reform.¬† And economic reform is about insurance reform — catastrophic economic reform.
If health care is central and vital to the health and well-being of the nation, then health insurance should be regulated as a utility.¬†¬† As if Dr. Howard Dean had been following our very advice, just yesterday on Meet the Press, he offered the same prescription:
There’s another way.¬† There’s two countries in Europe that have universal health care without–and it’s entirely run by insurance companies.¬† But they treat the insurance companies like regulated utilities.¬† If the insurance companies would prefer to be treated like regulated utilities, we’d drop the public option in a heartbeat.
– Howard Dean
This graphic from the morning’s news even better.¬† Shows that the administration may be serious about the fundamentals of a healthy economy first.