Great article. I just hope that the next time I take my kids for ice cream, they aren't denied service due to a pre-existing taste bud or due to too much lobbying from the doughnut industry (to kill the ice cream option).

See my thoughts on the Public Option and an Open Letter to the President at http://blog.poormanslobbyist.org.

http://www.billionairesforwealthcare.com/

Give me and everybody else mocha...

This is an emotional issue for many Americans.  This so-called “public option” in Government run health care presents serious challenges for us.  As Consumers we should be able to compare the cost and quality of health care services. How much is a specific surgery at one hospital, as compared with another? http://www.friendsoftheuschamber.com/media/

No trigger, exactly, because the reality of what happens with triggers, or should I say doesn't happen with triggers, they don't get pulled.  It just gives years, or decades, to the healthcare and medical industrial complexes, as well as the Congress and the President to varying degrees, to figure out, and do what they deem they have to, in order to stop the trigger from being pulled; or, delay it being pulled until there's no longer the support for it being pulled, etc..  This is a favorite with the remocrat conspiracy, because the corporate structure will pay whatever they have to, donating to the politicians, anti-healthcare public relations, so, they can determine the trigger doesn't get pulled.  Related is the insistence on "bipartisanship", which has almost sunk the world‘s, not just the nation's economy.  You see, if there are no remocrats to, "insist on bipartisanship", with, then the dempublicans don't have the excuse (the cover) as to why they're collaborating with the corporate structure against the majorities', the people's, interests, then their true intent is revealed; they want to get paid by the corporate structure- where they get exponentially more $ than the salary we pay them from.  A fair example, was Senator Harry Reid, President Barack, suggesting they might have to go with the, "trigger", in order to get Senator Snowe (white's) one remocratic vote for it; when they were just hoping they could 'get away with it', in order to get paid more by the corporate structure; yet, so far, we've not allowed them to ‘get away with it'- and we must continue   :)

Sample short letter to the editor   :)

Subject, as relates to an article in the (name of the newspaper) on healthcare reform:  Please, really reform healthcare, a strong public option is a minimum:

HI.  The clock is ticking, every 5 minutes another person dies because they do not have health insurance; someone you know might be next, soon- the time to act for real healthcare reform is now.  If you have heard something that concerns you, have a reality check on republican healthscare spin, check out Non-partisan   :) 

   http://www.FactCheck.org.

As well, please, advocate for single-payer healthcare, with Community First Choice Option and CLASS Act (Community Choice Act for the handicapped, elderly, autistic, disabled, etc.); H.R. 676 & S. 703, are the best of the lot, so far.  Thanks.  Goodbye.

Yours Truly,   (add your name, address, phone #)

reality

This morning's WAPO: http://www.washingtonpost.com/wp-dyn/content/article/2009/10/26/AR2009102603488_pf.html

I'm curious concerning Harry Ried's State opt-out option on the public plan. Are there States where a minority of voters would accept the public plan? Are those minorities so small that a majority ought to deny the option? Have any of these Senators given though to the fact that they are further polarizing and politicizing the issue by making this an issue of State election cycles?

The appeal to conservatism in making the public option more appealing to conservatives if there is a State opt-out is unfounded. Winston Churchill, no slouch as a conservsative came out in favor fo the NHS: "The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion. Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available."

It was a later strain of Tory, Thatcher & Co., in the vein of Goldwater/ Reagan/ Rand-devotees and their opposition to Medicare and public programs in general, that the NHS was somewhat hobbled and underfunded. We are facing a conservatism which has a more nouveau pedigree than their mock-originalism would have us believe. It lacks vision, ideals, progressivism, or populism and concentrates on the microcosm of the individual alone, not as part of society and community, as the highest good.

Is that a sound reason to want a State option on the public option? We already have an imbalance in Medicare across State lines, do we want to develop more disparities among Americans with respect to human needs?

To Harold, if you want examples of legal 'torture' against physicians, ask the next 5 physicians you come across.  If they are honest and alive, you will hear my point being echoed.

With regard to your assertion that health care is 'their right', this is a complex issue that cannot easily and fairly be reduced to a slogan.  See http://bit.ly/3t84KU

Michael,

Since you asserted that there is legal torture of physicians such as yourself, I would assume you can provide an example. I don't need to listen for echoes. I'll settle for an example from your experience.

As to tort reform, any offer to curb our civil rights in court must be taken far more seriously than any economic impact. The amount that actual torts cost the medical system is quite small, about 2% of aggregate cost. Nevertheless, it is possible that defensive costs, far more difficult to quantify, are not being fully considered. So, as a  doctor, what is it that you do which is wasteful and costly to patients, lowers your income, and decreases your effectiveness in order to protect yourself from the injustice of a lawsuit?

When it comes to health care as a human right, we have:

"We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all-regardless of station, race, or creed...The right to adequate medical care and the opportunity to achieve and enjoy good health" (State of Union Address, 1/11/1944, Franklin Roosevelt)

" (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection." (UN Universal Declaration of Human Rights, Article 25)

There is no complexity or sloganeering regarding the assertion of these rights. Their assertion predates this conversation by more than half a century and out of our own, great American heritage.

Hi Harold. I have performed colonoscopies and ordered CAT scans for defensive reasons, as has every other honest gastroenterologist.  I am regarded as a relatively conservative practitioner by my peers, so I surmise that my colleagues' volume of defensive studies are higher than mine.

With regard to health care as a 'right', is there no element of personal responsbility?  Does a man who won't take his medicines, see his doctor, wear seat belts, breaks speeding limits routinely, etc, still have an inalienable right to health care?  Is this fair to the rest of us?  What if we don't have enough money to give everyone 'adequate medical care'?  What happens when the individual's 'right' to health care conflicts with society's rights? Even the rights to assembly and free press are not absolute. 

"I have performed colonoscopies and ordered CAT scans for defensive reasons, as has every other honest gastroenterologist."

I can deal with that if what you're saying is that these tests left you no more or less certain of a diagnosis and were entirely superfluous. But doctors are not perfect and misdiagnoses occur on a daily basis even where extensive tests are performed. A test "just to be sure" is not a test performed defensively, it is performed to increase certainty and diminish doubt. For those of us without medical training, it isn't a question of your honesty, it's a question of your certainty.

"With regard to health care as a 'right', is there no element of personal responsbility?"

Yes, we are responsible for each other. Not every individual can take responsibility for himself, e.g.  children or the mentally challenged. But we can each look to the other and see the need. Those of us who can look after ourselves ought to in order to free up resources for those who cannot or do not.

"Does a man who won't take his medicines, see his doctor, wear seat belts, breaks speeding limits routinely..."

or isn't a vegan or at least a vegetarian, goes to MacDonalds too often, drinks coffee, drinks wine with meals, doesn't drink at all, eats red meat, goes hang gliding, drives to work, crosses busy streets, lives in an inner city, plays in a softball league, goes mountain biking, skis, or makes any choice which puts him at risk of sickness or injury...

", etc, still have an inalienable right to health care?"

Well, yes, if the right is inalienable, it can't be taken away. Judging each other keeps us divided. Life is messy and things happen, stuff goes wrong and we deal with it.

"Is this fair to the rest of us?"

What if we questioned the fairness of allowing those with political views different from our own vote and make decisions? Health care is not a reward for who you are and what you do or don't do - think or don't think. It is caring and compassion among people. You posit this as if the virtue of looking after yourself has a reward other than the benefit of good health and the ability to enjoy life that good health brings.

"What if we don't have enough money to give everyone 'adequate medical care'?"

The whole purpose for any system of economics is to distribute goods to satisfy the needs of people. If the needs cannot be met at current prices, the prices will be brought down even at the expense of others' wants. All that is essential is that costs, not desired prices, are covered. No one needs to make more than a living off of sickness or injury.

"What happens when the individual's 'right' to health care conflicts with society's rights?"

In order for society to have rights, there must be an expectation that the society, us collectively, have a claim against each as an individual. That would run counter to the tone you've set. But I would say that society is the duties we have toward each other by virtue of each person possessing sacred rights. At the top the list is our right to life. Anything that affects that right, for whatever reason, is dealt with first. Without this right, no others have any meaning. Health care is required for life.

Harold, I have reviewed your thoughful comments. For me, the issue is more complex.  Instinctively, I might also state that there is an inalienable right to health care, particularly since I am an MD.  With more thought, however, I have pulled back from this.  I do not agree with you that every individual should receive this 'right', regardless of his own irresponsible behavior.  Despite your idealistic intentions, resources are not infinite.  While I may wish for everyone to have access to health care, I am reluctant to conclude that this is a natural right.  I also wish for everyone to have a job, a successful marriage, prosperity 6 wks vacation each year, but there is no entitlement for these objectives.  Even the Constitution doesn't guarantee a right to happiness, only a right to the pursuit of happiness.  I think, Harold, that the issue is deep and goes beyond the individual.  My opinion may evolve, but at present, these are my thoughts. www.MDWhistleblower.blogspot.com

Good day to you, and thanx for all you do and don't, All. CGFC, Me, as well, your work is excellent. Single-payer is what "we,...", need, yet, with the uber-greed addict party, the remocrats, having run the roost for the previous 8 years, it's plausible that the dempublicans, the 'kind'er and gentler corporate agents, would only allow a public option to be squeezed out of them by the public; yet, we must keep up the pressure to make sure it's a real, strong, and actually a public option, at minimum. Not a half measure that will end up giving everything to the healthscare and medical industries, and cover to the dempublicans for 'trying their best'; being 'foiled' by those "dirty rats“, the remocrats- while the dempublicans, in secret, laugh all the way to the bank, having been bought by the corporate structure too, not just as much as the remocrats. No ‘trigger’, for reasons I stated above, the state opt-in is worse than a state opt-out, although, both allow the South to just move to the North, before they need long-term healthcare, meet nominal residency requirements, and get the public option on the North’s taxpayers backs; effectively, making the North pay for the whole nation’s coverage of the people who get the public option. Which might sink it, and, supposedly, give the remocrats the false ammunition to re-‘asserted “it failed because the Gov’t was involved“, etc.. Also, the remocrats bringing tort reform into this is a non-issue, as you say, yet, you’re missing some salient points. First, the remocrat doctors scream about the rising cost of ‘malpractice insurance’, because they’re doing most of it on purpose. Because, they’re mediocre, don’t care, want to charge patients more with band-aid medical ‘treatment of symptoms‘, engineering revolving door or unending patients, routinely suggest, order, unnecessary, and redundant medical tests, treatments, prescriptions, follow-up visits, etc.; for greed, not need. Second, they also are the predominant number of doctors who destroy and murder patients for political and classist reasons, for the remocrat con$piracy, mainly. Please, it’s not too late, advocate for single-payer healthcare, with Community First Choice Option and CLASS Act (Community Choice Act for the handicapped, elderly, autistic, disabled, etc.); H.R. 676 & S. 703, are the best of the lot, so far; i.m.h.o.. Related group and actions :)

http://www.singlepayeraction.org//join.html

reality

Medicaid Expansion is a Poison Pill for a Democratic Congress:

Any expansion of the so-called safety net, which includes MediCal (Medicaid) and the diabolical IMS (Indigent Medical Services, in Orange County, CA, will fail. As a nephrologist for 42 years in Santa Ana, the demographic I serve is largely uninsured, the lucky ones having MediCal. I see anyone with kidney disease whether they can pay or not, but I can't run tests, get x-rays or help from my colleagues who refuse to see the unfunded and the underfunded. And, the bureaucracy places hurdle after hurdle in front of the few doctors who are willing to see this very sick group of people. No wonder, after years of insidious neglect, they end up in crisis for an expensive ER encounter that might have been avoided. Most doctors don't like Medicare reimbursement, but we can live with it, and those of us who see the profession as a commitment and not as an entrepreneurial opportunity to nourish a profit center, will get by, complaining as we go. Fewer doctors will see more MediCal patients making a bad situation, worse! So Medicaid expansion defines a plan for failure, and a suicide pill for a Democratic Congress. The electorate, with their usual insight, fanned by Fox and the demagogues of the right, will see the opportunity for "competition," once again, and the muddled middle will switch sides.

Laura, I do not agree with you.  You seem to assign health care as a human right without any requirement for personal responsbilility.  I also disagree that the physician should assume the responsibility for the patient's health care decisions and behavior.  Every day I counsel patients as best as I can to protect their health.  But, I am not responsible if they reject sound medical advice or pursue risky lifestyles that result in illness or injury.  Before assigning them an inalienable right to health care, in my view, we must consider how this affects the rest of us, particulary as resources are not infinite.  www.MDWhistleblower.blogspot.com

Hi. Good day, and thanx for all you do and don't, All. Karoli,    You have a rational perspective, this blog is lacking, on the whole. CherokeeGirl,    Gotta admire your persistence, though, it’s a common misconception that remocrat conspirators are "just ignorant, or lacking information, and all we have to do is educate them"; they're pathological liars thinking they're garnering delusional profits and pleasures from playing political poker with the very existence of humanity and large mammals- how dangerous they are can't be under estimated. Laurence,     Yes, human rights, like most mores, ethics, morals, ethos, are based on consensus, although, if I may veer from your communication of one of the Madonna School of Knowledge’s tenets (their classic being everything is where you find it), in reality, that’s simply not true; for, the basis of all rights, while, individually, being that of comfort, needs met, and self and ego preservation, while being sociological, where consensus is fundamental, and societal, where historical realism, market necessity, and the supposed need of society to replicate itself are paramount, it is, elementally, evolutionary, universal, truth of life, discerned from the only right that actually exists in the universe- the right of life to defend itself. Also, while it may seem pedantic, or semantic, to articulate discernments in such a way, it’s not only necessary, for, as necessity may be the mother of invention, we can’t forget its father is the evolution, it’s a matter of life and/or death, on a grand scale. Not only is the clock ticking, as every 3 minutes another person dies because they don’t have health insurance, the remocrat process of ‘saying the opposite of the truth 200 million times, so, it beats your truth, being told only 200,000 times‘, as the ‘control‘, of the multi-media conspiracy is the ‘control’ of the corporate structure’s convolution’s largest consumerism addicted nation, US, supposedly, will ‘get’ them that ‘have it like that’, so, the healthscare industries can ‘get away with it’, their premeditated mass-murder masquerading as healthcare, it’s ticking on the actual existence of humanity and large mammals. For, 100’000’s of ‘scientists’ agree, the doomsday clock is at 5 minutes to the hour of humanities extinction, the point of irreversibility of the destruction of ecosystems; ergo, exact, accuracy is of the utmost import in every issue- which will, only then, pull the veil away, and the public see the remocrats pathological lying process for what it is. Yes, “why tell a truth when you can tell a lie”, “no good deed should go unpunished”, etc., can be practiced, they have ‘rights‘, yet, in spite of that being the fact, and the consensus, those rights are also wrongs; and our accuracy in communicating how might might seem to make right, while it always makes wrong, is basic to reminding people, not only of their civic, human, life, responsibilities, made exponentially more by their fathers and forefathers not exercising their responsibilities and, thereby, heaping them on their progenies shoulders, yet, also of the time, their time, their place in history- will they rise to the occasion, or will “humanity be extinct with a whimper”. In sum, the extinction is the largest and strongest ‘organizing’ ‘tool’ that humanity has ever faced, or has engineered, and the remocrat conspiracy supposed garnering of it through replacing humanity with exigency, the supposed necessity for “unending war”, etc., is what they‘re ‘all about‘, from tea baggers to moderate remocrats, to dempublicans ‘who insist “…we,…“ go down with the bipartisanship‘; and they mask their fascism in supposedly “being passionate about every issue”- while they’re just increasing the speed of their supposed Christian blitzkrieg of all life to stop the evolution from denying them the extinction they’ve engineered. The real left, struggling on every issue, for everyone, in every way , every moment of everyday, have given their lives to stop that extinction, , they think they ‘have’; don’t you let them ‘get it’; feel and relate more, be more thoughtful, introspective, insightful, and accurate, not less; remember, the machine can’t replicate if you refuse to ‘unbecome’ into a ‘part’ of it, divide and conquer can only work on the divided, the life is indivisible, 14all41- viva la evolution. As well, no trigger, for, they don't get pulled. Please, advocate for single-payer healthcare, with Community First Choice Option and CLASS Act (Community Choice Act for the handicapped, elderly, autistic, disabled, etc.); H.R. 676 & S. 703, are the best of the lot, so far. Thanx, again. Ciao.  :)

reality

the latest   :)

support women's healthcare now

http://womensrights.change.org/actions/view/support_womens_healthcare_now

As well, no trigger, because triggers don't get pulled.  Also, please, advocate for singlepayer healthcare, with Community First Choice Option and CLASS Act (Community Choice Act for the handicapped, elderly, autistic, disabled, etc.); H.R. 676 & S. 703, are the best of the lot, so far; i.m.h.o..

Related actions and group   :)

Healthcare Reform Actions   :)

http://healthcare.change.org/actions/view/healthcare_reform_actions

http://www.change.org/profile/189788/actions

http://www.singlepayeraction.org//join.html

reality