Theory of a “few bad apples”

The recent decision of AG Eric Holder to investigate CIA crimes limits the scope to only those who may have exceeded the Bush Administration’s legal guidelines on torture. This implies that there were simply a “few bad apples” who intentionally broke the law. In the end, if the only ones who are prosecuted are lower level CIA operatives, this will be a gross miscarriage of justice. The “few bad apples” theory may be correct; however they were those who authorized the activities in the first place. Perhaps this is why Mr. Cheney continues to vigorously protest these investigations. In the words of William Shakespeare: “Me thinks he doth protest too much.”

Healthcare Reform or Lobbyist Rhetoric?

Why we need healthcare reform and not irrational rhetoric

After reading the recent letters to the editor which simply parroted the insurance industry talking points designed to either stop or water down healthcare reform, I was struck by the fact that people are not looking at the real issues. Some members of Congress and their industry-paid lobbyist allies insist that we have the best healthcare system in the world, but in fact, our current system screams out for much needed reform. The organized effort to misdirect the conversation away from the real problems is counterproductive to resolving an impending healthcare crisis. Perhaps most members of Congress have relied for too long on their government-run health insurance to realize the problems that ordinary people face in trying to maintain their own health insurance. Instead of focusing on the real issues, they are disseminating misinformation about euthanizing senior citizens, paying for abortions, and putting government bureaucrats in-between you and your doctor. Here are the undisputed facts which can not be ignored which are available from independent sources:

*Nearly 50 million Americans do not have health insurance, and another 25 million are underinsured. Furthermore, all Americans are at risk of loosing private employer based coverage which is currently not portable when you loose you job.
*The cost of COBRA insurance (continuation of benefits from your old job) is unaffordable for most people who find themselves unemployed. Typically the employer will make the coverage available as required by the COBRA law, but they set the rates so that the former employee is paying 100% of the cost.
*Temporary health insurance policies available through private insurers are nothing less than the health insurance equivalent of predatory lending practices that got our nation into the current economic mess. These generally exclude all pre-existing conditions, so in practice they are really only available to healthy people. They also require huge deductibles and are only in effect for short terms up to a maximum of 90 days.
*A typical family health insurance plan now costs $12,000, but because employers typically pay about 70% of the cost, even those who have health insurance through their employer often don’t realize the true cost of their insurance.
*The current trend towards the so called “high deductible” plans which lowers the premium in exchange for people self-insuring more of their risk with health savings accounts simply shifts the cost of healthcare from the employer to the employee.
*The US spends more per capita on healthcare (twice as much as most other industrialized nations) and yet ranks only 19th in preventable deaths and 37th in overall performance according to the World Health Organization. In just a few years, healthcare expenditures in the US will exceed 20% of GDP.
*The annual increases of healthcare costs (average 7%) far exceeds the annual growth in real wages and is unsustainable not only for individuals but for the government’s programs like Medicare and Medicaid. Medical expenditures account for over 23% of the US federal budget and this will only balloon as the baby boomers reach retirement age and become eligible for Medicare. State governments are also dealing with the cost of increased healthcare spending as a larger part of their budgets. These same annual trends are making it increasingly impossible for business both large and small to offer medical benefits to their employees. In a globally competitive economy, this increasing cost of healthcare puts US companies at a global competitive disadvantage.

These are all symptoms of a broken healthcare system. Some would even argue that it is such a mess that it can not even be called a system because it was never designed as a system, but simply evolved over the years. Whether you agree or disagree with the characterization of the “system,” no rational person can objectively look at healthcare in the US and conclude that we are getting our money’s worth. Said another way, we are collectively getting taken to the cleaners by the current healthcare “system” as we pay premium prices and get inferior outcomes. This should be the true outrage.

This is not meant to disparage the thousands of dedicated health professionals who are tending to the sick and injured everyday; however, the collective “healthcare system’ run by insurance companies and corporate interests is more focused on financial performance than patient outcomes. This paradigm will not change unless we get some real reform, and not some watered down version of expanded private health insurance promoted by the industry lobbyists.

Here are some solutions that would have a significant impact:
*Standardize healthcare administration.
*Restrict the use of television advertising for prescription drugs.
*Change the law and allow the government to negotiate with drug companies.
*Implement a universal health insurance requirement.
*Implement a public option and restrict the ability of private insurance to deny coverage or terminate policies for frivolous reasons or pre-existing conditions.
*Increase enforcement of fraud prevention and fully prosecute perpetrators.
*Increase funding for medical scholarships and expand public universities to matriculate more medical students.
*Implement managed care programs for people with chronic diseases.
*Experiment with changing the business model from fee for service to salaried providers or payment for outcomes.

These are just some of the ways to really address the issues of healthcare reform short of a single payer system. Changes like these still leave the private sector ample room to run their business profitably, albeit with some different operating parameters. Opponents of healthcare reform are absolutely correct about the need to control costs, but they offer no concrete solutions other than disseminate misinformation like killing senior citizens. That is simply a manufactured distraction with the sole purpose of not killing seniors, but killing anything that resembles real reform. Don’t let them scare you. It is simply an effort to just maintain the status quo for the special interests who profit from the current inefficiencies of our broken system. This is the time to make changes, and if we don’t do it now, then when?