BILL CLINTON

Bill Clinton: GOP promotes fear over health care

 

By DAN NEPHIN (AP) – 12 hours ago

 

PITTSBURGH — Republicans have turned to terrifying people in the debate over overhauling the health care system because the GOP has no political clout to fight it, former President Bill Clinton told a gathering of progressive bloggers on Thursday.

Clinton was president when the Democrats made their last major effort to change the health care system. The big difference now, Clinton said, is that Democrats have a filibuster-proof majority in the Senate as well as control of the House.

The former president called "crazy" the charges that promoting living wills and other end-of-life planning is somehow promoting death.

Clinton spoke at the opening session of the Netroots Nation convention, a gathering of politically progressive bloggers and other online activists.

He urged the crowd to support President Barack Obama on health care reform, along with climate change legislation and other reforms.

"The president needs your help and the cause needs your help," Clinton said. "We have to preserve this progress majority now."

However, he advised them that change may not come as fast as they want and that they may have to accept smaller victories as they continue to work for their goals.

Clinton said that it was all right to hold politicians’ feet to the fire in terms of their promises but that it should be done to get work done.

"You hold the seeds of a genuine revolution in our public life and you do it by mobilizing people and generating emotion but also by getting people to think," Clinton told the gathering.

He said the United States had entered a new age of progressive politics that could last several decades in the right circumstances.

On a lighter note, Clinton joked that the great thing about being a former president was being able to whatever he wanted. The terrible thing was that no one listens, "unless your wife is secretary of state, then they really care."

It was an apparent reference to the fuss made over Hillary Rodham Clinton’s rebuke earlier this week to a Congolese student in Kinshasa who asked her for the opinion of her husband about an international economic issue.

Canadain Doctor Health care

A Canadian doctor diagnoses U.S. healthcare

The caricature of ‘socialized medicine’ is used by corporate interests to confuse Americans and maintain their bottom lines instead of patients’ health.

By Michael M. Rachlis
August 3, 2009

Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians’ services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

Our countries are joined at the hip. We peacefully share a continent, a British heritage of representative government and now ownership of GM. And, until 50 years ago, we had similar health systems, healthcare costs and vital statistics.

The U.S.’ and Canada’s different health insurance decisions make up the world’s largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact, an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two- to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn’t happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based Institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world’s best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada’s, or any other nation’s, experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn’t let us choose our own doctors. In fact, Canadians have free choice of physicians. It’s Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won’t get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

Michael M. Rachlis is a physician, health policy analyst and author in Toronto.

HEALTH CARE REFORM IN DANGER!!!

Health care reform is in trouble in the Senate.

Conservatives in Congress, including some Democrats, are trying to kill Obama’s public health insurance option not by opposing it outright, but by pushing weak half-measures and calling them “public plans.”¹ The latest is a proposal for small, regional “co-ops” that would have no chance of competing against insurance companies to bring costs down.²

If we act immediately, we have a good shot at defeating ploys like the “co-op.” The key is to make it clear that we support a strong public health insurance option and lay out exactly what that means.

Click below and we’ll fax a flier in your name (for free!) to Sens. Nelson and Martinez that sets the bar for a strong public health insurance option. Faxes come directly into the office, so staffers are guaranteed to see them. And if enough of us send faxes, staffers will pass the flier on to their senator.

http://pol.moveon.org/fax?tg=FSFL_1.FSFL_2&cp_id=967&id=16427-9668693-_CQxlax&t=3

It’s up to us to remind our senators that an overwhelming majority of Americans—83%—supports a public health insurance option,³ and that weak half-measures like the “co-op” plan are no substitute for real reform.

The flier says: “A strong public health insurance option must be part of health care reform this year,” and outlines key criteria that a plan must be based upon:

• Available to all of us: A strong public health insurance option should be available to anyone who chooses to participate. If you like your current plan, you can keep it; if you want to participate in the public health insurance plan, you can choose that.

• A national plan with real bargaining clout: In order to truly control costs and compete with private health insurance plans, a strong public health insurance option must be available nationwide.

• Ready on day one: Every day we wait on real reform, health care costs continue to rise. A strong public health insurance option with a broad network of providers right out of the gate is key to building a competitive program that will help control costs.

• A truly public plan: To ensure it’s held to the highest standards of accountability, a public health insurance option must be truly publicly run—accountable and transparent to Congress and to voters.

If thousands of us send faxes to Senate offices this week, we can make sure that message is heard loud and clear. Can you fax Sens. Nelson and Martinez today? Click below and we’ll send one for you:

http://pol.moveon.org/fax?tg=FSFL_1.FSFL_2&cp_id=967&id=16427-9668693-_CQxlax&t=4

Thanks for all that you do.