Killer Politics (9 page)

When it has been tried, socialized medicine has worked. Take Medicare for instance. Could you find ten retired Republicans in America willing to give up their Medicare benefits? Of course not. Not even the dozens of congressmen on Medicare would give it up. So what's the big argument about? This one was decided long ago. Opponents are wrong now and they were wrong in 1964 when LBJ delivered on Medicare.

In 1964 the Saint of Conservatism, Ronald Reagan, blasted Medicare in a speech. “Will you resist the temptation to get a government handout for your community? Realize that the doctor's fight against socialized medicine is your fight. We can't socialize the doctors without socializing the patients. Recognize that government invasion of public power is eventually an assault upon your own business.”

Let's break that down.

Handouts for Whom

Who's really getting the handouts in our health care system? In 2003, President George W. Bush drastically expanded the Medicare program with Medicare Part D (which subsidizes prescription drug costs for Medicare recipients), which I guess was OK, although it was as much a benefit to elderly Americans as a license to commit highway robbery for the pharmaceutical companies, which get to sell drugs under the program without any pesky negotiations to drive down prices. Oh,
that
was fiscally responsible.

Socializing Patients

I guess Medicare makes Grandma and Grandpa Commies. I'll bet if you check the closet, you'll find a statue of Karl Marx. Well, you had better hope Grandma and Grandpa have plenty in the bank, because according to Fidelity Investments, retiring elderly couples will need $250,000–$300,000 in savings to afford most basic medical coverage.

An Assault on Business

Are you kidding me? The assault on businesses has been the inability to be competitive while shouldering employee health care costs. From a competitive standpoint in the global economy, doesn't it seem ludicrous to expect our businesses to start in such a deep hole? The natural reaction is for businesses to relocate, taking away American jobs, in the interest of competitiveness. Yes, there are all sorts of other factors, from tax havens to the disparity in environmental regulations, but, ironically, the burden of health care has become unsustainable for the free market to bear.

According to Micah Weinberg, a researcher and expert on health care reform for the nonpartisan New America Foundation, “American businesses—large and small—are being hamstrung by soaring health care costs that are more than
twice
those of foreign competitors.”
Twice?
America can compete in a global economy, but the days have long passed when we could afford to spot every competitor that many points.

As far back as 2005 General Motors was spending more on health care costs (over $1,500) per car than on steel! That's an unreal advantage to foreign carmakers. Didn't anyone see this coming?

The brilliant Bill Clinton, who has an uncanny way of cutting to the heart of the issue, told Jon Meacham in a 2009
Newsweek
interview that the difference between what the United States spends in GDP (17 percent) on health care and what other industrialized nations spend, the average 6 percent difference, amounts to giving them a $900 billion competitive advantage!

It should be so simple, yet some conservatives are so dug into their dogma that they can't see that the policies they support are the ones killing the free market and the independent businesses they claim to revere.

UNCHECKED CAPITALISM CREATES NEGATIVE SOCIALIST OUTCOMES

Between 2000 and 2007, the average worker's insurance premiums grew
twice as fast as his or her wages.
During the same time frame, according to Joseph Antos of the American Enterprise Institute in Washington, premiums for employer-sponsored insurance jumped 98 percent—four times faster than wages.

This employee-based system has led to workers chasing benefits from job to job, not necessarily doing what they love or are particularly good at. Common sense tells us that this is no way for any society to thrive. Think about it. Poorly regulated capitalism has forced Americans into jobs for which they are ill suited, which is one of the great fears people have of socialism. Paradoxically, if we free workers from taking jobs based on whether or not that job provides health care, we strengthen capitalism because we encourage people to do what they are best suited to do.

CAREENING TOWARD INSOLVENCY

“You can't fix the economy without fixing health care,” President Obama has said. While I have been critical of the White House strategy on health care reform, I do understand what an incredibly difficult lift this is. Had he not inherited such a wretched economy and massive debt, President Obama could have passed much more substantial legislation because he would have had the money in the bank to make the initial investments. Instead, he had to settle for reforms that were immediately budget neutral or that promised savings. Had Bush II been held to that standard,
Medicare Part D, which Republicans passed despite its $1.2 trillion price tag (over ten years), would have been sunk. As it was, the unfunded plan floated away in a sea of red ink. Because Bush wrote all those hot checks then, average American families are paying the price now.

Before the Democrats took on health care reform, the New America Foundation projected that health insurance in 2016 could cost $20,400 annually for a family. Some will say if we are paying anything less than that in 2016, it is a victory. If so, it's a small victory, and I don't plan any kind of celebration in the end zone. The tiresome term used during the health care debate was that proponents wanted to “bend the curve” on costs—in other words, tamp down the
pace
of the increases.

The reality is, even with the consumer protections in any new health care legislation, there just isn't enough leverage to bring about any kind of immediate relief for most people. Families will probably still see their costs rise—but at a slower rate than had this runaway train been allowed to keep rolling. Under the proposed legislation under consideration as this book went to press, Americans will no longer be denied coverage, but what we don't know is how high rates will go. Can we expect real competition? Will we finally have a country in which getting sick doesn't mean financial ruin? Folks, it's too early to tell.

According to a Harvard and Ohio University study in 2007, medical-related expenses triggered almost two thirds of all bankruptcies in the United States that year, a 50 percent increase from 2001. “Our findings are frightening. Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy,” lead author Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School, said in a news release.

Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and coauthor of the Harvard and Ohio University study, said, “Only single-payer national health insurance can make universal, comprehensive coverage affordable by saving the hundreds of billions we now waste on insurance overhead and bureaucracy.”

Sadly, as the health care debate unfolded, we could see that most Republicans and some Democrats—enough to screw things up—were more concerned with the health of health insurance companies than they were about American workers.

Here was the response of Representative Eric Cantor (R-VA) in a town hall meeting after hearing about a woman who had recently lost her job and her insurance and then discovered that she had stomach cancer: He encouraged her to look to “existing government programs” or “charitable organizations.” Maybe she could get a tin cup and beg on the streets.

Representative Alan Grayson (D-FL) said sarcastically during a speech on the House floor, “Don't get sick. If you get sick, America, the Republican health care plan is this: Die quickly.” The failure of health care reform to cover everyone does kill, and the sad thing about the new health care legislation is that it will not cover some 23 million Americans.

A family that falls between the cracks and is living hand to mouth in a tough economy can't afford cancer screening. Too many people wait too long for treatment because they cannot afford it. How many victims of our for-profit health care system will we accept before we finally do the right thing and embrace universal care?

Think about this: During the past eight years, there's been about a
428 percent increase in profits
for the insurance industry giants, while middle-class families have been getting financially butchered—and the Republicans want to blame big government!

This is not America.

This is not the country I grew up in.

Fairness left the building with Elvis.

SO MANY PILLS, SO MANY DOLLARS

Let's take a look at the whole way we approach pharmaceuticals. Lobbyists have fixed the game against American consumers. Nowhere is the fix more blatant than in the Bush Medicare prescription plan for seniors.
The law is specifically written to deny the government the right to negotiate prices. Tell me, is that capitalism or theft?

Pharmaceutical prices are much higher in America than around the world because American drug companies charge what they can get away with—and they can get away with a lot. In fact, with health care legislation brewing, drugmakers raised their prices more than
9 percent
in 2009, according to the
New York Times
. In that story, Harvard health economist Joseph P. Newhouse said he found a similar pattern of unusual price increases after Congress added drug benefits to Medicare: “Just as the program was taking effect in 2006, the drug industry raised prices by the widest margin in a half-dozen years.”

In countries with some kind of socialized medicine, such as Canada, the government negotiates drug prices. Senator Byron Dorgan (D-ND) offered an amendment to the health care bill to allow Americans to buy prescription drugs from Canada, but it was quashed. He says, “The Lipitor that is sold in Canada is
one half
the price of the identical bottle of Lipitor purchased in the U.S. by American consumers. And the same is true for most of the brand name prescription drugs.”

The simple solution, according to Senator Dorgan, is allowing the American consumer to take advantage of the global economy. “I'm talking about allowing FDA approved drugs produced in FDA approved plants overseas,” Dorgan says. “The same pill put in the same bottle. How can that be unsafe?”

MEDICAL TOURISM—OUTSOURCING SURGERY

People have always traveled to other countries for medical procedures, but in some cases today—it's sad to say—traveling to another country may be the most affordable (and so, sometimes, the only) option. In many places, the quality of care and outcomes are equal to or better than our own. Heart bypass surgery, easily a $100,000 procedure here, costs $12,000 in Thailand. A $25,000 hip replacement in the United States can
be done in India for a fourth of the cost. As long as we are unable to lower medical costs for Americans, “medical tourism” is going to be part of the answer to our health care crisis.

Of course, even this is affordable only to the upper middle class. It's wonderful to have the option of having your dental surgery done on a tropical island, but what a sad state of affairs to realize that in the richest nation on earth, some citizens must travel to other countries for humane and affordable medical treatment. If you can't afford the price of a plane ticket, I guess you just endure.

OTHER COMMONSENSE STEPS TO A HEALTHIER AMERICA

We need to attack this health care crisis on all fronts. For one thing, we need a national focus and program on fitness, starting with our schools. Physical fitness is not the priority it needs to be. Today's kids are not as active as previous generations. Heck, if I had owned an Xbox 360, my butt might have been parked in front of it, too. But it wasn't an option. We played baseball and football in the neighborhood. If we make a commitment to physical activity and education in our schools, it will make a dramatic difference down the line. Our kids will be healthier, live longer, and pay less for health care as they age.

I know health insurance companies “grade” individuals based on age, weight, and other benchmarks to arrive at a premium price. I wonder, though, if we could implement a system of rewards for those who take part in exercise programs or adapt other measurable lifestyle changes. The idea is to give the consumer a real say in lowering the cost of insurance. I know this is an idea big businesses have been successful with—rewarding employees for lifestyle changes, which means healthier employees and fewer sick days. It also saves the company money.

The
Wall Street Journal
reports, “Syngenta's U.S. staffers collect as much as $250 a year for taking part in annual health-risk assessments,
exercise classes and similar wellness activities. When officials distributed T-shirts to introduce the program in 1998, obesity was so widespread that they ordered many sized XXXL. Syngenta said the [wellness] program helped lower its average annual health-care inflation to 8.9% between 2005 and 2008. That's less than the 9.7% average annual rate for all U.S. employers.” The company included spouses in the programs after discovering that spouses' claims exceeded those of employees by 30 percent.

Can we apply some broad criteria—a national wellness program—so that small businesses and individual policyholders can reap similar rewards? What a marvelous way of encouraging fitness and saving. A national wellness program will save trillions in generations to come and may be the finest legacy we pass on to our children and grandchildren.

And we need to stop protecting the tobacco industry and allowing them to purposely make their cigarettes more addicting than heroin. I'm not ready to ban tobacco or coffee or, for heaven's sakes, a cool one after eighteen holes, but this insidious practice of purposely making a product addictive, which they do, is immoral, and those predators need to be shut down
yesterday.