Guaranteed Healthcare

Under the theory of moral hazard, it is postulated that insured people overuse health care services and that patients themselves are a leading cause of health care inflation. If they would just have more “skin in the game” through enough cost-sharing (co-payments, deductibles and other restrictions), it is assumed that costs could be reined in.

Yesterday’s blog post by John Goodman and Thomas Saving of the National Center for Policy Analysis (NCPA) is the latest in an avalanche of unfounded assertions and distortions that have characterized the writings from this center for many years. The Dallas-based NCPA, established in 1983, describes itself as a “nonpartisan public policy research organization, with the goal to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector” (its website). This latest post puts forward, without context and with cherry-picked references, carefully selected statements that might seem to some to support their case—that deregulated markets will solve all of our health care problems. It would take a very long paper, or a number of papers, to respond to the many unfounded claims in their latest post.

At a time when so many Americans continue to fall through the gaping holes in our healthcare system, it's hard to imagine a more dysfunctional debate in Washington than the charade this week over the Republican effort to repeal President Obama's healthcare law.

By: Rose Ann DeMoro, CAN/NNU Executive Director

When President Obama struck a deal with conservatives on tax cuts, his opponents set the stage for 2012. With this legislation, the conservative agenda of the Bush administration once again becomes national policy. The goal: to redistribute wealth upward--even if that means letting the deficit balloon. By: Bealth Beat Blog

The idea of a Medicare for All type, single-payer healthcare system will be heard on the Senate floor.  Late last evening, Senator Bernie Sanders of Vermont filed Senate Amendment No. 2837, and there are two additional original co-sponsors of this amendment, Senator Roland Burris of Illinois and Senator Sherrod Brown of Ohio.

By Donna Smith

Some old adages survive because they are true.  No matter how you deliver the message – email, snail mail, voice mail, text message or old-fashioned word-of-mouth – if you forget to keep it simple and keep it local, your issue or candidate will lose.

The right-wing went into high-wind to scare seniors – a huge voting block – about healthcare reform.  And why not?  All politics is local. 

Tell a senior citizen you are going to raise property taxes for new schools and it won’t matter for even a moment that the money is for their grandkids’ education – those seniors will vote no.  Ask any number of local or state candidates for office.  Seniors, more than any other voting block, vote their pocketbooks and vote their own immediate well-being.

Don’t get me wrong, I love older folks.  In fact I am getting to be one. 

There's a fundamental lesson in collective bargaining that seems to have been lost on the White House, and those in Congress who devised their failing strategy on healthcare reform:

Don't make all your compromises before you walk in the room.

For all those now wringing their hands over the apparent abandonment of the public option and like Rachel Maddow  dissecting the train wreck of the once promising opportunity for genuine healthcare reform, it's time to ask:  what happened? who could have foreseen that semi barreling down the highway? and what do we do now?

Well, it's Sunday afternoon, and after working four consecutive 12+ hour day shifts in the ICU last week, taking care of the sickest, most vulnerable patients imaginable, I'll confess to being a bit tired and weary.  At home, I've begun sorting piles of laundry, and collecting the coffee cups that never seem to find their own way into the dishwasher.  MSNBC's Meet the Press is broadcasting in the background, and my boxer, Ginger, is dogging my heels and hinting that she'd really like to go for a walk to the park sometime today.   

My mind begins to wander back to some of the more poignant and intriguing memories of the past week. Yesterday afternoon three of my colleagues and I stood by with a 93 year old patient who was taking her last peaceful breaths less than 12 hours after her friends and family had prayed for her and said their last good-byes.  We watched her heart beat slow and then stop as her spirit left her body. We silenced and finally disconnected the monitor alarms that confirmed what we already knew.  She'd suffered a massive stroke just a few days after Christmas, and her family agreed that her wishes did not include aggressive and futile life support.  (Although a transfer to a medical bed or hospice care was ordered, none were available for her placement prior to her death.)

One of my colleagues who was serving as the designated Trauma response nurse was suddenly paged to the Emergency room.  A young man had been stabbed in the neck and was bleeding profusely. Major blood vessels were severed and the vascular team began preparing for immediate transport to the OR. The trauma room doc tried to control the bleeding by placing some temporary sutures and packing in the wound, when the young man began shouting that he didn't have insurance and that he couldn't afford to pay for any surgery. He said, "I don't want an operation, just let me go home."

Yes, he'd had a bit too much to drink, and was a danger to himself and not competent to make the decision to refuse.  The ER doc calmly explained to his young patient that he would die without the surgery.  Phone consent for treatment was obtained from his family. Two large IV's were started, and a bit of sedation was administered and emergency blood transfusions were initiated before the mad dash to the operating room got underway.  He would soon need that bed in the ICU.

And, on Meet the Press, David Gregory continued his interview of Senate Majority leader Harry Reid. Blah, blah, blah, Blagojevich, (the dish water is running), the war in Iraq...General Petraeus...the surge...and then, I heard Senator Reid express his opinion that George Bush is 'our worst president, ever.'

O.K. I thought, we all know how awful it's been. So, what then must we do?  I turned off the faucet; I was curious and began wondering, how's he going to justify his assertion?  What criteria, what example would have led him to that conclusion?  As the show was wrapping up, David Gregory fed Senator Reid a lead-in line, and it gave Reid the requisite opportunity to mention his recent book, The Good Fight.

By Donna Smith

WASHINGTON, DC –  Just yesterday, the new First Family measured the drapes in the White House just blocks from where I write this piece.  It has been but a week since we saw history as my U.S. Senator Barack Obama was elected to be our next President.  But for some of us, the joy is tempered by a reality that just won’t abate.

If I heard the candidates refer to the pain on “Main Street” one more time, I thought I might explode.  While I think most Democrats come closer to “getting it” on issues of economic disparity than most right-wing Republicans, I don’t really believe anyone yet is capable of embracing people who have been damaged and bruised as a part of the “change” we need in Washington. It may come, but we’re not there yet or they’d be acting with appropriate haste.

It is now widely recognized that we are in a global recession of historic proportions, raising comparisons with the Great Depression of the 1930s. The failures of deregulated markets, whether in housing, banking or other industries, has become obvious to all. So far the private health insurance industry has not been called to account, but its day is coming soon.