Steven Brill, author of the well-known 2013 Special Report, Why Medical Bills Are Killing Us, in Time magazine has just released his new book, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System. (1) Based upon in-depth reporting of interviews with more than 240 people involved in various ways across our health care industry, he gives us an inside look at how the Affordable Care Act was written, passed, implemented and changed over the last five years.
From the article:
"All the other rich countries have found financing models that cover everybody and they still spend much less than we do. We’ve ignored those foreign models, partly because of “American exceptionalism”—the notion that the United States has nothing to learn from the rest of the world."
Some solid points have been made in this essay-analysis, but the above diagnosis is way off, Doc.
It's the control by corporations that drives the agenda. American Exceptionalism is useful as justification to those who have already purchased candidates and lawmakers so that these paid puppets will do THEIR bidding.
It's no mystery that Obama's campaigns for the Presidency picked up a great deal of financial support from the Insurance sector, and like any good game of quid pro quo, he owed ;em. Hence: picking up and repackaging the market-driven forced insurance pay system that was modeled after Romney's program in Massachusetts.
In parallel, it's not American exceptionalism that drives U.S. foreign policy... it's the MIC, that same entity that Ike noted was already showing undue influence back in l960! Think of all the trillions hemorrhaged into weapons programs, foreign bases, the training of soldiers--mercenary and traditional.
The decisions reached are about power and profit and both purchase boatloads of influence.
In so many important areas Truth is being lost and replaced with narrow jingoistic frames repeated often. They are but veneers over the deeper darker motives driving this nation's agenda.
...Having read the final paragraphs, I see that the Good Doctor DID notice these things:
"We still need to ask more fundamental questions before we can see how to go forward with real health care reform, such as: who is the health care system for? (our current answer is the profiteering, mostly corporate stakeholders, not patients and their families); should health care be just another commodity for sale on an open market?; and is health care a personal right (as it is in most advanced countries), or a privilege based on ability to pay?"
Whenever I hear "market-based system" related to health care my hackles go straight up. Profit-driven, yes. Market based, no way.
If we had a market based system, physicians would not be harrassed and persecuted by medical societies when they commit the "crime" of treating patients with natural medicine plans and protocols. Even when patients are healed the only thing that matters to these arrogant fools is that the therapy is "not approved".
--People would be able to choose their own physicians and treatment plans.
--Everyone would have a health savings account, including Medicaid and Medicare recipients who choose to do so. Medicaid would provide the cash in the account for those people. The money could be spent on any licensed health care professional, even those the AMA hates. The money could also be spent on supplements.
--The FDA would stop declaring food and nutrients to be drugs. Supplemnents or foods such as cherries (the FDA threatend to declare them drugs if the producers didn't stop telling people about research on cherries, showing them useful in gout. Remember, most supplements except the weight loss ones are simply nutrients that people are not getting in their diets or cannot get enough of based on individual needs. When healing, one also needs far more of a number of nutrients than can be had with food, the amounts needed fall as healing occurs.
The medical profession does a good job on emergency care and necessary surgery. Past that, the healthiest thing to do is stay away from them or find the rare practitioner who doesn't push drugs and stays under the radar.
Dr Geyman should talk to Donald Miller, MD a recently retired cardiac surgeon in Seattle and to JV Wright, MD whose Seattle practice had provided natural medicine care for over 40 years.
" He cavalierly dismisses this alternative in these words: [My proposed regulations are] 'certainly more realistic than pining away for a public single-payer system that is never going to happen.'"
This ruse is often used by those opposed to single payer systems. That is, dismiss even the possibility of such a program as being pie in the sky. I'll never forget, way back in the day, on Public TV, the infamous Kokie Roberts dismissed any attempt at bringing single payer into the conversation when the Clinton Administration, wiith Hillary at the helm, tried to square the circle but ended up with an unworkable Rube Goldberg monstrosity that never saw the light of day. It works, if people believe it is impossible, then it is impossible. Where in his proposal does he, Brill, address the 40 million still uninsured under the ACA.
Market based - means provision of services based on ability to pay, not on basis of need ...means competition, not co-operation in the provision of those services ....
We have thought too long that healthcare is a commodity that lends itself to the tender mercies of the market, as opposed to a fundamental right that should be provided as a matter of need ..
Healthcare does not belong in "The Market" at all ...
Brill still seems to be enthralled with the essence of the "American Exceptionalism" motif - anything worth doing should be left in private hands ....
We got Medicare, for Pete's sake - perhaps one of the most successful "Gov't" programs of all time - seems to me a no brainer to simply extend it to all ....
Yup - you nailed it, convincing folks that something is "impossible" (another ex., "3rd parties can't win") is a self fulfilling prophecy ....
affordable care act can control costs and it is
single payer is better, but people on the left need to understand they are part of supporting getting rid of affordable care act and having it replaced with 60 million uninsured, again
Any solution that leaves the insurance companies in the driver's seat is unsustainable. Indeed, the Institute of Medicine declared 8 or 10 years ago that the medical care system in this country is unsustainable in the 21st century. Our system is such, however, that a system equivalent to improved Medicare for all must first be enacted in a state or two. Politicians must see that they can survive by embracing it and it must be shown to save money. About twenty states are working on such programs. SPANOhio(.org) is working toward that goal.
Nothing surprising about this guy Brill's proposals. He simply has, like all policy-wonks a terminal case of neoliberalism on the brain. The more efficient systems of Canada and Europe and especially the UK's NHS, would be utterly impossible to implement in today era of stampeding capitalist triumphalism - and indeed many of them are being dismantled or deliberately funding-sabotaged by the governments pursuant to dismantling - Harper/Cameron/Abbott in the Anglo-world...
Sorry, but the capitalists LOVE pseudo-science snake-oil medicine. It is a huge growth industry. And the capitalists- especially the banks - also LOVE "health saving's accounts" (earning no interest to the account holder of course) and other "consumer-driven" healthcare - so people can shop around for great cheap bargains in ER's or cardiologists when they are having a heart attack or stroke.
We need free health care for all - and the health care should be science-based.
You actually believe that medicine is science based? Does that include research studies that are projected by a computer and published as actual research? What about all the undisclosed research when it contradicts the politically correct or economically correct beliefs? According to the Institute of Medicine, getting sunshine is dangerous.
Real snake oil is very high in omega-3 fatty acids and would likely be beneficial with arthritis, depression, heart disease.
Modern medicine is addicted to drugs. Drugs CURE NOTHING. They only treat symptoms, while the problem festers.
Why do people always throw things like heart attack, stroke, gall bladder attack, etc at me? I am very clear that emergency care and necessary surgery are areas in which modern medicine excels.
5, Consumer driven healthcare means to me that we choose the type of medical care we prefer and the government does not interfere.
- So, capitalists love "pseudo science snake oil medicine". Of course they do, they love anything that is exploitable, like controlling our food supply but that doesn't make choosing chemical free food a mental disease (As the APA has done)
I'm sorry, but you appear ignorant of the reality of the Medical Monopoly. I, too, believe that everyone should have access to health care, it's just that most useful services exist outside the monopoly and the monopoly uses centralized systems to maintain their own profit.
You might be interested in Robert Mendelsohn's 1974 book "Confessions of a Medical Heretic" or Ivan Illich's 1974 classic "Medical Nemesis". There are new books by new MD's about this. I use the old references because the idea that the medical profession is mostly charlatans is not new. Check out drmercola.com and search science based research for an eyeopener.
"Brill’s meticulous and well documented reporting of our system problems falls apart when it comes to fixing these problems": I could not agree more and was VERY disappointed in his conclusions not to see the solution to this mess-- Single-Payer or, better still, Socialized Medicine.
"[My proposed regulations are] certainly more realistic than pining away for a public single-payer system that is never going to happen.": After I read this I wondered how would HE know it will never happen?
Aquifer, I see market based as free choice. New ideas come into the market and people have to have access to information and the right to choose. Anything else is a monopoly enforced by the gov't.
I have said many times that everyone is entitled to health care, but the problem is that the so-called "health care" we think everyone is entitled to is actually a pile of C***. I will repeat myself yet again, if the need is emergency care or necessary surgery .modern medicine excels. It's the drug based, drug driven system that ignores the reality that, given the right conditions, the body's ability to heal itself is unexcelled and that we are all biochemical individuals. All healing comes from those two premises and the goal is balancing and normalizing systems. .
PS I tried to respond to you in early January regarding your comment to me that many of your views are incompatible with those of libertarians. I would not disagree, but since our conversation was about forging alliances based on commonalities I wanted to suggest that, if you have the time, you could explore the "LRC Blog" on lewrockwell.com I think after a few pages you will certainly read things that make your blood boil but you will also see more commonalities than you may have thought.
AGREED-- "so people can shop around for great cheap bargains in ER's or cardiologists when they are having a heart attack or stroke." This really DOES happen.
How true. Health Insurance Companies will often more readily pay for drugs than necessary surgery and why a good number of people go overseas for surgery who actually HAVE health insurance.
Aquifer: I replied to your reply to me but somehow it's listed as a reply to myself. I wrote, in part: " PS I tried to respond to you in early January regarding your comment to me that many of your views are incompatible with those of libertarians. I would not disagree, but since our conversation was about forging alliances based on commonalities I wanted to suggest that, if you have the time, you could explore the "LRC Blog" on lewrockwell.com I think after a few pages you will certainly read things that make your blood boil but you will also see more commonalities than you may have thought."
"Markets" in a capitalist system don't work that way. The "new ideas" are the things they want you to want - not what you want. Cigarettes, automobiles, and other destructive stuff did not get "offered" and then people freely chose to buy them, they were made to buy them through psychological techniques, and mostly, refusing to offer the dead-obvious alternatives.
I think you might find people more sympathetic to your arguments in the "Reason" Magazine website or such.