Barkings! | The Small Dog Apple Blog

Get Greed out of Legislation

As I watch the battle over health care reform play out in Congress and on the airways, I am struck with how much of this debate is driven by greed. In this case, it is the greed of the health insurance companies that are fighting tooth and nail to protect the 30% of our health care dollars that go to the insurance companies. If you look at the voting records on health insurance reform, the lines are clear. Those that get lots of campaign contributions from the insurance companies tend to vote against the “public option” and those that get smaller contributions see the value if keeping those same insurance companies honest with a competitive public option.

Then there are the battling commercials, the surreptitious funding of protests by insurance company groups and literally hundreds of lobbyists trying to influence policy. None of our legislators is willing to stand up and say “I oppose the public option because the insurance companies have given me the huge bucks and I need the money” but the obfuscation of the true issues is apparent to anyone that looks closely. According to analysis by the Center for Responsive Politics, the 15 lawmakers to vote against the public option amendment offered by Sen. Jay Rockefeller received $69,137 more, on average, from the insurance industry since 1989 than the eight who voted for it. The 13 lawmakers who voted against another public option amendment offered by Sen. Chuck Schumer received $93,177 more, on average, from insurers since 1989 than the 10 who voted for it.

Even those that oppose the public option will grant that there is a pressing need for health insurance reform. The train is coming in the tunnel so the option of doing nothing doesn’t work as the current thing we call a health care system is failing. With annual double digit increases in premiums, well over the rate of inflation or wages, it is simply unsustainable to stand pat. At Vermont Businesses for Social Responsibility we have annually polled our members about health care and one of the most compelling signs of decay in the current “system” is that 75% of our members (and this slice of business is generally businesses that DO provide health insurance to their employees) have made changes to their policies in the past year that have either increased the cost to the employees, dropped coverage, moved to high-deductible plans or otherwise made changes to reduce the employer’s contribution to health insurance. The payer of last resort for health insurance now, is employer-funded health insurance. When the uninsured are provided care, the cost is shifted onto the big pool of private insurance and with that cost increasing and the pool decreasing we are facing a fiscal and a health-care time bomb.

The opposition is not pulling any punches. I got involved in a discussion on Facebook based upon a friend’s post about health care and all I had to say was that I was an advocate of a publicly-funded universal health care system and you would not believe the names I got called from people that didn’t even know me. I was called a socialist (I had to remind everyone that in fact, I am a capitalist entrepreneur), a communist and a nazi. The polarization has made dialog and compromise almost meaningless. I think this polarization is dangerous not only to civil dialog and good lawmaking but it is polarizing beyond the legislature.

Some have seen this as an opportunity to push other agendas as well. I was shocked to learn that there was a coordinated attack on women’s reproductive freedom with a move to restrict even private insurance policies from providing funding for abortions. Women’s health including reproductive freedom as established by the constitution and the supreme court should not be the issue as we discuss how to create a more intelligent health insurance system.

There is a parallel with climate change legislation. Stay with me on this one. In both cases we have experts that can see dire consequences if we do not take action. With health care it is a system on the verge of collapse, with climate change it is global warming and all the negative impacts on our planet and economy. In both cases, it is powerful special interests with huge war chests that prevent comprehensive and effect action. In both cases, we must break through this partisan gridlock and find common ground.

While you do not have to guess my position on either of these critical issues, I think that the key to breaking the gridlock on a long term basis is true campaign finance reform. We must get the big bucks out of our elections so that large special interests do not control the agenda but that the will of the people do.

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  1. Please!
    You have what appears to be a great store.
    There are people like myself who feel Obama is a total disaster for this country. Pleaser stick to your store and leave your politics out of it. If you continue to email me with political opinions I happen not to agree with i am going to take my business elsewhere.


    — Herb    2009-10-02 19:22    #
  2. Your analysis/ opinion is absolutely correct—as far as it goes, which is not far enough. Not only are almost all (nothing is 100%, even Mac’s get viruses, hard drives fail, etc) politicians & their staffs greedy & self- serving, but, apparently, so is the majority of the voting US citizens. Those against universal health care have theirs, and can’t imagine sharing.—Don’t even get me started on the left shift of the IQ scale in this country.
    If the Right is so right, why do they have to lie about the programs to convince others the programs are bad? (The infamous “Death Panels” are a prime example…).
    Personally I think lack of proper parenting is very much responsible for the lack of compassion, greed, me first, and general stupidity of the general population today.(Bush got elected twice, remember?!)
    Why is it the more someone “declares their “Christian” values, the more likely they are to hate and discriminate? The “outcry” (being cheerlead by the “F” network) against reforming the healthcare system is just another example of that hatefulness—they might have to share….!
    S Summers


    — Susan Summers    2009-10-02 19:32    #
  3. I always enjoy reading your opinion piece. I have never before felt the need to respond in any fashion, not because I always agree with what you say – I don’t – but because it is well reasoned and fairly articulate. Not so this time. You talk about the need for compromise – I would certainly favor that – but then you say: “Stay with me on this one. In both cases, we have experts who can see dire consequences if we do not take action. With health care, it is a system on the verge of collapse; with climate change, it is global warming and all the negative impacts on our planet and economy.” So let me ask you this. Since I think perfectly reasonable people could disagree with what you present as fact, especially when talking about man’s contribution to global warming, would you be willing to compromise and say that man’s contribution is not totally convincing so therefore we should do all we can do, as good stewards of the planet, but stop short of doing things that might harm us economically? If not, then don’t rant about the need for compromise. My experience, on both these issues, is that those who think like you are no more willing to compromise than those who think the opposite. It takes two to compromise, and I have not seen the willingness on either side.
    Mike


    — Mike    2009-10-02 19:42    #
  4. I thought Bush and his administration were the disaster? Obama is the leader of the cleanup crew isn’t he? Don, that was beautiful to the point and right on! As a New Zealander who grew up with, ‘GASP’, a socialist universal health care system. New Zealand, Australia, Germany and Brazil (all countries I have lived in) all have a universal health care systems, oh wait! All industrialized nations have a universal health care system. My mind is completely and utterly boggled at how a small number of Americans have responded to Obama’s proposal. And how they are getting a disproportionate amount of air time. I am a permanent resident here. I love the US, but if nothing is done to address the train wreck in motion health care system in the US, my American wife and I are going back to New Zealand. It is so sad as the US has so much potential but seems bent on it’s own destruction. Even sadder is how it seems the democrats have already sold themselves to corporate interests. I hope Americans realize if they fall they take the whole world with it.


    — Steve Paterson    2009-10-02 19:47    #
  5. A European reporter was speaking about the polarization in America today. It is, he felt, very similar to what occurred when Rabin attempted to reach peace with the Palestinians. The conservatives worked to delegitimize him and to polarize the public. The atmosphere they created was such that an ardent follower assassinated Rabin. The writer fears America is headed that way today. Chaos and anarchy – not good!


    — Carl Carter    2009-10-02 19:58    #
  6. To those who complain about you commenting on social issues-tough nuggies, We need to have responsible business people stand up for what’s right.


    — Peter Auerbach    2009-10-02 20:01    #
  7. heya Don —

    Being in the computer world, I’m surprised that you didn’t add a comment on how the healthcare companies have been using the Net to wage a fairly successful misinformation campaign in their efforts to protect their cash cow.

    Personally, I think it’s almost criminal that our nation spends more than twice as much per capita on healthcare, yet the WHO rates the US as #37 in the world for effectiveness of our expenditures.


    — Darren Young    2009-10-02 20:16    #
  8. The government has screwed up everything else it has ever touched. What makes you think this will be the exception?


    fred Johnson    2009-10-02 20:17    #
  9. If the government screws up the public option, then it will not be competitive and the insurance companies will be just fine.

    don


    — Don Mayer    2009-10-02 20:26    #
  10. I took a course on insurance in business school. It taught very clearly the larger the pool of insureds, the cheaper it will be for everyone. I don’t know why this simple fact is not more widely explained.


    — Carol LeKashman    2009-10-02 21:19    #
  11. I’m with you. The government doesn’t screw up everything; people love their Medicare! At 3% overhead instead of 18-30%
    The public option should be Medicare. We could provide it to young and healthy people for more than it costs (yet still cheaper than those bloated insurance companies) and the profit could address the looming Medicare funding issues. Why is it that our only public insurance system gets stuck insuring only the most expensive to insure? The aged and disabled. While the big-profit, high cost insurance companies cherry pick and spit out those who need coverage the most.


    — phil frassica    2009-10-02 22:21    #
  12. Since my high school days in the ’60s I have been saying that politics will not change until elections are publicly financed. Well I was wrong. Politicians have become even more corrupted by special interest dollars and lobbyists have become a way of life.


    — Jeff Overton    2009-10-02 22:24    #
  13. I’m completely with you on this. The opposition was wrong when they opposed Roosevelt on Social Security and Johnson on Medicare.
    We need to support President Obama, he the best president I’ve seen in my 58 years of life.
    But he has to stop the Republicans from turning this into another bonanza for the insurance industry.


    Robert Mrozowski    2009-10-02 22:32    #
  14. Don, you are taking a risk with your business in exposing your political views. You might turn some people off. On the other hand, I do business with your company because I agree with a lot of your positions. I honestly don’t see how any thinking person could actually disagree. Thank you for being a good citizen, and standing up for political, environmental, and social justice. I like doing business with like minded people, both as a customer, and as a supplier of services.

    Another person just mentioned how the government screws everything up. Perhaps if we would stop electing people who hate government, and can see no purpose in it, and who ultimately want to eviscerate it, we would have better government. How can you hate something so much and take pleasure in it’s proper functioning?

    Thanks Don!


    — Robert Burke    2009-10-02 22:47    #
  15. Well said! I’m glad you are vocal about your opinions. I like knowing that I’m supporting a business with politics in line with my own.


    — Murray Sampson    2009-10-02 23:19    #
  16. I agree with Voltaire (or his commentators).
    I seldom agree with Don.
    Has nothing to do with doing business with a capitalist.
    We need health reform.
    It includes tort reform and rationing in some form. It may or may not include a public option.


    — Alan Thiel    2009-10-02 23:35    #
  17. Thank you for your courageous piece. I say “courageous” because your writing something like this could cause you to lose business from those who oppose your point of view.
    I don’t know what has caused this great nation to ignore the needs of its citizens when every other great nation seems to pay attention to the needs of its.


    — Terry    2009-10-03 00:10    #
  18. HERE, HERE….!!

    Well Done !!


    — Joseph Casato    2009-10-03 00:11    #
  19. So the insurance companies are all evil, and the government is a big wonderful entity that will step in and save us? If greed is the motivation of the insurance companies, then power and control is the motivation of the government! It is very naive to think that those who are against government health care are all puppets of the insurance companies, and everyone else has totally pure altruistic motives! According to http://www.lockergnome.com/swordofdestiny/2009/08/13/are-these-evil-for-profit-health-insurance-companies-really-so-evil/, insurance companies had between a 2.5% and a 4.2% profit. What happens if these figures are negative? The companies go broke and no one on the plan is covered! Probably the biggest problem is that about 40% of the cost of health care is for doctors’ malpractice insurance. Get tort reform into place, and costs come down dramatically. But no, congressmen (and women) who are lawyers themselves, are paid off by other lawyers and law firms to prevent this from happening. What is a lawyer’s profit from a large case? They usually get 40 to 50% of the settlement. But congress would never bring in lawyers to parade in front of congress in a public hearing, because that was how many of them became rich!
    As for the so called “reproductive rights” of women, I am fine with whatever choices they make before a pregnancy. But I do not want my tax dollars to be given to the practice of killing innocent babies before they are born. They have a unique genetic makeup from the time of fertilization, so they are not just a blob of extraneous tissue that is just a part of the mother’s body. They are unique individuals who are at a very early stage of development. President Obama stated in his address to congress “One more misunderstanding I want to clear up — under our plan, no federal dollars will be used to fund abortions.” So unless you believe he is a liar who will go back on his words, why do you even bring up this issue as you discuss federal health care?


    — Bob Peake    2009-10-03 00:30    #
  20. Thanks for a thoughtful and polite step up to the plate to stand for what you believe. You are a ogood American. I happen to agree with you, but even if I didn’t, I would appreciate your courage in putting your money – your business- on the line to express your honest beliefs. Small Dogs everywhere are, once again, proud of you.


    — I try to evolve    2009-10-03 01:20    #
  21. Thank you Don for your outspoken support for health care financing reform.

    I fear that if we get a “public option” it will be a meaningless one that offers no competition for the criminals in the for-profit insurance business, but requires everyone but the sickest to be their customers/victims.

    The sustainable solution is a single payer system, and a meaningful public option’s only purpose is to put us on a path to that.


    Kevin Wildermuth    2009-10-03 01:50    #
  22. I agree with Don on part of this. I think we need to take greed out of politics. Campaign reform needs to come first. All contributions should be from individuals in the district of the official running. Why do giant Texas corporations get to contribute to campaigns of senators in Massachusetts? Does my representative really represent me when the vast majority of his/her campaign money is not even coming from people that he/she represents?

    I think we badly need heath care reform. Too many of may patients are suffering under the restrictions and bureaucracy imposed by Medicare and Medicaid. Yes, Medicare and Medicaid. I may be frustrated with how much extra work it is to argue with insurance companies on my patients’ behalf, but at least there is someone to argue with. There is no appeals process with Medicare and Medicaid. Anyone interested is welcome to email me for a list of ways my Medicare and Medicaid patients get worse care than my private insurance patients because of the asinine regulations and restrictions imposed by the government. The constant barrage of unnecessary government regulations and interference with me doing my job does nothing to improve access to or quality of care. It solely drives up the cost and takes my time away from taking care of patients. It deprives patients of access to cutting edge technology they could get with private insurance, or in Mexico for that matter.

    So I’m all with you on healthcare reform. I’m all with you on increasing efficiency. I’m up right now filling out useless duplicate and triplicate forms that the government requires so my patients can get taken care of. I would love for that to stop. I’m all with you on increasing quality, but I’m tired of defending myself against fraud charges by the government because someone that dropped out of high school reviews a chart 6 months after the fact and doesn’t know that anemia and low red blood cell count are the same thing! I’m with you on insuring everybody, that’s less people that don’t pay me and more patents for me to treat! No doctor is against reform, but the government that Don so correctly pointed out is so corrupt is NOT the answer! I could save this country a heck of a lot of money if the government would let me. I can provide a long list of examples of how Medicare’s guidelines prevent me from offering quality care at a low price. I am bound by the government’s regulations to make stupid medical decisions and even more stupid economic decisions. Those decisions currently are made by politicians, influenced by lobbyists for special interests like labor unions, drug companies, insurance companies, the American Hospital Association, and even the AMA. Those decisions should be made by individual patients and the doctors they choose, mutually agreed upon by both. That is how my plumber and I come up with a fair price for the work he does for me. That is how I decide where to buy a computer. The government does not dictate what my computer must cost, and what kind of computer I am entitled to, and what kind of service the computer store has to provide with that computer. That is between the computer store and me. I provide a valuable service, just like an electrician, a farmer, a plumber, a roofer, a tailor, a mechanic, and a computer store owner. Medical care is not a necessity. Look what the Egyptians, Greeks, Romans, Persians, Chinese, British, and so many other civilizations accomplished without modern medicine. Food is a necessity. Without food, we die in a few weeks. But I don’t see the government proposing all food should be free and provided by the government, and all farmers should be government employees, and that the government should control the entire food industry. The Soviet Union tried that and how many people were starving to death. Are bread lines really better than what we have?

    So while nobody is arguing that things should stay the way they are, expanding a system that is already terrible is a terrible idea. I don’t know who all these people are that “love their Medicare” I have been asking patients for months now what they think of Medicare and EVERY single one doesn’t like it, but they have no other choice because no private insurance company provides any more than secondary coverage to seniors. The government option has killed the private market even though the service is far worse. Oh, but that would never happen, right? So, fix the government first, then I will support the government taking away more of my ability to make decisions for myself and my family. Don is awfully trusting of a government he correctly claims is inherently corrupt. This is not about politics. It is not about one party or the other. This is not about greed for me (though for many, including most politicians, it is). I would likely make more money and work less with Don’s plan. This is about what is best for the patients I treat. As for party I support, I think they are all corrupt because of the way the system is set up. I support individual candidates, not one party or the other. I do not agree with either party, but I tend to vote for people who are willing to give up their own power rather than take more power for themselves. Think about that for a minute.

    Oh, and since it was brought up, on to “Global Warming”, or “Climate change” since we don’t actually know now whether it is warming or cooling. (Though Al Gore and Nancy Pelosi are doing their best to personally create as much CO2 as possible!) I recycle, car pool, conserve water, use electronic medical records, use low watt lightbulbs, dock my kids’ allowance for leaving lights on, and have geothermal heat and air in my house, but as to whether “Global Warming” is man-induced or naturally occurring, who cares? I’m sure the people in Manhattan greatly appreciate the recession of the glacier 12,000 years ago. The US government is not going to change China’s practices by enacting policies that hurt American citizens and American families. If the American people wan to save the planet, they need to do what I do, and what Don does. Don practices what he preaches. The effort has to come from people, not the government. If you don’t like Chinese pollution, don’t buy cheap Chinese goods. It’s the government’s fault we are not all using ethanol in our cars. If the government would stop subsidizing corn because of the massive campaign contributions by the corn lobby, we could plant sugarcane all over the south, and use switchgrass that grows natively all over Oklahoma, and ethanol would be so cheap that everybody would use it like they do in Brazil. Once again, it is the corruption in government that is impeding the use of existing renewable energy sources. If you believe in Global Warming, then it is the government that Don wants to take over healthcare that is contributing to the ruin of the planet Don and I both want to save. Still want to hand healthcare over to them? Fix government first, then the broken legal system. Right now, nobody in this country is denied care because of lack of ability to pay. It has been against federal law to do that for decades. Leave medicine to patients and their doctors (that means to everybody reading this, since almost everybody will be a patient at some point). Don’t turn your healthcare choices over to a corrupt, self serving government.


    Shon Cook    2009-10-03 02:03    #
  23. Don,

    I worked as an ER Physician for 15 years in Canada, then 10 in the US, moving back to Canada for personal reasons (retirement) in 2004. I now do some family practice.

    Publicly funded health care for all is the reality in the US. Show up at the ER and they are obliged by law to treat you to the limit of their capability. Cobra regulations prevent dumping of patients. All those in need of acute care get it regardless of their ability to pay.
    What we lack is PRIMARY PREVENTIVE care for the uninsured. If we were to divert even a small amount of the money paid to treat people in emergency situations to providing basic primary care, we could save a fortune, as studies have shown that preventive care spending reduces acute care spending.

    The whole idea that this is going to cost a fortune is ludicrous. Who will get the money? Not the nurse practitioners and PA’s who will provide primary screening.

    Also remember that many of the uninsured are so by choice and won’t attend primary care clinics even if they are free.


    — James Lunney    2009-10-03 08:56    #
  24. Wow. I agree with you. Thank you for so clearly stating it that way.


    — Colin    2009-10-03 09:01    #
  25. Here’s one possible solution. I’m sure there are others.

    An approach to lowering health care cost is not, a government take over, but allowing each of us to spend our medical dollars with those that do a good job for us.
    1) The government could set up Health Saving Accounts, where, pre tax money accumulates. If spent on Medical needs, no taxes paid, if spent for any other reasons it would be taxable.
    Taking the middleman (insurance companies) out. That will cause us to watch how we spend for our medical needs. You watch and compare when you are spending you dollars directly.
    Competition will drive the cost down, just as it has, in all cases, of elective surgery. IE: cosmetic surgery, Lasik surgery etc. All not covered be insurance.
    The cost for these medical service have been dropping each year.
    Let free enterprise work.
    It always does!


    — Alan    2009-10-03 09:28    #
  26. Thanks Don for another well thought-out and crafted Soap Box. I agree entirely with your position and have been a single-payer advocate since I was able to vote for Jimmy Carter in ’76. I especially agree with your point that the root of our legislative problems is campaign financing. We must get big money out of our election process. Only then will our elected officials be able to put the interests of the citizenry ahead that of their wealthy contributors.

    Thanks for speaking your mind and letting us know that there are responsible businessmen in the world.


    John Hadden    2009-10-03 10:10    #
  27. I agree that GREED is making a mess of health care but why stop there. Greed is what got this country in the mess it is in now. If not greed for money then power or both. Maybe someday we will get a government for the people again but not in my lifetime. This may not be the proper place for this soap box but one has to start someplace.


    — William Laraway    2009-10-03 10:40    #
  28. I read your emails to educate myself on more of Apple’s offerings and because you have a good store. I could care less what you think about healthcare or women’s reproductive rights. The government already pays for 50% of healthcare through Medicare and Medicaid and those programs are not exactly models of efficiency. Let the insurance companies compete across state lines to create true competition!


    — Ty    2009-10-03 10:56    #
  29. Great article. It’s very sad that those against HCR are completely manipulated by huge entities that have been doing this to us for years. They will argue that they are not of course, but none have researched who finances the “grass roots” movement against the reforms. Perhaps if they do, they will see the foolishness of being against their own interests. Until then “Don’t let the ba****ds wear you down”. Thank you for standing up for what you believe, you have a customer for life…


    — J. Stone    2009-10-03 11:34    #
  30. Well done, Don! Address the greed! I have long believed we need to bring about serious political/campaign/financial reform and these current issues only exemplify this need. Greed and deterioration of social consciousness and behavior, as someone else pointed out, are also largely responsible for the ugliness in any public discourse these days. I admire your willingness to walk-the-wolk and take your lumps.


    — Jayleen Hatmaker    2009-10-03 12:37    #
  31. To reduce the influence of big money on our political system TV and radio companies should be obliged to provide free air time for all legitimate candidates. We have tried to do it by limiting the amount of money tat can be spent on campaigns, which is now in the Millions of $$, but the Supreme Court has equated money with free speech. So free air time would avoid that trap.


    — Martin Ben-Ari    2009-10-03 12:59    #
  32. But if Herb agrees with your opinions then it’s OK to send him stuff?
    We need a public option for health care. I’m with you, Don.


    — Bobbie    2009-10-03 15:24    #
  33. My wife and I agree with Don’s rant all the way. The public option is critical to the reduction of health care costs. The majority of Americans agree.


    — pete & Pat Watson    2009-10-03 17:24    #
  34. Don, I agree with everything you wrote. Our society as a whole is so greedy these days. I live in Texas, and our Senators & Reps don’t really care what their constituents want.


    — Pamela Ball    2009-10-03 18:18    #
  35. Agree totally with you. We have the most expensive inefficient health care system in the world. We need reform.

    www.medicynic.com


    Paul    2009-10-03 19:14    #
  36. I agree 100%. It may take a constitutional ammendment to get big money out of politics, but unless we do, we will be stuck with govenment of big business, by big business, and for big business. It is shameful.


    PattiWagen    2009-10-03 22:13    #
  37. I’m against this bill and here’s why.
    It's over 1100 pages and nobody in Congress has read the entire thing. Certain people in the Govt. want this bill rushed through so nobody has the time to analyze it.

    Let's rush another bill like the Clunker Bill through Congress. That bill if designed properly to save US jobs and auto makers should have had a clause in it that limited payouts to the 3 US automakers and foreign autos that are manufactured in US plants.

    I’m afraid that the same rush to pass a bill, especially a large bill will result in the same sloppy work. I don’t think something this important should be rushed. I also believe in the KISS rule. Keep It Simple Stupid!

    Start over, keep the language simple, elaborate specifics as necessary and keep it short!


    — John McGibney    2009-10-03 22:37    #
  38. Don Mayer, you keep preaching on your soapbox!

    I have a personal story I want to share with you. My Dad, who was a family practitioner in San Francisco for many years, would have been so pleased with what our president is trying to accomplish. I worked for my father for about 12 years up until the time when he retired at the age of 63 in 1983.  

    In the family practice, Dad saw the patients, I was the office manager and ‘chief cook and bottle washer’. He retired primarily because at that time, insurance companies were making it mandatory for physicians to be covered by malpractice insurance if they wanted to continue seeing their patients at the hospital. My Dad REFUSED to be told by insurance companies what to do and how he should practice medicine. 
     
    If a patient called and needed to be seen that day, Dad made time to see them. None of this waiting days, when you were sick, to be seen.

    Back then, Dad was charging $15-20 for an office visit and up to $120 for a complete physical!!  If a patient couldn’t pay, he’d write it off or let them pay as the were able. A regular office visit lasted 15 minutes or more. When a patient needed lab work, Dad phoned the lab results to patients, he did not have them come into the office for an additional charge to discuss it with them.  He made his return phone calls to patients after the last office visit of the day. 

    If you came in for a splinter in your finger, Dad would check your eyes, ears, nose, throat, listen to your heart and lungs as he listened to why you came to see him. Dad made house calls. Earlier in his practice he performed appendectomies and delivered babies.  (When he entered medical school, he was going to become a general surgeon but his back had other ideas!) If you came in with a gash that required suturing, he did that … in the office. None of this requiring the patient to meet him in the ER. Dad’s practice was truly a family practice… he saw everyone from babies to great-grandparents. He knew each patient as a total entity (physical, psychological, emotional). When he needed to call a specialist for advice or refer you to one, he did. The patient was his primary focus. Dad took a conservative approach to medicine. He was not prescription-happy and averse to  ordering unnecessary tests. The 70s and 80s were a wonderful time to be in medicine. I enjoyed being a part of a true family practice business. It was my best job ever!
     
    Regarding insurance companies, Blue Cross and BLue Shield were non-profits at that time. Rates were LOW, i.e, affordable. Soon after, they became for-profit and ever since, rates have continually gone up and up and up and up, coverage, depending upon your plan, not at good, and not as accessible for lots of folks who may have had pre-existing conditions. Insurance companies became more aggressive is ‘casting’ folks out who were ‘liabilities’, profits went UP, CEO salaries went UP, premiums went UP, … you get the picture. Now, malpractice insurance rates for many doctors like surgeons and OBGyn docs is through the roof … over $50,000 -100,000+ a year and higher. That’s just the cost of malpractice insurance, not counting overhead costs such as salary, staff, supplies, rent, etc. that a doctor has to pay.
     
    This illustration about my Dad’s practice shows the need to get back to health CARE rather than the current state of health management for corporate welfare (WELL FARE) $$. President Obama’s outline in his speech a few weeks ago of how he envisions health care reform is a great start. 

    I might add that my Dad was a registered Republican up until a few years before he died. At that time, he became very disillusioned with the ‘mean-spiritedness’ of the party and changed his affiliation. My dear old Dad actually became a ‘green’ party advocate!
     
     
    Kathy Aanestad
     
    “When the power of love is greater than the love of power, then we shall have peace in the world.”


    — Kathy Aanestad    2009-10-03 23:23    #
  39. Amen!!!


    — R. Helmuth    2009-10-03 23:59    #
  40. Thanks Don for having the guts to stand up and contribute to this debate in a thoughtful way. I’m a permanent resident here (uk citizen) and am still, after 17 years appalled at what passes for a health care system in this country. I like to stay away from inflammatory conjecture in the debate though – preferring to stick to facts, so – in the spirit of it all – here are a few that may spur some thought:

    1) In 2009 we are at the leading edge of the baby boomers hitting retirement age.
    2) Older people represent a higher percentage of events requiring treatment.
    3) A disproportionate amount of medical staff (Doctors, nurses and other clinical staff) fall in this age group.
    4) The medical education system cannot supply replacement personnel at a rate fast enough to even keep pace with the projected shortfalls in capacity.
    5) The US system as it stands today spends a massive amount of GDP – far higher than other industrialized countries and yet falls 37th in the world in terms of medical outcomes.
    6) Administrative overhead of the US system is in the 20 – 30% range. In other industrialized countries – it is usually 2 – 5%
    7) Care providers (hospitals, clinics etc) charge for procedures according to what they think they can reasonably recoup. Insurance companies then deny a large percentage of these costs. The remainder shows up on the books as uncompensated care. In order to compensate for this accounting issue, decisions are made to raise prices to recoup more revenue. Insurance companies raise premiums in response.
    8) I have heard no one ever question why costs continue to increase at the rates they have been. I know from professional experience that in any given hospital process up to 40% of all the activity, time and resource usage is pure waste, endemic in the organizational structure.
    9) The trifecta of Insurance companies, providers and Pharmaceutical companies have obvious vested interests in reinforcing the status quo – which is why there are so many lobbyists for every US congressman on this issue.
    10) The basic ethos of the US system is retrospective. Get sick, get treated, provider gets paid. The UK has switched over to a system where the providers are compensated on the overall health of their patient pool and preventative care is actively provided because it is now compensated.

    So – ten facts that – when combined – paint a pretty dismal picture of the system and issues facing us. Any rational person can look at these ten and deduce that the current system is very unsustainable. in fact – it’s likely to be overloaded in the very near future, and get worse for the next twenty years or so unless it is restructured now. It is my sincere hope that we can all look at this system dispassionately and see the effects it will have on us all in the near future if it is NOT restructured. Only from such a basis can we truly put political alliances aside and really work to put a system in place that will address these challenges.

    My 2c…

    Lee

    Oh – and as usual – my opinions should not be taken to represent those of my employer in any way shape or form. They are purely my own. Thank you.


    — Lee    2009-10-04 00:38    #
  41. Thank you, Don, for saying what needs to be said. WE NEED UNIVERSAL HEALTHCARE!!! WE NEED CAMPAIGN FINANCE REFORM!!! We need to get special interest groups out of Washington DC. Keep up the good work.


    Gail Ann    2009-10-04 12:00    #
  42. For the love of Pete! Stop with the political stuff. I had to unsubscribe during the elections last year and now I’ll need to do it again. Why can’t you just talk about Macs — which I love — but you have to put your personal political opinion out there. Why don’t you have a separate list for those who want to hear it and leave the tidbits and other news of a Mac nature for those who don’t?


    — Marla    2009-10-04 17:14    #
  43. i completely agree with Gail Ann, XLI. i wish they would allow us to buy into Medicare. that is revenue neutral.


    — terry badger    2009-10-05 13:29    #
  44. Hey Don, The people who want you to stop writing your political views need to figure out how to use the scroll bar! There are folks who just can’t stand to let others have a point of view. I happen to agree with your prose, but if I didn’t, I’d still read it. Folks do business with you because they like what you offer. They don’t buy everything you offer, but they buy what they want of it and they enjoy the way you do business. So let them do the same with your newsletter. I am not politically aligned with a guy I buy antique car parts from, but I have conversations with him and we get along fine. He’s straight, I’m gay. He’s Republican, I’m Democrat. He’s got car parts I need, and I’ve got money to buy them with. We appreciate each other’s point of view. We understand we are both human and American and need to pursue our own happiness. Get a clue, America. We aren’t built to be forced into one way of being. But we do have to respect others. As to the particular subject of health care… I work in the industry and I just got my own rates increased tremendously. There’s nothing I can do but pay… Somehow we need to fix this. Personally, I’m for single payer. Thank God I don’t loose my Police, Fire or Military protection when I get too sick to work.


    — Joe    2009-10-05 17:54    #
  45. I don’t have any lobbyist pushing my views in Congress. Nor has any insurance company given big bucks. And I am not against the public option per say. BUT the way the Democrats are writing the bills, it is so much more than reform. It’s more like total replacement with a new system. It is what they are attempting to write into the bills that has me worried. One version said that the public option was not mandatory sort of. For example, an employer could keep those employees who were already on the employer health care program, BUT would not be allowed to enroll any more employees. This of course would eventually kill the employer program and force people on to the public “option”. When Republicans try to offer compromise amendments they always get voted down by the Democratic majority. So much for compormise and working across the ailse.


    — l jenkins    2009-10-05 18:11    #
  46. I don’t like the way this is being handled. First why does it have to be a single incomprehensible bill? Start with what should be fixed (like allowing Medicare to negotiate drug prices or letting Veterans who pay for Medicare use Medicare to pay for services at the VA Hospital and no VA care isn’t free for serviceman or woman). Second the Chinese had a system in which you paid your doctor until you got sick and then you stopped. What about a system that rewarded doctors for well people rather than sick ones. Finally we have a third rate system that costs more than any other system in the world. There are two possible approaches to the cost problem. One is to raise huge amounts of money the other is to reduce costs. I think there can’t be any question the politicians are salivating at the chance to get their hands on a huge pot of money because the more money they control the more power they have.


    — Douglas St.Clair    2009-10-08 20:19    #
  47. Eloquently said sir. Your opinions are part of the reason I buy all my Apple stuff from you. I like your customer service and I like the little packages of ‘small dogs’. I’ve almost got a collection going here.

    Sincerely,


    — Jsk    2009-10-11 17:55    #
  48. Hi, There is too much discussion on the health care reform plan.You have given some tough views on this matter.Thanks for this article.


    bluetooth freisprecheinrichtung    2009-10-12 01:41    #
  49. That was a very strong statement. I’m not so sure if I will hope or not anymore, but I will still.


    Dentist Bradenton    2009-11-10 03:06    #
  50. As an American, I much appreciate your trying to help figure out and solve our countries problems. Perhaps we start a new civil war and setup a dual track health care system. One track for all the republicans who are happy with the present system and another for all of us socialist commie liberals who believe that their government has been used to setup health care monopolies that are stealing our wealth and neglecting our health. After that is set up we could move the liberals upwind and let the conservatives choke on their coal fumes and bake in that global warming that they are so sure isn’t happening!


    — Charles Spencer    2009-12-02 01:00    #
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