A Letter to a Senator on Healthcare
Sep 11th, 2009 | By Frank Brady | Category: Featured, Morning Whiskey
Dear Senator McCaskill:
This is in response to remarks you made yesterday with respect to health care reform on Kansas City’s Morning News with EJ & Ellen.
First, here’s a bit of context for your consideration.
· The United States does not have a unitary “health care system.” Instead, there are multiple providers and competing methods of paying for care (Commercial Insurance, Blue Cross/Blue Shield, PPOs, HMOs, Medicare, and Medicaid, for example). Freedom can be a messy thing and the results are certainly uneven, but the variety of choices and the absence of centralized bureaucratic control have always been among the strengths of the American approach.
· Health care and insurance coverage are not the same thing. It is claimed that 46 million Americans are uninsured; the implication being that those 46 million Americans cannot obtain health care. That implication is simply false. Millions of people, mostly young, have simply decided not to purchase health insurance. A very large number of the alleged “46 million” uninsured are illegal aliens (or, if you prefer, “undocumented immigrants”). When these two categories of the uninsured are removed from the calculation, the number remaining without coverage is relatively small and it cannot be claimed that they have no access to care. American hospitals and physicians voluntarily provide millions of dollars worth of uncompensated charity care every year. In addition, almost every hospital in America is required by the Emergency Medical Treatment and Active Labor Act (EMTALA) to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. The law applies to all patients and they can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer their required treatment.
· Hospital care, medical care, and health care insurance have all become very expensive, but price increases for individual services and the increases in total health care expenditures are not the same thing.
· Government intervention, government regulation, federal program cost shifting, and unnecessary litigation are the primary causes of hospital and medical care price increases. These are the very things that the most vociferous advocates of “health care reform” refuse to address, primarily because their policies caused them in the first place!
· Increases in total health care expenditures are caused by all of the things described in the previous paragraph, plus increased demand for service spawned by first dollar insurance coverage and the provision of “free” or subsidized health care through government programs. Providing additional “free” or subsidized coverage to the uninsured under a public option will produce increased service demand and, consequently, produce even greater increases in total health care expenditures.
Although the mandatory end-of-life counseling requirement has reportedly been removed from at least some pieces of draft legislation, that provision is not the greatest threat to treatment access for the elderly ill. The Medicare program already refuses to pay for physician-ordered treatment that it deems “inappropriate” so the mechanism for a government agency to effectively override a personal physician’s judgment is already in place and is used on a daily basis. However, at the moment the patient retains at least potential options because Medicare is not a universal program. Fears that the public option will potentially threaten that option are well founded.
Here is what the President had to say on this subject just one week ago in Portsmouth.
President Barack Obama, “Town Meeting,” Portsmouth, NH, August 11, 2009
“…The idea is actually pretty straightforward, which is if we’ve got a panel of experts, health experts, doctors, who can provide guidelines to doctors and patients about what procedures work best in what situations, and find ways to reduce, for example, the number of tests that people take — these aren’t going to be forced on people, but they will help guide how the delivery system works so that you are getting higher-quality care. And it turns out that oftentimes higher-quality care actually costs less.”
The President’s remarks are disingenuous. The issue isn’t whether tests will be “forced on people.” The issue is whether treatment will be denied to people. If the public option insurer refuses to authorize payment for a physician-ordered treatment disapproved by the federal “panel of experts,” that refusal will certainly amount to denial of treatment for many, if not most, elderly ill.
The President and other public option proponents have characterized fears of care denial to the elderly ill as “outlandish,” but consider the President’s own thoughts on this topic just four short months ago.
President Barack Obama, April 14, 2009, New York Times Magazine Interview
“April 29 (Bloomberg) — President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a ‘sustainable model’ for health care. …“‘That’s where I think you just get into some very difficult moral issues,’ he said in the April 14 interview. ‘The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.’”
If a public option is included in the final legislation to emerge from Committee, the strong probability exists that it will include “comparative effectiveness,” a dehumanizing and immoral rationing methodology, strongly favored by the President’s advisors. Comparative effectiveness literally grants to government the power to decide who lives and who dies. This rationing method compares the estimated cost of a particular treatment against the imputed dollar value of a specific patient’s remaining years of life and makes the decision to approve or withhold care based on that cost-benefit analysis. In other words, it substitutes a computer’s statistical calculation for the clinical judgment of a real physician treating an actual human patient, reduces the value of each human life to mere dollars, and treats each patient as a statistic.
In summary, the argument against a public option, quite apart from its prohibitive cost, is compelling.
· No private insurance company can be price competitive against a public option that can operate indefinitely at a loss. Any public option will, in short order, become the only option.
· Because the potential demand for free health care is potentially unlimited, the public option’s need to limit expenditures will result in denial of treatment to the elderly ill, just as it already does in the many countries that promise universal health care.
Mussolini wrote in Fascism: Doctrines and Institutions, “The fascist conception of life stresses the importance of the State and accepts the individual only in so far as his interests coincide with the State.” Comparative effectiveness elevates the calculated financial interest of the state over the value of a real human being’s life. This is the literal antithesis of traditional American thinking.
Sincerely,
Frank J. Brady
President, Brady & Associates
http://www.bradyinc.com
September 11, 2009
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I agree with your views on government in general. I wish that it did not exist but it does because it is a good business and provides an easy and well paying job for an enormous number of people. I suppose the purpose of governmentis to prevent people from cutting each other’s throats.
Why a universal health care system is desirable is that countries which have such a system have better statistics in general than countries that have no system atall. It has nothing to do with freedom to choose, because governments are not concerned with personal freedom and never have been. They are only concerned with maintaining the status quo of endless taxes to in order to retain their jobs i.e politics.
Hey Frank:
Right-on! Isn’t it interesting that so many folks have seemingly lost the common sense to understand?
Cheers, Tex
Dear Mr Brady
Great letter. The complexities of health care are beyond the abilities of most of our representatives. They are going to vote based on there own agenda. I hope you sent your letter to every member of congress. We all must do everything possible to save our liberty and country.
Regards
Bill Kalter
Why A Strong Public Option Is Essential – By jacksmith — Working Class
Robert Reich explains the pubic option: http://bit.ly/dDYSJ
It’s not just because more than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.
It’s not just because according to a new AARP POLL: 86 percent of seniors want universal healthcare security for All, including 93% of Democrats, 87% of Independents, and 78% of Republicans. With 79% of seniors supporting creating a new strong Government-run public option plan, available immediately. Including 89% of Democrats, 80% of Independents, and 61% of Republicans, STUNNING!!
It’s not just because it will lower cost. Because a strong public option will dramatically lower cost for everyone. And dramatically improved the quality of care everyone receives in America and around the World. Rich, middle class, and poor a like.
It’s not just because it will save trillions of dollars and prevent the needless deaths of millions more of YOU, caused by a rush to profit by the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX!
It’s not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don’t work. Never have and never will. The US has the only truly free market based healthcare system in the World. And as you all know now, IT IS A DISASTER!
It’s not just because providing or denying medically necessary care for profit motivations is wrong. Because it is WRONG! It’s professionally, ethically, and morally REPUGNANT!, Animalistic, VILE and EVIL.
THE REASON THE PUBLIC OPTION IS ESSENTIAL:
The public option is ESSENTIAL because over 200 million of you are trapped in the forest of the wolves. Which is the forest of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! With no way out except through needless inhumane suffering, and DEATH. While the wolves tear at your flesh, and rip you limb from lib. Then feast on your lifeless bodies like a dead carcase for transplant parts.
At the most vulnerable times of your lives (when you were sick and hurting), millions of you have had to fight and loose cruel, but heroic battles. Fighting against the big guns of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! in the forest of the wolves. All because you have no place else to go. You have no other CHOICE!
But the PUBLIC OPTION will give you someplace safe to go. And it will give us someplace safe to take you. The public option will be your refugium (your refuge). Where the wolves cannot get at you when your down, hurting, and vulnerable. Where everyone who needs it can find rest, security, comfort and the care they need. Protected by the BIG GUNS of We The People Of The United States. THE MOST POWERFUL PEOPLE AND COUNTRY ON EARTH.
This is why it is so critical that we do not lead another 50 million vulnerable, uninsured Americans into the forest of the wolves, without the protections of a Strong Government-run public option. We The People Of The United States MUST NOT LET THAT HAPPEN to any more of our fellow Americans. If healthcare reform does not contain a strong public option on day one. YOU MUST! KILL IT. Or you will do far more harm than good. And millions more will die needlessly. Rich, middle class, and poor a like.
To those who would continue to obstruct good and true healthcare reform for the American people, and who seek to trap millions more vulnerable Americans in the forest of the wolves. We will continue to fight you. We are prepared to wage all out war against you, and will eagerly DESTROY! you. Time…is…UP! YOU HAVE BEEN WARNED! No Co-op’s! No Triggers!
Healthcare reform can be the GREATEST! Accomplishment of our time and century. A time when future generations may say of us, that we were all, AMERICAS GREATEST GENERATIONS.
BUT WE MUST ACT!
I therefore call on all my fellow Americans and the peoples of the World. To join us in this fight so that we may finish becoming the better America that we aspire to be for everyone.
SPREAD THE WORD!
I have been privileged to be witness as many of you fought, and struggled to take your first breath, and your last breath on this earth. Rich, middle class, and poor a like. Life is precious.
Whatever the cost. WE! MUST SUCCEED.
God Bless You My Fellow Human Beings
jacksmith — Working Class
Senator Bernie Sanders on healthcare (http://www.youtube.com/watch?v....._embedded)
As an RN of many years I must agree completely.
the young nurses and the older people who went into nursing whether women or men have not been in the profession long enough to have worked in the many aspects of health care.
Medical care is given to all in this country with or without insurance including illegals. Something the rich congress is not aware of as they have the best medical care in the country.
Thank you for an excellent letter which should be posted to all in the country. Like you I have been in medicine to long with one exception have taken care of people who were very appreciative and the ones who had no insurance that feel it is their privilege not to buy insurance bragging about the Big TV etc while the majority in this country work , pay for insurance for self and family.
Great letter; makes common sense for we the common people!
The main article about Insurance coverage and your letter to McCaskill is right on, as Life and Health General
Agent I know that anyone will not and cannot buy claims and stay in business, each Company is on it’s own so
to speak as to whether they stay in business or go broke, and it is certain if you have to cover all the ones who
cannot buy coverage because of health they are GOING TO GO BROKE. It looks like the ones in Washington
want to put all Health Insurance Companies out of business and put thousands of agents out of work. It
looks more and more like nearly all will have to work for the Government. or be dependent on give me a living
because I won’t work, what is the incentive to work if someone else is going to get most of your earnings and DO NOTHING TO GET THEM!!!!
Dear Mr. Brady:
Great letter. Any man who thinks the cost is more important than hip replacement surgery for his grandmother raises doubts about his motives in saying he wants to take care of all of us. I hope Granny disinherited him whether she had any money or not.
In case the Shooters wondered, you and I are neither related nor acquainted! There is no nepotism here at W&G. Every person who makes these pages (except me. I got lucky.) EARNS it, as you demonstrated so ably above.
Those who would be chosen to grant life or death, healing or pain, or walking or a wheel chair would be from the ranks of the AMA and big Pharma. They would not see patients, only numbers. There would be no exceptions and no consideration of other factors. I smoke and am 69, so the answer would be “no” to any treatment, no matter that my only drug is thyroid. Charles is 72, smokes, and is on no medication at all, but the answer would still be “no.” Those judging never noticed that what the Framingham study REALLY established is that those most at risk of heart attack are men with cholesterol below 170!
Welcome to the wonderful world of W&G, not relative!
Linda Brady Traynham
Dear Mr. Brady:
Great letter. Any man who thinks the cost is more important than hip replacement surgery for his grandmother raises doubts about his motives in saying he wants to take care of all of us. I hope Granny disinherited him whether she had any money or not.
In case the Shooters wondered, you and I are neither related nor acquainted! There is no nepotism here at W&G. Every person who makes these pages (except me. I got lucky.) EARNS it, as you demonstrated so ably above.
Those who would be chosen to grant life or death, healing or pain, or walking or a wheel chair would be from the ranks of the AMA and big Pharma. They would not see patients, only numbers. There would be no exceptions and no consideration of other factors. I smoke and am 69, so the answer would be “no” to any treatment, no matter that my only drug is thyroid. Charles is 72, smokes, and is on no medication at all, but the answer would still be “no.” Those judging never noticed that what the Framingham study REALLY established is that those most at risk of heart attack are men with cholesterol below 170!
Welcome to the wonderful world of W&G, not relative!
Linda Brady Traynham
Sorry, forgot to add great post! Can’t wait to see your next post!
Wait a minute, so cost or life expectancy should never come into the equation? Then again I guess when it’s other people’s money skies the limit right? I mean everyone has a “right” to force other people to pay for their health care no matter how expensive, or how small of a chance it has. I mean it’s free right?
Do you honestly believe that our society can afford unlimited health care for all, under all circumstances? This is why we have 40 trillion in unfunded Medicare/Medical liabilities. Because people won’t be honest with themselves and admit that there are limits.
Remember, you are asking someone else to pay for your health care, of course there are limits (if you pay for it yourself, feel free to spend whatever you want).
Let’s get some common sense back into the discussion.
Thanks,
Your letter is excellent. I write the following “case study” to give a perspective from my age of mid-seventies. Perhaps it will be of interest.
Years ago, I had some gastric reflux. Last year, my family physician (who is coincidentally a gastroenterologist) recommended an EGD, which involves inserting a tube with a tiny TV camera down one’s throat and into the stomach and duodenum. He found a precancerous growth in my duodenum, which I am given to understand, invariably turns into a nasty cancer of the bile duct, liver, and especially the pancreas. I was very lucky because mostly people do not notice this problem until they have intestinal blockage and a very dangerous cancer. After he did the one inspection, he did three surgical procedures via EGD. Then he found the growth was too infiltrated for him to treat.
Subsequently, I went to a prestigious NJ hospital and had some more EGD inspections and attempted treatment. They gave up. My bile duct was almost closed off by the adenoma. Then I went to a very famous specialist in CA. I had a couple of procedures there, including one which involved threading a wire through my back through my liver into my bile duct! Finally, the surgeon did an EGD procedure which had not been possible before. Turned out that the growth was imminently cancerous. Back to NJ. I went to the NJ hospital and had a Whipple procedure (as did Steve Jobs.) 6.5 hours on the table! OK, they ripped out my duodenum and part of my pancreas and a lot of little bits and pieces which I can hopefully do without. So, now I am fine and am told that the pre-cancerous growth won’t recur. Since my paternal grandparents live almost to 100 years with their full mental faculties, it gives me hope that this was all worthwhile.
All of this, at full prices, probably would have cost $300,000. Between Medicare and my health insurance company, both aggressively beating down the hospital “list” price, it was probably $150,000. (It is maddening to attempt to decipher the mass of billing statements and determine who paid how much for what. I gave up.) Anyhow, I am out of my pocket about $10,000. (Yes, I could have paid the entire cost myself, which would be the entire $300,000. That probably would have given me an ulcer!)
Speaking hypothetically,I like to think that if I were not otherwise in excellent health, and say, had Alzheimer’s creeping up on me, a bad heart, and sundry other afflictions that I would have chosen to fuhgeddaboudit (I am from NJ!) and just have myself doped up to semi-unconsciousness and let nature take its course. In the 1950’s, I watched my father slowly dying over the course of a year. He spent the last couple of months in a hospital with many tubes stuck into his body (including one in his urethra which really caused him a great deal of discomfort). There was no question in those days of anyone deciding to just let someone die. Any and all heroic efforts would be and were used to keep him alive. He was semiconscious, did not really recognize any of our family, utterly miserable, and doomed to die. There was no way at that time to heal him. I think, but don’t know really, that, had it been my choice alone, I would have told the docs to just remove the life support for him.
Well, that is just my personal view, and maybe I would not have had the guts to “just say no.”
But should a gaggle of government ethicists or whatever do the deciding by structuring their consultation to coach the patient’s family to agree to abandon treatment? No way.
###
@v.pearson
“Why a universal health care system is desirable is that countries which have such a system have better statistics ”
Statistics say whatever the statistician wants them to. We can’t even agree to define what good health care means. These statistics are meaningless. For example, how can we compare infant mortality between the U.S. (where all postpartum deaths are counted) and Cuba (where only deaths after the age of 3 months are counted)?
Basically government is power. Power will always be abused. This utilitarian approach to solving problems will generally come up with the wrong conclusion.
Dear Jacksmith: It appears that Mr. Brady does not answer his mail. If you wish to discuss your interesting viewpoint, it isn’t hard to find my address. Linda Brady Traynham
Good article…
I find most of what Dear Leader says is disingenuous subterfuge. His willingness to talk and listen to the opposition is exemplified by the dispersions used by his party progressives against average American Citizens.
Even our CON-gressional misrepresentatives here in WA will not return emails or phones calls regarding basic questions on the issue, then they find the nerve to slander us from behind locked doors… There is no dialogue or debate on this issue…Reality and the substance is whether or not the American people will allow themselves to be further subjugated by the Bush/Obama Change we never imagined and in this manner…Can anyone imagine what government mandated vaccines and preventive medicine will look like?
It make me shudder to think of all the possibilities…
Dear Lowell: Excellent comment! The WHO counts traffic deaths and homicides against us! Take those out because they are clearly not related, and surprise, surprise, who has the best health care in the world?
Dear Che’ Obama: Like your style and content, too. LBT
1) Healthcare and Health Insurance are not synonymous.
2) Insurance is a “profit making” endeavor, much like gambling. Usually the house wins in the long run.
3) Fair is a man-made concept.
Life is not FAIR. No amount of government meddling can make it fair. It is a food chain.
4) Compassion. Not sure where to start, societies are complicated. Some of the cruelest things are done under the name of compassion. The pain of the “unfunded” life should be a natural deterrent to making unsustainable choices. As a society, we give and receive help, actions. Today most think money and usually someone else’s will fix a problem.
5) The “Healthcare System” is a mess. The biggest reason is the lack of consumer participation in the payment end of things. “Insurance” has been picking up the tab so long (People have bragged for years how an illness didn’t cost them more than a co-pay.) individuals believe they should not have to bear the cost of their care.
6) Education has become “Indoctrination” of citizens, not the development of critical thinkers. Teachers and Professors have long over indulged their egos and taught more opinion than fact and skill. The arm twisting by local “do-gooders” has gone national and government wide.
Elected Officials are more worried about their legacy than the true results of their actions. The balance of individual choice and responsibility is unbearably tedious.
7) The lack of simple solutions does not automatically mean the government (the citizenry of the USA) can or should collect a larger share of the productivity of the people to ease the “suffering” of the more “compassionate”. This society has lost touch with the purpose of and
essence of life. Health is more than access to a DR or procedures. Lifestyle, religion (shouldn’t have said that…), nutrition etc, all play a part. Leading a healthy life is full of many HARD daily choices.
Routine care should be paid out of pocket and the costs contained by competition and cooperatives arrangements, not government dictate.
9) Greed on the part of consumers is equally destructive as the greed currently attributed only to the insurance companies.
10) YOU can not get something for NOTHING! Only thieves get a free lunch-for awhile.