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21 Ways the Canadian Health Care System is Better than Obamacare and Vermont Goes Universal November 22, 2013

Posted by rogerhollander in Canada, Health.
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Roger’s note: this posting gives you two articles on health care, including Ralph Nader’s on the Canadian system.  Having lived most of my life in Canada, and with the early detection of my daughter’s meningitis that saved her life at age two, I know first hand the benefits of no one excluded single payer.  Like the system in Great Britain (which is more like socialized medicine than Canada’s universal insurance), Canada’s health care is deteriorating, not because of flaws in the system, but rather neoliberal under funding.  It is not quite the Utopia that Nader pictures, but it is a thousand percent better than what Americans have.

 

 

Dear America:

Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian style single-payer full Medicare for all is simple, affordable, comprehensive and universal.

In the early 1960s, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months. There were no websites. They did it with index cards!

Below please find 21 Ways the Canadian Health Care System is Better than Obamacare.

Repeal Obamacare and replace it with the much more efficient single-payer, everybody in, nobody out, free choice of doctor and hospital.

Love, Canada

Number 21:
In Canada, everyone is covered automatically at birth – everybody in, nobody out.

In the United States, under Obamacare, 31 million Americans will still be uninsured by 2023 and millions more will remain underinsured.

Number 20:
In Canada, the health system is designed to put people, not profits, first.

In the United States, Obamacare will do little to curb insurance industry profits and will actually enhance insurance industry profits.

Number 19:
In Canada, coverage is not tied to a job or dependent on your income – rich and poor are in the same system, the best guaranty of quality.

In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage.

Number 18:
In Canada, health care coverage stays with you for your entire life.

In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you for as long as you can afford your share.

Number 17:
In Canada, you can freely choose your doctors and hospitals and keep them. There are no lists of “in-network” vendors and no extra hidden charges for going “out of network.”

In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking – thus restricting freedom of choice – and if you want to go out of network, you pay for it.

Number 16:
In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums.

In the United States, under Obamacare, for thousands of Americans, it’s pay or die – if you can’t pay, you die. That’s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time.

Number 15:
In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill.

In the United States, under Obamacare, hospital and doctor bills will still be terribly complex, making it impossible to discover the many costly overcharges.

Number 14:
In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone.

In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 18 percent of its GDP and still doesn’t cover tens of millions of people.

Number 13:
In Canada, it is unheard of for anyone to go bankrupt due to health care costs.

In the United States, under Obamacare, health care driven bankruptcy will continue to plague Americans.

Number 12:
In Canada, simplicity leads to major savings in administrative costs and overhead.

In the United States, under Obamacare, complexity will lead to ratcheting up administrative costs and overhead.

Number 11:
In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?”

In the United States, the first thing they ask you is: “What kind of insurance do you have?”

Number 10:
In Canada, the government negotiates drug prices so they are more affordable.

In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases, so they remain unaffordable.

Number 9:
In Canada, the government health care funds are not profitably diverted to the top one percent.

In the United States, under Obamacare, health care funds will continue to flow to the top. In 2012, CEOs at six of the largest insurance companies in the U.S. received a total of $83.3 million in pay, plus benefits.

Number 8:
In Canada, there are no necessary co-pays or deductibles.

In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans.

Number 7:
In Canada, the health care system contributes to social solidarity and national pride.

In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.

Number 6:
In Canada, delays in health care are not due to the cost of insurance.

In the United States, under Obamacare, patients without health insurance or who are underinsured will continue to delay or forgo care and put their lives at risk.

Number 5:
In Canada, nobody dies due to lack of health insurance.

In the United States, under Obamacare, many thousands will continue to die every year due to lack of health insurance.

Number 4:
In Canada, an increasing majority supports their health care system, which costs half as much, per person, as in the United States. And in Canada, everyone is covered.

In the United States, a majority – many for different reasons – oppose Obamacare.

Number 3:
In Canada, the tax payments to fund the health care system are progressive – the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent.

In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.

Number 2:
In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story.

In the United States, Obamacare’s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it.”

Number 1:
In Canada, the majority of citizens love their health care system.

In the United States, the majority of citizens, physicians, and nurses prefer the Canadian type system – single-payer, free choice of doctor and hospital , everybody in, nobody out.

For more information see Single Payer Action.

Ralph Nader

Ralph Nader is a consumer advocate, lawyer, and author. His latest book is The Seventeen Solutions: Bold Ideas for Our American Future. Other recent books include, The Seventeen Traditions: Lessons from an American Childhood, Getting Steamed to Overcome Corporatism: Build It Together to Win, and “Only The Super-Rich Can Save Us” (a novel).

 

Vermont Approves Single-Payer Health Care: ‘Everybody in, nobody out’

posted by Salvatore Aversa November 20, 2013, http://www.occupydemocrats.com

The Affordable Care Act continues to plow ahead, despite Republican attempts to fight it at every turn.  What is unfolding in front of us is nothing short of spectacular.  The problems with healthcare.gov are slowly being resolved which is helping more and more people sign up for affordable healthcare, many for the first time in their life.  The law provides so much more than that, including standards for even the lowest level plans, protections for young adults 26 and younger, and the elimination of pre-existing plans.  Of course, you will not hear the success stories on the news, because those stories are not nearly as sexy as the “Obama Lied” slogan they are so fond of.

The biggest downside of the ACA is the reliance on the private insurance industry.  It does not have to be this way, however.  There is yet another provision in the Affordable Care Act that can open the door for states to institute their own single-payer healthcare system.  Other states have a public option, especially for those below a certain income level, but no state had instituted a true single-payer system.  All of this has changed thanks to President Obama and the Affordable Care Act.

Vermont—Home of Ben and Jerry’s, Maple Syrup, Bernie Sanders and the first state to pass marriage equality.  Now, Vermont will be known for something that will impact every resident in the state.

The ACA provided states with federal funds to institute a Medicaid expansion.  The states chose to expand the program also were able to set up their own state exchanges, which were relatively free from the problems the federal site had.  Vermont decided to take it a step further by setting up their very own single payer system.

The slogan of the program: Everybody in, nobody out.

The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes.  In exchange, there will be no more premiums, deductibles, copay’s, hospital bills or anything else aimed at making insurance companies a profit.  Further, all hospitals and healthcare providers will now be nonprofit.

This system will provide an instant boost the state economy.  On the one side, you have workers that no longer have to worry about paying medical costs or a monthly premium and are able to use that money for other things.  On the other side, you have the burden of paying insurance taken off of the employers side, who will be able to use the saved money to provide a better wage and/or reinvest in their company through updated infrastructure and added jobs.  It is a win-win solution.

To make sure that it is done right the first time, Vermont brought in a specialist who knows a thing or two about setting up a single-payer system.

Dr. William Hsaio, the Harvard health care economist who helped craft health systems in seven countries, was Vermont’s adviser. He estimates that Vermont will save 25 percent per capita over the current system in administrative costs and other savings.

Many like to say that the United States has the best healthcare system in the world.  The problem is we don’t.  Not even close.  In fact, the only way you can get the best healthcare in the world, is if you are willing and able to pay for it.  The United States can and must do better for its people.

Costs have to be held down — there is no reason why the U.S. has to pay twice the amount per capita as the next most costly system in the world (Norway’s), and still not cover millions of its citizens. A Harvard Medical School study states that 45,000 Americans die each year from treatable diseases because they cannot afford to get treatment.

45,000 Americans die every single year because they cannot afford treatment, are you ready for that?  That is 15 times the amount of people that died during the September 11, 2001, attacks, or perhaps for you Righty’s out there you would rather see it put this way, 11,250 times the amount of people that died in the Benghazi attack.  That equals 5 Americans that die every hour, of every day, of every year because of a preventable illness that was not taken care of due to lack of access and means.

Even once the Affordable Care Act wrinkles are ironed out, which they will be, and every America is covered, which will happen, that will not change the fact that all of this is being driven by a for-profit system by companies that only care about their bottom line.  Despite rules in the ACA which prevent insurance companies from absolutely gouging their customers, insurance companies are not exactly know for their ethical behavior.

A single-payer system would all but eliminate anybody dying unnecessarily due to lack of access to healthcare.  Our Declaration of Independence states, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”  How can somebody have life and happiness, without their health?  Despite the glaring hypocrisy of rich, white males who owned slaves stating all men are created equal, we have come a long way from 1776.  Yet when it comes to the very basic need, we are left to the whim of a business.  Single-payer is inevitable, and the ACA is a giant step in that direction.  We need must hold our officials to a higher standard which will get us there faster.  40,000 people a year is absolutely unacceptable.  Vermont saw the writings on the wall.  Will the rest of us?

Video

Bernie Sanders on MSNBC discussing his state’s new single-payer system.

 

 

All U.S. Constituencies Oppose Obama’s “Individual Mandate” for Health Care April 3, 2012

Posted by rogerhollander in Barack Obama, Health, Race.
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Black Agenda Radio commentary by Glen Ford

President Obama’s mandate to buy private insurance was born in the rightwing Heritage Foundation, and has not found a home among any actual constituency of the public – white, non-white, Republican, Democrat, college-educated or not. A new poll confirms that “Obama has based his plan on a scheme that nobody likes – even his most loyal supporters.”

 

All U.S. Groups Oppose Obama’s “Individual Mandate” for Health Care

A Black Agenda Radio commentary by Glen Ford

The new poll shows that no significant constituency supports Obama’s individual mandate.”

When one takes a cursory look at where various groups in the nation stand on President Obama’s health care legislation – now under review by the U.S. Supreme Court – it appears the country is split along party and race lines. A new poll conducted by Princeton Research Associates shows 75 percent of Democrats support the Obama position, and 86 percent of Republicans oppose it, with so-called independents evenly split. The racial divide is similar. Sixty-eight percent of non-whites “strongly favor” or “somewhat favor” the overall health care law, with only 18 percent opposed. Whites are far more divided, with 33 percent favoring Obama’s law, and 47 percent opposed.

These numbers are, however, heavily influenced by what people think is in the law, and what side they think they should be on, based on their larger loyalties. It is doubtful that majorities on either side of the issue actually understand most of the law’s many provisions, some of which do not go into effect for several years. Therefore, many of the respondents are using the poll to register their broader preference for or against the incumbent president and his party. It is no surprise that majorities of whites and super-majorities of Republicans oppose ObamaCare, as Republicans call it, and more than two thirds of non-whites and three-quarters of Democrats support Health Care Reform, as Obama calls it.

However, most people do understand the central element of the law, the “individual mandate” that forces nearly everyone to buy health insurance from private companies, or face a fine. The new poll shows that no significant constituency supports Obama’s individual mandate, with only 28 percent of the overall public favorable to the scheme. Even non-whites, two-thirds of whom claim to support Obama on health care in general, balk at mandatory purchase of insurance from private companies. Fifty-three percent of non-whites give thumbs down to the individual health insurance mandate, as do 71 percent of whites. More Democrats are opposed to Obama’s individual mandate than favor it: 48 to 44 percent. And Republicans are off the scale in opposition, at 15 to 1.

Fifty-three percent of non-whites give thumbs down to the individual health insurance mandate.”

So, if the core of the Obama health care plan is the individual mandate, as both the administration and the Republicans contend in their arguments before the Supreme Court, then Obama has based his plan on a scheme that nobody likes – even his most loyal supporters.

There’s another interesting aspect to the new poll. It shows that only a hard core of one in four people want to tamper with Medicare as the Republicans do, with around two-thirds of all racial groups opting to keep the program the way it is, with the government paying doctors and hospitals directly for the service they provide to seniors.” Taken together, the poll indicates strong support for the core elements of the U.S. healthcare safety net, and rejection of private schemes, including Obama’s mandatory purchase of insurance from private companies. It appears that most Americans would rather have the option of dependable, direct health care paid for by the government – which was the case at the beginning of 2009, before Obama unveiled his health care scheme, when 60 percent and more of the American people favored single-payer health care. But Obama maneuvered them into a something they hadn’t asked for, and which, three years later, nobody wants. For Black Agenda Radio, I’m Glen Ford. On the web, go to BlackAgendaReport.com.

 

To Kill (a) Medicare March 20, 2012

Posted by rogerhollander in Health, Seniors.
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The House Republicans’ plan to end Medicare as we know it is coming back this week. Please take this opportunity to share information about this reckless plan with your friends and family.

The House GOP budget would fundamentally change Medicare from a single-payer plan that provides guaranteed benefits and coverage into a voucher plan designed to pay a portion of premiums to private insurance companies.

Representative Paul Ryan’s budget plan would so drastically change the way America’s seniors are provided health care coverage that it becomes a completely unrecognizable, inferior and dangerous program.

The Ryan plan essentially would revoke the guarantees that provide seniors and people with disabilities a specific set of benefits and services, replacing it with vouchers covering a portion of premiums to private insurance companies. If Republicans get rid of the guarantees to benefits and services, it will destroy the Medicare program that seniors have relied on for nearly 50 years. They talk about providing a traditional Medicare option at first, but the way they designed this guarantees it will soon fail and have to be eliminated.

We have paid into the Medicare system our entire working lives. Under the GOP’s plan, guaranteed coverage would be phased out over time. When we retire, whether that’s in 10 years or 40, we would be enrolling in a Medicare system based solely on private insurance companies.

Private insurers seek to maximize profits while minimizing costs. This leads to a health care system that wasn’t designed to ensure that seniors get quality care, but instead is designed to line the pockets of insurance company executives.

Click here to share information about this dangerous plan with your friends and family.

In the coming weeks we will send you more information about this attack on Medicare.

Best Wishes,

Will O’Neill Health Care for America Now


 

Abortion Foes Capitalize on Health Care Law May 16, 2010

Posted by rogerhollander in Health, Women.
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(Roger’s note: thank you, again, President Obama, for your progressive health care legislation.)
Published on Sunday, May 16, 2010 by The Associated Pressby Ricardo Alonso-Zaldivar

Abortion opponents fought passage of President Barack Obama’s health care overhaul to the bitter end, and now that it’s the law, they’re using it to limit coverage by private insurers.

[ Gerald Herbert / AP  FILE - In this March 21, 2010, file photo President Barack Obama speaks to the nation following the final vote in the House of Representatives for comprehensive health care legislation in the East Room of the White House. Obama and Democratic House leaders resolved a dispute over abortion earlier that Sunday, securing crucial support from a handful of lawmakers.]
Gerald Herbert / APFILE – In this March 21, 2010, file photo President Barack Obama speaks to the nation following the final vote in the House of Representatives for comprehensive health care legislation in the East Room of the White House. Obama and Democratic House leaders resolved a dispute over abortion earlier that Sunday, securing crucial support from a handful of lawmakers.

An obscure part of the law allows states to restrict abortion coverage by private plans operating in new insurance markets. Capitalizing on that language, abortion foes have succeeded in passing bans that, in some cases, go beyond federal statutes. 

“We don’t consider elective abortion to be health care, so we don’t think it’s a bad thing for fewer private insurance companies to cover it,” said Mary Harned, attorney for Americans United for Life, a national organization that wrote a model law for the states.

Abortion rights supporters are dismayed.

“Implementation of this reform should be about increasing access to health care and increasing choices, not taking them away,” said Sen. Patty Murray, D-Wash., a member of the Senate leadership. “Health care reform is not an excuse to take rights away from women.”

Since Obama signed the legislation law March 23, Arizona and Tennessee have enacted laws restricting abortion coverage by health plans in new insurance markets, called exchanges. About 30 million people will get their coverage through exchanges, which open in 2014 to serve individuals and small businesses.

In Florida, Mississippi and Missouri, lawmakers have passed bans and sent them to their governors. Most of the states allow exceptions in cases of rape, incest or to save the life of the mother. Insurers still could offer separate policies to specifically cover abortion.

Three other states may act this year – Louisiana, Ohio and Oklahoma. Overall, there are 29 states where lawmakers or public policy groups expressed serious interest, Harned said.

“You are going to see more actions like this,” said Tom McClusky, a lobbyist for the socially conservative Family Research Council. “This is not something we are just going to let fall by the wayside.”

Before the overhaul became law, five states had limits on private insurance coverage of abortion – Idaho, Kentucky, Missouri, North Dakota and Oklahoma. Abortion rights supporters are concerned that the list is growing as a result of the new federal law.

Murray had joined in voting down a federal abortion coverage ban when the Senate debated health care last year. Now she and other abortion rights supporters worry the same sorts of restrictions could spread from state to state.

“It’s really going to be a patchwork of state laws by the time these exchanges are set up,” said Jessica Arons, director of women’s health at the Center for American Progress, a liberal public policy institute.

Most private health insurance plans cover abortion as a legal medical procedure, but research indicates many women opt to pay directly.

The federal law allows private insurance plans in the exchanges to cover abortion as long as they collect a separate premium. That money must remain apart from public subsidies available to help pay insurance premiums for most customers in the exchanges.

That compromise split abortion foes in Congress and around the country. Anti-abortion organizations including National Right to Life and the U.S. Catholic bishops called it a fig leaf, and continued to oppose the legislation. But Catholic hospitals and many religious orders of nuns supported it.

Abortion rights supporters were cool to the compromise, but it broke a political deadlock threatening the bill.

Anti-abortion Democrats in the House cast critical votes for the legislation after Obama also agreed to an executive order affirming long-standing federal policy against the use of taxpayer funds for abortion except in cases of rape, incest or to save the life of the mother – known as the Hyde amendment.

Tennessee already has enacted a far stricter ban, with no exceptions. Democratic Gov. Phil Bredesen, who allowed it to become law without his signature, said in a statement it “creates a prohibition much broader than that found in current law and could unintentionally negatively impact the quality of health care options for Tennesseans.”

All eyes are now on Florida, where Gov. Charlie Crist will decide soon whether to sign a bill that restricts abortion coverage in that state’s insurance exchange. Florida is a politically diverse state, not known as a bedrock of social conservatism. Crist is running for the U.S. Senate as an independent, after it became clear that he would lose the Republican primary to former state Rep. Marco Rubio.

Crist, who opposes abortion, has indicated he has problems with a part of the bill that would require a woman seeking an abortion to view an ultrasound of the embryo.

“Florida has always been pretty much of a middle-of-the road state,” said Stephanie Kunkel, executive director of Planned Parenthood’s affiliates in the state. “If Florida passes it, it really open up more moderate states to passing these bans.”

Conservatives say they won’t forgive a Crist veto. “You can count him as done if he vetoes this bill before him now,” said McClusky of the Family Research Council.

© 2010 The Associated Press

Attorneys General in 14 States Sue to Block Health Care Reform Law March 24, 2010

Posted by rogerhollander in Health.
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(Roger’s note: it gets curiouser and curiouser.  Republican state Attorneys General, who couldn’t give a damn about the Constitution and just want to make mischief for the Democrats, have inadvertently hit the nail on the head.  They are questioning the government’s authority to force its citizens and residents to purchase a product, which in this instance is private health insurance, and which is universally considered to be a defective product.  Talk about doing the right thing for the wrong reasons.  It brings into relief this absurd strategy to reform health care in the US by creating a private monopoly instead of doing the logical thing, which is a public monopoly, which is what you find in Canada and most of Europe.  And it all has to do with the private health insurance and pharmaceutical industries virtually owning the presidency and the Congress.  US democracy in action.  What should Obama have done?  He should have from the beginning put forward a single-payer, medicare-for-all proposal, fought for it with all his eloquence and popularity, and then if it failed it would be on the Republicans and Blue Dog Democrats who would have killed it.)

Tuesday 23 March 2010

by: Warren Richey, The Christian Science Monitor
 

 

Miami – A lawsuit filed Tuesday in Florida includes 13 states and charges that the new healthcare reform law in unconstitutional. Virginia’s attorney general filed a separate lawsuit.

State attorneys general wasted no time filing legal challenges to President Obama’s healthcare reform law, swinging into action with legal filings in Florida and Virginia within minutes of the White House signing ceremony on Tuesday.

In Tallahassee, Fla., 12 attorneys general joined Florida Attorney General Bill McCollum in a 22-page complaint filed in federal court, charging that the new healthcare reform package exceeds Congress’s powers to regulate commerce, violates 10th Amendment protections of state sovereignty, and imposes an unconstitutional direct tax.

“This lawsuit should put the federal government on notice that Florida will not permit the constitutional rights of our citizens and the sovereignty of our state to be ignored or disregarded,” Attorney General McCollum said.

A Second Suit in Virginia

Virginia filed a similar lawsuit simultaneously in federal court in Richmond. That suit is slightly different in that it focuses in part on the clash between a recently enacted state law protecting the right of Virginia residents to refuse unwanted health insurance and the new federal law that imposes penalties on anyone who seeks to defy the national government’s command to purchase health insurance.

“Congress lacks the political will to fund comprehensive health care … because taxes above those already provided [in federal healthcare programs] would produce too much opposition,” the Virginia lawsuit says.

“The alternative, which was also a centerpiece of the failed Clinton administration health care proposal, is to fund universal health care in part by making healthy young adults and other rationally uninsured individuals cross-subsidize older and less healthy citizens,” the suit says.

The seven-page lawsuit presents a straightforward challenge to Congress’s decision to rely on its power to regulate interstate commerce to justify the federal mandate that every individual must have health insurance or pay a penalty.

“It has never been held that the Commerce Clause [of the Constitution] … can be used to require citizens to buy goods and services,” the suit says. “To depart from that history to permit the national government to require the purchase of goods and services would deprive the Commerce Clause of any effective limits.”

Aiming for the US Supreme Court

At a press conference in Florida, McCollum said his lawsuit is intended to move through the courts to the US Supreme Court. “I am confident the court is going to declare the new healthcare law unconstitutional,” he said.

Democratic leaders have downplayed any potential legal problems with the healthcare reform package. Many legal analysts agree with them. Others suggest the issue is open and could produce a landmark decision if the high court decides to take it up.

In addition to Florida, participating plaintiffs in the lawsuit include attorneys general from South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Michigan, Colorado, Pennsylvania, Washington State, Idaho, and South Dakota. The suing attorneys general are Republicans except James “Buddy” Caldwell of Louisiana, who is a Democrat.

The Florida-filed lawsuit identifies two victims. It says the new law infringes the liberty of individual state residents to choose for themselves whether to have health insurance. It also says the states themselves are victims of a federal power grab by leaders in Washington.

Worries About Bigger Medicaid Rolls

The new structure of the Medicaid portion of the healthcare bill – which deals with low-income Americans – leaves Florida with an offer it can’t refuse. The state can either opt out of Medicaid and leave millions of its most vulnerable residents uninsured, or opt in and surrender its authority to set priorities and run programs to an increasingly powerful national government.

Currently, Medicaid costs account for 26 percent of Florida’s annual budget. That is $18 billion for 2.7 million Medicaid recipients.

The suit says that, under the new law, Medicaid rolls in Florida are expected to increase dramatically. The corresponding soaring costs will fall increasingly on the Florida treasury, but state officials will have less authority to set priorities.

“[Florida] employees will be conscripted and forced to administer what now is essentially a federal Medicaid program for which Florida must bear a substantial cost,” the suit says.

Estimates are that the new law will impose additional costs on Florida ranging from $149 million in 2014 to more than a $1 billion by 2019.

The lawsuit says this amounts to an unconstitutional exercise of federal power that violates principles of federalism protected in the 10th Amendment. It says the healthcare reform bill commandeers the states and their employees as agents of the federal government’s regulatory scheme, and that it does so at the state’s own cost.

Another Beef: An Unconstitutional Direct Tax

The suit also says the tax penalty for noncompliance with the individual mandate to buy health insurance “constitutes a capitation and a direct tax that is not apportioned among the states according to census data, thereby injuring the sovereign interests of [the states].”

The tax penalty is unrelated to any taxable event or activity, the suit says. “It is to be levied upon persons for their failure or refusal to do anything other than to exist and reside in the United States,” the suit says.

This doesn’t just injure individuals who have a right to make healthcare decisions without government inference, the suit says. It also injures state governments who are forced to pay for the higher number of individuals coerced into enrolling in Medicaid.

Like the Virginia lawsuit, the Florida-filed suit also argues that Congress does not have the authority under the US Constitution to compel citizens to buy health insurance or punish them if they do not. An individual’s choice not to have health insurance is not “commerce” and thus does not fall within Congress’s power to regulate interstate commerce, the suit says.

A Third Lawsuit, in Michigan

In addition to the two state lawsuits, the Thomas More Law Center in Ann Arbor, Mich., filed a lawsuit in Michigan. It is filed on behalf of four individuals in southeastern Michigan who object to being forced to purchase healthcare coverage and who object to being forced to pay for abortions, contrary to their religious beliefs.

“Our Founding Fathers envisioned a limited form of government. The purpose of our Constitution and this lawsuit is to insure that it stays that way,” said Richard Thompson, president and chief counsel of the law center, in a statement.

“Let’s face it, if Congress has the power to force individuals to purchase health insurance coverage or pay a federal penalty merely because they live in America, then it has the unconstrained power to mandate that every American family buy a General Motors vehicle to help the economy or pay a federal penalty.” 

Health Reform Passes, But I Still Don’t Feel So Good March 23, 2010

Posted by rogerhollander in Health.
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by Randall Amster

Published on Tuesday, March 23, 2010 by CommonDreams.org

Hurray! I mean, Boo! Or is it, What? Perhaps we should just go with Whatever. No matter how you slice it, something has happened that is either historically fabulous, monumentally stupid, perplexingly intricate, or ordinarily mundane. I suspect, in the end, it will wind up being all of this and more. Welcome to the brave new world of health insurance reform, with a little something for everyone and a lot for some.

Don’t get me wrong: health care is a really good thing, something that should be a universal human right and never treated like a for-profit commodity. The only options approaching this horizon were long ago deemed “fringe” in the popular debate, leaving progressives to huddle around a lukewarm “public option” that never had a prayer of making the final cut when it came time to pass the bill. Staunch legislative holdouts miraculously caved at the last minute to support a problematic law, and the only folks representing the “no” side of the argument in the end were the regressive wingnuts rattling congressional cages with thinly-veiled homophobia and racially-tinged expletives. You know things are bad when that cadre even starts to make a little bit of sense on the issues — although of course, their alternative health plan probably includes requirements that people first show their birth certificates and pass an English test before being handed a set of bootstraps and a grade school anatomy book that omits any images of private parts and excludes anti-American doctors like Seuss, Zhivago, Ruth, and Spock.

The best part of the new bill is where we all get to buy health insurance from Monopolies Unlimited, and if we can’t afford it there will be subsidies given to us that we can then give right to the same insurance companies who have of course served our interests so well up to this point. If we don’t purchase this coverage, then the IRS can levy fines on us, which in many cases will be cheaper than the required tithe; this will leave some folks in the awkward position of having to pay to remain uninsured, which would be ironic if it wasn’t so excruciatingly real. However, even those who do pay for coverage — top dollar, too, since viable price controls are a non-sequitur by now — will be receiving only insurance and not necessarily actual care, since many steps on the ladder to treatment must be traversed in between insurance provision and medical fruition. The apex of the perverse options will be embodied by those who refuse to pay the insurance companies for an inherently defective product and also refuse to pay the fine for their transgression, leading to a class of people perhaps to be deemed the “Uninsurables” who will be made to wear the letter “U” on their chests and will be legally prohibited from ever getting sick.

But wait! This new bill is only a first step in the direction of better and more universal health care, say the apologists. It’s the best we could get in this political climate, and represents the sort of compromise that marks both maturity and good sense. It emboldens the Democrats to be more progressive, and provides our fledgling young President with a much-needed momentum boost. It will save money, cover millions more people, rein in some of the worst insurance practices, and bring America into closer alignment with the rest of the nations of the civilized world. To oppose this bill at this critical time would indicate that one is either hopelessly partisan (Republicans), plain old wacko (Teabaggers), naively socialistic (Single Payer), deeply unrealistic (Public Option), or electorally useless (The Actual Left). At the end of the day, we have to get on board with this, since it’s the only game in town, right?

Hmm, I almost even convinced myself for a minute there (not really). Here’s another rendering of the game. Corporate lobbyists opposed the bill until they got the one they wanted, and indeed this one looks a lot like their model version proposed in 2008. Huge sums of money flowed to key congresspersons to purchase/influence their votes, and even the few still on the board who seem at times to display integrity reversed course and gave this one a thumbs up. The political landscape is now dominated by one party with no ideas except regressive anti-intellectualism, and another with no spine that is pretty well bought out by Corporate Persons who vote (and vote and vote) with their unlimited dollars. As for we the people, our triumph is that we now get to have more of us relegated to universal serfdom and also must (or else) pay fealty and tribute to the neo-Robber Barons who have generously expanded the realm of insurance coverage in a selfless act of noblesse oblige. The politics of “least worst” once again prevails, and our health is now totally owned by the company store. And as a final insult, people you like and admire are cheerleading for this, and to do otherwise renders one anathema (which is not covered under most policies, of course).

Suddenly, amidst the celebratory gaveling and laudatory reveling, despite the incessant and pervasive chatter about health this and health that, and notwithstanding the wire-services version of the good news about expanded coverage — suddenly, I’m not feeling all that well. Watching my country continue down a path of feudalism posing as democracy, where our choices are constrained by the machinations of the far right and the center-right, has left me with a damaged heart and an open wound. While my personal disillusionment is no doubt preexisting, its exacerbation is ongoing and I’m beginning to wonder if there’s any hope for a cure at this point. Indeed, I had tried to ignore this condition in the misguided belief that it would magically go away, but it only seemed to get worse in the process. Now I fear it’s become chronic.

But hey, we finally got health care, and hope is restored! Yes, this should effectively balance out perpetual wars, environmental toxification, Big Brother, Bigger Bailouts, mainstream media, rampant recession, and climate change. Whew! It felt good to list all that out. Maybe I won’t be needing that required checkup from my cold-handed health insurance provider after all.

Randall Amster, J.D., Ph.D., teaches Peace Studies at Prescott College, and is the Executive Director of the Peace & Justice Studies Association. His most recent book is Lost In Space: The Criminalization, Globalization, and Urban Ecology of Homelessness (LFB Scholarly 2008).

Supporting Obama’s Health Bill: Lesser of Evils or Pact with the Devil? March 23, 2010

Posted by rogerhollander in About Health, Health.
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No one tears a patch from a new garment and sews it on an old one. If he does, he will have torn the new garment, and the patch from the new will not match the old. [37] And no one pours new wine into old wineskins. If he does, the new wine will burst the skins, the wine will run out and the wineskins will be ruined. [38] No, new wine must be poured into new wineskins.

Luke 5: 37-39

Roger Hollander, March 23, 2010

www.rogerhollander.com

The health industry stocks shot up once the bill passed.  More than anything else that tells us who stands to benefit.

What I find so frustrating is the notion, prevalent amongst Obama’s supporters, that by adding a few new benefits (some of which may or may not happen) to a totally corrupt system, somehow you have moved forward.  The Obamites badly needed a political victory, and they were willing to sell out not only their “progressive base,” as many have mentioned, but the vast majority of Americans who want, need and deserve a single-payer national plan.  Not to mention the roll back on a woman’s right to choose and such things as cruel, costly and stupid restrictions on undocumented immigrants buying health insurance.  

Perhaps the biggest irony is that the Republicans are attacking the bill as “socialistic” when in fact it is just the opposite.  The Republicans are making the right criticism (the government forcing people to buy private insurance, something that actually is right up their alley) for the wrong reason (trash the Democrats regardless of the issue).  Inwardly they are rejoicing at the bill’s entrenchment of private insurance with no public option while outwardly they are indignant at the “socialist” imposition of health insurance.  A win-win situation for them.

The Democrats might as well have put in a single-payer plan, which of course they didn’t not because they chose the wrong strategy, but because they just as much as the Republicans are owned by the corporate insurance and pharmaceutical industries. 

But it is the facile notion that a few crumbs are better than nothing that is staggering in its naïveté and its failure to realize that you do not pour new wine into old wineskins, that in so doing you may (may!) make some small gains at the cost of the ultimate objective.

To those who acknowledge that a single-payer, medicare-for-all plan is the only genuine solution, but that sometimes you have to settle for the lesser of evils, I suggest that there is a difference between the lesser of evils and a Faustian bargain with the Devil.

The Health Care Hindenburg Has Landed March 22, 2010

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(Roger’s note: as someone who has lived under both the US and Canadian health care systems, there is absolutely no doubt in my mind that the ONLY solution to the serious US healthcare problem is a single payer system, something like Medicare for all.  Should the passing of the Obama bill be celebrated?  I have argued that no bill is better than this bill, and that passing it will further entrench the existing system, which amounts to a corporate monopoly and make it nigh unto impossible to ever achieve genuine reform.  I wish that I were wrong, and that the current bill is a step in the right direction. Only time will tell, but I have not seen anything to convince me that we are on the right road with Obama’s bastardized, Byzantine, Rube Goldberg, corporate give-away concoction that he has pawned off on us a health reform.)

Published on Monday, March 22, 2010 by TruthDig.comby Chris Hedges

Rep. Dennis Kucinich’s decision to vote “yes” in Sunday’s House action on the health care bill, although he had sworn to oppose the legislation unless there was a public option, is a perfect example of why I would never be a politician. I respect Kucinich. As politicians go, he is about as good as they get, but he is still a politician. He has to run for office. He has to raise money. He has to placate the Democratic machine or risk retaliation and defeat. And so he signed on to a bill that will do nothing to ameliorate the suffering of many Americans, will force tens of millions of people to fork over a lot of money for a defective product and, in the end, will add to the ranks of our uninsured.

The claims made by the proponents of the bill are the usual deceptive corporate advertising. The bill will not expand coverage to 30 million uninsured, especially since government subsidies will not take effect until 2014. Families who cannot pay the high premiums, deductibles and co-payments, estimated to be between 15 and 18 percent of most family incomes, will have to default, increasing the number of uninsured. Insurance companies can unilaterally raise prices without ceilings or caps and monopolize local markets to shut out competitors. The $1.055 trillion spent over the next decade will add new layers of bureaucratic red tape to what is an unmanageable and ultimately unsustainable system.

The mendacity of the Democratic leadership in the face of this reality is staggering. Howard Dean, who is a doctor, said recently: “This is a vote about one thing: Are you for the insurance companies or are you for the American people?” Here is a man who once championed the public option and now has sold his soul. What is the point in supporting him or any of the other Democrats? How much more craven can they get? 

Take a look at the health care debacle in Massachusetts, a model for what we will get nationwide. One in six people there who have the mandated insurance say they cannot afford care, and tens of thousands of people have been evicted from the state program because of budget cuts. The 45,000 Americans who die each year because they cannot afford coverage will not be saved under the federal legislation. Half of all personal bankruptcies will still be caused by an inability to pay astronomical medical bills. The only good news is that health care stocks and bonuses for the heads of these corporations are shooting upward. Chalk this up as yet another victory for our feudal overlords and a defeat for the serfs.

The U.S. spends twice as much as other industrialized nations on health care-$7,129 per capita-although 45.7 million Americans remain without health coverage and millions more are inadequately covered, meaning that if they get seriously ill they are not covered. Fourteen thousand Americans a day are now losing their health coverage. A report in the journal Health Affairs estimates that, if the system is left unchanged, one of every five dollars spent by Americans in 2017 will go to health coverage. Private insurance bureaucracy and paperwork consume 31 cents of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough, Physicians for a National Health Plan points out, to provide comprehensive, high-quality coverage for all Americans. Check out www.healthcare-now.org. It has some of the best analysis.

This bill is not about fiscal responsibility or the common good. The bill is about increasing corporate profit at taxpayer expense. It is the health care industry’s version of the Wall Street bailout. It lavishes hundreds of billions in government subsidies on insurance and drug companies. The some 3,000 health care lobbyists in Washington, whose dirty little hands are all over the bill, have once more betrayed the American people for money. The bill is another example of why change will never come from within the Democratic Party. The party is owned and managed by corporations. The five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009. The Washington Post reported that up to 30 members of Congress from both parties who hold key committee memberships have major investments in health care companies totaling between $11 million and $27 million. President Barack Obama’s director of health care policy, who will not discuss single payer as an option, has served on the boards of several health care corporations. And as salaries for most Americans have stagnated or declined during the past decade, health insurance profits have risen by 480 percent.

Obama and the congressional leadership have consciously shut out advocates of single payer from the debate. The press, including papers such as The New York Times, treats single payer as a fringe movement. The television networks rarely mention it. And yet between 45 and 60 percent of doctors favor single payer. Between 40 and 62 percent of the American people, including 80 percent of registered Democrats, want universal, single-payer not-for-profit health care for all Americans. The ability of the corporations to discredit and silence voices that represent at least half of the population is another sad testament to the power of our corporate state to frame all discussions.

Change will come only by building movements that stand in fierce and uncompromising opposition to the Democrats and the Republicans. If they can herd Kucinich and John Conyers, the sponsors of House Resolution 676, a bill that would create a publicly funded National Health Program by eliminating private health insurers, onto the House floor to vote for this corporate theft, what is the point in pretending there is any room left for us in the party? And why should we waste our time with gutless liberal groups such as Moveon.org, which felt the need to collect more than $1 million to pressure House Democrats who had voted “no” on the original bill to recant? What was this purportedly anti-war group doing anyway serving as an obsequious recruiting arm of the Obama election campaign? The longer we tie ourselves to the Democrats and these bankrupt liberal organizations the more ridiculous and impotent we appear.

“I’m ready to listen to the White House, if the White House is ready to listen to the concerns about putting a public option in this bill,” the old Kucinich said on the “Democracy Now!” radio and television program before he flipped. “I mean, they can do that. You know, they’re still cutting last-minute deals. Put the public option back in. Make it a robust public option. Give the people a chance to really negotiate rates with the insurance companies … from the standpoint of having a public option. But don’t just tell the people that you’re going to call this health care reform, when you’re giving insurance companies an even more powerful monopoly status in our economy.”

© 2010 TruthDig.com

Do Not Resuscitate the ‘Public Option’ February 23, 2010

Posted by rogerhollander in Health.
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(Roger’s note: I have been inundated of late with passionate e-mail pleas from liberal and progressive Democratic Party web sites, urging me to join the bandwagon pushing for the so-called “public option.”  Senators who signed on to a petition to add the public option are being hailed as heroes, and we are being urged to contribute to the campaigns of those who are facing opposition because of their stand.  While it is pathetic that so many are willing to consider a few crumbs falling off the table as a political victory, it has further been argued forcefully that the current health form legislation, as it has been passed by both houses of congress, constitutes a disaster for genuine reform with our without the token public option that is being proposed.  I am convinced that in order to support genuine health care reform [i.e. some form of single-payer universal coverage], the current legislation in whatever form the appeaser Obama and the bought-and-paid-for Congress come up with should be opposed, and it should fail.  The reason for this is that this legislation will further entrench the blood-sucking health insurance industry under the guise of reform.  It will set back the cause of single-payer health care for decades or longer.  When will we learn that the kind of pragmatism practiced by Obama under the influence of Rahm Emanuel is self defeating and only feeds in the long run into the agenda of the neo-fascist right?)

Published on Tuesday, February 23, 2010 by CommonDreams.org

by Andy Coates

Like initiating CPR on a patient who was dead in the field and remained dead on arrival, the effort to resuscitate the “public option” is mistaken and futile.

Once upon a time, proponents of the “public plan option” sought a “Medicare-like” program that might enroll every other person in the nation and thus run private insurers out of business.

“A roadblock to reform” cried the insurance companies. In turn, nothing in the bills passed by the House and the Senate would erect a public insurer that could possibly influence the insurance market.

The House bill included a feeble government plan, to start in 2013, that would enroll perhaps 2 percent of the nation by 2019. The Senate bill simply nixed the idea altogether. Now the President, in his latest proposal, has also abandoned the “public option.”

In reality the “public option” was never much more than a K-street phrase, a shadow-puppet, a political posture. All along proponents of adding a new government-sponsored insurer boasted “talking points” but never offered workable health reform.

But the insurance companies oppose the “public option” and that proves its virtue, its supporters exclaim.

Hello? Of course the insurers oppose it.

Why would the insurers want to yield even 2 percent of the market to a public plan (House bill) when they’ve been given the “option” (Senate bill) of keeping 100 percent of the market? Why would the insurance companies not fight for the whole pie when the White House let slip that it saw the “public option” as simply a bargaining chip in private dealmaking?

But there is something else here.

With its reliance on the magic of the marketplace, the “public option” is simply not a proposal for reform. In fact, it has already been tried, and failed: in Maine, a “public option” insurer known as DirigoChoice, was established in 2003. It has failed to enroll but a tiny percent of the uninsured, did nothing to reduce the costs of insurance or health care, nor did it reduced overall health spending, nor did disparities in care improve – and in the last year DirigoChoice has fatally tanked.

In the United States a corporate oligopoly of huge insurers, with near-monopoly control in most locales, dominate the market. A government insurer of any size would simply add yet another bureaucracy to the present byzantine insurance mess.

Does it really make any sense to think that a government plan could give the private insurance companies a run for their money – within the contemporary corporate marketplace – without draconian regulation upon the industry? Even with regulation, as former Cigna executive Wendell Potter explained at the PNHP annual meeting this year, insurance companies simply “flaunt regulations.”

The insurance market cannot be tricked into reforming itself. The health insurance company that wins at the marketplace avoids and jettisons sick and poor patients and enrolls the healthy and the wealthy – and a “public option” will not change this fact. The market that serves the private interests – profiteering at the expense of the sick – would continue to do so.

The proper name for this kind of “market magic” is the race to the bottom. Adding a public plan into the private mix can not and will not change the character of this cruel game.

Any successful “public option” insurance plan would wind up covering the sick and the poor. It would be designed to lose, not win, the market competition. It would not prove affordable or comprehensive. Worst of all, a highly successful “public plan option” could put our nation on a fast-track to permanent two-tiered health services, exacerbating deplorable disparities that plague us.

Regrettably, that the “public option” has been given attention at all is but a measure of how deeply our culture has surrendered to neoliberal ideology, the ideas popularized by Ronald Reagan. It is a lie that the market will always provide, most especially when it comes to health care. So why would some of our friends still seek to revive the false promise of the “public option”?

Marie Gottschalk, University of Pennsylvania Professor of Political Science, identified the psychology at work. In a remarkably prescient essay written in late 2009, she compared health reformers in the United States to victims of the Stockholm Syndrome, in which hostages identify with – and even defend – the hostage-takers.

We ought to reach out with sympathy to our friends who have fallen captive to Ronald Reagan ideology and say: Do not resuscitate the “public option.” It is time to let it go.

All along, adding a feeble public insurance plan to the insurance market has been but a very poor excuse to support “insurance reform” that will criminalize the uninsured, divert billions of tax dollars to subsidize unaffordable private insurance premiums and protect pharmaceutical industry super-profits.

Another world is still possible. It is called Medicare-for-all, expanded and improved.

Andrew D. Coates, MD is a leader of Physicians for a National Health Program and the grassroots coalition Single Payer New York. (An earlier version of this essay appeared at The Progressive Media Project in December.)

A Patient’s View of the Senate Christmas Healthcare Gift December 24, 2009

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Published on Thursday, December 24, 2009 by CommonDreams.orgby Donna Smith

So, all the great fanfare and all the king’s horses.  The great and almighty U.S. Senate has spoken.  I will have to buy private health insurance — forever, amen.  The defective product that has left me wanting for real healthcare for all of my adult life is now a step closer to being the law of the land.

A lump of Christmas coal all polished up with sparkling rhetoric. 

Here’s what the Chicago Tribune said this week, and I agree: 

On Sunday, the Chicago Tribune published an exhaustive front-page analysis by Northwestern University‘s Medill News Service and the Center for Responsive Politics of how it was done. The main culprit: “a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation.”

The study found that 13 former congressmen and 166 congressional staffers were actively engaged in lobbying their former colleagues on the bill. The companies they were working for — some 338 of them — spent $635 million on lobbying. It was money extremely well spent — delivering a bill that, by forcing people to buy a shoddy product in a market with no real competition, enshrines into law the public subsidy of private profit.

As we approach the end of Obama’s first year in office, this public subsidizing of private profit is becoming something of a habit. It is, after all, exactly what the White House did with the banks. Just as he did with insurance companies, Obama talked tough to the bankers in public, but, when push came to shove, he ended up shoving public money onto their privately held balance sheets.

This is not just bad policy, it’s bad politics.

Now, back to my own thoughts as a patient:

I went broke while carrying health insurance, a disability insurance policy and a small healthcare savings account.  And if I get sick under this mess of a plan, it will happen to me again.  Little has changed except that millions more of my fellow citizens will join my ranks.

How does it happen to insured people under this plan?  Easy.  Step-by-torturous-step.  Slowly.  Like water-torture. 

1.       Buy health insurance at work or on the new exchange;

2.       Avoid using insurance due to co-pays, deductibles and out-of-pocket maximum exposures — not to mention lost work time and the worry about losing one’s job in a tough economy;

3.       If symptoms are noticed, treat by internet medical site suggestions and over-the-counter drugs until no other option but going to a doctor are available;

4.       Attempt to make appointment with doctor but first find one who accepts both new patients and your insurance;

5.       Go to doctor and pay co-pay up front before ever speaking to anyone about medical problem;

6.       Sit in outer waiting room for as long as required, missing work and worrying;

7.       Sit in exam room waiting for doctor for as long as required;

8.       See doctor for five or six minutes, if lucky, during which time you will either be prescribed some expensive drug to fix a problem the doctor isn’t sure you have, referred to another doctor who may have a month or two wait for appointments, be directed to get some tests done you aren’t sure your insurance will allow or pay for, and do it all sitting in your underwear or less;

9.       Leave medical office owing more than what you thought your insurance and co-pay advertised (and never get an explanation for how that is possible)  and never sure if this experience was much different than being to a used car lot where the sales folks have assessed your financing mechanism before showing you anything at all and then only show you what fits the financing not what you need or want;

10.   In the alternative, if you collapse or wait until symptoms get so severe that going for an office appointment is impossible, go to an emergency room — repeat steps five through eight — and either be admitted to the hospital if your insurance is adequate and you have any available sick-time from work (if not, beg for drugs and to be released) or go to number nine.

11.    Need a dentist?  Too bad.  Have dental insurance?  Still too bad.  You might get a cleaning and some x-rays, but getting the care you may or may not need will be again totally related to your ability to pay whatever portion of the dental work is not covered (and amazingly, every penny of what dental insurance will cover will be eaten up by whatever problem you may or may not have) — in the alternative, avoid dentists or just pull teeth as they go bad;

12.   When the bills roll in, try to pay some after trying to find out how you can possible owe hundreds if not thousands more than the insurance policy you have indicates is possible;

13.   When the collectors call to collect all of the balances due, try to negotiate payments but endure threats of lawsuit, garnishment and worse as the collectors report back to the doctors you saw for a few moments in number eight;

14.   Try to get your meds — if too costly, go without;

15.   Try to get well — if you cannot, go back to work;

16.   Try to act like this is all wonderful and you are grateful to have any insurance at all;

17.   Get sued by a collection agency for a doctor bill or hospital bill you cannot cover;

18.   Sell your house and use whatever proceeds you have to try to pay some of the debts;

19.   Collectors for the doctors and hospitals are not happy if you don’t pay it all in full and up-front most of the time;

20.   Feel stress, fear, anguish — but don’t gripe and don’t show it at work — buck it up, chump;

21.   Sell keepsakes and anything valuable to try to stay afloat;

22.   Stress, more stress.  Fear to answer the phone.  Friends and family fall away as they don’t want you to ask to borrow money;

23.   Keep working — sick or not, keep working or you’ll lose that damn insurance if you cannot pay the premium — or you’ll be back out on the exchange trying to buy another policy that is cheaper and even worse;

24.   Watch your elected officials claim victory and history as they work to make sure your kids and grandkids must suffer the same fate if they need healthcare in America;

25.   Have a Merry Christmas, so says your U.S. Senate.

Don’t think this can happen to you because it hasn’t yet?  Count your blessings this Christmas. 

I’d really like the gift of healthcare. Medicare for all, single-payer healthcare would remove so much of this awful process. That would be a gift.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

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