Sunday, June 14, 2009

Health War II

America's Health War I ended about 14 years ago.

We lost, the bad guys won.

Now Health War II has begun ...
Roert Reich's Blog: The Healthcare War is Now Official

Yesterday the American Medical Association came out against a public option for health care. And yesterday the President reaffirmed his support for it...


... All major lobbying firms in Washington -- many of them brimming with ex-members of Congress -- are now crawling all over the Hill. Lots of money is on the table. AMA's political action committee has contributed $9.8 million to congressional candidates since 2000, and its lobbying arm is one of the most formidable on the Hill. Meanwhile, Big Insurance and Big Pharma are increasing their firepower. The five largest private insurers and their trade group America's Health Insurance Plans spent a total of $6.4 million on lobbying in the first quarter of this year, up more than $1 million from the first quarter last year, and are spending even more now. United Health Group spent $1.5 million in the first quarter, up 34 percent from the $1.1 million it spent in the first quarter last year. Aetna spent $809,793 between January and the end of March, up 41 percent from last year. Pfizer, the world's biggest drugmaker, spent more than $6.1 million on lobbying between January and March, more than double what it spent last year. It also spent nearly $3.3 million lobbying in the fourth quarter of 2008. Every one of them is upping their spending....

... The President can't do this alone. You must weigh in and get everyone you know to weigh in, too. Bombard your senators and representatives. Organize and mobilize others. And let the White House know how strongly you feel...
In Minnesota our senators are Al Franken (still not seated) and Amy Klobuchar. I'm not worried about Franken, he'll do the right thing. I'm very concerned about Klobuchar. I've sent her an email through her extremely sluggish contact form.

This won't be pretty. I'd expect Obama to lose this one, except he's a pretty resourceful guy.

We know where we have to end up. We need to get to "Crummy Care".

Crummy Care is healthcare with dingy carpets and peeling (lead free) paint. Crummy Care is delivered by physicians, but also by a lot of cheaper routes. Crummy Care sends films to be (double) read in Malaysia, uses CT scanners that are four years past cutting edge, has waiting lists for services, and has tight formularies and highly optimized low cost standard care protocols.

Crummy Care is not what most of us want, but it is what we can afford to provide to everyone in America. (No, I'm sorry, electronic health records aren't really a miracle solution -- though they can make Crummy Care quite a bit better.)


Crummy Care is the good enough, affordable, minimalist solution. If you have money you can buy Mercedes care, but if you don't you'll get reasonably state of the art treatment for your breast cancer (sorry, probably not a bone marrow transplant) and reasonable preventive care (no PSA for your prostate).

So we know where we have to go. The problem is it's a lousy, harsh, innocence crushing trip. We won't travel that road if we try do do business as usual

Which is why we need the "public option".

If we don't get it, then I think we'll eventually decide we lost Health War II.

So what happens if we lose?

We wait 5-7 years for Health War III.

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