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Healthcare and Presidential Candidates

Physicians’ Perspective
Healthcare and Presidential Candidates
by Dr. Rick Bayer

Filmmaker Michael Moore reminds us in Sicko that nearly 50 million Americans are uninsured. Author Barbara Ehrenreich wrote in Why Does Everyone Bow Down to the Health Insurance Industry? that 18,000 Americans die every year because they cannot afford or cannot qualify for health insurance. Most medical bankruptcy occurs among the insured so no one can be complacent. Do you really understand the fine print? Even full-time insurance specialists struggle to understand it, so you would be unusual if you did!

In the US, insurers sell healthcare insurance as a for-profit commodity like cars. In countries with universal access, healthcare insurance is public, like police or fire departments.

America’s 1965 experiment with single-payer healthcare, Medicare, is successful for seniors. It is not socialized medicine because physicians remain in private practice rather than become employees. What single-payer health insurance advocates seek is Medicare for all Americans, not just those 65 and older. In spite of these facts, profiteers will frighten voters in 2008 with cries of “socialized medicine”! It’s an empty argument. No one disputes our socialized police forces, fire departments, or roads.

In America’s market-driven healthcare system, insurers compete by avoiding unprofitable patients, denying claims, or shifting costs back to patients or others. These actions generate huge administrative costs even to so-called “non-profit” insurers like Kaiser and Blue Cross who employ thousands to do nothing but deny claims. After large salaries and profits, there remains little money to care for sick people. American insurers have overhead costs 2 to 6 times the overhead of US Medicare. Is it any wonder Americans pay more for healthcare? And the final insult is that, even though we pay more, we get less.

During Bill Clinton’s first term, Hilary Clinton caved in to the big health insurers to produce an unworkable mess. Now universal care again is a hot topic. Candidate Clinton is cautiously matching proposals of Candidate John Edwards rather than breaking new ground. Both call for mandatory universal coverage in the first term of office by expanding systems of federal health insurance. Business would be required to provide coverage or pay into a federal funds pool.

Candidate Barak Obama may catch up with Edwards and Clinton but does not promise universal healthcare. Like Clinton, Obama’s ties to big business make it unlikely he will break new ground. So far, he requires employers to cover workers and promises insurance for children. He offers coverage choices similar to federal employees, but offers no option to those who cannot afford the premiums.

Candidate Bill Richardson would lower Medicare to age 55, expand Medicaid, and use tax breaks for businesses and indivi-duals to encourage universal healthcare. Richardson’s plan is clearly best among the top four Democratic fundraisers.

The best healthcare plan belongs to Candidate Dennis Kucinich’s Medicare-for-all, which would cover all Americans without raising taxes. The money now spent to market to the healthiest, deny claims to the sickest, and provide profits to the wealthiest, would instead take care of sick Americans. His plan does not provide any role for the for-profit health insurers.

What do the Republicans offer? As governor of Massachusetts, Mitt Romney signed universal coverage close to the Edwards and Clinton plans. Sadly, he already attacked Democratic plans as “European-style socialized medicine”.

Other than Romney, the Republican vision for healthcare is a world where the sick and dying get to deduct the cost for health insurance they cannot afford. Republicans will all shout “Hillary-care” but they have nothing to offer. Instead, they replay old fear tactics and hope American voters remain suckers.

By rejecting Medicare-for-all, Democratic candidates play into Republican fears. This is because, with the exception of Kucinich’s plan, the Democrats will have to raise taxes to continue to feed the for-profit healthcare industry.

So what happens if a universal healthcare candidate takes the White House? No, we do not automatically get universal healthcare. Candidates make promises that are hard to keep. Moreover, insurance and drug lobbies are not going away. They spend millions to make billions.

What can voters do? Demand universal healthcare. Demand that citizens come before profits. Then ask candidates, “How will your healthcare program show that American lives are more important than healthcare profits?”

Richard “Rick” Bayer, MD, FACP is board-certified in internal medicine, a Fellow in the American College of Physicians (FACP), practiced, and lives in Oregon.

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