extremophile

Health Care Letter to Editor

I used this tool to submit a letter to the editor in support of health care reform.  You should too if you are in support of this, otherwise the opportunity will pass.  Obama still needs grass-roots support even though he is president. Here’s my letter:

I am writing to state my strong support for Obama’s health care reform.  A system consisting of both public and private insurance options and a guaranteed coverage is a reform that will bring about a great and positive change in the country.  We cannot properly call our society a “civil” society if we do not attend to the health and well being of our citizens.  That we are a nation built upon principles of individual rights is a wonderful thing, but it would be of immense benefit to our society in my estimation to also commit ourselves to other rights such as the right to a basic level of health care.  This is a commitment that countless other materially wealthy nations the wordl over have made and which I believe we should as well. 

This is also a commitment that Republicans, I believe, can support. In fact, health care reform will enhance personal freedom and entrepreneurial activity in this country.  By ensuring that people will be able to get health care it could, for instance, end the type of pressure so common today wherein people remain in a job which does not suit their interests nor skills simply for the sake of retaining their medical insurance.  A reformed system might make it easier for individuals to afford health care thereby freeing individuals to seek out occupational niches that suit their skills and interests.  Health care reform, in this sense, can do much to increase the efficiency and productivity of individuals in our society in nearly every realm! 

Many of those who oppose health care reform seem to be concerned that health care reform will necessarily lead to the abridgment of individual rights or to “socialism.”  But this is fallacy. There is a world of difference between the system of health care that Obama is proposing and “socialized” health care.  Obama is proposing a system that retains private insurance companies while setting up a public insurance option that can compete with private insurance companies.  This competion will keep both the government run program and the private programs honest and competetive. 

There is however another level upon which reform is important.  No system of universal coverage that we create will be perfect.  Indeed, we cannot wait until we possess the “perfect” plan to enact reform precisely because that moment will never arrive.  But by reforming the system now we will begin to rectify a situation in which millions lack insurance.  Whatever system we end up creating, however, will not be perfect, but nor will it be final.  It will not become some big government agency that we cannot subsequently  modify and improve.  Indeed, it is precisely because we live in a democratic society—one in which the government must respond to the concerns and interests of its citizens—that we will continue to have the power to modify and improve and indeed even deconstruct any system of universal coverage that has been created.  We will be able to publicly debate important issues about what sort of coverage should or should not be provided and that may put us in the position as citizens of considering difficult questions. 

By contrast, if we do not pass health reform now then we will persist in a situation in which we have no control over the character and structure of our health care.  Indeed, we will persist in a situation in which it is private insurance bureaucrats that get to decide who gets to live or die, and these insurance bureaucrats (even less than government bureaucrats) have no need to answer to our concerns as citizens.  By enacting reform now, we will be giving ourselves the possiblity to control and improve the nature of our health care service.  Whether we are able to do that in the future will depend upon the quality and intelligence of our public debates and the seriousness and care with which we discuss how we would like our health to be provided in this country.

Part of Mousavi’s Speech given yesterday June 20:

I still strongly believe that the request for annulment of this election and a renewed election is a given right and it should be investigated impartially by a board trusted nationally, instead of rejecting the possibility of any positive results from the investigation beforehand; or propose the possibility of bloodshed in order to keep people from rallying and demonstrating; or the National Security Council, instead of answering the righteous question about the role of plainclothes in attacking people and public property, and inflaming public movements, resolves to [pyschological projection] and blaming others for the tragedies that have happened.

As I look at the scene, I see that it has been set to achieve more than just forcing an unwanted government on the nation, it is set to achieve a new type of political life in the country. As a companion who has seen the beauty of your green wave of participation, I will never allow anybody’s life to be endangered because of my actions. At the same time, I stand by my firm belief of this election being null and void, and insist on reclaiming people’s rights, and in spite of the little power I possess, I believe that your motivation and creativity can still result in following up your legitimate rights in new and civil guises. Be confident that I will stand by your side at all times. What this brother of yours advises for finding these new solutions, especially to the beloved youth, is: Don’t let the liars and fraudsters steal the flag of defending the Islamic regime from you; Don’t let “the delinquents and the strangers” [quote from Ayatollah Khomeini, quotation marks ours] confiscate from you the precious heritage of the Islamic Revolution, which is built from the blood of your honest fathers. With trust in God and hope for the future and relying on your capabilities, continue your social movements based on freedoms explicitly stated in the constitution and stay away from violence, as you have been doing. In this road, we are not up against the Basij members; Basiji’s are our brothers. In this road, we are not up against the Revolutionary Guard members; they are protectors of our Revolution and regime. We are not up against the military; they are the protectors of our [country’s] borders. We are not up against our sacred regime and its legal structures; this structure guards our Independence, Freedom, and Islamic Republic. We are up against the deviations and deceptions and we want to reform them; a reformation that returns us to the pure principles of the Islamic Revolution.

We recommend those involved [the office-holders] to, in accordance with Article 27 of the constitution, not only facilitate non-violent gatherings in order to achieve peace in the streets, but also encourage such gatherings and release radio and television from the shackle of ill-speaking and biased behavior. They should let the voices, before becoming cries, to get corrected and balanced in this flowing media in the shape of good argumentation and disputation. They should let the press criticize, report the news as it is, and in short provide a free space for people to express their agreements and disagreements. Let us let those who like to say Takbir’s say them, and let us not treat them as opposing us. It is perfectly clear that in this case, there won’t be a need for the presence of military and regulatory forces in the streets, and we won’t come face to face with scenes that upon watching them or hearing about them brings pain to the heart of everyone interested in the Revolution and the country.

Your brother and companion, Mir-Hossein Mousavi

Note the strong commitment to the idea of a republican theocracy.  For Mousavi, in any case, this clearly not about a change to the system, and while he says he’s following the “green wave of participation” of the youth, he doesn’t think that they are about a challenge to the idea of the system either.  What splits, if any, are there between Mousavi and the students?  Funny how this dimension has gone almost completely unexplored in the New York Times and other english sources.  This perpetuates what is probably the false assumption that these students oppose the whole kit and kaboodle.  And what’s worse the neocons are way out ahead of themselves, like Andrew Sullivan repeating the message of neocon Reuel Marc Gerecht’s Op-Ed in the New York Times, that this is “he clearest and most promising sign that the Islamist Wall is breaking up.”  Clearly, they are listening selectively to what’s going on and also using using their imagination to interpret events as we know neocons are so good at doing.

AMA opposes public health "option"

For those of you who didn’t notice the AMA yesterday stated its decision to oppose the public health option that is being discussed as part of health care reform.  This adds to a 70 year history by the AMA of opposing any state involvement in health care.  One can of course understand their objection.  It could lead to a decline in doctors’ salaries.  But it is as if they also believe the propaganda that they have helped promote about “socialiazed” medicine, as in the LP they  distribute as part of their 1961 Operation Coffee Cup Campaign with Reagan talking about how “socialized medicine” was a sure root to communism.  “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,” Regan said.  And one of the primary examples Reagan provided was the idea that the government could tell doctors where or where not they might practice.  Echoes of this delusional concern can be see in the AMA’s response to the New York Times article indicated above in which the organization states that it is not against the idea of universal health care, but that against any public option that “forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates…” Well, on the one hand the AMA doesn’t want doctors “forced” to participate (but how will a universal system work if all doctors are not required to accept all the insurance options?) and yet they also just don’t want any expansion of a Medicare system or a system that forces doctors to accept “Medicare rates,” that is lower rates.

Well, as I said just above, I can understand all of these concerns — the organization just appears to be defending the interests of its professional members, namely their renumeration and autonomy — but there is another obligation one would expect the AMA to uphold: that is the ethical obligation that extends from the Hippocratic oath, which in a modern context should mean supporting not just the interests of doctors but also a healthy reform of the existing system.  The public hasn’t seen the plan yet about the shape of the public health plan that Obama and others have suggested, but the principle to me at seems to be a good one.  People can keep their exisitng private plans.  Those plans will be restructured leading to lower rates because the entire business model of the private insurers will be modified by the fact that they will be required to accept all applicants regardless of preexisitng conditions.  The idea, as I understand it, is that the insurers are willing to participate because they will make up the difference by wider participation.  The reasons that insurers and now the AMA don’t like the private plan is that they think that the govenrment plan will price fix (that’s why the AMA doesn’t want docotrs to be “forced” to particpate in a public plan) and that the private insurers won’t be able to compete and will go out of business.

But I don’t think this is what will happen.  I think a public health insurance option will just be another factor keeping the private insurers on their toes.  The way I see it, there is not reason that the government should not also be allowed to compete.  Short of making health care — like policing and fire fighting — a purely governnment obligation, I don’t see why we shouldn’t tolerate a mixed private-government system.  We have seen successful examples of this already.

One example, is the student loan program created by Clinton which enabled the govenrment to loan “Federal Direct” loans to students at lower rates, and which competed with the alternate system (establihsed under Reagan I think) in which the government essentially paid private insurers to provide cheap loans to students.  Well, the Federal Direct loans are cheaper because the government can provide cheaper laons and moreover the government organization runs pretty efficiently.  In fact, a few years ago a scandal emerged in which private loan organizations were bribing and in some cases threatening loan officers at colleges so that they would not provide federal loans.  And at the same time, it turns out they were lobbying congress to say that the federal government should not be allowed to innovate, that it was unfair.

I see a similar idea emerging among those like the AMA and other who oppose the public option.  They don’t want the government to be able to compete and to innovate in the field of health care.  Because the fact is that they know that, even without price fixing, they are worried that the govenrment might just put up a pretty efficient and effective plan.  But why should the government not be allowed to compete?  Isn’t the whole point that our healthcare has become too expensive?  If the govenrment is in a position to compete with private insurers for who can provide the most efficient and cheap healthcare, should the government be allowed to compete?  This is not top-down socialism.  This is the government competing in the market with the consumers positioned as the ultimate judge.  This fits well within the logic of our existing decidedely consumer driven logic.  By contrast, it is really the AMA and the private insurance lobby that appear to be effecting a top down model of governnance in which they ensure that consumers will never get the public option.  In any case, I just called the AMA to give them a peace of my mind and to remind them of the obligations that I believe extend from the Hippocratic oath in this modern and contemporary context.  Here is the number if you too have the urge to let them know what you think about their opposition to the public option: (202) 789-7447.