By John P. Geyman
... instead of taking a progressive view of the responsibility of government to help solve our increasing problems of access, cost, quality, and equity of health care, we have the leading Democratic candidates perpetuating market approaches, with the already discredited notion that the insurance industry will respond to competition. Despite conservative public policies favoring health care markets, as illustrated by continued over-payments and lack of oversight of private Medicare plans, these leaders remain unwilling to confront the insurance industry in the public interest.
The public health policy choice facing us is whether or not to replace a failing private financing system with public single-payer financing. Making the right choice is the only way to gain affordable universal coverage of necessary care for everyone. It is that simple. This is not an issue to be compromised away by politicians. We need a new structure to heal many of the problems of U.S. health care. We have an opportunity now to galvanize a grassroots movement for real health care reform that may not come again for a long time. The Democrats are poised to regain the Presidency in 2008, together with both houses of Congress. We need activist government and leaders, as we have had earlier in our history, to confront our health care crisis. It is a matter of moral, economic, and social urgency.
The New York Times
January 5, 2008
Sen. Barack Obama: I have been entirely consistent in my position on health care. What I said, and I have said on the campaign trail this time, is if I were designing a system from scratch, I would set up a single-payer system because we could gain enormous efficiencies from it. Our medical care costs twice as much per capita as any other advanced nation. But what I've also said is that given that half of the people are getting already employer-based health care, that it would be impractical for us to do so...
Rudolph Giuliani: To go in the direction that the Democrats want to go - much more government care, much more government medicine, socialized medicine - is going to mean a deteriorated state of medicine in this country. I mean, I said jokingly in one debate, if we go in the direction of socialized medicine, where will Canadians come for health care? (Laughter.)
By Don McCanne, MD
John Geyman's Tikkun article on whether we are about to miss the boat on health care reform is an important piece that you may want to share with others. The policies that we need to enact are clear, but they are taking a back seat to politics, being an election year.
Barack Obama's comment demonstrates that he does understand health policy principles and specifically which policies would best serve our nation. But he also understands politics. The other leading Democratic candidates do as well. In a political year, politics prevails, but that does not mean that we should let up on our efforts to make sound policy drive the politics.
It is not clear to me that the Republicans understand the physical suffering and financial hardships that their health policies would cause. Though it is no surprise that Rudolph Giuliani would treat health care reform as a joke, it did cause me considerable anguish to watch his Republican audience laugh at it. I am going to assume the best by viewing this as an awkward response to a staged pratfall since I cannot believe that most Republicans would truly believe that reform is a joke.
At any rate, read and distribute John Geyman's article. The health care reform boat is ready to pull up its anchors, and we need to be on board. As John Geyman says, "It is a matter of moral, economic, and social urgency."