Killer Politics (10 page)

What they do is add ammonia, which allows more efficient absorption of nicotine. In a Pulitzer Prize–winning exposé in 1995, the
Wall Street Journal
reported: “Ammonia increases ‘impact' says Neil Benowitz, a professor and nicotine-research specialist at the University of California in San Francisco, because ‘the faster nicotine is absorbed, the more reinforcing or satisfying it is and the greater its psychological effect.'”

These people ought to be locked up.

Our approach to tobacco is pretty convoluted. Americans subsidized tobacco farmers $530 million between 1995 and 2006. (I can see subsidies for food, but for a product that causes so much misery, are you kidding me?) Meanwhile, federal and state governments spend millions more to
stop people from using tobacco—Florida alone spent $58 million in 2009 on such efforts.

How many lives could we save, imagine the boon to productivity, if we could beat cancer, stroke, autism, Alzheimer's, heart disease, and diabetes? The National Cancer Institute was budgeted to get $4.8 billion in 2009. The Department of Defense—$515 billion. Cancer kills 560,000 Americans each year. Heart disease kills 650,000. That's 1.2 million deaths a year. In comparison, there have been about 1.3 million American fatalities in all the wars America has
ever
fought.

It's a matter of perspective and priority.

Surely a Manhattan Project to cure these diseases is in order. Let's ramp up stem cell research, too. The hypocrisy of George W. Bush and his cronies effectively stalling stem cell advances for his two terms infuriates me. How much closer could we be to a breakthrough that would cure leukemia and other blood disorders if Bush hadn't stalled us? How far away has this put us from literally growing the organs for transplants that could save so many lives?

But if we socialize medicine, won't medical research—deprived of big pharma investment—stop dead in its tracks? Of course not; that kind of thinking sells our basic humanity short. There are always people motivated to make the world a better place. I'd like to think it's in everyone's DNA—except maybe Dick Cheney's. When Jonas Salk discovered an inoculation against polio, he refused to patent and profit from his years of research. When asked once who owned the patent, Salk replied, “There is no patent. Could you patent the sun?” We certainly should find a way to reward medical advancements handsomely, but we ought to be able to do so without holding sick people hostage to the high cost of new drugs and technology.

Perhaps we need to examine the funding relationship between private pharmaceutical companies and the government. The relationship has merit—certainly there have been some remarkable advances—but
why haven't we licked cancer yet? Meanwhile, we have a number of remedies for erectile dysfunction. Hey, I'm all for good wood, but doesn't it suggest that maybe our priorities get skewed when the potential for profit gets involved?

It took us decades to get in this health care mess and maybe it is unrealistic to expect to change overnight. We lost an entire generation and a golden opportunity under the Clinton administration. You can place the blame for that one right at the feet of the Republican Party.

What was even more ironic about the way the Republicans destroyed our chance for health care reform that time was that the Clinton plan was almost a mirror image of one proposed in 1974 by President Richard Nixon, who called for universal health care in his final State of the Union address. According to a 2007 report in McClatchy newspapers, “Nixon first proposed national health insurance as a conservative California congressman in 1947. He grew up poor and lost two brothers to tuberculosis, which marked him for life. He frequently pointed to the cure for tuberculosis as a medical marvel that underscored the need for a public-private partnership on health care.”

Of course, with Watergate coming to a boil, Nixon's dream of universal coverage faded. His successor, Gerald Ford, abandoned the idea when the economy went south. And that has been the story—we just keep pushing our problems down the tracks—and the price tag keeps getting higher every day.

In reality, there is no free health care. There is no free anything. At some level, we all must contribute. The emerging model of health care reform mandates that Americans buy insurance. That isn't new. We pay for Social Security and Medicare. What is different is that we are being forced to buy a product from private industry. I wrestle with that. It's a sticky, possibly unconstitutional issue.

We all understand that there is a price to citizenship, but I would feel a whole lot better if my mandated payment went to my government
for universal coverage rather than to a proven den of vipers in the health insurance industry.

NATIONAL HEALTH CARE IS THE MONEY SMART SOLUTION

Anything less than a national single-payer option is like using Band-Aids on a sucking chest wound. It'll end up wasting more time and more money.

The next baby step is the public option, a
viable
government competitor to existing health care insurers. If that happens, two things are possible: One, health insurers will slowly go out of business or find niche roles as they do in Singapore and other countries with government health care, or two, they will do what they should have done long ago, get efficient, get competitive, and for God's sake, get some ethics.

If government health care is as inefficient as the ideologues say, there should be nothing to fear from a government option. People will choose the best product. It's not like we're reinventing the wheel here. According to a 2009 report from the nonpartisan New America Foundation, “There are many examples of public and private insurance plans peacefully coexisting. More than 30 state governments…offer their employees a choice between traditional private health insurance products and a plan that the state insures. In Washington State, for example, the publicly insured option called the Uniform Medical Plan is the most popular choice, but about a third of public employees choose a private plan instead.”

And Medicare, a government program, works. Again, no one wants to say much about this, but I will. Yes, I trust my government with health care. I don't expect it to be perfect, but I expect it to be more efficient than private insurance. It's a well-established fact that 3 percent of every Medicare dollar is spent on administration compared to 13 percent and
higher with private plans. What if doctors only had to contend with paperwork from one insurer? Instead, we pay paper pushers to deal with fifteen hundred insurers with different forms and requirements. Going to a single-payer system would save $350 billion a year, according to Physicians for a National Health Program.

A friend of mine who worked in the medical industry argued that a single-payer system would mean fewer people entering the field, because they wouldn't make as much money. My answer? If people are becoming doctors just to become rich, they're part of the problem. I want a healer—not a businessman. That said, I want my doctors to be fairly compensated. We certainly cannot expect them to come out of medical school owing hundreds of thousands of dollars and then work for minimum wage—which brings me back to my belief that education has to be accessible and affordable (ideally, a right of citizenship) for everyone. In any case, I have no doubt that good people will still go into medicine when we have a national health care system. Smart, caring people still become doctors in Sweden and in France; nationalizing health care doesn't stop people from loving medicine and wanting to excel in that field.

AND, YES, IT'S ALSO TIME FOR TORT REFORM

While I do believe there has to be legal recourse for malpractice, the insurance premiums doctors are paying are oppressive, ranging as high as $200,000 a year. I support tort reform—changes in the civil justice system that would reduce a doctor's liability in the case of medical malpractice—because I believe it is part of the ultimate solution to reducing health care costs. According to a 2008 report by Dr. Michael Lynch in the
Concord Monitor,
medical malpractice premiums have gone up 50 percent in five years.

According to the Associated Press, malpractice lawsuits alone add about $6 billion annually to the cost of health care. The Congressional
Budget Office found in 2009 that the cost of malpractice insurance
and
lawsuits accounts for about 2 percent of health care costs—about $35 billion. Placed in context with the overall cost of our national health care system, $2.4 trillion, it isn't much, but the threat of lawsuits alone influences costs. It causes doctors to order battery after battery of unnecessary tests to avoid accusations of malpractice. The insurance company pays more, premiums rise…and well, you can see how prices begin to spiral out of control.

I can understand a physician's frustration at being treated like the enemy when something goes wrong. We have to understand that there are so many variables and uncertainties that sometimes patients just don't make it. If there is gross negligence, all right then: Consider a lawsuit. But we have to create an environment in which physicians don't have to feel as if they are always working with the Sword of Damocles over their heads.

TACTICIANS AND DREAMERS

There were two provisions in the new health care legislation that were made to placate Republicans. One was that abortions would not be funded under the program and the other was that illegal aliens would not be covered. Well, the notion that anyone with a sucking chest wound is going to be left to die on the emergency room steps is complete fiction. And are we really going to inoculate only American citizens and leave a large segment of the population unprotected, spreading disease? The last time I checked, the H1N1 virus was unable to distinguish between documented and undocumented workers. What if something far more serious began to spread? This is a dangerous political game.

I want to find one senator or congressperson who will look me in the eye and tell me first of all that this is plausible, let alone workable. It's fiction—a bullshit fairy tale for the American public to make them feel better. At some point, someone is going to have to run the numbers
through the Congressional Budget Office on this issue. We may actually save money by including illegal immigrants in the program rather than limiting them to high-priced emergency care.

During the debate over health care, many members of the House and Senate acted like ostriches. They were willing to run to the CBO to make sure the bill saved money, but no one wanted to ask the CBO how real universal health care would pencil out. They didn't ask because they were afraid of the answer. I am going to get behind legislation to make the ostrich the national bird—it will be perfect for this crowd.

Given a credible universal health care proposal, the CBO might well have discovered it to be cheaper than the present system. Americans would have been marching in the streets demanding it, and Congress would have been faced with a choice between doing what was right for the health care industry or for the American people. That's like asking Archie to choose between Betty and Veronica. Who to choose? If you are a politician, the chances are you're going to pick Veronica—the rich girl.

Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, made every effort to ram through a watered-down health care bill that to me looked like a giant suck-up to the health care industry. This is a guy who had raised nearly $12 million in five years for his reelection efforts. Let me tell you, that kind of money doesn't come from Billings, Montana. According to the
Washington Post,
“Baucus collected $3 million from the health and insurance sectors from 2003 to 2008…. Less than 10 percent of the money came from Montana.”

The
Washington Post
story continues: “Craig Holman, government affairs lobbyist for the Public Citizen advocacy group, said the
continued
fundraising by Baucus during the health-care debate is very troubling. ‘He's doing all this fundraising right in the middle of this effort to mark up a bill,' Holman said. ‘When you put these events close to matters concerning these lobbyists, clearly it's a signal. You are expected to show up with a check.'”

This begs the question: Who is Max Baucus looking out for? There are plenty of similar examples. In 2008 the Senate Finance Committee members received a total of $13,263,986 from health care industries. Do you think that influenced the process? According to the Center for Responsive Politics, the health care sector gave almost $170 million to federal lawmakers in 2007 and 2008, 54 percent of that amount going to Democrats.

Senator Charles “Don't Pull the Plug on Grandma” Grassley, an Iowa Republican, has received a cool $2 million from the health care and insurance industries since 2003. Grassley, a big supporter of the Medicare Part D boondoggle, apparently was good with end-of-life counseling when it was included in that bill!

Senator Joe Lieberman, the erstwhile independent from Connecticut, has pocketed $1.5 million in donations from the health care and insurance sector since 2003. This guy has the world's biggest ego matched with the world's smallest conscience—in short, the perfect politician. Two industries will make a mint off of Lieberman's cronyism and health care obstructionism—the insurance companies and the shoe repair shop that will replace all the heels Lieberman ruined from digging in against anything that might constitute a break for the American family. The only good thing about Bush II winning in 2000 was that it kept Joe Lieberman's wrinkly ass out of the vice president's office.

According to OpenSecrets.org data, Senator Blanche Lincoln, the Arkansas Democrat who helped shoot down a public insurance option—a huge favor to her friends at Blue Cross–Blue Shield—received more than three quarters of a million dollars from the health and insurance industry in the last five years. BCBS dominates 75 percent of the market in Arkansas. Lincoln is also a friend of Walmart, and predictably she opposes the Employee Free Choice Act, which would make it easier to form unions.