Friday, July 04, 2008

July 4, 2008 - A Senator's Legacy?

According to management and life-planning guru Stephen Covey (from the subtitle of his book, First Things First), the purpose of a human life can be summed up in four essential points, all of them beginning with the letter "L": "to live, to love, to learn, to leave a legacy." That last point, the legacy, is often mentioned with respect to politicians – especially when they're getting ready to leave office.

Senator Ted Kennedy has a serious case of brain cancer, that probably means he's in his last months in office (see my June 6th blog entry). Kennedy's had a long, distinguished and sometimes controversial career in the Senate. A July 2nd article in the Boston Globe hints that his most cherished dream, when it comes to his own political legacy, just may be universal health care (Lisa Wangsness, "Kennedy leads renewed effort on universal healthcare").

The Globe article reports on concrete steps Kennedy's key aides have been taking, in concert with other leaders in government, to plan for a swift, hard, bipartisan push to pass a universal healthcare bill in the first few months of the next President's tenure.

Kennedy's surely counting on his close ally, Barack Obama, to become the next President – and he is, in fact, leading in the polls. History has shown the first-year "honeymoon" of a new Presidency to be the last, best opportunity for getting history-making legislation through the Congress (think FDR's New Deal, or Johnson's Civil Rights Act). The Senator's aides are quietly laying the groundwork for such an effort, in the hope of launching it before their boss becomes too ill to lend his support.

As the article says, Kennedy and his allies are trying hard not to repeat mistakes that were made the last time there was a major push for healthcare reform:

"The last time a national healthcare plan was attempted, under President Clinton in 1993, the presidential panel charged with devising a proposal was widely criticized for not consulting enough with Congress, and protracted disagreements erupted, delaying its progress for months and ultimately resulting in its demise. Kennedy's effort appears to be designed to identify areas of common ground between Democrats and Republicans, business and labor, providers and insurers, and others before the new president takes office.

‘The senator is trying to learn from health reform attempts in the past and to build a fair amount of consensus among his Senate colleagues, House colleagues, and the Obama campaign . . . and find a strategy that could carry with some momentum into the new administration,' said Dr. Jay Himmelstein, a health policy specialist at University of Massachusetts Medical School and a former Kennedy staff member who has been involved in the talks."

For Senator Kennedy, this is personal – and has been so since long before he got sick. He's always been at the forefront of healthcare-reform efforts. This time around, the very fact of his illness may not only put a human face on this complex issue, but also provide an emotional boost that could push the effort over the top.

Not that Ted Kennedy has to worry about healthcare coverage himself. A very wealthy man, he could pay his own cancer-treatment bills out of pocket, without ever tapping the unparalleled medical insurance he receives as a member of Congress. Yet, to the extent that the Senator's physically able to stand up and debate the issue, his very presence will serve as a reminder of the human impact of the legislation.

The article continues,

"‘You have got to think this will be the Ted Kennedy Health Reform Act, because he's a beloved figure and he's championed the issue for so long,' said John Rother, policy director for the AARP, which has been involved in the discussions. ‘There are a lot of unknowns right now, but what we do know obviously is he is very close to Obama, and he also has quite a network of health policy experts that he can draw from.'

Melissa Wagoner, spokeswoman for Kennedy, added that ‘Making sure each American has access to quality, affordable healthcare is the cause of Senator Kennedy's life.'"

It's no secret, to readers of this blog, that universal healthcare is a cause I've come to believe in very deeply. I feel incredibly fortunate to have had access to remarkable (and very costly) medical treatments that have probably saved my life. These I could never have afforded without insurance. I've also heard enough horror stories – not only in the news, but also firsthand, in my ministry – of uninsured people who have fallen through gaping holes in the vaunted social "safety net."

"Let them go to the Emergency Room," said President Bush, not long ago – in a remark that sounded eerily similar to Marie Antoinette's apocryphal "Let them eat cake" gaffe.

Here's an example of the sort of thing that can happen to poor patients who go for help in an underfunded emergency room, here in the U.S.A.:

More on this shocking story, with a longer set of clips from the surveillance-camera tape, can be found HERE.

Senator Kennedy and his allies have an uphill struggle ahead of them. Misinformation about universal health care in Europe and Canada is rife, and irrational fears abound.

I can't help but think, on this July 4th holiday, that there may be no more important present-day declaration of independence for the American people than this: independence from the fear of losing everything – including even our lives – to skyrocketing healthcare costs.


Vance said...


This is a very complicated issue!

Sometimes, though, I get the feeling that many citizens feel overwhelmed to the point that they simply say, "Let the government fix it."

As if.

The question which I have not seen you or others address is this:

To date, you have enjoyed excellent care, including rapid access to radiographic studies and second opinions. In short, you have enjoyed the benefits of patient empowerment.

How will legislators ration costs while still allowing patients to be fully empowered?


Carlos ("Carl") said...


Well, we'll have to find a way to do it, won't we? There are plenty of models out there to examine, and learn from their mistakes: most all the other industrialized nations of the world, who have healthcare systems that are more efficient, and serve THEIR ENTIRE POPULATIONS much better than our system.

The question you ask, Vance, is really the wrong one. You frame it as a question to an individual, asking me to assess, personally, how my own healthcare may or may not change under a national health system. If you ask it that way, then, sure, there are going to be come troubling questions - such as whether or not I'll have to wait longer than I presently do for high-tech scans. Yet, if another question is asked - "How can we insure the best possible health care for every citizen?" - then the answer comes out very differently.

Why must we see healthcare as a commodity purchased by individuals, rather than as a fundamental right of all people?

It's all in how we pose the question, isn't it?

Vance said...

Why must we see healthcare as a commodity purchased by individuals, rather than as a fundamental right of all people?

Because patients are individuals, not groups?

I'm not really asking the wrong question. I'm asking the HARD question.

I'm asking what rights you are willing to surrender in order for everyone to have the same level of care.

Put another way, if there are finite resources available, and if the pie must be divided more ways in order to share equal access, then to what lower level of care are you willing to accept?

Which country do you think best exemplifies the kind of care you think Americans should aspire to?

(Carl, I'm not arguing here. I'm genuinely trying to understand your position.)

Life Insurance Canada said...

I wonder what will happen after the elections...Health care is so emotive topic, much more than oil prices and Iraq war. And I think it's hard for people to decide what is right. There are proofs for socialized h.c. and there are proofs against it. I think it will have impact on our health care as well. Among Toronto life insurance brokers it's pretty discussed topic, because there is a possibility of spreading (so far very limited) private health insurance, especially after recent announcement of Claude Castonguay. But if Obama wins (and it seems he will) the result is hard to predict.
Take care!

Carlos ("Carl") said...


I'm not sure the resources are absolutely finite, as in a pie that only has so many pieces. Our present system is wasting vast amounts of money on processing paperwork, providing routine healthcare through emergency rooms, etc. Moving to a national single-payer system would result in huge savings, that could be applied to the cost of providing healthcare to those who are presently uninsured. Also, when more people have access to basic healthcare, they'll be healthier, on the average. Some otherwise catastrophic illnesses will be headed off, before the patient's care runs into hundreds of thousands that the hospitals' charity-care programs presently have to write off as a loss. That's another net savings for the whole system.

Having said that, I'll admit that yes, there will be some individual sacrifices involved - either in terms of services not available to patients right away, or in higher taxes. I, for one, am willing to make sacrifices such as these, in order to see that healthcare is available to everyone.

The Canadian, British, French, Japanese, etc. systems aren't perfect. Yet, what an opportunity we have to learn from them, and craft a system that will be the best of all worlds! (I've heard that the Japanese have accomplished something like this, having carefully studied the European systems before organizing their own.)

Has there been ANY significant move, in countries that have national health, to go back to a free-enterprise system like ours? If there has, I've never heard of it. That's because, by and large, these systems work.


Vance said...


I completely agree that much expense is wasted by the need to push paper. With a single-payer system, those costs should definitely improve.

On the other hand, our government is infamous for waste, so how can we be sure that the savings will be redirected back into care for the needy?

How much sacrifice will you personally be willing to make? How will you feel when your doctor thinks you would benefit from Bexxar (for example), but you are not allowed to take it because the government deems it too expensive?

And how will you feel when you are denied the treatment you need to live, but yet the government will pay if you decide to commit suicide (as Oregon does right now)?

What has our government done to give you so much faith that you are willing to entrust your life to "them"?

Carlos ("Carl") said...


Well, at this point, I couldn't say the government's handling of medical claims would be any worse than the private sector's has proven to be. Certain politicians sold the American people a bill of goods some years back, promising that keeping medical insurance in the private sector would result in greater efficiency, and better service for all. This has proven not to be the case, for large portions of the population. Those same politicians used to run down Medicare's reputation all the time, but guess what? Medicare's doing a better job of serving the public than the private sector is!

America's insurance companies have proven that they don't have what it takes to police themselves. They have allowed greed to triumph. Their stockholders and CEOs have gotten richer, while their claims adjusters have turned sick people out on the streets. More and more Americans are getting fed up, and are looking for major, systemic change.

A national health insurance system will not be perfect. I think it was Winston Churchill who said that democracy is the worst form of government, except for all the others. Well, I'm coming to believe - based on what I've heard about other countries' experience - that national health insurance is the best healthcare system, except for all the others.


Anonymous said...

I always appreciate it when you come into the conversation, Vance because I know it's going to be lively. Thanks


Vance said...

Thanks, Wanda.

Carl, no argument from me with respect to private insurance. I hate them.

I will also agree that Medicare is doing a better job of serving its clients than does private insurance, but that ain't saying much!!

There is already a worsening oncologist shortage. Even considering new doctors entering the field, there is still a net loss of 150 oncologists per year. Add to that the increasing number of cancer cases as baby boomers age, and you have a crisis.

Have you read about the great number of physicians in ALL fields who have had to stop seeing Medicare patients because Medicare reimbursement does not even cover their overhead?

So Medicare (ie, the government health system) thinks that reducing payments to physicians in the face of a doctor shortage is a smart thing to do.

It is tempting to blame it on Bush, but we must remember that the laws which control Medicare are currently being written by a Democrat-controlled Congress. They are all guilty.

So again I must ask: What precedent do we have to believe that more government control in this country will actually help fix the problem?

Carlos ("Carl") said...


I'm not aware of any precedent. We're all just going to have to insist to our congressional representatives that, should moves be made in the direction of universal, single-payer health care, the system be adequately funded.


Vance said...


I'm not worried about the funding. I'm more concerned about the loss of control by patients and physicians. Granted, third parties have usurped much of the control, but if you can scrape together the means, patients still have options. With a single-payer system, I am concerned those options may disintegrate.

As I started out by saying, this is a complicated issue, and frankly, I don't know how to fix it. I suspect that a government takeover is inevitable, but I lack the faith in government that you and others seem to have.

In any case, you have answered some of my questions, and I appreciate it.

Enjoy your vacation!!


Anonymous said...

Hello it is 12:44 am and yes I am in NJ too. I am scard since I am taking care of my terminally ill mother. My mother is not going to make it she is a stage 4 breast cancer and it has spread throughout her body. She is so sick that i can not speak of the horrors she endures on a daily basis. I am now praying for a swift passage. Lately she can not even eat some yougert. Please pray for her. El