UPCOMING EVENT:
OLI FEIN’s VISIT TO PORTLAND. CLICK HERE FOR MORE INFORMATION
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Pardon our dust. The Mad As Hell Doctors website functional, but under construction.
Since returning to Oregon from our road trip to D.C., we have been following the events inside the beltway with great disgust. What may or may not make it to President Obama’s desk is neither going to bring us true Universal Access nor control spiraling costs. We have a lot of work to do!
Stay tuned for information about our plans.
Thank you for your interest.
Grassroots pressure is the way. Keep up the fight.
Dear Mad as Hell Doctors,
First of all – THANK YOU for all you have done and continue to do on behalf of all Americans. I would like to ask if there might be some way to join efforts w/all the other champions for health care reform. Seems that there are so many that folks get overwhelmed and are not sure which one to join/support, and the MILLIONS of us who are fighting every day for health care reform do not have a ‘base’ to go to. I think the cause would be better-served and stand more chance to be heard by the legislators if we were all in ‘one camp’ so to speak.
Again, thank you! Please keep up the fight…we need you now more than ever!
With hope for my grandchildren,
Judy, Columbiana County, OH
Anything wrong with the current system is due to government interference. Any doctors actually involved in this organization are definitely mad. Mad as a hatter. Stop trying to destroy America with your wrong thinking. If you love the inefficient socialized systems in other countries so much, why don’t you practice there?
Justin
Student Doctor, Class of 2012
Epidemiologist
former financial planner
A reply from Paul Hochfeld…..
Justin,
I live in this country and deeply care about us having a health care system that gives us the most health (and least suffering) we can achieve with the absurd amount of money we are spending. We don’t have a health care system. We have a sick care non-system, fraught with perverse incentives that drive up costs (and profits) without producing more health.
Every other developed country starts the discussion with the concept that access to appropriate, timely care is a human right AND it is a legitimate function of Government to accomplish this. As a result, they do a better job of keeping people healthy and caring for chronic conditions. They get better results at half the cost.
We don’t have the best health care system in the world. Granted, if I have a lot of resources and I have a serious problem, this is where I want to be. On the flip side, if I am an average person of average means (which is most of us), this is NOT the place I want to be when the crap shoot of life results a bad disease or injury that few of us can afford and predictably leads to bankruptcy. Yes, I might get the care that I need, but I might lose everything in the process. OR, worse yet, I might avoid the care that I need because of cost and end up dying of what might otherwise not be fatal…. just like 45,000 other people who die in this country every years because of financial barriers to appropriate care.
The average person in those countries wouldn’t even think about swapping what they have with what we have.
This gets at the heart of the issue. Is the goal of our health care system to provide for the health of the community or to provide great profits in caring for those get very ill while putting little resources into keep them well in the first place?
And what is the role of health insurance companies? They spend lots of resources stratifying the population into high and low risk groups, make profits (often with taxpayer subsidies) covering those at low risk and leave the high risk groups (the old, the poor, the disabled) to be financed by the taxpayer. If we had one giant risk pool, and one set of rules, we could save 20-30% right off the top… then we would have a “system” with which we could deal with the other drivers on cost and have some difficult discussions about the fact that we have nearly unlimited demand for limited resources.
That’s another discussion.
As for your concerns about socialism. We have public financing of education, police, fire, and infrastructure. It’s not socialism… and if it is, it’s a good thing we have it. The alternative is chaos and people suffering unnecessarily.
Justin,
You’re in training to be a physician and I wish you well. You seem pretty sure of yourself though for someone who has barely got his toe in the water.
As a practicing primay care physician for the last 27 years, I would like to suggest you read T.R Reid’s recent book entitled “The Healing of America…”
Try to keep an open mind when you read this book. One of my favorite professors in surgery years ago used to say, ” You know you can be wrong your entire life.”
Paul is so correct, Justin. The current system is totally unequal and unfair. You will see this as you progress in your career. I’ve been in medical care for 37 years and only see more inequality as time progresses.
Good luck to you, we need more “socialism” like roads, public education and libraries. Government is not the source of our problems!
Dear Justin,
How can epidemiology exist without government support and funding? We are the government. We can elect our representatives in or out of government. We have no such options if our health care monies are mismanaged by the for-profit insurance companies chosen by our employers. Medicare is managed by the government very well compared to the for-profit insurance companies.
I am a Mad-as-Hell Mom sick of being forced to switch insurance companies every year every time my husband gets laid off by his corporate employers. I have no health care freedom in America right now. When you have little or no money in America, you have no freedom. If you are born lucky (i.e. with a high math/science aptitude or with inherited family wealth) you have more opportunities in America.
This is a golden opportunity for the Congressional Progressive Caucus to take charge of Health Care Reform! But will they blow it by falling for the corporate Democrats call to pass the Senate version and later we can fix it!
Now that Coakley has lost, if Obama and Democrats still want Health Care Reform, the Blue Dogs can swallow their corporate paid pride and vote to expand Medicare to cover everyone. It only needs a 51 vote majority and a relatively simple change in the existing Medicare legislationof over 40 years!
It can be implemented within the year before 2010 elections. Republicans will not be able to run against it, or they will loose, as most (80% of seniors, liberal and conservative support Medicare) of the population will gladly support Medicare health care coverage with all its good benefits at much less cost where you pay into it based solely on your income! Then Congress should work to improve Medicare to have coverage like that of HR676.
Progressive Democrats can be heros of American people and will have more progressive influence on other issues in the future! Will they rise to the occassion and be more progressive than Democrat!
Justin, you’re entitled to your own opinion. You’re not entitled to your own facts.
The World Health Organization ranks us #37, two steps up from Cuba. America’s annual per person health expenditures are about twice what anyone else spends. Our 45 million uninsured citizens have radically restricted access to care, and so the spending on the median insured American is much higher. Canada, France, Great Britain, and Germany all cover their entire populations, and they do so for far less money than we spend. Indeed, Canada, whose system is the most costly of the group, spends only 52 percent per capita what we do.
I sincerely wish that universal child health care is the first to come to the table . Perhaps that is a sign that we are a civilized and progressive nation. Is there anyhope for President Obama to consider this even inthe current climate of Congress, with Dems losing out quickly??
For months now I have been a member of a local group advocating the Single Payer, Medicare for All for health reform. I am the owner of three health and vitamin stores and have been handing out flyers and talking to people about the movement. Daily I am amazed that almost no one has heard of Single Payer. When the concept is explained to them, they are all 100% for it. The only resistance I encounter is when I tell them this is what Canada has, the response is that 90% of the Canadians do not like their system and they come to the US for care. You can recognize that the propaganda being put out by the opposition has reached them, while the truth has not. This is what bothers me the most. The lies and liars are getting their message across, while we simply are reaching practically no one.
Several weeks ago I attended a conference of Health Care Now in St. Louis. This is just one of the movements for Single Payer in the country. Three things struck me from this conference. First, there are too many small groups. Granted we are all working for the same thing, but yet we are not heard loudly enough. Second, legislation by our government happens only when BIG voices with lots of money hold the legislators feet to the fire. Third, legislation for the good of the people often happens only after demonstration. We would not have the civil rights legislation that we have today were it not for the civil rights movement.
Folks; we; you, me and the citizens of this country have a problem. We have people out there going bankrupt, suffering and dying because we are the only civilized nation in the world that is not taking care of a very basic human need; health care. Health care has a broad meaning. It means body, mind, teeth and eyes from the day we are born until the day we pass from this earth. Care, not contracted by the wealthy insurance companies with limits and loop holes or pharmaceutical companies looking for the largest profits they can take, but from a controlled sustainable process that puts the majority of the money back into caring for all of us.
Finally I am to the crux of the matter. While I was at that conference, it became clear to me what we need is one HUGH, GIGANTIC( legislators and BIG, rich voices be damned) educational demonstration made to the American public to get them off their over-fed, over-indulged, over-weight bottoms.
How do we do that? How do we reach the public in one humungous thump on the head wake up call? The answer is obvious, television. When a large group of celebrities and musicians wanted to awaken people to world hunger, they staged an hour long TV show with its own song, stage full of well known faces and education to the fact of world hunger. Money poured in, but more than that people learned there was a problem.
What I propose is doing a Medicare for All one half to one hour show on TV featuring a catchy song written by a big name musician or two and as many celebrities as can be lined up to sing and even talk. It would include education as to what Medicare for All means to every one of us and endless information and examples of the horrors of the current system as there is time for. We must push people into action, by having them call, write and confront their congress persons and senators.
Obviously this is a big undertaking. But if the right people who believe in this, with the right abilities could be lined up to produce the show, we could win the battle of Medicare for All in one hour.
Is there anyone receiving this letter who has the contacts with people and finances willing to start the ball rolling? We don’t have lots of time. We need to get this process moving. The people of this country can’t wait for four years for help. They need it now!!
Since I wrote the above letter, the earthquake in Haiti has happened. It took less than two weeks for people to come together to stage a telethon to raise money. Could we not find someone to do the same thing, not to raise money, but to educate the people of this country to put pressure on the government to institute Single Payer?
Mary Kenney
5628 Birch Street
Roeland Park, Kansas 66205
(913)362-6767
mlkenney75@yahoo.com
I want to know if there are any doctors in Arizona who belong to your organization? Because that is who I want to receive medical care.
Mary,
Go to it and good luck. Here is what I know is going on concerning the approach you mention. In CA the State 1-Care coaltion (I’m not sure if that’s the right name but you can get to them via http://www.californiaonecare.org will be airing web videos with famous actors beginning, I believe in March. Elliot Gould, the actor, is coordinating the enlistment of many well known TV and screen actors. They hope to have a different video airing daily across the net and perhaps in some other media. I don’t know who is doing the fundraising and whether they have some deep pockets people to try and do something as ambitious as you propose. As far as music there are more professional and amateur musicians writing great songs on this issue than you can shake a stick at. But I haven’t heard anything as dynamic as the Mad as Hell Doctor’s Bob Wickline. Bob’s songs can be accessed through http://www.madashelldoctors.com and his material is public domain as long as you attribute him. He and the MAHDs have put together 30 and 60 second ads with his music and some voice overs that are beginning to run in media venues in Oregon. You can get to Bob through his own website, which I think you’ll find on the Mad as Hell Doctors website. All power to you and yes, we need coordination and yes we need a new national civil rights movement.
Marc
Marc Sapir MD, MPH
510-848-3826
marcsapir@gmail.com
As a practicing physician for 20 years, I can’t believe that other physicians want a “medicare for all”. Medicare is a bloated government program that is barely functioning. Now I’m not saying that our system is perfect- far from it. However, throwing out WHO statistics that rank us just above Cuba is misleading. Statistics only tell a certain amount of truth. For example, it is a well known fact that african-american women have a higher infant mortality rate than caucasions- irregardless of socioeconomic levels.
As someone who has worked in other countries (albeit in 3rd world countries), I feel that our level of care in this country is extremely high. Also, I had a personal situation which made me realize how high our general medical care is. My friend (a physician) was skiing in Canada when his son had an accident and struck his head and had a loss of consciousness. They were in Kelowna (the 3rd largest city in BC) and were told that the only CT scanner in the city was broken and the closest CT scanner was in Kamloops, a 3 hr drive away. If the kid had an epidural hematoma, he likely would have suffered the same fate as Natasha Richardson (wether she would have died if she was in Vail is another topic).
Yes there are problems with our system, but to paraphrase our President, instead of taking out a hatchet to the medical system, doesn’t it make sense to take out a scalpel? Address the issues that make our system work and address the issues that don’t work. Tort reform, insurance companies (Blue Cross with 180 million in profits and the CEO making 4 million), and the general costs of running an office all need to be addressed.
I’m not willing to trust the government to run our medical care. Have you guys forgotten what it’s like to work at the VA or at a county hospital? Also, how do you expect to pay for this one payer program? I don’t know about you guys, but if I relied on medicare/medicaid payments, I would have to close shop.
steve,
you “can’t believe it”, but it’s true. You ought to look around and read the large number of peer reviewed papers published in NEJM, the JAMA, the Archives of Int Med that all show the data on why we are the step child of the developed world in health care. Your anecdotes don’t impress because more US citizens leave the U.S. to obtain health care elsewhere than come here for care by far, orders of magnitude. Fourty five thousand people died in 2008 for lack of insurance. A half million Americans filed for personal bankruptcy because of medical bills they couldn’t pay. The rest of the world is laughing at us because nowhere else does anyone lose their financial solvency and their lives because of medical care bills or inability to get good care. I’ve practiced primary care medicine for 39 years and I’ve been around the block. the American Academy of Physicians realizes we need to consider this shift in funding and that coincides with the polls showing 55% of docs support a national health insurance program to cover all and shut down the cost inflation and chaos that insurance companies foist on everyone, including us. You may have trouble believing any of this, but it’s still the truth and that’s also why there are 17,000 doctors in our organization, the Physicians for a National Health Program. What is your field of practice and who do you work for that none of your own colleagues have brought you into the fold.
Steve: Let me begin by saying that NO medidal system provides everything to everyone with complete satisfaction. With that out of the way, let’s look at four measures of success for medical systems. These are Access, Results, Cost and Satisfaction. Sadly, our private industry coverage scores low on all four. Since others have addressed the first three issues, let me focus on the issue of consumer satisfaction. The October 2008 Consumer Assessment of Healthcare Providers and Systems survey by the U.S Agency for Healthcare Research and Quality interviewed over 450 thousand Americans from all 50 states and found that 62% of adults with commercial insurance rated their doctors at “9 or 10″ whereas 74% or Medical recipients rated their doctors at this level. Also, Medicare patients rated their healthcare at “9 or 10″ 56% of the time whereas only 47% of those with commercial insurance scored it that high. Health plan ratings were even more telling: 59% of Medicare patients thought their health plan was very good or excellent (9 or 10) but only 36% of adults with commercial insurance rated their coverage that high. Let’s face it, those of us with commercial carriers will always understand that despite the advertising and PR, these plans will put the bottom line before anything else including our health. Now that’s a fine way to run a business but it’s a terrible way to decide who should live and who should die. As an aside, our own Veteran’s Administration system consistently scores higher than HMOs and private carriers on measures such as diabetes control, hypertension managment and use of beta blockers after MI. As Americans, we all deserve better.
Eugene Uphoff, MD
Mad As Hell Doctor
Portland, Oregon
The only reason medicare is surviving is because of the higher reimbursement rate that physicians and hospitals are getting from private payers. Without the higher reimbursement rate from other payers, I know I couldn’t survive. Most doctors (primary care and surgical) limit the amount of medicare they see, because of the low rate of reimbursement. How many medicare patients do you guys see? How many unfunded patients do you see?
Medicare spending is currently growing at an unsustainable rate. Again, how do you propose to pay for your plan (oh, that’s right from medicare savings)? Sorry you can’t have quality, accessibility, and affordability. Somethings gotta give. Like I said in my original statement, there are problems with our system, but a government run system (medicare) isn’t working now.
Also who is the American Academy of Physicians? If you mean the American Academy of Family Physicians, your stat only represents a small segment of the total physicians. Also 17,000 physicians in your organization represents about 5% of the total number of physicians.
BTW, I don’t mean to belittle your efforts, in fact, I applaud them. Even though, I disagree with how you propose to overhaul the medical system, I still respect your opinions.
from Paul Hochfeld…
Steve,
In the end, we might agree to disagree, but we’ll have some respectful fun along the way. Let me take you on a little trip.
Already, 60% of all our health care dollars come directly or indirectly (because employers insurance premiums are tax deductible) from the taxpayer. The care of our oldest neighbors are financed by Medicare, i.e. the taxpayers. The care of our disabled neighbors is financed by Medicaid. Ditto the care of our poorest neighbors who, because health follows wealth, are also at greater risk of high expense. Fourteen hundred insurance companies, at significant expense, stratify the rest of the population by “risk”. Their top-secret formula results in them covering the employed people, small groups, and individuals who can prove that they are at low risk. What about the others? When those who can’t afford the premiums get sick, go bankrupt, and can’t pay their bills, “we” all pay for it in higher charges. Furthermore employer-paid premiums are tax deductible which means insurance company profits are subsidized by the taxpayer.
As near as I can tell, this is a big taxpayer rip-off. Additionally our non-system is fraught with numerous perverse incentives that result in more care, but not necessarily better care. Physicians must share a significant part of the blame here, but that’s a discussion for another thread. Addressing the perversities is problematic because we don’t have a Health Care System we have For-Profit Sick Care Non-System that, to extent that it has any design at all, is designed to serve the for-profit insurance and the pharmaceutical companies. Perverse incentives work for those who profit from them. They don’t work for patients or those who pay the bills, i.e., taxpayers.
Single payer would mean one risk pool. We gather all the money that employers and individuals are already paying for health care. It’s not more money. It’s the same money, it’s already being spent on health care, but by pooling it, we can save 20% right off the top. Furthermore think of the savings in office staff if you got paid the same for every equivalent service, without negotiating conversion factors with every payer? You only have to send your bills, electronically, to one place. And when you see a patient passing through town, you can access her medical record in Iowa. None of this is going to be accomplished until we have Public Health Authorities administering a health care SYSTEM with the goal of health, financed publicly and delivered privately.
This isn’t pie in the sky. Check out what the other developed countries are doing. Anecdotes aren’t helpful. We have 45,000 new anecdotes every year that illuminate how real or perceived financial barriers to timely, appropriate care cause unnecessary death.
The real question is whose “system” produces the most health, the least number of unnecessary deaths, and least unnecessary suffering for the dollars being spent. Yes, other contries have problems because of limited resources, but they are dealing with the problems maturely, they are making difficult decisions, and, by recognizing that health is a human right, they are getting a healthier population for less cost.
Is access to essential, appropriate health care a human right? If not we can agree to disagree. If so, it is a legitimate function of our government to make sure that nobody fall through the cracks. If so, doesn’t the government have a fiduciary responsibility to make sure the taxpayer is getting value for its health care dollars? Insurance company CEO’s have a fiduciary responsibility to maximize profits even if it mean investing large sums of money in manipulating public policy. And, that’s exactly what they are doing. It’s unfathomable to me that some people distrust “The United States” more than United Health Care. That may be where we end up agreeing to disagree.
In any case, the taxpayer is being ripped off, big time.
Hochfeld convinced me, but then I was already convinced, and have been for 20 years or so! These arguments are preaching to the choir. What is needed is how to reach bubba, and bubba does not use reason – he uses emotion, which the right so effectively uses, from Reagan on down. Check out Rush Limbaugh (but not too soon after eating). He and the other right wing multi-millionaire buffoons are very effective at making the stump-broke lumpen like what they get. We need to attack their strength with scorn and ridicule and not worry about finesse.
Incidentally, if we merely reduced our costs to the OECD developed countries average (half of what we spend) we could fully fund ‘Medicare for All’ with no new taxes, and probably add dental care to boot!