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A coalition comprised of the American Academy of Family Physicians, the American Academy of Pediatrics, the American
College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and
the American Psychiatric Association representing more than 560,000 physicians and medical students in the United States cautions
that deep cuts to Medicaid in the legislation would hurt the most vulnerable patients: pregnant women and children. The importance of expanded access to health insurance coverage and improvement
of our health care system rather than simply tearing down what is presently available is a critical need for our country.
These groups are watching and physicians look forward to helping with suggestions over a few months of consideration to move
forward with a well-thought-through and caring improvement to the ACA. The current bill is neither smart nor compassionate.
Learn how the Affordable Care Act and Medicaid impacts Family Health Care by clicking here.
More on Health Care
In socialized systems
the government owns, operates, and provides every aspect of the health care services. This is a bit like the
US Veteran's Administration Health System. The hospitals are an investment of the VA, the doctors are paid by the VA,
all the medicine is provided by the VA, etc.
A Single Payer System is a system where the PAYMENTS
are controlled by a payer, but the hospitals, doctors and other services providers are not owned or directly controlled by
the payer. This is like the MEDICARE system in the US. Independent doctors, hospitals and others control and provide services,
but are paid by Medicare. Most doctors and most patients are pretty happy, pleased and content with Medicare.
Health insurance has been around for more than two hundred years. Here
are some current facts to consider:
We most often cannot
predict what health issues may befall any individual's and health care costs can cause severe financial strain
and even ruin, groups coming together to share the risks and cover each other against devastating financial losses. The idea is to pool money so everyone pays in a portion (usually based on risks)
and takes out those resources needed. SLeeMD [See the Economic Data below]
Health Reform Bill- a view from Kansas City- by Sharon Lee
How is it that real truth becomes so easily twisted and believed by
real people who hear with twisted ears? On a daily basis the integrity of the US is sullied, muddied by a person who seems
to be without a moral core, who appears to lie as effortlessly as he breaths. My specific concern is the current lack of compassion
and selfishness that is permeating our culture.
|Artist- Geri Centonze
|Let me tell you about a patient I will call Toni. Toni was in my office,
worried about a lump in her breast. I examined her and knew immediately the lump which felt like a bit of concrete was likely
a breast cancer. But, Toni who was 52 years old did not have insurance. For Toni, there was no possibility of surgery, no
possibility of radiation or chemotherapy. As a Family Doctor working in a clinic for the poor, I was not able to help her.
Even a mammogram to provide “proof” she was facing a cancer diagnosis cost too much for her.
Her only hope was to rely
on the kindness of and charity from doctors and hospitals. After more than three months of calling many doctors and hospitals
to beg for her care, I finally found a team willing to provide these services “just this once.” Toni finally got
her surgery and then lost her maid job at a local hotel. Destitute, she was allowed State Medicaid coverage temporarily to
cover the hospital’s losses for her surgery. She got six months of chemotherapy and when she felt better, Toni went
back to work. Immediately she lost her Medicaid and thus her follow-up medication that was meant to prevent metastases. Although
she stretched the medicine by taking it less often than prescribed, she finally ran out. Later she returned to the clinic
with a lump in the other breast.
This is one story leading me to believe the US needs universal health care. I
think the best option for providing this is to expand "Medicare for All".
Paul Ryan has said:
Atlas Shrugged (Ayn Rand fiction) is one of three books he re-reads, gives as gifts and requires
as reading for his interns.
The division of the world into
"makers" and "takers" summarizes Ayn Rand's philosophy and these very words are used often by Paul Ryan.
Opposite of the Golden Rule: "Treat others as you would want
them to treat you"- kindness. More like the Trump Rule: "Ignore the needs of others and focus on what is best for
your self." SLeeMD
Ayn Rand's Selfish Rule- Individual Self-Interest Above All
Many of those who espouse Ayn Rand's
philosophy have missed that the world is very different from what she experienced that formed her views. She came to the US
from Russia on a Visitor Visa in 1926. As a non-observant Russian Jew, she felt more at home- safer in the US and never returned
to Russia. She overstayed her tourist visa but evaded deportation and in 1929 she married an American with subsequent
granting of a permanent visa. She became a US citizen in 1931.
Rand had a number of controversial political stances- She supported abortion rights, the rights of colonialists
"civilized men" to take land and control political decisions for others, and opposed the draft and war.
Ayn Rand's philosophy has been summarized as "rational self-interest as an
overarching moral principle". It is antithetical to the beliefs of most of the worlds religions that the overarching
moral goal is to "do unto others as you would have them do unto you" - the golden rule.
"Don’t try to be your brother’s keeper or to force him to be yours."
Yet the "happiest" people in the world live in Norway where they have completely socialized their educational,
health care and other societal supports. No one worries about when they will eat, where they will live, how their children
will get by in school or how they will pay for their families medical catastrophes. Relieved of these concerns through high
individual taxes (without a lot of loopholes), they are freer and happier to pursue their lives. There is a level below which
none will descend and all have the opportunity to rise.
Many of us care about the Affordable
Care Act that opened access to medical care to millions of Americans with no pre-existing exclusions. Family Health Care (FHC)
works for those who have no insurance or inadequate insurance with high deductibles or co-pays for more than twenty-seven
years. FHC is organized throughout with the concept that every person deserves dignity
and respect and that every life has value.
Each day at FHC, we choose to serve those who may have had bad luck, or been
treated poorly, or made bad choices and find themselves without good health. Each day FHC's staff and supporters ensure
that a few more people are provided access to health services they need. Each day we choose kindness. We choose generosity.
Please join with us in choosing to attend
to those who are suffering in this land rather than turn away. Please help with a donation or with your time as
a volunteer to bring healing to our neighbors in need.
Martin Luther King's words (paraphrased by Barack Obama) and keep pulling to "bend the arc of history towards
justice." Hilary Clinton and Tim Kaine used the words attibuted by some to John Wesley (eighteenth century minister):
“Do all the good you can, by all the means you can, in all the
ways you can, in all the places you can, at all the times you can, to all the people you can, as long as ever you can.”
At this time of uncertainty and when compassion may appear to have lost the immediate battle to meanness, please
keep pulling; keep doing good wherever and whenever you can.
Economic Data on Health Costs 2016-2017
Here are some economic facts about health costs and insurance today-
Per capita costs-
Health care comprises
a vast network of doctors and nurses, technicians, medical device manufacturers, pharmaceutical makers, hospitals and
in-home services, educational institutions, financial arrangements (insurers), and, above all, patients--along with
numerous others. It is a complex, sophisticated, and dynamic set of interactions that consumes more than $3 trillion of the
Nation's resources and represents about one-fifth of the economy.
(trillion) costs/325,000,000 (million) individuals living in the US = $10,345.
which is the annual costs
of health care in the US per capita. (325 million individuals live in the US.)
Health insurance companies
are not going broke-
The Standard noted in 2016:
combined annual profits of America's ten largest health insurance companies were $8 billion. Under Obamacare, the ten
largest health insurers' annual profits have risen to $15 billion.
The Economist reported:
prices of America's five biggest health insurers—UnitedHealthcare, Aetna, Humana, Cigna and Anthem—have all
roughly tripled” over the first five years of the ACA.
(With Annual administrative costs and profits
averaging 18% of the revenue per enrollee.)
In addition to rising profits for shareholders,
the administrative costs continue to soar- the top five insurers each paid their CEO’s $10-15 million (equivalent to
covering up to 8,100 individuals). *
*Cigna CEO David Cordani: $17.3 million
Aetna CEO Mark Bertolini: $17.3 million
UnitedHealth CEO Stephen Hemsley: $14.5 million
Anthem CEO Joseph Swedish: $13.6 million
Bruce Broussard: $10.3 million
you wondered how the poverty level is calculated?
In 1964 Mollie Orshansky (an economist working for the Social Security Administration) developed
the FPL measure.
- She based her figures not on what was enough, but what was not enough for the basics.
reasoned that the most basic need was for food and utilized a 1955 government survey which indicated families spent 1/3 of
income on food and assumed non-food costs remained proportionate.
- Then using the Department of Agriculture’s estimated food plan costs X 3 to determine
the poverty level.
Which food plan? The Department of Argriculture had several food plans calculated which were based on various
nutritional levels. Ms. Orshansky proposed different plans using three of these levels. Her superios chose to base the poverty
leve on the lowest plan- the "economy food plan" that was developed to provide only short-term nutritionally
adequate diet bundle, for "temporary or emergency use" as it did not have enough nutrients to provide a longer term
Today, although Americans spend far less of
their disposable income on food (2009 = 6%) than fifty years ago, the formula of calculating the cost of the food
bundle (now called the "Thrifty Food Plan") and multiplying by three has remained the basis for determining
the federal poverty level.