Health Insurance

Republicans need to Repeal Obamacare and

then Replace it with Medicare for All.

The federal government owns the South Texas Veterans Health Care System in which I am enrolled. This means that you, I, and every other taxpayer in the country own it and I can tell you that I am very appreciative of the free health care I receive - my primary doctor is a woman and she is fantastic. I can also purchase ridiculously low-priced prescription drugs through the VA pharmacy. For example, I have Hepatitis C. The cost of the 12 weeks drug regime is $56,500 dollars but I will pay only $27.00 - boy, what a difference.

Disagree with me if you like but the truth is the VA health care system is socialized medicine and it works.

Now, it is true that the VA healthcare system is wrought with problems but when it is compared to the non-VA/private sector health insurance industry, the VA has consistently out-performed them in quality of care and patient safety. This came about because of a major effort in the mid-1990’s to overhaul the entire VA system which included better integration of services and better use of information technology. By the turn of the century, the VA was providing better care to our veterans than the non-VA/private sector health insurance industry was providing to the general public and this trend has continued through today.

Another factor that needs to be considered is ‘People before Profit.” Take what Humana’s former CEO Michael McCallister said a few years back, “It is important to note if we have to choose between achieving our membership goals and achieving profitability goals, profits will win every time,”. The following year, he reiterated the company’s priorities in an interview with the Associated Press: “We will not play the market share game and will continue to price our business for bottom line profitability.”

Look, I have no problem with the free-market capitalist system when it comes to such things as car insurance, homeowner or commercial property insurance, life insurance. However, when it comes to health insurance, profit needs to be taken out of the equation. Let me give you another example. My wife and I run a private care home for hospice patients and over the course of the past eight years or so we have had close to fifty people come to live with us until they died. We provide room and board and palliative care; our patients choose their own hospice agency.

A quick side notes here for context, each year, 1.5 million Americans die while in hospice. It is a booming $14 billion ‘death care’ industry that has consolidated into increasingly gigantic publicly traded corporations and the for-profit hospices account for nearly all the growth in the field over the past decade —a shift away from the nonprofit model. Everyone and their brother seems to see a buck to be made off the sick and dying. Now let me ask you this, who is Roto-Rooter - plumbing, sewers, the yuck-stuff of life, right?

"Call Roto-Rooter, that's the name, and away go troubles down the drain."

However, plumbing is not where the company makes the bulk of their money anymore. Back in 2004, they acquired the Vitas Innovative Hospice Care chain. They kept the Vitas name for several years but eventually rebranded the corporate parent Chemed. For over a decade now, the guys with close to 80 years in the plumbing industry have been caring for your loved ones and how good of a job have they been doing? Let me quote from a Department of Justice press release from May, 2013. (click here to read entire release)

“The United States has filed suit against Chemed Corporation and various wholly owned hospice subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, alleging false Medicare billings for hospice services.... Vitas is the largest for-profit hospice chain in the United States and provides hospice services to patients in 18 states (Alabama, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kansas, Michigan, Missouri, New Jersey, Ohio, Pennsylvania, Texas, Virginia and Wisconsin) and the District of Columbia.

“The government’s complaint alleges that Chemed and Vitas Hospice knowingly submitted or caused the submission of false claims to Medicare for crisis care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. According to the complaint, the companies set goals for the number of crisis care days that were to be billed to Medicare. The companies also allegedly used aggressive marketing tactics and pressured staff to increase the numbers of crisis care claims submitted to Medicare, without regard to whether the services were appropriate or were actually being provided. For example, the complaint contends that Vitas billed three straight days of crisis care for a patient, even though the patient’s medical records do not indicate that the patient required crisis care and, indeed, reflect that the patient was playing bingo part of the time.”

In the beginning, my wife and I took referrals from nearly every hospice agency in the phone book but after a few years, we began to see a very disturbing difference in patient care provided by a for-profit agency like VITAS vs. a non-profit agency like CHRISTUS.  While the Nurses, Doctors, CNA’s, Chaplains and Social Workers of all the agencies were terrific, it was the unseen voice at the other end of the phone, the corporate pencil pushers my wife and I had a problem with. Take Novus Health Care Services in North Texas for example. According to the FBI, the owner of the company regularly directed nurses to give hospice patients overdoses of drugs such as morphine to speed up their deaths and maximize profits. An aberration, not in my and my wife’s experience and that is why we only work with non-profit hospice agencies today.

All of this brings me to this point. One of the major complaints I hear about my Congressman, Lamar Smith is that he is out of touch with his constituents and nothing could be closer to the truth than his support of the Republican plan to repeal and replace the Affordable Care Act. It does not seem to bother Smith that if the Republicans succeed in their efforts over 30,000 people in his district will be stripped of their health insurance. That is unacceptable to me.

I believe what is needed  at this time is a public option, i.e a government-run health insurance agency which would compete with private health insurance companies for your business and a Kaiser Foundation poll taking just before last years presidential election shows that a majority of Americans support the public option. However, I see the public option only playing an interim role, a step in the right direction so to speak. What I believe we really need in this country is a single-payer national health insurance program otherwise known as ‘Medicare for all.’

Oh, I know that Smith and the Republicans as well as a few Democrats would scream and yell about socialized medicine but we already have socialized medicine in this country serving over 17% of our population. Those two programs are the VA Health Care System and Medicare. If these two programs are good enough for our veterans and our senior citizens, it should be good enough for the rest of the country.

Now, I don’t know about you but I am not one for reinventing the wheel. If someone else has already done the math, I am more than happy to give them credit and built on what they have to offer. That is why I support and you should support Physicians for a National Health Program. Here is what they have to say: 

“Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

“The program would be funded by the savings obtained from replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.”

Now, what about the Affordable Care Act or Obamacare, the Republicans vow to repeal it. So what should we be doing about it? First off, according the Physicians for a National Health Program “ the aim of the Affordable Care Act was to expand coverage to about 30 million Americans by requiring people to buy private insurance policies (partially subsidizing those policies by government payments to private insurers) and by expanding Medicaid. However:

• About 30 million people will still be uninsured in 2023, and tens of millions will remain underinsured.
• Insurers will continue to strip down policies, maintain restrictive networks, limit and deny care, and increase patients’ co-pays, deductibles and other out-of-pocket costs.
• The law preserves our fragmented financing system, making it impossible to control costs.
• The law continues the unfair financing of health care, whereby costs are disproportionately borne by middle- and lower-income Americans and those families facing acute or chronic illness.”

That all said and I am sure I will get some grief for this but I do support the Republican effort to repeal Obamacare but only if it is replaced first by a public option with a clear goal of a single-payer ‘Medicare for All’ system in place by 2020. Enough said!

 

 

 

 

 

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  • published this page in Campaign Blog 2017-03-12 15:32:43 -0500