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Bill Moyers & Michael Winship: Oysters for Health Care

This is a story of health care and two Americans; a tale of two citizens, if you will.

This week, Regina Benjamin was nominated by President Obama as our next surgeon general, charged with educating Americans on medical issues and overseeing the United States Public Health Service. She was the first African American woman to head a state medical society, a member of the board of trustees of the American Medical Association and last year was named the recipient of a MacArthur Foundation genius award.

But more important, she’s a country doctor, a family physician along the Gulf Coast of Alabama, serving the poor and uninsured – white, black and Asian. After Hurricane Katrina destroyed her clinic – the second time a hurricane had done so – she mortgaged her own home to rebuild it. The day it was to reopen, a fire burned the clinic to the ground. Moving to a trailer, Dr. Benjamin and her staff never missed a day of work.

Stan Wright, the tobacco-chewing mayor of Bayou La Batre, the small shrimp-fishing community in which Dr. Benjamin practices, told National Public Radio, “She’ll do whatever she’s gotta do to make sure everyone’s taken care of.”

Benjamin will no doubt bring that same ethic to the fight for health care reform. When President Obama announced her nomination in a Rose Garden ceremony Monday, Dr. Benjamin said, “These are trying times in the health care field, and as a nation, we have reached a sobering realization. Our health care system simply cannot continue on the path that we're on. Millions of Americans can't afford health insurance or they don't have the basic health services available where they live.”

Although the clinic has not been able to give Dr. Benjamin a salary for years – Mayor Wright says she’s owed over $300,000 – she buys medicine for her patients out of her own pocket.

In fact, many of the folks in Regina Benjamin’s bayou town are so poor that sometimes she’s paid with a pint of oysters or a couple of fish. She’s fine with that. And she makes house calls.

Now meet H. Edward Hanway, the chairman and CEO of CIGNA, the country’s fourth largest insurance company. At the beginning of the year, CIGNA blamed hard economic times when it announced the layoff of 1100 employees, but it reported first quarter profits of $208 million on revenues of nearly $5 billion. Mr. Hanway has announced his retirement at the end of the year, and the living will be easy, financially at least. He made $11.4 million in 2008, according to the Associated Press, and some years more than that.

That’s a lot of oysters, although he lags behind Ron Williams, the CEO of Aetna Insurance, who made $17.4 million last year, or John Hammergren, the head of McKesson, the biggest health care company in the world. His compensation was $29.7 million.

Here’s the difference. To Dr. Regina Benjamin, health care is a public service, helping people in need with grace and compassion. To Ed Hanway and his highly paid friends, it’s big business, a commodity to be sold to those who can afford it. And woe to anyone who gets between them and the profits they reap from sick people.

That’s what Wendell Potter, the former CIGNA executive turned health care reform advocate, told us on last week’s edition of BILL MOYERS JOURNAL.

“Just about every time there has been significant legislation before Congress, the industry has been able to kill it,” he said. “Yeah, the status quo works for them. They don't like to have any regulation forced on them or laws forced on them. They don't want to have any competition from the federal government, or any additional regulation from the federal government. They say they will accept it. But the behavior is that they will not.”

As we reported last week, that behavior includes spending nearly a million and a half a day to make sure health care reform comes out their way. Over the years they’ve lavished millions on the politicians who are writing and voting on health care reform. Now it’s payback time.

Proposed legislation finally is coming out of House and Senate committees, and Thursday’s LOS ANGELES TIMES reported “signs that the debate was moving into a more bruising phase in which insurance companies, hospitals and others fight to shape the details of legislative provisions that affect them.”

It’s going to get ugly, especially now that some Democrats, according to ABC News, are contemplating new taxes on health insurance and phamaceutical companies to help pay for reform, perhaps as much as $100 billion worth.

In other words, no more Mister Nice Guy. Those TV commericials you’ve been seeing from the health care companies about their generosity and miracles of modern medicine are about to change, as the opposition shifts gears from charm to alarm. It’s the war against the Clinton health care plan all over again.

This time, don’t let them scare you. “It should not be this hard for doctors and other health care providers to care for their patients,” Dr. Regina Benjamin said when she was nominated this week. “It shouldn’t be this expensive for Americans to get health care in this country.”


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Greetings Bill Moyers and Michael Winship,
I appreciate your concern for the people of this great country...
In order for this country to maintain its superior life style; it is necessary that we do what we have done in the past and what we are good at. We must make the necessary changes to our social system that will resolve the problems.
In the first place, we will need to adjust the amount of money available to maintain a quality society. The problem is that the demand side of economics has been undermined to a point where it cannot support the supply side of economics. We need a positive income tax that distributes income equitably so that it provides people the necessary money to support quality lifestyles.
The next requirement is to eliminate lobbyists by providing election costs to prospective candidates who are qualified for the job. Donations to a general fund for candidates would be limited to individuals only; no institutions allowed to participate. Government employees would be elected by the people instead of bought and payed for by the institutions.
Finally, the government budget would be as approved by the government legislators who would be advised by fiscal experts.
Instead of economics based on a roll of the dice it will be managed to maintain an efficient balance of supply and demand. The quality of people's life will be the bases of economics. When the people have sufficient funds to pay reasonable health insurance and the health insurance companies are made responsible for people's health care. We will again have bragging rights as to the quality and equity of our social systems. Society is intended to work for everyone.

"The leader's unending responsibility must be to remove every detour, every barrier to ensure that vision is first clear, then real."
Jack Welch

Mr Moyers,

Much thanks to you for your coverage of the issues that matter most to us all.

I have seen a lot of talk lately about health care reform and I whole heartedly support a public option at a minimum. I feel betrayed by my own audacity to hope.

The health care industry represents 1/6 of our economy. I am surprised that there is no discussion about the impact of the rest of our economy on our health. First and foremost, I am greatly concerned about our food supply. We are seeing spikes in obesity, diabetes, heart disease, ADHD, and bi-polar disorder to name only a few. All of these are directly related to or have a component rooted in our food supply. The more I learn about our food supply, the more concerned I become. There is only one word to describe it: contaminated.

NPR has done a great job addressing parts of this issue, which I've linked to. But aside from their discussions on how food affects the brain, there is far too little talk of the benefits and economics of organic food.

My hunch is that if we want to fix health care, we must fix the food supply and Americans' access to verifiably healthy sustainance. We could also stand for a new work week structure and few more holidays, but I won't get into that here...

Thanks again! Keep it up, Bill!

As many commentors have stated ''everyone has a healthcare horror story to tell'' - so why are so many against healthcare reform ?
It's really quite simple, GREED.
There are too many people that would be affected in their pocketbooks if ever a single payer system was instituted.
America can no longer claim it's place at the head of the table, instead it should be hanging it's head in shame.
Shame on America for bringing the world's economy to it's knees and then bailing out the banksters who perpetrated the deed.
Shame on America for letting so many suffer needlessly to maintain the wealthiests rights to the finest healthcare in the world.
Shame on our elected officials who state healthcare is not a right to all it's citizens (even though our elected officials get free healthcare for life).
And finally shame on our newly elected president for not keeping his promises.

Republican Senator Mitch McConnell, expressing his views on healthcare reform this past Sunday on Meet the Press continues to say, in the face of very clear contrary evidence, that we have the very best health care system in the world. At $6,700 per person per year it should be but it isn't. Our overall medical outcomes are not good. The medical profession always publicizes examples of their “heroic” exploits, where teams of twenty, thirty or more medical professionals perform face transplants or deliver eight children simultaneously. Great, but just try to get your insurance company to do this for you. And before you do, ask them what the limitations of your policy are and focus not just on the procedures but on the financial limitation. For starters, our "free market" system is hobbled by the lack of solid, universal preventive care that solves the small medical problems that in the long run, if left unattended, become large expensive one. Senator McConnell repeatedly presents anecdotal evidence, again on Meet the Press, like "I have a friend in Canada whose friend died because their health care system said he was too old for the treatment he needed." Lets terrorize the general population with that 9 letter word, rationing. All for profit healthcare plans in America are rationed care plans, either with financial constraints, limited service offerings or both. And all of these plans have "bureaucrats" that determine your medical necessity, your eligibility, the full extent of your coverage and denial. Today these plans limit the interaction between the patient and their doctor. This is because in all but the most trivial of medical procedures, the insured must first get permission from the plan "bureaucrat” in order to have the coverage and the procedure approved. Many times the news of denied or coverage limitations is delivered to the policy holder at a critical moment, just before they are about to exercise their right to a coverage they thought they were entitled to but are now denied. End of life care is considered the most expensive and unlike preventative care, when it is successful it rarely improves our country's productivity, only short term the well being of that individual. This is one of many reasons as to why we need a full blown national debate about what as individuals and as a country we expect from a healthcare system. What I expect from a health care provider is some reasonable coverage at a reasonable cost. There will be items, for reasons of sane rationing, that a national health care plan will not provide. As it is today, it will still be up to the individual to provide any additional finances needed in order to pay for services excluded as a result of rationing. What I don't expect to see is much of how our health care system operates today. You can't get into see your physician any time soon but a physician's assistant will see you today. You are told that next week or next month your CT or MRI is available when nobody is now scheduled to use these expensive, overly plentiful devices between midnight and eight AM. I no longer want to fill out a myriad of forms about my prior health and health care in order to see another doctor or to possibly be denied coverage because Aunt Emma, who died forty years ago, had cancer. My medical records should be automated and provided to me and those that should have access, at no cost. Neither I, nor any individual, should be denied coverage for preexisting conditions. The debate about how to pay for a "universal" public health care plan, available to all, rages on. I'm certain there are ways of taxing and cajoling people, businesses and corporations that would at least make it appear that a new plan is being paid for. But let’s take a more simplistic look at how to get from here to healthcare utopia over the remaining seven years of the Obama administration. Nobody rational denies that our country’s health care costs are the highest in the world and by a large margin. Today it exceeds two trillion dollars annually and cost have been going up at six percent or more (mostly more) every year, year after year. The result of doing nothing means that in seven years the annual cost of heathcare will exceed three trillion dollars and costs will double to over four trillion dollars in twelve years. One trillion dollars is needed to fund this proposed new paradigm in health care. So there you go, just freeze all cost increases for private and public plans during the next seven years and let them sort out how to squeeze the excesses out of the system while providing as good, if not better health care outcomes for all Americans. If this seems to be impossible, and it probably is, then let the Fed tell our healthcare providers, especially the for profit insurance companies, that for every one percent they increase cost the federal government will exact that same amount from the company in taxes. Sure, these companies will then try to further limit services but only to find that the public will push even harder for a single payer or public health care plan option. Radical and unworkable ideas? Perhaps, but not nearly as radical when compared to what the impact of our health care system costs will be on our citizens and our country's productivity in the not too distant future. A for profit capitalistic society makes a lot of sense except when it has a direct impact upon the lives and well being of all of its citizens. We demand that our government, not for profit armies, police, and firemen, defend all of us from our enemies and protect our lives and our property from those who would take advantage of us. We pay our government for these services. So why then are we not demanding that we have healthcare protection for all, is this really any different? If we don’t solve this problem now there won’t be rationing in the future because most American’s won’t have any healthcare, or if they do it will be minimal and even more expensive.

Iranian Ayatollahs=American CEOs

L. Smith: Where can people send dental relief money? Maybe directly to a caring dentist? No one in dental pain can really concentrate, work or do very much else. It drives some to illegal drugs. Cloves don't help once the impaction starts and the bone becomes involved. Dentistry is as important as the rest of medical care combined in saving and extending life. It should be covered too.

Mr. Moyers,
Much discussion has been given to the state of health care in the U.S. but almost no dialog concerning our slide into the near third world status of our dental care system. I am a disabled woman with medicaid living in an impoverished area along the gulf coast of Florida. Better known for the massive air force bases surrounding us which once carried out open air testing of agent orange over the entire population of this location. We are now ground zero for the missile and bomb testing which was moved here after the Island of Viaques demanded that these operations be ended because of the 25% increase in cancer rates there. The unusually high instances of cancer,birth defects and other fatal diseases here are so dire that they warrant an individual investigation of their own. The striking divide between rich and poor is especially stark when it comes to finding dental care of any kind under the supposed provisions of medicaid. The reimbursement rates are so low that virtually no dentist for a radius of hundreds of miles will take a medicaid patient. The result is unspeakable suffering for tens of thousands of the working poor and disabled here. Children fare no better as many have lost their lives due to dental abcesses that spread to brain regions. I have diabetes and two advanced tooth abcesses with no ability to find dental care of any kind. Having to resort to selling any small item of value in order to gather together the $600-1000 cost to have the teeth extracted has taken months while the infection spreads each day. My story is not uncommon and probably mild compared to others but the larger picture seems to be that this experience is playing itself out all over the country without comment from our elected officials in Washington, D.C. Most people who share my situation simply give up as there is little to no hope of any change in the future. How can this issue go unaddressed in one of the worlds wealthiest countries? Can a person actually attain any level of health without dental care? Individuals can simply not have one without the other. How can this situation be brought to light and included in the overall health care debate? Every effort I have made has fallen on deaf ears and my coping skills and strength have become frail. Sincere thanks for providing this forum to at least have the opportunity for comment.

I'm sure every American in this country has a personal health care story. It shocks me that some Americans and conservatives and even a few Democrats continue to fight for a healthcare system that is failing us all. Government can run healthcare just fine. My dad just had prostate surgery through the VA in Arkansas last month. They were not understaffed; his Dr. had time to explain things to him, and my dad felt well cared for. We can do this without being beholden to the healthcare companies, their ceo's and their share holders.

It is truly risky to the American consumer what measures will evolve from new legislation to provide health care to millions.

First, let's examine what happened to universal prescription coverage. The administration and Congress supported a plan to totally aid their money supporters - the drug companies. Medicare Part D requires everyone to pay full retail for prescriptions! Can you imagine what the cost of drugs would be if it were a negotiated price for millions of customers?

Then Congress won't touch the subject of controlling the drug companies by restricting their direct marketing of drugs on TV commercials. The place for a discussion of which prescription or other alternative medicine is best for the patient is when they sit down with their physician, not "talk to your physician to see if 'Viagra' is good for you". Drug company sales are profoundly boosted by this method, and, contributions to doctors are boosted by the number they write. The pharmaceutical industry could just contribute those millions now going to television marketing and divert it to payment of universal health care. Thirdly, the payments to doctors and our political system in favors, vacations, and outright grants by Big Pharma should also go to universal health care. All three measures would remove the pressures on congressional men and women to vote a certain path, our personal prescription bill would be lessened, television commercials would be improved in substance and hopefully a decrease in repetitiveness, and the citizens, rich and poor, could better afford the costs of health care. Short of these miracles, why not follow the lead of the State of Vermont and secure federal legislation that requires physicians to disclose every nickel received from outside sources, i.e., Big Pharma.

It's hard to imagine that anything substantial will get done by these representatives that depend on the healthcare industry for their bread and butter. Which brings us back to public financing for campaigns which I haven't seen much of lately. I can envision the same phalanx of vested interests lining up against that also. Change we can believe in is beginning to sound like the same old same old.

I would love to see Bill Moyers in a 60-minute roundtable discussion with top executives of the 'managed care' companies where he elicits THEIR recommendations for healthcare reform that provides coverage for all 47-plus million uninsured Americans, and THEIR solution(s) for bringing down the cost of healthcare by 1-2 percent a year. No vociferous arguments from naysayers.... Just their 'best ideas' to solve the problem of inequity in the marketplace.

To me, the mananged-care business-model is incapable of addressing inequities, and is therefor corrupt and should be discarded ENTIRELY.

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