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Dear America,
I write to you today about what I believe to be-- and I am not alone in this opinion-- the most prominent of the two or three most pivotal aspects of the American slide into economic ruin: the cost of medical care. We pay approximately 15% of our gross domestic product (GDP) for medical care, and that is the highest percentage by at least a third among the major industrialized nations, including Great Britain, France, Germany and Japan. And compared to those four, we are the only nation without a single payer system, which, by the way, even as recently as the late Bush administration years more than 60% of the American people favored...that is before the Republican conservative complex (Rcc) began roiling the sentiments of the populace with false arguments about government control and the effectuality of the free market in keeping costs down. The reason that I raise this issue again is that I have sleep apnea. No, it's not really that personal for me, but my apnea has provided me with an example that makes the point.
The most often prescribed treatment for sleep apnea, which was just recently diagnosed in me but which I have had the symptoms of all my life, is something called Continuous Positive Airway Pressure (CPAP) Therapy. CPAP is the use of a machine to regulate the flow of air into the respiratory system with an electric blower pushing air through a tube and into a mask that covers either the nose, the mouth or the nose and the mouth, an uncomfortable process at best. I had to go through two "sleep studies" to come up with a diagnosis that my wife could have given them from just sleeping beside me for the past twenty five years, and the process was a miserable experience, the second one yielding no usable data in the bargain. Then, my pulmonologist, an M.D., referred me to a medical equipment provider that sold the machine to me through my insurance company for about $1,100 along with a tube for $30.00 and a little piece of sponge that serves as an air filter, both of which I could have gotten for half that price. And as to the machine itself, they initially appeared to bill my insurance company in the amount of about $1,500, though the lower price is what I guess they settled for. They also sell the masks and tubing, which must be replaced every 90 days, and the head gear as well, all for about twice what I can get them for on the internet. Those things are supplies however, and I have to pay for them myself...every ninety days. Just as a point of interest, I found the machine on the internet for $629, and my insurer should have been able to find it too, especially considering what health insurance premiums are today, which insurers attribute to high medical costs. In other words, the provider inflates the price, the insurer pays it for us, and then charges us inflated premiums, both providers and insurers constituting the "free market" in this instance. So free market or not, the American consumer pays more than things are worth in medicine. And here's the kicker. There appears to be a mouthpiece you can wear at night that realigns the lower jaw and may accomplish the same thing for a whole lot less and with half the personal discomfort, though no professional I have met has seen fit to mention it.
But all that being said, it is only an example of how the free market is working in American medicine, which demonstrates the need for reform, and not just of health insurance. In fact, while the Rcc resistance to any kind of socialized enterprise is constant and ardent, one of the main reasons that we got health insurance reform instead off health care reform and a single payer system is a Democrat, Senator Max Baucus. Baucus is the senior senator from Montana, a Democrat all of his career, which started in the Senate in 1978. He is the chairman of the Senate Finance Committee, and ranks high on several other important committees in The Senate. And though he characterizes himself as a moderate, he was connected, at least tenuously, to Jack Abramoff and when Montana recently needed a new U.S. Attorney, Baucus didn't hesitate to nominate his girlfriend. So it is no surprise that when he called hearings on the health care reform issue, his witnesses included the pharmaceutical companies, insurance companies and HMO management to the exclusion of consumer advocacy groups, which were still excluded even after lodging complaints. He voted against repealing tax subsidies for corporations that send their jobs overseas, and he voted in favor of making bankruptcy more difficult for the debtor and more protective of the creditor. He is ranked poorly by every progressive political observer group, and he is to the Senate what the Blue Dog Democrats were to the House of Representatives. In fact, Baucus and a handful of other Senators in league with a couple of dozen conservative Democratic congressmen are the reason that we got health care reform that is as much a boon for the insurance industry as it is for the insured.
I bring up Baucus because he is the apotheosis of Democrats in service to conservative political causes, and his term isn't up until 2016. And though most of the Blue Dog Democrats in Congress lost in 2010, there is still a hard core of business oriented, anti-consumer conservatives who oppose any social program in favor of only those benefits that trickle down from the wealthy to the rest of us. So, when the polls come out showing that both the Democrats and the Republicans are in disfavor, that young people are gravitating toward the Republican Party, and that the public at large does not seem to see the larger culpability of conservatives over the progressive movement when it comes to the dysfunction in Washington politics, the prospect of our government dealing with a problem that affects 15% of our total economy is bleak. Still, we have to talk about these things, and we have to point to them whenever circumstances permit. For the reality is that we will never balance our budget on the backs of the poor and the middle class as conservatives tell us we must. And it may be that only with control of medical costs, that is with a single payer system since the free market that is the only alternative isn't working now and it never has, can we ever come out of this depression and return to what we were...a nation that handed all of its children, not just the rich ones, a better country generation after generation.
Your friend,
Mike












