[fiestynurse]

A message from Jeoffry Gordon, MD, MPH, a San Diego member of Physicians for a National Health Program (PNHP) and California Physicians Alliance (CaPA):

Subject: Shift in strategy

Dear Friends:

It seems to me that our current world crisis has changed the political playing field and opened the probable opportunity for a swift move to a national health program. We ought to adjust our rhetoric, strategies, and thoughts accordingly.

(1) The terrorist attack has the unintended byproduct of curing the civil society malaise described by Robert Putnam in BOWLING ALONE (an outcome he predicted), and people are not just rallying around the flag, they are esteeming the government, depending on it for safety and solutions. This is a tectonic shift in attitudes.

(2) We are in a recession; businesses are going to be doing poorly and watching their pennies very closely.

(3) Health insurance companies are at a point in their business cycle where, after competitively driven price cuts and consolidation, they will be requiring repeated >10% price increases to maintain viability (Aetna or PacifiCare/Secure Horizons) or profitability.

(4) The health insurance premium costs are going to be very onerous to all businesses who will be passing on costs to employees or dropping benefits or health insurance altogether.

(5) As people are laid off (and have been in huge numbers in the service industries as a result of 9/11), the number of uninsured is going to explode and many of the newly uninsured are going to be middle class.

Thus the stage is set for an as yet publicly unanticipated crisis - the final breaking point - in the health care system in the USA. The federal government is going to have to step in (and can with the rationale of protecting the public welfare during wartime). The simplest solution and easiest to promote is to expand Medicare to everyone (and not to get into much of the details about how the providers organize themselves). This will have great public support from the newly uninsured and unemployed, and maybe even from the AMA, etc., as doctors and hospitals feel even more squeezed by falling income and will be eager for public subsidy for "a physician full employment program," and by the states who will now be too poor to subsidize their own reformed health systems. As unlikely as it seems, the Republicans (like Bismarck and Lloyd George) are likely to be more successful at pulling off a national health program than the liberals and the Democrats as a way to help the business and corporate classes (except for the health insurance industry) save money (overhead costs) and as a way to reward, support and calm a worried and activated civil society.

PNHP can have a pivotal role in promoting these changes, especially if we anticipate the need, publicize it, and organize around it with a simple implementation strategy. What do you think?

Please circulate this message to whomever you think will be interested.

Jeoffry Gordon, MD, MPH
paradocs2@home.com


Comment: If you wish to respond, you may reply directly to Dr. Gordon at: paradocs2@home.com If you wish to have your comments considered for distribution to this list, send them to: mccanne1@home.com A couple of responses may be selected for distribution, although, strictly because of the volume, most will not be. If you respond, please indicate (1) if you do NOT want your comments shared (otherwise consent will be assumed), and (2) whether or not you wish to have your e-mail address included with your comments. Without explicit consent, your e-mail address will not be distributed.

You may also wish to contact the following:

Physicians for a National Health Program
Ida Hellander, MD, Executive Director
pnhp@aol.com

California Physicians Alliance
Carla Woodworth, Executive Director
capa@jps.net

[Mijourney]

Hi feistynurse. So much for reducing the size and ability of the government, huh? September 11, in my mind, was the first day for the rest of our lives. Not only are we probably going to end up playing an integral role in the financial rebuilding of governments in developing nations who support democracy, we're also going to have to fork out more for our own national defense and offense. Even though I've never been gung ho for the government, I've never seen such an outpouring of support for our elected officicials in recent memory. I must say this support will be needed as our demographic shift and increased consumer demands will put our economy thus our public officials under a great deal of stress. If the government can bail out the airlines, who were so dramatically affected by the vengeful air attacks in NY and the Pentagon, then surely the government will realize that as a matter of defense and offense that it would be in the country's best interest to see that everyone is insured and can get adequate access to necessary health and medical services and good health care.

The move toward universal health care will definitely take the power away from the employers who are increasingly complaining, as indicated in your post, about the high cost of insurance premiums. One way or another whether it's in the form of taxes or premiums, we're going have to ante up the money for health and medical care. I don't think going it alone will be the answer for most Americans. For those of us who have chronic health problems and have to rely on some form of continous treatment or service, I think we would be amazed at how little our copay, deductibles and other costs we are required to pay cover in terms of goods and services. Some of us pay anywhere from $400, $500 dollars on up for family coverage per month. One episode in the hospital or outpatient could wipe out the yearly cost of premiums.

We will see whether the general public would be supportive of universal health care. In my neck of the woods, I'm not so optimistic. Increasing taxes for health and medical expenses will be necessary in my mind to handle the large influx of boomers and the aged. People in my community and many others down here in the South don't even like the sound of a pen suggesting that taxes be increased.