Activate!

What is the appropriate verb for "Activism"? Whatever it is, we need to do it.

I have given it a go: I've used the web site Congress.org to write to several representatives. But most representatives will only accept mail from their constituents. Therefore, appropriate addresses need to be entered. Join me in writing to them - especially to members of the Ways and Means committee.

Here is what I've written:

Dear Rep. Cummings,
As a member of your constituency, a public health professional, and a young person, I urge you to work with your colleagues who are stymieing the very necessary health care reform in HR 3200. It is imperative that we have a mandate that all Americans have health insurance. To achieve that, we must provide free and subsidized insurance premiums for those who need it. We must have a public health insurance option to allow those who live in areas with minimal insurance options to have greater choice, and to incite necessary competition for the insurance industry. And, to hold all of this together, Congress must work towards creating an agency which sets fair reimbursement prices, guidelines for when procedures are excessive, and devises a continually updated list of first and second line pharmaceutical preparations which need to be used before expensive new treatments are prescribed.

As a supporter of progress in our great country, I urge you to use your office to sway members of our party who are succumbing to the propaganda that reform in the US = a "Canadian style" health system. Please remind them that every developed nation in the world has better health indicators that we do; That health care decisions which are made based upon medical necessity as opposed to ability to pay is a right, not a privilege; and that if budgetary decisions need to be made to finance this important reform, there are many industries whose benefits can be trimmed to support the transition of health care from an industry to a egalitarian and equitable system.

Back to Politics

I've been out of the blogging realm for nearly 2 months. From time to time, I think that I should write, but one of two things keeps happening. Either the topic I'm considering is one that gets me so riled up, I can't gather my thoughts, or I assuage my sharing needs by putting up something on FB. For example, Wal-Mart is now open in Amritsar, Punjab. The US side of Niagara Falls, far inferior to the Canadian side as far as infrastructure is concerned, has been overtaken by Indians - there are at least 6 Indian restaurants/dhabas/chat-wallas and far too many South Asian tourists who forget their deodorant. Tid-bits that don't deserve an entire post.

But back to the point: Today, I return to an issue that has really captured my attention.
HEALTH CARE REFORM

I can see the near future of this movement - It involves another round of baseless accusations that we are becoming a socialist country, that government intervention will result in rationing of health care, and that the government cannot be as efficient as the private sector. Additionally, the private sector, who has the most to lose from reform, will argue that a public insurance option will put them out of business, because the government can be more efficient in administering such a program. They will argue that it is un-American to ration health care, while turning a blind eye to the daily rationing that occurs due to the inability of many Americans to pay for the care they need. And finally, they will remark that ours is the 'best' health care in the world, and there is no reason to change that - all the while forgetting that the 'best' care does not produce anywhere near the best results, at more than twice the cost of our "socialist" counterparts.

Although I feel so strongly, I haven't done anything about it. I'm ashamed, in fact, that I have not called or written to a single congress person about this issue. Perhaps that will end today. In fact, I believe that I'll write to them, the following:

Dear elected official whose name I never hear,

Although it pains me that you have the power to derail or facilitate this necessary reform, I must appeal to your better judgement. Do not be swayed by the lobbyists of the health insurance association, pharmaceutical companies, or hospital industry. Everyday citizens, particularly those without great means, do not have lobbyists working for them. Instead, we have you. And in that exalted capacity, I urge you to enact health care reform which will serve to remove health care decisions from the political cycle, while extending the human right for health and health care to each and every person within our borders.

There is no medical student who enters and survives the education process with the goal of becoming a wealthy, unscrupulous, cream-skimming physician. Yet, the incentive structure for their profession, from the day that residency ends until the day they retire, forces many to choose between payment and provision of care. This is unacceptable. One part of the health care reform plan must include provisions which reduce the cost of the medical education (it is free in many countries, where doctors are considered a public necessity whom the government supports), increase the prominence of primary health care, and reward physicians for preventing health expenditures and procedures. Here, we can look to the example of Cuba, the neighbor we pretend does not exist. Their model for health care is holistic, every doctor is required to be a community physician for a certain period of time, and physicians are rewarded for ensuring that each household and individual within their geographic realm receives promotive and preventive health care on a regular basis. By giving physicians a geographic territory, problems of not enough physicians in rural areas are minimized, while all members of the population have access to similar care. Of course, those with means may opt to receive more care, but not at the expense of those without.

The need for a public insurance option is high. This option has the possibility of being the entry way towards a more national health system, with a single payer. Experts from the economics, public health and medical fields agree that a single payer system is the most efficient, however it is clear that such immense reform is contentious. The public insurance option serves many roles. It provides citizens with an alternative to exploitive insurance plans in regions without much choice. It paves the way for a more consolidated payment system, and reduces the ability of non-medical professionals to make decisions on the treatment of clients.

Finally, in conjunction with a public insurance option, cost containment and other measures, the most important part of the care-giving process should be removed from the hands of companies who report to shareholders, and as a consequence are profit maximizing. Decisions on which treatment/procedure/drug should not be tied to the remuneration that one can receive from said treatment, nor to the short term savings which can be achieved should said treatment be withheld. Rather, the decisions should be based upon medical objectives, such as quality of life gained, and the benefits which can accrue to the individual over the course of their life. This is not equivalent to rationing. Rather, it allows cost containment efforts to become de-monetized and to instead become personalized. Good examples of this include the Michigan Primary Care Consortium and others.

In conclusion, please vote for a health reform plan which will extend insurance coverage to all Americans, which will increase the medicare eligibility criteria to at least 200% FPL, and to provide a public health insurance option, independent of employment status with subsidized premiums until 400% FPL without exclusion criteria. Further, please be open to the merits of single payer health care, but recognize that it is more important to set a precedent for reform now rather than hold out hope for a best case solution later. Engage health care researchers in searching for the best methods for physician/health practitioner compensation - one which rewards appropriate quality care, not volume of care. And do not fear government involvement in this public good and right.

Sincerely,
Your concerned constituent.