The is a disappointing report from the last White House Forum on Health Reform held in Los Angeles on April 6. My general impression is that the attendees are being used as window dressing to preserve the power of the insurance companies.
Disappointing Exposure
I am a family doctor who has practiced in San Diego for almost thirty years. Five per cent of my patients are uninsured, 10 per cent are on welfare (MediCal) and many are under-insured or loosing their insurance.I belong to Physicians For A National Health Program (www.pnhp.org) which supports single payer health reform (HR 676 - Conyers) or Medicare for All. I believe that with universal enrollment, there will be no need for marketing, medical rating, recisions, or the complex inefficient wasteful administrative bureaucracies of the for profit private insurance companies, not to mention their profits and executive salaries. Under coordinated single payer financing, health outcomes will improve in the United States, especially for poor and minorities and in certain underserved states, all without "socialized medicine," i.e. ownership of facilities and employment of providers by the government. In fact,under universal coverage, private insurance companies will provide NO ADDED VALUE except for boutique services and preservation of freedom for those who want to pay more to preserve special provider relationships.
Today April 6, 2009, by personal invitation of the Governor of California, I attended the last of the five regional White House fora on health care reform. I was in San Diego along with about 100 other folks, participating in a live satellite feed from the main meeting in Los Angeles. Our group in San Diego was facilitated (dominated) by San Diego County Supervisor Cox and Calexico Mayor Louis Fuentes (more about him later). Los Angeles was graced and controlled by Governors Arnold Schwarznegger of California and Christine Gregoire of Washington, and White House Domestic Policy Advisor Melody Barnes. In sum, the whole presentation and dialogue which took over two hours was primitive and diversionary. Several previously selected citizens gave absolutely heart rending stories – about their husband’s death tangled in insurance denials, and about their child’s death from MRSA, about being medically rated out of insurance as they grew sick or older and having care cut off or prevented (until in one case being rescued by Medicare,) about the homeless and the mentally ill being superficially treated in emergency rooms. Nonetheless, the moderators without exception followed up these stories by abruptly turning the conversation to preselected speakers who extolled the potentials of preventive medicine (including the famous Dr. Dean Ornish, among others, to promote healthy lifestyles, smoking cessation, and diet,) and the value of expanding information technology and telemedicine, all in the name of "cost containment," probably based on the myth that people who live healthy life styles never get sick or die. Governor Schwarzegger with the ease of Hollywood hogged the microphone extolling his long lived interest in health reform and healthy lifestyles without mentioning his twice vetoing our state’s single payer legislation (SB 840.) His attitude was seconded by SEIU representatives and the AARP invitee (who neglected to reveal she worked for an insurance broker not a patient advocacy organization.)The whole tenor of the meetings revolved, in truth, around using the memes of technology and prevention to avoid any substantive discussion about social justice, the uninsured, the poor performance of our medical system, the role of private insurance companies, or the current constrained discussions in Congress. Rarely was any distinction made between guaranteed and subsidized access to private health insurance and guaranteed access to universal medical care. No mention was made of the excessive inefficiencies, costs, and profits of the insurance companies. Early on in the program the health reform activist Anthony Wright representing HEALTH ACCESS was personally called out of the audience to give his reflections. Remarkably he was uncritical of the process and content of the meeting. He made no mention of the single payer option but did sneak in the sole mention of support for a public plan along side the commercial ones. The single exception to all this obfuscation was the great Marion Wright Edleman who gave many embarrassing international comparisons in health care outcomes for women and children, comparing the USA to third world statistics, in her impassioned plea for real change.
Ironically, the most important moments for me came after our local meeting was severed from the video feed. The young Hispanic Republican mayor of Calexico who frequently pleaded for an insurance system that covered "younger people of my generation" and who bragged that he twice voted for Governor Schwarznegger revealed that he had had a major health crisis of his own. He described how he had been diagnosed with an esophageal problem and two bleeding ulcers. Due some unexplained circumstances his family’s medical insurance would not approve the urgently needed surgery. He then reported that his family chose to take him to Mexico and pay cash out of pocket for the surgery which was life saving. He showed no insight into the irony of his Republican politics in view of his scary personal experience. Finally, I am happy to report, that as our local San Diego group was left on its own to converse about the issues, a firestorm of comment and protest arose from the attendees complaining about the lack of any previous discussion about the disasters attendant upon relying on private for profit health insurance and the need for single payer reform. Nonetheless, it was apparent to me that everything is not on the table and the Obama Administration and Congress, along with state and local officials are using these fora to obscure the true causes of the failures of our contemporary medicinal care system and protect the politically potent lobbies.
Can anyone tell me what the other regional fora were like?