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December, 2008



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Winning The War On Health
By Stephen Simac

The Health Care system, as it's euphemistically called, costs Americans over $2 trillion per year. That's not even counting lost economic value from our epidemics of health problems. We aren't getting great value, since every other industrial nation spends far less per capita, while their citizens enjoy better health by every measure. Despite this record, most health care reformers focus on symptom tinkering, instead of systemic change.
Single Payer Health Care is promoted by progressives as if government funding of medical costs would solve the myriad health problems plaguing our citizens. It's hard to fathom this confidence, when the Institute of Medicine's own conservative numbers blame medical treatment for causing more deaths in the US than anything except heart disease and cancer.

To be sure, significant costs could be saved by reducing the 30% administrative overhead of private insurance to the 3% of Medicare/Medicaid. Electronic billing might shave off a few percent, but will further erode patient privacy. These savings won't make Americans healthier.

To be blunt, the abysmal health of our nation is directly attributable to the American Way of Life. (AWOL). Improving our health will require more than treating the symptoms, but doing so would actually fix the holes we've been pouring money into.

Most fixes revolve around how to pay doctors and hospitals for treating a host of health problems Americans suffer from. And then we die, when a natural event is milked for maximum expense. Because of the enormous expense of medical treatment, there are politically powerful and vastly wealthy interests that are solidly opposed to systemic changes that will reduce their profits.

Systemic health care reform will have to weave through the intertwined interests of physician associations, insurance companies, the pharmaceutical and medical supply industry, mainstream media, advertising/PR and other business and consumer groups. Any "reform" passed by politicians will be shaped by the demands of these "stakeholders" brought in to craft something they can live with, like the Clinton effort, the Massachusetts experiment and undoubtedly by the new president. Because actually improving the health of the citizens gains only lip service from these groups their efforts will quickly founder on the spiraling costs of medical treatment.

Successful systemic changes for real health care, instead of merely funding medical insurance costs will require tactics and strategy to build coalitions of supporters while exploiting divisions among the opposition's ranks to undermine their influence and sap entrenched positions.

Physician associations are not as monolithic as they were. Conventional medicine has been frayed around the edges by doctors' dissatisfaction with patient loads, HMO oversight, reduced payments and increased overhead. The growing enthusiasm for holistic medicine by many M.D.s is fracturing treatment consensus.

The majority of physicians are aware that prevention is more economical than treatment, but are stuck doling out symptomatic relief in the current system due to their extensive training and income requirements.

Many lifestyle and environmental illnesses can be treated as effectively at far less cost using Complementary and Alternative Medicine (CAM). Real Universal Health Care (RUHC) would cover treatment (with affordable co-pays based on income) by licensed or certified practitioners of other "health care" approaches. This would lower overall costs and reduce patient loads for overwhelmed M.D.s. Regulatory oversight by their licensing associations and an independent investigative agency of the single payer would reduce fraud and misuse.


Improving our health through systemic social change and shifting treatment options away from unneeded care will reduce single payer costs to less than the billionaire bailout package recently rushed through congress. Since 80% of medical costs are spent on 20% of the population, mostly those with chronic illness or near death, changing how we treat these patients could realize huge savings for a single payer. Death with Dignity options would reduce costs dramatically for end of life care.

Supporting patients with chronic illness within a team of therapists and social workers actually costs less overall than crisis response, but changing social and environmental conditions to actively prevent many illnesses and injuries will save more money and a lot of unnecessary suffering.

Most information about health care choices flows from a mainstream media as enthralled by the miracles of modern medicine as they are heavily subsidized by pharmaceutical and medical treatment advertising. Going around their Maginot Line of propaganda to teach consumers about real health care will require creative persistence.

The pharmaceutical industry is on the ropes now with scandal after public health catastrophe dogging them, but their enormous wealth and PR machines will crush any pre-emptive strike against the Gut of the Beast.

IT'S THE ECONOMY STUPID! Business groups are mainly opposed to single payer insurance because most proposals for funding start by taxing employment. Having a job improves health, so taxing employment will have unintended consequences. The current economic catastrophe will make the flaws in employment based coverage obvious. Medicaid expansion to the jobless is more likely, yet those costs will rapidly bankrupt states

Paying for RUHC by charging mitigation fees on known or suspected causes of illness and injury to directly pay for their treatment instead of taxing employment would split business opposition. The rapidly growing Green Business sector will become competitive with Polluting, Health Hazardous Industries that haven't been paying for their external harm. Pursuing mitigation fees can add allies to the coalition while dividing business groups.

It's usually futile to try to ban toxic substances and practices. There's 80,000 synthetic chemicals already in play and 2, 000 new ones added each year, with only a few dozen having been banned while most are not even regulated. There's little economic incentive for government to ban health hazards, but charging fees to pay for their medical costs will effectively reduce their use. Government loves to discover new ways to raise money and this there's no shortage of options with this approach will be politically popular.

Health care mitigation fees will keep Medicare/Medicaid solvent even through the approaching silver tsunami predicted to swamp them. Taxing injury, disease and mortality inducing products and practices could pay most of the costs for RUHC for Americans,

Prevention costs less than a dime for every dollar spent on treatment, so funding systemic changes that enable people to walk regularly, eat more organic or locally grown vegetables and fruits, strengthen social ties, reduce financial stressors and reduce exposure to toxins will really reduce health care costs. Promising Americans they can Lose Weight and Save Money is so sexier than Single Payer Now.

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