Promoting a single payer health plan helps insure a good public option

Posted on October 17th, 2009 in Health by Robert Miller

Don’t give up on supporting a big push for the single payer health plan, as we head down the home stretch for healthcare reform legislation. According to Dr. Steffie Woolhandler, Harvard Professor of Medicine, the popularity of a single payer health plan (HR 676), and the persistent advocates of such a plan, have been a significant factor for keeping the public option on the table, an option that is still in place in four of the five healthcare reform bills that have been coming out of the House (3) and Senate (2) committees. Only one of those bills, the Baucus plan, lacks a public healthcare option. A consistent advocate of a single payer plan is the California Nurses Association. Their recommendation is to phone your congressional representatives and let them know about your choice–it’s more effective than emails and faxes. If you go to their website, they can direct you to the phone numbers of your Senators and Representatives or you can get them from *.gov sites. You can find House members here and Senate members here.

In today’s New York Times, Senator Tom Harkin, chair of the Senate Committee on Health, has predicted that Congress will pass a healthcare reform bill and that it will contain a public option plan. Nancy Pelosi has promised to bring the single payer plan, HR 676, the “Medicare for All” bill to the House floor for a vote. An overwhelming level of support for that bill will directly impact on the public option plan in all the others. Right now, the public option plan of the other bills is a bit murky, but none of the bills under consideration will allow the 160 million workers currently insured by their employers, to participate in the lower rates that could be afforded through the public option. So all these bills in their current form still support the for-profit system of our present healthcare disaster and don’t provide much wiggle room for removing ourselves from employer-based insurance–the real enemy of reform.  On the other hand, public support for HR 676 is strong, with a majority endorsing such a system. Even if it cannot pass into law this year, strong public support for the single payer plan, best endorsed by massive phone calls, will directly impact on the details of the public option of any bill passed this year and could lead to expansion of that option to include those currently left out. Only by reducing profits and preventing health insurance companies from participating in the American casino-style economy, can we begin to have a rational healthcare system. We need our healthcare reform to serve as the beginning of a people’s revolution through insistence on conforming to public demands and serving public needs.

The single payer plan is gaining momentum, now that we have had a chance to see the deficiencies in the other plans, especially the one that just came out of the Baucus Finance Committee. But, should a single payer bill pass, through heroic efforts of constituents, followed by a celebrated signing in the White House, we could begin to chisel Obama’s likeness onto Mt. Rushmore. A recent CBC poll in Canada had Tommy Douglas, father of the Canadian single payer healthcare system, voted as the greatest Canadian politician in history. All we need is a few miracles created by continuous public pressure to overcome the massive lobbying done by the health insurance industry and the Chamber of Commerce.

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Obama’s Nobel Peace Prize

Posted on October 10th, 2009 in Culture,Politics,War by Robert Miller

Alfred Nobel’s will assigned the selection for his Nobel Peace Prize to a committee of five selected by Storting,  the Norwegian Parliament. This prize has impacted the world and greatly influenced the citizens of Norway. Having just spent a full day with two Norwegian scientists last week, I came away impressed as I learned about the many Norwegians who are active globally in peace efforts, as they have a strong national commitment for pursuing international efforts for peace.  They take special pride in the fact that their small country not only selects the Nobel Peace Prize awardee every year, but there are many Norwegians who are involved as peacemakers in the United Nations and throughout the world. In his will, Alfred Nobel was especially interested in awarding his Peace Prize to those whose efforts led to reduced levels of arms and armaments and in more modern times, the Peace Prize committee has been equally concerned about the reduction of nuclear arsenals.

From the first paragraph of the Nobel Peace Prize announcement “The Norwegian Nobel Committee has decided that the Nobel Peace Prize for 2009 is to be awarded to President Barack Obama for his extraordinary efforts to strengthen international diplomacy and cooperation between peoples. The Committee has attached special importance to Obama’s vision of and work for a world without nuclear weapons.” You can appreciate from the first paragraph of the prize announcement that Obama’s speeches about reductions and eliminations of nuclear stockpiles has inspired a new vision for a future date when an international community of nations can live without the threat of a nuclear disaster. I have personally never felt more threatened by nuclear arms than I do today, simply because of the possibility that a terrorist organization sophisticated enough to detonate such a bomb would put an American city’s name on it as their first choice.

The other half of health

Posted on October 8th, 2009 in Health by Robert Miller

Health in a society is a two-sided coin, one of which we are debating right now as we try to form a new healthcare system to replace the disgusting, irreparable failure we call healthcare in America. Our current healthcare system has already been stamped as a disaster, though not labeled as such, by the United Nations World Health Organization (WHO) who have passed judgment on all the healthcare systems of the world, with their latest evaluation of 2000, which shows that the United States ranks 37th in the World. If you look at other health indicators, we do much worse. For example, we rank 46th in the World for infant mortality, a statistic that tells us how deficient we are in providing prenatal care to our citizens. Every time a pregnant woman goes into labor and shows up in our emergency rooms, seeing doctors for the first time, the risk factors for a successful delivery are all pointing in the wrong direction. Without broad distribution of prenatal care, we will always look like a third-world country in the area of infant mortality. By the standards of any other civilization, such an outcome would be viewed as an unacceptable failure of their medical care delivery. No woman in America should be allowed to go through her pregnancy without good prenatal care, directed by a knowledgeable physician, i.e., an obstetrician. Countries that do much better on the infant mortality rankings do so because they feel they have a stake in promoting a good outcome for the mother and the child. A healthy outcome benefits not only the mother and the child but is ultimately more beneficial to the society compared to the projected outcome if prenatal care is unavailable. Of equal importance is the fact that people who have access to adequate healthcare offer a much better chance of caring for others as a natural extension of a nurturing society. So, having access to adequate medical services, the very elements of which we are now struggling to achieve, is a common denominator of social decency, indicative of a healthy society, but a factor glaringly absent in our culture. Now that we are having a serious national debate about healthcare, we have revealed the details of our lack of good healthcare delivery to the world, which is shocked by the contrast between our wealth and our system of healthcare. Worse, our healthcare system that gets incrementally worse each year, as expensive healthcare options become to costly for small businesses. We must admit to ownership of one of the worst healthcare systems in the world, if for no other reason than we have the wealth and already pay enough to cover everyone in America with adequate healthcare protection–we need a no-fault system for our health services, not a bonanza to another for-profit industry. We do not embrace a sufficiently adequate healthcare system, one that provides for meeting the minimum requirements necessary to support a successful civilization and we are crumbling piecemeal as a society for the lack of such minimal support. We are uncivilized because of our healthcare delivery system and yet we continue hear Americans advocate that we have the best healthcare in the world. Go figure.

But, flip the coin–there is another side to health–the social health of a culture. Social health is that aspect of a society wherein everyone feels like they are members of an extended national clan which shows concern for the basic social requirements necessary to lead a successful life. This includes diversity of employment opportunities that match the diversified interests of a healthy society. There are a large, but finite number of support elements to a healthy society that begin with our physical health and extend to our sense of social health through a shared view of social justice. A healthy culture supports the full range of needs that exist in a modern, complex society. Thus, the other half of health includes the availability of good paying jobs and job security, support for child care as both family members now find it essential to participate in the work force, with long-term security as a reward for good performance, accessible educational opportunities and a sense that the country, supported by the taxes of its  citizens, is moving in an agreeable direction and using its resources wisely. It should be plainly clear to every American by now, that we cannot lead the world as a military power, while at the same time, leading the world in the avoidance of providing decent health and social services to our citizens. There is something seriously wrong with such an image. While on the one hand we need to have a system that provides the full range of social safety net services, including health care, we also need to have some assurances that, as we build a sturdy log of a reliable healthcare delivery system, someone isn’t cutting off our constructive efforts by sawing on the log at the other end. That is what happened to our retirement systems, where many companies that used to have a pension plan, changed to a 401K retirement plan in which both employers and employees contributed and then, at some point,  the company stopped paying their share and dropped company contributions to retirement altogether. We need, deserve and must demand that our multicultural society reflects and supports the interests of our collective social structure, and not concentrate on its most affluent periphery: our cultural diversity is our greatest asset, not a liability, and we must stop viewing the super wealthy as those we should try to emulate. Jobs in America are created by the interests of business and manufacturing, but we need to increasingly promote good paying jobs derived out of the personal interests within our culture, those not driven by the wealth needs at the top, but with interests and viewpoints beginning at the bottom. We need a better culture and we are diverse enough and large enough to insist on one.

Add to those two baskets of social essentials that crystallize into the concepts of our physical and mental health, the additional need to address the threat from global climate change and you come up with a trifecta of social and medical health that includes the need for ongoing efforts about our long-term future on the planet. A society that fails to address the environmental needs is a failed state, quite irrespective of how that society deals with the perceived threats from other cultures, i.e., in our case, the largely manufactured threat of terrorism. To deal effectively with this trifecta, we have to project a vision, rightly or wrongly, for  the environment 100 to 200 years down the road, because the half-life of carbon dioxide in the atmosphere is within that range or longer, depending on how far up the carbon scale we get before we begin to bring it down. So if we stopped adding carbon to the atmosphere tomorrow, we would be unlikely to see benefits from the reduced carbon load until decades later and there is no guarantee that we can go down along the same curve we went up on. Species will die out on the way up and we won’t get them back on the way down. We only hope that the human species is not among those lost along the way, though we are projected to perhaps lose many. But, what the hell! Our experiment so far has only lasted a few million years.

While dealing with those far-reaching issues such as climate change is also part of a healthy society, I’m still stuck on jobs–the availability of good paying jobs and the promise of stability in the workplace!  I share with most of you a significantly large bushel full of pet peeves about our financial industry and its selfish devotion to the accumulation of wealth, accompanied by the complete disregard for any sense of social obligation to the workers of this country, whose jobs are wasted in the form of a down payment to the accumulation of wealth by those already wealthy. Private equity firms are the enemies of good jobs. They take over companies, many of which are doing well, force them into debt to pay off their own greedy need for bonuses and then force the company to downsize, often at the peril of the company itself. Companies that have been successful for more than a hundred years and have found ways to adapt to our “modern” economy have been run into the ground by private equity firms and this is now happening on an almost daily basis.

Two days ago, the New York Times had a good front page article on the Simmons Mattress Company and how they had been owned by five different private equity firms over the past several years. We have all heard of the Simmons Mattress company, a company that has been selling mattresses for 133 years. Many of us have slept on these mattresses. Eleanor Roosevelt herself extolled the virtues of the Simmons Beautyrest mattress and “the brand was immortalized on Broadway in Cole Porter’s song “Anything Goes”” (quote from the NYT article). So you know how private equity firms work: they typically buy a company and borrow the money to finance the deal (the old-fashioned “leveraged buyout”), forcing the company to assume much of the debt, which often includes bonuses for the private equity executives and exorbitant fees paid to lawyers and financiers to complete the sale. The first private equity buyer for Simmons was William E. Simon, a Treasury secretary under Richard M. Nixon. He and his colleagues bought the Simmons mattress company in 1986, using borrowed money ($120 million) and sold the company three years later for $241 million–resulting in a nice tidy profit. What a model for the future. But as part of the buyout plan of 1986, Simmons stopped contributing to its pension plan, since the stock ownership plan shares were meant to pay for the the employees’ retirements (where have you seen this before). But putting the employees retirement plans into the value of the stock is precisely the same as what Bush wanted to do by privatizing Social Security. So when the crash began in 2007, the housing market tumbled and with large debt payments for the Simmons mattress company, the employee retirement resources all but disappeared. Where in all the financial hubris was there any concern expressed for the workers of the company? The last private equity firm to own Simmons was the Thomas H. Lee (THL) partners of Boston, who added a super-increment of borrowing laid to Simmons, which has now filed for bankruptcy with $1.3 billion in debt. The new debt contributed substantially to the super wealthy lifestyle of THL executives as well as the CEO Charlie Eitel, who ran the Simmons company and escaped with his financial dream still intact. While CEO of Simmons, Eitel charged country club memberships and personal use of a corporate jet, while earning more than $40 million in compensation, bonuses and other perks. For a while, the Simmons mattress company even paid the $92,000 salary and benefits for the captain of his yacht. The assumption of so much debt, acquired at very high interest rates (10%), prompted the Simmons company to undertake risky new initiatives to sell more mattresses. The HealthSmart mattress, which had a liner to guard against dust mites, did not go through significant product testing or market research, as was typical for the company, and it turned out to be a major market flop. In 2007, THL took more money out of the company by borrowing and saddling Simmons with additional debt in a process known as “dividend recapitalization.” We should all remember those words because Wall Street is currently trying to bring private equity firms back with a vengeance and so far we have no oversight functions to prevent them from doing so. For the Simmons mattress company, when the economy began to go south in 2007, the writing was on the wall. The downturn in sales for Simmons led to default on their loan payments, employees were let go without any benefits or severance payments, while the executives of THL prospered with their lavish salaries, expensive homes and yachts.

The Simmons mattress company began in Kenosha Wisconsin in 1876. As the company grew, it evolved into an extended family operation in which its employees were viewed as family members, with Christmas parties, retirement parties and the sense of connection that comes from producing a product of quality with worldwide distribution and recognition. The good begot better. All of that was eliminated however, as employees were let go and retirement packages were ruined because they were tied into the stock value of the company. You remember ENRON.
The other component of this story is that the private equity firms always claim their ambition is to improve the company sales and profits, reminiscent of President William McKinley’s stated desire to go to war against Spain, as our first imperial war,  so that he could liberate the little brown people. The arrogance of the private equity firms is that they think they can run a company better than those who have been running them for decades if not more than a century. More importantly however, nowhere do you see any consideration of the workers affected by this false picture of “improved productivity.” During the process of “improvements in efficiency,” worker downsizing is institutionalized, and many workers, including senior workers with little chance of getting equivalent jobs, are let go before or during the bankruptcy of the company. According to the Times article, of the 220 companies that have defaulted on their debt this year, more than half were owned at one time or another by private equity firms: Harrah’s entertainment and Six Flags theme parks are among the losers. When will we learn that private equity firms, which have the same advantages for secrecy as hedge funds, with virtually no oversight, are making profits by destroying American companies, not by building them up. The epicenter of a company is its workers. That is the source of a company’s creativity. The esprit decor and positive work environment of a company cannot exist if everyone is faced with anxiety about their job security and their future. This is lousy social health and it impacts on our physical health, as it enhances a sense of helplessness about our future. If you are immune to these kinds of nightmares you are probably retired or very close to it or perhaps, like me, you have tenure.
Ever since we allowed Ronald Reagan to destroy the Air Traffic Controller’s union, we have allowed our work force to be less and less represented by unions. This trend needs to stop and we need to recognize that our own government has been involved in a can-do conspiracy to flatten whole industries because of their union representation. The participation of our government in flattening the American automobile industry, while allowing the Japanese and Koreans to have full access to our markets is one of the untold stories of this decidedly black chapter in our trade policy history. It is time to eliminate private equity firms and leveraged buyouts as an un-American, destructive practice to the health of our society. We need to stamp out the drive for super wealth as a health index of our society, for surely we have proven over the last 30 years that, as private wealth has grown, the public good has been incrementally destroyed and the concept of a healthy society has been virtually wiped out by the greed of hedge funds, private equity groups and leveraged buyouts. Business needs to serve the interests of workers, not be free to dispose of them like so much cannon fodder. Believe it or not, in the 1950s, we had a culture where business executives had more pride in an employee getting the gold watch at his/her retirement than they did for the value of the stock. The latter would take care of itself if the product was good and it was clear that product improvement was based on employee participation to identify and facilitate new areas for improved product quality and productivity. Our genius resides in middle class prosperity and the other side of our health coin cannot be adequately forged if we don’t begin to restore our sense of social justice about job creation, job security and job priority. One short-term solution is to have the government provide low interest loans so that for any company threatened by the buyout practices of private equity firms, the employees get the first opportunity through such loans to buy the company and preserve the jobs. My guess is that most companies would run better without the absurd interference from dreamy executives who want to create a new lifestyle for everyone in the company, but mostly for those at the top. That is ENRON all over again. Surely we know better by now.

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