Tag: Mike Magee

Charting The Economic History of US Health Reform

Nov 25, 2019• 7

By MIKE MAGEE, MD

Adam Gaffney’s recent Boston Review article, “What the Health Care Debate Still Gets Wrong”, a landmark piece that deserves careful reading by all, reaches near perfection in diagnosing our health system malady.

Dr. Gaffney is president of Physicians for a National Health Program, and a co-chair of the Working Group on Single-Payer Program Design, which developed the “Physicians’ Proposal for Single-Payer Health Care Reform.”

A seasoned health policy expert, his article cross-references the opinions and work of a range of health commentators including Atul Gawande, Steven Brill, Sarah Kliff, Elizabeth Rosenthal, Zack Cooper, and Canadian health economist Robert Evans. But his major companion is Princeton health economist, Uwe Reinhardt, whose posthumous book, Priced Out: The Economic and Ethical Costs of American Health Care, was recently published by Princeton University Press.

Gaffney’s affection for Reinhardt is evident as he recounts his desperate upbringing in post-war Germany, challenged by poor living conditions, but made whole by access to health care. Quoting a 1992 JAMA interview, Reinhardt states, “When we needed medical care, we got it at the local hospital, no questions asked. When you were sick, society was there for you.”

That acknowledgment is not only personal but historically significant, as I outline in my recent book, Code Blue: Inside the Medical Industrial Complex. The services Reinhardt received were part of a new national health care system funded fully by American taxpayers as part of the Marshall Plan. At the very same time, American citizens were denied a national health plan of their own as Truman was effectively branded a supporter of “socialized medicine” by the AMA and a cabal of corporate partners.

The Efficiency Mandate: To Achieve Coverage, the U.S. Must Address Cost

Aug 28, 2019• 15

By MIKE MAGEE, MD

It is now well established that Americans, in large majorities, favor universal health coverage. As witnessed in the first two Democratic debates, how we get there (Single Payer vs. extension of Obamacare) is another matter altogether.

295 million Americans have some form of health coverage (though increasing numbers are under-insured and vulnerable to the crushing effects of medical debt). That leaves 28 million uninsured, an issue easily resolved, according to former Obama staffer, Ezekiel Emanuel MD, through auto-enrollment, that is changing some existing policies to “enable the government agencies, hospitals, insurers and other organizations to enroll people in health insurance automatically when they show up for care or other benefits like food stamps.”

If one accepts it’s as easy as that, does that really bring to heel a Medical-Industrial Complex that has systematically focused on profitability over planning, and cures over care, while expending twice as much as all other developed nations? In other words, can America successfully expand health care as a right to all of its citizens without focusing on cost efficiency?

The simple answer is “no”, for two reasons. First, excess profitability = greed = waste = inequity = unacceptable variability and poor outcomes. Second, equitable expansion of universal, high quality access to care requires capturing and carefully reapplying existing resources.

It is estimated that concrete policy changes could capture between $100 billion and $200 billion in waste in the short term primarily through three sources.

Doctors Will Vote With Their Patients

Jul 30, 2019• 5

By MIKE MAGEE, MD

As Robert Muller’s testimony before Congress made clear, we owe President Trump a debt of gratitude on two counts. First, his unlawful and predatory actions have clearly exposed the fault lines in our still young Democracy. As the Founders well realized, the road would be rocky on our way to “a more perfect union”, and checks and balances would, sooner or later, be counter-checked and thrown out of balance.

On the second count, Trump has most effectively revealed weaknesses that are neither structural nor easily repaired with the wave of the wand. Those weaknesses are cultural and deeply embedded in a portion of our citizenry. The weakness he has so easily exposed is within us. It is reflected in our stubborn embrace of prejudice, our tolerance of family separations at the border, our penchant for violence and romanticism of firearms, our suspicion of “good government”, and –unlike any other developed nation – our historic desire to withhold access to health services to our fellow Americans.

In the dust-up that followed the New York Times publication of Ross Douthat’s May 16, 2017 article, “The 25th Amendment Solution for Removing Trump”, Dahlia Lithwick wrote in SLATE, “Donald Trump isn’t the disease that plagues modern America, he’s the symptom. Let’s stop calling it a disability and call it what it is: What we are now.”

Recently a long-time health advocate from California told me she did not believe that the majority of doctors would support a universal health care system in some form due to their conservative bend. I disagreed.

It is true that, to become a physician involves significant investment of time and effort, and deferring a decade worth of earnings to pursue a training program that, at times, resembles war-zone conditions can create an ultra-focus on future earnings. But it is also true that these individuals, increasingly salaried and employed within organizations struggling to improve their collective performance, deliver (most of the time) three critical virtues in our society.

Is “Medicare For All (Who Want it)” Enough?

Jul 8, 2019• 2

By MIKE MAGEE

In the 2^nd night of the Democratic Primary debate on June 27, 2019, Pete Buttigieg was asked whether he supported Medicare-For-All. He responded, “I support Medicare for all who want it.”

In doing so, he side-stepped the controversial debate over shifts of power from states to the federal government, and trusted that logic would eventually prevail over a collusive Medical-Industrial Complex with an iron lock grip on a system that deals everyone imaginable in on the sickness profitability curve – except the patient.

On July 30, 1965, President Lyndon B. Johnson signed into law “Medicare,” a national insurance plan for all Americans over 65. He did so in front of former President Truman, who 20 years earlier had proposed a national health plan for all Americans, and for his trouble was labeled by the AMA as the future father of “socialized medicine.”

For Truman, there was a double irony that day in 1965. First of all, the signing was occurring at around the same time as our neighbor to the north was signing their own national health plan, also called “Medicare”, but their’s covered all Canadian citizens, not just the elderly.

The second incongruity was that Truman was fully aware that in 1945, as he was being tarred and feathered as unpatriotic by taxpayers for having the gall to suggest that health care was a human right, those very same citizens were unknowingly funding the creation of national health plans as democracy stabilizers in our two primary vanquished enemies – Germany and Japan – as part of the US taxpayer funded Marshall Plan.

All for One, One For All

Mar 28, 2019• 5

By MIKE MAGEE MD

Within the ever-widening array of Democratic contenders for the Presidency, the “Medicare-for-all” debate continues to simmer. It was only six weeks ago that Kamala Harris’s vocal support drew fire from not one, but two billionaire political rivals. Michael Bloomberg, looking for support in New Hampshire declared, “I think we could never afford that. We are talking about trillions of dollars… [that] would bankrupt us for a long time.” Fellow billionaire candidate Howard Schultz added, “That’s not correct. That’s not American.”

Remarkably, neither man made the connection between large-scale health reform’s potential savings (pegged to save 15% of our $4 trillion annual spend according to health economists) and the thoughtful application of these newly captured resources to all U.S. citizens without discrimination. Bloomberg’s own 2017 Health System Efficiency Ratings listed the U.S. 50th out of 55, trailed only by Jordan, Columbia, Azerbaijan, Brazil, Russia. Yet he seemed unable to connect addressing waste with future affordability.

Schultz was similarly short sighted. While acknowledging that the manmade opioid epidemic, mental health crises, and income inequality are “systemic problems” and at levels “the likes of which we have not had in a long time”, he failed to connect the cause (a remarkable dysfunctional and inequitable health care system) with these effects.

As I outline in “Code Blue: Inside the Medical Industrial Complex” (Grove Atlantic/ June 4, 2019), today’s greatest risk to continued progress and movement toward universal coverage and rational health planning is sloppy nomenclature. To avoid talking past each other, we need to define the terms of this debate while agreeing on common end points.

A Unique Offering for Students, Professors, and Lifelong Learners: “The ‘Right’ to Health Care and the U.S. Constitution.”

Oct 30, 2018

By MIKE MAGEE

“The ‘Right’ to Health Care and the U.S. Constitution.”

(Register For Virtual Zoom Access Here.) https://securelb.imodules.com/s/1878/lg21/form.aspx?sid=1878&gid=2&pgid=1306&cid=3139&srce=WBpcfall2021

Join me, in-person or virtual, on 4 consecutive Thursdays this Fall.

Together we’ll examine 250 years of history and case law, to expose what our U.S. Constitution says (and leaves unsaid) about Americans’ “right” to health care. From the Bill of Rights to the Federalist Papers, from McCulloch v. Maryland to Griswold v. Connecticut, from “Comstockery” to Sanger, and FDR’s “Court Packing,” we’ll cover it all.

You’ll learn about “penumbras” from William O. Douglas, and Due Process within the XIV Amendment; how the AMA chose Reagan as their spokesperson against “socialized medicine”, and how LBJ forced integration of hospital wards on Bible Belt states.

We’ll do a deep dive into Roe v. Wade and learn how Justice Blackmun arrived at his compromise solution for “Jane Doe” and others, and examine why Texas Governor Abbott is trying to torpedo it a half-century later.

We’ll revisit the politicization of the Terri Schiavo “Right to Die” case, and uncover “conflicts of interest” and deficiencies in “informed consent” at the University of Pennsylvania that contributed to the research death of Jesse Gelsinger.

We’ll hear the voices and opinions of students and professors, analyze Justice Roberts’ National Federation of Independent Business v. Sebelius split decision that preserved the Affordable Care Act…address mandated vaccines, and much, much more.

In just four 90-minute packed sessions, you’ll gain a perspective on the current struggle for health care in America. Most of all, you’ll learn and participate in the process. That’s a promise!

Register Today HERE. https://securelb.imodules.com/s/1878/lg21/form.aspx?sid=1878&gid=2&pgid=1306&cid=3139&srce=WBpcfall2021