March 10, 2010

Medicare for all!

Stop the medical insurance bail-out bill! Dave Lindorff writes at Counterpunch:

When Obama came to my neighborhood this week to press for public support for his health “reform” bill, he wasn’t just greeted by tea-party hecklers. Speaking to a large group of mostly supportive students and local residents at Arcadia University in Glenside, the president at one point mentioned that “people on the left” want “single-payer.” But before he could add that that approach wasn’t going to happen, he found himself drowned out by cheers calling for Medicare for all and single-payer.

That kind of says it all.

I’m with Marcia Angell, editor of the New England Journal of Medicine. The Obama plan for health care “reform”, as well as the two versions passed by the House and the Senate, are all devious disasters that do nothing to solve the nation’s burgeoning health care crisis, and in fact, will make it worse.

The only thing to do at this point is to take the whole stinking pile of paper and put it in the compost heap. Kill it.

This whole effort was never about reform from the day last March when the new president called on Congress to begin deliberations on health care reform. It was about catering to the wishes of the big players in the Medical Industrial Complex--the big pharmaceutical multinationals, the hospital companies, the physicians and, most of all, the insurance industry. People and their health care needs had little or nothing to do with this.

That’s why we’ve ended up with proposals that would do nothing to control costs, that would force health young people to buy unregulated, high-cost and high-profit plans that would be money in the bank for the insurance industry, and that would finance any subsidies for the poor by cutting back on benefits for the only group of Americans who currently have a form of single-payer insurance--the elderly with their Medicare.

President Obama began this whole obscene nightmare with a lie, when he said that even though single-payer systems clearly work to open access to all and keep costs down while providing better overall health results in places like Canada and some European countries, they cannot be applied in America “because that would mean starting over from scratch.” He knew when he said it that this was a lie. America already has a well-run and successful single-payer healthcare program in place that is bigger than the entire Canadian health care system, and that’s Medicare, which was established in 1965, and which currently finances the care of 45 million Americans. You just have to be 65 or disabled to be eligible for it.

As Dr. Angell pointed out on a recent Bill Moyers Journal segment, the simplest way to solve America’s health care crisis would be to just start a gradual expansion of Medicare, say by lowering the age of coverage to 55, and then 45, and then 35, until everyone was covered and the insurance industry was pushed out of the health sector. ... Medicare gives the elderly a freer choice of physician and treatment than any but the most gold-plated private insurance executive health care plan.

Obama continued this lie when he claimed, in his last mention of the issue during his State of the Union address to Congress, that he and Congress had considered every idea. In fact, he and Congress have for the last year, carefully prevented any consideration of the idea of single-payer, or of expanding Medicare to cover every American. Bills that would do that, authored by Rep. John Conyers (D-MI) in the House and Sen. Bernie Sanders (I-VT) in the Senate, were blocked from hearings or votes in both Houses by Democratic leaders, at the White House’s urging, while the White House itself barred single-payer advocates from any of its discussions.

Instead the president met behind closed doors with the lobbyists of the various health care industries, to cut deals with each sector in order to gain their support for his “reform” plan. It was as if the Department of Justice had called meetings with the various crime families of the Cosa Nostra in order to cut deals before developing a plan to “tackle” the Mafia. ...

The US currently devotes 17.5 percent of Gross Domestic Product to health care, and if this “reform” in any of its guises is passed, that share of the economy devoted to health care will quickly rise past 20 percent, with no end in sight. This is madness. Expanding Medicare to cover everyone, as I have written earlier, would actually save everyone money immediately, and the country as a whole. Consider that the most expensive consumers of health care--the elderly--are already in the system. Adding younger, healthier people to Medicare would cost incrementally much less. That’s why the Canadians spend about 9 percent of their GDP on healthcare, while covering every Canadian, while we spend nearly twice as much and leave 47 million of our citizens uninsured and unable to visit a doctor.

How could it be cheaper to add everyone to Medicare? Expanding Medicare to cover everyone would probably cost somewhere between $800 billion and $1 trillion a year. That sounds like a lot of money, until you consider that we already spend $100 billion a year to care for veterans through the Veterans Administration, and $400 billion a year to care for the poor through Medicaid. We also spend $300 billion a year subsidizing hospitals that have to provide “free” charity care to the poor who don’t qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, that’s $800 billion a year in current expenditures saved right there.

... You don’t want to pay more taxes? Well wait. If you were covered by Medicare, you and your employer would no longer have to pay for private insurance, which would mean a savings to workers of thousands of dollars a year, and even more to employers who currently pay the majority of health insurance premiums for employees. The net savings would be enormous.

Nobody has talked about this.

Universal Medicare would make American companies more competitive in the global marketplace, where other companies are not responsible for health care costs of their workers. It would make Americans wealthier, because they would no longer be paying for health care out of their own pockets. It would make everyone more secure, because they would no longer have to fear losing access to health care if they lost their job, and would eliminate most bankrupties, which are reportedly caused by medical bills.

So we know what needs to be done.

And we know that the current “reforms” on offer don’t do it.

So Dr. Angell is right. Obamacare needs to die.

There is reason to hope that it will die. Republicans oppose it, though not for any decent reason. They want unregulated private insurance and unlimited profits for health care industries. Ditto some conservative Democrats, who are also anti-government ideologues whose wallets are stuffed with health industry swag. But their reasons for oppposing health bill don’t matter. All that is needed is for a few progressive members of the House and Senate to admit that the health bills being considered are not reform, but the antithesis of reform, and to also vote against it, and Obamacare will be dead.

At that point we can start seriously demanding that the Congress and the President act to bring us real health reform in the way that really works: expanding Medicare to cover everyone.

March 7, 2010

It's Time for Revolution

Bill Quigley writes at Huffington Post:

It is time for a revolution. Government does not work for regular people. It appears to work quite well for big corporations, banks, insurance companies, military contractors, lobbyists, and for the rich and powerful. But it does not work for people.

The 1776 Declaration of Independence stated that when a long train of abuses by those in power evidence a design to reduce the rights of people to life, liberty and the pursuit of happiness, it is the peoples right, in fact their duty to engage in a revolution.

Martin Luther King, Jr., said forty three years ago next month that it was time for a radical revolution of values in the United States. He preached "a true revolution of values will soon cause us to question the fairness and justice of many of our past and present policies." It is clearer than ever that now is the time for radical change.

Look at what our current system has brought us and ask if it is time for a revolution?

Over 2.8 million people lost their homes in 2009 to foreclosure or bank repossessions - nearly 8000 each day - higher numbers than the last two years when millions of others also lost their homes.

At the same time, the government bailed out Bank of America, Citigroup, AIG, Bear Stearns, Fannie Mae, Freddie Mac, the auto industry and enacted the troubled asset (TARP) program with $1.7 trillion of our money.

Wall Street then awarded itself over $20 billion in bonuses in 2009 alone, an average bonus on top of pay of $123,000.

At the same time, over 17 million people are jobless right now. Millions more are working part-time when they want and need to be working full-time.

Yet the current system allows one single U.S. Senator to stop unemployment and Medicare benefits being paid to millions.

There are now 35 registered lobbyists in Washington DC for every single member of the Senate and House of Representatives, at last count 13,739 in 2009. There are eight lobbyists for every member of Congress working on the health care fiasco alone.

At the same time, the U.S. Supreme Court decided that corporations now have a constitutional right to interfere with elections by pouring money into races.

The Department of Justice gave a get out of jail free card to its own lawyers who authorized illegal torture.

At the same time another department of government, the Pentagon, is prosecuting Navy SEALS for punching an Iraqi suspect.

The US is not only involved in senseless wars in Iraq, Afghanistan and Pakistan, the U.S. now maintains 700 military bases world-wide and another 6000 in the US and our territories. Young men and women join the military to protect the U.S. and to get college tuition and healthcare coverage and killed and maimed in elective wars and being the world's police. Wonder whose assets they are protecting and serving?

In fact, the U.S. spends $700 billion directly on military per year, half the military spending of the entire world - much more than Europe, China, Russia, Iran, Pakistan, North Korea, and Venezuela - combined.

The government and private companies have dramatically increased surveillance of people through cameras on public streets and private places, airport searches, phone intercepts, access to personal computers, and compilation of records from credit card purchases, computer views of sites, and travel.

The number of people in jails and prisons in the U.S. has risen sevenfold since 1970 to over 2.3 million. The US puts a higher percentage of our people in jail than any other country in the world.

The tea party people are mad at the Republicans, who they accuse of selling them out to big businesses.

Democrats are working their way past depression to anger because their party, despite majorities in the House and Senate, has not made significant advances for immigrants, or women, or unions, or African Americans, or environmentalists, or gays and lesbians, or civil libertarians, or people dedicated to health care, or human rights, or jobs or housing or economic justice. Democrats also think their party is selling out to big business.

Forty three years ago next month, Rev. Martin Luther King, Jr. preached in Riverside Church in New York City that "a time comes when silence is betrayal." He went on to condemn the Vietnam War and the system which created it and the other injustices clearly apparent. "We as a nation must undergo a radical revolution of values. We must rapidly begin the shift from a "thing oriented" society to a "person oriented" society. When machines and computers, profit motives and property rights are considered more important than people, the giant triplets of racism, materialism and militarism are incapable of being conquered."

It is time.

March 6, 2010

Single payer now ... or in 2017? If in 2017, why not now?

As reported by Ryan Grim at Huffington Post, at his recent meeting with House progressives about the health insurance regulation bill that was supposed to be a health care bill,
"Obama pointed Kucinich toward single-payer language that Sen. Bernie Sanders (I-Vt.) was able to get into the bill. Kucinich fought for an amendment that would allow states to adopt single-payer systems without getting sued by insurance companies. Obama told Kucinich that Sanders's measure was similar but doesn't kick in for several years.
Section 1332 does indeed allow for states to establish a single-payer insurance system -- in 2017!

But many states are ready to implement such systems right now. Why the wait, if it's such a good thing?

Instead, Obama is fighting hard to criminalize not having health insurance, to force people to buy an expensive and mostly worthless product to protect the profits of private insurance companies. Just like with the collapse of the home mortgage market, he is opting to spend a trillion dollars to save the robber barons and to sweep crumbs to their victims.

I say it is a worthless product, because, as Michael Moore's film Sicko showed, having insurance doesn't mean very much when you actually need it. The majority of people who have insurance and are satisfied with it most likely have not experienced anything catastrophic yet.

(Single-payer [e.g., Medicare in the U.S.] aside, that is actually not as common in other countries as one might think. It is the system in Canada, and in Great Britain they also have socialized delivery of care [e.g., the Veterans Administration in the U.S.]. Most countries, however, simply recognized the conflict between profit and health care and so removed that aspect for universal care. That's called "people before profits", or representational democracy. A government that puts business before people is called "fascist". For a good overview of several systems around the world, see T.R. Reid's The Healing of America.)

A Harvard Medical School study estimated that 45,000 people die in the U.S. each year because of lack of insurance. Forcing them into worthless plans that they can't afford isn't going to help. To apply the words of John Kerry's 1971 speech about Vietnam to our current for-profit work-linked health insurance system,
How do you ask a man to be the last man to die for a mistake? ... We are here to ask, and we are here to ask vehemently, where are the leaders of our country? Where is the leadership?
Adam Green of the Progressive Change Campaign Committee wrote in response to Ryan Grim's article:
Obama is telling America, "No, we can't." But we've been showing more and more each day, "Yes, we can" pass the public option. If President Obama doesn't think the votes exist in the Senate, he needs to name which senators would oppose it. If he can't or won't, there's no reason for House progressives to be part of the White House's loser mentality.
Hear, hear! Waiting until 2017 for state-run single-payer is bullshit, and health insurance reform without a nonprofit public option is bullshit.

March 4, 2010

Denmark ranks low in 2010 environmental performance index

Agricultural practices and high reliance on coal, oil and gas gives the country a poor environmental ranking

Denmark is ranked a modest 32nd in the ‘Environmental Performance Index 2010’, compiled by researchers from American Ivy League universities Yale and Columbia.

The index ranks 163 countries, measuring factors such as greenhouse gas emissions, protection of habitats for fauna and flora, general pollution, aquatic environments and sanitation.

Although many of the countries that are ranked ahead of Denmark are not industrialised, many others are, including its Scandinavian neighbours Sweden and Norway, which place fourth and fifth respectively. Another Nordic country, Iceland, tops the list as the most environmentally respectful country. [And Finland is 12th. Click here to see all of the rankings.]

Christine Kim, one of the researchers behind the project, said Denmark wasn’t the pioneer it claimed to be when it came to the environment.

‘When it comes to greenhouse gases, Denmark is not much of an environmental leader,’ she said. ‘And it’s mainly due to the way the Danes use and produce energy.’
Click here to read the rest of "Denmark’s environmental standards dismal" at Copenhagen Post (29 January 2010)

The point of calling attention to this is not to beat up on Denmark. It is to note that despite being the world leader by far in wind energy "penetration", they have still to deal with the same problems as other industrialized countries. Wind didn't change things much.

P.S.  Fun facts:  In 2008, the United States got 48% of its electricity from coal. In 2008, Denmark got 48% of its electricity from coal.

wind power, wind energy, environment, environmentalism

February 24, 2010

The lies of a wind developer

Angus King, formerly governor of Maine and now an industrial wind developer, had an opinion piece published in Sunday's Portland Press Herald. It is a response to letters pointing out some of the shortcomings of industrial wind turbines that must be weighed against their alleged benefits.

Rather than acknowledge such impacts in any way (a signal that the benefits side of the argument isn't at all viable), he engages in the classic rhetorical devices of straw man, red herring (changing the subject), ad populum (weasel words), and simply lying.

"Myth" 1: Building wind turbines destroys mountains. King: Mountaintop removal for coal destroys mountains.


King actually asserts that since nothing in the blasting and grading for roads and platforms is removed from the mountain, it's not destructive.

"Myth" 2: The sound can be heard for miles. King: Half a mile maybe.

Evidence of harm from noise experts and physicians suggests that noise from a line of turbines on a mountain can be a problem 3-5 kilometers (~2-3 miles) away, depending on the terrain. They suggest a minimum setback of 2 kilometers (1.25 miles) on flat terrain. In contrast, while half a mile is more setback than most developers will allow as reasonable, it is not based on actual experience, where in fact, the sound -- to a degree that is harmful to health -- can be heard a mile or more away.

"Myth" 3: Maine's wind power law cuts the people out. King: There were public meetings.

There is a political imperative behind industrial wind, which even the environmental groups cited by King support. Combined with the huge amounts of free (i.e., taxpayer-supplied) money involved, serious limitations on that development were inevitably kept to a minimum. The fact is, the purpose of the wind power law is indeed to make it easier to erect giant wind facilities, which requires cutting the people, and the environment, out.

"Myth" 4: Wind turbines will make you sick. King: Only annoying, if you're too close.

Again, this is more than most developers will admit, but it is still insulting, misleading, and false.

Insulting:  King is calling everyone who suffers very real effects of ill health, many of them forced to sleep elsewhere or to abandon their homes altogether -- he is calling each of them a liar, an hysteric, a believer in "mysterious emanations".

Misleading:  Annoyance is in fact an acoustical term meaning the noise is bad enough to trigger drastic action (such as suing or moving). These actions are common around wind energy facilities. Many of them result in the company buying the neighbor's property (and forbidding them to speak of their problems ever again). Acoustics is not a field of medicine, so it can only imply that annoyance could also be caused by or is a predictor of health effects. There are no journal-published studies by physicians of this issue.

False:  What is "too close"? The most rigorous case series to date, by Dr. Nina Pierpont, documents serious adverse health effects (as proven by the need to abandon the home, which action cured the symptoms) up to 4,900 feet (almost a mile). Others report health effects up to 2 kilometers (1.25 miles) away. The "annoying" effects are not simply irritability and anxiety, but also include headaches, nausea, dizziness, memory and concentration problems, and throbbing sensation. Studies of wind turbine noise in Europe consistently find, even with models that are much smaller and distances which are much farther than in North America, that wind turbine noise is uniquely annoying -- at lower sound levels and at greater distances than expected.

"A Dangerous Dependence": Finally, King raises the specter of fossil fuel use and appeals to xenophobia. Self-sufficiency and cleaner fuel use are indeed worthy goals. What King neglects to show is any connection between industrializing Maine's mountains with giant wind turbines and achieving those goals. (Furthermore, Maine wind is eyed for the supposed benefit of Massachusetts and New Brunswick, not Maine.) Conservation would obviate the small amount of low-value (intermittent, highly variable, and nondispatchable) energy that wind could ever hope to provide.

wind power, wind energy, wind turbines, wind farms, environment, environmentalism, human rights, Maine

February 17, 2010

Pierpont, peer review, and expert witnesses

If I may jump in here as an editor of medical journals, I would just like to note that single case reports and case series are a major part of their content. That is how information is shared. When the authors are noticing something new (or more often, noticing something in a new way), they are clear about the limitations of a case series for making conclusive statements. For example, this is from an article I read last week about a new surgical technique:
It is important to note that there are limitations to our study, primarily because it is a case series. Therefore, we have no comparison group and there may be selection bias, though we attempted to minimize this by reviewing our entire endoscopic database and selecting all patients who underwent this procedure, not just a subset. Although this is the largest series presented to date, it still comprises only 12 patients, all of whom were seen at a single GI referral center with expertise in esophageal dilation and treatment of esophageal strictures. Therefore, the results may not be generalizable to other settings.
Those "limitations" did not prevent it from being published in a peer-reviewed journal. They are normal.

Nina Pierpont notes the limitations of her work (pp. 124-125): interview-only and limited medical records, comparison by memory, inaccurate reporting by subjects, English-only, small sample, limited follow-up. (She also describes how she endeavored to minimize each these effects.) On page 123, she notes the research that needs to be done to more definitively describe the syndrome, risk factors, and mechanisms. (Another limitation, mentioned in the text (p. 39-40), is that "participation by Americans was limited by non-medical factors such as turbine leases or neighbor contracts prohibiting criticism, court decisions restricting criticism of turbine projects, and community relationships".)

It is important to note that authors typically suggest the reviewers for their papers. It is not adversarial, as detractors seem to imply. Successful peer review just means you've been able to hold up your end of the conversation, not that you've slain all skeptics. It is more a process of refining the paper, as I believe Pierpont did with her panel of reviewers (and why in part it took so long to get into print), whose reports are on pp. 287-292. In turn, most journals also include a lively letters section in which the real peer review is shown to begin after publication.

Choosing the most effective expert witness must of course be done according to each case's focus and strategy, but I dare say, opposing counsel would have a lot harder time undercutting Pierpont's work than they would that of most "peer-reviewed experts".

In other words, "peer reviewed" is not a defense. Conversely, lack of one form of peer review (that for journal publication) is not much of a charge. A court room is perhaps the ultimate peer review.

These comments are in response to some of the reactions to Wind Turbine Syndrome that have been written. There is no question of WTS, whether you call it that or not. There remain questions of mechanism, but not of cause. And determining its extent and risk requires large epidemiologic studies. These are not criticisms. Pierpont says them herself. That is the process of science.

If only more people in power were so skeptical about wind industry claims!

February 12, 2010

Adam and the Queen of Eden

ADAM AND THE QUEEN OF EDEN

by Eric Rosenbloom
copyright 2010

One day while strolling to take the air,
Sir Adam spied a garden fair
        Its keeper called
        He was enthralled
With Eve at home atearing her hair.

He entered on her invitation
Flattered by her fine flirtation
        And there he stayed
        With the merry maid
His life now and ever a boon vacation.

But dragons keep from him a tree
Where golden fruit would often be
        Athought of gifts
        His sword he lifts
And gathers food, Lilith to see.

But Lilith the maid is not to be found,
Her garden is withered to the ground
        The fruit of his shame
        He brings the same
To Eve — who with Cain has moved to town.