Maggie Mahar on "Bill Moyers Journal" Tomorrow

By John Ballard

Maggie Mahar's book, Money Driven Medicine has been made into a documentary by Academy Award Winner Alex Gibney. The dvd is being made available to institutions and libraries, not for private sale. I contacted my local library who have ordered one. Snips are up on You Tube but I think Bill Moyers will play the whole show tomorrow night. Maggie Mahar is an investigative journalist who has been looking at medical care in America for some time. Her book was published two years ago.

I began to learn about the healthcare industry while I was a writer and senior editor at Barron�s -- from 1986 through 1997. During that time I covered both Wall Street and Washington, and wrote stories on a wide range of subjects.

Many of those stories focused on healthcare companies: drug-makers, device-makers, insurers and for-profit hospitals. I also wrote about managed care, the FDA and its battle against Big Tobacco. I analyzed the Clintons� plans for healthcare reform. I compared non-profit HMOs to for-profit HMOs.

What I learned, during those years, is that in our health care system, profits often trump patients. A great many people are selling and selling hard. By law, for-profit corporations are supposed to put their shareholders� interests first: this means that they must strive to maximize profits. And this goes a long way toward explaining why U.S. healthcare is so expensive.

In 2003, I began writing MONEY-DRIVEN MEDICINE: THE REAL REASON HEALTH CARE COSTS SO MUCH. (Harper/Collins, 2006) At the time, I believed that when President Bush left office, the country would be ready for a political pendulum swing�and health-care reform would, once again, become a possibility. (Admittedly, I didn�t foresee that Bush would be re-elected. The book was early.)

When I began to gather material for the book, I knew that I wanted to talk to a great many doctors�and I started calling them. The great majority did not know me. I expected responses from perhaps 20 percent. Instead four out of five called back. Most talked for 30 minutes�or longer. To a man, and to a woman, they were most passionate about what many saw as the declining quality of health care. With few exceptions, I was struck by their genuine concern, not only for themselves, but for the plight of their patients, the state of their profession, and their own inability to cope with the problems.

�We want someone to know what is going on,� explained one prominent Manhattan physician as he explained how much care had deteriorated in many of New York City�s major hospitals. �But please don�t use my name,� he added. �You have to promise me that. In this business, the politics are so rough, that would be the end of my career.�

Readers who have been following details of the debate already know of her blog, Health Beat.

The comments thread at Moyers site is long and interesting, with opinions from everywhere. This one struck me as smart, insightful and politically utterly fantastic -- which is to say, waaay out in Dreamland. 

The Republicans should be pushing for Single-Payer healthcare reform. God knows they need a winner in the worst kind of way.

Countries such as Britain, France, and Germany have a Single-Payer National Healthcare System. Their businesses are more competitive because they are not saddled with the huge healthcare drag American businesses are burdened with. Their national healthcare cost are 50% less than the United States.

All we have to do is clone one of those existing healthcare systems and the American business community and the United States get all those benefits. Seems like a Win-Win to me.

The cost and resource benefit to all American businesses cannot be calculated but it would be HUGE. No more guaranteed retirement healthcare benefit plans, no more COBRA, no more annual shopping for healthcare insurance, no more healthcare consultants, increased employee productivity, no more HR managing healthcare insurance, no more fine print,....this list goes on and on. �All� of the American business community would benefit. Restaurants, Mac Donald�s, Walmart, Jack-In-The-Box, shoe stores, Dupont�if you got a business it includes you.

Consider the benefit to state and local government. Their employee and retirement healthcare burdens would disappear (ok, California you can drool). All the taxpayer funds expended annually to maintain/adjust healthcare laws, rules, regulations, and boards would go away�. this list goes on and on also, would be saved.

What perplexes me is this, what I said seems obvious to me. If it is obvious to me, then why are there no Republican Conservatives (the real ones, not the wackos) pushing this? If nothing else it removes a huge burden off �All� American businesses. It reduces the United States cost of healthcare by 50% and at the same time eliminates 47 million uninsured, stops all medical bankruptcies, eliminates the need for healthcare fairs�etc.

Its not like there are any political risks in cloning one of those Single �Payer healthcare systems. They all work. They are right there operating every day with all their good points and warts. The argument: We get all these benefits but will initially have to live with "these" warts. We'll work on those warts later. Not a hard political position to make.

It strikes me that pushing this is tailor made for the "traditional" Republican Agenda: huge financial/resource benefit to all American Businesses, huge financial/resource benefit to all State and Local Governments, and the cost of healthcare expended by the United States reduced by 50%.

So where are the �real� Republican Conservatives? Have they left the party?

That's what happens when ordinary people start looking into politics and business. The actually believe all that stuff they hae read about conservatism and fiscal responsibility. The author of this comment is a throwback to an era when "Mr. Smith Goes to Washington" may not have been a fantasy.