Warm Southern Breeze

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Rand Paul, Conscription, Slavery, & Health Insurance Reform

Posted by Warm Southern Breeze on Saturday, May 14, 2011

Recently, U.S. Senator Rand Paul, a “TEA Party” Republican from Kentucky, and ophthalmologist specializing in cataract and glaucoma surgeries, LASIK procedures, and corneal transplants, was quoted as saying that “a right to healthcare… means you believe in slavery.”

Dr. Paul is the ranking member of the Senate HELP Subcommittee on Primary Health and Aging subcommittee, and made his comments at a Wednesday, May 11, 2011 hearing about emergency room use in American hospitals.

He said that, “With regard to the idea whether or not you have a right to health care you have to realize what that implies. I am a physician. You have a right to come to my house and conscript me. It means you believe in slavery. You are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants, the nurses. … You are basically saying you believe in slavery.

He added that, “Our founding documents said you have a right to pursue happiness, but there’s no guarantee about physical comfort. When you say you have a ‘right’ to something there is an implication of force. … I will always treat people who come into the ER because that is what we always have done and because I believe in the Hippocratic Oath.

It is part of human nature on occasion to say stupid things – particularly during highly emotionally charged discussions. Yet it is also part of human nature to to seek understanding. In this instance however, it seems that Rand Paul’s perspective is skewed. It likely always will be. It’s not because he’s a physician, it’s because of his political philosophy.

For him to assert that he will “always treat people who come into the ER because that is what we always have done and because I believe in the Hippocratic Oath” is not problematic per se, but rather points to, and confirms a problem that already exists. That problem is that because many people do not have primary care physicians and/or access to affordable and/or adequate health care, either for preventive or secondary care, they often make unnecessary visits to hospitals’ Emergency Departments for non-emergency/non-life threatening problems. Rand Paul’s comment not only confirms the problem, but continues to exacerbate it because it offers no solution and continues the status quo.

The irony of his remarks is that he made them at a hearing about emergency room use in American hospitals.

The American Medical Association and others have researched the issues, and in a study commissioned by them (which was funded by a HMO) reported that “chaotic” health insurance claims processes takes time away from patient care, robs as much as 14% of physicians’ revenue, and costs “as much as $210 billion annually, without creating value.”

Physicians and other healthcare providers are the victims of insurance companies’ quest for increased profits, and are victimized by relentless fights with them over payment and authorization for tests and procedures they order for their patients. Indeed, statistics indicate that while health insurance premiums have risen 87% since 2000, workers’ pay has actually declined, thus exponentially increasing the burden of health care costs upon families. Using a variety of measurements, the World Health Organization ranks the U.S. 37th internationally in the quality of health care, while per-capita spending is at least twice as high as any other nation. Comparing the U.S. with Canada, Americans spent $6,697 per person on healthcare and health insurance costs in 2005 while Canada spent $3,326. Meanwhile, insurance companies have sharply increased  premiums while decreasing coverage and the number of the insured. Over 47 million Americans do not have any form of health insurance, because employers cannot continue to bear the insurance companies’ increased burdens.

Findings by the Physicians for a National Health Program (PNHP) confirm the problems, noting that “Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented…With a universal health care system we would be able to cut our bureaucratic burden in half and save over $300 billion annually.”

A so-called “one payer,” unified system of health insurance – one in which the federal government is the insurer, and sets standards for payment – would be far better than what is now available in our nation.

So in that sense, and with that as a comparison, Rand Paul is at ideological odds over policy with national professional organizations.

Let’s examine several germanely related issues, beginning with an examination of his “conscription is slavery” statement in the light of several perspectives.

Using the United States Constitution as a guide, one can and should acknowledge that conscription has existed in this nation for quite some time. It is not likely to permanently disappear. Over a period of years, conscription has come and gone, and during the Viet Nam era, became highly charged and very politically unpopular, leading even for some citizens to spit in the faces of those men and women whom served our nation and her citizens, voluntarily, or through conscription. Hence, we now see a wholesale reversal (a backlash, if you will) of such horrible and atrocious behavior in numerous generalized “We support our troops” expressions by many, if not most, of all political persuasion. And honestly, to honor them is right, because conscriptees had no choice, for it was either serve, or go to federal prison. Some, as history tells us, fled to other nations during the Viet Nam era, including many to our next-door northern neighbor, Canada.

Secondarily, Paul said, “You have a right to come to my house and conscript me. It means you believe in slavery.” That is blatantly false.

Conscription is NOT slavery. So when Rand equates conscription with slavery, he is, in essence, calling every conscripted military member – if not all service members – a slave. I’m certain our present military service members and veterans would have a very different perspective.

Third, rights and slavery are at odds with each other. Slaves don’t have rights. So in that sense, Rand Paul’s own statement is self-contradictory.

Fourth, our United States Constitution states in the preamble that the purposes of the Constitution are to “to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity.” For a nation (and when I write “nation,” I mean her citizens) to NOT have access to health care services is to actively deny promotion of “the general welfare.”

To deny health coverage is to destroy one’s family from within. It is not merely exhibiting so-called “passive aggressive” behavior. It is an active and direct contribution to the demise of the nation. Further, it contributes to the detriment of the national defense, because it directly affects the readiness of its citizens to serve and thus “provide for the common defense.” Already, numerous high-ranking military leaders, active, reserve and retired, have all acknowledged that obesity in our nation is already directly affecting our national security because so many are unfit to serve because of obesity-related disease.

An anecdotal observation of a friend of mine – whom I’ll call Adam – was on-target with his remarks. He, by the way, has never worn the uniform of our nation’s military, nor has he ever served in the National Guard. He remarked about a man he knew – whom I’ll call Blaine – whom joined the military some years ago.

Blaine was Adam’s peer, and has made serving our nation in the military his career. Adam remarked that when Blaine joined the military, he had very poor dentition – which is medical speak for “teeth.” In fact, Adam said that Blaine’s teeth were in such poor condition, that he wouldn’t have been surprised if many of them had to be extracted. Further, Adam noted that Blaine’s eyesight was poor. Fortunately, Blaine had his eyes examined and was fitted with the proper corrective lenses.

As Adam continued telling Blaine’s story, he concluded with the following observations, asking rhetorically, “Why does the military feed, clothe, house and care for the medical needs of it’s members? It’s because they realize they’ll get a better quality service member as a result.”

Yes, it’s hard to fight on the battlefield when you’re hungry, improperly clothed, inadequately sheltered and sick.

That is a specific example in our nation’s military service members. The general example will be in our nation’s general population. Support for it is found in the Constitutional clause to “promote the general Welfare.” To be accurate, the term “welfare” means overall “well-being,” and refers to the quality and characteristic state of one’s comprehensive, thorough and total being. It asks the question “how well are you faring?” Hence the origin and derivation well + fare = welfare.

Recollecting recent history, health insurance is a relatively new thing, and though it has existed for at least fifty years, it has come into – morphed into – a megalopic mammoth, operated almost wholly by, and for the fiscal profit and pecuniary benefit of the Insurance Industry, and their corporate stockholders.

Approximately 30 years ago, as the American insurance industry realized they could significantly increase profits with minimal or almost non-existent expenditure, they heavily courted physicians to join and participate in Health Maintenance Organizations (HMOs) and/or Preferred Provider Organizations (PPOs). Through massive internal corporate-to-corporate promotions and advertising campaigns initiated, operated, and paid for by the insurance industry, the ideas of HMOs & PPOs became popular very quickly with employers and the public, which took advantage of “low-cost” deductibles for physician office visits, prescriptions, and hospitalizations.

In essence, the insurance companies’ pitch line to physicians was two-fold: 1.) cost savings; and 2.) profit sharing. The insurance companies’ salesmen pitched physicians upon the idea that they could save the insured (patients) money by participating in an element of management of their medical practice, and pass the savings along to the participating physicians as a type of profit-sharing.

However, it wasn’t long until the widely touted “health insurance” programs which were so immensely popular, had their Achilles heel discovered by disgruntled member/participants – otherwise known in insurance industry parlance as “the insured.” Gradually, insurance companies began reducing or denying payments for certain procedures. Most notable among the procedures that were stopped was the then-new procedure known as Radial Keratotomy, which was the precursor of today’s laser vision-corrective surgery. Insurance companies justified their actions by calling such procedures “elective” and “not medically necessary.”

Suddenly, when the insured populous discovered that their HMOs & PPOs would pay for vision corrective surgery, they began, almost en masse, to have the procedures performed. The health insurance industry quickly put the kibosh on payment for the procedure, thus effectively ending opportunities for many to continue life without requiring corrective lenses. That was in the mid-to-late ’80’s, and early ’90’s.

Reduced or non-payment for procedures or medications became a well known, and highly contentious issue nationally. In fact, a popular joke at the time was,
Q: “What’s the difference between an HMO, PPO and the PLO?
A: You can negotiate with the PLO.

The PLO is the “Palestinian Liberation Organization,” a terrorist organization formerly headed by the late Yasir Arafat.

Interestingly, the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. has acknowledged the wisdom of the United States Department of Defense realization in that area (by providing laser vision corrective surgery to their service members) and wrote, “In addition to improved performance, the military could realize significant financial savings by making laser corrective procedures broadly available to soldiers. Approximately 300,000 soldiers require new spectacle prescriptions each year, with each soldier requiring two pairs of glasses and mask inserts. Inability to meet vision standards is the primary reason for medical disqualification among flight applicants, so laser corrective procedures have the potential to increase recruiting prospects. In this way, LASIK surgery could have far-reaching positive effects for the military and its service members. Since the establishment of the first refractive laser center, more than 20,000 soldiers have undergone laser corrective procedures.”

Here again, we see the provision of a surgery the insurance industry calls “elective,” which is a characteristic or distinguishing quality of the promotion of “the general welfare,” which is secondary (according to the Constitution) in the provision “for the common defence.”

Reduced and non-payment for services by insurance companies has even angered physicians, whose costs are increased by the veritable deluge of administrative overhead (translate: insurance paperwork) they must file in order to get paid. And in many cases, patients leave physicians offices frustrated because the physician ordered a test or procedure deemed necessary to diagnose, cure or treat a disease or symptom, but the insurance company refuses to pay for it. Thus, the “insured” must cough up money out-of-pocket to pay.

One reason the BIG INSURANCE companies do NOT want regulation by, or competition from the United States government is because they know that they cannot compete with Uncle Sam, otherwise known as “We the people.” Thus, the insurance companies take an anti-competitive stance with the government (through elected officials) to ensure that things do not change to benefit the patient or physician.

It’s also one large reason they and their minions have demonized health insurance reform – calling it “Obamacare” – which passed Congress and was signed into law by President Obama. I have written extensively about this and related issues about the law and its provisions in these and other entries entitled:

Healthcare Reform Addresses Rising Health Care Costs.

Congress Passes Socialized Medicine and Mandates Health Insurance

It’s official… I’m a nerd.

House Republicans move to repeal Obama health insurance reforms

Insurance costs and health-care reform: Are health insurers making huge profits?

WikiLeaks: Insurance Company Internal Documents Show Problems

Insurance abuses

“Paging ‘American Healthcare Reform,’ paging ‘American Healthcare Reform’… you’re needed in the OTC Pharmacy – STAT!”

Two Numbers – ONE BIG, one small

WWJD Health Care: “Will this make your life better?”

How is it that the for-profit insurance industry just doesn’t get it? How do they not understand?

It’s because their “bottom line” is the dollar.

They’re not in business for the love of people, or some other humanitarian or altruistic motive, and they don’t give a damn about you, your health, your family, neighbors, grandma, fuzzy kitty cats or puppy dogs. All the insurance industry is interested in is MONETARY PROFIT – MONEY, MONEY, MONEY.

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