Sunday, October 4, 2009

Mad As Hell Doctors Care-A-Van


Get Mad.
Stay Mad.
Make History.

There's no nice way to say it. The moral and financial cost of our current health care disaster is literally killing our citizens, hobbling our economy, crushing small businesses, and threatening the solvency of our government. In the meantime, the Health Care Industry is spending almost two million dollars a day lobbying Congress and manipulating public opinion to accept “reform” legislation that leaves a vicious, for-profit system intact.

The "public option" is a trap. What we need is real reform that finds immediate savings, controls costs, and accomplishes the moral imperative of true Universal Access. A single-payer plan is the only real path to a Health Care System that is socially, ethically and fiscally responsible. And yet, our elected officials refuse to even discuss the possibility of a Single Payer plan.


PORTLAND, OR (8/9/09) – Furious with the health care ‘options’ coming out of Washington, D.C., seven “Mad as Hell” Oregon physicians are taking an unprecedented road trip across America to lobby Congress for a single-payer health care system. A big part of their plan is to take the entire country with them.

Called a “Care-A-Van,” these road-tripping Oregon physicians will leave in a used motor home from Portland, Oregon on September 8th, inviting doctors and ordinary citizens from other states to join them on their twenty-city tour across the country. Their journey will culminate in a D.C.-based protest event on September 30th, scheduled to take place on the steps of Congress. Demonstrating with the doctors will be thousands of fellow ‘Mad as Hell’ single-payer advocates, all adorned with the movement’s new symbol – the white ribbon. Their demand: Single-Payer Now!

Several national, single-payer advocacy organizations including Physicians for a National Health Program, Health Care Now, Single Payer Action, and even groups like Progressive Democrats of America and Jobs with Justice are supporting the Oregon physicians by setting up “Mad as Hell Town Halls” across the country in anticipation of their arrival.

The Mad As Hell Road trip has just wrapped up, and I for one applaud their valiant effort to bring about real discussion about what is being proposed. As Doctor's they are real "insiders" who know just how much their ability to care for their patients is limited by private, for-profit health insurance companies.
Things like who they can refer patients to, what they can prescribe, and the percentage of their costs going to dealing with the insurance paperwork (and not patient care).

The definition of crazy is doing the same thing & expecting a different result.
Albert Einstein

Dr. Ottoway explains it well:

We are the only industrialized countrywhere people go bankrupt from medical bills. Lots of people are not getting care for treatable illnesses and even lethal illnesses like cancer, because they can't afford it. People don't have health insurance or they use it all up. We have the most expensive health care in the world yet are ranked 37th overallfor health care. And the insurance companies first job is to make a profit. The money that they and their investors pocket could go to health.

No, the government won't do it perfectly, but exactly what in your life is perfect?

The people of the United States agreed to have the government help maintain roads. The people can decide that everyone has a right to health care. Our government does not belong to corporate America. I will make a noise until Congress remembers that we the people are the ones who vote: not the corporations, no matter how much money they have. The insurance companies are paying 1-2 MILLION dollars daily to lobby to keep their profit, at the expense of someone's health. Thirty percent of the healthcare dollars go to administration and profits and that is not where I want it to go. Health care for health, not for profit!

Wow! They even have a theme song!

Check out the MAHD theme song written and performed by Bob Wickline!
Click here to hear the "Mad As Hell Theme Song"

Sample Lyrics:
Our politicians forgot who they are serving
Our Interests are special too

A glimpse of the blog posts...

But I Don't Want to Pay for the Obese, Smoking, Couch Potato....
by Dr. Katy Ottoway

I went on the Mad as Hell Doctor's tour for a week. I went from Seattle to Denver with stops for town halls one to three times a day. We talked about single payer health insurance, HR 676.
One question or objection to a single payer system was: Why should my money go to pay for some obese person who drinks and smokes, doesn't exercise and doesn't eat right?
Three answers to start with:
1. You already pay for them.
2. Put out the fire.
3. People want to change.
First: You already pay for them. As a society, we have agreed that people who show up in an emergency room get care. Suppose we have a 53 year old man, laid off, lost his insurance, not exercising, not eating right, smokes, drinks some and he starts having chest pain. Suppose that he lives in my small town.
He calls an ambulance. They take him to our rural emergency room. Oh, yes, he is having a heart attack, so they call a helicopter to life flight him from small town hospital to a big one in Seattle. This alone costs somewhere between $7000 and $12000. Now, do you know how many clinic visit he could have had for $7000? To see me, a lowly rural specialist in Family Practice where I would have looked at his blood pressure and nagged, that is, encouraged him to stop smoking. We would have talked about alcohol and depression. And who is paying for the helicopter meanwhile? All of us. The hospital has to pass on the costs of the uninsured to the rest of the community, the government is paying us extra, with a rural hospital designation. 60% of health care dollars already flow through the government. One estimate of the money freed from administrative costs by changing to a single payer system is $500 billion.
Taking care of people only when they have their big heart attack is ridiculously expensive. It is a bit like driving a car and never ever doing maintenance until suddenly it dies on the highway. No oil, tires flat, transmission shot and ran into a tree in the rain because the windshield wiper fluid had been gone for a while. I get to take care of Uncle Alfred. He is 80 and has not seen a doctor for 30 years and is now in the hospital. "But he's been fine," says the family. Nope. He has had high blood pressure for years, that has led to heart failure, he has moderate kidney failure, his lungs are shot from smoking, turns out he developed diabetes sometime in the last 30 years and he's going blind. Can't hear much either. We have a minor celebration in the ICU because he doesn't drink, so his liver actually works. He goes home on 8 new medicines.
Secondly: Put out the fire. When someone's house is burning down, as a society we do not say, well, she didn't store her paint thinner right or trim her topiary enough and she has too many newspapers stacked up. We go put out the fire. Putting out the fire helps us as a society: it keeps the fire from spreading to other houses. It saves lives and is compassionate. We think firemen and women are heros and heroines. And they are.
In the past, a homeowner would have to pay for fire service and would have a sign on their home. If the house was on fire and a different company was going by, that company wouldn't put out the fire. We have the equivalent with health insurance right now. It would be much more efficient and less costly to have a single payer. Medicare has a 3% overhead: it is a public fund paying private doctors and hospitals. The VA is a socialized system, with the hospitals owned by the government and the medical personnel paid by them.
When someone asks why they should help someone else, I also know that they haven't been hit yet. They have not gotten rheumatoid arthritis at age 32 or had another driver run in to them and broken bones or had another unexpected surprise illness or injury that happened in spite of the fact that they don't smoke, don't drink, eat right and exercise. Everyone has a health challenge at sometime in their life.
Third: people want to get better. Really. In clinic I do not see anyone who doesn't hope a little that their life could change, that they could lose weight, stop smoking. True, there are some drinkers who are in denial, but I will never forget taking the time to tell a patient why he would die of liver failure if he didn't stop drinking. He came back 6 weeks later sober. I said, "You are sober!" (We don't see that response very frequently.) He looked at me in surprise: "You said I'd die if I didn't stop." He never drank again. It made it really hard to be totally cynical about alcohol and I can't do it. People change and there is hope for change. I feel completely blessed to support change in clinic and watch people do it. They are amazing. But they need support and they need someone to listen and they need a place to take their fears and their confusion. Primary care is, in a sense, a job of nagging. But it is also a job of celebration because people do get better.
We are already paying, in an expensive, inefficient and dysfunctional way. It saves money to put out the fire. People want to get better. Winston Churchill said, "Americans always do the right thing after they have exhausted all other possibilities." It is time to do the right thing. Single payer. The current bill is HR676. We can and we will.

and another, by the same Doctor....

There seems to be fear that extending medicare to everyone will mean that "granny will die from refusal of care." Granny dies now. Everyone will die eventually. I am hopeful that I have many years yet, but none of us know. The fear that care will be rationed ignores the concerns that I have about the end of life: we don't discuss it and so there is enormous fear and confusion; and that some of the treatments add only hours or days or weeks at enormous cost.

When I first moved to Port Townsend, I was taking care of many elderly frail sick patients. I went to our internist, Dr. L.

I said, "I keep seeing very ill patients in their 80s and 90s that have pulled through THIS hospitalization, but that I think will probably die soon. They and their families don't seem to know it. What should I do?"

Dr. L. said, "You do them a great favor if you tell them. If you have a frank discussion with them, they and their families can make decisions and have a special time. Doctors do not tell patients often enough."

Since then, I have had that discussion many times. It is never an easy discussion but it is important and feels right. I say that I might be wrong and would be happy for the person to live 10 more years and prove me wrong. We often discuss how much care they want and whether they would want to die at home. If we can have the family in the discussion, all the better.

Once I had a call from the daughter of a patient whose name I knew. The patient saw my partner. I said, "Forgive me, but I know your mother's name and I heard that she was dying."

There was a long silence and the daughter said, "I wondered if she was, but no one said anything, so I thought I must be wrong." The daughter had nearly called an ambulance because she was afraid her mother was uncomfortable, but she also knew her mother did not want to go back to the hospital.

We were able to discuss what was happening and how to keep her mother as comfortable as possible. The daughter was to call me back if they needed transport to the hospital to ensure that her mother was comfortable. The call, however, was enough. Her mother died at home within 48 hours. We had talked about kidney failure and how the breathing changes near the end. The daughter was frightened. She later thanked me for explaining what was and would happen.

We all need to speak up about death. There will be less fear and better care if we can speak.

Before & after~ the transformation of "Winnie"


Fran said...

Sorry this is so long, but the points these doctors are making are so good, I had to post them.

Plus it was fun to see the before & after on the coach- transformed into a shining billboard rolling down the highway.

These Doctors make a strong argument.... that just having insurance (forced as in the same old stuff) is not enough.... it needs to be totally revamped, because the insurance companies will just come up with new tricks & ways for them to stay super wealthy.

nonnie9999 said...

the bottom line is that the insurance companies serve no purpose whatsoever, other than to make their ceos and stockholders rich. they don't supply health care to anyone. they don't treat illnesses. they don't give care or comfort. they collect everyone's money and keep a huge chunk of it for themselves.

Kvatch said...

The insurance companies are paying 1-2 MILLION dollars daily to lobby to keep their profit...

And therein is the whole crux of the problem. With the exception of the US is there a single industrialised democracy that allows it's health care system to operate 'for profit'?

Fran said...

nonnie~ the spin doctors had us so entrenched between the yes/no of the public option..... we need to pay close attention to what it is we are saying *yes* to.

In this hurried, votes for sale emotionally charged
fight... we need to make sure we cover these fine details the medicos are talking about.

We don't want the insurance companies to just get more paying customers, but still keep much of their business as usual tactics in place- or new creative ways to find loopholes.

Kvatch~ That's a lot of coin to be having as extra to buy votes.
We have got to stop this armed robbery of healthcare.

We have no system.

Cirze said...

Thank you, Fran, and everyone else for your courage in getting this almost too-plaintive message out there.

I just keep feeling that there must be some group that wants to lead a national movement for this challenging moment in our country's history.

Where are they?

Thanks again!


Fran said...

Suzan~ The teabaggers were effective in creating a yes/no distraction.... but it is time to look at the proposal @ hand & come up with some fine print of our own.

We need to turn the tables & stop letting the insurance companies own & dictate if & how health care is distributed.

I noticed my Sen. Wyden was rejecting this current proposal- the so called public option Baucus is offering.... Wyden has been a health care champion-- so if he is digging in his heels, it makes me think there is a problem with it.