A little late but it too a while to get these pictures done (they are hand developed). As a strong group of NPA leaders, we had our the Monday after our National Meeting. What was remarkable? In 2007, the whole group fit on picture. Now? I count 24 people here (including me behind the lens) and that wasn’t even everybody! Next time in DC we need a bus!

A recent CNBC segment posed the question of whether healthcare is a right. They brought on commentators to argue in favor and against, one from the Cato Institute and one from the National Physicians Alliance. (you can see the clip at curethis.org)

The host started by posing the question to the conservative commentator, Michael Cannon. “I think it should be a right,” he replied. “And therefore I think physicians should work for nothing.” Sarcasm notwithstanding, his point was clear: healthcare cannot be a right because it involves payment. The exchange of goods and services for money equals capitalism, which puts healthcare squarely in the category of commodity.

Mr. Cannon backed up his point by contrasting healthcare with other things we commonly think of as human rights, like freedom of speech and religion. No one has to be paid in order to let us speak freely and worship freely, he implied, which is why they are rights and healthcare is not.

This argument is persuasive. We like to think that a human right is something you are born with, not something that has to be given. The very phrase ‘freedom of speech’ suggests its simplicity: just let people speak! It’s not that hard! Healthcare, on the other hand, is not accomplished by standing aside and letting citizens exercise their freedoms. For healthcare to be your human right, something has to actively be done to you.

But is it true that freedom of speech requires no involvement by the government? Let’s imagine taking a trip to place where there is very little government, for example Somalia. You might have the basic human right to freedom of speech there, but it’s not worth much. If you stand on a milk crate (assuming you can find one) and give a speech that others find disagreeable, those people may choose to gag you, stuff you in the trunk of a car, drive you 20 miles out of town, and perhaps kill you. The government has done nothing to take away your freedom of speech, but they haven’t done anything to protect it either.

We often ignore the role of infrastructure, such as our police force and civil and criminal court system, in allowing rights like freedom of speech and religion to flourish. The U.S. legal system is a highly complex bureaucracy, and it plays an important role in keeping the right to free speech alive.

The same principles apply in healthcare. We have a complex bureaucracy in place — doctors, nurses, hospitals — to protect our right to health. There’s no difference, in principle, between free speech and healthcare, so why is one an unquestioned human right while the other is relegated to a commodity?

In fact, no matter what human right you can name, there is an infrastructure in place to protect and defend it. And the professionals who manage that infrastructure need to get paid. So it’s foolish logic to argue that since doctors are paid a salary, healthcare cannot be a right.

Now, an opponent of the idea that healthcare is a right could argue that sure, the legal system keeps freedom of speech alive. But it also does other things. We would need cops and judges around to deal with violent crime, even if society had no right to free speech. So the added cost to society from having freedom of speech is pretty minimal.
But the same argument could be made for healthcare. The medical industry has to exist regardless of whether healthcare is a right or not. Once again we can see that healthcare and freedom of speech are identical.

Still, let’s be generous. Let’s say we do accept the distinction that Mr. Cannon was trying to make when he drew a bright line between healthcare and freedom of speech. I think what he was trying to get at was that there are two types of rights. And actually, he’s correct. Philosophers and ethicists commonly refer to them as “positive” rights and “negative” rights.

In the U.S., we are very comfortable with the latter category. Negative rights are when a person has the right not to have something done to him. For example, the right not to be tortured, not be persecuted for your religion, and not to be thrown in jail for disagreeing with the government.

Healthcare falls into the category of positive rights, for obvious reasons. (i realize, by the way, that i’m not using the strict philosophical definition of these terms. If you really care, check out Wikipedia.) We Americans, when polled on this subject, have always been uncomfortable with positive rights. Positive rights seem to imply whininess, laziness, petulantly asking others for help.

But positive rights are actually a strong part of our tradition. Universal public education was introduced in the U.S. in the late 1800s, and today it is as American as apple pie. Ask any fourth-grader if she has a right to go to high school, and you’ll get a quizzical look because the answer is so obvious. We still fight about ways to improve education in the U.S., but no one has seriously proposed abolishing the public school system. Why? Because we understand what an incredible boon to our country it has been to have a well-educated workforce.

So we’ve established that healthcare, from the standpoint of principles, is no different than other accepted human rights. And from a practical standpoint, we see that Americans already support rights that are very similar to healthcare, like education.

So it seems to me that healthcare is a right. Other people, of course, can disagree. What they can’t do is pretend that there are objective, empiric differences between healthcare and other accepted human rights.

The major battle lines in the upcoming debate about health care reform will likely be drawn around the idea of creating a choice of a public health insurance plan to compete in the market with regulated insurance companies. Republicans have made it clear they will not support such a plan, and many Democrats have announced they will oppose reform that lacks this option.

Compromise is as American as motherhood, apple pie and the creation of the US Senate. Undoubtably, our political leaders will attempt to find compromise on this issue as well. While it is less important for the House (where the majority party has near total control), it will be necessary to obtain the 60 votes that may be needed in the Senate. However, the two positions appear mutually exclusive at the moment.

But I think there will be proposals that will attempt to find a middle ground. I anticipate they will be focused on the area of competition, since that is a linch-pin of modern GOP talking points. In particular, they are many places in the country with only one or two private health insurance providers, so the creation of a public health insurance plan would engender competition in those markets. (These areas also tend to be rural, which may attract the votes of Senators from important states such as Iowa and Maine.)

One approach that has been suggested for similar debates in the past is to create a public plan only for people who live in areas that lack competition among private plans. Thus, the public health insurance option would create competition and choice for those who currently don’t have it.

Is this a compromise we could live with? Or should every American have the option of enrolling in a public-sponsored insurance plan, regardless of how many private options they also have?

Now, consider the alternative proposal that will be suggested to stimulate competition: allow Americans to purchase health insurance across state lines. Currently, health insurance is regulated at the state level. Some states have passed laws requiring health insurance to be quite comprehensive; other states have only minimal requirements. However, if people could choose insurance from any carrier in any state, it would create more options for everyone to choose from.

I would call this type of proposal the “UnderInsure America Act”. It would lead to many more people purchasing inexpensive and, too late for them to realize, inadequate coverage.

Now, how does that first compromise look in comparison? Maybe it is something worth considering … it would create public plans for some people, allow us to work out the details, have a model to expand to other markets as insurance companies exit, etc.

On the other hand, the public insurance plans would likely exist only in rural areas, which have a much different population than urban centers. It may be harder for those plans to build the numbers necessary to demonstrate efficiencies over private insurers.

Is this a compromise we could consider?

Last night, CNBC featured a segment on “Is Health care a right or a privilege?” and invited two speakers to debate the question. One of the speakers was Dr Mai Pham, senior policy advisor at the National Physicians Alliance (NPA). The NPA fimly believes that health care is a human right and our campaigns and mission speak directly to that. The other speaker was Michael Cannon, director of health policy at the CATO Institute, a free-market, libertarian organization.

We applaud Dr. Pham’s cool and collected manner and her ease at articulating her points under fire. We could learn some tips on how to stay on point and how to debate an issue, from her appearance on the debate.

In any case, it was a pleasant surprise to see this issue covered by CNBC, and a great thanks to them for asking us on the show; perhaps the station will cover such issues in the future!

Ok, eye catching title, but I admit this has nothing to do with Sex, Lies and Videotape, other than what we need for healthcare may be what this movie did for independent film (to revolutionize it).

Nor do I want to suggest any of the described below are lies…. this is for readers to decide….

This just in from the New York Times: Richard L. Scott, a conservative that ran a company convicted of defrauding the government of hundreds of millions of dollars in the 1990′s (yes, he is still filthy rich), and whose investment firm claims “integrity” as one of its principles, now is embarking on a campaign à la Swift Boat Veterans against the Obama health plan. Which health plan? The one currently being developed by Congress, aka The People?

Hard to believe that someone with such a history will be taken as credible, so many of us who want affordable health care for all may welcome his attempt to influence the public…. Richard Kirsch, campaign manger for HCAN, of which the NPA is a partner, is quoted as saying: “We cannot have a better first person to attack health care reform than someone who ran a company that ripped off the government of hundreds of millions of dollars.”
Scott’s mantra “Choice, Competition, Accountability and Personal Responsibility” hardly disguises his “businesslike approach to health care” which is “bottom-line-driven”, and has seems to have helped make him a very wealthy man. And calling his organization “CPR” just seems too corny.

It is easy to offer urgent care services for “respiratory illness, headaches, sore throats, sprains or fractures, cold or flu symptoms, burns, cuts, ear and eye infections, pulled or strained muscles, coughs, and childhood illnesses; and physicals, including school or sports, pre-op, and basic check-ups“, as Scott’s company Solantic does, and leave true, costly emergencies for hospitals to deal with. This will not fix our healthcare system, nor have choice and competition taken care of the 46 million uninsured and many more underinsured people stuck with high deductible plans so far (of course Scott is quick to tell you its the governments fault).

Rick, we all agree our healthcare system is too expensive and not sustainable. Other than that, you seem to have little in common with me. I would suggest we all work on a solution that puts more money in people’s pockets, not in yours or mine. Let other, more credible folks (patients, health care professionals and dedicated law makers such as Kennedy come to mind) worry about how to fix healthcare.