Tuesday, January 23, 2007

New NY Gov. Spitzer Wimps Out On Health Care Too

Putting aside the meaningless tripe King George Bush will spew forth tonight on Health Care on National TV,I thought maybe superstar former Attorney General - now Gov. Eliot Spitzer of the great state of New York would see the light and propose a health care plan that would dare to use the phrase "single payer". Instead like Romney of MASS, Schwarzenegger of CAL, Rendell of PA and probably several others.

Mr Spitzer like these other big state Govs have proposed complex plans that 1) are not fully understood because they are overly complex 2)in some cases require federal and state legislation to implement and 3)take too damn long to achieve desperately needed health care for all in their states now. Mostly however they all seem to buy into continuing their relationships with Big Insurance whose overhead costs and greed are bankrupting the health care system- to put aside Big PhRMA/BIO for the moment.

Spitzer had one of the strongest financial incentives to be bold but, alas he wimped out.

Here is what Gov Spitzer said recently at his state of the state address-from ONE NEW YORK- to his New York constituents (excerpt)

Next, we must fundamentally reform our health care system.
No one can afford health care anymore - not New Yorks working families, not our businesses and not our government.

In just the last 15 years, state spending on Medicaid as a share of the budget's General Fund has increased from 14 percent to 35 percent.These are dollars we have made an affirmative decision not to spend on education, tax cuts, infrastructure or the kind of health care investments that are so desperately needed, like preventive care,workforce retraining and insuring New York's 500,000 uninsured children. And these are dollars we will need to sustain the local cap on Medicaid expenses-a critical tool to lower property taxes and to relieve pressure on localities.

It will take a fundamental restructuring of our health care system to
make health care affordable again and to free up the resources for
other urgent priorities

This restructuring requires hard choices:

We will be forced to close and consolidate hospitals that have been mainstays of their communities, yet because of excess capacity, have cost taxpayers millions of dollars to support.We must shift spending away from expensive institutional nursing homes toward community and home-based alternatives, so seniors can have the care they want at a price they can afford.

We must use the state's vast bargaining power to reduce the prices we pay to large drug companies and pharmacy chains for expensiveprescription drugs.

And we must aggressively fight Medicaid fraud through a state False Claims Act and a Martin Act for Health Care, which I will propose this year.

The savings from reform will not just be reinvested in other priorities such as education and property tax cuts. Savings will also be spent on the kind of health care investments that make good moral and economic sense.

We will introduce a budget that, in the very first year, guarantees access to health insurance for all of New York's 500,000 uninsured children. And within four years, we will further cut the number ofuninsured. Using a new streamlined enrollment process that guardsagainst fraud, we will enroll the 900,000 uninsured Medicaid-eligible adults.

Expanding access to health care will reduce state spending significantly in the long run, because seeing a primary care doctor costs farless than providing charity care for the same patient in an emergency room and it leads to far better care.

We will also invest in better management of high-cost cases involving patients with multiple chronic illnesses a relatively small number of cases that make up a disproportionately high cost to the system. Better managed care will not just save money for patients and the state,but will lead to better overall care.

In making these hard choices, we will not turn our backs to the millions of New Yorkers who rely on us for their health care. The actions we take will not be arbitrary, but in furtherance of a comprehensive strategy to restructure our health care system".

One of my most intelligent friends calls these approaches "a slice of baloney at a time" and believes in incrementalism in health care reform.

I reject this incrementalism and believe we need a single payer system now

Under Mr. Bush's "reign" health care has dramatically worsened in the US by almost any measure and costs have skyrocketed to unimagined heights. And frankly as a citizen and a doctor in the US I am tired of being ashamed.

As far as I can acertain Dennis Kucinich running for President and Dr.Howard Dean DNC Chair are supporting single payer systems.Who else is? out there?

I am watching Senators Clinton an Obama carefully.

Stay tuned as this unfolds now given that this issue ranks very high among US voters concerns (after the war) say credible polling organizations and "the pols have at last caught on to the polls" and, of course, the stimulus of the Dec.6, 2006 watershed US election is not to be minimized.

The Heathcare Reform Issue is finally with us. I personally hope for moral and ethical reasons as much as financial ones

Dr. Rick Lippin


Anonymous Sheldon Samuels said...


The next step [first significant slice of baloney] is shaping the overall administrative structure.

We need to end the uncoordinated mess that neither Kennedy or Hillary could fathom 14 years ago. What we have in place are diverse structures in DHHS and DOL, none of which are properly constituted or coordinated for the work ahead.

What we need is a Health Security Agency at the same subcabinet, independent agency level as the EPA. The EPA structural experiment has worked! Learn something from it! Take Medicare, Medicaid from SSA; health and hospital planning, medical social work, health manpower and program evaluation tasks from the DHHS Secretary's office; NIOSH and Black Lung from CDC; well baby and other community health programs from PHS; uranium miners and nuclear workers programs from DOE; and all the worker's comp programs from Labor Department.

Every proposal to date, including single payer which you espouse, merely adds another level of red tape and huge unnecessary administrative costs.

I'm afraid, Rick, that administration is not a medical specialty taught in medical school and certified by the AMA or its affiliate boards! You can't just foist another mess on top the existing collection!

Shel Samuels

7:58 AM  
Blogger Blake said...


Please write more on this blog about your Health Security Agency proposal

Rick Lippin

8:00 AM  

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