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(Yes, even in the future - getting sick and paying for it will be painful)

It's always amazing to hear what the future is going to look like, as viewed from the past. Invariably, all manner of convenience will be commonplace, all menial labor will vanish, all worry about getting sick will still be around.

And who is going to pay for it? Even in 1956, they were scratching their heads. The writing was on the wall - more people on the planet, and more of them getting older and well . . .sicker. The good news was the leaps on modern medicine would be greater (that's happened), but people going broke over receiving those leaps would plague us seemingly forever.

In September of 1956, on the occasion of their annual convention, NBC Radio, via their Monitor series, hosted a panel discussion with members of the American Hospital Association (Albert W. Snoke, Lowell T. Codishall and Chicago Daily News Science Editor Arthur Snider), discussing just what this thing was going to be looking like in the future.

Arthur Snider (Chicago Daily News): “ I think foremost, is and has been for some time the matter of costs. For a considerable time people . . the anger was directed towards hospitals, but now with the introduction of hospital bill . . or hospital insurance plans, we have the matter of increasing premiums. And people now are being a little bit unhappy about that. They say, when they get their bills they could have enjoyed a nice couple of weeks at a fancy hotel for that price. I’m sure that argument is fallacious, I’m sure Dr. Snoke has a thought on that.”

Albert W. Snoke (American Hospital Association): “Everybody gets irritated over having to pay any kind of money for anything. They just don’t enjoy paying out money. I don’t blame them for being concerned about hospital costs and hospital charges. The thing that I’d like to first get clear is that there are two different problems we’re talking about. One is how much does it cost to run a hospital. And next, how much does the patient have to pay when he comes into the hospital. And cost and charges are two different things.”

Bear in mind in 1956 Health Insurance was a relatively new thing, but even in 1956 costs were spiraling out of control. Of course at the time no one thought to lay some blame at the feet of the insurance companies - they were still the new kids on the block.

So now that they've become the bullies of the neighborhood . . .

The Harvard Medical School released a study yesterday that I dare you to read without your heart breaking.

Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.

"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

This is well up from a 2002 estimate showing 18,000 preventable deaths per year from a lack of health insurance. And the increase is directly related to the increase of the uninsured, as well as the scaling back of public hospitals or free clinics or access to care, particularly for those in poor areas. Diabetes and heart disease are two of the most common preventable diseases among this class of the uninsured. As one of the professors in the study puts it, "it's completely a no-brainer that people who can't get health care are going to die more from the kinds of things that health care is supposed to prevent,"

If anything, we're going to see this get worse, if nothing changes. Jobless rates are expected to remain high for years, according to the OECD. With the rapid job loss in this Great Recession, nobody expects as rapid a return. And that means more people dropping off the health insurance rolls. In addition, employers will raise costs and lower coverage, if they even keep it. And for every new member of the ranks of the uninsured, the chances increase exponentially for a preventable death.

The need for fundamental health care reform isn't just a statistical issue, or about budgets, or bending cost curves. It's a matter of life and death.

(I have been doing some work as a blogger fellow with Brave New Films on their Sick For Profit campaign. Visit us on Facebook.)

Today Brave New Films released their second installment in the Sick For Profit series, taking a look at the corrupt practices of CIGNA, denying care to their customers while their lead executives rake in millions and lead lavish lifestyles.

Meet Jo Joshua Godfrey. She had cancer without knowing for over a year.

"I would go to CIGNA and they would tell me I had bronchitis and give me medicine and send me home. No matter what medicine they gave me I wouldn't get better. Then the CIGNA Director called me up and she told me that there was nothing wrong with me at all. I called the doctor, and I came with my film and my CAT scan and he just put it in, it took exactly thirty seconds. He told me, 'You have cancer,' and he said the reason CIGNA did not want to give you your records is they've known right way back for years that you have cancer and they're not going to treat you."

CIGNA took in $19.1 billion dollars in revenue last year, with a $292 million dollar income. That doesn't include the salaries given to people like CEO Ed Hanway. He made a cool $12 million last year, and over the past five years he took in $120 million. Hanway has $28 million in unexcercised stock options. The company corporate jets, also not seen in profit statements, cost $68 million. This money is gained, as former communications director Wendell Potter says in this video, through denying claims and dumping the sick, enhancing the value of the company for Wall Street investors. The effect on people's lives, meanwhile, is tragic. Nataline Sarkysian, featured in the Americans United For Change advertisement, lost her life after CIGNA repeated denied her a liver transplant, despite the family having full coverage.

Meet Stephen Coddington, the wife of Marian, a stroke victim:

The case manager at the nursing home called me in and was really upset, and she said, "CIGNA is wanting to discontinue therapy with her. The doctors called and appeals were denied." It has been a day-in and day-out fight. Every talk that I've had with them, it's been, how can we wiggle off this hook.

This is the human cost for an insurance company's existence, for the record profits and supreme lifestyle of their executives. Welcome to the American health insurance industry. Instead of helping policyholders attain the health security they need for their families, big insurance companies get rich by denying coverage to patients. Now they're sending lobbyists to Washington, DC to twist the arms of lawmakers to oppose reform of the status quo. Why? Because the status quo pays.

CIGNA is not a special case in the insurance industry. It's perfectly normal and expected for a corporation to maximize profits. The difference with insurance is that the profit comes at the expense of your well-being, and frankly, all the regulations in the world won't substantively change that. The best way to fight back is through exposure, a juxtaposition of the human luxury paid for by human misery.

So help us shine this spotlight. CIGNA's advertising tagline is 'A Business of Caring.' We think they ought to come up with something more appropriate for their actual practices. If you come up with one, post it on our Facebook page. Here are some examples. We'll send the best over to CIGNA. In addition, Jo Joshua Godfrey will join SEIU Healthcare 775NW outside the CIGNA corporate offices in Seattle, Washington today as they demand quality and affordable health care for every American as a fundamental right and not a privilege.

And send this video to your friends. Everyone needs to know what's at stake in health care reform. This kind of denial of coverage can happen to anyone under the current system.

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(LBJ Signing Medicare Bill - hysteria conspicuously absent)

On July 28, 1965, the Senate passed by large margin the Medicare bill. Despite grumblings from the right of "socialized medicine" and other fear-based rants, common sense prevailed and one of the milestones of 20th century social programs became law.

Dallas Townsend: “Now awaiting Presidential signature in Washington, is the milestone program of Social Security expansion and health care for the elderly, or Medicare. The Senate passed it yesterday, 70-24 thus completing Congressional action.”

Proof it can happen.

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Lawrence O'Donnell actually uses the "L" word with Rep. John Culberson. This is the end of an over ten minute segment where O'Donnell continually asks Culberson whether he would have voted for Social Security and for Medicare and Culberson gets mad at him for interrupting him, which he does. He interrupts him though because he's trying to avoid giving him a straight answer to his questions.

After finally getting Culberson to admit that he would have voted for both Social Security and Medicare, O'Donnell calls him out for the fear mongering done by Republicans on the issue of health care reform, and tells him they're lying to the American people every time they demonize socialized medicine, but refuse to vote to repeal Medicare.

Culberson obviously wasn't too happy with O'Donnell for both the interrupting or for calling him a liar. His retreat was to attack MSNBC and say no one watches them, and go on the defensive about being called a liar and say that O'Donnell doesn't know him personally.

I hate to break this to you Congressman, but he doesn't have to know you personally to watch you and the rest of the Republicans fear mongering about socialized medicine. Culberson then goes on to prove O'Donnell's point.... by attacking government run health care and more fear mongering.

You can watch the entire exchange at MSNBC's web site.

As usual, if Bill Kristol's lips are moving, it's pretty safe to assume he's either lying or has no clue what he's talking about.

Bill Kristol, who writes frequently about health care and advises the Republican Party about how to vote on bills, is misinformed on the basic facts of the situation. And even his misinformation isn't terribly coherent: Later in the interview, he says that the Army health-care system -- which is fully socialized -- is the best health-care system we've got, and the reason we can't give it to all Americans is that it's too expensive. Socialized medicine, in other words, works. The rest of us just don't deserve it.

To be fair, I don't believe that Kristol believes that. When he says that the danger with Obama's plan is that it "would put us well on the road to government-run health care," I take him at his word. But it is interesting to watch what happens when his adoration for all things military collides with the distrust of all things federal. Turns out that the conservative in Kristol is no match for the militarist.

Ezra has some nice charts as well showing the error of Bill Kristol's talking points.

A funny, and all too true, video from the satirical HAARM.ORG (Healthy Americans Against Reforming Medicine).

Open Thread below....

The DCCC sent out an exceptionally well-done clip today pointing to the difference between Obama's vision of Hope and the Republican vision of failure. Please take a look at it. There's no doubt that the Republicans are on a mission to not just obstruct, but to undermine-- everything, from health care reform to the economic recovery and even to the safety of the nation itself. The clip puts forth a strong message, a compelling message. But it just isn't bipartisan enough. After all, it isn't only Republicans who want the single most important piece of Obama's change agenda-- substantive health care reform-- to fail. Plenty of Democrats get the exact same huge handouts from the exact same Medical-Industrial Complex and Big Insurance lobbyists and CEOs. And they will do anything to prevent single payer health care from passing-- or even being brought into the discussion!

I've got the full story up at DownWithTyranny, but John called from the airport and asked me to remind everyone to please consider helping out with the Blue America initiative to save the public option. As John keeps pointing out, health care reform isn't really a Republican vs Democratic issue; it's an issue for the welfare of all American families-- which is why a staggering 83% of Americans want the public option.

Blue America has launched this new campaign to persuade senators who routinely take a great deal of money from Big Insurance to work for their constituents, not for their campaign contributors. We are working with Brave New Films to put together a series of TV commercials that we will start running next month in Arkansas, home of two anti-reform Democrats, Blanche Lincoln and Mark Pryor. Please read more about the plan-- and consider helping us put it into effect-- here at our Blue America page.

Minnesota Governor Tim Pawlenty held a press conference this afternoon to tell the media that he's not planning on running for a third term for governor.

A source close to Republican Minnesota Gov. Tim Pawlenty confirms to First Read that Pawlenty will announce today that he will not be running for a third term in 2010.

This announcement, of course, will raise speculation about whether Pawlenty plans to spend the next three years preparing for a presidential bid in 2012.[..]

Pawlenty gave a firebrand speech at the Republican Governor’s Association meeting in Miami, a week after the party’s sound November election losses. He gave some tough medicine to the party, saying, “It needs to get younger, more diverse and build a broader coalition,” we wrote at the time. "If we're going to successfully travel the road, as a Republican,” he said at the time, “we need to see clearly, and be honest about where we've been and where we're headed. … If we're going to be the majority, we're going to have to see we need to grow the party. We cannot compete in the Northeast, the West; we're losing seats in the Great Lakes region. We have a large deficit with women, Hispanics, African Americans -- people with modest financial circumstances. That is not a formula for a majority." In the halls at the meeting, Pawlenty was lukewarm toward another potential 2012 GOP candidate, Sarah Palin. In fact, during his speech “he delivered a line that might sound like an opening 2012 shot at Palin,” we wrote then.

"'Drill baby, drill' by itself is not an energy policy," he said. "It's not enough. We're going to need wind and solar and bio mass."

Pawlenty neglects to mention that even if he did dare try for a third term, he'd be unlikely to win re-election. Just a few days ago he acknowledged to local press that winning a third term would be an uphill battle, even though last year he has said he'd make his decision in early '09. His continued support of Coleman hasn't helped him at all in his state. The Minnesota DFLs tell Pawlenty "Don't let the door hit you..."

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You can't really talk about serious health care reform without looking at major changes in the American way of childbirth. The L.A. Times this morning points out that one of the things driving costs ever upward is the U.S. Cesarean rate, a major surgical procedure now performed in almost one-third of hospital births:

Once reserved for cases in which the life of the baby or mother was in danger, the cesarean is now routine. The most common operation in the U.S., it is performed in 31% of births, up from 4.5% in 1965.

With that surge has come an explosion in medical bills, an increase in complications -- and a reconsideration of the cesarean as a sometimes unnecessary risk.

It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.

"We're going in the wrong direction," said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the "perinatal paradox," in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, "is a microcosm of the entire medical enterprise."

As the No. 1 cause of hospital admissions, childbirth is a huge part of the nation's $2.4-trillion annual healthcare expenditure, accounting in hospital charges alone for more than $79 billion.

Because spending on the average uncomplicated cesarean for all patients runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs. (Among privately insured patients, uncomplicated cesareans run about $13,000.)

Pregnancy is the most expensive condition for both private insurers and Medicaid, according to a 2008 report by the Childbirth Connection, a New York think tank.

"The financial toll of maternity care on private [insurers]/employers and Medicaid/taxpayers is especially large," the report said. "Maternity care thus plays a considerable role in escalating healthcare costs, which increasingly threaten the financial stability of families, employers, and federal and state budgets."

Are there other options, other solutions? Yes. Off-site birthing centers and home deliveries have lower C-section rates and healthier outcomes for mothers and babies. For decades, the all-powerful American College of Obstetricians and Gynecologists has managed to prevent any truly rigorous review of statistics here (preferring to use data that counts miscarriages as home deliveries), but the Netherlands have done it for us.

They found that births where women actually prepared to deliver at home (as opposed to precipitous labors where sudden complications forced them to deliver there) were just as likely to have a safe delivery and healthy baby as those who delivered in a hospital under the care of a midwife.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background - the risk of complications is higher in both these groups.

[...] But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was "a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

Here are just some of the things you can avoid in a home delivery: Hospital "supergerms"; birthing positions that actually make fetal distress (and thus, a C-section) more likely; the use of powerful labor-inducing drugs that not only increase the likelihood of a C-section, but also of uterine rupture; and an episiotomy that may be painful for years.

I did it both ways: A hospital birth with a doctor and nurse-midwife, and a home delivery attended by lay midwives. (I told my then-husband I would "never" have another child in a hospital after they almost killed my first-born and then bragged about how they "saved" him.) Not only did I give birth at home with my youngest, I was up cooking breakfast for everyone just a few hours later. It was an experience I wouldn't trade for the world. It was better in every possible way.

For more info on home deliveries, see Rikki Lake's documentary "The Business of Being Born" on YouTube.

From The Young Turks Nov. 13, 2008 some good news for AIDS patients.