A Fairy Tale to Failure

By Sandy Prisant

Do you believe in fairy tales? How about “The Emperor’s Suit of Clothes”? You have to decide right now, because just at the moment the whole Washington establishment, is madly spinning a new suit of clothes for the Emperor, in the form of a Health Care fable for the nation.

It feels like 2nd grade. We’re all gathered around as most of Washington---pundits and politicians full of self-congratulations—opens the big storybook and spins the fable.

Just as in Hans Christian Andersen’s story, some of us are dubious about what the Emperor’s minions are telling the people. So Washington has come up with a new twist on Andersen, meant to thwart all possible opposition. It’s the ultimate defense: “It doesn’t matter what’s wrong with this bill; don’t think about all the self-serving riders the insurance industry added,” Washington says, “anything is a good, first baby step.”

Really? Real-world history says things don’t work that way. The well-documented record of legislative bodies (elected and unelected) confirms: nations, including the US, rarely build effective programs in steps, bill by bill. Especially when (unlike Medicare and Social Security) the very architecture of this bill leaves little room for expansion and true reform.

Many individual Acts by the President or Congress have included expansion of policy in planned stages, but usually the main milestones for such expansion are set down in a single document and decision.

Policy ideas that were weak compromises--often sold to the nation as “good first steps”--have not been:

}It took over half a century for the Supreme Court to move from the “Separate But Equal” baby step to real equality through “Brown vs. Board of Education.”

}Drafting the Constitution quickly produced the Bill of Rights, but in general, human rights have not expanded for Americans in the ensuing centuries. And bills like the Patriot Act have actually set them back. For all our proud independence, we still do not have the right to privacy fixed in law. Nor total sexual freedom among consenting adults. HIPAA laws limiting access to medical records seem to now keep them only from the patients themselves.

}It took over a century from the creation of our democratic republic to move from voting by certain classes of men, to voting by certain women. And then another half-century to finally establish voting by everyone.

When the country is really serious about something, it takes clear action: for the most part, wars, financial regulation (Glass-Steagall Act (1933), that Patriot Act, and the abolition of slavery each were enacted in one fell swoop.

So when someone tries to tell you the current Health Bill is “a great first step”—or even “a great baby step we can build on”, think about whether legislative history suggests these are credible claims.

And think about what would happen if we let this step-by-step fantasy play out. Look at the challenges facing such a scenario:

1. First, everyone will say we must be sensible and see how this bill works out. It’s in-built timetable assures we won’t have a new system “up and running” to know what’s not working until at least 2025. That’s four Presidential elections and at least 3 Presidents from now.

2.Last week, National Public Radio reported the results of a cost study on the current draft bill. According to the Henry J. Kaiser Family Foundation, the average employer-provided health insurance policy is currently on track to cost about $31,000 in 2019. The Foundation projects average family income at $50,000. This is not a misprint. Over 60% of income will go to pay health premiums based on the current Congressional drafts.

3. Put aside the 30 million extra premium payers in this bill for a moment. What stakeholder with leverage will stand up for the final 8-12% uninsured in 2025, to meet this President’s pledge of universal coverage?

4. What stakeholder with leverage will stand up for an absolute cap on health spending growth in 2025 when the President promises the failure to control overall costs will destroy our recovery before then?

5. What stakeholder with leverage will get health professionals to make the slightest financial sacrifice to achieve affordability in the system?

6. What stakeholder in 2025 will stand up and say ‘60% health premiums that deny us food and shelter must be cut in half’?

7. Finally, what stakeholder with leverage will ever say: ‘This country is based on competition. American health reform MUST include competition, not within, but independent of existing health insurers’?

Now ask yourself: is it realistic to think any of this scenario could retroactively fix the structural flaws that make it impossible to expand or build the current drafts into an efficient, American-style solution, through baby steps.

Is it ever likely we’ll achieve health reform success in parts? Effective, economic national health systems exist on every inhabited continent. All were created whole-cloth, through single acts that did not cost an arm and a leg. Please remember that in the late 40’s, when Britain was still on rations and on its knees, an affordable, universal health system with cost controls, was set up in a very short time. This is fact, not fable.

Why is America the only nation incapable of looking over a score of long-successful health systems and choosing one that’s already proven and adapt it to best suit us?

Either we do this or we are doomed to a failure we cannot afford. Think not? Eerily, over 170 years ago, Hans Christian Andersen sent a message for our time:

Andersen wrote in his fairy tale: “What a splendid idea," thought the Emperor. "What useful clothes to have. If I had such a suit of clothes I could know at once which of my people is stupid…”

Bottom Line: What’s happening now is a distraction. This is not about Congressional negotiations. With great sadness, we must face these facts. Will the Emperor prevail or will we be as wise as the people at the end of the fairy tale, by seeing the truth...

And starting over.

Footnotes:

"Health Cuts With Little Effect On Care,"The New York Times, December 30,2009 http://www.nytimes.com/2009/12/30/business/economy/30leonhardt.html?partner=rss&emc=rss

1. "Comparing the House and the Senate Health Care Proposals: Public Plan," The New York Times, December 19, 2009 http://www.moveon.org/r?r=85859&id=18398-17397961-OzOYRBx&t=5


"The House Bill and the Senate Bill," The Now! Blog, December 21, 2009 http://www.moveon.org/r?r=85861&id=18398-17397961-OzOYRBx&t=6

"Why We Need a Public Health-Care Plan," The Wall Street Journal, June 24, 2009
http://online.wsj.com/article/SB124580516633344953.html

"Why a public health insurance option is key to saving costs," Economic Policy Institute, June 25, 2009 http://www.moveon.org/r?r=85866&id=18398-17397961-OzOYRBx&t=7

2. "Assessment of Affordability Provisions in the Exchange in House (H.R. 3962) and Senate (H.R. 3590) Health Reform Bills," Health Care for America Now
http://hcfan.3cdn.net/46590729111c307ccc_lom6b3a6r.pdf

"Finishing Reform Right: Fixing affordability before the President signs a health care bill," The Now! Blog, December 22, 2009 http://www.moveon.org/r?r=85867&id=18398-17397961-OzOYRBx&t=8

"Comparing the House and the Senate Health Care Proposals: Individual Mandate," The New York Times, December 19, 2009 http://www.moveon.org/r?r=85860&id=18398-17397961-OzOYRBx&t=9

"The House Bill and the Senate Bill," The Now! Blog, December 21, 2009
http://www.moveon.org/r?r=85861&id=18398-17397961-OzOYRBx&t=10

"Senate health bill is launch pad," Jacob Hacker, December 22, 2009 http://www.po/litico.com/news/stories/1209/30871.html

3. "Comparing the House and the Senate Health Care Proposals: Abortion," The New York Times, December 19, 2009 http://www.moveon.org/r?r=85862&id=18398-17397961-OzOYRBx&t=11

4. "Comparing the House and the Senate Health Care Proposals: Paying for the Proposals," The New York Times, December 19, 2009
http://www.moveon.org/r?r=85863&id=18398-17397961-OzOYRBx&t=125.

"Comparing the House and the Senate Health Care Proposals: Insurance Regulations," The New York Times, December 19, 2009 http://www.moveon.org/r?r=85736&id=18398-17397961-OzOYRBx&t=136.

"H.R. 3962, Affordable Health Care for America Act," Congressional Budget Office, November 20, 2009 http://cbo.gov/doc.cfm?index=10741

"Patient Protection and Affordable Care Act," Congressional Budget Office, November 18, 2009
http://cbo.gov/doc.cfm?index=10731

"REPORT: How the Senate Bill Compares to Other Reform Legislation," Think Progress, November 19, 2009 http://www.moveon.org/r?r=85670&id=18398-17397961-OzOYRBx&t=14

Galapagos #2: Survival Against All Odds

Photos: Tracy & Sean Haling

By Sandy Prisant

One species that Darwin did not directly study in his time in the Galapagos was our own.

Thankfully, the Ecuadorian government has remedied this omission. It requires every visitor, prior to departure to drop in on a straightforward, historic presentation of mankind and its buffoonery in the unfolding Galapagos saga. Nothing as sinister as reliving Nazi camps at the Holocaust Museum. Here, we just come off as a race of imbeciles.

What Darwin did not envision in his revolutionary, evolutionary theory about the natural order of life, was how hard human kind would work to undermine everything he discovered, even though the first hint of ourselves as the main threat, came with the very first discovery of the Islands.

An expedition led by the 4th Bishop of Panama stumbled upon the Galapagos in 1535. His first report suggested colossal stupidity. Fray Tomas de Berlanga (Bishop from 1530-1537) wrote back to Charles V, Holy Roman Emperor and King of Spain:

“…many sea lions, turtles, iguanas, tortoises; many birds like
those from Spain, but silly that they didn’t know how to
flee and many were caught by hand…”

It’s important to put those comments in context. Darwin’s work had the effect of questioning Divine Creation. Essentially he was challenging theological dogma that pre-dated him by almost two millennia.

It was the great irony of Darwin’s life. He had rejected science by dropping out of medical school at Edinburgh University, to study theology at Cambridge--with the intent of becoming a clergyman in the Church of England. He wound up becoming the scientist who upset the theological apple cart.

Much of the Church’s basic teaching about man’s divine nature, particularly at the time of Fray Tomas De Berlanga, focused on our species and our planet as the center of everything. The argument went that God gave humans special gifts, precisely so that we could dominate all other species. So that we could in turn be at the center of the center—if not gods ourselves, Princes of the Universe, at least.

So by simply observing the finch and finding 13 subspecies, with beaks adapted to different conditions on different islands, Darwin was not just doing a modest study, as part of a 4-year mapping and nature expedition. He was indirectly questioning the very premise underlying much of Church ideology. He was, based partly on just five weeks in the Galapagos and only 19 days on land, questioning the very essence of divine creation.

And what better support could Darwin have had beforehand to make his point, than from the Church itself. In this case, through a pioneering bishop whose own divine creation does not seem to have been dealt from a full deck.


While the Englishman’s work had an unprecedented impact on Western thought, little of that stunning new understanding of life helped to protect the Galapagos. In the centuries after the Bishop’s visit, at least a half-dozen destructive attempts to mercilessly exploit the islands and their peaceful inhabitants all ended in commercial and ecological disaster. From the slaughter of 250,000 (98%) of the giant tortoise population to the slaughter of men in the misguided creation of a first prison colony in the 19th century that failed , to an even more misguided concentration camp in the 20th century. Unsurprisingly that, too, failed after another brutal uprising.

But that wasn’t the half of it. How incompetent has man been as stewards of this global treasure?
Before and after, let us count the ways:

1800’s—Ill-conceived sugar plantations that produced few crops but great environmental damage.

1830’s—Ill-conceived dye production that produced greater environmental damage.

1860’s---The Great Powers (including the US), tried to rape the Islands, smash and
grab the resources and wrest them from Ecuador. (So much for the Monroe Doctrine,
both politically and ecologically.)

1927-28---Norwegians are urged to colonize the Galapagos in the late 20’s. The
Ecuadorian government described their attempts at commerce and settlement as
leading them to become “disillusioned and sick from loneliness”. The majority of these
brave pioneers fled back to Norway in less than a year.

1929---The final attempt at emigration turned paradise into a sordid,
violent Peyton Place, as Europeans brought all their desires and neuroses with them.
It led quickly to adultery among the few families, broken homes, and mysterious
disappearances at the turn of the decade. The blue-footed booby had never seen
the likes of such gross behavior. Photo: Susan Prisant

The Bottom Line: As the government now openly admits in it’s museum presentation:

“close to four centuries of exploitation of the natural riches of the Galapagos did not only cause deterioration in the environment, but also ended with tragic cost in human lives.”

And yet, against all odds, the Galapagos have managed to overcome mankind’s destructive influence. While Hawaii struggles to sustain 5 (five)% of its indigenous species, the Galapagos have managed to hold on to 95% of theirs.

It is not Darwin that should attract you to these islands. It is all those species that attracted him as well. Species which have each figured out how to find a decent, tolerable place within their world.

Leaving only the “divinely created” human race—masters of all they survey—utterly adrift.

The Galapagos Islands: Lessons From the Locals

All Photos: Sean & Tracy Haling

By Sandy Prisant

Santa Cruz Island, Ecuador—In less than four hours you can escape the empty calories of American politics and arrive in Ecuador—where the jewel in the crown is the Galapagos Islands.

Don’t misunderstand. Ecuadorian politics are full of empty calories, too. (Now, wide-ranging daily blackouts are causing havoc everywhere in the country—the direct result of 20 years’ gross negligence in maintaining/expanding the national electric grid.) After all, this was one of those Banana Republics.

But that electricity havoc is in the regions dominated by man and his ways. In the Galapagos, 550 miles offshore in the Pacific, and the one Federal State largely controlled by wildlife, there is a calm, serene and rational world. The difference is striking. Here, there really is the Law of the Jungle. No pretense. Mother birds abandon their eggs to save themselves. Bluntly, cute things are eating other cute things the whole time. But there is no neuroses about it.

Yes, I know, underneath our suits we’re running the same Jungle-based system, but somehow, it’s not the same. Rather than harmony and effectiveness, our revered free will and political liberties have given us unsolvable Afghanistan, Iraq, Iran, and an inability to engage each other in discussion on profound social issues:

1. Congressional members have government health coverage they shamelessly deny to the very people they were allegedly elected to serve. We’ve been patiently awaiting a real solution since the 1st national health bill was proposed in 1917.

In the Galapagos, no vermillion fly catcher, no sea lion has had anything vital awaiting action since 1917.

2. Years too late, we still don’t know how to kick-start a real legislative discussion on the first timid attempts to control a small fraction of carbon emissions.

In the Galapagos, not a single species needs to burn carbon to function. When its cold, marine iguanas pile up--lying on top of each other to keep warm, for the common good (a concept we’ve relegated exclusively to campaign speeches). When it’s too hot for a pregnant sea turtle to come ashore, they simply hover in the cool Pacific, a few feet out, waiting patiently for the sun to go down and the temperature to drop below 70F naturally, so they can come ashore safely and build their nests.

I’m unaware of other species that need to make unrecyclable waste or burn fossil fuels to survive or flourish. Not even ones like the woodpecker finch here, that use tools. Why is that?

3. And in the “the community of nations”—our specie’s own system—corruption thrives. From corruption we know about in Afghanistan. To corruption we don’t. Ecuador for example. As ire and shame rise with the electricity fiasco, there are a million excuses. One features the international shrug of helplessness, accompanied by the lament, “Ecuador is poor.”

And then one day I met a man who has lived his life in the Galapagos. Just a normal man. But he was adamant.

“Ecuador is NOT poor. Ecuador is rich. In natural resources and corruption.”

Possibly he’s been effected by all the creatures literally around him—none of whom are corrupt; none of whom risk the future of their tribe for personal gain.

We often hear our own failings glossed over with the words, “it’s a messy system, but we’re free.” Well, we’re now reaching the point on a dozen fronts that make “messy” a poor euphemism for melting ice caps and a melting middle class.

The word “free” is losing meaning, too. The unspeakable fact is we’ll never return to 5% unemployment. (And if you can’t work, you can’t eat and that leaves little room for new ideas or creative individual action.)

So here’s the balance sheet: on the one hand we have thousands of species, most having prospered for eons longer than humans have existed, by doing sensible things every day—no frills, or greed or egos.

On the other hand, we have just one race in which a few hundred years ago, some presumed wise leaders gave away all of Manhattan for beads. And less than a decade ago, almost 50% of American voted to get 2% of them a tax cut. Such folly does not occur within species endemic to the Galapagos.

What really makes places like this so rare and appealing to us is that we are in the presence of other sentient beings who act without guile, contempt or hubris in their dealings with others. It’s not only unique to have a giant tortoise and every other species one foot away from you and not hiding. It’s also that they do not, unlike humans, change behavior in any way. Not scaring you or impressing you or wanting a damn thing from you. No contempt. No fraud. No games. In short, none of the falseness that informs initial meetings between most humans. It is this that is the most rare of experiences and actually explains why tourism to these volcanic islands doubled in recent years. And then doubled again.

It is what we crave and cannot find amongst our own kind, anywhere. This difference begins with all other species naturally or through evolution, being able to live in complete harmony within their environmental system; where all is based on rational, efficient instincts that allow the system—their world—to flourish. Every penguin, every finch looks energetic and well-fed. Apparently their system is in balance.

Only we are evolving in exactly the opposite direction, allowing less and less in our lives—and theirs—to thrive. Why is this happening?

In explaining what went wrong with the US economy, former Federal Reserve Chair Alan Greenspan testified that it was shockingly simple: “It never occurred to me that CEO’s and CFO’s would not act in a rational manner and in the best interests of their companies. All Fed policies hinged on that one premise.”

If Mr. Greenspan had spent 5 weeks here as Darwin did, it might have helped.

For sadly, the Federal Reserve could only work on Greenspan’s premise if it were purpose-built for the rational, efficient locals of the Galapagos.

Thank You, Sandra Cisneros

By Claudia Ricci

It is a Monday in early November. Mid-day. A milky sky is overhead. Sunshine has been missing for days, maybe weeks. The breeze is up, and yellowing leaves are cascading to the streets.

The woman is a writer, but lately, she hasn’t been writing.
She’s been fighting to write. Dying to write. Desperate to write.

But lately, she’s begun to face reality: it just isn’t happening. As her husband gently pointed out the day before, as they toured an art gallery, “you can’t force it.”

Today, she is grading a few papers, and preparing for her class at the university. She opens a book. She begins to read the words of Sandra Cisneros, who has written a new introduction to her classic work, The House on Mango Street.That book is 25 years old this year and in her introduction, Cisneros is telling the story behind the story, how the book – a set of marvelously poetic vignettes – came to be.

The House on Mango Street is much more than a story about a house. It is the tale of a quest. It tells in vivid bursts of language the story of a young Latina woman named Esperanza, whose name translates into “hope.” The book is about Esperanza’s growing up in Chicago, and the painful realities she faces in her neighborhood.

It is also the story of Esperanza’s invention of herself in words. It is about the place of quiet serenity that Esperanza – and Cisneros herself—seeks. It is about a place in a rundown Chicago neighborhood and a place beyond, a space into which she can escape: “a house quiet as snow, a space for myself to go, clean as paper before the poem.”

When the woman reads Cisneros’ words, she is sitting at her kitchen table in her apartment in the heart of Washington, DC. It is quiet, except for the occasional garbage truck backing up, loading: there is the crunch and fracture of recycled glass.

She is calmly eating a salad for lunch. But somehow, the urgency of Cisneros’ words makes her heart beat a little bit faster. This is what she reads:
“She thinks stories are about beauty. Beauty that is there to be admired by anyone, like a herd of clouds grazing overhead. She thinks people who are busy working for a living deserve beautiful little stories, because they don’t have much time and are often tired. She has in mind a book that can be opened at any page and will still make sense to the reader who doesn’t know what came before or comes after.”

The woman thinks about what she has read. She thinks about a book that can give tired and stressed people something that will boost their tired spirits. She thinks about the people she knows who read the Bible. How some of them pick it up and open it at random, and let their eyes fall on some words that give them hope. Comfort. Inspiration.

She thinks about the world around her. The world she sees on CNN, and in the newspapers, and on-line. She thinks about the constant reports about swine flu, about the deaths of soldiers and civilians in Afghanistan and Pakistan. About the bombs in the Middle East.About the tensions in Iran and elsewhere.
She thinks about the problems some of her dearest friends are facing. They would like to be working for a living but they have lost their jobs. They are now in danger of losing their homes. They have no health insurance.
She thinks about the way stories operate. About how important they are to our lives. About how they give us food for thought.Nourishment for our souls.She thinks about how they show us what is good – and what is not so good – about being human. About how they instruct us. And distract us, from the stress and monotony of our lives.

She keeps reading what Cisneros wrote:
“She experiments, creating a text that is as succinct and flexible as poetry, snapping sentences into fragments so that the reader pauses, making each sentence serve her and not the other way around, abandoning quotation marks to streamline the typography and make the page as simple and readable as possible. So that the sentences are pliant as branches and can be read in more ways than one.”

And with that, the woman puts down her fork and stops eating her salad. She goes to the other end of the kitchen table, to her laptop. She has to write. Something.

A story. Yes, a story. She’s not sure what she will write.But she will write a story. As she starts, the sun is suddenly sending bold stripes of light across the wooden floor of the apartment.

She begins typing, and then she thinks to herself, oh yes,I should write a thank you note, before I forget, to Sandra Cisneros.

Writer and Professor Claudia Ricci is on sabbatical teaching at Georgetown University. Her first novel, Dreaming Maples, is available through Amazon.com. She is a founding Contributor to Wordsmith Wars.

Nationwide Demonstrations Spark A New Civil Rights Movement

By Alexander Prisant

In what organizers are calling “the largest non-violent civil disobedience movement” since the 1960’s marches for civil rights, over a thousand grassroots health care activists of all ages have staged a second round of sit-ins and controlled confrontations at corporate health insurance offices across the nation.

Some sit-ins are being led by veteran front-line emergency room and pediatric physicians willing to go to prison in Los Angeles, New York and Baltimore, all for the cause of better health care.

Typical of the activist physicians is Dr. Ken Weinberg a 25-year emergency room doctor in the New York area who put it bluntly: “The insurance companies are criminals,” he declared at a press conference.

The protesters say nothing being considered by Senator Harry Reid will provide a workable system. However, the doctors said there are still other bills in Congress that could transform the system.

Virgilio Marquina, 72 of Miami, faced down a score of police alone (photo above). He was cuffed and arrested for simply standing outside a building with a CIGNA office in South Florida. “I have Medicare,” he said. “I’m doing this for my family—they have nothing.” At the scene, a veteran journalist was held back by a Sunrise, FL police officer who claimed: “You can’t be a journalist—you’re wearing funny shoes.” Protestors were outnumbered 3 to 1 by police, who were waiting with a hovering helicopter, riot van and full fleet of police cars nearby. Demonstrators simply asked that CIGNA allow physicians permission to give life-saving treatment to CIGNA patients facing death. The company refused.

Two hours later in Glendale, near Los Angeles the father of 17-year-old Nataline Sarkisyan--- who died when CIGNA refused to allow a liver transplant---spoke passionately at the company’s door to sit-in volunteers, including Dr. Matt Hendrickson--and police preparing to arrest them.

“Can our system work anymore?” said Dr. Weinberg. “This is our attempt to make something happen before, I believe, it will get vastly worse for Americans needing care.”

The doctors provided recent accounts of having to turning away the seriously ill—from those attempting suicide, to a mother of three with aggressive cancer-- because insurers denied hospital admission. “We see it every day,” said Dr. Hendrickson, a veteran Los Angeles ER physician.

The protestors are staging sit-downs and facing arrests at the front doors of for-profit insurers in nearly a dozen cities. It is the second round of such protests in two weeks. But this week the protests spread from Virginia Beach to Portland. From San Francisco to Columbus, Ohio. Further demonstrations are planned for additional cities later this week.

The for-profit companies being picketed are spending on average $1.4 million per day in lobbying fees on Capitol Hill. They include Humana, Blue Cross, United Health, Cigna, WellPoint, Aetna and others.

“Within little more than a month we’ve grown into the largest non-violent civil-disobedience campaign since the Civil Rights movement,” says Kai Newkirk of Mobilization for Health Care Now. “We must create the moral imperative.”

One observer noted: “The American people are beginning to feel that health care is really about civil rights for the individual and the grass roots are responding the way it did in Martin Luther King’s day.”

It was Dr. King who famously noted: “Of all the forms of inequality, injustice in health care is the most shocking.”

Dr. Margaret Flowers, a Maryland pediatrician, put it in her own words: “Doctors watch the continuous decline in quality health care because of insurance hurdles, every day.

“We’d hoped for real debate this year,” she explained. “But the Washington debate is not between the stakeholders in health care—doctors and patients. It’s only between the stockholders of for-profit companies in the industry.

“The market model has failed our nation. For decades.” she concluded.

It’s Time to Name Names

By Alexander Prisant

Not unlike Barnum & Bailey or the Ice Capades, the fire-eaters, dancing bears and tight-rope walkers of the Health Care Road Show have wended their way through our TV sets, our frontal lobes and a town near you, for months. And months.

We’ve missed a bunch of Congressional and White House deadlines, changed direction more times than that and still don’t know when or where we’ll wind up.

One of the questions now must be: Why?

If the original objective was simply to make this a healthier place for most Americans in a cost-effective way—at least up to the standard of, say, Austria or Australia, why can’t we just do what they do? It's true that in a recent poll, Nevadans called the man they elected--Senate Majority Leader Harry Reid-- as spineless. But that's too simple to explain it all.

The real answer is: this Road Show is not actually about health care at all. It is about the Great Divide that bedevils every major debate in this society. The same divide that hung over a nation when it debated a Civil War, the Gold Standard, Social Security, Civil Rights and so on.

This is about National Interest vs. Self Interest. There are a lot of health care stakeholders, but if we’re honest they’re not all altruists. Most doctors want to make good money. Most patients want “Cadillac Health Care” (whatever that means) for their own family. Most nurses would like some more sleep and more rational shifts, all of which cost money, and finally, there are the private heath insurers. Their goal is more transparent—greater profits than Goldman Sachs with executive pay that would ---and does—make Ben Bernanke blush.

Most of these stakeholders do genuinely see some direct benefit in a healthier America, but it may at last be time to stop this Obama-speak that infers we’re all in this together. Because we are not.

Having personally lived in four European and Middle Eastern nations with slightly differing forms of single-payer national health care and having enough chronic illness to get inside these systems first- hand, I am still perplexed as to how my care suffered in any way because there wasn’t a non-medical middle-man in a bad suit with a profit motive, between me and my doctors. Where did I lose out? On a larger scale, I‘ve yet to figure out what entire element of good national health care practice goes wanting in those systems, because those middle-men aren’t around.

(Astonishingly, the absence of any cogent debate on this point in America hasn’t prompted a single press conference heckler to wonder out loud what private health insurers do for their money and why it helps anybody for them to push paper around. A hundred countries get on just fine without that fifth wheel at all. But Americans don’t seem to want to know.)

So it may be time to say what we all secretly know about the 800 pound elephant in the room—some health care stakeholders are in it for the nation; while some are possibly a bit more involved in protecting their wallets. They see the American body politic, anatomically, as their Profit Center.

The following insurers include some that tried to attack the Baucus bill at the very last minute for the ignoble reason they wanted his mark-up to include even stiffer penalties for the “stragglers” not plumping in new premiums to insurer coffers in a new system (nothing about national interest in that line of attack). These folks had no concerns about whom, how or whether anybody received health care in the bill—just the demand that everyone pay premiums—to them. (What? Current profits of 63.1 billion for just one insurer aren't enough?)

So here are some of those billionaires, complete with teasers that speak to their personas:

Aetna - Paid $470 million to settle a physician-led class action suit for short-changing consumers and doctors.

Cigna - Refused a liver transplant to 17-year-old Nataline Sarkisyan, by calling the treatment “experimental” in 2007. The result: Death.

WellPoint – Sued the State of Maine for $9.5 million for insufficient profits from state residents, after increasing profits by 88% in previous 3 years. Was the 1st insurer to oppose Gov. Schwarzenegger’s plan to provide coverage for all Californians in 2007. $10- million/year CEO Angela Braly refused to allow treatment or even speak with Melanie Shouse, a WellPoint member with Stage 4 breast cancer, this month--during the Senate health care debate.

Blue Cross – Sam Pullen’s altruistic, sit-down protest cost him 5 days and nights in Los Angeles’ Central Men’s Jail this week, simply because Blue Cross refused to reconsider its policy denying 20% of life-saving treatments to its own subscribers. Even after Pullen’s release, Blue Cross has flatly refused to speak with him.

Humana – According to the California Nurses’ Association, Humana, like its fellow insurers, denies an average one in five physician requests to treat patients at risk of death. Government statistics estimate such refusals and non-insurance cases result in over 45,000 needless deaths in the US every year.

Why?

American Protest: Boston Tea Party Replaced By Twitter

We're all mad as hell about something. But hardly anybody's budging.

Once upon a time in America, people would say: "Sometimes I have to stand up and be counted." That was in the past.

But today, I had a glimpse of the past. So did this woman. 75 and cuffed. This afternoon.

Somewhere along the way, Americans, who had been willing to commit a Class A felony, to protest by seizing and destroying private property in Boston Harbor, have been reduced to protest-by- tweet, from the couch. That won't even get you a Class C Misdemeanor.

Which brings us to this echo of past protests: an actual demonstration at one of those alleged death panels--the corporate offices of a health insurer so big it could send any Transformer to the ER. Trust Me.

This day was about civil disobedience --an orderly-sit in to coincide with similar sit-ins at major health insurers across the nation. It was also about 8 police cars, 20 sheriff's officers, plus 2 paramedics and one growling police dog. It was also about arrests.

The wild-eyed radicals who demonstrated were mostly senior citizens and mostly middle class, except for some like Leslie Elder who lost all insurance when her cancer recurred twice and now risks losing her home because of medical bills. (It's the way a majority of Americans go bankrupt these days.)

All these people had done was respectfully submit a letter at Humana's door asking merely one thing: Allow treatment prescribed by a Physician for life-threatened Humana patients. The company refused. So a few gentle people sat down at the door until they got a better answer.

The group Health Care Now says: "Nonviolent action is a worldwide tradition based on an understanding that in a society power flows not from guns or positions of authority but from the consent and cooperation of the people."

Martin Luther King said: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

The first sheriff's officer to move toward and prepare to handcuff the gentle folk sitting peacefully on the lobby floor glowered and said: "All criminals."

"I"m doing this for my daughter," said James Elder. "She's 27 and if we don't fix health insurance now, it could ruin her life later." As I write, Mr Elder, a simple man well into his 60's, sits in jail.

Sandy Prisant

Dr. Martin Luther King, Jr.

Health Insurance Reform: Heading for the Bridge to Nowhere?

Pericles, Eucleides and all the Athenians who founded democracy must be cringing. The last 6 months in Washington could not possibly be what they had in mind.

On the day I was born, the doctors told my father I could not live 24 hours. That was how my interest began in health insurance and its impact on our society. Today, more than 50 years later, I continue to lead a full, productive life. But during all of that time I have had to scrap and struggle for health coverage and have had to live half my adult life outside the US to get that sensible, single-payer national insurance coverage.

My story makes me a virtual poster child for that kind of well-established health care approach. Having paid in tens (hundreds?) of thousands to FICA and corporate health insurers during my decades as a senior executive, I am now "ineligible" for any coverage in the US. Nonetheless I decided to return home last year to try to play a role in promoting a 21st century policy. But even I did not expect this--Congress has been replaced by Cirque du Soleil.

In short, I'm playing Russian roulette with my own health and my family's financial stability for the sake of a country in which the lobbyists for virtually every nook and cranny of the for-profit industry have already gotten Congressional commitments to keep their "share of the pie". (NY Times, 11 October)

If I fall down in the street today, I pray no one takes me to a hospital--it would bankrupt my loved ones. That is the nightmare 47 million Americans now live with. If Americans believe there is a right to life, there must also be a right to health care sans bankruptcy. It is an intrinsic corollary.

After decades of personal frustration, I've now had to endure with all of you months of calculated propaganda--false to the last word. There has been less debate than what you can get by reading a box of Cocoa Puffs.

Can we all at least agree on one thing? That every American should, at a minimum, have the health care rights on paper afforded the citizens of Vanuatu and Uganda. Even if only to appease ancient Athenian spirits.