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End-of-Life Warning at $618,616 Makes Me Wonder Was It Worth It

End-of-Life Warning at $618,616 Makes Me Wonder Was It Worth It
By Amanda Bennett | Bloomberg


Along with my colleague Charles Babcock, I spent months poring over some 4,750 pages of documents collected from six hospitals, four insurers, Medicare, three oncologists, and a surgeon. Those papers tell the story of a system filled with people doing their best. And they raise complex questions about a health-care system that consumes 17 percent of the economy.

Days to Decipher

As I leafed through the stack of documents, it was easy to see why 31 percent of the money spent on health care goes to paperwork and administration, according to research published in 2003 by the New England Journal of Medicine. That number has either stayed the same or grown, said Dr. Steffie Woolhandler, a professor at Harvard Medical School and a co-author of the study cited by the journal. Some bills took days to decipher. What did “opd patins t” or “bal xfr ded” mean? How could I tell if the dose charged was the same as the dose prescribed?

The documents revealed an economic system in which the sellers don’t set and the buyers don’t know the prices. The University of Pennsylvania hospital charged more than 12 times what Medicare at the time reimbursed for a chest scan. One insurer paid a hospital for 80 percent of the $3,232 price of a scan, while another covered 24 percent. Insurance companies negotiated their own rates, and neither my employers nor I paid the difference between the sticker and discounted prices.

‘It’s Completely Insane’

In this economic system, prices of goods and services bear little relation to the demand for them or their cost to make -- or, as it turns out, the good or harm they do. Read more.

What States Need from Congress to Make State Single-Payer Healthcare Work

From PNHP:

We, the single payer movement, are very concerned that the current legislative language in the Senate bill prohibits states from passing state-based reform such as single payer until at least 2017. Several states are poised to pass single payer this year and next year. This will be an important step in moving towards national single payer. We need the following language in the final legislation through the reconciliation process. We hope that you will work with us to insert this language or find members who are willing to stand together to fight for this important language. I hope to touch base with you soon to discuss this matter.

Language for a Real State Single Payer Option or "ERISA + 4"

A real state single payer option would meet the following minimum criteria.

Disturbing Story Of Fallujah's Birth Defects

Disturbing story of Fallujah's birth defects
By John Simpson | BBC News

Six years after the intense fighting began in the Iraqi town of Fallujah between US forces and Sunni insurgents, there is a disturbingly large number of cases of birth defects in the town.

Fallujah is less than 40 miles (65km) from Baghdad, but it can still be dangerous to get to.

As a result, there has been no authoritative medical investigation, certainly by any Western team, into the allegations that the weapons used by the Americans are still causing serious problems. Read more.

Ask These Reps to Oppose Healthcare Bill Unless States Rights (Single-Payer) Language Restored

Ask 14 congress members to withhold support for a healthcare bill unless language is restored allowing states to create healthcare solutions.

What States Really Need: Chuck Pennacchio Replies to David Sirota

Chuck Pennacchio has the following response to this column by David Sirota:

Interesting piece, David. Thank you.

It's conceptually compelling. But, in detail, the US Senate healthcare bill to which you refer would undermine state innovation, especially state-based single payer legislative campaigns that are making tremendous headway all across the nation.

The US Senate's poison-pill language preempting state initiatives/reforms until 2017 would lock in industry control over HC funding (and, thus, delivery); provide a mandate-driven, ready-made market of some 30M new "consumers" to a predatory, profit-first insurance industry; and, perhaps worst of all, tie the hands of some 20 state-based single payer legislative campaigns working closer and closer to enact the proven Single Payer Solution as both a model for other states and the national government.

"It Isn't Nice," Sung by Margaret Flowers

On Thursday morning, Feb. 25, 2010, a sidewalk summit advocating “Medicare for All,” was staged in Washington, D.C., at Lafayette Park, North, not far from the White House. To close the rally, Dr. Margaret Flowers sang her rendition of “It Isn’t Nice,” a ballad authored by the late, great songwriter and activist, Malvina Reynolds. Dr. Flower was introduced by activist Katie Robbins. For background on the Sidewalk Summit, go here.

Overview of Single-Payer Healthcare in the States, Thanks to Kathlyn Stone

Kathlyn Stone has done what I should have done and collected my recent postings on state level single-payer healthcare on her blog.

imageThe question isn’t if a state will enact true health care reform before Congress, but which state and when.

Forget Congressional action on meaningful health care reform. It’s clear that whatever national health care legislation is passed, its main intent will be the preservation of a for-profit system.

Actual delivery of health care to all Americans who need it remains a lesser priority than keeping the system profitable. The federal plan will protect the insurance CEOs’ eight- and nine-figure salaries and the system of monthly premiums, which with promised rate hikes, will soon equal or exceed our monthly housing payments. Individuals will continue to fund the insurance industry’s marketing and bureaucracy through taxes and premiums. As an added bonus for the industry, citizens could be fined if they refuse to purchase its insurance.

The real reform action is taking place in the states.

Single-Payer Healthcare Coming to Minnesota and Maryland

By David Swanson

California keeps passing bills for state single-payer healthcare, but Ahhhnold won't sign em, and Jerry Brown who wants to be governor doesn't seem to want it badly enough to make a commitment on healthcare. Meanwhile, Pennsylvania is encouraged that their current governor has said he probably will sign a single-payer healthcare bill, and the legislature just might pass one. But Minnesota has an angle neither of these other states can claim: a serious candidate for governor who is the state's leading advocate for single-payer.

State Senator John Marty was the Democratic nominee for governor of Minnesota 16 years ago and is making another run for it. My friend Vin Gopal, who's working on Marty's campaign, tells me "Senator John Marty is the real deal. If he gets elected Governor this year, which he has a good shot at, it's a whole new ballgame for the single-payer movement. No other statewide candidate in the country is as committed to the movement as he is."

Pennsylvania Likely to Get Healthcare Before Rest of U.S.

By David Swanson

I've been writing about various states just beginning campaigns for single-payer healthcare. Pennsylvania is on the cusp of completing one.

They claim to have the best legislation, which will provide everyone with healthcare, pay for it, and in fact save people and businesses money, as well as getting around the federal restrictions Congressman Dennis Kucinich has attempted unsuccessfully thus far to waive for states. In Pennsylvania they have Democratic and Republican cosponsors. Imagine that in Washington, D.C.! And they have a governor ready to sign the bill into law.

State of Reform

State of Reform
By Lauren Daley | Pittsburgh City Paper

State Sen. Jim Ferlo likens his quest for health-care reform to breaking a concrete wall with a five-pound sledgehammer: Hit the wall once, it shakes. Strike it 10 times, it cracks. Twenty times and it crumbles.

"This is like the sledgehammer against the Berlin Wall," Ferlo says of his effort to create a statewide single-payer health-care plan. Such a measure would bypass insurance companies entirely, having a government agency reimburse doctors and hospitals for medical treatment. "But it's doable."

During much of 2009, debate over the health-care system focused on Washington, D.C., but Democratic efforts at a nationwide reform stalled after a Massachusetts election placed Republican Scott Brown in the late Democrat Ted Kennedy's U.S. Senate seat. That deprived Democrats of the 60-vote majority they need to head off a Republican filibuster of the bill.

But with efforts in Congress faltering, advocates see an opportunity for change at the state level.

"The chance of anything of substance happening in Washington, D.C. ... is less than zero," says Chuck Pennacchio, executive director of Health Care for All Pennsylvania. "We've been saying that for more than three years. Now people are finally listening."

In fact, this month the Pennsylvania Democratic State Committee called for the passage of a single-payer system. Pittsburgh City Council and Allegheny County Council also previously passed resolutions supporting various single-payer initiatives.

Ferlo says he's not sure the most viable Democratic candidate ran against Brown in Massachusetts, and he believes Brown's victory was voter reaction to the Democratic Party. "We finally win power in the House, Senate and White House and we're sitting on our hands. That's why I think a lot of people are frustrated," Ferlo says. "They want decisive action.

"I hate to criticize my own party," Ferlo adds -- but "[w]hat great things have they done?"

Ferlo's own initiative is Senate Bill 400, known with a companion measure in the House [HB 1660] as the Pennsylvania Family and Business Health Care Security Act of 2009. The legislation proposes a statewide, publicly funded health-insurance system to replace what Ferlo calls "profit-driven insurers." Read more.

Colorado Could See Single-Payer Healthcare

By David Swanson

Maryland's state senate has scheduled a hearing on a single-payer healthcare bill for March 10th. California's legislature has passed a single-payer bill three times. Single-payer healthcare bills are advancing in Pennsylvania, Ohio, Minnesota, Massachusetts, and New Mexico. I recently wrote about two state legislator candidates, Marcus Brandon in North Carolina and Byron DeLear in Missouri, who plan to introduce state single-payer bills immediately upon being elected.

Now, let me tell you about Colorado. Mark Mehringer is a candidate for the Colorado State House from District 7 (Denver). His website at has an issues page and a video on the home page that both put a Medicare-for-All healthcare solution at the top of his agenda.

Make a Citizens Arrest of the People Denying Us Healthcare

Every year
45,000 of us die
930,000 of us go bankrupt
2,300,000 of us lose insurance
because of our broken health care system.

The insurance industry’s lobby front group AHIP is back in DC for another conference.
It’s time for justice to be served.

We are gathering a citizen’s posse to hold them accountable for their crimes against Americans’ health.

We need your help to conduct a mass citizen’s arrest of the insurance industry.

Here’s what we’re looking for:

Posse Officers – Meet us at Dupont Circle at 10:30AM Tuesday March 9th to join the citizen’s posse. We’ll all get sworn in, then we'll march to confront AHIP for their crimes.

Deputies – the citizen leaders of our posse — we need you to show up for a coordinator's training Monday evening, then join us at Dupont Circle Tuesday AM where you will help corral the posse.

We must end AHIP's obstruction of our care, their obstruction of Congress and their obstruction of justice. Let Congress know that we won’t let big insurance control our care any longer. Join us!

For more info and to sign up to be Deputized::

Single-Payer Healthcare Coming to Missouri

By David Swanson

Canada did not create a civilized healthcare system nationally until its provinces led the way.  Clearly Congress is dragging behind the states in our country, and it is through state successes that we will eventually compel the U.S. government to provide our people with this basic human right.

Blogging GREAT Chile Earthquake/Tsunamis; Pres. Bachelet A Steady Leader; Japan Prepares For Tsunamis

by Linda Milazzo

UPDATED: Feb, 28, 2010/5:40AM (local Chile time)

CNN International is now reporting 101 aftershocks have been recorded in Chile since yesterday's 8.8 earthquake with 7 at 6.0 or higher. Over 300 fatalities have been reported with 60 reported missing.

Japan is seeing tsunami flooding on its northern island of Hokkaido. The tsunami projection from NOAA reports a wave of 4 feet has just arrived. 320,000 coastal residents have been evacuated. The tsunami warning for Russia has been lifted.

UPDATED: Feb, 28, 2010/3:40AM (local Chile time)
The death toll in Chile is now confirmed at 300. Chile has not yet asked for help from other countries. More than one million buildings have been damaged. More than a half million houses have been completely destroyed and two million people affected. President Bachelet has been coordinating services steadily for nearly 24 hours since 5AM yesterday.

Look Who Loves French Health Care

Look Who Loves French Health Care
By Jonathan Cohn | The New Republic | December 14, 2009

It's Matt Welch, editor-in-chief of the very libertarian Reason magazine:

To put it plainly, when free marketers warn that Democratic health care initiatives will make us more “like France,” a big part of me says, “I wish.” It’s not that I think it’s either feasible or advisable for the United States to adopt a single-payer, government-dominated system. But it’s instructive to confront the comparative advantages of one socialist system abroad to sharpen the arguments for more capitalism at home.

For a dozen years now I’ve led a dual life, spending more than 90 percent of my time and money in the U.S. while receiving 90 percent of my health care in my wife’s native France. On a personal level the comparison is no contest: I’ll take the French experience any day. ObamaCare opponents often warn that a new system will lead to long waiting times, mountains of paperwork, and less choice among doctors. Yet on all three of those counts the French system is significantly better, not worse, than what the U.S. has now. ...

In France, you are covered, period. It doesn’t depend on your job, it doesn’t depend on a health maintenance organization, and it doesn’t depend on whether you filled out the paperwork right. Those who (like me) oppose ObamaCare, need to understand (also like me, unfortunately) what it’s like to be serially rejected by insurance companies even though you’re perfectly healthy. It’s an enraging, anxiety-inducing, indelible experience, one that both softens the intellectual ground for increased government intervention and produces active resentment toward anyone who argues that the U.S. has “the best health care in the world.” Read more.

An Accidental Experience with a Health System that Seems to Work

By Dave Lindorff

Geneva, Switzerland--As I write this article, I’m seated in a hotel room across from the train station in Geneva, Switzerland. There’s a slight, dull pain in my forehead from a two-inch line of stitches that are pulling together a gash that runs diagonally across my brow, thanks to a stumble on a high step on a sidewalk in the rain last night, that sent me flying airborne headfirst into a round metal lamppost.

I have been covering the Fourth Congress Against the Death Penalty sponsored by the United Nations and the international abolition movement, which brought together anti-death penalty groups from all over the world, and featured talks and workshops with a number of people, several from the US, who had spent years and even decades on death rows before being found innocent of the crimes that had put them there.

VA To Reopen Gulf War Vets' Files

VA to reopen Gulf War vets' files
By Kimberly Hefling, Associated Press Writer | Yahoo! News

The Veterans Affairs Department says it will take a second look at the disability claims of what could be thousands of Gulf War veterans suffering from illnesses they blame on their war service, the first step toward potentially compensating them nearly two decades after the war ended.

VA Secretary Eric Shinseki said the decision is part of a "fresh, bold look" his department is taking to help veterans who have what's commonly called "Gulf War illness" and have long felt the government did little to help them. The VA says it also plans to improve training for medical staff who work with Gulf War vets, to make sure they do not simply tell vets that their symptoms are imaginary — as has happened to many over the years.

"I'm hoping they'll be enthused by the fact that this ... challenges all the assumptions that have been there for 20 years," Shinseki told The Associated Press in an interview.

The changes reflect a significant shift in how the VA may ultimately care for some 700,000 veterans who served in the Gulf War. They also could improve the way the department handles war-related illnesses suffered by future veterans, because Shinseki said he wants standards put in place that don't leave veterans waiting decades for answers to what ails them. Read more.

Could a New UN Resolution End Doctors' Participation in Torture?

ScienceDaily (Feb. 26, 2010) — A new UN resolution has the potential to fight torture and cruelty, say experts on the British Medical Journal website.

The resolution, passed in March 2009, goes further than previous rulings, say the authors and spells out that "states must never request or require anyone, including medical or other health personnel, to commit any act of torture or other cruel, inhuman or degrading treatment or punishment."

Lead author, Dr Peter Polatin from the Rehabilitation and Research Centre for Torture Victims in Denmark, says there is substantial evidence that health professionals have been involved in torture around the world, for example in Saddam Hussein's regime in Iraq in the mid-1990s, in Israel and in Guantanamo Bay.

Progressive Caucus Announces Surrender, Then Feints Forward Thrust, Just Gets Laughed At

Progressive "last stand" made on one leg, hands tied 

This morning's Progressive Caucus pronouncement probably would have worked better:

Today’s summit is an opportunity for Americans outside the beltway to learn about the best health care proposals. We believe the public option is the best and most effective proposals to reform our country’s broken health care system and provide affordable, accessible health care for every American and it should be included in today’s discussion.

Yet another reason for healthcare reform

Pharmaceutical Industry Support Not Desirable but Frequently Accepted by Residency Program Directors

ScienceDaily (Feb. 22, 2010) — Most directors of internal medicine residency training programs would prefer not to accept pharmaceutical support for the residencies they oversee, but more than half report doing so, according to an article in the February 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Terrorists or Internists? What's the Real Threat?

Sepsis and Pneumonia Caused by Hospital-Acquired Infections Kill 48,000 Patients, Cost $8.1 Billion to Treat

ScienceDaily (Feb. 22, 2010) — Two common conditions caused by hospital-acquired infections (HAIs) killed 48,000 people and ramped up health care costs by $8.1 billion in 2006 alone, according to a study released in the Archives of Internal Medicine.

This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death.

Breaking America's Addiction to War & Debt: Out with the Enablers!

by Marcy Winograd

Imagine if in 2010 we did not spend one more borrowed penny to manufacture new weapons, occupy new lands, or recruit new mercenaries. Going cold turkey on military spending would wipe out nearly $1 trillion of our 1.6 trillion dollar deficit. A year and a half of war & weapons abstinence could erase our debt entirely.

Unfortunately, America is addicted to war and to debt. Fortunately, we can work together to kick the perpetual war and debt habit.

DC! Single Payer Advocates Hold Sidewalk Summit on Thursday, Feb. 25 - Call White House, Congress, Rally In Your Community!

Single-Payer Healthcare | Photo by Chris Hondros/Getty Images North America

Let the President Know About a Better Approach to Reform

President Obama recently said, "If anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know."

We should let him know that single-payer, Improved Medicare for all, accomplishes all those goals.

Call the White House at 202-456-1111. Tell them, "I'm letting you know that improved Medicare for all (HR 676) is better than the health bill proposed by Congress."

If you have another second, email the President here to ask him to start from scratch on health reform.

And don't forget to call Congress for single-payer.

"Margaret Flowers invites everybody to the Sidewalk Summit on Thursday, Feb 25th. Gather at 9 am on Pennsylvania Ave in front of the White House (north side) to hear why Medicare for All is the solution. If you can't be in DC, then hold your own Sidewalk Summit. Info at" -- from Dr. Margaret Flowers

Much more at Health Care NOW!

Three-Percentism - or - What's the Matter With Palm Beach?

By David Swanson

What the liberal activist world is doing for healthcare bears a striking similarity to what Christianists do for billionaires. Supporting tax breaks for the richest three-percent of Americans because you hate gay people or women or blacks or sex does not at first look much like supporting a "public option" for three percent of the poorest of Americans.

But both shape national policy around a supposedly national program that in reality will benefit only some small percentage of people. Feel free to quibble over the number, but Obama promised the insurance companies in a speech to a joint session of Congress on September 9, 2009, that it would be under 5 percent. Let's be generous and call it four, a "public option" for four percent of us.

Doubling of Childhood Leukemia Rates Confirmed in Southern Iraq

ScienceDaily (Feb. 18, 2010) — Childhood leukemia rates have more than doubled over the last 15 years in the southern Iraq province of Basrah, according to the study, "Trends in Childhood Leukaemia in Basrah, Iraq (1993-2007), published in the American Journal of Public Health.

The authors, three of whom are from the University of Washington, say they hope their calculations can now pave the way for an investigation into reasons why the rates have climbed so high, and why they are higher than found in nearby Kuwait, or in the European Union or the United States.

The study documents 698 cases of leukemia for children aged 0-14 during the 15-year period, with a peak of 211 cases in 2006. Younger children had higher rates than older ones.

Will this be part of healthcare reform?

Charging Less for More Effective Treatments Could Reduce Health Care Costs While Improving Health

ScienceDaily (Feb. 16, 2010) — Value-based insurance design (VBID) in which consumer payments are waived for highly effective treatments, but are raised for less effective ones, could increase the benefits of healthcare in the US without increasing expenditures, according to research published in PLoS Medicine. The costs saved by VBID could be used to subsidize coverage for the currently uninsured, providing a substantial improvement in health outcomes.

Speaking Events


War Is A Lie: Second Edition
Published April 5, 2016
Tour begins here:

(Invite David Swanson to your town!)


April 11, Washington, DC, 6:30-8:00 p.m. at Busboys and Poets at 5th and K Streets.
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April 12, Baltimore, MD, 7:30 p.m. at Red Emma's.
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April 14, Bellingham, WA

April 15, Seattle, WA

April 16 Portland, OR




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