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Save Trillions with Universal Health Care: Lose Weight, Save Money and Feel Better with Ultimate Wellness

Save Trillions with Universal Health Care: Lose Weight, Save Money and Feel Better with Ultimate Wellness

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Save Trillions with Universal Health Care: Lose Weight, Save Money and Feel Better with Ultimate Wellness

Lunghezza:
417 pagine
6 ore
Pubblicato:
Feb 22, 2014
ISBN:
9781311345455
Formato:
Libro

Descrizione

"Stephen Simac puts his finger on the pulse of American medicine and on its wallet and finds huge destruction in the mismatch. Save Trillions is a rational fix for a troubled system."
Dr. Walter Bortz, author of Next Medicine: the Science and Civics of Health
former Professor of Medicine at Stanford School of Medicine.

Save Trillions with Universal Health Care is a map for expanding health care without raising taxes by reducing medical expenses from ineffective and expensive treatment and funding societal prevention. There are many books on the problems of the American medical system. Save Trillions provides solutions to transform it, with Freedom of Choice in health care.
What was a strategic plan to transform ObamaCare into Universal Health Care, this post Trump edition concludes with the Republican reform implosion. The chapters on American Epidemics of Heart Disease, Cancer, Diabetes, Alzheimer's to Autism and Mental Illness now include Trauma and Infectious and Autoimmune Diseases. They reveal how trillions can be saved with wellness, prevention and non-orthodox treatments. Replacing the Standard American Diet (SAD) and sedentary, stressed out American Way Of Life (AWOL) will not just treat their symptoms. Reimbursing for Freedom of Choice in health care will break up the Medical Monopoly that drives spiraling costs.
Save Trillions describes the poisoning of Americans with unhealthy products and builds the case for charging Medical Expense Fees to pay for their externalized costs. It informs and supports readers on their own wellness journey and describes a healthier vision for society. My original proposal for MEF on hazardous products and practices to pay for Universal Health Care is now supplemented with shifting priorities in government budgets to provide for the General Welfare. Solutions for predistribution of income from social capital and inequality reducing tax reforms will make rich and poor alike healthier and happier.
It proposes alliances of public health educators, integrative medical physicians, traditional, complementary and alternative practitioners and organizations of consumers/ im-patients to tilt resources towards real prevention and reimburse all health care practitioners to unclog an overburdened system It's an entertaining and informative overview of health care, full of humor, history and insights from forty years of research, practice and reporting on health and wellness.

Pubblicato:
Feb 22, 2014
ISBN:
9781311345455
Formato:
Libro

Informazioni sull'autore

I have been researching and writing about health and wellness for thirty five years. I have a masters degree in integral health studies, extensive knowledge of nutrition, supplements, exercise and years of practice in a variety of healing, recovery and stress reduction techniques. My focus is on individual and public wellness promotion and this book is the result of an idea for health care reform that prioritizes improving health rather than treating preventable illness and injury.

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Save Trillions with Universal Health Care - Stephen Simac

Stephen Simac

Save Trillions with Universal Health Care (1)

Lose Weight, Save Money and Feel Better with Ultimate Wellness

First published by Paradise Press in 2018

Copyright © Stephen Simac, 2018

All rights reserved. No part of this publication may be reproduced, stored, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise without written permission from the publisher. It is illegal to copy this book, post it to a website, or distribute it by any other means without permission.

Sixth Edition

This book was professionally typeset on Reedsy

Find out more at reedsy.com

Contents

Copyright Original

TABLE OF CONTENTS

Introduction to Universal Health Care

I. PART ONE

Blood and Treasure

A Short History of Health Care Reform

ObamaCare Burdens

How the Hellth Did Medicine Become So Expensive?

Heart Attack or Self Defense

Cancer Cathedrals

Alzheimer's to Autism: A Grayscale Spectrum

Diabetes: An Epidemic of Amputations

Psychiatry: Voodoo Science

Infectious and Autoimmune Diseases: Flip Sides of the Same Coin

Trauma: Ghosts in the Machine

Healthy Aging or Bust

When Prevention Costs More than the Cure

Medical Insider Turns Holistic

Death by Nutrition

Big Food, Big Crimes

Soda Taxes Fizzing Up

Golden Bullets from the Sun

EFA Better than Snake Oil

Massage the Messenger

Alternative Health Care at the Table

Toxins and Hazards Pay their Share

Socialized Medicine Cares for Communities

A Populist Strategy for Gaining UHC

How We Gonna Pay for Universal Health Care?

Better, Cheaper, Fairer Health Care

The Final Solution: Prioritize Public Health

Acknowledgements

Copyright Original

This book is not intended to advise readers on personal medical decisions or replace recommendations from physicians or other health care providers. It is intended to inform decisions about health care reform the quest for ultimate wellness.

Text Copyright 2017 Stephen Simac

This book is licensed for your personal enjoyment and education. Some Rights Reserved, [license_3.0] This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. For more information, please visit http://creativecommons.org/licenses/by-nc-nd/3.0

Seeded in 2006 with an article in The Coastal Post. Extended into a white paper on scribd.com in 2010 as Universal Health Care in America. Expanded in 2013 on smashwords.com to Lose Weight, Feel Better and Save Billions on Health Care. Published electronically on smashwords and kindle in 2014 as Save Trillions with Universal Health Care: Transform ObamaCare. Expanded with two more chapters in 2015 edition. This 2017 edition changes the subtitle, adds three chapters and revises the rest to match the changing times.

Published by

Paradise Press

Box 224

Stinson Beach, CA 94970

Save Trillions is volume one in The Medical Monopoly Series

Cancer Cathedral: Prevention is the Cure

Mandatory Vaccination = Totalitarian Inoculation

Other books by this author

Lose Weight, Save Money and Really Reduce Greenhouse Gases

TABLE OF CONTENTS

INTRODUCTION: An overview of health care for all funded by Medical Expense Fees.

1 BLOOD AND TREASURE: The crippling burdens of our medical system. Popular solutions for cost reductions fall short. Orthodoxy entrenched, reformers must organize.

2 A SHORT HISTORY OF HEALTH CARE REFORM: HMO’s to ObamaCare and beyond. Evidence based medicine thrown out with cost controls.

3 OBAMACARE BURDENS: Younger Americans pay for the sins of their elders, but they’re not healthy either. Medical Monopoly exposed.

4 HOW THE HEALTH DID MEDICINE GET SO EXPENSIVE? Overview of health care through the Ages. An American Sickness infects medicine with Greed and Fear.

4 HEART ATTACK OR SELF DEFENSE: Cardiac disease theories explained. Social relations and diets that protect hearts. Cholesterol exonerated, statins scam.

5 CANCER CATHEDRALS: The War on Cancer waged, hyped, failed repeatedly. Oncology Trinity = Poison, Slash, and Burn. Prevention practices, censored Cures.

6 ALZHEIMER’S TO AUTISM, A GRAYSCALE SPECTRUM: Brain damage shares causes. Government denies, media ignores, citizens confused. Treatment options.

7 DIABETES: AN EPIDEMIC OF AMPUTATIONS: Intestinal removal and kidney dialysis are medical solutions. Reversed with diet , exercise and healthy habits.

8 PSYCHIATRY: VOODOO SCIENCE: Mental illness treatment is history of horrors. Pharmaceutical propaganda promises help, disables most.

9 INFECTIOUS AND AUTOIMMUNE DISEASE: FLIP SIDES OF THE SAME COIN: No vaccines for modern killers. Immune Symphony Tune Up. The Enemy Within.

10 TRAUMA: GHOST IN THE MACHINE: Pervasive effects of abuse, violence and neglect reverberate through generations. Body oriented therapy and community cures.

11 HEALTHY AGING OR BUST: The Boomer Tsunami and catastropharian Cassandras. Secrets of a longer Healthspan. Beyond Falls Prevention.

12 WHEN PREVENTION COSTS MORE THAN CURES: Medical prevention causes more harm than benefits. Cancer screening, fluoride, inoculations hyped as healthy.

13 MEDICAL INSIDER GOES HOLISTIC: China Study reveals corruption in food research and regulation. Prescribes Whole Foods Plant Based Diet cure.

14 DEATH BY NUTRITION: Dieticians selling seal of approval. National Enquirer nutritionist and Harvard professor pushed sugar, fast food, sodas and fluoride.

15 BIG FOOD. BIG CRIME: Salt, Sugar, Fat review. Corporations sell addictive products anytime, anywhere. Class action suits to pay for their sins.

16 SODA TAXES FIZZING UP: Sugar water ID’d as subsidized serial killer. History of failed attempts until Berkeley taxes sweetened beverages. Sin tax dike breached.

17 GOLDEN BULLETS FROM THE SUN: Solar powered prevention. D heals across the spectrum of disease from bones to brains. Pennies per pound of prevention.

18 EFA: BETTER THAN SNAKE OIL: Essential Fatty Acids magic bullet cure. Proven benefits from fish and plant oils.

19 MASSAGE THE MESSENGER: CAM to OAM, alternative medicine barred from evidence based club. Vioxx vs HCG.

20 HEALING POWER OF PRAYER for UNIVERSAL HEALTH CARE: Doctors’ death rates. Populists history. Transmaterialistic medicine.

21 ALTERNATIVE HEALTH CARE AT THE TABLE: Gaining reimbursement by exploiting divisions. Organizing for Freedom of Choice

22 TOXINS AND HAZARDS PAY THEIR WAY: Funding Universal Health Care with Medical Expense Fees. Big Food, motor vehicles, chemical poisons. Proven risks, known costs.

23 SOCIALIZED MEDICINE CARES FOR COMMUNITIES: Community Gardens pay dividends. Health Care a human right despite debate. Social cohesion radiates health.

24 POPULISM: A STRATEGY FOR UHC: Historical lessons from the true populists. Community coalitions that educate and empower citizens.

25 HOW WE GONNA PAY FOR UNIVERSAL HEALTH CARE?: Income inequality, waste and fraud in government and private industry exposed. Capitalism examined for health hazards.

26 BETTER, CHEAPER, FAIRER HEALTH CARE: Review of a global search for medical care. Different western and, eastern models contrasted with ours,.

27 FINAL SOLUTION: PRIORITIZE PUBLIC HEALTH: Ultimate Wellness, a user’s guide from biome to beliefs. Outsourcing health care to the lowest bidder.

Introduction to Universal Health Care

Stephen Simac puts his finger on the pulse of American medicine and on its wallet and finds huge destruction in the mismatch. Save Trillions is a rational fix for a troubled system. Dr. Walter Bortz, author of Next Medicine: the Science and Civics of Health and The Roadmap to 100: The Breakthrough Science of Living a Long and Healthy Life, retired Professor of Medicine at Stanford School of Medicine.

Where a well packaged web of lies has been sold gradually to the masses over generations, the truth will seem utterly preposterous and he who speaks it a raving lunatic. Dresden James

The medical myths this book exposes as a web of lies have been embedded in a monolithic matrix of scientific medicine since the early 20th century. Even as facts have fractured and fallen away, the web remains, a false front of beliefs rarely challenged. These myths are the foundation of Americans' faith in modern medicine, accepted without questioning or doubts. For them this book will be heresy pointing towards freedom from chronic illness and suffering. For those with more knowledge of alternative health care and/or experience with failed conventional medical treatment, Save Trillions offers a strategic plan to achieve true health care.

The orthodox medical system is costly and futile when treating chronic illness caused by a culture guaranteed to create disease. Treating the symptoms erupting from lifestyle induced epidemics and the high cost of dying are the major drivers of medical costs. A prevention-focused model for universal health care can be funded with medical expense fees on toxic and hazardous products, shifting budgetary priorities towards community health and reducing inequality. Universal Health Care has bipartisan appeal, both more affordable with better results and Freedom of Choice.

Save Trillions was a plan for transforming the Affordable Care Act (ACA) aka ObamaCare into Universal Health Care (UHC). (Styling it as ObamaCare accented the corporate origins and beneficiaries of the ACA.) With Donald Trump and a Republican majority Congress, that rough beast seems like a dead man walking. Whether they repeal and replace ObamaCare or scale back the smoking corpse, their plan is unlikely to resolve the fundamental fault lines of the Medical Monopoly.

President Trump tweeted, Nobody knew how complex health care is, before their plan imploded. Republicans whipped out their 600 page bill, before it could even be analyzed by the Congressional Budget Office. When they predicted 24 million would become uninsured in a decade, the usual shitstorm around gutting Medicare shut out any sunlight from shining on the inner workings of the Medical Monopoly, the reason for spiraling insurance and health care costs.

Most Americans weren't all that interested in health care reform until now, because most books and articles about it are mind numbingly boring. I've done the hard work of slogging through the boring stuff, to serve up a distilled liqueur from the swill. People have called my writing many things, but never boring. Like Eduardo Galeano, I confess I get a pain from reading works by experts who write in code. Hermetic language isn't the inevitable price of profundity. It can simply conceal incapacity for communication, [or] serve to sanctify the present order, confirming that knowledge is the privilege of the elite.

Like him, I want to spread some ideas of other people, and some experiences of my own, which might dispel a little of the fog from questions always pursuing us, like obstinate flies that disturb one's sleep.(Open Veins of Latin America: Five Centuries of the Pillage of a Continent). Where I've had to use medical terminology, I've defined it. Don't worry, this book does not delve into the arcana of medical insurance reform plans. It's not about the details of creating a new plan from scratch, but an overview of what to change and why.

It describes an overall strategy and specific tactics to convince a majority of Americans that universal health care is both more affordable and effective than the system we have now. Any system used by other industrial nations is measurably better and cheaper than those pushed on us by first Democrats and now Republicans, so I've reviewed the global alternatives.

My idea on funding universal health care with Medical Expense Fees on toxic and hazardous products and practices is bipartisan. Both parties will hate it because it benefits American people, not corporations. I've revised this edition, dropping Transform ObamaCare and retreating to my original subtitle before the ACA was passed, only to drag the Democratic majority and presidency down with the sinking ship. Health care that is more affordable and effective can be a healer, not a divider, but UHC is still a stretch. Luckily, stretching improves health.

It's a non-academic primer for readers whose eyes glaze over when medical treatment reform is discussed, yet want to know more about health and wellness, as long as it's entertaining and informative. I've written for a popular audience (hopefully). References and citations are in the text, not footnoted. They can be found in referenced books, journals, articles or searched on line.

Each chapter in the Major American Epidemics section calculates the costs from ineffective treatment and prevention for the top killers and cripplers. It exposes fraud and damages by the medical industry and reports proven alternatives and preventive practices. I'm proposing a health care system that reimburses traditional, alternative, complementary and integrated medicine practitioners. One that funds prevention, not just medical treatments or diagnostic tests.

Sometimes you can't fix a broken system. There's no guarantees in life, only statistical warranties around healthy habits. This is an evidence based health and wellness guide for readers that doesn't repeat the party line. Our Freedom of Choice includes the Right to Refuse Medical Monopoly tyranny given legal authority over parents and patients. Yes, We Can! promote prevention on individual, local and national scales. We can fund programs that lower medical costs and improve our health.

Public awareness of the costly failures of conventional medicine will increase support for UHC by patients, among health care practitioners and politicians. The enormous cost of medical treatment has created politically powerful and enormously wealthy interests. These groups resolutely oppose systemic health care reform. The most influential medical industries backed ObamaCare, which rewarded those invited to the table. Look where pleasing special interests got the Democrats. Creative tactics with a long-term strategy can transform that rough beast into shape changing submission to real health care.

Knowing the history of health care reform, global alternatives and medical failures and fraud is essential for informed debate about universal health care we can afford. Public demand from a dedicated minority has shaped more change than not. We must win real health care, or let our children greet financial and societal ruin. Opposing this dystopian future of the status quo, I've outlined a utopian vision to act as template for transformation. Kumbaya.

This book is not an exhaustive (or exhausting) encyclopedia of alternative treatments for every illness, nor a complete condemnation of conventional care. The materialistic philosophy dominating medical science is actually scientism, a faith based religion that seized the legal and political reins of American health care. I've been a health reporter and practitioner for forty years in the wilderness of the Free Press and non-reimbursed treatment. This book distills my practice, research and observations over a lifetime. I left in my quirky sense of humor and satire, although America's medical catastrophe is no joke. Some readers may object, but they have many serious books about healthcare reform.

Laughter is medicine, and readers will be informed and possibly laugh out loud at the absurdities down the rabbit hole of the medical maze. In The Annotated Alice in Wonderland Martin Gardner paraphrased Reinhold Niebuhr who preached we preserve our sanity by laughing at life's surface absurdities because humor is a no-man's land between faith and despair. Cynicism is unhealthy, although so is suicidal despair over failed dreams. He also warned that laughter turns to bitterness and derision if directed towards the deeper irrationalities of evil and death. Medical humor treads a fine line between no mans landmines.

There are times when you need a real doctor and with UHC they will be refreshed and attentive, not overwhelmed with patients they can't help with conventional approaches. Those readers inspired to organize alliances with practitioners and patients to achieve this goal are my preferred audience. You can present this book for admission to the UHC VIP lounge at health care reform conventions. This push will have to come from outsiders because politicians, academics, institutions and industry are not likely to jump off the gravy train just because it's heading off a cliff.

I

Part One

1

Blood and Treasure

Medical treatments cost Americans over $3 trillion in 2015, up from $2 trillion ten years ago, when I wrote the first draft of this chapter. Measured by the standard measures of life span, infant mortality, teenage pregnancies, infertility, rates of disease and disabilities, our medical system has the poorest outcomes for industrialized nations, yet they all spend far less money on their versions of socialized medicine.

Our ranking in healthy life span was at the bottom of the barrel for wealthy countries when the World Health Organization measured disability adjusted life expectancy in 2000. We were number 24 then, with Japan at the top of the heap. You die earlier and spend more time disabled if you're an American than members of other advanced countries. Christopher Murray, director of WHO's Global Program on Evidence for Health Policy was quoted in The Hundred Year Lie by Randall Fitzgerald.

Medical costs are projected to be over $4 trillion by 2020 at this rate, even with Republican reforms. Americans aren’t getting great value, since other industrial nations spend less than half as much per capita, while their citizens enjoy better health. No health benefits could be shown to result from $700 billion worth of medical treatment according to the Congressional Budget Office in 2006. Despite this record, most health care reformers focus on symptom tinkering, instead of systemic change.

Even Single Payer Health Care, with the government funding all medical costs, won't solve the problems plaguing Americans. It could even worsen them. Over 100,000 Americans died each year from using pharmaceutical prescriptions as directed, the Institute of Medicine reported in 1993. A Harvard Medical School and RAND Corporation study in 1997 blamed adverse events from medical treatment for 180,000 deaths and 1.3 million injuries at a cost of $50 billion. A Hearst Company study concluded that 200,000 Americans died from iatrogenic (medically induced) causes in 2009. Few of the many recommendations to reduce medical havoc were adopted. Medical treatment is the third leading cause of mortality in America, without counting bad nutritional advice and unacknowledged deaths.

Dying is ridiculously expensive. The American Medical Association reported in 2009 that 30% of Medicare funds are spent on the last year of life, with 80% of this in the last month. These medical procedures mainly increase suffering, yet Death Panels to reduce this painful waste panic patients and industry alike.

Meanwhile, medical costs are an economic catastrophe for patients, also disastrous for health. Toxic subprime mortgages did less damage to the housing market than medical expenses. The Kaiser Family Foundation found that 49% of foreclosures in California were caused by medical problems in a 2008 study. The American Journal of Medicine found that medical expenses caused 60% of bankruptcies in the U.S., whether insured or not.

One fourth of cancer patients used up all their savings following treatment, even with insurance. Cancer patients are six times more likely than the general population to be bankrupt five years after a diagnosis. Medical treatment costs Americans more than housing or food and is a bigger expense for businesses than materials.

Medical insurance corporations posted 25% profit margins annually before ObamaCare capped it at 20%. They still pay top executives millions, mainly for shaving costs to increase profits. The medical insurance industry pocketed a quarter trillion dollars profit a year, while millions of sick and injured Americans went belly up with debt. Their cash torpedoed a public option in the Obama health care reform bill, and they're still making out like bandits, while crying poor.

Reducing the 20% overhead of private insurance companies to the 3% administrative costs of Medicare/Medicaid is possible. Billing expenses and reimbursement time would be reduced significantly with single payer.

One progressive idea for universal health care is to allow all Americans the choice to buy into Medicare or Aid through state and federal insurance exchanges, with subsidies as needed. It makes economic sense, because it would pump money in while skewing their patient demographics towards younger and healthier. Universal Medicaid is unlikely to make Americans healthier, though. Poorer Oregonians who hit the jackpot in their 2008 state lottery for expanding Medicaid were no healthier two years later, than those who'd lost out.

Because this is both sensible and politically reviled by most Democrats and all Republicans in bipartisan agreement, other approaches to control spending have been plugged. There are pet ideas by political think tanks to slow the rate of increase in medical costs. Electronic billing will shave off a few percent, while further eroding patient privacy.

Medical errors cost $30 billion in 2014. Most could be avoided through recommended changes in procedures, yet even surgical checklists haven't been widely adopted. A standard claims form and identical approval rules would save $18 billion a year.

Malpractice reform would reduce some expenses that hospitals, physicians and insurance companies pay out. This is unlikely to change the practice of over treatment, sometimes called defensive medicine, because that's systemic. Built in profit margins from reimbursement for unneeded tests and procedures drive this culture more than lawsuits.

Prescribing generic pharmaceuticals and allowing Medicare to practice collective bargaining for drug pricing would save patients and providers billions. Simply use the discounts already negotiated by the General Services Agency for federal agencies. No need for duplication of bargaining processes.

There'd be less political theater of slaughtering hogs as Missouri Senator Clair McCaskill called the congressional spankdown of the hedge fund billionaire owner of Valeant Pharmaceuticals. He jacked up the price of a drug his company owned too fast, too soon, instead of a steady 10% like the rest of the pharmaceutical industry, whose pigs get fed and never have to testify.

Some of those savings might actually go to consumers. However these are all symptom tinkering, unlikely to save more than 20% of total medical costs. Even those savings will still bankrupt federal and state governments from the silver tsunami of 76 million baby boomers reaching their golden years in the next two decades.

Projected medical costs for a morbid, aging society spiral upwards, while all signs point to the fiscal cliff American lemmings are headed for. To be blunt, the bankrupting costs from abysmal health of our nation are caused by the American Way of Life, (AWOL). Focusing on creating health, not treating the symptoms would fill the holes we’ve been pouring money into.

Conventional medicine enjoys a lucrative monopoly on health care in the untied states without producing acceptable results. Most proposed fixes only pay for treating epidemics of chronic illnesses and preventable injuries. And then we die, when a natural event is milked for maximum expense.

Americans’ poor health is not primarily the fault of allopathic medicine, but they profitably treat the symptoms of a sick and toxic society. The enormous expense of conventional medical treatment has funded politically powerfu interests opposed to systemic change. The medical industry employs more than 14 million Americans, four times the automobile industry. It's one-fifth of the economy, bigger than the military industrial complex.

Reducing their profits promotes the general welfare, while squeezing an influential chunk of the economy. Illness is their white bread and trans-fat margarine. An array of hospital, physician and medical profession associations, private insurance companies, pharmaceutical and medical supply corporations, mainstream media and advertising/PR conglomerates, government regulators and legislators, along with a slew of academic, scientific, business professionals, and industry funded consumer groups stand opposed to systemic health care reform.

Any hope of improving Americans’ health will have to weave through the warp of their intertwined interests. It couldn't hurt to click your heels together three times while visualizing UHC, but only an alliance of public health educators, alternative and integrative medicine practitioners and im-patient citizens will succeed in cutting through this Gordian Knot while running with sharp scissors.

2

A Short History of Health Care Reform

All reforms proposed by politicians have been shaped by the demands of the major stakeholders, whose profits depend on the current system. Hilary Clinton and her health policy consultant, Ira Magaziner tried to reform health care in 1993 after her husband Bill was elected President. They led private meetings with a group of stakeholders and decided regional Health Maintenance Organizations would control costs if they were given near monopolies to provide medical treatment and compete with insurance companies.

President Clinton abandoned the health care reform battle to belly butt a reluctant Democratic majority Congress into passing the NAFTA trade deal that fall. Jeff Faux reported he was serving his centrist corporate campaign funders and powerful backers in The Global Class War. Clinton betrayed the union supporting Democratic base and his wife's health care efforts. Hilary wrote, Loyd Bentsen, (then Treasury Secretary), Secretary of State Warren Christopher and economic advisor Bob Rubin were adamant about postponing health care reform and moving forward with NAFTA in her memoir. That was the devil's bargain the financial industry demanded from the man they brung to the dance. William Jefferson Clinton knew the Wall Street Waltz backwards.

That fall, the unions, devoted Democrat donors and grassroots supporters were squandering their resources in a futile battle against NAFTA. This free trade agreement would create a giant sucking sound as Ross Perot described it, of union and non-union manufacturing jobs siphoned across northern and southern borders. Unions turned off the spigot for their National Health Care Campaign just as opposition forces rolled out the big guns. HilaryCare, code named Health Security, crumbled after the insurance industry frightened the voters with television ads featuring their common couple creation, Harry and Louise were the public face of the insurance industry to confused television viewers.

Major manufacturing industry CEO's were pressured by insurance companies to dam health care reform. HilaryCare had been designed to provide financial relief from labor costs due to rising medical insurance premiums. A car made in Canada cost $1,000 less than one from Detroit because of their publicly funded national health care program. In the end, country club class solidarity won out over corporate profits in the fight against socialized medicine.

Newt Gingrich led Republicans to a majority in the House for the first time in forty years in 1994 by pledging a Contract for America. Their victory was due to Bill's lunge to the right on NAFTA and stirred up outrage over Hilary's stillborn plan, not some rarely remembered 12 point plan. Clinton had betrayed his blue collar and green beanie base, promising non-enforceable side agreements to protect worker and environmental rights. They stayed home, ceding the mid term elections to the enraged Republican base and middle class swing voters.

Later that decade, regional HMO's achieved near monopoly status, briefly slowing costs by squeezing doctors, customers and hospitals. Media fueled outrage over their denial of doctor choice and executive salaries was led by physician associations and Big Pharma, eroding HMO hegemony into a free style mudslide.

The Massachusetts plan was passed by their Democrat majority state legislature in 2006 and signed by Republican Governor Mitt Romney. He had little to do with crafting it, although its ideological origins began with Republican market driven, private sector solutions from the Heritage Foundation. Fine tuning was left up to the usual cabal of stakeholders. It was only called RomneyCare later as a rebuttal to the ObamaCare epithet when they ran against each other in the 2012 election. The seed for this book was planted then, when I was living in the Bay State, with a letter to the local paper proposing how to pay for Universal Health Care.

That plan has been shedding previously eligible residents and reimbursed treatments to shave expenses ever since. The Massachusetts law was originally promoted as a way to contain costs as well as expand coverage. As people became insured they would use primary care physicians instead of more costly ERs. As cost continued to grow rapidly, the stated rationale changed. The intention all along was just to get everyone insured and deal with costs later.

Most Massachusetts residents now have insurance, but premiums, deductibles and co-payments increased so much that some can't afford to use their insurance. Massachusetts now spends more per capita on health care than any other state. Residents are measurably healthier, but medical spending consumes over half the state budget at the expense of education, public safety, human services and infrastructure. That was a predictable arc for ObamaCare.

This rough beast began shambling in following Barak Obama's Hope and Change fueled 2008 election. Before he began campaigning to become Illinois Senator in 2003, Osama was for Single Payer, a universal health Insurance plan with everyone in, no-one out. Back then America spent 14% of GDP on medical costs, but cannot provide basic health insurance to everyone. He backpedaled even during that campaign, to some kind of public/private hybrid White House correspondent, Bill Press relates in Buyer's Remorse: How Obama Let Progressives Down.

The White House insiders tell all book Confidence Men by Ron Suskind, mainly focuses on the Obama Team's attempts to stimulate the economy without reining in Wall Street. Suskind also details how the best of technocratic health care reform intentions were wrecked on the boulders of medical industrial lobbyists pursuing short sighted, financial interests. He delivers an insiders view of the conception and delivery of the Affordable Care Act, or ObamaCare as it was christened on birth.

Peter Orszag was Clinton's senior economic advisor, and kept on as Bush's Congressional Budget Office head. His 2008 report on reforming medical finances pointed out the vast inefficiencies in the financial catastrophe of medical costs. He accepted Obama's offer to head Office of Management Budget with the agreement that health care reform was going to be done. There are few rooms where he's not the smartest guy in it, even though Obama filled his conference rooms with several claimants to that crown.

Orszag was enamored with the Medicare and Medicaid studies of Jack Wennberg, a professor at Dartmouth College in New Hampshire. Wide variations in the rates and costs of common medical procedures are performed around the country, even between neighboring counties, with no evidence that patients benefit from their higher use or price. Wennberg showed that the number of specialists in an area drove the rate of procedures done by that specialty. Wennberg was treated as a dangerous heretic for years by America's medical papacy, until his findings were acknowledged as indisputable.

Orszag was obsessed with this evidence based cure for rising medical costs. The Dartmouth studies had shown $700 billion a year in cost savings if practice variations were corrected. Ending Medicare/Medicaid reimbursements for these procedures would pay for expanded universal coverage, but Orszag couldn't get this in the final package because of physician and hospital organized opposition. He threw his weight behind deficit reduction along with most of Obama's economic advisors, instead.

Massachusetts Institute of Technology economist Jonathon Gruber was a more influential advisor than Orszag. Congratulating College of the Holy Cross graduates in 2010, he said The only way we we're going to stop our country from becoming a latter day Roman Empire and falling under its own weight is to get control of the growth rate of health care costs. The problem is, we don't know how. He wasn't about to drive across the state line to Dartmouth.

That didn't stop him from crafting ObamaCare's economic model of subsidizing insurance for lower income Americans, while sharing more costs with patients. They were to become consumers of health care, calculating complex ratios of premium prices vs how much they would have to pay out of pocket for treatments and providers. Gruber derided these same consumers intelligence in an interview after it passed, sneering voters were stupid to blindly accept ObamaCare.

Matt Taibi had a different take on the political process of the bill’s drafting when a public option, single payer or Medicaid for All failed to make it into the ACA. President Obama provided limp leadership, even though it was part of his campaign platform. He "acted like a man still running for president, not someone

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