Health Care Talking Points *For When They Tell Us We Can’t Afford Universal Health*

[McCamy Taylor]

I. Know the Enemy: The MEDICAL INDUSTRIAL COMPLEX

Did you know that there is something bigger and meaner and more ruthless than the Military Industrial Complex? The Military Industrial Complex plays upon our fears of foreign threats to encourage us to stockpile weapons we may never need while discouraging negotiations that could bring lasting peace. It’s a big waste of money, but it does not to result in harm---unless some village idiot president out of Texas decides to use the stockpiled weapons.

The Medical Industrial Complex exploits our fear of sickness and death to create new, expensive often ineffective sometimes dangerous treatments which are foisted upon us while preventive care that might actually keep us healthy is denied all in the name of corporate profits

Sound like the stuff of science fiction? Read on.

http://www.edwardgoldsmith.com/page191.html

Today the same can be said for America's health policy. If anything, the 'medical industrial complex' as it is increasingly referred to, is even bigger and more powerful than the military industrial complex. Its turnover is massive. A small group of companies that make medically-related machines and drugs and sell health services, is responsible for fully a third of the $600 billion spent on the nation's health in 1989.

Their influence on decision-making is obviously enormous, exerted in such a way as to ensure health policies are no longer necessarily taken in the interest of improving the nation's health but "in the interest of increasing sales, maximising efficiency and containing costs". To satisfy these requirements the accent is on maximising expenditure on technological interventions, regardless of their ineffectiveness.

Not surprisingly, the cost of medical care in the US goes up from year to year. Today it adds up to almost 12 percent of the gross national product. By the year 2000 on current trends, some 15 percent of gross national product will be spent on high-tech medical care. The fact that it goes on increasing in this way suggests that it is very ineffective and that, in spite of the billions spent on it, the health of the nation continues to deteriorate.

II. “Just the Facts Ma’am” Alarming Statistics About America’s Ailing Health Care System


Fact : The United States spends more person per year than any other country for health care under our current health care is a luxury not a right system . We spend $5,267/year per person which is over 50% higher than any other country on earth. Switzerland is the next most spendthrift country. Most other countries with universal health care, like Canada, France, Great Britain spend half as much per citizen per year.

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=283969

The above article compares waiting lists and medical resources such as CT scanners, nurses, doctors, hospital beds and finds that the countries with more efficient universal health care systems actually have more health care resources and many of them do not have longer waits and the people have better access than they do in the United States. So, why is health care so much more expensive in the U.S.? The authors suggest that one reason might be because health care services are overpriced in the unregulated United States health care system.

Fact: The United States ranks at the bottom of industrialized nations on a list of health indicators (even though we spend twice as much for health care per person) . You read that correctly. We pay exorbitant rates for shitty healthy care in this country. While the people in France are getting a Cadillac, we are getting a rusty old Vega.

Here is a Commonwealth Fund study which shows that the U.S. ranked last among 19 industrialized nations in tackling the problem of preventable death----deaths caused by disease which could be prevented with proper health care. Be sure to check out the graphs. Maybe we should all print them out and show them to the next person who tries to tell us that universal health care is scary . Death is scarier, and the authors estimate that 100,000 lives per year could be saved if the United States copied the (cheaper) health care practices of some of these other countries.

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=640980

How about infant mortality? Don’t ask unless you want to hear the answer.

Infant mortality in the United States is still higher than in many other industrialized countries, with progress stalling this decade, the U.S. government said on Wednesday.
The United States ranked 29th lowest in the world in infant mortality in 2004, the latest year for which comparative global figures were available, the U.S. Centers for Disease Control and Prevention said in a report.

This extends a worsening trend for the United States in global infant mortality rankings. The 2004 ranking compares to 27th in 2000, 23rd in 1990 and 12th in 1960, the CDC's National Center for Health Statistics said.

"Infant mortality is one of the most important indicators of the health of a nation, as it is associated with a variety of factors such as maternal health, quality and access to medical care, socioeconomic conditions and public health practices," the report said.

http://www.nlm.nih.gov/medlineplus/news/fullstory_70500.html

And look at where we rank on child death rates. Just ahead of Poland and eastern European countries.

http://www.mindfully.org/Health/2007/US-Death-Rate1may07.htm

Most distressing of all, life expectancy is actually stagnating or decreasing for 19% of U.S. women in selected economically disadvantaged regions of the country, including Appalachia, the South and Texas. Researchers believe that this is a result of increased smoking, obesity and lack of access to health care. For life expectancy to decrease in time of peace is almost unheard of in an industrialized country.

http://www.imaginis.com/breasthealth/news/news5.27.08.asp

Take away point: the US spends twice as much per person per year on health care to get results that put us at the bottom of industrialized nations in terms of overall health.

So, when a lobbyist or a Republican says We can’t afford universal health insurance right now you snap back We can’t afford not to change our health care system right now .

Trimming our health care expenditures by 7.5% of the GNP would be a tidy bit of cash.

III. What Are They Doing Right (And We Doing Wrong?)

They (countries which offer comprehensive cradle to grave universal health insurance) inevitably begin to realize that they can keep their citizens healthier----and costs down----by taking measures to prevent diseases. These measures include early childhood interventions to promote exercise and prevent obesity, programs to discourage smoking, environmental cleanup, family planning services among others. All of these are relatively cheap compared to the medical problems they prevent like AIDS, emphysema, heart disease, diabetes, stroke.

These measures are resisted by the Medical Industrial Complex, which stands to lose money as people become less sick.

From the first link above, the one about the Medical Industrial Complex.

Aaron Wildavsky of the Graduate School of Public Policy, University of California, considers that "the medical system (doctors, drugs, hospitals) affects about 10 percent of the usual indices for measuring health". This means, as Ross Hume Hall notes, that "90 percent of all illness is unaffected by high-tech. medicine".

The problem is what Aaron Wildavsky <2> calls "the great medical equation: medical care equals health". The truth of the matter is the best way to assure the health of a nation is not by spending money on high technology health care but by creating those social and ecological conditions in which the incidence of disease is minimised. In the 19th century the accent was on prevention and it was very effective. As Ross Hume Hall notes,

"the engineering of sanitary sewers and public water mains were the major factor in wiping out tuberculosis, cholera and typhoid, the major causes of death in the 19th century."

But prevention does little to satisfy the short-term economic requirements of the medical industrial complex.

In other words, the Medical Industrial Complex wants you glued to your television set, an unfiltered Camel in one hand, a beer in the other, a plate of nachos balanced on your knee. The Medical Industrial Complex salivates when it sees young men and women having unprotected sex. The Medical Industrial Complex knows that smog means full hospital beds and lots of requests for durable medical equipment.

As long as we maintain our current system, it will pay to keep Americans as sick and as miserable as possible. As long as every single elderly American is fully insured by Medicare but tens of millions of young working Americans have no access to preventive health services, our country will continue to pay tens of thousands of dollars per person to treat the end stages of years of neglect of conditions that could have been controlled with a little diet, a little exercise, a little counseling----to the delight of the companies that make the pills and the heart catheters and the MRIs and the surgical tools and the schools that turn out the cardiothoracic surgeons.

For the want of the nail, the war was lost. For the want of a cholesterol check, you life was lost.

IV. Won’t We Have to Increase Our Public Spending on Health Care A LOT ?

Even now, the Republicans are accepting money to filibuster health reform legislation in the Senate. Lobbyists for the health insurance and medical technology industries have their arguments ready. Universal health care is socialized medicine It will bankrupt the economy. We can not possibly spend as much public money as the countries in Europe do on health care----

Guess what? We already do.

http://www.infoplease.com/ipa/A0934554.html

Look at that! We spend more public funds (as a percent of our GNP) than either Canada or Italy on health care. My mom got run over by a Vespa in Italy. When she went to the ER, they did not ask for an insurance card. She got state of the art medical care---and no bill.

We spend more public money on health care in the U.S. than they do in Italy, but if she was run over by a scooter here, the first thing they would ask when they wheeled her through the hospital emergency room door would be "Can we have your driver's license and your medical insurance card?"

We already spend the money. All we have to do is spend it in a sensible way.

If the billions of dollars that are currently being wasted on the treatment of preventable disease could be spent on a coordinated program of illness prevention, we could insure more people, keep them as healthy as they do in places like France and save a bundle on premiums to health insurers who collect money from people who never get sick.

United Health, Pfizer and HCA are among those hoping that health care reform dies a grisly death in the U.S. Senate next year just like it did in Bill Clinton's first term---otherwise they may see 6-7% of the nation's wealth slip through their fingers.

V. Because You Read All the Way Through This, From Monty Python, the Machine that Goes "Ping:

http://www.youtube.com/watch?v=lxOu1DyVQV8

[yardwork]

1. k&r

[Cleita]

2. K&R

I'm on the frontlines of this. Thank you so much.

[liberalhistorian]

3. Thanks for posting, this has always

been a major issue for me and a cause for which I'm quite passionate!

[babylonsister]

4. Thanks, and do you have any advice for this person?

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x4429751

[HowHasItComeToThis]

5. WATCH " WHY WE FIGHT"

IT WILL OPEN YOUR EYES

HEREIT IS http://www.sonyclassics.com/whywefight/

[PATRICK]

6. The main economic argument

I see is that you will throwing a lot of useless middleman jobs into unemployment. The actual money spent can go down drastically even in an inefficient government single payer system. The overall effect on the economy would be enormous and psychologically uplifting. Arguments to the contrary are mainly those espoused by those leeching off this vital human need, just like anti-union arguments always come from the owners.

As our newly elected Rep. Massa(NY-29) says, the controversy is mainly gone in actuality since we will own a lot of this private money management structure already via the Wall St. collapse and bailout.

One guy at the knife fight has dropped his knife and the massively defeated corporatists want us to pick it up, sharpen it, hand it back and politely wait for them to make the first strike. The opportunity for single payer health is really a necessity for the health of the entire American economy. What better way to begin than to begin?

[eridani]

7. In only one case does the insurance industry actually add value, and by sheerest coincidence--

--that is exactly the function that requires the largest number of warm bodies. I mean claims processing. We can preserve a lot of employment if claims processors either work for the government or are regulated by the government, because the government can flat out FORBID outsourcing.

[PATRICK]

9. Bravo

but what about the CEO's? I think we could extend pay to candy stripers for cleaning bed pans and enlist the aid of out of work CEO's to increase the ranks.

[McCamy Taylor]

11. They have seen the writing on the wall and they are trying to peddle their scam in developing

countries in South America, Africa, India, China places like that.The health insurance companies are moving in to peddle their products while the tobacco companies and soft drink manufacturers (who work together with the Medical Industrial Complex) have moved in to peddle chronic disease. Once they get obesity and vascular disease and diabetes on the rise in those countries (aided by toxins, chemicals, environmental pollutants) , they hope to rip off those other populations, because they know that sooner or later the U.S. is going national health.

[McCamy Taylor]

10. Medicare is the cheapest claims processing organization the country. Their overhead is lower than

any private insurance company around.

[eridani]

12. Yes--they only have to pay claims processors

No profits, no underwriting, no outrageous CEO salaries. We can keep private claims processors working, sez I.

[snake in the grass]

8. Thank you for compiling this.

[The Doctor.]

13. I'm working on it, I'm working on it....

Gimme a few more years.

[newtothegame]

14. "We already spend the money. All we have to do is spend it in a sensible way."

I believe that goes for all current taxes.

[planetc]

15. And also, thank you for the Python clip

It was delicious. The hospital administrator was perfect, and the doctors were superb, and I think the mother and baby survived.

So now they're going to say we can't afford to lose the "health care" jobs? This is an outstanding case of misplaced sympathy. We had no sympathy for the outsourced jobs in dozens of other industries, but our sympathy for insurance processors must govern national health care policy? Gimme a break, as it were.

And after we've seized ownership of the health care industry, let's retrain any medical secretaries who want the training as nurses and aides. Last time I was in the hospital, I never saw a nurse, who all appeared to have morphed into lower level administrators, but had fine care taken of me by the aides, who seemed to actually like people, and to enjoy helping them out. I'm not quite sure what to do about doctors, but there are many fine ones out there, and perhaps they could retrain the others.

If in fact we're all dying anyway, slowly or quickly, let us organize our health care for the maximum comfort and ease of us, the customers, the consumers. Tell us how to maintain the health we were born with, fix our broken legs if they occur, and the rest of the time, get out of our way as we try to extract as much meaning and beauty from our short lives as we can. (Yes, I know there are diseases and conditions that require long treatments, some of them expensive, but if we just get the insurers out of the picture, we can probably afford to do whatever we need to do.

And can we have some dental and eye care and some in-home care for the elderly who need a little help caring for themselves?

Excuse me while I just jot down a note to Sen. Obama, with a copy to Mr. Emmanuel.

[FatNSassy]

16. Obesity is a Scapegoat

I think this was a great article. BUT, as a sociologist who has researched the stigma of obesity for decades, I must take exception to the assertion it is obesity that is shortening our lifespans. The scare studies concerning obesity are bought and paid for by the weight loss industry. The American and International Obesity Association members are a who is who of diet companies and pharmaceuticals. What the public does not realize is that there has never been a diet pill that has not caused harm to some part of the population who used it. Guess what. That gets counted under obesity, NOT risky weight loss practices. Furthermore, in industrialized societies obesity is associated with poverty. But studies rarely control for social class. So the effects of poverty on health often get counted under obesity. The purpose of the studies is not good science, but marketing. They want to scare people into buying pills. Then they use the side effects of the pills as further evidence how unhealthy obesity is TO SELL MORE PILLS.

Furthermore, carefully done studies have shown that exercise alone can give all the benefits weight loss does. It is a cultural myth in our society that one can't be fat and fit, or if we were living "healthy" lifestyles, we would all be thin. The problem is exercise is free! There is just not as big a profit for corporations if we all started walking instead of using our cars. So they insist everyone needs to be one certain weight (and they lowered the standards a few years ago to sell more pills) to keep their profits flowing! If obesity was really shortening life, how come Australia has overtaken the U.S. as the world's fattest nation (allegedly) and they have the second best longevity in the world, second only to Japan?

If anyone is truly interested in getting both sides of the story vs. repeating propaganda, I would recommend "Big Fat Lies" by Glen Gaessar. He is an exercise physiologist who believed fat and fit were impossible until he started doing some research....

[McCamy Taylor]

19. Depends upon how you get your weight. No exercise, too much unhealthy food is the bad way.

Farmers who eat a balanced diet and who work hard all their lives can afford to carry extra pounds, and indeed women farmers need to carry extra pounds as they enter middle age in order to build up their bone mass so that they do not get osteoporosis and bone fractures as they go about their work.

However, I think that the women they are talking about, the ones whose life expectancies are decreasing are sedentary women who smoke and who eat a diet that is high in processed, saturated fat and low in vegetables and probably not especially high in protein. Plus, their stress level is high, because they live in poverty in a land of affluence, so they suffer the medical complications of income disparity which causes depression, anxiety, increased family violence as well as an increased risk of alcohol and drug addiction in themselves and family members. They may even have eating disorders secondary to their income disparity induced problems. Or, they may just be eating the cheapest foods they can find which are often greasy.

Being told "You are not even deserving of good health" is a pretty nasty blow to a human being who lives in one of the richest countries in the world. When we enact universal health, it will be a bit like electing Obama---a whole bunch of people who have been on the outside looking in will suddenly say to themselves "Now I belong, too!"

[JDPriestly]

24. It's a combination of inaccessible health care and stress that reduce our life expectancy.

Many people eat to alleviate stress. Others take drugs to alleviate stress. Thus, their is a statistical link between early mortality and stress as well as excessive drug use. What causes what? Not always clear, but certainly exercise alleviates stress and prolongs life.

Generally, in our society, obesity is considered ugly. That's just the way it is. Social ostracism of the obese is good if it encourages people to exercise. Fat and fit, of course, is possible. Lots of people who do very hard physical labor are overweight. Depends on the degree of the obesity.

I personally know a person who is so obese that she could barely get to work and had to have accommodations in her workplace. Naturally, when her employer decided to lay people off, she was among the first to go. It was very sad, but that is the reality of it.

My father died of the result of complications of his obesity. Doctors will tell you that obesity increases the risk of surgery. Obesity makes exercise difficult. Extremes are not good. Morbid obesity is extreme and not good. Sorry. That's just a fact. I've seen it in my family. The fat die first.

[AllyCat]

17. Thank you! I need stuff like this everyday.

I'll send this to a number of coworkers as we prepare to renegotiate our union contract at our hospital.

[Overseas]

18. K&R -- thanks for the compilation

I appreciate your having pulled together all the reasons in favor of national health care.

The tired old myths are trotted out again and again by our legislators who get lots of large donations from the medical industrial complex and have government supplied PPO-type health insurance for themselves.

THey pretend that "people like to choose their own doctor" -- but two of my favorites weren't on my HMO.

They pretend that "It'll be awful like the UK where you have to wait months for treatment," as though we haven't called for appointments to HMO doctors and been told nothing is available for months.

Those are the two big ones.

And I'm hoping that since the election was a large majority for what the Right was calling "socialist" that we can go right ahead with "socialized medicine."

GLAD TO HAVE THOSE GLARING STATS TOO FEW OF OUR LEGISLATORS MENTION -- that our health is worse than other countries with the dreaded "socialized medicine" in many measurable ways. All that money and all that frightening financial insecurity over medical bills and we are sicker than the countries smart enough to provide national health care.

[vinylsolution]

20. The Medical Industrial Complex....

... is as gluttonous and wasteful as the Pentagon.

If we could trim just a small fraction of the Pentagon's colossal waste, we could easily afford universal healthcare.

Specifically health CARE, not health coverage. An important distinction.

[Beartracks]

21. K & R..... n/t

[restored386]

22. another example

consider circumcision, as every country that has medical services based on overall costs have dropped circumcision coverage (and thus the circumcision rates have declined). since the U.S. has a for profit system the prcedure is very attractive, $300-$500 for 15 minutes of work on a patient who essentially can never sue because he will never be able to say he truly knows what he is missing in a court of law

this procedure has been disproven on every medical benefit on a cost/risk versus risk basis (I did mean to have risks on both sides because there are risks on both sides, and the risks associated with circumcision are there) however if a circumcision does cause complications, no problem we can charge you for surgeries or viagra to fix/ help alleviate the problems

[truedelphi]

23. The article states this - and I want to point out a flaw

Article states:
We spend $5,000 Plus dollars per person per year.

This is an underestimate of what the average person in their fifties spends.

We have to HOPE we can even find an insurer because of our pre-existing conditions.


Then our insurance premiums may well be about $ 500 a piece. So we are spending
around $ 12k a year - just for insurance.

Then there are the co-pays and the medications that are not covered. And if our HMO is lousy, we need to go to specialists that the HMO won't allow (though technically you can sue to recoup those expenses, at the height of an illnes you might forget)

So the $ 5 K figure seems like a bargain to me!!

[D-Lee]

25. Great post -- but some "preventive care" concepts are also questionable

So much scientific research is either poorly designed or questionable.

I'll just give a couple of links.

Here is an analysis by an independent MD of some of the questionable aspects of the recent research report claiming statins have multiple health benefits: http://www.proteinpower.com/drmike/cardiovascular-disease/1853/

Here is another analysis of the same study by a very bright lay expert: http://diabetesupdate.blogspot.com/2008/11/should-you-be-taking-statin-what.html

This post criticizes the Bush "de-regulated" FDA drug approval process: http://diabetesupdate.blogspot.com/2008/10/why-this-election-matters-fda.html

And this book is wonderfully written:
Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen

Junk science is more prevalent than one might think ...

[McCamy Taylor]

26. There is also junk science to prove Coca-Cola is good for you and cigarettes are not addictive.

And that guns wont kill you. The medical industrial complex makes out like a bandit treating our lack of prevention (smoking is a big cause of preventable death, if it was just flat out banned our costs would go way down---and so would medical profits). Health care should be about seat belts, gun safety (which is not the same as banning all guns anymore than auto safety is about banning cars), no smoking, safe drinking, good nutrition, exercise, safe sex, all starting in adolescence when people develop their habits.

[Willo]

27. Kick (too late to rec) nt

[fed_up_mother]

28. Great article except for the part on infant mortality

Our infant mortality is not nearly as dire as those statistics would indicate.

We attempt to save many more babies than the rest of the world. If a baby dies after a month in the neonatal unit, or even a few days, that is counted as an "infant mortality" which brings up the mortality rate considerably. In other countries, some of these same babies are conidered miscarriages, and I believe some countries don't even include babies that die in the first couple of days as infant mortality.

By the way, I am a strong supporter of single payer, universal healthcare. I believe healthcare should be a fundamental right in any civilized society. And I totally agree with you "We already spend the money. All we have to do is spend it in a sensible way" !!!

[McCamy Taylor]

30. Black infant mortality higher in some urban areas than in Jamaica!

Infant mortality among African-Americans in the United States is at a crisis level. And it is not a result of bad habits or bad lifestyles as some would like to believe. My own research has lead me to believe that there are numerous factors at play including 1) asthma (higher among African-Americans) which is exacerbated because of all the ozone and pollution in the areas where urban Blacks traditionally live 2) environmental toxins esp. PCBs which have been linked to preterm delivery a big cause of increased infant mortality in Blacks which pollute the nations waterways and ground again with increased dumping and pollution in minority areas 3) income disparity which leads to increase in chronic stress which causes hormone changes and other health problems that can have a negative impact on pregnancy.

President Obama needs to (finally) shine a great big spotlight on this nation health emergency. If we continue to let Black infants be born premature, we doom them to a lifetime of ills.

African-American infant mortality has been shown to be higher among college educated women than among women without a college education in studies in Fort Worth, a hot zone for the problem. This ought to be a clue that there is more going on than just "lifestyle" factors or lack of access to health care. There are medical factors at play that no one wants to identify. I believe this is because they are environmental factors that would force local and state governments to clean up toxins. College educated women are more likely to get out of the home and spend time in areas that have higher amounts of car exhaust, smoking and have more exposures to other toxins on the job since they are almost certain to work.

[fed_up_mother]

32. What we can say is that black infant mortality is higher than white infant mortality

here in the U.S, and that the disparity is pretty great. However, again, we don't use the same measuring stick as Jamaica. How many first class neonatal units does Jamaica have? Not many, I would imagine. How many babies do they attempt to save with intensive critical care as opposed to let die at birth? See the difference?

When my child was in the neonatal unit for three months, I searched out this topic very much because I too was alarmed at the statistics, and found out the more babies a country tries to save, the higher the infant mortality rate will be because they won't be counted as spontaneous abortions. As sucky as our healthcare system is, and although it's horrible that many women don't get proper prenatal care, once that infant is born he will be given the same lifesaving treatment in a neonatal unit as a "paying" infant. When my child was in the neonatal unit, fully half of the infant patients weren't "paying." As I sat there day after day, I know the doctors and nurses cared for every baby with as much dedication as the next baby. :)

And, yeah, stress can significantly affect the outcome of a pregnancy. I know firsthand. :(

Peace.

[dixiegrrrrl]

29. We need a system of affordable health care, NOT mandatory insurance.

No "privatizing" of health care that rewards insurance and other providers at the expense of quality or need.

The home/health/car insurance industry has already proven it will not provide the
service that premiums are supposed to pay for.

[McCamy Taylor]

31. Agree. Here is what will happen if we force everyone to buy private health insurance.

If the government offers cash or tax breaks so that everyone can sign up with BlueCross or UnitedHealth....

BlueCross and UnitedHealth only make money when they get to cherry pick healthy people, take their money as monthly premiums and tell people with pre-existing conditions like diabetes, high blood pressure etc. to take a hike. So, the first thing that private insurers will negotiate for is the right to take all the healthy people and force all the rejects onto some type of government high risk insurance program. This will result in a windfall for the privates, while the taxpayers will sink deeper into debt paying for the sickness which will result from the neglectful care that people will receive from their private insurers who will not bother with preventive care---why should they? As soon as their members get really sick, the privates will find a way to squeeze them off the plan (by forcing them to travel long distances to see a specialist or restricting their drug choices, saving themselves a lot of money. And so we will continue our present system of no prevention and everyone ends up old and sick and the Medical Industrial Complex makes out like a bandit with the bill paid for by Medicare and Medicaid.

If the feds are smart and do not allow the health insurers to cherry pick, then they will begin restricting services right away. This will drive the sick people off their plans and onto the government sponsored plans immediately.

The only way to incorporate private health plans is to offer one of them the chance to become part of the government team forever . That would have to be someone like Kaiser, which has already demonstrated a willingness to enact preventive strategies. The others would have a chance to remodel themselves into preventive health networks---or they could move overseas and peddle their products in India and China.

[DU GrovelBot]

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34. K&R

It cannot be fixed with the insurance companies calling the shots - period.