The DISH

Unbossed and unbought news and information you can use

Vol. 12 Issue 21…Dedicated to the Dialogue on Race…May 25, 2009

Hood Notes

US Lags in Health Care

By Lorraine Lilja

Although we like to think of ourselves as world leaders, we are way behind in health care. We'll be hearing a lot about it in the weeks ahead.

According to the Institute of Medicine of the National Academy of Sciences, the United States is the only wealthy, industrialized nation that does not provide universal health care.

In the 1880s, most citizens in Germany became covered under the mandatory health care system championed by Otto von Bismarck. The National Health Service (NHS) was established in the United Kingdom in 1948.

The World Health Organization rates France with the best overall health care among major countries, followed by Italy, Spain, Oman, Austria and Japan.

The French system is not inexpensive. At $3,500 per capita, it is one of the most costly in Europe, yet that is still far less than the $6,100 per person in the United States. That's because the French share Americans' distaste for restrictions on patient choice, and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new health-care funds.

Sécurité Sociale freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled U.S. counterparts envious. However, the average American physician earns more than five times the average U.S. wage, while the average French physician makes only about two times the average earnings of his or her compatriots. But practice liability is greatly diminished, and medical schools are tuition-free. Thus, French physicians enter their careers with little if any debt and pay much lower malpractice insurance premiums.

The French system strongly discourages the kind of experience rating that occurs in the United States, making it more difficult for insurers to deny coverage for preexisting conditions or to those who are not in good health. In fact, in France, the sicker you are, the more coverage, care and treatment you get. Would American insurance companies cut a comparable deal?

Economists estimate that between 25 and 45 percent of the U.S. labor force is now job-locked. That is, employees make career decisions based on their need to maintain affordable health coverage or avoid exclusion based on a preexisting condition.

With the problem of the uninsured Americans continuing to grow, states have taken the lead in developing proposals to reform their health-care systems with the goal of significantly increasing the number of people with health-care coverage. Three states, Maine, Massachusetts and Vermont, have enacted and are implementing reform plans that seek to achieve near universal coverage of state residents.

Bit of History

Althea Gibson (1927-2003)

The daughter of sharecroppers, Althea Gibson was born on August 25, 1927 in Silver, South Carolina. Raised in Harlem, New York City, where her family lived on welfare, Gibson was a client of the Society for Prevention of Cruelty to Children. Gibson had a troubled childhood. Often in trouble at school and truant, she frequently ran away from home.

Despite her troubled home life and problems in school, Gibson excelled in horsemanship; she competed in golf, basketball and table tennis. She won a number of table tennis tournaments sponsored by the Police Athletic League and the New York City Department of Parks and Recreation.

Musician Buddy Walker noticed her playing table tennis and introduced her to lawn tennis at the Harlem River Tennis Courts. Dr. Walter Johnson, a Lynchburg, Virginia, physician who was active in the black tennis community, helped with her training. Through donations raised for her membership and lessons, Gibson became a member of the Harlem Cosmopolitan Tennis Club, a club for black American players. By 1942 Gibson had won the girls' singles event at the all-black American Tennis Association's New York State Tournament. The ATA provided tournament opportunities not otherwise available to black American tennis players. In 1944 and 1945, Gibson again won ATA tournaments.

With the assistance of a sponsor, Gibson moved to Wilmington, North Carolina in 1946 for tennis training, and in 1947 at the age of 20, she won the first of 10 consecutive national championships run by the American Tennis Association.

At age 23, Gibson finally got the opportunity to compete in the 1950 U.S. Championships following an editorial by Alice Marble that appeared in the July 1, 1950 edition of American Lawn Tennis Magazine. According to Marble, "Miss Gibson is over a very cunningly wrought barrel, and I can only hope to loosen a few of its staves with one lone opinion. If tennis is a game for ladies and gentlemen, it's also time we acted a little more like gentle people and less like sanctimonious hypocrites.... If Althea Gibson represents a challenge to the present crop of women players, it's only fair that they should meet that challenge on the courts." Marble said that if Gibson were not given the opportunity to compete, "then there is an uneradicable mark against a game to which I have devoted most of my life, and I would be bitterly ashamed."

Gibson continued to improve her tennis game while pursuing an education. In 1953, she graduated from Florida A&M University on a tennis and basketball scholarship and moved to Jefferson City, Missouri to work as an athletic instructor at Lincoln University.

Gibson won the 1955 Italian Championships. On May 26, 1956, Gibson won her first Grand Slam title, capturing the French Championships in singles and in doubles with her partner, Jewish Englishwoman Angela Buxton, who had faced discrimination from other players and the tennis establishment similar to those experienced by Gibson.

Over the course of her amateur career, Gibson won 56 singles and doubles titles. She won 11 major titles in the late 1950s, including single's titles at the French Open (1956), Wimbledon (1957, 1958) and the U. S. Open (1957, 1958), as well as three straight doubles crowns at the French Open (1956, 1957, 1958).

n 1957, she was the first black to be voted by the Associated Press as its Female Athlete of the Year. She won the honor again in 1958. In 1958, Gibson published her autobiography, "I Always Wanted to Be Somebody." After winning her second U.S. Championship, she turned professional. One year she earned a reported $100,000 in conjunction with playing a series of matches before Harlem Globetrotter basketball games.

There was no professional tennis tour in those days, so Gibson turned to the pro golf tour for a few years, without much success. She worked as a tennis teaching pro after she stopped competing.

Gibson became New Jersey State Commissioner of Athletics in 1975, a post she held for 10 years. She then served on the State's Athletics Control Board until 1988 and the Governor's Council on Physical Fitness until 1992.

On September 28, 2003, at the age of 76, Althea Gibson died in East Orange, New Jersey due to respiratory failure and was interred there in the Rosedale Cemetery. On the opening night of the 2007 US Open, the 50th anniversary of Gibson's victory at the U.S. Championships in 1957 (now the US Open), Gibson was inducted into the US Open Court of Champions. She is a 2009 inductee of the New Jersey Hall of Fame. (Sources: www.aaregistry.com, www.altheagibson.com, and http://en.wikipedia.org/wiki/Althea_Gibson)

Caught by Surprise

By John Burl Smith

Anticipating President Barack Obama's new Healthcare plan, a vision which is supposed to improve America's healthcare system and make its delivery affordable for all citizens, most Americans are hoping for a resounding success. The President said recently, "This past week brought us closer to health reform: a coalition of organizations pledged to reduce the annual health care spending growth rate by 1.5 percentage points and save more than $2 trillion over 10 years, and leaders in the House of Representatives have committed to voting on health reform legislation this summer." However, the desire for a single-payer system, which will reduce cost and increase access, does not seem to be on the table. The promises of the 2008 campaign have faded for most Americans, as promises to gain acceptance of the Grady privatization plan are broken.

Grady Memorial Hospital in Atlanta, Georgia is a prime example of how business interest and the well-to-do profit from broken promises to those at the bottom. During segregation, blacks had to use the back door, if they got service at all at Grady. Once the iron grip of Jim Crow was broken in the 1960s, Grady became the black folk’s hospital, following the successive election of five black mayors. By the 1980s, Grady's staff and administration was predominately black and charges of incompetence and corruption reverberated in the legislature and media.

Although, as with most public hospitals, Grady always ran an annual deficit, the fact that the state of Georgia under-funded indigent care was overlooked, as critics blamed Grady's financial problems on the racial composition of its board, administration and staff. Privatization became the way out of the funding debacle caused by the state. Despite vigorous opposition and behind a smokescreen of lies, including no reductions in services, no increase in fees and no closure of facilities, big business had its way and Grady was privatized.

Caught by surprise, now that the ink on the contract is dry and the hoods have come off, residents in DeKalb and Fulton Counties are experiencing the true value of political promises. First, co-pay arrangement and formula changes mean the poor has to pay more for the same services. On May 6, 2009, Grady's CEO Michael Young announced Grady's dialysis center would be shut down. This was a major rescission of a promise to gain acceptance of privatization.

Then on May 13, 2009 the Atlanta Journal-Constitution reported that three neighborhood clinics had been axed without any community input. These centers provide some basic services to low income communities in outlying areas. Again, Young promised "no patients will lose services," since these health clinics will be consolidated with other clinics some miles away. He framed the matter as strictly a cost cutting move, "Patients will actually receive better services, since clinics on the chopping block offer limited services. The South DeKalb clinic sees only about 35 patients a day and has no lab, pharmacy or X-ray machine. The closings will save about $1.5 million annually."

Young tried to minimize the impact on the poor with, "One clinic is located in a Kroger supermarket, and another sees as few as eight patients a day." His opinion was not shared by those who utilize the facilities. Caught by surprise, Julia Horton, a patient since it opened 13 years ago disagreed; she cited convenience and economic reasons to keep the center open. The South DeKalb staff, also caught by surprise, took exception to Young's claims, and offered their own numbers. "It is true, on a daily basis, over 35 patients are seen at the center. The pediatrician sees 16 to 19 patients daily and its adult medical doctor sees 22 to 24 patients. However, both numbers are above the 16 patients a day standard set by Grady for its doctors. This center logged 8,800 visits in 2008."

Elected officials also reacted with surprise and outrage to the center closings. DeKalb County Commissioner Larry Johnson blasted the decision as a "travesty." Johnson continued, "My district in southwest DeKalb, with its relatively large low-income population, is medically under-served and needs the clinic. DeKalb provides Grady about $20 million annually." He viewed the situation as a question of fairness and equity, while threatening to reduce county funding, if some equitable solution was not found. "We need primary care more than ever, people are losing their jobs and don't have health care."

Fulton County Commission Chairman John Evans, founder of Stone Mountain-based Operation LEAD, said, "I'm not surprised that Grady claimed underutilization and plans to close the South DeKalb Center. In our community, that's the common denominator. The main thing is if they say one thing and we can prove otherwise, we can fight them." Fulton Commissioner Emma Darnell was more direct in her criticism, "Closing the Center Hill center and transferring patients elsewhere is totally unacceptable. They don't have the transportation. People are really, really upset."

Most Americans are hoping there are not any surprises in the Obama health care plan once it is unveiled. Banks, insurance companies and the automobile industry were generously given taxpayer dollars, even though they caused their financial problems. Those in need of health care coverage and access to care are being victimized by the same culprit - insurance companies- but the government cannot find enough money to do what is needed to help ordinary citizens. Is anyone surprised that this government's leaders lied to them?

News You Use

We Got Work to Do

By John Burl Smith

For those of us truly concerned about the healthcare crisis we got lots of work to do. Groups around the country are gearing up for what will be a real battle to pass meaningful health reform, including greater access for all, reduced cost and a single-payer system that reigns in HMOs and insurance companies. Everyone needs to make their voices heard through emails, telephone calls and letters. Get out and attend meetings, forums and rallies to support the needed reforms.

The Center for American Progress Action Fund sent out this call for a forum to be held May 29, 2009 at 10:00 AM - 11:30 AM at the Capitol Visitors Center United States Capitol Washington, DC. As the nation works to reform our health care system, we must also ensure that these reforms work for children's unique needs. Over the past decade, this country has seen notable successes in ensuring that more children have affordable, meaningful health care coverage, including the Children's Health Insurance Program (CHIP). Today, Congress is weighing new approaches to providing affordable coverage for all Americans and reforming the health care delivery system. These proposals would affect how all Americans--including children--obtain health coverage and interact with the health care system. While legislation is not yet available, policymakers are considering a combination of strategies, such as public program expansions, new strategies for subsidizing private coverage, restructuring the health insurance market, a single-payer option and new investments in delivery system improvements.

Please join the Center for American Progress Action Fund, The Children's Partnership and a distinguished panel of experts for an examination of how proposed reform elements will affect children's coverage and children's health and how these policies can best take into account the unique needs of children. This discussion will explore the opportunities offered by the coming debate to ensure that health reform works for children.

Out in the nation, concerned groups are mounting a sustained effort. For instance, on Wednesday, May 27, 2009, Rep. John Conyers will be in Atlanta, Georgia for a series of meetings and rallies for Single-Payer universal health care at Grady Memorial Hospital. Rep. Conyers has been out-front fighting for working peoples' rights. Co-founder of the Black Caucus (1969), Rep. Conyers is now chairman of the House Judiciary Committee. He will hold a press briefing in front of Grady Hospital at 10:00 AM and have lunch with employees in the Grady Cafeteria at about 11:30 AM. Later that evening, Rep. Conyers, who sponsored House Resolution 676, will speak about its major provision for a single-payer healthcare system at the IBEW Auditorium (International Brotherhood of Electrical Workers) building, 501 Pulliam St. SW at 6:30-8:30 PM.

Then on Thursday, May 28, at 3 PM the Grady Coalition will meet at First Iconium Baptist Church, 542 Moreland Ave., SW to plan a response to Grady service cuts. The Grady Memorial Hospital Board plans to close three of its nine neighborhood clinics. This has sparked outrage among local officials and fears among patients who are afraid they will lose health coverage. Join the Fight! We Got Work To Do!

Venue for an Artist

Health Care: Protectionism Free Traders Love

By Dean Baker

Suppose that people in the United States paid twice as much for our cars as people in Canada, Germany, and every other wealthy country. Economists would no doubt be pointing out the enormous amount of waste in the US auto industry. They would insist that we both take advantage of the lower cost cars available elsewhere and take steps to make our own industry more efficient.

For some reason, economists do not have the same attitude towards health care. Most seem little bothered by the fact that we spend more than twice as much per person as people in other countries, with no obvious benefit in terms of health care outcomes. This lack of concern is especially striking since health care is a far larger share of the US economy than autos, comprising 17 percent of total output, as compared to about 3 percent for autos.

The excess health care spending comes to more than $1.2 trillion a year or the equivalent of more than $16,000 for a family of four. Paying too much for health care has the same economic impact as a health care tax. In effect, we have a health care waste tax that is about 10 percent larger than the projected federal revenue from the personal and corporate income tax combined. In short, this is real money.

However, the enormous waste in the US health care sector does not arouse anywhere near as much concern as items like the "buy America" provision in the stimulus package. This provision, which applies to a small fraction of the recently passed stimulus package, was the topic of a front-page article in The Washington Post. The article warned that this protectionist provision could lead to the unraveling of the world trade system.

While features of health care can make trade in health care services more difficult than trade in autos, it is possible for the barriers to be bridged. If the self-proclaimed "free traders," who dominate the economics profession and policy debates, actually were free traders, they would be pushing hard to allow people in the United States to benefit from international trade in medical services in the same way that US consumers have benefited from low cost imports of cars and clothes.

There are several obvious paths through which the United States could gain by freer trade in health care. First, we could construct trade deals that simplify the process through which foreigners can train to meet US standards for becoming doctors, dentists, and other highly paid medical specialists.

The point would be to set up procedures through which students in countries like Mexico, China, and India could train to meet our standards, and then would have the same ability to practice in the United States as US trained doctors. This could be easily implemented and offer large gains to both countries, especially if the US paid a fee to compensate for the medical training offered to foreigners, so that two to three doctors could be trained for every one that practiced in the United States.

An even simpler route for gaining from trade would be to allow Medicare beneficiaries in the United States to buy into the much cheaper health care systems in other countries. The government could split the savings with the beneficiaries, allowing them to pocket thousands of dollars a year, while saving the government the same amount. The receiving country could even get a premium over its costs in order to give it an incentive to take part in the program.

Finally, the government could try to standardize rules around the rapidly growing industry of medical tourism. Every year, tens of thousands of patients travel to Thailand, India, and other countries to have major medical procedures performed at prices that are often less than one-tenth as much as those in the United States. The savings can easily offset the cost of travel for the patient and several family members. If facilities were regulated and clear rules established for legal liability, then more patients would be able to take advantage of the potential cost saving.

However, the free traders are not interested in promoting free trade in health care. They would rather just tell us that there is nothing that can be done about exploding health care costs in the United States. This might have something to do with the fact that the primary beneficiaries of protectionism in health care are doctors and dentists, not autoworkers and steel workers (and the drug and medical supply industry).

Economists and other self-proclaimed free traders are anxious to use trade to reduce the income of manufacturing workers; they are very happy to have protection for highly paid professionals. After all, their parents, siblings and children can be doctors and dentists. They are unlikely to be autoworkers and steelworkers.

So, we are stuck with a hopelessly bloated health care system that most of the economists and pundits say cannot be fixed. Insofar as this is a true statement, it is because they and their wealthy friends do not want it to be fixed. It really is that simple.

About Me: Dean Baker is the Co-director of the Center for Economic and Policy Research. CEPR's Jobs Byte is published each month upon release of the Bureau of Labor Statistics' employment report.

Disgruntled wants to know: On Saturday, May 23, 2009, CNN minority anchors, T. J. Holmes and Betty Nguyen, shared a few laughs. Personally, there is nothing funny about most of the "news" coverage provided by CNN and other 24-7 news stations. While I suffered through a few minutes of the program, there was a segment on sports in which the announcer failed to mention Roland Garros. In addressing this oversight, Holmes ignorantly stated something to the effect, "There are no serious American contenders at the French Open." Had Holmes referenced his remark specifically to the men's draw, I would have more readily accepted his faux pas. Even though I am certain the American men, there are at least six of them, including Andy Roddick and James Blake, did not enter this slam to lose, so they are serious contenders, too. However, on the women's side, seated number 2 and 3 are serious contenders Serena and Venus Williams, respectively. Serena is a past French Open champion. Are these women not Americans?

Disgruntled feels: Omitted! According to some media cheerleaders, there are signs that the worst of the US economic recession is over. Fewer jobs were lost in April than expected, home sales have improved and the level of consumer spending has risen from the low of a few months ago. Even as unemployment rose to 8.9 percent, there are shades of optimism as President Barack Obama announced the dark clouds are lifting and the US economic engine is slowly turning again. Forgive me for injecting a dose of reality. But, on the ground where I reside, that 8.9 percent unemployment rate is only the tip of the iceberg when it comes to unemployment, because the stat omits part-time workers and those that have stopped looking. And, while the first black president looks with optimism at that 8.9 percent national unemployment rate, he has omitted any reference to the Depression era black unemployment rate of more than fifteen (15) percent. In fact, President Obama has made not one mention of plans to tackle the nation's structural employment problem, which is rooted in racism and renders black workers twice as likely as whites to be unemployed.

Disgruntled says: House Speaker Nancy Pelosi took impeachment off the table for one of the most corrupt administrations in this nation's recent history. That was a monumental error that has cost this nation lives and treasure. Now, she is embroiled in the brouhaha over the use of torture. The CIA claims she knew detainees were being tortured; she says the spy agency misled Congress. The CIA is known for its deception; politicians are notorious for lying to get elected; then they lie once in office to cover the lies told while campaigning for votes. Pelosi is a politician. The CIA is what it is; enough said. We, the people, do not know who to believe. The nation needs an independent investigation, if such a thing is possible, to clear the air and scrub its name and reputation. Otherwise, it will continue the downward spiral as the rule of law and democracy hypocrite it has become known. To that end, the Bush administration's enablers, Republicans and Democrats, need to put criminal prosecution of those responsible for breaking the law, including torture, on the table.

Mailbox: E-Mails, Faxes and Telephone Calls

Email www.ich.com ..."Get Out of Iraq. Get Out Afghanistan"..."Come Home America."...By Dennis Kucinich... Speaking on a Supplemental Appropriations bill that would continue to fund the wars in Iraq and Afghanistan, Congressman Dennis Kucinich (D-OH) today made the following statement: "America went to war against Iraq based on a lie. We were told back in 2002 that Iraq had weapons of mass destruction. The previous administration even pursued torture to try to extract false confessions in order to justify the war. It is time to tell the truth. The truth is we should not have prosecuted a war against the Iraqi people. The truth is the Democratic Senate could have stopped the Iraq war in 2002. The truth is we Democrats were given control of Congress in 2006 to end the war. The truth is this bill continues a disastrous war, which has cost the lives of thousands of our soldiers. The truth is the occupation has fueled the insurgency. The truth is the Iraq war will cost the American and the Iraqi people trillions of dollars and as many as a million innocent Iraqis have lost their lives as a result of this war. "Don't tell the American people that you are ending the war by continuing to fund the war. Don't tell the American people that the war will end when their plans leave 50, 000 troops in Iraq. Don't tell the American people that the way out of Afghanistan is to escalate our presence. "Get out of Iraq. Get out Afghanistan. Come home America."