Health care or disease care? Pt.1
Len Saputo: We need publicly funded health care, but we need more – a system based on prevention
PAUL JAY, SENIOR EDITOR, TRNN: Welcome to The Real News Network, coming to you from Washington, DC. We are at the conference America’s Future Now. It used to be called Take Back America, and I guess we are to understand that America has been taken back. So we will find out what that means. Today, right now, we’re joined by the authors of a book called A Return to Healing. (And I’m hoping that’s centered properly; and if not, we’ll do a close-up of the book.) It’s written by Len Saputo, who’s a doctor, and Byron Belitsos, who is the publisher. And thank you for joining us.
LEN SAPUTO, MD AND AUTHOR: Thank you, Paul.
BYRON BELITSOS, JOURNALIST AND AUTHOR: Thank you very much.
JAY: So rate the Obama administration so far, particularly as it comes to health-care reform. That was one of the primary promises of his election campaign. And the debate is fast and furious. What do you make of how he’s doing?
SAPUTO: Well, he seems to be changing his position. I mean, to start with, I had the impression he was interested in a single-payer system, and we’re finding out now is it’s off the table.
JAY: Now, why did you think so? ‘Cause he said in the campaign that even though single-payer, if we’re starting from scratch, might be the best plan, it’s not doable. And he proposed a plan that was not single-payer. And so he was certainly elected on this idea of having a federal plan that would be open to people.
SAPUTO: I still had the impression that that’s the message that came across to me, even though maybe he didn’t say that directly.
SAPUTO: That’s what it felt like when I was listening to him talk. I was inspired by what he was saying.
JAY: So isn’t that something that tells us a lot about his support? So many people didn’t listen to the words and had an emotional feeling. So now that you elected them on the feeling, not what he said—.
SAPUTO: Well, not entirely. I mean, certainly, some of what he said inspired America, and I think some of the things he’s trying to do are going to be good for America. I think the whole idea of health-care reform is huge. And whether it’s a single-payer, it’s universal health care, or some other form isn’t where the whole story is. That’s something that’s necessary, but it’s insufficient.
JAY: So what’s sufficient?
SAPUTO: We have to have a health-care system that does health care. We’ve got a disease-care system that’s—it’s based on treating diseases. It’s too expensive, we’re all sick, and it’s not safe. So we need to go back to the basics to try and save dollars to give people the care that they need, not get sick in the first place, and use medicine only when it’s necessary.
JAY: So, before we get more into that, which we will, let’s talk a little more about the politics of where we’re at. The health-care reform debate now is taking place mostly at the Senate Finance Committee. Senator Baucus, who’s the chair of the committee, is sounding like there’s a possibility that we may have a reform which is based on just regulating the private industry. And the public component is now even a question of debate. It’s not even a question of single-payer or a competing public plan; there might not even be a public plan at all.
BELITSOS: Well, it would be a betrayal. And if Baucus tries to pull that off, I think he will hear from the American people, who know what the score is, which is that he has corruption in around his office, which we all know—I think most of us know—that he receives lots of money from the people he’s regulating.
JAY: Now, that’s not necessarily corruption, because it’s pretty public. I mean, corruption would suggest he’s getting money we don’t know about, and it’s quite—we don’t know that there—we don’t know that—.
SAPUTO: Well, there’s a conflict of interest.
BELITSOS: That’s true. [inaudible] conflict of interest, but it’s rather extreme.
JAY: But if you call it corruption, you have to say that about the entire Senate and Congress.
BELITSOS: Well, we can go there if you want.
SAPUTO: Well, you can. I think that’s fair.
BELITSOS: But certainly in his case, he should not even be involved in this, in my humble opinion, because he so obviously has a conflict of interest. So no wonder he took this thing off the table, that is, the public option was taken off the table, let alone the single-payer.
JAY: Well, we don’t know for sure the public option’s—.
BELITSOS: Yeah, he’s sort of equivocating about that, so we’ll see.
JAY: It seems very gray at the moment. But what does seem to be the case is that Baucus is determined to have the health-insurance companies buy into the plan. He wants their agreement. They don’t want to get into a battle with the private insurance companies. So whatever that plan is, there’s going to be some kind of compromise, which is not what candidate Obama campaigned on.
BELITSOS: That’s right. Yeah. So in a sense this is skewing the whole discussion toward what Baucus wants.
JAY: So one of the things that President Obama has said is that single-payer might be the best option if we were starting from scratch, but, he says, we’re not. Now, every country that has a single-payer option didn’t start from scratch. No country, you know, in the 19th century started with a single-payer health-care plan. So every country had to make a transition. So what would you guys like to see? So let’s say President Obama came to you and said, okay, let’s say we’re starting from scratch or where we are now.
SAPUTO: Well, look at the problems we have.
JAY: How do you start from now and get to where you want to get?
SAPUTO: Well, you have to look at, first of all, a system that’s affordable. I mean, health care is driving this country bankrupt. We’re spending now, as of this year, 18 percent of the gross national product on health care. We can’t afford that. Why do you think Ford, Chrysler, GM, and some other big companies are going bankrupt? You can’t have a discordant system where other countries don’t have that 18 percent and expect your businesses to do well. So we have to do something to spend our dollars more efficiently. A single-payer system is definitely superior, because it has about—we don’t spend the $0.30 on the dollar for the administrative and for the bonuses that are given to the insurance companies. In a single-payer system, the beauty of it, really, is that it uses only 5 percent of that money it spends to run and make the business work. So from that point of view, single-payer is better than something that includes the insurance companies. We already know the stories that the insurance companies have come up with. They want your money and they don’t want to give you service. They’ve taken a lot of huge bonuses from it. And it’s simply not right; it’s immoral.
JAY: Now, one of the main points of your book is to move past this debate, that once there is a public health-care plan, what you do with it and how do you actually make sure the outcome is better. So the insurance part is just one piece of the argument, but what’s the rest of what you’re saying?
SAPUTO: Well, we’re based on a system that’s a sick-care system. You’re always going to spend way, maybe way more dollars, okay, to get people well using the system that we use that isn’t that safe. It doesn’t work that well, because 50 percent of America still has a chronic disease. So we’ve got to go back to a system that is more enforcing wellness, so we can teach lifestyle as the first thing.
JAY: When you say "go back," what does that mean? Go back to what?
SAPUTO: Go back to—.
JAY: When was it that you had this?
SAPUTO: Well, in older times, okay, a hundred years ago, we may have had a shorter lifespan at that time, but we were dying because of public health issues which are now resolved. But if you go back and look at the things that they were doing, they were much healthier. They were eating better. They were sleeping better. There was probably as much stress, and that’s something we need to work on. Their weight was certainly better. And the epidemic of chronic diseases was much lower. So we’ve got to go back to wellness and prevention as the first thing, and then maybe move to non-invasive strategies like Chinese medicine or Ayurveda or Indian medicine or something like that, then move to supplements and herbs, then move to drugs, and maybe then to surgery. That hierarchy of how you treat things is absolutely essential. Otherwise, we’re back in the sick-care system, where we spend too much, we start with too-aggressive therapies, and we wind up paying way too much money.
JAY: And that’s part of shown up in some of the statistics comparing publicly owned hospitals and privately owned hospitals, wherein certain diseases, privately owned hospitals have worse outcomes because they move to surgery too quickly.
SAPUTO: Well, if we deliver more health care, it’s not necessarily better. It’s been shown that in areas where there are the densest number of physicians doesn’t have the best outcomes. The best outcomes happen when you do the things you need to do to stay healthy. That’s why personal responsibility is huge. People need to be able to go back and take care of themselves the way they’re empowered to do. They can’t, just because somebody advertises Pepcid, go ahead and eat the pizza, you know, the whole pizza, after they take a Pepcid to prevent it. This direct-to-consumer advertising and the way big Pharma is operating is immoral.
JAY: Now, most people know this. I mean, it’s kind of commonly understood that Pharma, as an industry, is more interested in making money than in your health. Everybody knows fast food’s not particularly good for you. To have a real transformation the way you’re talking, doesn’t it take a powerful public health-care plan and a powerful government intervention? ‘Cause the free market does not seem to be capable of doing this.
BELITSOS: What if we did this public option but didn’t write into the public option this issue, which is prevent what Len’s talking about, preventive medicine, actual preventive practices by the population, supporting that with infrastructure, prevention infrastructure, which we don’t spend money on, to get the population to live this healthy lifestyle? Put that in that plan. Put it in the public option. Don’t just give this lousy system to everybody. Let’s give health to everybody and have this public option in case you get sick. So these two things have to dovetail.
JAY: Well, I can hear Rush Limbaugh now saying, so you want the government to tell us how to live. So in the next segment of our interview—.
SAPUTO: Someone has got to tell us how to live.
JAY: Well, in the next segment of our interview, let’s take on that argument. Please join us for the next segment of the interview, this interview, on The Real News Network.
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