HealthCommentary

Exploring Human Potential

Wednesday at 1:30 PM EST – Join Me For the Most Important Health Debate of the Year.

Posted on | May 2, 2021 | 2 Comments

 

Mike Magee

This Wednesday afternoon, May 5th, from  1:30 to 3:00 has been 3 months in the making. Last week, President Biden said, “We’ve talked about it long enough, Democrats and Republicans. Let’s get it done this year. This is all about a simple premise: Health care should be a right, not a privilege in America.”

Is he right? What are the legal, political and cultural dimensions of this debate?

To find out,  I hope you’ll reserve May 5, 2021, from 1:30 to 3:00 PM, for a fascinating online lecture: “The Constitution and Your ‘Right’ to Health Care.” Best of all, the $20 fee helps support the lifelong learning programs at the University of Hartford. These virtual programs are open to all comers and are an invaluable resource to help combat the isolation, fear and worry that has affected all of our citizens over the past year.

This 90-minute slide lecture explores the recent political history and legal controversy surrounding attempts to establish universal health coverage in America. “Is health care a right?” viewed within the context of the Bill of Rights and especially the 9th and 10th Amendments? What are the legal arguments advanced over the past decade to challenge the Affordable Care Act (Obamacare)? And does the Covid-19 pandemic make it more or less likely that “Medicare for All” will pass legal muster in the future?

Join me for this stimulating interactive session, including time for audience participation, and contribute $20 to a great cause. You can register online HERE.

Confused How to Register? Here are the steps:
Registration and Payment Steps:
1. Go to site: https://www.hartford.edu/academics/library/presidents-college/presidents-college-calendar.aspx?trumbaEmbed=view%3Devent%26eventid%3D483398641
2. Click on “Program Registration” to the left.
3. Click on “Listings for Spring 2021 Presidents’ College Courses” to the right.
4. Select “The Constitution and Your ‘Right to Health Care’ in America” (2nd on list)
5. Select the offering
6. Select “checkout.”
7. Enter Registration information and proceed with payment.

Historic Cultural Clashes and Access to Health Care: Griswold v. Connecticut.

Posted on | April 29, 2021 | No Comments

Mike Magee

On Wednesday, May 5, 2021, I hope you’ll join me from 1:30 – 3:00 PM for a virtual lecture that President Biden highlighted in his speech to Congress this week – “Health Care ‘Right’ and the U.S. Constitution”. Register HERE. (Here is a small segment.)

____________________________________________________

It began on March 7, 1844, with the birth of one man, Anthony Comstock, in New Canaan, Connecticut. Raised in a strict Christian home, his religiosity intensified during a two-year stint in the Union Army during the Civil War.

A member of the 17th Connecticut Infantry, he took great offense to the profanity and debauchery he witnessed in and among his fellow soldiers. With the strong support of church-based groups of the day, and as the self-proclaimed “weeder in God’s garden”, he sought out a purpose and found a political vehicle in New York City’s Young Men’s Christian Association, which he parlayed into a post as the United States Postal Inspector.

His overarching goal was to advance Victorian morality by stamping out smut. The New York Society for the Suppression of Vice, was chartered at his insistence by the New York state legislature in 1873, and included the twin mottos of “Morals, not Art and Literature” and “Books are feeders for brothels.”

Using local postal agents, his searches and seizures, whose subsequent sales were shared 50/50 with his own organization, bankrolled the lobbying of Congress necessary to pass the “Suppression of Trade in, and Circulation of, Obscene Literature and Articles of Immoral Use”, otherwise known as the Comstock Laws.

Pornography, contraceptive equipment, reproductive health literature, and books deemed risque’ or suggestive all fell into his cross-hairs. By his own account, prior to his untimely death on September 21, 1915, he had prosecuted 3600 defendants, seized 160 tons of obscene literature, enjoyed the active support of industry, the AMA, and the Catholic Church among others, and sparked equally restrictive and intrusive legislation in 24 states – one of those being Connecticut.

Along the way, he made powerful enemies. For example, in 1905 George Bernard Shaw, on hearing in London that his new play, “Man and Superman” had been removed from the New York Public Library, had this to say in a public letter published in the New York Times: “Dear Sir – Nobody outside of America is likely to be in the least surprised. Comstockery is the world’s standing joke at the expense of the United States. Europe likes to hear of such things. It confirms the deep-seated conviction of the Old World that America is a provincial place, a second-rate country-town civilization after all.”

A decade later, arch-enemy Margaret Sanger, laid him bare with these words, “We know the capitalist class must have a slave class, bred in poverty and reared in ignorance. That is why it is quite consistent with their laws that there should be a heavy penalty of five years’ imprisonment for imparting information as to the means of preventing conception. Industry…(must) under sell its rival competitors. They have only one way to do this, and that is to get labor cheap. The cheapest labor is that of women and children; the larger the number of children in a family, the earlier they enter the factory.”

Two decades later, with World War II looming FDR and Justice Hughes weighed priorities and decided indecency was less of a threat to the country than venereal disease among the troops. The AMA lent its support as well.

But the final nail in the Comstock coffin was fittingly delivered nearly 50 years after his death in the crusader’s home state where Comstock Laws were still on the books. The protagonist was Estelle Griswold, Executive Director of the Planned Parenthood League. In 1961, Griswold was arrested and fined $100 for providing contraceptives and birth control advice in their New Haven office. That arrest led to a landmark suit (Griswold v. Connecticut) in the Supreme Court with effects far beyond Comstock.

On June 7, 1965, in a 7 to 2 decision, Justice William O. Douglas wrote: “Would we allow the police to search the sacred precincts of marital bedrooms for telltale signs of the use of contraceptives? The very idea is repulsive to the notions of privacy surrounding the marriage relationship. We deal with a right of privacy older than the Bill of Rights — older than our political parties, older than our school system.”

Arthur Sackler – On Trial.

Posted on | April 20, 2021 | No Comments

Mike Magee

Former Wall Street Journal reporter, John Carreyrou, in a New York Times review of New Yorker columnist, Patrick Radden Keefe’s new book, Empire of Pain, decries the author’s early focus on Arthur Sackler, the patriarch of the clan who died in 1987, a decade prior to the FDA approval of OxyContin. Any who have read my book, Code Blue: Inside the Medical Industrial Complex, will not be surprised that I side with Keefe on this one.

Carreyrou makes this case: “While Arthur’s life makes for fascinating reading — he had three wives and became an avid collector of Asian art, negotiating a secret deal with the Met to store his coveted collection in one of the museum’s wings free of charge — he played no role in the OxyContin saga, which made me question Keefe’s decision to devote fully one-third of the book to him.”

Here’s why he is wrong.

The official narrative, as it exists today, oft repeated by premier medical and cultural organizations, who maintained schools, exhibit halls, and colloquia that beared his name, features:

1. A remarkably industrious boy who, from an early age, supported his parents (who lost everything in the Depression), put himself through college and medical school at NYU, doing the same for two younger brothers who sought medical school overseas to escape prejudice.

2. A boy who grew up in “hard times”, whose parents were grocers in Brooklyn, chose medicine as a vocation at the age of four, but whose passion drew him more than equally to Art, pursuing art and sculpture lessons as a teen, and taking courses at New York’s famed Coopers Union while attending college and funding the family besides.

3. A committed physician and researcher who generated 140 science related papers, dealing primarily with exploring biologic approaches to psychiatric illness in the 1950’s.

4. A remarkably prolific philanthropist focused on brand name institutions in Medicine and the Arts.

5. A very successful business man, whose extended family fortune was pegged in 2015, at $14 billion, 18 years after his untimely death at age 73 from a heart attack on May 26, 1987.

Yet, the details that tie Arthur M. Sackler to the Man-made Opioid Epidemic, and the well-established tactics that helped consummate the Medical Industrial Complex in the second half of the 20th century are largely hidden from public view.

The truth diverges dramatically from the varnished version, and reveals a rich kid who set his sites early on becoming the marketing poster boy for a wildly profitable Medical-Industrial Complex (MIC) and laid the seeds for the Opioid Epidemic.

The story continues HERE.

Is Health Care a “Right”, a “Privilege” – or Simply a “Necessity?”

Posted on | April 8, 2021 | 8 Comments

Mike Magee

I am currently knee-deep into preparations for an online lecture at the Presidents College at the University of Hartford on Wednesday, May 5th, at 1:30 PM titled “The Constitution. and Your “Right” to Health Care in America.”  

I’ve been at it for over a month. The classic debate centers on the Constitution’s emphasis on negative rights (that is protection of citizen prerogatives from overreaching of their federal and state governments), rather than positive enumerated rights, which carry with them implied obligations of enactment or enforcement (as in The Bill of Rights).

On a practical level, the same debate– from high schoolers to policy elites – reads from one source like this:

“Proponents of the right to health care say that no one in one of the richest nations on earth should go without health care. They argue that a right to health care would stop medical bankruptcies, improve public health, reduce overall health care spending, help small businesses, and that health care should be an essential government service.”

“Opponents argue that a right to health care amounts to socialism and that it should be an individual’s responsibility, not the government’s role, to secure health care. They say that government provision of health care would decrease the quality and availability of health care, and would lead to larger government debt and deficits.”

The 90-minute lecture, presaging a full-blown course this Fall, will place me in the middle of this debate – part practical, part esoteric, legal and nuanced. But the reality that I’m fast approaching is that it really doesn’t matter. That’s because – whether a “right” or “privilege”, universal, accessible, affordable and effective health care in America is now a “necessity.”

Here are three reasons why this is true:

1. Performance: By any measure available, our predatory and profit-driven approach is a 70-year old historic misstep that is roughly twice as expensive and half as effective as most of the 36 OCED comparator nations.

2. Economic: This highly inequitable and remarkably variable system now accounts for roughly 1/5 of our entire GDP, powered by a bureaucratic workforce with 16 workers for every physician, half of which have absolutely no clinical function. The resultant corporatized Medical Industrial Complex supports opaque pricing, legal kickbacks, and an integrated career ladder where medical scientists actively collude with CEOs from health insurance, hospital, pharmaceutical and research arenas.

3. Strategic: Our decentralized approach to care lacks any coordinated national strategic public health apparatus. There is no national plan. When stressed by the current pandemic, it failed on a massive scale resulting in the needless deaths of hundreds of thousands of citizens, vast damage to our economy, and near collapse of our major hospitals nationwide. In the process, it revealed historic underfunding of public health, prevention, and the social determinants of health, preferring instead to rely on last minute, high science intervention come to the rescue.

The question we need to be asking ourselves – whether you align with  “right” or “privilege” – is no longer a philosophical debate, but rather a practical question.

“What kind of system do we need to create to make America and all Americans healthy?”

Putting the Genie Back In The Bottle. Health Care For All Is the Cork.

Posted on | March 24, 2021 | No Comments

Mike Magee

Two years ago, James Comey wrote an editorial in the New York Times which began, “America has long had a radioactive racist soup in the center of our national life. Donald Trump thinks he is stirring it for political benefit. He’s actually doing something more dangerous.”

The January 6th insurrection, followed by the past weeks two mass shootings, add credence to his earlier warnings. Modern civilized societies rely on a double-armed approach to maintain order, peace and security.

The first arm is laws. But laws are of little value without enforcement. As Comey stated, “It was long a statutory crime to kill another human being; it just wasn’t against the law in practice to kill a black person in many places. The rights to vote and to equal treatment sounded muscular on paper, but they were weaklings in much of America.”

The second guard rail of civility is culture. MIT professor Edgar Schein  describes it this way: “Culture has three layers: the artifacts of a culture — our symbols and signs; its espoused values — the things we say we believe; and, most important, its underlying assumptions — the way things really are.”

In the Senate chamber this week, and in Republican controlled state houses across the nation,  Americans witnessed a colossal collision of reality and ideals in the form of new Jim Crow laws to suppress minority voting rights, and refusal to address gun violence in the wake of not one, but two mass shootings, involving sale of weapons of war to civilians. 

Were these the only flashing alerts signaling danger ahead, that would be enough to cause sleepless nights. But unenforced or unevenly enforced laws, and value dissonance in America, do not occur in isolation, but are supported by an even more erosive underpinning – greed-induced economic inequality.

A 2019 pre-pandemic report in the Wall Street Journal laid out the numbers. While the vast majority of growth in assets in the prior three decades went to the top 10% in the US, debt increased by $9 trillion with ¾ of the debt issued to the bottom 90% of American families. For the top 1% during this period, median net worth grew 178% to over $11 million. For the rest of us, earnings had been flat while housing prices increased 290%, four year college tuition soared 311%, and average per-capita health care expenditures rose 51%.

A May, 2021 WSJ report from the Federal Reserve reinforced the uneven impact of the pandemic: “Almost 40% of households earning less than $40,000 a year experienced at least one job loss in March, versus 19% of households earning between $40,000 and $100,000 and 13% of those earning more than $100,000, the Fed said. And while 85% of those with no work disruption said they could pay the current month’s bills in full, just 64% of those who had lost a job or had their hours cut said they could cover their expenses for the month.”

To put this genie back in the bottle, we must simultaneously address the nation’s values, its culture and its economics. To accomplish this, artificial barriers like the filibuster rules in the Senate must be dismantled.

Beyond this, the quickest, most direct pathway to address income inequlity, safety and security is now through universal health coverage. Not only would this offer the opportunity to distribute wealth more equitably, but it would also offer the country the opportunity to acknowledge mistakes of the past, and work anew at aligning our actual behaviors with our stated values of compassion, understanding and partnership.

Can the Bureau of Labor Statistics Predict America’s Appetite For Change?

Posted on | March 10, 2021 | No Comments

Mike Magee

This past month we added 379,000 jobs and Wall Street blushed. But the fact remains that there are 9.5 million fewer jobs in our economy compared to a year ago, and first-time jobless claims rose last week. As former Federal Reserve economist Julia Coronado reported, “We’re still in a pandemic economy.”

Pre-pandemic, the Bureau of Labor Statistics predicted a 3.7% growth for the coming decade. The newest update downgraded that to 1.9% if the pandemic impact is “strong”, and 2.9% if it is “moderate.” Even without this biological tragedy, permanent changes in the job market had been forecast including more remote work, higher tech service demands, further declines in travel and entertainment, and greater investment in public health and health services.

The 2019 study did a deep dive for hundreds of detailed occupations over the next decade. The largest declines, as you might expect, were projected in transportation, travel and hospitality. Hidden deeper were signs of a changing world order – like the fact that if you are a computer savvy teen with only a high school education, your likely employment in the future will be in software development, not as a cashier.

How good are these projections? It depends on who is doing the forecasts and what are the assumptions. For example, if the health care status quo persists in America, chasing cures and tolerating inequities, a prediction that the largest increases post-pandemic will be in the medical, health-science and technology fields is a pretty safe bet.

The sector is also America’s dominant employer. But at the same time, many of these jobs deliver zero benefits when it comes to patient care. In fact, there are 16 health care jobs for every one physician, and 8 of these 16 are non-clinical.

A shift to a centralized health insurance system, while preserving local choice and autonomy over care delivery, would carry estimated savings of up to $1 trillion off of our nearly $4 trillion annual health care expenditure. Of course that means many insurance agents, coders, billers, and data specialists would lose their jobs. What would become of them?

Likely they would follow the money. But how might that $1 trillion be best spent? The best answer was embedded in the startling fact that the U.S. is the only developed nation that spends more on health care than all other social services combined. These services – including housing, education, transportation, environmental protection, sanitation, safety and security –are all proven determinants of health.

Advancing health and wellness requires physical and technologic infrastructure. Once built, the physical and human scaffolding must be managed and maintained. Translation: jobs, jobs, jobs.

Pandemic Accelerants: The Time Is Right For Change.

Posted on | March 8, 2021 | 1 Comment

Mike Magee

 “…quietly below the surface, there are transformational forces underway fueled by pandemic accelerants.”  THCB Gang, March 4, 2021.

Change on a societal scale promotes opposing forces – fear and retrenchment battles innovation and exploration. As we’ve witnessed in Washington, the clash can be epic and violent with Democracy itself at stake.

Resolution sometimes involves compromise, other times brute power. That is pretty much where the Democrats and President Biden found themselves this week as they passed an historic $1.9 trillion coronavirus relief plan on a 50-49 vote in the Senate. The “pandemic accelerant” here was massive public support for the bill, including 77% of all voters and 59% of Republican voters.

Buried inside the bill was a range of funding for health care, and as important, for the social determinants of health care. For example, $125 billion in new federal funding for K-12 education, was added to the already committed $67 billion, for a total new funding of $192 billion or an additional infusion of $2,600 per K-12 student.

Paralysis of our public education system has had a profound impact on our physical, emotional and financial health. It has also demanded sacrifice, teamwork, empowerment, and momentum. A quick Education Week review of the past year helps explain why.

Jan. 29, 2020: 1st mention of possible need for pandemic safety in schools.

Feb.15, 2020: Temporary school closures in Washington and New York.

Feb. 25, 2020:  A CDC warning for schools.

March 5, 2020:  A move toward distance learning begins.

March 11, 2020:  WHO declares pandemic.

March 12, 2020:  Gov. DeWine closes Ohio schools.

March 16, 2020:  Schools now closed in 27 states.

March 17, 2020:  Kansas annouces closure of schools for the year.

March 25, 2020:  All US public school buildings closed.(Idaho is the last to go.)

May 6, 2020:  Nearly all states now close schools for the year.

May 19, 2020:  Teacher morale and student mental health surface as issues.

May 25, 2020:  Addressing the George Floyd murder remotely becomes an emotional challenge for teachers and students.

June 15, 2020:  Studies expose a “digital divide” between poor and rich students to broadband and computer devices.

July 28, 2020:  In a virtual town hall, Dr. Fauci tells teachers they are “part of the experiment.” Teachers union threatens to strike if “forced” to return.

September 15, 2020:  74% of the 100 largest school districts chose remote learning only for over 9 million students.

September 23, 2020:  400 educators have died from Covid-19.

October 15, 2020:  Majority of schools now embrace hybrid learning model.

November 2, 2020:  Research supports safe school opening with precautions and testing.

November 7, 2020:  Joe Biden elected President. He declares, “Everyone wants our schools to reopen. The question is how to make it safe, how to make it stick. Forcing educators and students back into the classroom in areas where the infection rate is going up or remaining very high is just plain dangerous.”

December 11, 2020: The first emergency authorization of a vaccine for Covid-19.

January 6, 2021: The insurrection at the Capitol.

January 7, 2021: U.S. Secretary of Education Betsy DeVos resigns.

January 20, 2021: President Joe Biden inaugurated.

February 7, 2021: Chicago Teachers Union agrees to reopen schools.

February 9, 2021: 1/5th of teachers vaccinated; another 1/5 scheduled. 70% state they will be vaccinated.

February 21, 2021: CDC Director Rochelle Walensky states, “I want to underscore that the safest way to open schools is to ensure that there is as little disease as possible in the community. Thus, enabling schools to open and remain open is a shared responsibility.”

March 1, 2021. New U.S. Secretary of Education Miguel Cardonais a champion of safe school reopening. 856 retired and active public schools teachers have died from Covid-19.

March 2, 2021: President Biden directs states to prioritize vaccinating teachers.

From the beginning of the pandemic, the nation’s school house has been in play. This unique tragedy has now claimed over a half million American lives, and carried with it economic devastation for many million more. The elimination of in-person schooling has also profoundly disrupted the labor market.

But after all we have been through over the past year,  the majority of parents surveyed feel going back to the way things were would be short-sighted. They find themselves in the camp of health reformers who seek something more ambitious and transformational.

The same holds true for other social systems that impact societal health, equity and fairness – like safety and security, transportation, the environment and housing. Americans fear slipping back into the status-quo, and missing this moment of opportunity.

Few have access to an expert in the field of Advocacy. I am fortunate to have a son, Marc Porter Magee, PhD, a sociologist and Director of Advocacy Labs at Georgetown University. Here are a few of his insights from “Insights Into Effective Advocacy From The Nation’s Leading Experts”:

Momentum:  “The hardest changes to secure are the modest ones. There is a natural friction to policy change, like trying to push an object across a table. Once you apply enough force to get it off its resting place, it is more likely to travel a foot than an inch.”

Empowerment:  “The powerful aren’t as powerful as you think. It seems logical to assume that the advocacy efforts of the powerful should succeed more often than those with less power, but this isn’t true. When it comes to seeking a policy change, powerful groups are no more likely to win than any other group.”

Teamwork:  “The most effective lobbying doesn’t look like lobbying. Arm-twisting, raised voices or threats rarely get results. Instead, most change happens when policy makers and outside advocates see themselves as members of the same team.”

Sacrifice:  “If you want people to stay involved, ask them to sacrifice. It’s natural to think that the best way to keep people involved in your cause is to make it easy for them to take action. However, it is the very act of sacrifice that generates a long-term, personal commitment to the cause.”

keep looking »
Show Buttons
Hide Buttons