Alyssa Morse: Health care vote is a blow for insured poor

By Signal Contributor

Last update: Wednesday, May 17th, 2017

Editor’s note: The following column was addressed to Congressman Steve Knight and a copy sent to The Signal.

Iam a 3rd year medical student at the Keck School of Medicine of USC. My family and I are also your constituents in Valencia.

I have spent most of my short medical career caring for patients at LAC+USC Medical Center, which is responsible for serving the low-income communities of East Los Angeles.

Before Obamacare the majority of my patients were uninsured, and now because of your vote they have the most to lose.

According to the UC Berkeley Labor Center, as a result of your vote for the American Health Care Act (AHCA), more than 1 million low-income adults who are enrolled in the Obamacare Medi-Cal expansion will lose their health insurance in Los Angeles County alone.

It is clear that you do not understand that for our patients, health insurance is not about choice in a free market; it is about life and death.

How dare you hide behind the guise of your wife’s nursing profession when you have no idea what it is like to be on the front lines for these patients.

Contrary to your statement, the American Nurses Association, which represents 3.6 million nurses in this country, has publicly spoken out against the AHCA. Medical students, nurses and physicians spend time listening to the stories of these patients and caring for their acute (and pre-existing) conditions every day.

As a budding physician, I am expected to stay up to date on the latest medical literature and advances in medical therapies to ensure that I am providing the best care to my patients. Your constituents expect you to do the same when new legislation is proposed.

It was wholly irresponsible for you to cast your vote for the new version of the AHCA when the Congressional Budget Office had not yet released an analysis of how it would affect your constituents.

You have shown your true colors, and your actions will have consequences. I promise you that my colleagues and I will be at your town halls in our white coats, on our phones calling your constituents, and knocking on doors in my neighborhood to protect our patients and to ensure that this term is your last.

A Valencia resident, Alyssa Morse is a medical student at the Keck School of Medicine of USC and constituent of Steve Knight. She is also a member of the national Protect Our Patients movement and the non-profit organization Los Angeles Physicians for Health.

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Alyssa Morse: Health care vote is a blow for insured poor

Editor’s note: The following column was addressed to Congressman Steve Knight and a copy sent to The Signal.

Iam a 3rd year medical student at the Keck School of Medicine of USC. My family and I are also your constituents in Valencia.

I have spent most of my short medical career caring for patients at LAC+USC Medical Center, which is responsible for serving the low-income communities of East Los Angeles.

Before Obamacare the majority of my patients were uninsured, and now because of your vote they have the most to lose.

According to the UC Berkeley Labor Center, as a result of your vote for the American Health Care Act (AHCA), more than 1 million low-income adults who are enrolled in the Obamacare Medi-Cal expansion will lose their health insurance in Los Angeles County alone.

It is clear that you do not understand that for our patients, health insurance is not about choice in a free market; it is about life and death.

How dare you hide behind the guise of your wife’s nursing profession when you have no idea what it is like to be on the front lines for these patients.

Contrary to your statement, the American Nurses Association, which represents 3.6 million nurses in this country, has publicly spoken out against the AHCA. Medical students, nurses and physicians spend time listening to the stories of these patients and caring for their acute (and pre-existing) conditions every day.

As a budding physician, I am expected to stay up to date on the latest medical literature and advances in medical therapies to ensure that I am providing the best care to my patients. Your constituents expect you to do the same when new legislation is proposed.

It was wholly irresponsible for you to cast your vote for the new version of the AHCA when the Congressional Budget Office had not yet released an analysis of how it would affect your constituents.

You have shown your true colors, and your actions will have consequences. I promise you that my colleagues and I will be at your town halls in our white coats, on our phones calling your constituents, and knocking on doors in my neighborhood to protect our patients and to ensure that this term is your last.

A Valencia resident, Alyssa Morse is a medical student at the Keck School of Medicine of USC and constituent of Steve Knight. She is also a member of the national Protect Our Patients movement and the non-profit organization Los Angeles Physicians for Health.

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Signal Contributor

Signal Contributor

  • Brian Richards

    Ms. Morse, did it ever occur to you that Knight and others are doing exactly what they were sent to DC to do? You didn’t elect him, I did, and Obamacare is an utter disaster unless you’re getting it for free, then it’s great. Only with the current American left do they expect politicians that they didn’t vote for to act like the politicians they did vote for.

  • lois eisenberg

    Alyssa, Thank you for your opinion column and your care and concern in serving
    the low income communities in East LA.
    Your opinion about Steve Knight was most compelling and “it was wholly irresponsible for him to cast his vote for the new version of the AHCA when the Congressional Budget Office had not yet released an analysis of how it would affect your constituents.”
    Alyssa, I’m so proud of the stance that you have taken against this appalling
    Health care vote that is a blow for insured poor.
    Kudos to you and your other “budding physicians” for your efforts concerning
    this unfair and selfish new health care farce.
    Your patients are going to be very lucky to have you as their Doctor.

  • Ron Bischof

    MediCal is a state program and there’s no right to unsustainable Federal subsidies, Ms. Morse.

    Citizens of California who agree with you can fund MediCal from their own pockets.

  • Brian Baker
  • Brian Richards

    Ms Morse, I hate to break it to you, but you are not the only one that talks to people in the medical profession. Last week my doctor told me he would rather treat someone for free than accept medical. The paperwork and low reimbursement cost made it a losing proposition. The tone and substance of you letter suggests people who think as you are responsible for this, Republicans namely. Over 5 decades ago I was brought into this world at a cost to my parents of under $300.00. They had no insurance and many people didn’t at the time. Today that cost would be approximately $2,300.00 based on inflation. What changed? Could it just possibly be that the answer we all seek, more affordable medical coverage, cannot be found by adding layer upon layer upon layer of government? I have more news for you, the same analogy can be made of the cost of higher education. What changed from 50 years ago when literally everyone could afford a higher education without the need of decades of financing? Could it be again that more government is not the answer?

    • charles maurice de tallyrand

      Can you name a country that has a free market healthcare system?

      • Brian Richards

        I’ll answer if you can tell me why your question is germane?

      • Ron Bischof

        Can you name one country that produces ~25% of global GDP with 5% of the world’s population?

        https://yourlogicalfallacyis.com/bandwagon

      • Jim de Bree

        The Netherlands, Switzerland, Australia and Singapore have a free market system that is regulated like a utility.

        • charles maurice de tallyrand

          But they are not “free market systems” as for instance in Switzerland insurance is compulsory but those who can afford are given generous subsidies by the government, Australia has medicare for all and as such guarantees universal coverage, and in the Netherlands well you should know about them and how they try to get everyone covered. I think about 2/3rds of the population receives some form of subsidies from the government to get coverage. Aren’t all entitled to be automatically insured?

          I think a better question might be, is the delivery of healthcare and health related services, is it a market in the traditional sense?

          • Jim de Bree

            A regulated free market system is not he same as a traditional free market system. It allows for a degree of free market forces to facilitate innovation, but it also allows for a much greater degree of consumer protection.

            I am not sure if you are asking about the Netherlands. Everyone makes monthly payments for healthcare, similar to our insurance. There is a mandate and if you are over the age of 18 you have to participate or else you are subject to a tax that greatly exceeds the cost of obtaining insurance. There is a portion of Dutch corporate income tax that is designated to cover insurance premiums for those below a certain income level which is about 15% of the population. All of this gets you into an HMO, if you purchase private insurance you can get a PPO type of system and move to the proverbial head of the line. The government also provides a residual risk collar to the insurance companies that is no more than a few percentage points of the total cost. The Dutch system is like Obamacare but without the effects of lobbying by insurance companies, pharmaceuticals and other providers.

            To answer your question about free market healthcare systems–I suspect that they may exist in third world countries where only the wealthy can afford to get care and everyone else suffers. The Economist had an article about this some time ago.

          • charles maurice de tallyrand

            The issue is conservatives in the United States seem to have an irrational fetish for the traditional free market system. If any of those three systems were to be fully adopted in the United States they’d be screaming sic semper tyrannis and calling for less government intervention not more, claiming as always there’s a free market solution though never clear exactly which that is. It’s a pretense for some misdirected anger however, a feeling that they might in some way be paying for those they deem unworthy participants of society. I wish they’d just drop the pretense however that they actually want universal coverage or that they have viable solutions to provide for it and instead just be honest and state that in the marketplace of healthcare some people will lose out, some people won’t get the care they need, and they’re perfectly fine with that and prefer it to the idea of having to pay for it. We’re in an era where the word regulation automatically is equated to being unnecessary. Any tax is unfair and burdensome (despite claims to care about deficits or the debt). People actually believe in an a very incoherent manner that government does not have a role in most things. The very idea of a public good itself is being undermined.

  • Gil Mertz

    “…According to the UC Berkeley Labor Center…”

    No bias there. Could you not find a credible source?

  • Phil Ellis

    It is really a shame that Ms. Morse hadn’t read Mr. de Bree’s insightful commentary prior to printing her not so insightful commentary. It is also sad that the liberals are so intent on spewing forth false news.

  • Ron Bischof

    False Morality
    by Peter Venetoklis

    The other day, I had an extended… lets call it a “discussion…” with a couple socialized medicine advocates on the Internet. Yes, yes, silly me. Arguing on the Internet is like (per Google’s third suggestion) playing chess with a pigeon. Nevertheless, I persist in doing so, because, if I do it right, I expose my opponent’s flaws to third parties. It is the existence of those third parties that make the futility less futile, and it’s why I never engage in arguments via email or messenger.

    As such discussions so often go, the other guys got around, after just a few exchanges, of accusing me of selfishness and indifference to the poor. They commingled this ad hominem attack with broad, highfalutin presentations about how a modern society takes care of its weakest, about how providing health care (which they dub a “right”) to those who cannot afford it is a moral imperative, and with references to Christ and Biblical scripture.

    The purpose of all this is to attempt to lay exclusive claim to a moral high ground, to bolster their position (especially after their talking points get knocked down) by claiming to be “better people” than those they argue against. For all I know, they actually believe this, and do not see the problems and falseness of their position.

    Libertarians are, at this point, nodding in agreement, as are some conservatives who are frequent pugilists in the Internet swamp. Others might ask what’s so wrong with the notion that a moral society takes care of its weakest?

    The flaw lies not in that precept, but in the presumption that this should be accomplished by government. That giving government the power and authority to be the caretaker of the weakest is synonymous with society fulfilling that role. The flaw is two-fold: it supplants the voluntary cooperation of individuals occupying a common space (this is what “society” actually is) with forcible action by a few on a few; and it presumes against all evidence that this is a better alternative than relying on society to naturally accomplish that role.

    Some believe that voting for politicians who promise to take care of the poor is a good way to be charitable. Some (including a Senator that recently ran for president) even believe that charity should be the exclusive province of the government. Here’s something that should be obvious: You are not being charitable when you give away other people’s money.

    Government has no money of its own. Even that which it prints, creates via various mechanisms, or borrows is either the wealth of the citizens or an obligation placed upon the citizens. Thus, every dollar that the government gives to people or spends on people is a dollar taken from people. Thus, voting for the government to take care of people is voting for the government to take from people. The justification is that the people being taken from can afford it, and the people being given to need it. Does this ring a bell?

    Here, let me help:

    From each according to his ability, to each according to his need.

    This was the core of Karl Marx’s thinking and the core of socialist/communist society. This thinking has destroyed societies, resulted in death tolls that exceed the worst plagues in history, kept billions in poverty, perpetuated human misery around the globe, and vanished trillions in wealth. It flies in the face of the most basic of moral precepts: that a man owns himself and the fruit of his labor, and establishes an arbitrary set of criteria for enslaving some to others.

    http://www.pigsandsheep.org/false-morality/

    • Brian Richards

      Great post Ron!

      • Ron Bischof

        The remainder of the piece by Mr. Venetoklis is worth the read.

  • Ron Bischof

    The price tag on universal health care is in, and it’s bigger than California’s budget

    “It would cost $400 billion per year to remake California’s health insurance marketplace and create a publicly funded universal heath care system, according to a state financial analysis released Monday.”

    Read more here: http://www.sacbee.com/news/politics-government/capitol-alert/article151960182.html#storylink=cpy

    • Jim de Bree

      Comparing it to the budget tells only part of the story. A $400 billion cost makes it about 16% of CA’s GDP. CA’s GDP was about $2.4 trillion in 2016. In 2016 healthcare spending in CA was estimated to be about $367.5 billion. So healthcare spending already is significantly bigger than California’s budget.
      http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/PublicSharePB_FINAL_8-31-16.pdf

      I am fairly certain that there will be at least a 5% increase in 2017, so that puts annual CA healthcare expenditures at ~$400 billion for this year. About 71% of this amount is already funded by taxpayers, (although the ACHA would likely reduce that level of funding). That is about $285 billion. The increase in taxes is offset by a reduction in insurance premiums. Private party expenditures in 2016 were about $107 billion. That amount likely increased by at least $8 billion in 2017, so you are replacing private expenditures with expenditures funded by tax revenue, which means that healthier and wealthier taxpayers will shoulder a larger portion of the bill.

      Having said that, I don’t think that a CA run single payer solution is the best way to deal with the problem, but using the state’s purchasing power will probably help rein in costs. That is the part of the calculus that the state is considering. The ACHA does nothing significant to rein in costs, it’s principal fiscal result merely cuts federal funding.

      Furthermore, the cost of providing medical services to uninsured people gets passed onto insured people because the providers have to increase what they charge people who can pay to cover the cost of services to those who cannot pay. The real question should be how can we most effectively manage the costs of those who cannot afford health insurance. The AHCA does not consider this paradigm.

      • Ron Bischof

        The utility of the article I posted is putting these enormous sums into perspective.

        Here’s another: Siemens AG, a 170 year old German multinational conglomerate, has a market cap of ~126B.

  • Dr. Edward Simon

    It is clear that the passion in “soon to be” Dr. Morse’s argument came from her desire to serve. It is sad that a discussion of life and death issues descends in to an argument citing percentages of GDP and the theoretical failings of communism.

    I commend her for her stance, her passion and her simple desire to serve those in need.

    • Ron Bischof

      The author’s passion to serve is indeed commendable, Dr. Simon.

      Are you positing that Ms. Morse’s objective didn’t include political pressure to marshal economic resources in a particular manner?

      Do medical professionals like yourself engage in cost/benefit analysis?

      Please advise.

      • Dr. Edward Simon

        Yes and yes.

        But to that second “yes” I would posit that American and humanity shine brightest when despite a clearly negative “cost-benefit” a heart is transplanted, Siamese twins are separated, an autistic child is given therapy or a man walks on the moon.

        I understand your position. The demarcation between charity and abuse, liberalism and conservatism and even right and wrong is often gray.

        I commend you for your passion as well!

        • Ron Bischof

          I dispute your first yes as the political nature is established by addressing it to Rep. Knight with a cc: to The Signal and advising of political consequences are clearly articulated. Thus it argues for continuity of the existing economic ordering of medical services payment.

          Our system of self-government is based on recognition of individual liberty and the dynamism of our market economy depends on voluntary exchange.

          Such does not preclude voluntary cooperation to achieve objectives that are deemed beneficial to our society.

          It’s inherently illiberal to advocate for the coercive power of government to act against the expressed will of the electorate.

          To my mind, Ms. Morse’s communication threatens under the guise of altruism rather than persuades.

          Wisdom gained by experience often tempers such impulses of youth.

          • Dr. Edward Simon

            I stand corrected, the first “yes” should have been a “no.”

            But are you suggesting she be condemned for attempting to direct the spending of her tax dollar in line with her principles?

            Are you not doing the same thing?

            And isn’t it totalitarianism that places the benefit to the state over that of any particular individual?

            Democracy is the greatest when it protects those that are most powerless.

          • Ron Bischof

            There’s no condemnation made or implied, Dr. Simon. Rather, I’m adding clarity that Ms. Morse is also acting in her economic self-interest, a communication aspect your original post deplored. Note that she’s also advocating for the expenditure of resources beyond her own contribution. Therefore, others like myself have a say as well. It may appear pedestrian to seek a rational and sustainable medical services financing model but it isn’t morally deficient.

            Tell me, does forcing a person to engage in economic activity to subsequently regulate it for purposes of redistribution strike you as placing the interests of the state over the individual?

            Our Republic was architected to safeguard individuals and their property* from the tyranny of the majority. Recollect that the Athenian democracy decided it was in the interest of the polis to order the death of Socrates. Democracy also is quite capable of depravity, is it not?

            * Property, as defined by James Madison, “embraces every thing to which a man may attach a value and have a right; and which leaves to every one else the like advantage.”

            http://press-pubs.uchicago.edu/founders/documents/v1ch16s23.html

          • Dr. Edward Simon

            I did not state you don’t have a say nor did I imply any moral deficiency.

            I don’t understand your question. First, who is being “forced to engage in economic activity?” The patient? The health care provider? Tax paying citizens? A theoretical “all of the above” and if so what do you mean by forced?

          • Ron Bischof

            Deprecation of a descent into economics verses “life and death” is how you stated it.

            By force, I refer to the individual mandate to procure Federal approved insurance.

            Now that I’ve clarified, is this not the state overriding the interest of the individual?

          • Dr. Edward Simon

            That is more clear. Since all citizens will eventually require some degree of medical care I would think that you would want all citizens to be required to contribute to the collective pot to the extent they are able. There are no atheists in fox holes and even a life long uninsured libertarian deserves end of life hospice care.

            The conundrum is that government exists to reasonably protect every individual at the reasonable expense of every individual. The devil is in the details. So as I said in an earlier post, the line where you are wrong and Dr. Morse is right, and vice versa, is a vivid gray.

            And with that I wish you a good night and best wishes!

          • Ron Bischof

            Your rationalization for the state overriding the individual self-determination is noted. It is an application of government force, no doubt.

            Though unacknowledged, there were other points I successfully argued and I’m sure they didn’t escape your attention.

            A pleasant event to you as well, Dr. Simon.

            “Government is the great fiction, through which everybody endeavors to live at the expense of everybody else.”

            ― Frédéric Bastiat