Thomas Jefferson wrote on the Declaration to the American
 Independence, approved on July 4^th, 1776, these marvelous words:
“Life, Liberty and pursuit of Happiness”
Life  in this contest means  GOOD HEALTH FOR ALL Americans , not just for  a certain privileged  group! 

There are at the present time (2003) 216 independent territories  or nations. The United States of America is the ONLY NATION in the world that  DOES NOT  have a national health service for every inhabitant.

WHY? 

We have more people working for the medial insurance companies than we have in ALL our armed forces! The American people are spending more than 500 billion dollars per year on UNNECESSARY PAPER  WORK 

Here is the article and lecture that I gave more than ten years ago:

I am very grateful to you for this opportunity to discuss “The Status of today’s Health Care in America.” I have been a physician for 36 years. I am practicing Internal Medicine, in Bristol, R. I., for the past 30 years, after training at the Lahey Clinic, in Boston, for 3 years.

Today, I am speaking to you, on my own. I do not represent here any medical institution, or any group of Physicians. My remarks will be totally independent. I want this to be very clear and understood.

American Medicine is considered to be the best in the world. The United States ranks highest with the best physicians and the best surgeons. We have the best hospitals and the best Clinics: Mayo Clinic, and Lahey Clinic, are examples. The United States is the nation in the world, that has the largest number of Nobel Prizes in Medicine. America is the nation that has achieved the most discoveries of antibiotics and other medications, including laboratorial and paramedic techniques.

Daily, from various nations, numerous patients come to the United States in search of a correct diagnosis and the sure cure for their diseases. American Medicine is the best in the world, and it is also the most expensive.

Why?

Today’s Health Care in America is sick, extremely sick. It suffers from a malignant cancer. The remedy has to be radical surgical treatment otherwise it will die similar to a patient with AIDS.

What are the causes for the American Health Care to be so terminally ill?

(1)     Health Insurance Companies
(2)     Medical Doctors
(3)     Malpractice Insurance
(4)      And let us not forget the Politicians.

Let us analyze each individually in a simple and clear manner.

Let us look at the Health Insurance companies

Do you know how many different trade marks of beers we have in the United States? Five hundred. Do you know how many health Insurance companies we have in America? Over 1500! Why? Because they make a tremendous lucrative profit by exploiting the American people, the consumer, the patients. These insurances represent the greatest waste of money in the Health Care in America.

The Gulf War, with all its planes, ships, missiles, etc. cost the American people 45 billion dollars. The American people, in 1993, will spend more than two hundred billion dollars on unnecessary paper work imposed by the so called health insurance companies!!! At the present time 20 per cent of the medical care in U. S. is spent on paper work: administrators, secretaries, computers, etc.

Do you think I am exaggerating and inventing these statistics? I want to call your attention to an article published in the prestigious “The New England Journal of Medicine”, May 2, 1991, by Drs. Woolhandler and Himmeltein.

Let us analyze a concrete example that these two physicians give in their article.

In Massachusetts the Blue Cross and Blue Shield has two millions and seven hundred subscribers. They have 6,682 employees to take care of the paper work.

In Canada, with a population of 27 million, ten times more people, the National Health System of Canada spends LESS money in administrative paper work than the Blue Cross / Blue Shield of Massachusetts! Incredible and astounding!!! Where do the billions of dollars come from to pay all the employees to take care of the unnecessary paper work? From the exploited and unfortunate American people. And this system is legal. They call it free enterprise!!! I have other names for it, and I am sure you do too!

The same physicians stated in “The New England Journal of Medicine” that in the U. S. the paper work involved for one Medicare case is more than one hour of paper work, which is, twenty times more time than in Canada. In America the payment for medical service is all fragmented, involving many tons of paper, while in Canada there is only one paper!

In Canada you have a choice of a doctor! Here in U. S. your health insurance company selects the doctors for you. If the patient speaks Chinese, or Portuguese and there are medical doctors who speak the patient’s language, the Insurance Company does not care. They challenge your by saying: “No sir, you have to go to where we say, you must abide by your contact, or you will be penalized!!! “ Employers buy the contracts from the Health Insurances, who are very comparative. The employees, the patients, accept, not knowing or understanding the contact or coverage. But nobody cares, and the patients then learn the hard way.

If the physician does not speak the patient’s language, it does not matter how well is he trained in this country, he cannot give the patient the best psychological medicine, because he cannot communicate with the patient.

Nowadays, when you go to see your family physician and he seems to hurry up things, you should realize that your doctor is spending more than 30 per cent of his or her time on the paper work of your medical record. Why? Because there are now “inspectors”, -- I call them KGB agents-- to inspect your record, review and get copies of your medical history. They do not care how much time the doctor spends listening or attending the patient. The patient does not count. What counts is the overwhelming amount of paper work. The doctor has to document it all! If the doctor does first class medicine, but does not document it he is rated and subject to be penalized.

Authorization is an obnoxious word in the practice of medicine today. You come to my office, I diagnosed you as having acute appendicitis and I sent you to the hospital to be operated. Your life is on the line. If you are not operated in a few hours you will die. But the surgeon cannot operate until we check with some nurse turned secretary at your medical insurance company to obtain permission to operate on you. When I call the insurance company, I do not speak with a medical doctor. Many times, I speak to a machine which asks me to leave a message, while you lie in the Emergency Room between life and death! Does any one from the medical insurance sees you, personally, to make the correct diagnosis, and decide in the emergency treatment for you? NO. Does any one in the medical insurances companies examine any patients, make any diagnosis or give any prescriptions? NO. Are any member of any insurance medical companies necessary for the practice of medicine? NO. Why, then, do they exist?

What is the responsibility of the Medical Doctors in 
today’s health condition of the Health Care in America?

Out of 50,000 professions, Medicine has always been considered the most scientific, and also the most rewarding for the practicing physician. The practice, the art of Medicine, should be the most compassionate and humane of all professions. Yet the American Medical Association and the Medical Societies across this country consent that more than 37 millions Americans have no medical coverage of any kind. Out of more than 170 nations in the world the United States of America and South Africa --where they still have Apartheid-- these are the only two countries in the industrialized world that do not have any National Health Service! Certainly the American Medical Association has had the lobbying strength in Washington, D. C. to persuade the Congress and the Presidents to have more charity to alleviate the suffering of these 37 million unfortunate Americans. For this reason I am no more a member of the AMA

For many years in this country the Medical Doctors do not care about the cost of Medicine to the patients. They solve the problem very easily. They increase their profile. Do you know what profile means? Profile is the fee. They increase their fees and let the chips fall where they may. I believe a Medical Doctor should be concerned with the overall well being of the patient: not only their prescriptions but also how much does the patient has to pay for his medical coverage.

For too many years the American Doctors, as semi-gods, did not care how much the medical insurance companies were interfering and corroding the practice of medicine. Now we are all paying for the consequences. 

Malpractice. How does Malpractice Insurance affect the Health Care in America?

As a practicing family physician I pay over twelve thousand dollars per year for malpractice insurance coverage. A thousand dollars per month is similar to a rent that I have to pay to the insurance company. If I see 5,000 patients a year, each patient that comes to my office, has to be charge an extra two dollars, for me to satisfy the premium of my malpractice insurance.

Portugal with a population of ten million people has 3 Law Schools and 3 Medical Schools. In Portugal there are 23,000 physicians and 3,000 lawyers. The physicians in Portugal do not have, nor need malpractice insurance, because there are not enough lawyers to sue them. Rhode Island is the State of the Union that has the largest number of lawyers per capita and a new Law School in Bristol is in the process of opening!

I believe every citizen has the right to sue any professional. However, we should have a law in this country that if the person that sues and  looses the case he or she should have the burden of paying the expenses and the time that the person sued lost during the case, plus the expense incurred by the defense lawyer. This would be truly democratic and fair. Ninety per cent of the law suits would disappear from the American tribunals. Let me quote what Shakespeare said about lawyers, four hundred year ago: “The first thing we do, let’s kill all the lawyers,” [Shakespeare: II Henry IV , iii

Every doctor in this country has to practice defense medicine because he has to protect himself against the monster of malpractice law suits. The doctor has to order many unnecessary laboratory tests, that cost billions of dollars a year. We do not need an MRI to make the diagnosis of migraine headache! Who pays? You do!

To this day I have NEVER gone to a Court to defend myself against a medical law suit. It is obvious that the history of medical malpractice in this country is horrendous and should be controlled by common sense and decent law. It should not be dominated by greed. Unfortunately the American people continues to pay for the tremendous expense in billions of dollars to maintain the insurance payments and compensations awards.

This country certainly needs radical laws to control the growing cancer of Malpractice Insurances and the medical law suits.

What is the responsibility of the Politicians in the Health Care in America?

All American politicians talk about Human Rights in China and in Russia. About Human Rights at home in U. S for our fellow Americans? This year we are celebrating the 250 anniversary of the birth of Thomas Jefferson. 217 years ago Jefferson wrote in the Declaration of the Independence “that all Men are created equal”. If Jefferson could visit us here today he would say: “that all Men are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, Pursuit of Happiness and equal Health Care.”

Our health is more important than our political affiliation. The conclusion of Lincoln’s Gettysburg Address therefore should be applied, with much stronger emphasis and enthusiasm, to the Health Care of this Nation: “that Health Care of the people, by the people, for the people, shall not perish from this country”!

With all the discussions, all the tremendous wastes, we continue to forget the most important person, the patient, the American Citizen. The control of Medical Health Care in this country should be given back to the American people, taken away from the hands and from the muscles the Interested Groups which are corroding the Health Care in America.

Do you know the name of the president of your health insurance? Did you vote for him? Do you know his salary? You pay for it! You have no saying whatsoever in controlling the cost, or the doctor of your choice to take care of your health and your family’s. It is amazing, in a country that supposed to be the champion of Human Liberty. The most important part of your life, preserving your health, you have your hands and feet tight in chains, when it comes to choosing your doctor or your Health Care!! It is a paradox! This situation is anti-American!

The Government in U. S. is divided in three branches to balance the Powers. We should apply the same principles to the universal medical services. In the delivery of the Health Care in America there are three parties: (1) the patients (the people), (2) the doctors and (3) the hospitals. They all three should exist with checks and balances. And the people should be the most important check of these balances. After all, it is the American People that pays the entire bill.

We should have in this country, similar to Germany, a Health Corporation, composed by representatives of the various business and professions, to control the fees of the doctors, the fees the hospitals and the cost of the medications. To control also unnecessary and repeated laboratory tests or even unnecessary surgery. - The Directors of said Health Corporation should be selected by the people.

In this system everyone should pay 20 or 25 of the cost, as we already have in Medicare. I am not in favor of a National Service. Why? Because in a system when the people do not pay anything for the medical care, the service is not appreciated, and there is also much waste by taking advantage of it. Each citizen should have some responsibility to appreciate the medical services or medications he or she receives.

Who can cure the terrible condition in which the Health Care in America is today?

The knife, for radical treatment for the malignant waste of the Health Care in America, today, is in the votes of politicians in the Congress: Senators and Representatives.

Do they have the courage, the stamina, the guts to approve laws to solve this mess? I do not think so, because of the overpowering of the dinosaurs named medical insurance companies and malpractice insurances laws.

We have several other major health problems that affect very much the Health Care in America. Let me just touch upon one example.

Last year (1992) more than one million and one hundred thousands beautiful single American High School girls became pregnant and the men who got them pregnant assumed no responsibility! In China and Portugal when a woman gives birth and registers the baby, by Law, she must declare on the birth certificate who is the father! The men have to share the responsibility of supporting the new baby! When are we going to have a similar a Law in U. S. to finish this monstrous bastardy ? When are we going to stop this tremendous source of Welfare in this country by the millions?! What are the politicians doing about this tragedy?

Conclusions:

(1)     The high cost of medicine is due in great part to the waste, to the unnecessary paper work, imposed by the 1500 health insurance companies.

How can this mess, this cancer, of today’s cost of the Health Care in America be cured? By eliminating the Health Insurance Companies in U.S. A

How? By phasing out the insurance health companies like President Clinton and the Congress is doing now by closing the military bases in U. S. and abroad. We have more people now working for health services than we have working for the Armed Forces. Therefore the Congress and the President have to be more perseverant in changing the laws regulating the Health Care in America because there are many more interested groups involved in the delivery of Health Care and malpractice law suits than in the Armed Forces Bases... The millions of people that work in the offices, doing unnecessary paper work, should be used instead on the human service, such as day care in the homes of our fellow Americans...

(2) Health Corporation:

Rhode Island is the ideal State to experiment with the creation of the Health Corporation. An independent organization, directed by the representatives of the people, to check and counter check the costs of the doctors, hospitals and medications. It only takes guts from the Congress to adopted it.

Ladies and Gentlemen:

I came to this country more than 47 years ago, against my will. Now, I tell my two sons that I love America more than they do. Why? Because I am here by my choice. They were born in this country, they had no choice.

America is still the greatest country in the world, giving equal opportunities to everyone. I am a living example of that truth. I do not have to tell you how hard I worked to be a successful Medical Doctor.

It saddens me and my heart bleeds for America, a country that possess the best Medicine in the world, and is being destroyed by interested and selfish groups which are only interested in their own well being and not in the well being of their fellow Americans.

Keep Healthy!
Good Luck!

Many thanks for your  attention!

What is the situation today in America?
Worse! And getting  even worse!

Today, 2003, we have in U.S.A. more than 42  MILLION  Americans who  do NOT have any form of medical coverage for themselves or  for their families.

 Why? Because the responsible people do not care for their fellow Americans. 

The Americans  that have the power to decide on medical health laws  are selfish,  and they have  a paranoia against nationalized medicine. They do not realize that we already have  National Health Services  which are Medicare and Medicaid. 

The Americans are so naïve by not realizing  that if every citizen from birth to the grave was part of a nationalized health system,  the individual  coverage would be much cheaper, because the young do not need as much medical expense as the people that are in the seniors citizens group. 

I have verified that the people who  have medical health coverage are AFRAID  of their medical health coverage BECOME DILUTED  IF THEY BELONG TO A  NATIONAL  HEALTH SERVICE.  Strange, indeed!

The Americans are still afraid of the communist ideas  or socialized ideas. Unfortunately  only  when America reaches some form of  national health tragedy will they then  approve a National Health Service for everyone! 

In the mean while the parasites of the  health care system in U. S. A. -- the  lawyers and the medical Insurances companies -- will  continue to eat, drink  and  be merry at the expense of the sick Americans.

This is really tragic indeed and is the antithesis of the words  of the Declaration of the Independence: "Life, Liberty and pursuit of Happiness!"

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