Recently in Health Care Category

Recently I asked a question that needs to be answered in the context of our health care debate: Given that the majority of health care dollars are spent on people in the last stages of their lives, shouldn't we be talking about who gets to decide whether or not Grandpa gets "life-saving" treatment?

We'll be reading more about this as time goes, but now, this question has come up in the context of disaster planning in the event of an influenza pandemic:

Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The wealthiest among us will always have access to what they want and need -- nothing new there. But in order to create a safety net for the rest of us, this is a question that will not have any easy answers.

So let's frame the question before someone does it for us. It comes down to this, IMHO:

Which do you want?

A) A for-profit corporation (answerable to its shareholders) deciding who lives and dies?

B) A not-for-profit government entity (answerable to the voters) deciding who lives and dies?

Anyone want to take a crack at this?

Seems to me a fundamental question is not getting asked about who will make the decisions about health care in our present (and future) system. I'd like to pose it here:

Given that the majority of health care dollars are spent on people in the last stages of their lives, shouldn't we be talking about who gets to decide whether or not Grandpa gets "life-saving" treatment or not?

In other words, someone has to do it, right? After all, despite the best efforts of the Federal Reserve, there are only a finite number of dollars in existence. And as they dwindle down, more get printed, but they are worth less and less.

So, recapping the question:

Do y'll want:

A) A for-profit corporation answerable to its shareholders and the bottom line deciding it?

B) A not-for-profit government entity answerable to the voters deciding it?

Anyone want to take a crack at this?

Elizabeth Edwards has gotten a lot of notice recently for her high-profile writing on the topic of health care mandates; the press short-hands it as "Elizabeth backs Hillary's plan" or some such. I don't know if there's an endorsement in the cards (I doubt it, but who knows?).

I will say this: I just don't like health care mandates. Yes, mandates work with car insurance but people get tickets and have their license taken away if they are scofflaws. I don't know of a similar set of penalties that could or would work for health care. Besides, maybe it just is what it is: people love cars more than they love...people. I dunno.

Anyway, I'm skeptical of mandates. I don't think it'll work and I think the so-called subsidies for those who can't afford the premiums won't nearly be enough. Massachusetts' subsidy fund is massively in the red -- and that's with only 7% compliance with the mandates. That's not good.

Then there's the whole problem of insurance versus care. As Michael Moore correctly points out, just because you're insured doesn't mean you get the care you need -- not from a for-profit insurance company anyway.

Eugene says it best, at the end of a great analysis of Edwards' plan:

If Elizabeth can reconfigure her thinking on health care, and come to see ... that we need to guarantee affordable access to health care to everyone - then she will be on the right path. And it won't be a path that involves mandated insurance.

What do you think?

If so, I encourage you to attend the premiere, on U-Mich campus, of a new film: Life is for the Living, a documentary about the people, the politics and the science of stem cell research. It will be shown on March 12 at the Michigan Theater (603 E. Liberty St.) at 7:30 pm.

The film has added relevance as Michigan will be voting on a stem cell ballot initiative this fall.

The film includes the stories of five American families living with the painful realities of Juvenile Diabetes, Parkinson’s, and Spinal Cord Injury.

It is in the context of the statewide ballot initiative in Michigan this fall and the national debate over embryonic stem cell research.

As that debate continues in Washington and across the country, three generations of Americans reveal their challenges, their frustration with the President’s policy, and the hope that more funding for embryonic stem cell research will lead to new treatments and cures to relieve their suffering and save their lives.

Life is for the Living also explores the science behind stem cell research and the political debate taking place across the nation.

The film includes an introduction by CBS 60 Minutes' Mike Wallace and interviews with the nation's leading scientific researchers, political leaders, and advocates.

Here's a partial list of those who are in the documentary:

• The Honorable Janet Reno, Former United States Attorney General
• Senator Carl Levin (D-MI)
• Michigan Governor Jennifer M. Granholm
• Congressman Michael Castle (R-DE)
• Former Congressman Joe Schwarz (R-MI)
• Dr. Sean Morrison, Director, University of Michigan Center for Stem Cell Biology
• Dr. Clive Svendsen, University of Wisconsin Madison
• Dr. David T. Scadden, Co-Director, Harvard Stem Cell Institute
• Dr. Stuart H. Orkin, Chair, Department of Pediatric Oncology, Harvard Medical School
• Dr. Amy Wagers, Harvard Stem Cell Institute
• Dr. Alejandro Sánchez Alvarado, University of Utah School of Medicine
• Dr. Robert Lanza, VP Research, Advanced Cell Technology

Again, if you are in the area tomorrowthis evening, March 12, go see Life is for the Living at 7:30 pm at the Michigan Theater.

P.S. Oh and one more thing: the filmmaker, Michael Rubyan, is my son. He's 20 and a junior at U-M. I couldn't be prouder of him!

by Mark Adams

If you answered that "unabashed Marxist" Hillary Clinton, (go ahead and giggle at that one, I did), you win.

Seriously, Hillary is best know to Wingnuttystan as the failed author of what they like to call "Hillarycare" and I've been waiting since 1994 for it to be implemented. But instead of immediately entering the presidential race by offering a health care plan she has been identified with for a decade and a half, she originally said that she'd like some kind of vague "universal" program to be implemented by the time she leaves office after her second term.

She's upped the timetable to the first term, and echoing John Edwards includes a mandate that requires medical coverage for all (Obama's plan does not) making it truly universal, sets up a competing public system to compete with private insurers like Edwards proposes, removes obstacles to access for pre-existing conditions (Edwards, ditto), and except for the devil-in-the-details tax considerations and the relative burden on small businesses, it does look every bit as "very, very sound" as the one offered by John Edwards.

Laughter isn't the best medicine. It's the only medicine.

Get Well Soon.
June 29th.

Salon's Andrew O'Hehir reviews Michael Moore's newest, Sicko, and comes away impressed:

When Americans do get to see "Sicko," Moore says, "They will understand that this was about helping 9/11 rescue workers who've been abandoned by the government. They're not going to focus on Cuba or Fidel Castro or any other nonsense coming out of the Bush White House. They're going to say: 'You're telling me that al-Qaida prisoners get better medical treatment than the people who tried to recover bodies from the wreckage at ground zero?'"

Hmmm. Wonder how they'll spin that?

Oh -- and the part about Moore, a right-wing blogger and his cancer-stricken wife will blow your mind. But you'll have to read that part for yourself.

"I hope this film engenders discussion, not just about healthcare, but about why we are the way we are these days," Moore told us. "Where is our soul? Why would we allow 50 million Americans, 9 million of them children, not to have health insurance? Maybe my role as a filmmaker is to go down a road we might be afraid to go down, because it might lead to a dark place."

Dark but entertaining for sure.

When Moore interviews Tony Benn, a leading figure on the British left, his larger concerns come into focus. Benn argues that for-profit healthcare and the other instruments of the corporate state, like student loans and bottomless credit-card debt, perform a crucial function for that state. They undermine democracy by creating a docile and hardworking population that is addicted to constant debt and an essentially unsustainable lifestyle, that literally cannot afford to quit jobs or take time off, that is more interested in maintaining high incomes than in social or political change. Moore seizes on this insight and makes it a kind of central theme...

I haven't seen the film yet, and/but I have a concern here. If Moore presents this as a shadow-policy, coordinated at the highlest levels, I'm skeptical because everyone knows no one is in charge. But that's a minor point. Either way you cut it, it's a devastating observation.

So I guess this film is going to rile people up. There is certainly something in Moore that brings out the worst in right-wing Bush apologists. They just go...nuts when he pops up on the radar. Of course, maybe there's not so many of them left and the few-and-far-between might finally have learned how to control themselves by now.

As far as the accuracy of my movies goes, [says Moore] I think the record speaks for itself. Maybe people will say: He warned us about General Motors, he warned us about school shootings and he warned us about Bush.

Crikey. This'll definitely drive them around the bend.

I can hardly wait!

by shep

Quite obviously, American insurance-industry-run heathcare is a failure teetering on collapse. It is completely unavailable to nearly one-sixth of the population and only tentatively available to everyone else, except for the wealthy. Employer-paid health insurance, the most accessible form of healthcare for most people, now drives our decisions about who we work for, who in the family works and whether we can afford to change jobs. People are regularly denied access to heathcare, because they are sick.

The system is poorly regulated, either by industry or government. 100,000 people die from medical mistakes in hospitals alone. The average cost for drugs is two to four times higher than in other industrialized countries and also injures and kills many thousands. The real regulator and last recourse for those who are harmed by the actions of insurance companies, pharmaceutical companies and/or doctors is a widely-reviled tort system that siphons off huge amounts of money (in addition to the huge amounts siphoned-off by insurance companies themselves) that should be being spent on medical care.

Yet, our system is monstrously expensive compared to other industrialized countries. It severely undermines US competitiveness in world markets. As technology and our collective average age continues to advance, it is predicted that more people will be driven from the system, healthcare will have to be (even more) rationed, its cost will bankrupt the government, or all of the above. It also, due to the short-term profit motives of insurance companies, becomes ever more expensive because people don’t have easy access to wellness or preventative primary care that might help them avoid costly disease.

Our market-driven healthcare system is literally killing us. Only those whose thinking is corrupted by simple-minded market ideology remain committed to such a system and only the fact that our elected officials are beholden to the status quo industries’ campaign cash explains why we haven’t abandoned it for a rational alternative. Here are five critical things that we need to fix our current system that a market-based, insurance industry approach can never achieve:

1) Pool risk and cost as broadly as possible, creating the lowest average cost per person for healthcare.

2) Allow for a simple administrative system with a single point of contact, one set of rules and one processing system.

3) Create a level competitive marketplace for all healthcare providers.

4) Allow for an emphasis on cost-saving wellness, preventative and primary care.

5) Give the public-at-large control over the specific features of the healthcare system through their elected representatives.

We will be forced to adopt a government-administered single-payer system of some sort eventually, like every other industrialized nation on earth. The question now is only how much more human suffering and how many more $billions we will waste on the current industry-run system.

Next: what a government-administered single-payer system might look like, including the role for insurance providers (actually, I’ve already given that one away).

(Cross-posted at Queen Of All Evil)

Update: OK, I realize that saying healthcare, “is completely unavailable to nearly one-sixth of the population,” is a bit of hyperbole. What I am talking about is the entire system: primary care, specialists, screening, wellness, etc. If waiting until you're sick enough to wait four to eight hours to be seen in an emergency room and then being sued by the hospital and having your credit destroyed does it for you…

The Republicans used tort reform and smaller government as a way of firing up their base. So if the Democrats need an issue to fire up their base, insurance reform would be my first pick.

Here's just the latest two examples of what makes my blood boil:

[State Farm Insurance,] the nation's largest residential insurer said Wednesday that it would stop selling new homeowners and commercial policies in storm-damaged Mississippi because of lawsuits and legislative saber-rattling over the company's handling of claims from Hurricane Katrina.

The decision ... is the latest by a major insurance company to reduce its risks by retreating from the nation's coastlines. Allstate Insurance has canceled or weakened coverage, or refused to write new policies in more than a dozen coastal states including Mississippi, Louisiana, Florida and Texas.

"We've reluctantly come to the conclusion that it is no longer prudent for us to take on additional risk given the uncertain legal and business climate" in Mississippi, said Fraser Engerman, a spokesman for the Bloomington, Ill.-based insurance giant.

Translation: we're getting sued big time and the legislature is about to force us to pay up. So we're taking our ball and going home. So there.

This is part of an ongoing trend of insurance companies cherry picking the easiest, lowest-risk accounts in order to maximize their profits. And not only that: they have ALWAYS dragged their feet when it is time to pay a claim. In the aftermath of Hurricanes Katrina and Rita we had to nag and nag and nag our insurance company to come up with a settlement that would actually make our home whole again -- and then they raised the rates as though it was a shock to them that hurricanes happen in Lousiana.

Hel-lo? What is insurance for anyway? Don't they have any actuaries who can actually, you know, read a weather table?

Then there's this:

United Health Group, its United HealthCare and Oxford subsidiaries and several United and Oxford executives, including former United CEO William Maguire, are accused of violating the U.S. Racketeer Influenced and Corrupt Organizations Act (RICO) in a law suit filed Tuesday in the U.S. District Court...by Jamaica Hospital Medical Center and Flushing Hospital Medical Center.

The hospitals...accuse United Health Group...of implementing a “rogue business plan” on a “national level” that, for more than three years, “has contributed to UHG’s profits, which, in turn, have been utilized in attempts to justify outlandish compensation to Maguire and to enhance the value of illegally backdated options for UHG stock” which were given to Maguire, other UHG senior executives and to managers of its business units.

[...]

David Rosen, president and CEO of both hospitals, said: “UHG, United and Oxford have clearly established and refined a pattern of deceitful practices and myriad means to improperly retain money they owe to service providers, and to arbitrarily and unjustifiably deny payment for their members’ medical services under their plans.

This is why I believe that the government should be the sole provider of health insurance for everyone: at least you have a voice in how the system gets run. With insurance companies, the best you can do is be a shareholder and then it's one share equals one vote. The big guys control the system and dictate who gets covered and who doesn't. It's all about the bottom line and devil take the hindmost.

I'd be happy to see Medicare for all and an end to all health insurance companies. Period.

P.S. Read more on the United Health lawsuit.

From John Derbyshire over at The Corner:

CHRISTMAS PRESENT [John Derbyshire]
My health insurer has just notified me, in a brief form letter, that my monthly premiums are to rise from $472.33 to $857.00 on January 1st. That's an increase of 81 percent. ***E*I*G*H*T*Y*-*O*N*E* *P*E*R*C*E*N*T*** Can they do that? I called them. They sound pretty confident they can. Ye gods!

***B*w*a*h*a*h*a*h*a!***

P.S. Did I ever tell you that I hate insurance companies the same way Republicans hate the government? The difference, of course, is that I have a chance at changing the government. But insurance companies? Not so much.

(HT to Kevin Drum)