Tuesday, July 31, 2007
Surely you must qualify for disability. Right?
Don't have disability coverage through your job or personally? Might as well go for SSDI (Social Security Disability Income).
Take a number. In fact, your number is 2,500,001.
Every year 2,500,000 apply for SSDI.
It gets worse.
Of 2.5 million people who file disability claims annually, nearly two in three get denied initially. If they pursue a federal hearing, they join about 745,000 others whose appeals are backlogged.
So who get's approved?
Not these folks!
Jason Hoaks was a corrections officer in Wyoming when he was diagnosed with a malignant brain tumor in 2002. He suffered a stroke during surgery that resulted in vision problems, the loss of strength and sensation on his right side, memory loss and depression. He applied for Social Security disability benefits and was denied.
Brain tumor. Stroke. Seems like these should be a slam dunk.
Houston, 46, says he was injured in 1999 when 32 sheets of plate glass fell on him, shattering his shoulder. He says he suffers from congestive heart failure, chronic diabetes, asthma, phlebitis, sleep apnea and deteriorating discs in his back. Yet a judge assigned to his case ruled in 2003 that he could be a parking lot attendant.
Congestive heart failure. Diabetes. Discs.
Yep, you probably could be a parking lot attendant.
But let's say you like a challenge. You think you can beat the odds. How long before you are awarded the benefit?
As of June, their average wait for a decision was 529 days
How long is 529 days?
One and a half years.
That's 18 months without a paycheck.
Can't wait that long? Don't live in Atlanta. The wait is 932 days. Want a short wait? Move to Harrisburg, PA. The wait is only 276 days.
So what do you do while you are waiting on the appeal?
"People are living in cars. People are going from one family member to the next," says Matt Greenbaum, a New Orleans lawyer who has represented disability claimants for 30 years. "I had a hearing the other day where the judge asked him his address. He couldn't give an address because he didn't have one."
No address. Bet he doesn't have a phone either.
So how is Social Insecurity going to let him know the status of his appeal? Maybe they will send Ed McMahon out . . .
But once you receive the award, you get to keep your benefits, right?
Not so fast.
Katie Probst was awarded benefits in 1991 for her lupus and depression but lost them five years later. The Clayton, N.C., woman got them reinstated, only to be told in 2001 that she had collected them improperly and owed more than $50,000. It took five years to win her appeal, during which time her husband worked seven days a week. "It was like starting over," Probst, 52, says. "I still had to prove to them that I was sick."
Debbie Cline, 45, of Loganville, Ga., waited three years to collect insurance for bipolar and manic depression. She became homeless and moved back in with her ex-husband. "They just keep you waiting like you're a puppet," she says.
Moving back in with the ex. That's almost as bad as moving back with mom & dad.
Sounds like the Social Insecurity Administration isn't doing a very good job of managing assistance for those who need it most.
God help us if we finally get a government run universal health care plan and they turn it over to Social Insecurity to manage.
Monday, July 30, 2007
But all is not well in the Peach State.
Consumer health advocate Linda Lowe said, "There are widespread reports of children with serious conditions being denied therapies while their medical providers jump through arbitrary authorization hoops."
Widespread reports . . . denied therapies.
Sounds like rationing of services.
The state believed the HMOs "could do a better job managing the care of our members" and save taxpayers money,
The plan worked. In the last fiscal year the state saved the taxpayers of Georgia $78,000,000.
Since the HMO startup, a number of doctors, aggravated by what they call slow and reduced pay from HMOs, have limited the number of patients they will accept from the government programs. Dr. Richard Wagner, a Sandy Springs pediatrician, is one who has cut his Medicaid/PeachCare patient load. The HMO experience, he said, "has been a mess.''
And based on lower fees and more administrative hassles, Dr. Mark Ritz, a Homerville dentist, says he and other dentists are re-evaluating their participation in the government programs.
It would appear that medical providers don't want any part of this program that covers approximately 900,000 Georgians.
What good does it do to have a taxpayer funded program for the poor if they are denied access to services?
A lingering problem involves gaps in the HMOs' doctor networks. Beth Sullivan, a family doctor in Commerce, said a 5-year-old patient had to be driven more than 100 miles to Augusta for an orthopedist willing to treat his broken wrist under his HMO.
That's a two hour drive.
Of course, had it been an emergency care could have been administered closer to home.
At least, that's the theory.
Adding to the chorus of criticism are complaints from many hospitals that say they're losing money on the government programs. "It has been an administrative nightmare," said Tish Towns, vice president of government relations for financially strapped Grady Health System, which operates Grady Memorial Hospital in Atlanta. "I think there's a tremendous amount of work to do to get this right.''
So doctors aren't the only ones threatening to pull out.
"Several rural hospitals have faced near-failure to make payroll, and most rural hospitals are in a cash-flow crisis" because of reimbursement problems
What does this tell us about the future of government managed health care?
Georgia has an estimated 4.6M citizens. About 900,000 of them are on Medicaid. If the state can't do a better job of managing care for 20% of their citizens, then how well would they do if they were to cover 100%?
Right now the state is experimenting on the poor. People who have few, if any choices. If this type program were instituted to cover 100% of our citizens, how many with the means to pay would simply cross state borders, seeking care from private practitioners willing to treat on a cash basis?
Thursday, July 26, 2007
Yeah, I find it hard to believe too.
The Main family of Port Charlotte, Florida was supposed to be in Michael Moore's movie but somehow got left out.
Tom Main, a self-employed electrician making about $40,000 a year, had no health insurance and did not qualify for the Florida KidCare state insurance program after moving here from Colorado.
He joined the National Association for the Self-Employed, making him eligible for health coverage. In December 2005, an agent from MEGA Life and Health Insurance Company sold them a family policy at $227 a month.
That's a low price for a family of 4. No one questioned it?
The policy they bought is a limited benefit plan that caps the payout to providers.
Did they read and understand the policy limits?
According to the carrier:
"Mr. Main indicated that he understood the policy and at no point expressed that he had been told anything different about the policy by the agent who sold the policy, or express dissatisfaction with his coverage and benefit selections," Ledbetter said in an e-mail.
So Mr. Main clearly understood what he was buying, right?
An ambulance took Kenny to All Children's Hospital in St. Petersburg, where he was diagnosed with acute lymphoblastic leukemia.
When Tom Main handed over his insurance papers to the administration office he was prepared for the $5,000 deductible, but surprised when he was told the policy would not be adequate.
In all fairness, insurance policies can be written in language that might as well be in a foreign tongue to the untrained eye. That is why one should never buy a policy, even from a carrier you know, without first asking a disinterested third party to review the details.
You can start by asking your doctor if they take assignment of benefits from that carrier. If the answer is no, then go no further.
Your next call should be to the business office of your local hospital. Ask them the same question. Better to know up front than after the fact.
If Mr. Main had done this before his child became ill perhaps much of this could be avoided.
This is not casting blame, but when you buy a plan that is designed to provide you with a virtually unlimited line of credit when you need it most, it is better to find out IN ADVANCE is this is the plan you need.
In October, a film crew accompanied Hesper Main and Kenny in the family minivan on the drive to St. Petersburg, filming inside the van, at All Children's and then back at their home, where they treated the family to pizza.
When they were cut from the film, Hesper Main said that the production assistant they had been dealing with felt so bad that she offered to push their story to a companion piece running in "People" magazine.
The family's story made it into the July 23 issue, with Harry Potter on the cover.
This is a situation that even a wizard can't cure.
Do yourself a favor. Stop what you are doing right now and get your policy. Read through it paying particular attention to policy limits. Next call your doc and your local hospital. Ask them what they know about the carrier or the policy you have. It might even be worth your time to buy a cup of coffee for someone in the business office of the hospital.
Better to spend a few bucks now than losing your home later.
The post from Colorado Insurance Insider is a must read! Here is the tease . . ."Dealing with health care providers without the assistance of an insurance company is like dealing with the mafia."
Wednesday, July 25, 2007
This comes in the form of universal, single payor health insurance funded with (what else?) . . . taxpayer dollars.
The Democrats control the cheese state's Senate and are considering bypassing GO and forgetting about the $200 by going directly to a full blown "cover everyone" plan. No baby steps for these folks. Going directly to "free" insurance for everyone.
So how much does "free" cost?
The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes. It represents an average of $510 a month in higher taxes for every Wisconsin worker.
So, assuming their numbers are correct (and we have a history of politicians UNDER estimating costs) that means doubling the current tax revenue base and then some.
Employees and businesses would pay for the plan by sharing the cost of a new 14.5% employment tax on wages. Wisconsin businesses would have to compete with out-of-state businesses and foreign rivals while shouldering a 29.8% combined federal-state payroll tax, nearly double the 15.3% payroll tax paid by non-Wisconsin firms for Social Security and Medicare combined.
Out of state competition for business? Surely that won't happen!
How dare companies in IL, IA, MI and other neighboring states EXPLOIT the people of the great state of Wisconsin by undercutting prices (since THEY don't have to pay the 14.5% tax) costing jobs for Wisconsinites.
And let's not forget the folks that say guv-ern-mint can do a much better job, more efficiently, for less money.
So where will savings come from? Where they always do in any government plan: Rationing via price controls and, as costs rise, waiting periods and coverage restrictions.
Seems to me the folks need to keep what they do best. Turn out some really good cheese and a good football team.
Wonder what Brett Favre thinks about this?
David Malleau awoke in hospital with a gaping hole in his skull.
The 44-year-old Hamilton truck driver had suffered a devastating car accident in 2004 that forced doctors at Hamilton General Hospital to remove a fist-sized piece of bone from his skull to relieve pressure on his brain.
Once the swelling subsided and he was ready for surgery in March 2005, Malleau was sent home and placed on a waiting list.
Three months passed. Then six. He waited at home, a prisoner unable to leave the house for fear something would hit the exposed side of his brain - for him a potentially fatal incident. In the end, it took nearly a year before he could get skull replacement surgery.
Placed on a waiting list.
My, my, my.
Malleau, after finally getting his skull replacement surgery in January of last year, is paralyzed on his right side and his speech is only now beginning to return.
"I've pretty much had to fight for everything," says his wife Pat, a former bookkeeper.
"We were taxpayers. Owned our own home. We went from having our jobs, being in the middle class, to nothing."
Excuse me. I thought it was only in America where people could lose their home due to the health care system we have.
Mr. Malleau could have avoided the wait by coming to America...as long as he had the ability to pay.
Seems like a Catch 22 situation.
Tuesday, July 24, 2007
While recognizing that many Canadians believe that we have one of the best health care systems in the world, the founders of Timely Medical Alternatives Inc. also recognize that there are some 875,000 Canadians currently on the waiting list for referrals to specialists or for medical procedures.
An organization to help Canadians with the ability to pay to take charge of their health care.
We have helped our clients to regain their mobility, to get relief from chronic pain, to get diagnoses of illnesses and we have, in some cases, helped to save the lives of a number of our fellow Canadians.
Isn't that what health care is all about?
Few Canadians realize that:
• Surgical waitlists in the US are measured in weeks instead of the years which Canadians are often forced to wait.
• Cutting edge medical procedures and pharmaceuticals which are unavailable in Canada, are readily accessed by American patients.
No waitlists, cutting edge medical procedures & pharmaceuticals, no rationing of operating room time.
Probably just me, but isn't this a BETTER system?
We believe it is time that Canadians realize that the rest of the developed world is NOT out of step. It is Canada which is out of step with the rest of the world.
And this is interesting as well.
If Canadians choose to go outside the system and pay for care, they can go here and find private fee for service clinics in Canada and the U.S.
With all that "free" care, why would anyone want to come here?
Was Michael Moore wrong?
Monday, July 23, 2007
They're receiving care despite cutbacks that crippled the staff of Grady Memorial Hospital's ophthalmology department.
The eye clinic — a relatively small service in a medical complex serving almost a million patient visits a year — now schedules 60 to 80 patients a day, down from 120 just weeks ago. Many of its patients include those with advanced glaucoma or diabetic eye complications
One million patients per year.
Most without insurance.
Almost all receive "free" care courtesy of the taxpayers of Fulton & Dekalb county Georgia.
Patients without Medicaid or insurance have no choice but to live with the delay, said Annie Tribble, 51, the uninsured glaucoma patient who stays at a women's shelter. Waiting, she said, "is better than not seeing about yourself at all."
Symptomatic of public health.
More than 400 of the health system's 562 eligible employees accepted, about twice as many as administrators said they expected. A third were nurses, nursing assistants, clerks and other workers in patient care, which accounts for 1,500 of the hospital's 5,000 workers, said Kirk Wilks, Grady's vice president for public affairs. Another 13 percent came from laboratories and radiology.
Of the 422 positions vacated by retirees, about 300 have been or will be refilled since no bedside nursing jobs will be eliminated, Wilks said.
A few days later, Wilks was gone — laid off in an additional cutback
Cutbacks in non-essential personnel.
The buyout was an attempt to stem losses at the state's largest public hospital, which has operated in the red every year since 2000. Consultants hired by the hospital's governing board reported $67 million in losses last year and said 2007's deficit could be even higher.
The more money that comes in, the more that flows out.
There is no end.
In a cash-strapped hospital with aging equipment and a largely indigent patient population, "people learn to make things work and maximize resources," Lewis said. In addition, he said, the senior staff "developed long-term relationships. Those are the things you lose."
Delays in care.
Is this any way to run a health system?
One uninsured ophthalmology patient who came through the emergency room this summer told doctors she had been sent there by a private physician who told her that, because of the wait for a clinic appointment, she should lie and say she'd been hit in the eye, said ophthalmologist Broocker. His team discovered a tumor.
The woman now receives ongoing treatment at Grady.
Told by her doctor to go to Grady.
Because care there is perceived as "free".
Even by someone who (should) know better.
Sure, this is Grady. Just one hospital in one city. But the issues Grady faces are reflective of what can happen with taxpayer funded, government mis-managed health care.
Is this really what the public wants?
Sunday, July 22, 2007
Now that we're talking about Q’s, let’s talk about health care queues.
Do governments deliberately manage the cost of their health care and single-payer insurance systems by restricting budget expenditures, thereby restricting capacity and forcing people to queue up and wait for health care services?
Persistent patient queues are evidence that the answer to this question is “yes.”
Many people claim that there are no meaningful queues in countries such as Canada and the U.K. That claim is false. The Canadian Supreme Court ruled in 2005 that "delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care."
In the U.K., complaints about waiting times for services continually comprise more than 25% of procedural complaints (i.e., excluding clinical complaints).
Many other people claim that there are no such problems in waiting for access to health care in the U.S. That claim is equally false.
Well, now, does that mean the objections to single payer because of waiting lines, are invalid because there are waiting lines in the U.S., too? Whoa, whoa, not so fast.
Two media reports just in the past week point to a major cause in the U.S. for people having to wait in line for health care. Irony of ironies, that cause is government-financed health insurance.
The first report appeared in the Wall Street Journal on July 19. This front-page article was about Medicaid, under which physician reimbursements are set so low that doctors say they lose money for most Medicaid services they perform. More and more doctors refuse to see Medicaid patients. Fewer participating doctors = waiting longer for an appointment.
The second report says that more than 25% of mammography centers in New York have closed since 1999, causing almost a tripling of wait times for appointments. Reason? Medicare pays only about 2/3 of the cost of a mammogram, and the centers are exiting that business. Fewer mammography centers = waiting longer for an appointment.
Is there any reason to believe either Medicare or Medicaid would do a “better” job if the government controlled 100% of health insurance in the U.S? I say no.
I think there are good arguments for single-payer, and there are good arguments against it. As a nation we are really not very close to resolving this debate on any rational basis. (We may be close to resolving it on some irrational basis – that’s a subject for another day). Meanwhile the queues in Canada and U.K. persist, and waiting lines are growing in Medicare and Medicaid. These events suggest that, while government-financed health insurance systems can be effective at reducing their budgets, they are much less effective at reducing health care costs. Accordingly, their strategy of reducing budget expenditures has the principal effect of reducing health care capacity. Less capacity = waiting longer for an appointment. Anyone think that's a solution? Not me. It's my idea of running thru Hell in gasoline pants. (thank you, Nipsey Russell).
Saturday, July 21, 2007
The zone was recently expanded to include one of London’s largest hospitals, Chelsea & Westminster. And what happened? “Suddenly, the hospital’s emergency room was busiest just after 6 p.m. – when the zone stops operating – instead of at 4 p.m.” The chief executive of the hospital remarked that “maybe the ER patients are not as urgent as they thought they were.”
The article further reports that “People who can prove they drove through the zone for a genuine medical emergency can get a refund but that doesn’t include women in labor” to which a woman who recently had a baby at this hospital and paid the fine for driving there commented: “it wasn’t worth contesting because they really do not care.”
Stiff upper lip, you blokes. See, medical care in the sceptered isle is still free.
Friday, July 20, 2007
Thursday, July 19, 2007
So here are some new ones you may know.
Stupid carrier trick #236. Blue Cross of Georgia decides to roll out a new product. Actually, it isn't new but rather imported from their parent company in California. Seems Tonik has been a hot seller in California so now it is time to introduce young Georgian's to it.
On Monday 11/20/2006 an email goes out to all brokers announcing the new product and inviting brokers to the kick off & training session.
So what's the problem?
Monday, 11/20/2006 is 3 days before Thanksgiving.
The meeting is on Tuesday 11/21/2006.
Next comes Coventry with their new individual product. They have been active in the group market for some time (operating under various names) and decided to introduce a new individual major med product to Georgia. This plan is suppose to compete handily with the much entrenched Blue Cross plans. The new Coventry plans are almost a carbon copy of the Blue plans but with more bells & whistles and a lower price. They feature quick turn around in underwriting, fast issue . . . everything you would want.
The product is approved for sale for April 15th effective dates.
The kick off meeting is never officially announced to the brokers but by way of the grapevine I find out the kick off meeting is to be held on 4/19/2007 . . . four days after the product could officially be offered.
Despite a less than auspicious start the product has been well received. In fact, too well.
They have so many applications they cannot get the policies out the door until weeks after the effective date. Letters are sent out informing a client they are approved for coverage yet when those clients call customer service it seems the enrollment department has no record of the underwriting approval issued 3 weeks earlier.
Of course since enrollment has no record of the individual, no premiums have been drafted.
Next comes Humana. (Might as well spread it around. No need to just limit it to one carrier.)
They roll out new products in Colorado and are well received. A few months later they are introduced to AZ, IL, MI, LA, OH & TX.
So how is the announcement handled?
With a write up in a business newspaper.
And the brokers?
Not a word . . .
In case you are wondering, most carriers get 85 - 90% of their new business from brokers.
Not direct to consumer advertising.
Not from home office captive agents.
From independent brokers.
Now comes one of my favorite carriers.
Last year about 60% of the business I wrote went with United HealthCare (AKA Golden Rule).
They are a great company with very good customer service, competitive products and a strong network. Their forte' is the HDHP (high deductible health plan) coupled with a seamless HSA (health savings account).
UHC owns Exante Bank. When a client buys the health insurance from UHC and opts to let Exante handle the HSA they can also let UHC draft directly from the HSA to pay providers.
The way this works is neat.
You see your doc, give them your card, and when you leave you do not pay. The doc files the claim with UHC on your behalf. About 2 weeks later the claim is processed and adjudicated by UHC and the lower, negotiated rate structure is applied. UHC then drafts your HSA and pays the provider for you.
This system works so well that I asked UHC if they would be willing to do the same for their other high deductible plans that are not HSA compliant. What could be more simple? The carrier already has the ability to perform a service to their client, allowing them to access providers without making a payment at time of service.
Granted, the HSA is a tax qualified plan but you can also have a non-qualified HSA. All the same benefits EXCEPT the tax favored transactions.
UHC has the system in place to draft directly from Exante Bank accounts.
UHC owns Exante Bank.
Simple request, huh?
The response is . . . "UHC will not be introducing new products with this capability".
What new product?
Same product you have now. The only change is performing a CUSTOMER SERVICE by drafting from an account OWNED BY UHC, funded by the policyholder and paying the provider directly.
This stupid carrier trick tops my list.
At least for now . . .
Perhaps the U.S. can do what the Brit's have done and ration health care.
One approach, used in Britain for many years, is rationing. This brief examines many of the issues involved with rationing health care by applying its principles to radiology, using examples from the budgetlimited British health system. There, policymakers and medical providers routinely grapple with two difficult and value-laden questions: How much should be spent on the expensive but life saving technology? And how much should be spent on very costly research to evaluate that investment?
An argument that appears quite often is the amount spent on health care in the U.S. as a percent of GDP when compared to other countries. This report (albeit from 2001) shows the U.S. spending 14% of GDP compared to 9.5%, 9.7% and 7.6% respectively for France, Canada & the U.K.
Since these other countries supposedly have better results by spending less then the solution seems simple.
Either we ration care like they do in the U.K., or we use 40% fewer medical services, or simply persuade the medical providers to accept 40% less than they do now.
Seems simple enough.
Wednesday, July 18, 2007
Tuesday, July 17, 2007
Monday, July 16, 2007
Well, hip replacement surgery is okey-dokey, as is breast-reconstruction following a cancer-related mastectomy. Wouldn't it follow, then that gender-realignment procedures would be eligible for consideration?
Well, according to those neanderthals at the IRS, the answer is "no:"
"(A) 57-year-old suburban Boston man underwent a sex-change operation. Then she [he?] wrote off the $25,000 in medical expenses on her [his?] taxes.
But the IRS disallowed the deduction — ruling the procedure was cosmetic, not a medical necessity — in a potentially precedent-setting dispute now before the U.S. Tax Court."
And there it stands; the gentleman, er, lady in question has sued the IRS, seeking to have the substantial cost of the surgery made eligible for special tax treatment. The IRS maintains that this is elective, cosmetic surgery; the plaintiff argues that it's medically necessary.
Should make for some fascinating Court TV.
[*See comments for an update]
Insurability and affordability.
Now it appears the HR Policy Association in conjunction with Aetna is preparing to offer coverage with few strings attached.
Under the Retiree Health Access program, no retiree could be turned down for coverage, regardless of prior medical conditions. Specifics of the plans will vary by employer, but a typical plan will have an annual deductible between $500 and $1,100 and a monthly premium between $400 and $1,200, depending on how much an employer chooses to contribute.
Sounds good to me. Read more here.
Friday, July 13, 2007
Thursday, July 12, 2007
Wednesday, July 11, 2007
Heck, there is even a film about how bad health care is in this country . . .
Well I decided to do a little searching on my own and guess what I found. There is a plan that covers everything for less than $2000 per year.
So what do you get for that kind of money?
Just about anything you need.
Complete coverage for everything including medicine. Most pre-existing conditions are covered after a waiting period.
There are some downsides such as asking you to provide a urine sample in a mayonnaise jar, having to wait in line to see a doctor, waiting in line to have X-rays or lab work. If you have an unanticipated medical need (but non-emergency) in the middle of the day you will be lectured about why you didn't show up at 7:30 in the morning. Eventually you will be seen.
Almost everyone who has a job receives coverage at no charge to them.
So what's the catch?
You may have to travel a bit to receive coverage. You will be required to use state run facilities if you want to receive full benefits. And it helps if you speak Spanish.
Want more details?
Look here, here and especially here.
Tuesday, July 10, 2007
Monday, July 09, 2007
Sunday, July 08, 2007
I haven't seen all of Sicko, just enough to make a few comments. Yeah, the production looks good technically but basically, I think the movie should be no more relevant than, say, Hunt for Red October to an intelligent discussion of the issues of health care and health insurance. Why do I say that?
Because the undeniable fact is that insurance is expensive because health care is expensive, not the other way around. Does Moore say that? No he does not. The cost of insurance is rising because the cost of health care is rising. Does Moore say that? No, he does not. The high cost of insurance is a symptom of the deeper problem of health care costs – and if our nation cannot solve the deeper problem, we will never be rid of the symptom. Does Moore say that? No, he does not. He’s pecking around the fringes, not facing the problem itself. Worse he does not clearly articulate the problem as either health care or health insurance. Sorta like some people in Colonial times, he’s stuck a feather in his cap and called it macaroni. Of course what one sees is nonsense on stilts. But it is what it is.
So Moore confuses the difference between health care and health insurance – I think deliberately, since Moore is not a stupid man. Confusing these two hides the real problem. It ends up feeding people’s fears that they cannot afford “health care” because they can’t buy insurance when the truth is that most of us can’t afford health care because HEALTH CARE costs so freakin much!
IMO, what Moore is selling will screw us. And because I think he knows exactly what he is doing, I see him less as an advocate and more as a pimp. By pushing confusion about the deeper problem, Moore in fact is an impediment to understanding. That is why I say, the movie should be irrelevant to an intelligent discussion. Should be. But won’t be. Won’t be irrelevant because the discussion is driven by naivete, ignorance, fear, and cynical politics.
It is a natural human temptation to minimize the importance of facts one doesn’t want to be true, especially when the facts reveal problems that are very difficult to solve. In this case, I believe that the people who are most pleased with Moore’s movie don’t want certain facts to be true. Think about our government's biggest existing health insurance programs - Medicare and Medicaid. Facts are, these programs are rapidly being crushed by the cost of health care (Medicare alone has a $60 Trillion unfunded liability) and are far from effective in meeting the needs of the elderly and poor populations because of fraud, waste, federal budget politics, political corruption, organizational inflexibility, bureaucracy, and the massive amount of law & regulation that governs everything they do. Add to that the health costs driven by our own unhealthy behaviors; we are becoming a population that refuses to take responsibility for our own health except as it can come in a pill-bottle or operation that we demand someone else pay for.
Is there a single reason to suppose that these problems would go away - that our government could do a "better" job with health insurance - if only the government controlled all of it? I think the answer is obvious. No, it could not.
Many of the same people who prefer not to talk about the very real problems in our present government insurance programs, also don’t want to take seriously the problems and occasional failures in other countries’ health insurance schemes. As though if they were to admit there might be a problem elsewhere, the cause of attaining the universal health care in this country would be derailed. Is universal health care such a fragile patient that it cannot stand an honest examination?
IMO, an unwillingness to consider forthrightly the problems that all governmental insurance systems do have is a major obstacle to designing a plan that has a chance of being a “solution”. It is an obstacle because it gets in the way of clear analysis. Instead we hear far too many ad hominem attacks, or appeals to false authority, or fallacious logic, or the old chestnuts “everyone knows” and “this is a no-brainer” not to mention the usual litany of complaints about the cost of insurance, all the while ignoring the cost of health care that is responsible for the high cost of insurance.
BTW, I favor universal health care. I also favor universal health insurance to help pay for health care. There is a lot of work to do because wishing does not make it so. I do not confuse health care with health insurance. I believe that the linkage of group health insurance with one’s employment, while a useful tactic for decades, has outlived its usefulness and it’s time to re-think. At the same time, I believe that any universal insurance scheme whether public or private CANNOT succeed in this country, unless the costs of health care can be reduced and the annual rate of growth in those costs is brought under meaningful control. I favor a substantial role for the private insurance sector in any universal health insurance scheme - as in France, or Germany, or Chile or other countries. IMO, a basic public insurance plan that can be supplemented by private insurance is a reasonable approach and a preferable alternative to the enormous bureaucracy that results within a fully-centralized health care and insurance system such as in the U.K. And, of course, I think that Moore’s movie should be irrelevant to an intelligent discussion of the issues with either health care or health insurance in this country.
More Equal Than Others.
One of the most prolific, and tenacious, canards cited by those who advocate a nationalized health care system here is the (demonstrably) false assertion that such a system saves more lives than ours.
Let’s play a game. Roll time forward a bit…universal healthcare has arrived and you are now a Regional Head of the Healthcare System. You have an annual budget that you absolutely can’t exceed. The medical expenses for your region have been increasing and this year you’re going to exceed your budget. What do you cut? Medical staff? Drug expenditures? Or do you defer maintenance and maybe cut back on some housecleaning?
Some Future's Aren't Fun
“The National Health Service in England faces a shortage of nurses and family doctors over the next four years, according to a leaked government planning document seen by the Health Service Journal” and NHS “also predicts an oversupply of 3,200 hospital consultants [i.e., specialists], the medical weekly reported on Thursday.”
More from Across the Pond…
As we’ve noted before, the British National Health System (NHS), while touted as far superior to our own flawed efforts, continues to prove its proponents wrong. For example, Britain's Royal College of Obstetricians and Gynaecology is now urging doc’s to do away with sickly infants, which “can disable healthy families.”
No Tickee, No Chemo…
“Thousands of prostate cancer sufferers in Scotland are facing a "postcode lottery" over a new treatment for the disease.
The drug Zometa, has not been approved for use in Scotland, despite being available in England and other EU countries.”
The Dark Side of Universal Health Care
Multiple Sclerosis is “an autoimmune disease that affects the central nervous system (CNS)...In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions.” It is a debilitating disease, one that robs its victims of their health and, sometime, life.
It is also, generally, treatable and manageable. Medications and protocols exist that help those with MS function, contribute, and enjoy life.
And that concludes today's review. Any or all of these may appear on your final exam.