Archive for the ‘State Plans’ Category

Much to say in Mid May

Monday, May 19th, 2008

I’ve been on a brief sabbatical and a lot has happened in the two weeks since I’ve last written for this web log.

A patient suffering from Hepatitis - C recently died because he wasn’t placed on the organ transplant list. One reason given was his use of medical marijuana. The doctor used his pot smoking as one of her reasons for declining to enroll him. If it was a moral decision it was wrong. If it was a medical decision the doctor had to make a choice. Who should have access to the limited supply of donor organs? The discussion about the morality of drug use and the socially destructive ‘war on drugs’ is not the purview of this web site but I do have an opinion I wish to share about transplants in general.
There are very few organ donors even though many people die with perfectly good working organs. (If they die of head trauma, their heart, lungs, kidneys, and liver are still alive and functional.) Unless these people have given their advance permission to use their organs, or unless the person with power of attorney for the deceased person’s estate gives permission, these organs die with the individual. Far more organs and organ tissue is wasted than donated. Organ donation should be automatic. There would be less, if any organ shortage for those requiring transplants and the cost would drop measurably. It would lower the prices for transplants, thus giving insurance companies less of a reason to decline covering transplants. (I knew there was a tie in to universal health coverage here.) Any one with religious objections such as Christian Scientists or worshipers of ancient Egyptian gods could opt out of the donation program but they would have to carry a card saying “I am not an organ donor….”

A May 4th story in the New York Times explains that it is not only the growing numbers of uninsured feeling the pinch of health care but the insured also cannot afford to be ill. Insurance was supposed to absorb the cost of illness so as to not destroy the finances of the individual who becomes sick or their family. Employers too are feeling an economic impact. Private insurers seem to be covering a smaller and smaller percentage of medical expenses while making increasing profits. People are paying obscene amounts of money in order to stay well. I am convinced the rash of medical bankruptcies has hurt the overall economy nearly as much as has the mortgage crisis and will continue to damage the economy until we have a national single payer health insurance system.

The next bizarre story is about a gentleman who kept getting billed for a service performed after the death of his wife. This relates to the transplant issue that opened this story. The Seattle Cancer Care Alliance had continued to look for bone marrow to transplant into the woman who had leukemia. She died as a result of a reaction to chemotherapy. They were unaware of her death and the insurance company refused to pay for the services rendered since the patient was deceased.

There were two stories about insurance companies abuse of the Medicare system.
States have requested Congress to allow them to regulate the insurance industry. Many people are buying into private Medicare plans that provide less overall coverage than the government run Medicare plans. The states can currently do little to regulate the industry or mediate insurance disputes between HMO and other insurance  providers and individuals.
With the above lack of regulation in mind the second story is about aggressive marketing. Insurance salesmen deceive the elderly or disabled into believing they are better off joining a private plan. they are using their access to the Medicare lists to cold call Medicare recipients and sell them on privately run Medicare programs. I know of people who have received Pfizer drug marketing pamphlets in government Medicare statements. This is using tax money to provide private enterprise free access to our homes. All the evidence shows that privately run programs are less efficient than publicly run programs. Check out the book Bleeding the Patient by Dr. David Himmelstein, et al, for details on this phenomena.

There have been stories comparing the health plans of the candidates. I’ve written some on that before so I won’t go into too much detail. However, the Seattle Post-Intelligencer (P-I) headline “Democrats’ health care plans follow U.S. tradition” demonstrated the need to bring the discussion about a national single-payer health insurance system into the mainstream. Americans need to know there is a better alternative to privately run health insurance. we need to demand that the candidates support HR676 as the only viable health care option.

There was a Seattle P-I story on the growing number of chronic pharmaceutical users in the USA. Although much of the increase in people using medicine is due to the worsening public health resulting from the American diet, a vast part of the problem is direct to the public advertising by the pharmaceutical companies. Combined with deceptive marketing to physicians, people are being over prescribed medications of dubious value. Melody Petersen’s book Our Daily Meds goes into detail on the subject of the big drug advertising blitz. Petersen and her book were featured on Bill Moyers recently and is discussed by Alison Rose Levy on the HuffingtonPost blog.

David Myers, who has the blog Discuss Race, sent me this story; Ethel Long-Scott, is the Executive Director of the Women’s Economic Agenda Project and wrote in the Black Commentator web log that, “Our nation is being presented with an amazing opportunity right now.”
It is a worthwhile read.

John McCain’s Health Care Nonplan

Thursday, May 1st, 2008

John McCain’s market approach to health care is a fiasco waiting to happen. We already know from Nixon’s White House recordings (after the tone) that discloses the original concept that Health Management Organizations will be to collect payments from employers and individuals without providing benefits to those insured. It is the primary method by which HMOs make a profit as presented to John Erlichman by Edgar Kaiser founder of the infamous Kaiser Permanente HMO. The marketplace provides this incentive. The idea that shifting the burden of insurance cost from the employer to the employee “to foster competition” is irrelevant with such a business plan in place. What will the private insurers compete for?

McCain plans to provide a $5000 tax credit to families in order to pay for insurance. This does a whole lot of good for those people who make $5.85 per hour minimum wage. Since $5000 is nearly half the yearly wages of $12168 for a 40 hour work week, these people won’t receive more than what their current tax refund already is. The tax credits don’t help them one iota.

McCain plans to help the poor by providing some money to the states to administer. However, his plan calls for state administered insurance “pools” so that chronically ill, injured, and older people can be covered. Basically, the states will be “contracting” with insurance companies who will then administer the state programs. This smacks of privatizing Medicare and Medicaid. It has been demonstrated time and again that privately run programs cost more and provide less than non-profits or Medicare.

The McCain plan is like a wolf in sheeps clothing. The wolves are the HMOs. The rest of us are being fleeced.

(Read Bleeding the Patient for a great analysis of the private health care industry.)

NYTimes Report of Massachusetts troubles

Saturday, April 5th, 2008

    Massachusetts has recently implemented a universal system that requires everyone to purchase health insurance. It is no surprise that there is a sudden influx of new patients and that the new system is being taxed to extreme. Whenever a new universal system is implemented we will likely see the same thing happen.

We can count on these statistics being used as proof that a universal system is flawed. Don’t fall for it.

Once there is an equilibrium reached in the number of new patients who have previously been left untreated and the number of patients who are receiving hitherto unaffordable preventative care, this will no longer be a problem. At some point, the number of new patients should start to decline to manageable levels.

As in Canada, the problem is a shortage of doctors and not a result of the payment structure. The cost of receiving a medical education is the problem which results in the subsequent shortage of medical personnel.

http://www.nytimes.com/2008/04/05/us/05doctors.html?_r=1&hp=&oref=slogin&pagewanted=print

….In pockets of the United States, rural and urban, a confluence of market and medical forces has been widening the gap between the supply of primary care physicians and the demand for their services. Modest pay, medical school debt, an aging population and the prevalence of chronic disease have each played a role. Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance….


SinglePayerHealth.org