Health Care Front and Center

It is nearing "put up or shut up" time for reforming health care. The right-wing lobbyists at the U.S. Chamber of Commerce will spend $100 million to defeat Obama's plans for health care and a clean energy economy. They call it their "most important project" in nearly 100 years. Apparently the only way to stop them is by a loud and vocal citizenry using the only tools they have - the telephone and e-mail - to demand real reform. If the Senators and Congressmen get massive calls from voters wanting Obama's public option to compete with the insurance companies they just might get the message. The only two things they listen to are 1) deep pocket lobbyists and 2) messages from the folks back home who have the ability to vote them out of office.

Medical bills are behind more than 60 percent of U.S. personal bankruptcies, U.S. researchers reported.

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

Below is a link to an excellent article entitled "Why Can't the United States Learn From Other Countries?" In it you will find reference to that excellent PBS documentary on how the single payer insurance succeeds in other countries and spend half per capita than we do.

Max Baucus stubbornly refused to listen to anything that would elminate the 'for profit' insurance industry out of the equation. Do you think there might be a correlation to the $45,250 donation from just one insurance provider, AETNA ? Baucus proudly proclaimed that we would end up with a plan that is "uniquely American". Sounds like he is too prejudiced to admit that other countries can do better than we can or to learn from them

I am sick of hearing that we have the best health care system in the world. Yes, we have the tools and hospitals, but we are among the lowest for results. The World Health Organization ranks us 37th.

You can read this excellent article by clicking on the link.

The Isolationism of Health Reform Why won't Congress consider how other countries do it?

By Timothy Noah

http://www.slate.com/id/2220534/


(I have copied a few excerpts from the following article. It has been heavily edited and redacted by me, but if you have time and are interested in the current fight over health care reform it contains some valuable information. Warnng: it is a long article).

The Cost Conundrum

What a Texas town can teach us about health care.

by Atul Gawande

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yra June 1, 2009

McAllen, Texas is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.

Our country’s health care is by far the most expensive in the world. Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It’s also devouring our government. “The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

McAllen, Texas, the most expensive town in the most expensive country for health care in the world, seemed a good place to look for some answers.

“People are not healthy here.” McAllen, with its high poverty rate, has an incidence of heavy drinking sixty per cent higher than the national average. And the Tex-Mex diet has contributed to a thirty-eight-per-cent obesity rate.

I went on rounds with Lester Dyke, a cardiac surgeon. In the past twenty years, he has done some eight thousand heart operations. I walked around with him as he checked in on his patients recuperating at the three hospitals where he operates. It was easy to see what had landed them under his knife. They were nearly all obese or diabetic or both. Few were taking preventive measures.

Was the explanation, then, that McAllen was providing unusually good health care? I took a walk through Doctors Hospital at Renaissance, in Edinburg. The place had virtually all the technology that you’d find at Harvard and Stanford and the Mayo Clinic. Rich towns get the new school buildings, fire trucks, and roads, not to mention the better teachers and police officers and civil engineers. Poor towns don’t. But that rule doesn’t hold for health care.

There’s no evidence that the treatments and technologies available at McAllen are better than those found elsewhere in the country. Nor does the care given in McAllen stand out for its quality.

Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down? “Practically to zero,” a cardiologist admitted. There is overutilization here, pure and simple.” Doctors, he (General Surgeon) said, were racking up charges with extra tests, services, and procedures.

The Mayo Clinic has fantastically high levels of technological capability and quality, but its Medicare spending is in the lowest fifteen per cent of the country—$6,688 per enrollee in 2006, which is eight thousand dollars less than the figure for McAllen. The four states with the highest levels of spending—Louisiana, Texas, California, and Florida—were near the bottom of the national rankings on the quality of patient care.

Health-care costs ultimately arise from the accumulation of individual decisions doctors make about which services and treatments to write an order for. The most expensive piece of medical equipment, as the saying goes, is a doctor’s pen.

He knew of doctors who owned strip malls, orange groves, apartment complexes—or imaging centers, surgery centers, or another part of the hospital they directed patients to. They had “entrepreneurial spirit,” he said. They were innovative and aggressive in finding ways to increase revenues from patient care.


Then there are the physicians who see their practice primarily as a revenue stream. They instruct their secretary to have patients who call with follow-up appointment when a phone call would do.

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If you read the article you will discover that there are several places that are the opposite of McAllen. The Mayo Clinic is one and Grand Junction, Colorado is another.

My impression of the point of this article is that by computerizing the system, eliminating unnecessary tests and requiring group medical practice, as done at the Mayo Clinic, the cost of medical care could be drastically reduced. Doctors would no longer be allowed to order unnecessary tests to increase their incomes. The way they are paid could manage this. In addition, more emphases must be placed on preventative medicine.

To sum it up, a single-payer system would eliminate the high cost of administration, copying the Mayo Clinic's way that doctors are paid, and practicing preventative medicine would drastically bring down the cost of health care. All will have to be put in place to achieve the goal of getting our health care system under control.

If it isn't done now no elder will see it happen in his lifetime. The confluence of a sinking economy, a president willing to push for it, and the public's demand for it will not happen again in many years. The time is NOW.