On Tuesday, August 30 actress and activist Daryl Hanna was arrested in front of the White House for sitting in against the Keystone XL oil pipeline. That pipeline, if built, would transport oil from Alberta, Canada’s tar sands fields to Texas at the Gulf of Mexico.
What does that have to do with our health? you might ask. Indeed, that is a logical question.
First, the oil in question is extremely dirty crude oil. Its carbon content is exceedingly high. In fact, tar sands oil produces 82 percent more greenhouse gas than conventional crude oil. So not only is it much more expensive to convert to, say, gasoline than conventional crude, it also has a far worse effect on the environment even if it doesn’t spill.
But when it spills, it spells disaster. Residents of Michigan can tell you about that. An existing pipeline extends from these same oil fields to refineries in Oklahoma. Now barely a year old, that pipeline has leaked twelve times in twelve months. In July 2010 it spilled one million gallons of tar sands crude into a Kalamazoo River tributary. Forty miles of river are still contaminated with the oil more than a year later. In part, that’s because tar sand sinks in water. Of course, it still coats and kills fish and wildfowl.
So if you don’t want crude oil contaminating your waterways and drinking water or excess carbon, sulfur and mercury polluting your air and soil, there must be cleaner energy alternatives. Or maybe we just have to cut back on our use of energy and our miles of driving, perhaps using electric cars (which still require us to produce that electricity in the first place—we know).
But that soil, air and water pollution don’t really affect us, right? Breast cancer is still on the rise wordwide. Of course, that’s because of “Western” lifestyles, right? According to the World Health Organization (WHO) there will be 20 million new cases of cancer per year by 2030, up from 12 million new cases in 2008. But if the cause were simply our Western lifestyle as so much of the media assure us, shouldn’t the cancer rate reach a steady state, at least in the U.S.? How do we blame a continuing increase in cancer rates worldwide on our Western lifestyle? Has life changed that radically in India and Southeast Asia?
Incidentally, the National Cancer Institute (NCI) reports that the current increase in cancer translates into approximately 56% more cancer in men and 22% more cancer in women over the course of a single generation. The NCI reports that one in two men or women will experience cancer in their lifetime. And it expects the cancer rate to double by 2050. In Ireland, a report just out states that cancer cases have risen 50% since the 1990s. Has Ireland become that much more “Westernized” since 1990?
If this is purely the result of a Western lifestyle, which presumably means inadequate exercise and a diet of processed foods, why do the rates keep rising? Once one does not exercise and one’s diet consists entirely of processed food—which is, unfortunately, the case for many of us—how can you justify further increases in cancer?
The only explanation, we believe, is a continuing deterioration in our environment, with subsequent ill effects on our health. And the Keystone XL pipeline is one more giant step in that direction.
Some of us, no doubt, choose to ignore what’s going on in Japan whether because it’s too much to bear or because we just don’t care. But for the rest of us, whether we are glued to the TV for the latest update or following it at a distance, the ordeal befalling so much of the Japanese population is unspeakably tragic.
And it’s easy to understand how the Japanese people got there. For an island nation with scant natural resources, nuclear energy was the obvious wave of the future. Nuclear energy made them independent of foreign oil–which they desperately needed to power their automobiles, in any case–and harnessed them instead to one of those pursuits the Japanese people do best: technology. So it’s difficult to fault the Japanese for thinking that nuclear power was the obvious solution to their needs.
What were the odds, after all, that an earthquake followed by a tsunami would turn nuclear facilities into seething death traps? Probably quite slender. Yet, as the Japanese and the rest of the world have just found out, those slim odds do come in on occasion, and when they do, the results are devastating. There was a level 9.0 earthquake and it did lead to a tsunami, and the best-conceived power plant technology of 60 years ago has utterly failed. You can’t depend on electrical cooling systems in times of emergency. Nothing less than a foolproof gravity-fed system would have been good enough, and we doubt there is such a thing as a foolproof system anyway. (The plant first to fail, ironically, was built by GE, not by the Japanese.)
But we’re not here to tear apart the promise of nuclear energy. Plenty of others, we suspect, will be doing that in the months to come, though it remains to be seen whether they will be able to alter a national energy policy that is bent on renewing the licenses of numerous American power plants, many of which are leaking radiation and probably in worse shape than the Fukushima nuclear plant was when its recent troubles began.
No, after several days of watching this drama play out in the news (and predicting that we would see a Chernobyl-style disaster or worse before it was over) we were finally struck by a recollection we thought worth sharing. If you are a frequent visitor to these pages, you know our views on fluoride and fluoridation. Despite the propaganda still proffered by the American Dental Association (ADA) fluoride is as certainly detrimental to human and animal health as it is questionable as an aid to dentition.
As Joel Griffiths and Christopher Bryson put it so succinctly in Fluoride, Teeth, and the Atomic Bomb:
Unfortunately, much of the proof of fluoride’s safety rests on the work performed by Program F Scientists at the University of Rochester. During the postwar period that university emerged as the leading academic center for establishing the safety of fluoride, as well as its effectiveness in reducing tooth decay, according to Dental School spokesperson William H. Bowen, MD. The key figure in this research, Bowen said, was Harold C. Hodge—who also became a leading national proponent of fluoridating public drinking water. Program F’s interest in water fluoridation was not just ‘to counteract the local fear of fluoride on the part of residents,’ as Hodge had earlier written. The bomb program needed human studies, as they had needed human studies for plutonium, and adding fluoride to public water supplies provided one opportunity.
Alas, the origin of the whole fluoridation saga in this country (which is–make no mistake–where it all began) was none other than our own Atomic Energy Commission (originally the Manhattan Project, now the Department of Energy, or DOE). The government found that if it was going to pursue nuclear weapons during World War II or, for that matter, nuclear power in peacetime, it would have to overcome one sizable obstacle that overshadowed all others: the toxicity of fluoride, which is used massively in processing uranium. So it ran secret experiments using an unsuspecting public as the guinea pigs. The Manhattan Project had done this with uranium and plutonium and did it as well with fluoride.
Christopher Bryson recounts further in his excellent book, The Fluoride Deception, that Dr. Howard Hodge was assigned to clean up the image of fluoride while he was secretly both the head of the Atomic Energy Commission’s Department of Pharmacology & Toxicology and head of the International Association for Dental Research (IADR). Writes Bryson,
So, for example, on behalf of the bomb makers he covertly monitored one of the nation’s first public water fluoridation experiments. While the citizens of Newburgh, New York, were told that fluoride would reduce cavities in their children, secretly blood and tissue samples from residents were sent to his atomic laboratory for study.1
Bryson also notes that “Adding to water a chemical so toxic that it was once used as rat poison was a uniquely American idea and is, increasingly, a lone American practice.”2 He then adds, “So if this tale of how fluoride’s public image was privately laundered sounds eerily familiar, maybe it’s because the very same professionals and institutions who told us that fluoride was safe said much the same about lead, asbestos, and DDT or persuaded us to smoke more tobacco.”3
We do not find it reassuring to know that our own federal government was largely behind the deliberate poisoning of our public water supply as a solution to the problem of how to dispose of all the toxic waste produced by the chemical fertilizer industry–the same industry that burgeoned at the end of World War II when the government discovered it had all those munitions factories on its hands producing frightful amounts of nitrate compounds for weapons manufacture. Someone got the bright idea that all that nitrogen-based pollution could be converted to fertilizer. And the industry took off, subsidized by the American taxpayer.
Industry continues to pour out fluoride in massive quantities as toxic waste, which is packaged up as fluorosilic acid—a substance too toxic to be placed in a landfill—and shipped off instead to be poured by municipalities into the public water supply. Through municipal taxes, we fund our own poisoning.
The brains behind all this are the same folks who brought you high-fructose corn syrup (a source of mercury and lead as well as fluoride) for your food and corn ethanol for your automobile’s gas tank. Of course, the fertilizer industry, as we’ve already said, was not alone in producing fluoride as a by-product. Production of aluminum and zinc are other massive sources of the poison. The atomic energy industry used it abundantly in World War II and still does today.
Christopher Bryson, The Fluoride Deception, p. XVII↩
Cream has never struck me as a relative term. But recently, I came to realize that it is. I’m talking about the cream that floats on the top of cow’s milk. As it comes from the cow, milk readily separates into milk and cream. The cream rises to the top.
But you already knew that. It’s the stuff of clichés and metaphors.
That’s ostensibly why homogenization was invented. Homogenization keeps the milk and the cream from separating. One would think that was for the purpose of keeping a certain amount of fat content (cream) inside the milk. But now that I’ve come to question the absolute concept of cream, I’ve begun to question that notion too.
You see, for a few years now I’ve bought my dairy products from an Amish farm. That means that I was able to purchase unhomogenized, unpasteurized milk, butter and cream. The cream I obtained from the farm, while far more expensive than what’s available in your local store, is not even remotely similar to the stuff delivered in those cardboard cartons. In fact, you wouldn’t even be able to get it out of them, because it almost doesn’t pour. In fact, when suitably stirred together–even cream itself tends to separate into layers of different densities–it pours about like blackstrap molasses. When you first remove the lid from its plastic container, the cream on top has to be spooned out. That’s why we tend to mix it with the slightly thinner cream on the bottom.
But even that thinner cream exceeds the thickness of so-called “heavy cream” obtained from the supermarket. Mystified by this, I began to do some research. After all, we already know that everything is figured to a cost-benefit ratio in manufacturing. If it costs more to do a recall and make the repair on a defective auto, for example, than it does to settle the resulting lawsuits for deaths and injuries, then the recall doesn’t happen voluntarily.
So presumably someone somewhere is paid to figure out just how much milk they can put in that carton labeled “heavy cream” before it steadfastly refuses to whip when you beat it with your average mixer. As for putting it in our coffee, most of us are pushovers. We’ll use milk–even skim in some cases–so half-and-half is as much like cream as most people ever expect.
Personally, I’ve been avoiding drinking coffee in public–whether Starbucks or otherwise–in part because I’ve learned to drink my coffee with real cream, not the watered-down stuff.
The classifications, please…
Sure enough, there are several classifications of cream based on how it was prepared the old-fashioned way. I can still remember that when we milked the cows on my grandparents’ farm, the milk got poured from those big stainless-steel buckets into the separator. A separator is simply a centrifuge designed to spin the milk, separating out the cream. Then the cream went into a churner–whose mechanism I can no longer recall–and became butter.
The point is, nowadays we “make” cream, or really separate it from the milk using mechanical processes that are a bit more hi-tech, possibly, than my Amish farm uses. The old-fashioned way to make cream is to pour the fresh milk into shallow pans and wait for the cream to rise to the top. After 12 hours, you have what is called “single cream.” And after 24 hours–probably as long as you would want to let fresh milk sit around–you have la crème de la crème, so to speak: “double cream.” That, it turns out, is what I’d been paying a premium for while enjoying real cream from the Amish farm.
It is also a real snap to make into so-called whipped cream. Simply add a bit of sugar and, if you’re being fancy, a bit of cocoa powder, and by the time you’ve mixed the ingredients, it’s what you’d call whipped cream. No need for an electric mixer, simply stirring by hand will do it. Whip it too much, in fact, and you’ll quickly get butter. (I don’t think you’ll have much luck making butter from the “heavy cream” sold in your grocery store, but go ahead and give it a try if you’re curious.)
Another way to make cream is by clotting the milk, which must be unhomogenized, of course. That means heating it in a pan so that the cream rises to the top. This actually provides an even richer cream than “double cream,” which has about 48% milk fat.
In case you are avoiding using these real creams for fear of dropping dead because of a heart attack, keep in mind that the French still liberally use this stuff, and their coronary health is to be envied by the majority of Americans.
“Make the U.S. the envy of several African nations,” he says
Whether you agree with him or not, you have to admit that Bill Maher is the master of acerbic whit and political satire. Here he displays his growing irritation with Obama’s apparent laissez-faire attitude toward right-wing Republicans and the inroads they have made against the Obama administration. He then rips into the healthcare debate in a way that no one we know of can better.
Just a warning: there’s some language partially bleeped out in this one, but you can still tell what Maher is saying.
To counterbalance Maher’s acerbity, we’re following that video with an interview with Bill Moyers, in which Bill Moyers displays the command of language, of history and of the issues that has made him so revered as an observer of the American scene.
If you’re a conservative and not too fond of Bill Maher, we urge you to skip the first video but view the second. Moyers is ever the gentleman. He points out that the big difference between the healthcare fight and the civil rights fight is that the healthcare fight is opposed more strenuously by Big Money. And he points out that the Republicans have every reason to oppose healthcare reform. Not only has there been a conservative revolution in the U.S. in recent decades, but Republicans are reluctant to hand President Obama the biggest political victory since President Johnson established Medicare.
The things they try to slip past you. We were catching up on our reading in the general press, in particular reading a piece in the New York Times about New York state requiring its health care workers to get both seasonal and swine flu vaccines, which has the unions of the health workers up in arms. And there it was, in the Times:
Immunologists generally agree that real protection against any disease requires vaccination rates over 90 percent. But because rumors always circulate and many people fear needles, voluntary acceptance never gets that high.
Nice try, NYT. “Real protection against any disease requires vaccination rates over 90 percent”? (Italics mine.) Does that mean real protection as opposed to the illusory protection we get from vaccines otherwise?
Obviously our NYT reporters are confusing issues here. They refer, we think, to so-called “herd immunity,” which, the story goes, requires over 90 percent vaccination rates to protect the remaining 10 per cent or fewer who are unvaccinated from being exposed to the disease. In other words, if you don’t get vaccinated and over 90 percent of the total population does, your chance of getting the disease drops to a rate comparable to that for people who did get vaccinated. That’s assuming, of course, that the vaccine really works and people really do derive immunity from it, both increasingly dubious assumptions these days.
That, apparently, is what the New York Times considers “real protection.” But, as the main thrust of the Times story clearly demonstrates, 58% of health care workers across the country disagree with that analysis and choose not to get vaccinated against the flu—H1N1 or otherwise.
This first video, a brief excerpt from a roundtable discussion, focuses on the public option in healthcare. In it, first Robert Reich says a few words, then Nobel prize-winning economist Paul Krugman tells us what’s behind the resistance to the public option in the Senate. Then in the clip below that, Robert Reich, who is a former Secretary of Labor under President Clinton and currently a professor at the University of California at Berkeley, explains what the public option really means.
Krugman is Professor of Economics and International Affairs at the Woodrow Wilson School of Public and International Affairs, Princeton University; Centenary Professor at the London School of Economics; and an op-ed columnist for The New York Times. In 2008, Krugman won the Nobel Memorial Prize in Economics for his contributions to New Trade Theory and New Economic Geography.
Robert Reich (below) is currently Professor of Public Policy at the Goldman School of Public Policy at the University of California, Berkeley.
This excellent video combines many of the themes we have discussed here at Health Spectator. We have warned about the dangers of genetic modification (The allure of genetic modification) and extolled the virtues of organic and locally grown foods.
All in all, the movie gives excellent coverage of the range of issues (political, economic, social and technological) involved in growing and distributing our daily bread—or virtually any other food, for that matter.
With a tip of the hat to David Corthell, who pointed this one out to us.
In July 2009, an angry constituent confronted Rep. Bob Inglis (R-S.C.) at a town hall meeting. “Keep your government hands off my Medicare!” the man demanded. Inglis tried as he could to explain that Medicare was and had been from the beginning a government program, but the voter would have none of it.
That episode illustrates the level of confusion surrounding health care reform in particular and our health insurance system in general. For the record, Medicare is a single-payer system, though in recent years private insurance has made huge inroads in altering the system, aided and abetted by Congress. Since it is not purely single-payer in the broadest sense of “everybody in, nobody out,” it does not achieve the economies of scale a nation-wide all-inclusive single-payer system would. And of course, you have to be 65 to be eligible for Medicare.
Our very own socialized medicine
The Veterans Administration (VA), on the other hand, is an example of socialized medicine, since the providers of the healthcare are government employees and the hospitals are all government facilities. So we do indeed have socialized medicine in this country. It is just (ironically) that it exists where most people least expect it—within and on the periphery of the military.
Neither system is inherently bad, though generally Medicare seems to get higher marks from its constituency. The problem with both systems, contrary to what most people believe, is that they are the poor boys of the healthcare system. Because they cater to two groups that have relatively little power compared, say, to the insurance industry—namely, the elderly and veterans—Medicare and the VA system get relatively little attention from Congress.
… and our single-payer system under attack
Let’s be clear that what makes Medicare single-payer is the formula of a government-sponsored payment plan for privately administered healthcare. To the degree that this model is adhered to, Medicare is popular among those it covers. Most of the problems with the Medicare system stem from its concessions to the prevailing external system of private insurance companies. The best example of this single-payer model gone astray is Medicare Part D, which covers reimbursement for prescription drugs.
This system is so complex even pharmacy professionals were totally confused by it for the first year or so it was in effect. It illustrates the downside of having a health care system dominated by the insurance and pharmaceutical industries.
For one thing, when Medicare Part D was passed in 2003 to become effective January 1, 2006, it required seniors to purchase insurance to cover prescription drugs. In a good single-payer system, pharmaceuticals would be covered the same as laboratory tests or doctor visits. Depending on the system, there might or might not be a small copay. But all these issues should be transparent to the patient.
Part D is completely different. There is none of the beauty and economy (for the consumer) of universal coverage. Instead, we have an enigmatic system that has both reduced coverage and increased costs at the same time—precisely what happens when private insurance gets the upper hand.
What’s more, once Part D went into effect, enrollees had to sign up for these benefits within a short period of time or be penalized. (All this from a group of patients whose predominant source of income was presumably Social Security!) As one of our senior readers pointed out in a private correspondence,
Obama says [he wants to cut spending on] Medicare, but that delivered benefits to patients will not be cut. Apparently, he wants to get back some of the money the insurance companies have been stealing. (For example, when Medicare-D was introduced by the Bush League, the insurance companies slashed benefits, increased premiums, raised copayments, and just kept all the extra money the government was giving them.)
Belatedly, the Democrats figured out what was happening. But Obama doesn’t say how he intends to stop the insurance companies from stealing the money. The insurance oligopoly just does whatever it wants unless there is a single-payer system or at least a government-run competing option. But unless Obama can straighten out Medicare, I have no confidence he will straighten out the larger system. It is about time for him to stop talking bipartisanship and to start exposing all the whores and thieves. Here is a perfect opportunity to show why we need a single-payer system—to prevent the sort of larceny that occurred with Medicare-D.
Indeed, an essential part of that larceny was a provision passed by Congress that forbids Medicare from negotiating drug prices with the pharmaceutical companies. Medicare has to pay whatever price the drug companies ask. Yet, given its large constituency, the Medicare system is in an enviable position to exact savings on the part of the seniors it represents. (The VA, in fact, does do this for veterans.) But for Medicare, that practice is strictly forbidden by law, costing taxpayers billions annually.
Given these shortcomings in our existing single-payer system, it is easy to see why so many citizens throw up their hands and shy away from health care reform altogether, even if they have managed to figure the whole system out. But Medicare could be made much better by keeping it to the pure single-payer model rather than saddling it with all the trappings of our private insurance system.
Private delivery of publicly paid care
What’s good about Medicare is that it leaves the healthcare delivery side of the equation alone. You can go to your existing doctor or find another one if you like. (Not all doctors accept Medicare, but then they aren’t all in the same “networks” of existing private PPOs, either. So for those who think they’ve just found a major shortcoming in the single-payer system, nice try—but it’s a wash.)
Walking away from healthcare reform just leaves the thieves and liars to run the show. Far better to exclude them altogether. A pure single-payer system is the only option that makes total sense, because it stands to save the public $4 trillion over the next 10 years, while simultaneously extending coverage to the 47 million or so Americans who are currently uninsured.
That’s why it becomes the least expensive way to cover everyone. By absorbing the money now taken by the insurance industry for overhead and profits and putting that money towards health care, we can add the uninsured to our rolls without increasing overall costs. Suddenly, you don’t have to worry about losing your insurance should you lose your job or about becoming uninsurable because of a prior illness. The current private healthcare system makes it a practice to remove people from its rolls once they begin to need its services.
Choices aren’t always what they’re cracked up to be
Adding a vague “public option” into the mix of private plans providing meaningless choices such as HMO vs. PPO, deductibles vs. copays, should be considered only as a fall-back position in the event that all else fails. We envision a single-payer system in which you get care from your hospital or doctor and the government pays the bill—a healthcare system that is privately administered but publicly funded.
The halfway measure of adding a government-sponsored insurance alternative to the current bewildering array of private plans is not only unnecessarily complex and inefficient, it will simply cost more compared to straightening out Medicare and extending it to all U.S. citizens.
We suggest you write your Congressman and tell him that.
While writing this editorial, we have noticed a few interesting things happening in the media. One is an exchange between CNBC’s Maria Bartiromo and Rep. Anthony Weiner (D-N.Y.) captured on MSNBC.
We had always respected Bartiromo as a business journalist, though we haven’t watched CNBC in years. So we were surprised when she began spouting shop-worn platitudes in the course of this discussion. The notion, for example, that the availability of Erbitux is the barometer by which we judge a healthcare system is totally bonkers. And how many people in this country have access to it via private insurance anyway? We would like to know. (If you have been given Erbitux and had it paid for by your private insurer, please use our comment form below to let us know about it.)
I was a guest on MSNBC’s “Morning Joe” to talk about health care and Bartiromo, who used to work closely with a relative of mine at CNN, was friendly before the segment started. So I was surprised when the show started and Bartiromo went on the attack, asking me how I could say America didn’t have the best health care in the world. Everyone, she said, would choose to be treated in America if they could.
I was staggered for a moment, I admit it, because I thought she was kidding at first. We were probably a full minute into the debate before I realized it wasn’t a joke. And here’s the really funny part: toward the end of my appearance, I said something about how health care in America is great, if you’re an executive at Goldman, Sachs. Then I left the set and… guess who they brought right afterward on to rip me and praise the American health care system? Bartiromo’s colleague at CNBC, Erin Burnett, a former Goldman, Sachs executive.
Bartiromo, both with me and in this spot with Weiner, has been hammering home the same point, that the proof that a public option won’t work can be found in the fact that the public health care system in England will not pay for the colorectal cancer drug Erbitux. I guess she is trying to say that there is rationing of health care in a single-payer system — that the fact that the government will not pay for the most expensive non-generic cancer drug on the market is proof that we shouldn’t have a public option in the U.S.
It drives me crazy when people make this argument. [A] fancy boutique drug like Erbitux[!] I have a very expensive private plan and I can’t even go to a doctor, not even to ask a simple question, unless it’s an emergency. I can’t get a routine checkup, can’t find out what that weird lump in my left foot is, can’t have the pleasure of a routine proctological exam unless I want to pay cash for it, and, well, forget about getting a filling replaced or seeing a therapist to deal with my incipient nervous collapse/burgeoning mid-life crisis.
Hell, forget about paying for Erbitux, if I wanted to get a colonoscopy to find out if I needed Erbitux, I wouldn’t be able to — I’d probably have to wait until I was a fully symptomatic cancer patient before I could even have that conversation on my insurer’s dime. And I’m one of the lucky ones, I actually have money to pay for care out of pocket, if I had to. No country in the world rations care more than the U.S. There are whole generations of Americans (20-40 year-olds in particular) who don’t know what it is to be able to go to a doctor for preventive care or routine checkups. Erbitux, for Christ’s sake! Give me a break.
To watch this short interview and see what your take on the whole thing is, click here. Don’t forget, then, to tell us all what you think about it by clicking on the red text, “leave a comment” in the grey box that marks the end of this posting. That will open up the comment box (if it isn’t already visible) below the posting itself.
Franken, the senator
Another video that hit the wires recently was of Al Franken (D-Minn.) calming down constituents at the Minnesota State Fair. This impromptu discussion is well worth watching, because Franken gives a generally good primer on health care reform issues.
We admit we had our doubts about Franken as a serious lawmaker before, but he shows here that he has the “people skills” it takes to show and earn respect in politics. So far as we’re concerned, that and the level of sensitivity and intelligence he demonstrates here is all he needs. We predict good things to come from this senator and wish him well. The exchange is here.
And to show just how ugly things can get (without even going into the incident in which a man had part of his finger bitten off) here’s a tape from the Star Ledger in New Jersey showing the shoddy treatment given a disabled woman in a wheelchair who tried to speak up about her situation in a New Jersey town hall meeting. There’s much more to it than that, but we’ll let you see for yourself here. Excellent work by the Ledger reporter, Brian Donohue.
There’s one misconception in this video that you should be aware of: Medicare is not socialized medicine, though the VA system is. Medicare, as we said before, is primarily a single-payer system, though private insurance, through its agents in Congress, is making inroads into corrupting that system. And while the narrator is certainly entitled to believe in tort reform, in reality that is a side issue completely unrelated to health care reform. As a pseudo issue, it’s been cleverly planted, we believe, by the opponents of health care reform. We agree with him about the importance of disease prevention and health maintenance in general, but again—those issues are not directly related to health care reform, if by that we understand the matter of reforming health care insurance, or in other words, the ways that we pay for and distribute health care.
Maria Bartiromo and Rep. Anthony Weiner (D-N.Y.) mix it up on MSNBC.
Al Franken (D-Minn.) shows his stuff in calming down a potential angry mob.
Wheelchair woman tries to speak at New Jersey town hall meeting, gets heckled by unruly crowd.
Yes, we’re being ironic. There really is no Republican health care reform plan, as you probably already know. Unless, of course, you count the prattle trotted out by McCain and others who talk about needing to enact tort reform whenever they are cornered and forced to say a few words on the subject of health care reform.
We might have voted for McCain in 2000, given the opportunity, but his policies are looking a bit long in the tooth these days. How times have changed!
Unfortunately, rather than doing something constructive such as joining with the Democrats for bipartisan reform, most Republicans in the House and Senate have settled for blowing smoke and repeating platitudes, most of which are not only shop-worn, but inaccurate.
Recently, one of them ran afoul of that process: a freshman senator in the second district of Kansas, Lynn Jenkins. Confronted with a respectful but persistent 27-year-old constituent who is the single mother of a 2 1/2-year-old boy, Jenkins saw the crowd turn against her after she essentially attempted to blow off the waitress’s question, which the crowd happened to think was a reasonable one: what was wrong with a government-run plan for Americans who are currently uninsured?
Having already stated that she was against any “public option,” Jenkins seemed to think answering that question was beneath her. Then she volunteered that a public option wouldn’t cover just Elizabeth Smith, the 27-year-old hard-working waitress, but would cover everyone in the room. That drew howls from much of the rest of the room, which sported quite a few gray heads. Cries of “what’s wrong with that?” rang out.
So, putting down the notion of a public option can backfire even in a conservative state like Kansas. It’s funny how people are beginning to catch on that maybe they do, after all, deserve health care. Watch it here.
Meanwhile, over at Huffington Post, Jamie Court has government statistics uncovered by the California Nurses Association showing that Pacificare Health has a procedure kill rate of 40%, while CIGNA’s is 33%. That means, quite simply, that these companies routinely deny 40% and 33%, respectively, of procedures ordered by doctors caring for their patients.
Why should you care?
Well, Natalie Sarkisyan’s parents had CIGNA health care, and Natalie Sarkisyan fell within that 33%. Wendell Potter, the former VP of Communications at CIGNA, was obviously choked up as he recounted in this video the final days of the Sarkisyan family’s campaign to obtain Natalie a liver transplant. Watch it here.
Overall, the California statistics show, one in five requests for treatment is denied by California health insurers regulated by the California Department of Managed Health Care. That’s a 20% denial rate for procedures ordered by private doctors throughout the state. Remember those apocryphal warnings of “faceless bureaucrats” coming between you and your doctor? To us, it looks like all of California is covered by a private insurance death panel.
Sadly, California is not alone. It’s no doubt happening in your state as well.
Finally, we have a video for those who might like help separating myth from fact. Alison in Rome supplies palliative facts in this video. Did you know that over 18,000 die each year in our country because they don’t have medical coverage? That’s six times as many as died in 9/11, or 50 people every day.
To Representative Lynn Jenkins from Elizabeth Smith: “Why shouldn’t my government guarantee all of its citizens health care?”
Wendell Potter, former CIGNA exec, recounts the story of Natalie Sarkisyan.
AlisoninRome dispels 3 healthcare reform myths. Were you misinformed?
There’s so much confusion out there about health care reform, and it’s all to the detriment of consumers. For one thing, the very phrase “health care reform” is a misnomer. What we really mean when we talk about health care reform is “health insurance reform,” because the real problem with our system is how we pay for health care.
You see, it’s just too expensive for the average person to pay health care costs given today’s system. Someone we know recently had to spend the night in the hospital for tests when he thought he might be having a heart attack. At the time, unfortunately, he was uninsured.
When he went in, he was told that he could apply to the hospital for charity forgiveness of a portion of his bill. He filled out the necessary forms to establish that he was uninsured and unable to pay. After he was billed separately by both the hospital and the doctors for each individual test and diagnosis, he received a response to his charity application, which was really a summary bill from the hospital. For his one night stay, he was shown a “charity care amount” of $10,626.00. The hospital said it only expected him to pay $3,542. Keep in mind that this was after he had already been billed almost $2,000 for various tests, services and doctor’s fees.
$3,542 for what?
What did he have done? A test of blood enzymes to determine whether he’d actually had a heart attack, limited additional blood tests (primarily a lipids panel), a chest x-ray and a stress test to determine how strong his heart was.
Had he been insured, however, the insurance company would have put a limit on what it would pay for each of those services, as well as for his bed and so on. We’re certain that same night in the hospital would have cost the insurance company less than half what it cost someone who had just proven he was destitute! An amount on the order of $10,626 would never have been mentioned.
In this case, the issue wasn’t with the health careper se. It was the manner of payment—the same thing we’re proposing to fix when we talk about health care reform.
Ideally, someone thinking he’s having a heart attack in a strange city shouldn’t be faced with a dilemma about how to pay. He shouldn’t have to pay more for being out of state (which was a factor in this case) and he certainly shouldn’t have to pay more for being uninsured when it was not his choice to be so. After all, he’d been dumped by his insurance company.
Choice of hospitals and doctors wasn’t really much of a factor in this case. Our hero went to the closest hospital and was treated by the doctors on duty—absolutely no choosing for him at all. But had this not been an emergency, he would have had the option of shopping around for a doctor under a single-payer system.
Why should there be “out of network”?
By contrast, most private insurance plans expect you to pay more for a doctor who is “out of network” if they will cover such visits at all. And if you belong to an HMO, good luck! Your choices are highly proscribed and you are very likely to be told you can’t have certain treatments, just because giving them to you will have an adverse effect on the HMO’s bottom line. We’ve seen it happen in real life.
Insurance companies tell you they’re giving you choices, such as whether to pay a higher premium and get a lower deductible, or vice versa. But the meaningful choice in health care isn’t getting to choose an insurance plan, which merely determines how you pay. Meaningful choice is about who treats you, where you go for treatment and which treatment you will receive. You want to have control over those things, as well as over what conditions you think merit treatment. Since a single-payer system provides private delivery of health care (just like we have now) it wouldn’t change the meaningful choices. The only part it changes is how the bill gets paid. A single-payer system centralizes payment so that it is done either by the government or by a publicly owned agency. There’s no insurance company middle man.
Australia and Canada, for example, have single-payer health care systems. Those two countries rank 7th and 8th, respectively, in life expectancy among nations, according to CIA figures. The U.S. ranks 50th. In 2003 (the latest year for which we could find the figures, calculated in U.S. dollars) Australia spent $2,886, Canada $2,998 and the U.S. $5,711 per capita on health care.
What choices best serve the consumer?
As we go through the debate about health care reform, one of the issues informed consumers should watch closely is whether or not a single-payer option is put on the table. This is the solution least likely to be offered because it is the most beneficial to the public and therefore the least profitable for industry. In fact, a bill in Congress—H.R. 676—represents just such a single-payer system, based on expanding Medicare coverage to cover all. (The bill, introduced by John Conyers of Michigan, is called “Expanded and Improved Medicare for All,” not so surprisingly.)
You won’t find many in Congress or the Senate standing up to push H.R. 676, though, because it is precisely the bill the health insurance industry does not want to see enacted under any circumstances. If it passes, over $400 billion in annual profits will disappear from the health insurance industry, along with a lot of perks for congressional supporters.
And what’s worse, the CEO of United Health Care will have to give up making $120,000 an hour, or at least find some other industry in which to make it.
We bet you’re going to lie awake nights now, worrying about him.
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