Dose of Reality: My Rogue Big Toe

Neil Davis' latest Dose of Reality confronts a cost-saving measure often touted by those who don't follow their thought through to its consequences:

One oft-repeated conservative mantra we hear nowadays is the one telling us that the road to health care reform requires each of us to take on more personal responsibility for our own health care. You have to read between the lines to get the intended message here: each of us needs to take care of our own—and nobody else’s—health care needs. In there also is the idea that we should not help raise overall health care costs by running off to the doctor with every little sniffle and ache.

Davis experienced the hidden ingrown toenail in this viewpoint: quite literally.

I suddenly found myself unable to walk and with severe pain that improved only slowly as I spent the next two days in the Intensive Care Unit of Fairbanks Memorial Hospital, and then, after being Medivaced to Anchorage, another nine days in the ICU of Providence Hospital.

Sometimes, it's best to let the experts deal with small things, before they turn into big expensive painful things. And since your average person doesn't have the training to recognize when a small thing can become dangerous, how can one distinguish between "taking responsibility" and "risking life and limb"?

Baucus bill written by Wellpoint

An interview today on Democracy Now! with Dr. Steffie Woolhandler makes it clear that the health care reform bill is skewed. Woolhandler explains:

The reform process in Washington has been hijacked by the private health insurance industry. If you look at the Baucus framework, which was the basis of the Senate bill—it’s on the Senate Finance Committee website. Just right-click on that document, and it turns out the author of the document was Elizabeth Fowler, who’s a former vice president of Wellpoint, the nation’s largest private insurance company, covering 35 million people. So the private insurance industry has hijacked the process. What’s come out of the House, what’s likely to come out of the Senate, is a completely inadequate bill that takes about $500 billion in taxpayer money and hands it over to the private health insurance industry.

… the Massachusetts plan is considered the model for the national legislation. There’s a mandate that makes it illegal to refuse to purchase private health insurance. The fine is up to $1,068. The good thing with the Massachusetts plan was there was a big Medicaid expansion, but you didn’t need to do the mandates in order to do the Medicaid expansion.

Much of the Massachusetts plan has been wildly expensive. According to the state’s report to its bondholders, it’s cost $1.3 billion this year. The state has opted to pay for that by stealing money from safety net clinics and hospitals, so that safety net providers that care for immigrants, the mentally ill, people with substance abuse, that provide primary care, they’ve seen their funds shrunken, so that money could be handed over to purchase insurance policies. Massachusetts now has the highest healthcare costs in the history of the world.

Democracy Now! has been closely following the health care reform issue. For further background on this bill, see also this recent interview with Rep. Dennis Kucinich and Jane Hamsher.

Franken on medical bankruptcies

Health care discussion panel

The University of Alaska Fairbanks Student Pre-Medical Society will host a free public panel discussion on health care reform and how it could affect Alaskans Sunday, Oct. 25, from 4-6 p.m. at the Davis Concert Hall on the UAF campus.

"The UAF pre-med society's goal is to offer the public useful information and discussion on health care reform in understandable language," said Nick Bajada, public relations officer for the society and an undergraduate in UAF's biomedical program.

Panelists include Richard Seifert, a UAF professor and member of the Fairbanks Memorial Hospital Foundation Board; state Sen. Joe Paskvan, vice chairman of the Senate Health, Education and Social Services Committee; Melanie Arthur, UAF assistant professor of sociology; Mike Powers, Fairbanks Memorial Hospital CEO and fellow of the American College of Healthcare Executives; state Rep. John Coghill, member of the Health, Education and Social Services Committee and the HESS finance subcommittee; Lloyd Hilling, Tanana Valley Campus economics instructor; and Dr. Mark Simon, medical director of Golden Heart Emergency Physicians.

The event is free and the public is encouraged to attend. Seating is limited.

CONTACT: Nick Bajada, UAF Pre-Medical Society public relations officer, nickbajada@gmail.com. Marie Gilbert, Institute of Arctic Biology information officer, at 907-474-7412 or megilbert@alaska.edu

Health care reform is real

This month's Dose of Reality concerns the way the American public pays for health care:

[I]t is important to remember that the public always pays, and in fact, it is the only payer of the cost of health care. Many decades ago, the members of the public mostly paid for health care in only one way: by direct payment to health care providers using cash if they could, or chickens and pigs if they could not.

Then during World War II especially, the public begin to pay more of its medical bills by funneling money through insurance companies…But now that is changing as the system is being reforming in an underhanded, backdoor fashion. Leading the reform is the for-profit health insurance industry, and by doing so the industry is slowly putting itself out of business. The steps the industry is now taking to retain profitability are forcing the American public to funnel an increasing proportion of its health care expenditure through other, more efficient pipelines, namely direct payments to medical providers and payments to them through government channels.

In other words, the insurance companies are making it so onerous to pay premiums and co-pays and deductibles that their customers are simply dropping insurance altogether—which means the companies get nothing from them.

Two Town Meetings on Health Care

Alaska’s two senators have now held town meetings on Health Care in Fairbanks, Senator Murkowski on August 13, and Senator Begich on September 26. The contrast between the two hosts and their events was striking.

Based on their comments, questions, and levels of applause to statements, I concluded that the 500-member crowd attending the Murkowski town meeting was largely right-leaning Republican, with the majority having an anti-Obama, anti-government attitude that biased them against increased government involvement in health care. This group also showed a substantial presence at Senator Begich’s town meeting hosting about 300, but probably were outnumbered by persons of less conservative bent who were in favor of greater government involvement in the form of establishing a public health insurance option and greater regulation of the health care insurance and pharmaceutical industries.

Perhaps most striking was the difference in approach and performance of the two hosts. Senator Murkowski stated at the outset that she was against more government involvement in health care. That statement not only made the majority of the audience happy, it set the tone of the entire meeting: generally negative toward any substantial health care reform. Senator Murkowski responded to questions and comments in ways that built on the fears of those in the audience and promoted what I took to be her own personal views. Although she proclaimed that she wanted input from all quarters, it was quite obvious to me that she was not receptive of any new information.

Thinking back on that town meeting after attending Senator Begich’s later one, I was struck by Senator Murkowski’s comparative lack of knowledge about health care issues and apparent willingness to ignore factual information on the topic. To me, this was best illustrated when someone asked if Senator Murkowski knew of even a single country where universal health care was successful. Ignoring the well-known fact that universal health care is successfully operating in every modern country except for the United States, the good senator walked slowly across the stage, shoulders hunched, head shaking and eyes downcast as though seeking inspiration from the floorboards as she replied, “No, I can’t.” Oh come on, Senator, I thought to myself, you are not that ignorant, you know better than that and are just being disingenuous.

By contrast, Senator Begich displayed an impressive breadth of knowledge about and understanding of health care issues. He too had made an opening statement. Unlike Murkowski’s negative opening, Begich’s contained positive assertions regarding desirable goals of health care reform. Some of them were little more than motherhood statements, but at least they were positive in nature. I did not agree with some of Begich’s views—for example, he stated that he was against having a government-operated single-payer health system—but he did at least display an attitude of guarded openness toward the proposal of a public option insurance program.

He used a question on that issue to suggest that perhaps a better option might be to allow everyone to buy into the Federal Employees Health Benefits Insurance program enjoyed by members of Congress and all other federal employees and retirees.

I hope Senator Begich was aware that he was making quite a radical proposal because in this program the government (using funds supplied by the taxpayers) picks up 75 percent of the premium cost. Now that is serious government involvement in health care! At least financially, it is about three-fourths the way to a single-payer health care system. To complete the process the next logical step will be to eliminate the useless middleman: the health insurance industry.

Desperate measures for desperate times