With some 45 million Americans uninsured, how to pay for medical treatment is a big issue in this year's presidential election. Now officials in Oregon say they have come up with a fair way of providing coverage for some of those who cannot afford it. [. . . . ] More than 90,000 in Oregon are vying for a maximum of 10,000 places in the state's healthcare plan. Yet it is a drop in the ocean. There are some 600,000 uninsured in Oregon. At the Outside In community clinic in downtown Portland, doctors see 7,000 different patients a year, 90% of whom have no health insurance.Now if they will just contract with ABC to do a show about some of the winners that would follow the format of Extreme Makeover.
Thursday, April 03, 2008
Healthcare by Lottery
If the choice is ultimately between socialism or barbarism, Oregon is evidently trying, as a poster to LBOtalk mentioned, to "make barbarism entertaining."
Wednesday, April 02, 2008
On healthcare
My brother forwarded an e-mail, saying:
> Just something that scares me a lot!?
>
>> http://www.freemarketcure.com/brainsurgery.php
If that scares you, check out this story of different brain tumor outcomes in the US (and if you doubt this guy's credentials here's evidence that he's actually a fucking genius)
What scares you? No one dares to talk about a single payer plan in the US. The only candidate who was for it was Dennis Kucinich and, to an extent, John Edwards (on that note, if you aren't into reading here's a US story. Here is a link to a pithier segment on Good Morning America. The guy above mentions this case in his post as well.) In other words, it is unlikely that any candidate that might win would do anything to change the current configuration, wherein bean counters at Aetna or Cigna or Humana decide if you live or die (or go into enormous debt--about one half of all personal bankruptcies in the US are due to people incurring debt from high medical care costs and the latter also contribute heavily to overall credit card debt)
I would also note that our grandmother died from a complication in the private portion of the US healthcare system (a brain issue as well; malpractice that we were unable to sue for because of the good ol' boy system--and who knows what that jerkoff got in the way of kickbacks for proscribing Thalidomide); and if it weren't for the government run system of Medicare mom and dad would have had to pay out of pocket for her care at the end (granted that system obviously has problems as well, as dad would attest--though the problem there seems to be getting her to qualify for the care so the problem is more with access into it rather than its functioning.) Still, including a bid to expand that system is hardly the same as eliminating private health plans altogether. This video (and this single case) that scares you is just one case and it seems to be some serious bout of fear-mongering: and since the issue isn't whether this guy was allowed to do it but whether the government would pay his bill afterwards, he hardly seems to be in any worse shape than the US citizens in much greater medical debt--and with no one to appeal to for help. Many of these people had insurance, but their insurance didn't cover the procedures they needed.
On this, if you are really interested in the topic, I recommend you at least check out Sicko. It's not that much time out of your day and there is a lot less of Michael Moore being annoying than in some of his other films. It's more straightforward and it does help present a contrast to our own system. It discusses not only the US system but the Canadian, English, and French systems--all of which are shockingly different than our own. I have no doubt that these are just snapshots and there are bugs and hitches he doesn't show, but it is very surprising to see so different a basic philosophy about health care--much less to see it basically dominant in every other industrialized country.
I think this is a big problem and we should have some imagination about how we solve it. Since every other industrialized country has a different model than ours and they ALL have healthier populations, jingoism and fear-mongering hardly seems productive. The other thing to realize is that the current system is really only about 30 years old--and it only became dominant in the past 15.
Further info...
The US currently pays more per capita than any other industrialized country for our healthcare system but we are in last (19th) place for preventable deaths (note that Canada is 6th). Let that sink in: these are 100K deaths that we could prevent and yet fail to at a rate that is worse than any other industrialized country--most of which pale by comparison of overall GDP and position in the world:
--31% of health care expenditures goes to administrative costs in the US as opposed to 16.7% in Canada--and as "consumers" of this product, we also end up spending a great deal of our own time "administrating" this as well, on the phone trying to sort out all the billing and payment problems that, supposedly, only happen in a sickly tax funded government bureaucracy.
--We have the second worst infant mortality rate in the "modern world" with only Latvia having a worse rating:
--Canada is hardly the only country we could compare the US system to, and it is kind of stark to see the numbers stacked up: the graph there is based on the data in the excel spreadsheet from the OECD here summarizes the fact that the US pays almost TWICE as much as Austrailia, Canada, France, Germany, Japan, Sweden and the UK (they all hover at about $3000 per capita while we're over $6K) and between 1/3 and 1/2 more as a % of GDP for: Lower life expectancy, higher infant mortality rate, fewer doctors and nurses than all of them.
--Finally, if you're looking for something to scare you, there is a general consensus that, if there was any bioterrorist event (like the Anthrax scare that happened up here a few years ago) or a pandemic of flu, our system of medical care couldn't handle it for even a matter of hours--and it is a direct result of the most recent changes which make health care responsible to investors and the hedge fund managers that have just crashed the housing sector. A recent series on NPR mentions one author who's been looking at this:
In short, I think you should be scared, but not because of some invasion from Canuckistan. In fact, our Canadian friends moved back home as fast as they could. They welcomed paying higher taxes because they felt they'd be taken care of. And they have had first hand experience: her dad was injured quite badly in a hockey accident.
Every system has problems. The question is how those are balanced with the benefits. A recent Op-Ed in the Washington Post outlined some of what we might consider, but there are certainly all kinds of options we could explore. The point is that we already have been insinuating a "Free Market Cure" into the system and, frankly, it is far worse than the disease: regardless of what we might think, our system is not all that great in aggregate when compared to other countries and there is little doubt (amongst Medical professionals, the OECD, the WHO) that it is because of our introduction of market model to health care.
I'll leave off here rather than worry too much about skewering the guys who produced this video and the way this story has been picked up by the right wing spin machine and cycled through FOX, Free Republic, etc. (there is also some evidence that the organization who funded it has connections to--i.e. people on their board RUN--several hedge funds which invest in private medical care.) But none of the people who made it have any more medical qualification than Michael Moore and the facts are largely stacked against them, whatever anecdotes they can find. I think it is good that they are pointing out some of the problems with the Canadian system, but they aren't doing so in good faith (i.e. it isn't to try to give information to help the Canadian people improve their system): they are doing it to create fear about Democratic health plans--again, none of which calls for the importation of the Canadian model wholesale. That is just innuendo and, in my opinion, it is misplaced. Right now there are far more Canadians that are afraid of getting a US model.
> Just something that scares me a lot!?
>
>> http://www.freemarketcure.com/brainsurgery.php
If that scares you, check out this story of different brain tumor outcomes in the US (and if you doubt this guy's credentials here's evidence that he's actually a fucking genius)
What scares you? No one dares to talk about a single payer plan in the US. The only candidate who was for it was Dennis Kucinich and, to an extent, John Edwards (on that note, if you aren't into reading here's a US story. Here is a link to a pithier segment on Good Morning America. The guy above mentions this case in his post as well.) In other words, it is unlikely that any candidate that might win would do anything to change the current configuration, wherein bean counters at Aetna or Cigna or Humana decide if you live or die (or go into enormous debt--about one half of all personal bankruptcies in the US are due to people incurring debt from high medical care costs and the latter also contribute heavily to overall credit card debt)
I would also note that our grandmother died from a complication in the private portion of the US healthcare system (a brain issue as well; malpractice that we were unable to sue for because of the good ol' boy system--and who knows what that jerkoff got in the way of kickbacks for proscribing Thalidomide); and if it weren't for the government run system of Medicare mom and dad would have had to pay out of pocket for her care at the end (granted that system obviously has problems as well, as dad would attest--though the problem there seems to be getting her to qualify for the care so the problem is more with access into it rather than its functioning.) Still, including a bid to expand that system is hardly the same as eliminating private health plans altogether. This video (and this single case) that scares you is just one case and it seems to be some serious bout of fear-mongering: and since the issue isn't whether this guy was allowed to do it but whether the government would pay his bill afterwards, he hardly seems to be in any worse shape than the US citizens in much greater medical debt--and with no one to appeal to for help. Many of these people had insurance, but their insurance didn't cover the procedures they needed.
On this, if you are really interested in the topic, I recommend you at least check out Sicko. It's not that much time out of your day and there is a lot less of Michael Moore being annoying than in some of his other films. It's more straightforward and it does help present a contrast to our own system. It discusses not only the US system but the Canadian, English, and French systems--all of which are shockingly different than our own. I have no doubt that these are just snapshots and there are bugs and hitches he doesn't show, but it is very surprising to see so different a basic philosophy about health care--much less to see it basically dominant in every other industrialized country.
I think this is a big problem and we should have some imagination about how we solve it. Since every other industrialized country has a different model than ours and they ALL have healthier populations, jingoism and fear-mongering hardly seems productive. The other thing to realize is that the current system is really only about 30 years old--and it only became dominant in the past 15.
Further info...
The US currently pays more per capita than any other industrialized country for our healthcare system but we are in last (19th) place for preventable deaths (note that Canada is 6th). Let that sink in: these are 100K deaths that we could prevent and yet fail to at a rate that is worse than any other industrialized country--most of which pale by comparison of overall GDP and position in the world:
France best, US worst in preventable death rankingThe World Health Organization said about the same thing a few years ago:
Tue Jan 8, 2008
By Will Dunham
WASHINGTON, Jan 8 (Reuters) - France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.
If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.
[. . . .]
France did best -- with 64.8 deaths deemed preventable by timely and effective health care per 100,000 people, in the study period of 2002 and 2003. Japan had 71.2 and Australia had 71.3 such deaths per 100,000 people. The United States had 109.7 such deaths per 100,000 people, the researchers said.
After the top three, Spain was fourth best, followed in order by Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland and Portugal, with the United States last.
The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th .Some other facts:
--31% of health care expenditures goes to administrative costs in the US as opposed to 16.7% in Canada--and as "consumers" of this product, we also end up spending a great deal of our own time "administrating" this as well, on the phone trying to sort out all the billing and payment problems that, supposedly, only happen in a sickly tax funded government bureaucracy.
--We have the second worst infant mortality rate in the "modern world" with only Latvia having a worse rating:
"American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found."
--Canada is hardly the only country we could compare the US system to, and it is kind of stark to see the numbers stacked up: the graph there is based on the data in the excel spreadsheet from the OECD here summarizes the fact that the US pays almost TWICE as much as Austrailia, Canada, France, Germany, Japan, Sweden and the UK (they all hover at about $3000 per capita while we're over $6K) and between 1/3 and 1/2 more as a % of GDP for: Lower life expectancy, higher infant mortality rate, fewer doctors and nurses than all of them.
--Finally, if you're looking for something to scare you, there is a general consensus that, if there was any bioterrorist event (like the Anthrax scare that happened up here a few years ago) or a pandemic of flu, our system of medical care couldn't handle it for even a matter of hours--and it is a direct result of the most recent changes which make health care responsible to investors and the hedge fund managers that have just crashed the housing sector. A recent series on NPR mentions one author who's been looking at this:
Stephen Flynn, former Coast Guard commander and author of The Edge of Disaster, says that the United States medical system is unprepared to handle a catastrophic emergency such as a flu pandemic or a major terrorist attack. The problem, Flynn says, is that hospitals have been trying to cut costs. "The medical community has been moving in the direction of much of our economy," he says, "which is wringing out the extra capacity in order to essentially focus on the bottom line."
In short, I think you should be scared, but not because of some invasion from Canuckistan. In fact, our Canadian friends moved back home as fast as they could. They welcomed paying higher taxes because they felt they'd be taken care of. And they have had first hand experience: her dad was injured quite badly in a hockey accident.
Every system has problems. The question is how those are balanced with the benefits. A recent Op-Ed in the Washington Post outlined some of what we might consider, but there are certainly all kinds of options we could explore. The point is that we already have been insinuating a "Free Market Cure" into the system and, frankly, it is far worse than the disease: regardless of what we might think, our system is not all that great in aggregate when compared to other countries and there is little doubt (amongst Medical professionals, the OECD, the WHO) that it is because of our introduction of market model to health care.
I'll leave off here rather than worry too much about skewering the guys who produced this video and the way this story has been picked up by the right wing spin machine and cycled through FOX, Free Republic, etc. (there is also some evidence that the organization who funded it has connections to--i.e. people on their board RUN--several hedge funds which invest in private medical care.) But none of the people who made it have any more medical qualification than Michael Moore and the facts are largely stacked against them, whatever anecdotes they can find. I think it is good that they are pointing out some of the problems with the Canadian system, but they aren't doing so in good faith (i.e. it isn't to try to give information to help the Canadian people improve their system): they are doing it to create fear about Democratic health plans--again, none of which calls for the importation of the Canadian model wholesale. That is just innuendo and, in my opinion, it is misplaced. Right now there are far more Canadians that are afraid of getting a US model.
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