Tag: health care

Fractured health system a drain on us all

My wife’s Ob-Gyn just raised her fees from about $225 a visit to more than $300. And she doesn’t take insurance.

The news was a shock to the system, of course, another in a long line of increasing expenses that seem to impinge upon the alleged freedom of choice we Americans supposedly enjoy.

Yes, we could change doctors, find an Ob-Gyn who is in our plan or one who might charge less, but Annie likes her doctor, feels comfortable and confident in her abilities, so changing doctors seems foolish.

And yes, we will be reimbursed for some of our costs (I can’t remember exactly what the percentage is), but we still have to put the cash out and deal with the personal cash flow issues.

I’m not relating this story to whine, but to explain that the American health care system is failing not only those without insurance but so many of the rest of us forced to rely on employer-provided coverage. The reason is that the system is based on profit and not on care. Every decision made by employers who negotiate contracts with insurance companies, every decision made by those insurance companies about the legitimacy of medical expenses and even many of the decisions made by doctors — including who to see and what kind of services to provide — are made with the bottom line in mind. The idea is to minimize expenses but to maximize price, meaning that we are paying more and more for each visit to the doctor but getting less time with our doctors.

That’s one of the points that Michael Moore has been making as he makes the rounds promoing his film “Sicko” (haven’t had a chance to see it yet). As he told Business Week:

“Do you know of anyone who hasn’t had a problem with the insurance company, or getting some procedure covered?” he asks. “Anyone who sees this film will understand exactly the mess we’re in right now.”

Adds Daniel Vallin:

Moore’s main point is that the profit motive of private health insurance corporations is what causes the problem. The need, codified in law, in fact, to increase profits as much as possible for the benefit of the tiny number of shareholders of the corporations, trumps the concern for adequate health care for the policy holders. The health insurers are institutionally bound, not to care for the sick, but to turn a profit for their shareholders, and thus many who believed their health care costs were covered find that they are cut out from the most expensive healthcare system in the world in order to cut costs for the insurance company.

And we’re not talking about extreme or experimental treatments. We’re talking about regular care in most cases, such as standard diagnostic testing and referrals to some specialists.

So, it’s not just he 43 million Americans without health insurance who are suffering under the current dysfunctional system, though they tend to suffer more than the rest of us. It is all of us.

Marie Cocco sums it up:

We are guilty of national malpractice for allowing the profit motive to drive decisions about who gets health care, and of what sort.

Malpractice is an apt way to describe the problem — though the only court we have in which we can petition for redress is the court of politics.

Of the presidential contenders, John Edwards and Dennis Kucinich understand this best, though both Barack Obama and Hillary Clinton are offering proposals designed to fix at least part of the problem. The GOP plans, where they exist, would do nothing.

But plans crafted in the run-up to elections often fall apart once candidates gain office as high-paid corporate lobbyists — in this case for the health insurance and drug companies — work to preserve the status quo (remember Harry and Louise?).

So it is up to us — the system’s abused consumers — to create momentum for change.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick
The Cranbury Press Blog

E-mail me by clicking here

Email me at grassroots at comcast dot net.

Fix health care now

Americans understand something that the political classes are just beginning to take seriously: America’s health care system is dysfunctional.

As a poll of 1,281 Americans conducted in February and issued in March by CBS News and The New York Times, about nine in 10 say “the system needs at least fundamental changes, including 36 percent who favor a complete overhaul.”

Much of the concern, according to the poll, is due to cost. Most people say “they are generally satisfied with the quality of their own health care, including 41 percent who say they are very satisfied,” but only “one in five are very satisfied with what they pay for health care, while a majority (52 percent) are dissatisfied, including a third who are very dissatisfied.”

A report issued today by the Commonwealth Fund, a non-profit group that studies health care, offered a glimpse into where the dissatisfaction comes from.

The report, which studied health care in Germany, Great Britain, Australia, New Zealand and Canada, found that all five “provide better care for less money,” according to Reuters. The U.S. system “ranks last … on measures of quality, access, efficiency, equity, and outcomes,” the non-profit group said in a press release.

“The United States is not getting value for the money that is spent on health care,” Commonwealth Fund president Karen Davis told Reuters.

That seems pretty obvious, though Congress has made little effort to do more than nibble at the edges since the failure of the Clinton health care plan more than a decade ago.
Congress, President George W. Bush, many employers and insurers have all agreed in recent months to overhaul the U.S. health care system — an uncoordinated conglomeration of employer-funded care, private health insurance and government programs.

Despite spending about two times per capita what the other countries studied spend — $6,102 for the United States in 2004, compared with $3,005 for Germany, $3,165 for Canada, $2,083 for New Zealand, $2,876 for Australia and $2,546 for Great Britain – there are about 45 million Americans with no insurance.

And this disparity is likely to get worse, unless we change the way we manage our health-care system.

The answer? Single-payer, universal coverage.

Taking the profit out of the health-care system would level the playing field while addressing the long-term costs that our broken system creates — offsetting the cost to taxpayers of implementing universal coverage.

And it is the right thing to do — health care should not be a commodity but a right. No one should have to worry about whether he or she has enough to see a doctor.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick
The Cranbury Press Blog

E-mail me by clicking here.

Email me at grassroots at comcast dot net.

File under: Bad ideas in medicine

It appears that some doctors in North Jersey — and I suspect elsewhere in the state — are “are asking patients to sign a contract promising not to sue for malpractice” as a way of trying to control skyrocketing insurance costs.

As The Record reported on Sunday, the contracts are a condition of treatment and replace litigation with binding arbitration as the only recourse a patient would have should the doctor not live up to his or her end of the bargain. In addition, the contracts cap pain and suffering awards.

The contract, the story says, “blames patient lawsuits for ‘ever-escalating’ malpractice insurance rates” — a dubious assumption given that the insurance crisis faced by doctors has more to do with avaricious insurance companies than anything else. the contract, therefore, does little more than potentially penalize patients — a notion The Record rightly criticizes today:

(P)atients didn’t cause this problem. Patients should not have to sign away their rights to fix it.

The contract that patients sign states that rising premium costs are caused by patient lawsuits. Evidence doesn’t back that up. From 2001 to 2003, New Jersey had a 21 percent decline in malpractice payouts. Nationally, payouts have also fallen.

Just as when New Jersey’s auto insurance rates spiraled out of control in the 1990s, the malpractice premium increases are caused by a complex mix of factors. It is not an easy fix. The Legislature was right a few years ago to reject the idea of capping jury awards for malpractice victims. But the state needs to look for other solutions, including possible limits on the size of yearly premium hikes to doctors.

In the end, the doctors are making the wrong call on this. Rather than go after patients, they should band together with them and take on the insurance companies.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick
The Cranbury Press Blog

E-mail me by clicking here.

Email me at grassroots at comcast dot net.