Good news about health care in the U.S.: The case for Obama’s health care reforms

March 7, 2012

Here’s a preview of another piece of television that many Republicans hope you will not bother to see, a piece that explains exactly how and why the health care reforms championed by President Obama will help you and millions of others:

Program: U.S. Health Care: The Good News

Episode: The Good News in American Medicine

Journalist T.R. Reid examines communities in America where top-notch medical care is available at reasonable costs and, in some instances, can be accessed by almost all residents. Included: Mesa County, Colo.; Seattle; Everest, Wash.; Hanover, N.H. In Mesa County, for instance, doctors, hospitals and insurers place an emphasis on prevention; and a program that offers pre-natal care to poor women has proved popular.

T. R. Reid’s report started airing on PBS stations in mid-February.  If you haven’t seen it, go to this site to view the entire production.

More, resources (suggested by PBS, mostly):


Glenn Beck doesn’t know Canadian health care

September 22, 2009

Just one more thing Glenn Beck doesn’t  know that he spreads disinformation about.

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Bathtub reading, mortuary, cemetery, restaurant and airport version

August 30, 2009

Family funerals combine bitter and sweet.  A long life well-lived, the grief over loss, getting together with family and friends from eight decades — and then it’s back to work in a jolt.

Trying to stay caught up:

Outrageous insult to Darwin and Constitution in Missouri: Were the parents concerned about the quality of the brass section in the band, or did they really object to a humorous depiction of “the evolution of brass” in 2009, the bicentennial of Darwin’s birth?

They deserve to have their brasses kicked, but the innocent kids don’t.

P. Z. Myers caught the grossest tragedy:

Band parent Sherry Melby, who is a teacher in the district, stands behind Pollitt’s decision. Melby said she associated the image on the T-shirt with Charles Darwin’s theory of evolution.

“I was disappointed with the image on the shirt.” Melby said. “I don’t think evolution should be associated with our school.”

She doesn’t want her school associated with evolution?  How about associating the school with the Taliban of Afghanistan?  How about associating her school with Homer Simpson’s stupider brother?  How about associating her school with backwards thinking, 16th century bad science?  How about associating her school with the St. Bartholomew’s Day Massacre and the sort of stupidity that leads religiously-based violence?

Ray Mummert probably got the call to help Sedalia out, and he’s organizing to fight the forces of smart and intelligent people.  Comments from residents of Sedalia are shocking in their lack of information, and depressing.

Kids, pay attention in science class: A proud science teacher in Minnesota, and probably some proud parents, tooTip of the old scrub brush to Pharyngula on this one.

Anybody who complains about this deserves to get their tail kicked with Tom Delay and every Republican who redistricted Texas last time around. (Sen. Ted Kennedy suggested the Massachusetts legislature should allow the governor to appoint a temporary replacement to represent the state in the U.S. Senate in the event of a vacancy, until a special election can be held.)

First Amendment wins again: Kentucky had a law that said the state could be safe from al Quaeda attack only by the grace of God.  A judge, noting that it will take a lot of work by a lot of dedicated Kentuckians who deserve credit, and that it’s illegal to make such a claim in law, overturned the law.

Private insurance failed this woman; Medicare would pay for the treatment under some circumstances, but there is no lie opponents to health care reform won’t tell in order to scare people away from the facts. They claim the woman couldn’t be treated under government care, but Medicare pays for the expensive drug in question.  Can’t they at least tell the truth?

This is getting depressing.  I’m going to go look at mountains.


Where’s a conspiracy theorist when you need one?

August 30, 2009

1 Corinthians 12:26, “If one member suffers, all suffer together with it…”

While Tom Delay dances with the starlets, and Jack Abramoff actually does time, isn’t anyone curious about who organizes all the protests against health care reform?

(Lookie here, P. Z. — Christians doing good.  Of course it’s not justification for the faith.  It’s one hopeful sign in the Sea of Hamhovind idiocy.)

You may also want to see:


End the hoaxes, part 4: When India’s health care beats the U.S., it’s time to change

August 23, 2009

Can’t see any reason to reform health care in the U.S.?  Read this letter to the editor of the Stockton (California) Record:

August 22, 2009

I recently returned from India with my partner (a Lodi resident, born and raised in Stockton), who had hip surgery there because he has inadequate health insurance and could not afford to have the surgery done here. He, by the way, had excellent care there at a fraction of the cost here, including travel.

It is difficult to understand the paranoia of citizens who are blind to the obvious manipulation by politicians and insurance executives. Insurance companies, through their politician spokespeople, continue to succeed in duping Americans into believing they cannot trust the government, while they make decisions based primarily, if not solely, on huge profits. Certain politicians are willing to sell Americans down the river in the hopes of regaining some political ground.

Though the government may not be great at controlling costs, it does not make decisions based only on maximizing profits into private pockets, and it answers to us at election time. Is our faith in our system at so low an ebb that we alone among industrial nations cannot manage this? Insurance companies act only for themselves.

Me? I trust the government over insurance companies any day. Common sense tells us we need reform, we need it now, and it must address the inequalities of a system that is inherently untrustworthy due to greed and selfish motivation. A real, functional public option is key to meaningful reform.

Susan Amato
Lodi

Need health care?  Insurance company won’t authorize your treatment?  Just fly to India.

It’s the “India Option Plan” from Sen. Chuck Grassley. Claims that health care in the U.S. is the “best in the world” need to be qualified:  Best in the world for those fortunate enough to have insurance that will cover treatment, and which won’t drop them when the bills start coming in; for others, second-world and third-world coverage is reality.


End the hoaxes, part 3a: Government plans pay for cancer treatment, private insurance no better

August 23, 2009

Sad story out of Oregon, but a familiar story to anyone who has followed health care issues during any part of the past 40 years:  A woman gets cancer, her physician recommends a pharmaceutical or surgical procedure, but the insurance company denies coverage.

In this case, the story is being pushed by opponents to health care reform as a scare tactic.  ‘Health care reform means cancer-fighting drugs won’t be covered.’  The tenuous link to reality this argument has is this:  The woman is insured by Oregon’s public insurance alternative, a one-state effort to do what private insurance failed to do.  So, the critics reason, if she can’t get coverage under Oregon’s public plan, no one will get coverage under any government plan.

The pharmaceutical is a recently-developed cancer fighter, Tarceva.

It’s a crude bluff.  Reality is different.

  1. Medicare may pay for coverage of the drug in question, Tarceva. The Oregon public program has a rather high standard for coverage — 5% chance of survival for 5 months or more, established in clinical trials — but Medicare supplemental insurance plans, a federal program, will pay for Tarceva for non-small cell lung cancer treatments.  Oregon’s program may not be equivalent to the federal program proposed.
  2. Private insurance companies often deny coverage for cancer treatments. The story from Oregon shows the disparities in care, and it demonstrates well that rationing of health care is a key feature of the current system, a key reason to work for reform.  But denial of coverage occurs across the nation, and, I think statistics would show, more often from private insurance companies, often for less judicious reasons.  In Kansas, Mary Casey got the rejection from her private insurance company:  “But when Casey went to fill her Tarceva prescription at the pharmacy, her insurer, Coventry Health Care of Kansas, denied her coverage for the drug, saying it considered Tarceva experimental in her case, even though Tarceva is FDA approved for other lung and pancreatic cancers.”  There is no significant difference between private coverage and the Oregon public plan.
  3. Private insurance failed:  This woman is on the Oregon plan because private insurance didn’t provide any coverage for her.

Barabara Wagner’s story troubles anyone with a heart.  It’s not an argument against reforming health care and health care insurance, however, because Wagner wouldn’t be alive to this point without a government plan in Oregon, analogous to the public option proposed in the House bill; because private insurance does not differ significantly in its coverage of cancer victims; and because this woman is on a public program in the first place because private insurance simply failed to cover her at all.  Under private insurance, this woman would have been dead months ago, if not longer.

Other notes:


“Death panel” as fiction

August 22, 2009

Odd observation: Electronic searches of H.R. 3200, ‘”America’s Affordable Health Choices Act of 2009,” find that the word “death” occurs only twice in the bill, on pages 588 and 596.

On page 588, the reference is to fines to a “skilled nursing facility” for lapses in care that result in the death of a patient. On page 596, again the reference is to a fine to a nursing facility for a lapse in care that results in the death of a patient.

In each case in which the word “death” occurs, the context is a fine for causing death.

The word “mortality” occurs once, on page 620. It occurs in a section that requires the Secretary of Health and Human Services to set priorities in national health care quality improvement, and to give priority to ideas that “have the greatest potential to decrease morbidity and mortality in this country, including those that are designed to eliminate harm to patients.”

In the only case in which “mortality” occurs, the context calls for reducing mortality.

Don’t take my word for it. Go search the bill yourself.

Critics appear not to have read the bill.  When writing fiction, sometimes it’s best not to be bound by reality.  However, when one is not bound by reality, one is writing only fiction.


End the hoaxes, part 2a: Great need for health care reform, Flagler County Free Clinic

August 21, 2009

Health care professionals and legislators struggled with the need for reform of health care for the past 40+ years.  Tweaking of specific, small parts produced no great reduction in health care cost inflation.  More millions of people fall out of the pool of people who have access to health care in a timely and affordable way.

And yet people claim not to see the need?

Faith Coleman of Flagler County Free Clinic: Faith Colemans ordeal as an uninsured cancer patient drove her to help others without health insurance. (CNN Image)

Faith Coleman of Flagler County Free Clinic: "Faith Coleman's ordeal as an uninsured cancer patient drove her to help others without health insurance." (CNN Image)

Meet Faith Coleman.  She was a young nurse, delivering health care for many different employers, when she was struck with kidney cancer.  Since she worked part time for so many, no one offered her health insurance as an employee.

Faith Coleman could mortgage her home for the $35,000 to save her life.

Her cancer is in remission.

But she then organized health providers in her town to take care of others in her situation.  Week in and week out, more than a hundred people show up to her essentially free clinic, trying to crawl out of the cracks in the health care delivery floor.  CNN featured the story.

I have been given another chance, and I felt that it was important for me to make a difference and to help other people,” she said.

So after her recovery in 2004, Coleman approached Dr. John Canakaris. The local physician with 60 years of experience had been treating the indigent population for years. Canakaris was eager to reach more patients in need.

The two worked together to establish the Flagler County Free Clinic in Bunnell, Florida, which provides medical care for the uninsured. It has treated more than 6,700 patients.

The clinic opened its doors in February 2005, with eight volunteers treating eight patients. Since then, it has expanded to 120 volunteers who see about 80 patients every other weekend. Coleman said she’s seen an increase in the number of patients at the clinic, which serves people who meet federal poverty guidelines.

Go read the story, look at the videos, and help out where you can.

One sure-fire way you can help:  Stand up for health care reform. We need it now.  In Texas, each person with health care insurance pays $1,800 a year to mend the holes in the safety net — we need to reduce that cost (for my family, that’s $7,200/year).

Stand up for health care reform now, and stand against the hoaxes claiming we have no need, or that expanded programs won’t help.


End the hoaxes, part 1: Health care costs cause bankruptcies

August 17, 2009

Health care costs, especially coupled with lack of adequate insurance even for insured people, drove our nation to the brink of economic collapse.

We need health care reform now, to help get our economy back on its feet.

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. Health.com: Expert advice on getting health insurance and affordable care for chronic pain.

They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically-related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study — 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.” Health.com: Where the money goes — A breast cancer donation guide.

Personal bankruptcies played a large role in the banking crisis of late last year and early 2009.  Personal bankruptcies played a huge role in the collapse of mortgage securities markets, which prompted the banking crises.

If anything, current proposals do not go far enough in reforming insurance.

“To ignore the fact that medical costs are an underlying problem of the economic meltdown we’ve experienced would be to turn a blind eye to a significant problem that we can solve,” she said [Elizabeth Edwards, senior fellow at the Center for American Progress].

Edwards was joined by Steffie Woolhandler, a co-author of the Harvard study [discussed above] who sharply criticized current reform efforts.

“Private insurance is a defective product that leaves millions of middle-class families vulnerable to financial ruin. Unfortunately, the health reform plan now under consideration in the House would do little to address this grave problem,” Woolhandler said.

Without new legislation along the lines of the Democratic proposals in Congress, our nation faces economic doom.

Phony assertions of “death panels,” phony assertions of “creeping socialism,” phony claims about bad care in England, Canada and France, are all tools that help push our nation to economic failure.

Please do not be hoaxed.

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Obama on health care: With an eye and an ear to history; with heart to those who hurt

August 16, 2009

Did you catch Obama’s op-ed in the New York Times yesterday?

OUR nation is now engaged in a great debate about the future of health care in America.

Of what famous speech does that line remind you?

Obama is looking to past presidents’ efforts to push legislation, too — learning from the failures and hoping not to repeat (think Wilson and the campaign to ratify the Treaty of Versailles), learning from successes and hoping to expand (think of Lyndon Johnson and the creation of grants to college students).

Mostly, Obama’s hoping to give a boost to health care reform efforts slowed by the vicious, false rumor campaign against it.

See what Obama himself wrote, below the fold.

Read the rest of this entry »


Republican death trip

August 14, 2009

Senate Finance Committee members said yesterday they would strip out of the health care discussion any mention of helping older Americans or others with terminal diseases make adequate plans with, for example, durable powers of attorney and living wills.

Newt Gingrich and others on the wackaloon right have made the topic toxic, despite it’s having been urged by Republicans, to ensure privacy and individual rights near the end of death.

And so, also, we bid farewell to morality, reason and backbone among Republicans nationally.

Two pieces you should read:

  1. “Republican Death Trip,” Paul Krugman’s column today in the the New York Times
  2. “Sarah Palin’s death panels,” at former Labor Sec. Robert Reich’s blog

Refusing to be shouted down, on rants against health care reform

August 13, 2009

People who just know they’re right, damn the facts, irritate me; I’m allergic to unnecessary bull excrement.

Here, at The Elephant’s Child, I scratched the itch a bit.

The post from Elephant’s Child is answered, ad seriatum.  (I wrote this on the fly, and I may have missed a statistic here or there; if I find errors, I’ll correct ‘em.)  EC’s responses are indented:

Remember that this thread starts out with your savaging a program to support child abuse prevention programs.

We will have to agree to disagree. The federal government runs the Indian Health Service which is a disgrace and a tragedy.

Private health care on the Navajo, Hopi, Pine Ridge and other major reservations is [essentially] non-existent. Yes, the IHS is inadequate by any rational standards. It’s also underfunded, and a key problem is that many enrolled members of tribes lack other health insurance.

The federal program may be a wreck, but it’s 1000% better than the private alternative, which in that case is nothing at all.

And this is what I fear: Without government intervention, Indians are left to die from easily preventable and easily treatable diseases. Without government intervention, 50 million other Americans are left to die from easily preventable and easily treatable diseases, and 150 million more have limited access.

For reasons I cannot fathom, you favor letting the people die rather than fixing things. Surely you’re not making that decision on the basis of any rational system of rationing, are you? I don’t think the poor and unemployed “deserve to die.” Talk about death panels!

They run Medicare, which is going broke from waste, fraud and abuse.

Absolutely false. Medicare has problems from rapid inflation by the private sector and other causes. But it is NOT “going broke from waste, fraud and abuse” by any measure. Compared to private health care, Medicare is purer than distilled water.

They run Medicaid, ditto.

Ditto. Medicaid has problems from overuse because too many people lack private insurance. Waste, fraud and abuse are significantly reduced from private systems.

Which leads me to wonder why you favor a system that is going broke from inflation, waste, fraud and abuse. The denialism runs strong in you.
(No — it’s going broke mainly from uncontrolled inflation — but if you can make wild unsubstantianted charges, I can at least point out that your favored position is worse.)

And they run the VA, which has some bright spots and poor care in general, at least according to vets.

And what does the private insurance system do for vets? Any injury due to war is excluded from coverage.

Again, you choose no coverage over some coverage. Whose side are you on? Not the vets’ side, it appears.

Our current health care system is the best in the world. We have better outcomes for the major diseases, and most people are satisfied with their health insurance and happy with their care.

Except for heart and lung disease, where Canada, France and England lay it all over us, on an epidemiological basis. Their systems do a lot fewer major procedures because there is much less heart disease, and problems are discovered earlier and treated much more effectively and cheaply.

Yes, the U.S. does a lot more heart transplants, easily by double. The problem is we have nearly quadruple the need for heart transplants. Heart disease is often preventable, almost always treatable, well before heart transplant time. It’s cheaper and better for the patient if we treat heart disease before it progresses to cripple the victim.

Yeah, we do more transplants. The tragedy you don’t name is that we need to do them.

We pay more for it in general because we can afford it.

Have you discussed this with small businesses? We can’t “afford” to pay double what every body else pays. These incredible expenses broke Chrysler and General Motors. The cost keeps small businesses from creating plans for employees.

Worse, that $6,000 per capita includes spending for the 50 million people excluded from easy access. We pay double for services, and we pay for a lot that we don’t get. Talk about waste!

Our system spends nearly 25% of every “health care” dollar in insurance administration, mostly designed to keep the minority of uninsured from getting care at all.

Don’t tell me we should spend hundreds of billions of dollars to bar the doctors’ offices doors, and then claim any system is more wasteful. There is no more wasteful system possible, and it’s a moral imperative that we fix it.

We pay double because the system is broken. We can’t afford it.

Medical care has been transformed in recent years with CT scans, MRIs and all sorts of new drugs and treatments that have saved and extended life. That’s expensive, but worth it.

Mostly unavailable to about half of Americans. Insurance plans pay for surgery that costs six to eight times a CAT scan, because it doesn’t like “expensive technology” without justification. If a CAT scan discovers no problem requiring surgery, insurance won’t pay. “Doctor error.” So doctors don’t use the technology as it could best be used.

But when that heart disease that could have been prevented ends up in the surgery theatre, Katy bar the doors on expenses!

The health care bill before Congress is estimated by the CBO to cost $1.2 trillion over the next ten years, and another trillion over the 2nd decade. Health care costs will increase by 8% a year while revenues increase at only 5%.

Without it, health care costs will continue to rise at nearly twice that rate, 15% annually.

Don’t look now, but the lousy bill you don’t like is better than the catastrophe you’re defending.

Yes, I did read the bill. Medicare was estimated by the CBO to cost $12 billion by 1990. By 1990, it cost $110 billion.

Why? Do you know?

Medicare was expanded because it worked so well. Plus, it turns out there was a much greater need than anyone had projected.

In 1994, health care inflation was estimated to run about 8% annually if the Clinton plan didn’t get passed. Instead it ran closer to 16%.

The problem you cite is doubled in private insurance. Don’t tell me you don’t like waste and then propose to double the waste.

Waste is waste whether it’s government-run or private business run, and it hammers costs either way. Greater waste hammers us more greatly.

Government-run health care will cost vastly more than private insurance ever cost.

That’s not so for programs in either Medicaid or Medicare, compared to comparable coverage offered by private companies. The record, in every other nation AND in the U.S., is that government-run systems are cheaper. Especially where government simply takes over the payment, and not the delivery (leaving private health care providers as private health care providers), government systems are vastly less expensive.

This is why the insurance companies started to squawk about how unfair it would be for the government to compete against them. Competition is the key to an effective free-enterprise system — we need to inject some into health care now.

Doctors will leave the profession — Some doctors have estimated that 20% of doctors will retire early.

Compared to the estimates of 30% of doctors are retiring early now, right? We’ve had a physician shortage for 40 years. Here in Texas nearly 20% of our counties have no physicians at all. There is a reauthorization for a 40-year-old program to encourage medical students to graduate and serve these populations — you called it “socialism.”

Or you didn’t know it was in the bill.

Either way, the sensible solution would be to pass the bill and get more doctors for less money to serve the underserved areas, thereby reducing the incredible expenses of health care and even greater expenses of delivering no health care to millions of Americans.

There is nothing whatsoever in the house bill that will reduce costs.

The single most important cost-saving step is to cover people who lack insurance. No program can reduce costs at all without that. That’s a key target in the bill.

The cheapest health care system is the one that delivers care appropriately, on a timely basis. We spend an inordinate amount of money in the last 6 months of patients’ lives — 50% by some estimates — because they lacked good health care that would have kept them more sentient and more ambulatory until death.

The most important thing we can do is move health care delivery from the old to the younger, from the hospital emergency room to the doctor’s office. We can only improve that if everyone has access to a doctor on a timely basis, for the delivery of simply preventive programs, for the delivery of early treatment of disease.

Government health care has failed in Massachusetts, failed in Hawaii, failed in Tennessee, failed in Oregon, and failed in Maine.
To cut costs, which the government will have to do, they will have no choice but to ration.

We ration health care now by cutting out one out of every seven people for no care at all (though we pay for it — they just don’t get it; the money goes to “insurance company administration” instead of health care delivery). We ration health care now by denying technology to most Americans. That rationing saves no money for the nation — it seems to double the cost.

In contrast, Medicare patients, in the biggest government-run program, are the single least-rationed group.

There will be rationing until we equalize access, which will require more doctors, more clinics, more nurses, less emergency room use and more doctor’s office visits. But that rationing now is draconian and cruel, based chiefly on whether one works for a company with a health plan or not.

That’s unfair and cruel. Worse, it multiplies the costs for everybody. (An enormous part of hospital charges to private insurance-covered people is to provide the pool of money for indigent care.) Multiplies, not “adds to.”

Non-fraudulent waste may be many times fraudulent waste. We need to stop it.

The first step is to cover everybody.

Both presidential health care advisers Ezekiel Emanuel MD, and Peter Orzag, his budget director,have pointed out extensively the high costs of end-of-life care and the need to cut back on those expenses.

Under the present system, yes. Emanuel’s paper in January talked about the rationing decisions made now, how unfair they are, and how they increase pain and suffering.

Damn straight we need to reduce those costs — to increase delivery of health care.

Don’t defend private rationing by pretending it doesn’t exist, or by pretending it’s more fair, when no study shows it is fair or cheap.

Pain pills for the older folks instead of hip replacements or motorized wheel chairs.

That’s what happens today, yes. Unless, of course, they’re on Medicare, the government run program. That’s why the advertising for carts for the immobile notes that the companies selling the carts will take care of Medicare paperwork.

God help you if you’re not on Medicare. Private insurance won’t.

All government-run health care programs ration care. Which they do because they will not do the things that would actually reduce the cost of health care, like tort reform, increasing free market competition, offer insurance across state lines, and offer medical savings accounts, high deductible policies.

Hold on — Medicare and Medicaid allow free market competition, offer insurance nationally (in contrast to private plans), and allow medical savings accounts (though that’s not a viable solution for the poor, unemployed, students and retired people).

Tort costs about 1% of health care — and to my view, it works well. I don’t think swimming pool companies should be able to suck the bowels out of children without paying for it.

We do have a tort problem with OB-GYN, but it is largely caused by the insurance companies’ refusal to defend good doctors. That’s not a tort reform issue.

You cite problems that exist now, problems that are subject to attack by H.R. 3200. We’re not going to get anything at all if yammering yahoos don’t stop fighting against all change.

Doing nothing is cruel and costly. If you want to make a case for adding something to H.R. 3200, make the case.

Defense of current incredible waste is not a rational, moral option.

All health care systems ration health care. Our system rations health care on income and geography, and age. Higher incomes, big-company-employed, urban locations, and higher ages get the care.

Is that smart? It’s not cheap.

I don’t think These all are proven to save costs, but the trial lawyers are second only to the Unions as financial support for Democrats.

Those figures aren’t accurate, or they demonstrate that political giving doesn’t have much effect.

Tort cases take up the slack where government regulation ends. Should we allow McDonald’s to keep burning old ladies almost to death? (I thought you were for reducing costs, no?) Unless you will allow the Ministry of Coffee Temperature to regulate every fast-food drive through, tort cases are real money savers in the long run. (It cost less than $2.00 to fix the Pinto’s gas tank so it wouldn’t explode on impact. How many lives should we have sacrificed instead? I thought you were for reducing pain and suffering.)

I know no Republican or Conservative who does not observe that Liberals want to guarantee equality of outcome.

But none of them can show anyone who actually proposes to do it, not since Lenin abandoned the idea in 1920. I know no Democrat or Liberal or Republican or Conservative who urges equality of outcome. I’ll wager you can’t name major players who do, if you can name anyone at all.

That’s the problem with a lot of Republicans and conservatives — they’re not even tilting at windmills, they’re tilting at wind. We need action to make things better.

You propose we stick with the most wasteful and inefficient health care program in the industrialized world, one guaranteed to bankrupt the nation, or collapse soon.

Better you should tilt at windmills.

It’s obvious in their legislation. All kids get vaccinated, they are required to be vaccinated before they can enter kindergarten, and help is available if they cannot afford it. Silly claim.

All kids getting vaccinated (religious exceptions honored), is a great idea, a high ideal, compassionate, money-saving and wise.

My brother had polio, and the complications killed him early. I’m partially deaf from measles, or maybe scarlet fever. I don’t think vaccinations are bad things at all. Back when we lost 1 out of 3 babies before their second birthdays to infectious disease, the nation was not better off.

Universal health coverage keeps a population healthy, learning and working. You don’t like it? Take a look at any nation where disease is rampant — like malaria in Uganda. The lack of simple preventive measures tends to cripple a nation’s economy and destabilize its government.

That’s not good.

I would challenge most of your claims, but there is no point. According to what I know to be true, you are vastly misinformed, but you probably think that of me. I simply do not have time to carry on pointless discussions.

Who was it who observed, it’s not what we don’t know, it’s what we know that isn’t true that gets us into trouble?

==========================

Don’t you be shouted down, either;  Share the facts, with the system of your choice:

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MoveOn.org: Top 5 health care reform lies

August 11, 2009

I get e-mail from all sides — this one reflects a lot of my thinking, and came suitably footnoted:

Dear MoveOn member,

The health care fight has turned ugly, fast. Right-wing mobs are crashing congressional town halls,1 lies are spreading via anonymous email chains,2 and Sarah Palin bizarrely said that President Obama was going to set up a “death panel,” whatever that is.3

Many of these claims are just incredible—but if we don’t fight back with the truth, the right will continue to poison the health care debate. So as part of our Real Voices for Change campaign this August, we’re working to set the record straight.

Check out the list below: “Top Five Health Care Lies—and How to Fight Back.” Can you spread the word by passing this email along to 10 of your friends today?

Also, if you’re on Facebook, please post the list today by clicking here: http://www.moveon.org/r?r=51746. If you’re on Twitter, retweet: @MoveOn Check out the Top 5 Health Care Lies—and How to Fight Back. http://bit.ly/Bncs5

Top Five Health Care Reform Lies—and How to Fight Back

Lie #1: President Obama wants to euthanize your grandma!!!

The truth: These accusations—of “death panels” and forced euthanasia—are, of course, flatly untrue. As an article from the Associated Press puts it: “No ‘death panel’ in health care bill.”4 What’s the real deal? Reform legislation includes a provision, supported by the AARP, to offer senior citizens access to a professional medical counselor who will provide them with information on preparing a living will and other issues facing older Americans.5

Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!

The truth: With reform, choices will increase, not decrease. Obama’s reform plans will create a health insurance exchange, a one-stop shopping marketplace for affordable, high-quality insurance options.6 Included in the exchange is the public health insurance option—a nationwide plan with a broad network of providers—that will operate alongside private insurance companies, injecting competition into the market to drive quality up and costs down.7

If you’re happy with your coverage and doctors, you can keep them.8 But the new public plan will expand choices to millions of businesses or individuals who choose to opt into it, including many who simply can’t afford health care now.

Lie #3: President Obama wants to implement Soviet-style rationing!!!

The truth: Health care reform will expand access to high-quality health insurance, and give individuals, families, and businesses more choices for coverage. Right now, big corporations decide whether to give you coverage, what doctors you get to see, and whether a particular procedure or medicine is covered—that is rationed care. And a big part of reform is to stop that.

Health care reform will do away with some of the most nefarious aspects of this rationing: discrimination for pre-existing conditions, insurers that cancel coverage when you get sick, gender discrimination, and lifetime and yearly limits on coverage.9 And outside of that, as noted above, reform will increase insurance options, not force anyone into a rationed situation. 

Lie #4: Obama is secretly plotting to cut senior citizens’ Medicare benefits!!!

The truth: Health care reform planswill not reduce Medicare benefits.10 Reform includes savings from Medicare that are unrelated to patient care—in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.11

Lie #5: Obama’s health care plan will bankrupt America!!!

The truth: We need health care reform now in order to preventbankruptcy—to control spiraling costs that affect individuals, families, small businesses, and the American economy.

Right now, we spend more than $2 trillion dollars a year on health care.12 The average family premium is projected to rise to over $22,000 in the next decade13—and each year, nearly a million people face bankruptcy because of medical expenses.14 Reform, with an affordable, high-quality public option that can spur competition, is necessary to bring down skyrocketing costs. Also, President Obama’s reform plans would be fully paid for over 10 years and not add a penny to the deficit.15

We’re closer to real health care reform than we’ve ever been—and the next few weeks will decide whether it happens. We need to make sure the truth about health care reform is spread far and wide to combat right wing lies.

Can you forward this email to your friends today? And remember, also post it on Facebook by clicking here: http://www.moveon.org/r?r=51746. And on Twitter, by retweeting: @MoveOn Check out the Top 5 Health Care Lies—and How to Fight Back. http://bit.ly/Bncs5

Thanks for all you do.

–Nita, Kat, Ilya, Michael and the rest of the team

P.S. Want more? Check out this great new White House “Reality Check” website: http://www.whitehouse.gov/realitycheck/ or this excellent piece from Health Care for America Now on some of the most outrageous lies: http://www.moveon.org/r?r=51729&id=16778-5763840-nJFS5Ux&t=1

Sources:

1. “More ‘Town Halls Gone Wild’: Angry Far Right Protesters Disrupt Events With ‘Incomprehensible’ Yelling,” Think Progress, August 4, 2009.
http://www.moveon.org/r?r=51733&id=16778-5763840-nJFS5Ux&t=2

2. “Fight the smears,” Health Care for America NOW, accessed August 10, 2009.
http://www.moveon.org/r?r=51729&id=16778-5763840-nJFS5Ux&t=3

3. “Palin Paints Picture of ‘Obama Death Panel’ Giving Thumbs Down to Trig,” ABC News, August 7, 2009.
http://www.moveon.org/r?r=51728&id=16778-5763840-nJFS5Ux&t=4

4. “No ‘death panel’ in health care bill,” The Associated Press, August 10, 2009.
http://www.moveon.org/r?r=51747&id=16778-5763840-nJFS5Ux&t=5

5. “Stop Distorting the Truth about End of Life Care,” The Huffington Post, July 24, 2009.
http://www.moveon.org/r?r=51730&id=16778-5763840-nJFS5Ux&t=6

6. “Reality Check FAQs,” WhiteHouse.gov, accessed August 11, 2009.
http://www.whitehouse.gov/realitycheck/faq#i1

7. “Why We Need a Public Health-Care Plan,” The Wall Street Journal, June 24, 2009.
http://www.moveon.org/r?r=51737&id=16778-5763840-nJFS5Ux&t=7

8. “Obama: ‘If You Like Your Doctor, You Can Keep Your Doctor,’” The Wall Street Journal, 15, 2009.
http://www.moveon.org/r?r=51736&id=16778-5763840-nJFS5Ux&t=8

9. “Reality Check FAQs,” WhiteHouse.gov, accessed August 10, 2009.
http://www.whitehouse.gov/realitycheck/faq#r1

10. “Obama: No reduced Medicare benefits in health care reform,” CNN, July 28, 2009.
http://www.moveon.org/r?r=51748&id=16778-5763840-nJFS5Ux&t=9

11. “Reality Check FAQs,” WhiteHouse.gov, accessed August 10, 2009.
http://www.whitehouse.gov/realitycheck/faq#s1

12. “Reality Check FAQs,” WhiteHouse.gov, accessed August 10, 2009.
http://www.whitehouse.gov/realitycheck/faq#c1

13. “Premiums Run Amok,” Center for American Progress, July 24, 2009.
http://www.moveon.org/r?r=51667&id=16778-5763840-nJFS5Ux&t=10

14. “Medical bills prompt more than 60 percent of U.S. bankruptcies,” CNN, June 5, 2009.
http://www.moveon.org/r?r=51735&id=16778-5763840-nJFS5Ux&t=11

15. “Reality Check FAQs,” WhiteHouse.gov, accessed August 10, 2009.
http://www.whitehouse.gov/realitycheck/faq#c1

Sources for the Five Lies:

#1: “A euthanasia mandate,” The Washington Times, July 29, 2009.
http://www.moveon.org/r?r=51732&id=16778-5763840-nJFS5Ux&t=12

#2: “It’s Not An Option,” Investor’s Business Daily, July 15, 2009.
http://www.moveon.org/r?r=51743&id=16778-5763840-nJFS5Ux&t=13

#3: “Rationing Health Care,” The Washington Times, April 21, 2009.
http://www.moveon.org/r?r=51742&id=16778-5763840-nJFS5Ux&t=14

#4: “60 Plus Ad Is Chock Full Of Misinformation,” Media Matters for America, August 8, 2009.
http://www.moveon.org/r?r=51734&id=16778-5763840-nJFS5Ux&t=15

#5: “Obama’s ‘Public’ Health Plan Will Bankrupt the Nation,” The National Review, May 13, 2009.
http://www.moveon.org/r?r=51744&id=16778-5763840-nJFS5Ux&t=16

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Palin proposes “death panels”

August 11, 2009

Isn’t that a fair headline?

She must be proposing them — they don’t show up in the health care bill before Congress.

Update: Over at Le-gal Ins-ur-rec-tion, Cornell Law prof William A. Jacobson dug out an article by Rahm Emanuel’s brother Ezekial, a respected bioethicist at the National Institutes of Health, and suggests strongly that Palin is just contributing to the the debate.  In the paper (at Lancet, subscription required, but access to this paper is free because it’s so important), Dr. Emanuel and others discuss how to allocate health care resources to provide the greatest healing among many competing, worthy patients, when resources cannot be allocated to all of the worthy patients.  Jacobson said:

Put together the concepts of prognosis and age, and Dr. Emanuel’s proposal reasonably could be construed as advocating the withholding of some level of medical treatment (probably not basic care, but likely expensive advanced care) to a baby born with Down Syndrome. You may not like this implication, but it is Dr. Emanuel’s implication not Palin’s.

Jacobson misses the greater point here, the part the sticks in the craw of those of us who have lived with these issues for 20 years, or 30 or 40:  Dr. Emanuel’s paper discusses how to improve the current system of allocation of resources.

We aren’t debating whether to have “death panels.”  The discussion is on how to make them work more equitably, and how to expand health care resources to make the need for such decisions less frequent. Palin’s point is to defend unfair death panels used often.  She doesn’t know that, and Jacobson should realize that and not defend it.

Here’s the summary at Lancet:

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.

He’s working to make the death panels more fair, more accurate, more beneficial.  Palin suggests we should leave the current system in place where Palin’s death panels, though working hard, often are unfair and inaccurate, and waste resources.

In the present system, resources generally are allocated first on the basis of who has money.  De facto, the system writes off to death anyone with a serious disease who is poor.  “Poor” in this case doesn’t mean destitute.  An annual income of $60,000 would put one into the category of “poor” I’m talking about here.

Jacobson said:

These critics, however, didn’t take the time to find out to what Palin was referring when she used the term “level of productivity in society” as being the basis for determining access to medical care. If the critics, who hold themselves in the highest of intellectual esteem, had bothered to do something other than react, they would have realized that the approach to health care to which Palin was referring was none other than that espoused by key Obama health care adviser Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel).

I took the time to find out.  I knew in advance.  I’ve sat through hours of legislative hearings on this issue.  In my opinion, Sarah Palin is still a carbuncle on the face of this debate.  Her calling these panels “death panels” is designed to obfuscate the issues and deny the debate Jacobson says we need to have.  She’s providing heat for cheap political gain, not light.  She’s defending death, not life.

Shame on her.  Jacobson should know better, too.  I can all but guarantee that Palin didn’t read Dr. Emanuel’s paper, and didn’t consider the issues at all.  I’ll wager she does not know that hospitals in her state make these decisions regularly.

Under Palin’s way, death panels already exist. Death panels make decisions on life or death every day, and the poor and uninsured are at the bottom of the scale of who gets to live, top of the list of who gets to die.  Uninsured people often get shut out of the process, allocated pain and death from the start, because they lack insurance.

H.R. 3200 doesn’t do much to change this equation, the authors and legislators hoping to avoid cyanide politics like Palin plays; instead the bill encourages programs to help patients be on the “live if I want to live” side of the equation.  These encouraged programs should be bread and butter to legal clinics at most law schools, by the way — great help to the poor in anticipating what to do in life-threatening emergencies.  (I mention that because Jacobson is a clinical law professor — I don’t know which end of the legal clinics he works in, but he should know better anyway.)

We’ve already got the debate, and we already know that Palin’s trying to poison the well and fog up the lecturn, so that health care resources are misallocated.  In reality, this leads to more unnecessary and preventable deaths.

Yes, let’s have the debate:  Palin’s wrong to stand with unfair death decisions.  She’s had her say, and she should be held accountable.

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Think you have health insurance? Wrong

August 7, 2009

Baseline Scenario lays out the facts: People fear government reform of health care because they think it will interfere with their own health insurance.  Such people need to understand that they don’t have health insurance, and a broader government plan is the only saftey net they have to protect them from going naked against major health expenses.

Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, “69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.” Since most Americans currently have health insurance, they see reform as a poverty program – something that helps poor people and hurts them. If that’s what you think, then this post is for you.

You do not have health insurance. Let me repeat that. You do not have health insurance.

Just one more point in a series of misconceptions, misperceptions, and unwarranted listening to false claims about health care and legislation designed to save our tails.  James Kwak and others at The Baseline Scenario do a good job explaining economics in the U.S. today.  In this piece he makes the point that in terms of health care, we are all among “the poor” (save for those few of you who make more than $1 million a year and have done for the past decade).

Ask not for whom the health insurance reform bill tolls; it tolls for you.


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