Universal Health Care? April Fools!

[McCamy Taylor]

I just read the New York Times piece entitled "Democrats Agree on a Health Plan" and I am hoping that this is their idea of an April Fool's joke. Because what they describe as a consensus makes about as much sense as the year anonymous April Fools pranksters stole our front porch hammock---and never brought it back.

http://mobile.nytimes.com/article?a=351390&single=1&f=21

Lobbyists and Congressional aides have discussed a possible compromise: Congress would authorize a new government-run insurance program, but it would come into existence only if certain conditions were met - if, for example, private insurers failed to rein in health costs by a certain amount after several years. Such a condition would serve as a strong incentive for insurers to ratchet down payments to doctors and hospitals.

Is Congress having a collective "senior moment"? If there was any way that private insurers could possibly price gouge health care providers any more than they already do now don't you think that they would have already done it? If they had some super secret plan to deny sick people even more care than they are already denying, wouldn't we already know about it?

The problem with health care in America is not the insurance plans. Or rather, they are a problem, but they are not the source of our biggest problem, which is the fact that we pay twice as much as any other industrialized nation in the world per person for health care results that would embarrass a former Soviet block country.

You do not decrease your national health care expenditures--currently 15% of the GNP and rising --by telling private insurance companies "Spend less money or we will make a competing government plan." Private insurance loves a competing government plan---if it is Medicare and it assumes the care of all the old and sick people in the country, leaving private insurance free to collect premiums from the rest.

You decrease your national health care expenditures by teaching the American medical establishment to prevent disease rather than waiting for diseases to present. And that can only be done through a coordinated public health education program which teaches Americans that they can no longer live their lives fat, lazy and smoking---and then expect a total tune up at the age of 65 to repair 40 years of damage.

If our bodies were our cars, we would take better care of them. People are more likely to change their oil than they are to think about their cholesterol in their 20s---and so the arteries harden and the heart disease forms.

Private insurance, which makes money by discouraging its members from using health care services, will not waste a cent on disease prevention, because the benefits of their investment may be reaped by another insurance provider---such as Medicare when the healthy young adult turns into a healthy senior. UnitedHealth, Blue Cross and the others were not put on this earth to save the tax payers' money on the health care of the nation's growing elderly population. They exist to collect a lot of premiums fast---and do everything humanly possible to avoid paying out those premiums on claims.

Bravo to the health insurers for agreeing (at least verbally) to cover all comers, without the pesky "previous medical conditions" clauses that currently prevent anyone with a history of asthma, acne, depression or a host of other diseases from getting health insurance. And, if you believe their promise, I have some swamp land to sell. Cheap. Through their managed care products, private insurers have become adept at driving away "sick" patients. They do this by limiting the number of providers, requiring tons of paperwork and basically making the people who need health care most jump through hoops for it.

But Republicans say a government plan would have unfair advantages and could drive private insurers from the market.

Wrong. We have a huge public health program, one which matches private health care spending dollar for dollar. It is called "Medicare" and "Medicaid" and the "VA" among other names. Private insurers just love having a public health insurer which is willing to cover the truly needy. The scandal of our current health care system is that privates collect our premiums when we are young and do not get preventive care (that would cost pennies) to stop the progression of disease that cost the government much more money to fix once we are on Medicare.

I do not have a crystal ball, but I can already hear the private insurers whining (a year or two from now, when they hold our health in their hands)...

"We had no way of knowing that the new members we signed up with pre-existing medical conditions would need so much health care. Give us lots and lots of extra money now or we will stop paying our bills" If you doubt me, look at Wall Street and the bankers. Blackmail works if it is something we really need like our homes or our medicine.

"If only the federal government would preempt state regulation of insurance, we could be so much more efficient."

And, the always popular "If the federal government steps in to stop people from suing us and their medical providers then we will be able to offer cheaper care."

But no combination of tax increases and Medicare savings comes near to covering the full cost of the proposals, which Democrats say could easily top $1 trillion over 10 years.

And when you are topping $100 billion a year, you can bet that Congress will listen to any recommendation that allows them to trim a few bucks--even if it means dismantling the fragile system of checks and balances which currently exist to protect the medical consumer.

The super-secret private insurance companies' plan to make more money under government subsidized health insurance goes something like this. Everyone in the nation is required to buy health insurance. If you are poor, the government will make your payments for you. Private insurers will begin making everyone in the whole country (except members of Congress) jump through hoops for their medical care. Those who are healthy enough to jump will keeping paying their premiums year after year through the process of inertia. Those who are too sick for acrobatics will be weeded out by the obstacle course, and they will end up raising their hands to the federal government in supplication, saying Please, please put us on Medicare.

And the nation's health care expenses will rise while our health will deteriorate even further.

The definition of insanity is doing the same thing again and again and expecting a different result. We already have a system in which the private insurers get first pick and then the government takes care of everyone the privates reject. Adding 50 million more people to that same equation will not fix what ails us.

[quidam56]

1. We need a cure for health care...

http://www.wisecountyissues.com/?p=62 In East Tennessee, profit care comes ahead of patient care.

[Fumesucker]

2. We have the very best government big, big money can buy..

If you don't have big money, and trust me, the insurance companies do, then you get ignored if you are lucky.

Anyone who didn't see this coming has had on rose tinted glasses that you could use for viewing solar eclipses without risking damage to your eyes..

"I can envision a day when you will have to show proof of insurance at the job interview" -Hillary Clinton

[imdjh]

3. Why is this so F'ing hard? What does Congress not understand? n/t

[SwiperFox]

4. They knew, they know!

They under$tand everything all too well. You don't seem to understand the real issue here. The Republicrat is a party of and for the corporations. Bush, Obama, Biden, Cheney, Pelosi, etc. All employees of the corps. How can people not see this after all the past and present evidence is beyond my understanding.

[dflprincess]

5. "would come into existence only if private insurers

failed to rein in health costs by a certain amount after several years"

They really are whores, aren't they?

They can explain to the 18,000 that will die each year because they don't have access to health care that the insurance companies had to be given "several years" to fix the mess they created.. (And GM gets 60 days?)

[progressoid]

6. I just saw tonght's Frontline about healthcare.

Pretty fucking scary.

[eridani]

7. "teaching the American medical establishment to prevent disease "

This is nonsense, and betrays a lack of awareness about where health care expenses come from. 5% of the population accounts for 50% of costs, and 15% of the population for 85% of the costs. Ragging on the 85% who are never going to get expensively sick to live cleaner is pointless. Since they account for only 15% of costs, all that clean living has no effect whatsoever on the bottom line. Of course it is still a very good idea to promote prevention, because it improves overall quality of life for everybody dramatically. It just isn't a money saver.

[Merlot]

8. It's not about living "cleaner" lives - it's about catching an illness in it's early

stages when it's easier to treat.

I have a friend without insurance. Got terribly ill, was in hospital for 3 months, had multiple surgeries and almost died on the table. If she had gone to the doctor for regular check ups, her
illness would not have gotten as bad and as expensive to treat. Instead, she ended up in emergency. Even a doctors appointment a week earlier would have saved a lot of pain.

People who don't have insurance are afraid to go to the doctor.

[eridani]

9. IMO early intervention is actually a different thing than prevention per se

Like that kid with the infected tooth who died. I think of prevention more as having programs in schools and dental offices about how to brush your teeth and avoiding too many sugary snacks. I'd define early intervention more as giving mom $80 to have it pulled instead of giving her $250,000 to spend on a futile attempt to save the kid's life.

Maybe this is hairsplitting, as common usage often conflates the two. However, on DU as in many other places, the term "prevention" is often covertly used to mean "I'm tired of paying for lazy slobs who eat too much junk food." Quite a few people think that the reason they've never been expensively sick is that they, unlike others, live right. The reality is that most people are never going to get expensively sick, just like their houses will probably never burn down.

[SwiperFox]

10. ...

How much is spent on "defense"? How much on gifts to corporations/banks? None for our health and it is OUR money!
Damned thieves all of them. From the top to the bottom of "both" parties.

[McCamy Taylor]

12. Is nonsense to say that 5% of the population is doomed to suffer CHF

which is the biggest money sink diagnostically for Medicare. Congestive heart failure in America is usually the result of years of poorly controlled hypertension with left ventricular hypertrophy along with myocardial ischemia from a combination of factors that include 1) smoking (which a sensible public health prevention effort would seek to phase out in this country through federal government policy changes) 2) hyperlipidemia which may be partly familial but which owes a lot to our fast food diets 3) diabetes which is made worse by our diets (esp. soft drinks), obesity, lack of exercise and people not getting the care they need young when they first begin to have elevated blood sugars. Even those who are destined to clog their coronary arteries because of their genes could benefit from early medical care aimed at preventing the first MI.

This sense of inevitability is exactly what is wrong with health care in the US. There are many cheap, effective measures which we, the people, could begin to implement in school, if only we had a sane public health policy in this country.

However the Medical Industrial Complex makes big money off the years of neglect which cause us to become unhealthy seniors. If we started preventing disease, all those CT surgeons would have no one to do CABGs on. There would be fewer people needing dialysis. ICU beds would go empty.

I have seen American health care from both perspectives---ten years in family practice as a physician and then as a Master Public Health. The amount of preventable serious disease that I saw in private practice broke my heart. So many of those people would have lived longer, healthier more productive lives if only our country was more like Japan, which knows that you can not buy good health at the end of life, you have to work towards it all your life---and that is why Japan spends so much less on health care but gets results that are so much better, even though they are an overly rich, overly pampered country just like the US. They can have all the luxuries that we have---too much good food, cars that limit the need for exercise, extra cash for cigarettes--but their public health structure teaches them a better way.

Here is a typical American health consumer (real story follows): Man in his 60s is told by his physician that his cholesterol is up, his sugar is up, his blood pressure is slightly up and that he needs to change his diet in order to correct these problems. Man's response: "Doc, can't you just give me a pill."

Oh, the American pharmaceutical industry just loves that Man.

[eridani]

16. I said that 5% of the population accounts for 50% of all costs, not that they all had CHF

Besides which, Japanese men smoke like chimneys. And if the Japanese diet itself accounts for their high longevity rates, why did that traditional diet result in near third world life expectancies before WW II? Japan is noted for having the single highest increase in longevity in a single generation, which was accompanied by a higher caloric intake of a much more westernized diet. Salarymen are not known for their athletic prowess either.

Successful prevention is in fact responsible for a large chunk of our increased medical costs. Compare three generations of Type II diabetics--grandmother, father and me. When my grandmother was my age, she had been dead for 9 years. When my father was my age he had been dead for 3 years. My a1c values didn't go over 7 until my 62nd birthday. This is a result of better knowledge of how to manage foods with a high glycemic index, and an aggressive pretreatment with metformin when the a1cs were in the 6-7 range. Also the class privilege of a job which came with an excercise club in the basement and the control over specific work hours that enabled me to use it.

It ought to be obvious that of the three of us, my lifetime health care expenses are going to be the highest. Prevention helps people with crappy genes live long enough to have something nasty and expensive happen to them. Although my lifetime health care will be more expensive, there are social benefits that don't show up on the health care costs bottom line, namely that society got an extra 10-15 years of use of my expensive subsidized professional education. Also a lot of volunteer community work between now and the time I die.

The basic fact about health care costs is that a minority of the seriously sick will be responsible for most of them, just as only a few people are responsible for the costs incurred by fire protection. Therefore all of us should underwrite the costs of both, because it is not likely to be you, but it COULD be you.

[geckosfeet]

11. Another not so well disguised taxpayer funded giveaway to the insurance industry.

The insurance industry will benefit, by insuring only those who don't need health care (and leaving the rest to fend for themselves and use government programs) and SIMULTANEOUSLY claiming that the cost of providing health care is too expensive and is bankrupting them. And since they provide a service essential to the American public they most certainly cannot be allowed to fail. (Hold out greedy little corporate hands and demand protection money from the taxpayer.)

Why don't we head this off at the pass and save trillions of taxpayer dollars and just set up a government administered "single payer" health care program that covers everyone in the country regardless of socio-economic status.

[Bluenorthwest]

13. The people I know with no insurance

can not afford it, and will not be able to even if they bring it down by $2500 or whatever. We are hemmoraging jobs, the employed face cut backs, and they think they can simply present a mandated bill and the money will appear from nowhere?
And if suddenly millions of Americans have to spend each and every penney on Insurance, not health care, how will the rest of the economy suffer? No money for anything but Humana. And taxes.

[area51]

14. Excellent post.

I wish I could nominate it for the greatest page. The insanity of demanding everyone buy what's basically unregulated, private, for-profit health insurance is just mind-boggling.

Every year, 100,000 people die due to lack of healthcare in the U.S.

We need single-payer healthcare NOW.

[area51]

15. Kick. (n/t)