Monday, September 28, 2009

What doctors think about health care reform

What do doctors think about proposed health care reform? The voices of physicians in the current debate have been almost exclusively from national physicians’ groups and societies, and little has been known about "the doctor in the trenches" and how they view things. A recent study the The New England Journal of Medicine sheds new light on this issue.

Turns out that a majority of physicians (62.9%) support reform that includes both a public and private plan options. 27.3% support reform offering only private options.

Wednesday, September 23, 2009

One reason medical care is so expensive: We All pay a Hidden Tax

Those of us who currently have private health insurance pay a "hidden tax", included in our premiums, to pay for costs incurred by those without coverage. A new study now calculates that cost to be $1,017.00 per family in 2008, which is in addition to the actual taxes paid to support Medicaid and other government programs.

In 2008, the uninsured received $116 billion worth of care from hospitals, doctors, and other providers, which was usually provided for emergencies that could no longer be ignored. Those costs had to be paid for somehow, and they were covered in the following ways:
  • On average, the uninsured themselves paid for more 37 percent of the total costs of the care they received.
  • Government programs and charities, paid for another 26 percent of that care.
  • The rest, approximately $42.7 billion in 2008, was unpaid (So called "uncompensated care").
To cover the rest of this "uncompensated care", the cost was shifted to private insurers by charging more for health services. These charges then result in the higher premiums we all pay. In 2008 the extra charge for family health care coverage was $1,017.00 and for a single person was $368.00.

The next time you here someone bemoan "increased taxes" to pay for health care reform, remember the truth. We need to get rid of the tax we already bear, and substitute a planned system that actually gets people in for needed care before things fall apart, thereby saving us all money.

Sunday, September 13, 2009

Do we wish to be the only rich nation in the world that lets a 32-year-old woman die because she can’t get health insurance? Is that really us?

"Nikki was a slim and athletic college graduate who had health insurance, had worked in health care and knew the system. But she had systemic lupus erythematosus, a chronic inflammatory disease that was diagnosed when she was 21 and gradually left her too sick to work. And once she lost her job, she lost her health insurance." Nicholas Kristof tells the true story of Nikki White in an Op-Ed column in the New York Times on September 13, 2009.

The story of Nikki White graphically explains what is wrong with our current system, and why health care reform is so desperately needed. After she lost her job and health insurance, Nikki tried everything to get medical care, but no insurance company would accept her. As Kristof explains, "She spent months painfully writing letters to anyone she thought might be able to help. She fought tenaciously for her life.

Finally, Nikki collapsed at her home in Tennessee and was rushed to a hospital emergency room, which was then required to treat her without payment until her condition stabilized. Since money was no longer an issue, the hospital performed 25 emergency surgeries on Nikki, and she spent six months in critical care."

Here is the irony - “When Nikki showed up at the emergency room, she received the best of care, and the hospital spent hundreds of thousands of dollars on her,” said her step-father, “But that’s not when she needed the care.”

By then it was too late. In 2006, Nikki White died at age 32. Her doctor, Amylyn Crawford, said, “Nikki didn’t die from lupus, Nikki died from complications of the failing American health care system.”

Access to early, appropriate health care is something that any of us can loose without warning. We need reform. I do not want to live in the only rich nation in the world that lets anybody die because they can’t get health insurance.

Sunday, September 6, 2009

How American Health Care Killed My Father

That is the provocative title of an article by David Goldhill in the September, 2009 issue of The Atlantic monthly magazine. After the needless death of his father, Goldhill began a personal exploration of the health-care industry. He found that for years it has delivered poor service and irregular quality with an astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form, and he believes that the timid health-care reform now being contemplated will not fix it. His insights as a non-health care professional business executive, who looks at things from a business point of view, are profound, and I encourage everyone to read the article. You understanding of the compelling need for change will be enhanced.

So, if change is needed, what is the experts prescription for change, in a nutshell? In a September 6, 2009 article from the The Brookings Institution a group of 10 health care policy experts detail a set of concrete, feasible steps to revamp the system to control cost and improve saftey and quality. The plan, “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth,” focuses on reducing the growth of health care spending, while also improving quality.

Their strategy consists of four interrelated pillars:
  • First, we all need better information and tools to be more effective in getting the right care.
  • Second, payments to health care providers should reward improvement in quality and reductions in cost growth, while emphasizing disease prevention and coordination of care.
  • Third, health insurance markets must be reformed and government subsidies restructured to create competition and improve incentives around value improvement rather than risk selection. This will require all to be covered in some way.
  • Fourth, people need support for improving their health and lowering overall health care costs, including incentives for achieving measurable health goals.
The report is well worth a read, in order to understand each of the pillars. Only by being informed on the issues so we know what is really being suggested can we cut through the claims of those trying to derail needed change. You can get a copy of this report by clicking on this text.