This helps frame the debate. Not the summertime town hall antics just these simple stories of how real Americans are forced to make impossible decisions.
October 04, 2009 | Permalink
If you don't have time to read it, consider this:
The world champion at controlling medical costs is Japan, even though
its aging population is a profligate consumer of medical care. On
average, the Japanese go to the doctor 15 times a year, three times the
U.S. rate. They have twice as many MRI scans and X-rays. Quality is
high; life expectancy and recovery rates for major diseases are better
than in the United States.
And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
A different view of the debate from Kristoff in the NY Times this morning...
Opponents suggest that a “government takeover” of health care will be a milestone on the road to “socialized medicine,” and when he hears those terms, Wendell Potter cringes. He’s embarrassed that opponents are using a playbook that he helped devise.
“Over the years I helped craft this messaging and deliver it,” he noted.
Mr. Potter was an executive in the health insurance industry for nearly 20 years before his conscience got the better of him. He served as head of corporate communications for Humana and then for Cigna.
He flew in corporate jets to industry meetings to plan how to block health reform, he says. He rode in limousines to confabs to concoct messaging to scare the public about reform. But in his heart, he began to have doubts as the business model for insurance evolved in recent years from spreading risk to dumping the risky.
Then in 2007 Mr. Potter attended a premiere of “Sicko,” Michael Moore’s excoriating film about the American health care system. Mr. Potter was taking notes so that he could prepare a propaganda counterblast — but he found himself agreeing with a great deal of the film.
A month later, Mr. Potter was back home in Tennessee, visiting his parents, and dropped in on a three-day charity program at a county fairgrounds to provide medical care for patients who could not afford doctors. Long lines of people were waiting in the rain, and patients were being examined and treated in public in stalls intended for livestock.
“It was a life-changing event to witness that,” he remembered. Increasingly, he found himself despising himself for helping block health reforms. “It sounds hokey, but I would look in the mirror and think, how did I get into this?”
Mr. Potter loved his office, his executive salary, his bonus, his stock options. “How can I walk away from a job that pays me so well?” he wondered. But at the age of 56, he announced his retirement and left Cigna last year.
This year, he went public with his concerns, testifying before a Senate committee investigating the insurance industry.
“I knew that once I did that my life would be different,” he said. “I wouldn’t be getting any more calls from recruiters for the health industry. It was the scariest thing I have done in my life. But it was the right thing to do.”
Mr. Potter says he liked his colleagues and bosses in the insurance industry, and respected them. They are not evil. But he adds that they are removed from the consequences of their decisions, as he was, and are obsessed with sustaining the company’s stock price — which means paying fewer medical bills.
One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.
As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses.
Mr. Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.
All this is monstrous, and it negates the entire point of insurance, which is to spread risk.
The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.
Mr. Potter argues that much tougher regulation is essential. He also believes that a robust public option is an essential part of any health reform, to compete with for-profit insurers and keep them honest.
As a nation, we’re at a turning point. Universal health coverage has been proposed for nearly a century in the United States. It was in an early draft of Social Security.
Yet each time, it has been defeated in part by fear-mongering industry lobbyists. That may happen this time as well — unless the Obama administration and Congress defeat these manipulative special interests. What’s un-American isn’t a greater government role in health care but an existing system in which Americans without insurance get health care, if at all, in livestock pens.
President Obama in this morning's weekly address warned Americans that his foes will "scare and mislead" in order to preserve the status quo as they fight his lead in reforming health care, and he once again shot down the "death panel" silliness:
...let’s look at one of the scarier-sounding and more ridiculous rumors out there – that so-called "death panels" would decide whether senior citizens get to live or die. That rumor began with the distortion of one idea in a Congressional bill that would allow Medicare to cover voluntary visits with your doctor to discuss your end-of-life care – if and only if you decide to have those visits. It had nothing to do with putting government in control of your decisions; in fact, it would give you all the information you need – if you want it – to put you in control of your decisions. When a conservative Republican Senator who has long-fought for even more far-reaching proposals found out how folks were twisting the idea, he called their misrepresentation, and I quote, "nuts."
He reiterated the now familiar requirements of what he's advocating, including eliminating caps on coverage and pre-existing condition exclusions as well as requirements for coverage of preventive care.
And, in case anyone has forgotten since the last one hundred times he's said it: If you want to keep your own doctor, you can.
He evoked the spirits and battles of Democratic presidents in the past and reminded Americans of the hard fights and ridiculous scare-mongering faced by his predecessors:
So when folks with a stake in the status quo keep inventing these boogeymen in an effort to scare people, it’s disappointing, but it’s not surprising. We’ve seen it before. When President Roosevelt was working to create Social Security, opponents warned it would open the door to "federal snooping" and force Americans to wear dog tags. When President Kennedy and President Johnson were working to create Medicare, opponents warned of "socialized medicine." Sound familiar? Not only were those fears never realized, but more importantly, those programs have saved the lives of tens of millions of seniors, the disabled, and the disadvantaged....
Nearly fifty years ago, in the midst of the noisy early battles to create what would become Medicare, President Kennedy said, "I refuse to see us live on the accomplishments of another generation. I refuse to see this country, and all of us, shrink from these struggles which are our responsibility in our time." Now it falls to us to meet the challenges of our time. And if we can come together, and listen to one another; I believe, as I always have, that we will rise to this moment, we will build something better for our children, and we will secure America’s future in this new century.
Another from Morning Newsbeat. Kevin's on fire this morning...
Denmark Adopts Fat Tax
There has been a lot of discussion here on MorningNewsBeat in recent weeks about the possibility of a fat tax in the US, which led one MNB user to point out to us that Denmark is actually imposing one, with extra taxes ladled on foods that are considered unhealthy – a move that is designed to promote healthy eating and reduce that nation’s obesity problem.
These taxes are scheduled to kick in at the beginning of next year.
A calmer voice...
Whole Foods CEO John Mackey had a long op-ed piece in the Wall Street Journal yesterday in which he addressed the ongoing health care debate, writing that “while we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment.”
There are two specific recommendations/observations that Mackey makes that we will focus on here:
• “The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees' Personal Wellness Accounts to spend as they choose on their own health and wellness.
“Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan's costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.”
• “Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.
“Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
“Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age. Health-care reform is very important. Whatever reforms are enacted it is essential that they be financially responsible, and that we have the freedom to choose doctors and the health-care services that best suit our own unique set of lifestyle choices. We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health.”