[Oe List ...] [Dialogue] health care reform

Fri Aug 28 09:06:28 CDT 2009

Another part, and I'm not sure of the statistics, is medical care for  
the poor and the "undocumented."  I have occasion to visit the  
emergency rooms of Austin hospitals several times a month and they are  
always filled day or night with women and children.  Wait times are  
extended.  Some of the emergency physicians I have known tell me they  
are giving up or are moving to other states, because most of the work  
is pediatric and GP medicine.  A couple of the hospital administrators  
I've met tell me the costs are killing them.  Giving people tax  
credits to purchase health insurance will hardly cover people who  
don't make enough to pay income taxes.

I've also noticed news items reporting hugh profits of the health  
insurance companies and hugh compensation for CEOs.  I wonder what  
that contributes to health or wellness care.  I keep receiving more  
and more beautiful magazines and  a steady stream of statements and  
other advertisements in the mail from the health insurance company we  
use, and we seldom make use of its services.  It has no option to  
receive all this through email.  That's got to cost a lot of money.   
We've also received bills for lab tests after the insurance company  
said they were paying the cost, and we have to fax them their own  
agreement, sometimes more than once to prove the point.  It's always a  
hassle. In shopping for specialists, some of the doctors they claim on  
their lists, tell us they are not on that insurance. When you try to  
verify or get information from the companies, you are put on hold,  
sometime the call is dropped, and you wind up repeating your  
information 3 or 4 time as you are shuffled to the "right" person.   
It's a mess.  People who like their insurance, probably haven't used it.

The last time I was in a doctor's office there were three pharma  
salespersons working the group of doctors, which added about 30 or 40  
minutes wait time.  They were all very young, very attractive ladies,  
probably just out of college, and one wonders just how much medical  
information that brings to the system, but assistants were filling up  
closets with their samples.

We write, email, call our congress people, read, try to get educated  
but I'm not sure yet what's in the bills.

I think some kind of government health care like in Europe or Japan  
would be preferable to this mess.  But whether we get a chance to vote  
on that one way or another, seems remote.  We live in a Corptacracy  
and participating in it and changing it appears to have rules few  
know.  Much of what gets decided is found out years later.  This is  
perhaps the contradiction.

George Holcombe
14900 Yellowleaf Tr.
Austin, TX 78728
Home: 512/252-2756
Mobile 512/294-5952
geowanda at earthlink.net

On Aug 28, 2009, at 12:09 AM, Don Elliott wrote:

> Marshall,
>
> You are exactly right in your analysis of the proposed health  
> legislation, it doesn't deal with the
> major reasons for the high costs.  Former Senator Bill Frist made  
> his fortune from for-profit hospitals,
> Senator Edwards made his fortune suing doctors and hospitals.  Any  
> health plan that refuses to deal
> with high drug costs and leaves out tort reform cannot lower costs  
> significantly.
>
> Charles Krauthammer writes:  "When a neurosurgeon pays $200,000 a  
> year for malpractice insurance
> before he even turns on the light in his office or hires his first  
> nurse, who do you think pays? Patients,
> in higher doctor fees to cover the insurance.  And with jackpot  
> justice that awards one claimant zillions
> while others get nothing -- and one-third of everything goes to the  
> lawyers -- where do you think that
> money comes from?  The insurance companies, which then pass it on to  
> you in higher premiums.
>
> But the greatest waste is the hidden cost of defensive medicine:  
> tests and procedures that doctors order
> for no good reason other than to protect themselves from lawsuits.   
> Every doctor knows, as I did when
> I practiced years ago, how much unnecessary medical cost is incurred  
> with an eye not on medicine but on the law."
>
> http://www.washingtonpost.com/wp-dyn/content/article/2009/07/23/AR2009072302723.html
>
> The much touted Medicare drug benefit passed under Bush, provided  
> for obtaining drugs at the prices
> set by the drug companies, no volume discounts, no negotiating for  
> price reductions.  The Canadian
> Health Service buys these same American drugs for a fraction of what  
> Medicare pays, and now we
> find out the current administration has cut a deal with PhRMA that  
> continues this arrangement.  At
> first a deal was denied, then admitted.  There really shouldn't be a  
> secret WH deal with PhRMA.  Congress
> is presumably writing the legislation.  Will Obama refuse to sign a  
> bill that provides for negotiating for
> lower drug prices for Medicare after promising PhRMA there will be  
> no negotiating?
>
> See these links.  www.huffingtonpost.com/.../phrma-walks-back-claim-of_n_256111.html 
> ,
> www.huffingtonpost.com/.../internal-memo-confirms-bi_n_258285.html
>
> How about a piece meal overhaul, starting with drug prices and tort  
> reform?  And then consider insurance regulations.
> Medicare has already cut hospital and physician reimbursement  
> significantly, now other sectors need work.
>
>
> Don Elliott
>
> -----Original Message-----
> From: W. J. <synergi at yahoo.com>
> To: oe at wedgeblade.net; dialogue at wedgeblade.net
> Sent: Thu, Aug 27, 2009 1:26 pm
> Subject: [Dialogue] health care reform
>
> Colleagues,
>
> I've been continually amazed at your silence on the wildfire  
> 'debates' on health care 'reform' in the USA. We did hear from Bob  
> Rafos up in Canada, but very little else.
>
> Especially with the travesty of 'town meetings' across the country  
> this month, which were highjacked by the right wing nut cases eager  
> to exploit the obvious lack of a participatory methodology for real  
> proposals for reform. Where were the ICA types when we needed them??
>
> Enjoying our 'retirement', you say?
>
> Well, what about being part of the Medicare generation (at last),  
> with the widespread fears that 'death panels' (thank you, Sarah)  
> will ration health care at the end of life, and that extracting  
> bloated, inflationary expenditures from the only government-run  
> sector of the system (apart from the VA and Medicaid) will reduce  
> the quality of senior care? Still asleep on that one?
>
> My own view of what sustainable health care will have to look like  
> has evolved to the point where Obamacare looks like a rerun of  
> Hillarycare--a complex hodgepodge of Bandaid fixes designed to keep  
> the present system up and running, maintain a robust private for- 
> profit sector that skims Medicare/Medicaid, include more people  
> under the private insurance 'umbrella' (remember the travesty of The  
> Travellers/CitiCorp merger?), and still preserve access to  
> healthcare as a privilege of citizenship/economic affluence rather  
> than a human right available without 'co-pays' to all who enter the  
> system, including those who sneaked across our borders to harvest  
> our food for minimum wage and no health benefits, and who get  
> deported (via expensive international Med-Evac flights) to third  
> world shacks rather than treated for expensive health conditions by  
> our public hospitals, our healthcare safety net of last resort.
>
> Yeah, I know that was a long, complex sentence, but the new  
> healthcare reform bill is gonna be long and complex too.
>
> If you want a fairly understandable example of the problem, in which  
> the highest health care bills are extracted from one of the poorest  
> populations in the nation, please read:
>
> http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
>
> More later, but this is a start.
>
> Marshall
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