IT'S TIME FOR UNIVERSAL HEALTH CARE

If you want to read about the demise of Medicare ( slow but sure ) start reading some of the medical blogs and read why many MDs are very, very upset.

It used to be that Medicare covered everything that regular insurance covered. Then, holes in the plan were discovered, which were then supposed to be plugged up by the Medigap insurance plans.

Now...medicare is shrinking some of it's coverage, and one I picked up on a Medical Blog, yesterday, was the planned refusal of Medicare to cover ( in the future ), certain types of UTIs and all pressure sores ( bed sores ) and any resultant surgery that would be need to repair damaged tissue.

I suspect this is just the begining of the end for the original Medicare.

I think you can nitpick any plan. I am sure that Medicare can be improved. But it is, overall, better than any other plan in the USA.

Interesting info on cost and quality of care.

June 14, 2007
In Health Care, Cost Isn't Proof of High Quality
By REED ABELSON
Stark evidence that high medical payments do not necessarily buy high-quality patient care is presented in a hospital study set for release today.

In a Pennsylvania government survey of the state's 60 hospitals that perform heart bypass surgery, the best-paid hospital received nearly $100,000, on average, for the operation while the least-paid got less than $20,000. At both, patients had comparable lengths of stay and death rates.

And among the 20 hospitals serving metropolitan Philadelphia, two of the highest paid actually had higher-than-expected death rates, the survey found.

Hospitals say there are numerous reasons for some of the high payments, including the fact that a single very expensive case can push up the averages.

Still, the Pennsylvania findings support a growing national consensus that as consumers, insurers and employers pay more for care, they are not necessarily getting better care. Expensive medicine may, in fact, be poor medicine.

I don't fully agree with this post, however the analysis may include more detail. But one thing that I think could skew this number is that I'm sure that the more life-threatening, immediate, and dangerous cases went to the hospital that had the better doctors, so while the death rate may be higher for the hospital as a whole, this may be because the surgeries they completed were much more complicated.

I would hope the anaysis took this into account, meaning they compared similar procedures and the cost for those procedures.

I'm also making the assumption that the best doctors work at the most expensive hospitals, which I don't know to be true.

maporsch, You bring up some interesting questions about the conclusions drawn by this one study. It reminds us to not believe everything we read in the media untili we have more information on how the study was performed. What you said makes sense. Thank you.

Problem-Riddled Health Care Solution


A recent Wall Street Journal/NBC news poll noted that health care topped all other economic concerns when ranked among top priorities for President Bush and candidates running for president in this country. Indeed, access to affordable health care looms large in the upcoming presidential race, as 47 million Americans (including more than eight million children) go without health insurance. Although the United States spends more money than any other country in the world on health care, we rank lower than many industrialized countries in health outcomes such as life expectancy and infant mortality. Meanwhile, a health care reform proposal in New York this past November recommended the closure of nine New York state hospitals as a way to manage rising costs. Separately, the Bush administration is proposing a solution that provides tax breaks so more people can afford to buy insurance. The problem is, both of these "problem-solving tactics" put the accent on the wrong syl-là-ble, as my mother used to say. Closing hospitals won't stop anyone from getting sick and needing medical care. And providing tax breaks isn't going to address the real problem, which is out-of-control health care costs and the excessive use of prescription drugs, the side effects of which often lead to even more prescription pharmacy. The result being, of course, a health care system that, according to statistics, is not making us healthier at all.
--bottomlinesecrets.com

No one is forcing any patient to buy an Rx medication. You, as the patient always have the option to not fill the Rx. In many situations, a placebo has the same effect as an expensive drug.

Doctors have a tendency to over-prescribe drugs, but I wouldn't choose not to take any medication based on my own knowledge - placebo or no placebo effect.

That's wisdom speaking...

SICKO

HEALTH CARE
A SiCKO America
Approximately 45 million Americans lack health insurance. Health care costs are increasing faster than wages, and six in ten insured Americans are "worried about being able to afford the cost of their health insurance over the next few years." But these high prices aren't buying the world's top care. Even while U.S. health spending per capita is higher than any other country, America is not necessarily the best country in which to get sick. Documentary filmmaker Michael Moore highlights the deficiencies in the U.S. system in his new movie, SiCKO, which opens nationwide on June 29. Moore travels to Great Britain, France, Canada, and Cuba, comparing the accessibility and costs of those systems with health care in the United States. He finds that his own country often comes up short for Americans who can't always afford high premiums. "Every American has a human right to know that when he gets sick, he can go to the doctor without worrying if he can afford it," Moore said. Moore recently spoke with Oprah about America's broken health care system, which you can view here, along with clips from the film.

MYTH #1 -- THE CARE IS WORTH THE MONEY: In 2006, Bush promised that his administration would "confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need." He has not lived up to his promise. Instead, our health care system is pushing millions of hardworking Americans into relentless financial constraints and sending thousands to early graves. Health care costs skyrocketed 87 percent over the last five years, despite wages increasing just 20 percent. As Moore highlights in SiCKO, these costs are significantly higher than what people in other nations pay for care. According to a 2004 study published in Health Affairs, more than "one-quarter of U.S. adults (both insured and uninsured) spent more than $1,000 out of pocket on health care in the past year, far exceeding expense burdens in the other countries." As a result, nearly half of all sick adults in the United States "said that they did not see a doctor when sick, did not get recommended treatment, or did not fill a prescription because of cost." Perhaps not surprisingly, U.S. health care spending also significantly outpaces the spending of other countries. "Health spending per capita in the United States is much higher than in other countries -- at least 24% higher than in the next highest spending countries, and over 90% higher than in many other countries that we would consider global competitors." According to a CNN poll from May, 64 percent of the public believes the "government should provide a national health insurance program for all Americans, even if this would require higher taxes." Compared to people in other developed countries, Americans are the most likely to say that their health care system needs to be completely rebuilt.

MYTH #2 -- THE UNITED STATES HAS THE BEST HEALTH CARE IN THE WORLD: One of the myths that Moore tackles in SiCKO is that the United States has the world's best health care. As Center for American Progress Distinguished Senior Fellow former Sen. Tom Daschle notes, this myth is that "we have the best health system in the world -- and changing it will lower quality, reduce access, and hurt our businesses. The perception of excellence stems, rightly, from the exceptional performance of many of our health professionals, researchers, and institutions. Yet, some of our self-image results from the mistaken belief that we get what we pay for -- which, in health care, is a lot." Still, the right wing continues to perpetuate this myth, arguing that it is dishonest to highlight the deficiencies in the U.S. health care system. "The fact is, the United States provides the best health care quality in the world," said Sean Hannity this past Sunday on his show Hannity's America. Earlier this month, Fox News's John Gibson argued, "In the film, Moore says that our health care system is inferior to dozens of other countries. So why are so many people from other countries coming to America for medical attention?" But unfortunately, what often distinguishes the United States is "its relatively poor performance." The United States is behind in preventing asthma-related deaths, vaccinating children against polio, and providing flu shots to seniors. The "likelihood of surviving a kidney transplant is 6 percent higher in Australia, 13 percent higher in Canada, and 4 percent higher in the United Kingdom and New Zealand than in the U.S." Additionally, one in three sicker Americans "who seek care suffers some type of error," and U.S. patients experience approximately 98,000 medical deaths per year.

MYTH #3 -- AMERICANS ARE THE HEALTHIEST IN THE WORLD: While no health care system is perfect, the American public recognize that the U.S. arrangement needs an overhaul. A 2006 poll found that 96 percent of Americans believe that there are problems with the health care system in the United States. Health care reform is an urgent priority, as Americans on average die at a younger age compared to the average age of death of comparable nations. The U.S. infant mortality rate is 6.9 deaths per 1,000 live births, while Japan and Sweden have rates below 3.5 deaths per 1,000 live births. And the obesity rate among adults in the United States is 30.6 percent, the highest rate of developed countries; this rate is nearly 21 percent higher than the rate of the second highest country, Mexico. An estimated 45 percent of Americans had a chronic illness in 2000, a number that is projected to rise to 50 percent by 2020. Additionally, the "number of people with diabetes has doubled in the past fifteen years," and one in three persons born in 2000 can expect to have diabetes in his or her lifetime. As Center for American Progress Senior Fellow Jeanne Lambrew notes, "Certain racial and ethnic minorities are particularly vulnerable: the rate of diabetes is 59 to 80 percent higher among African-Americans than it is among non-Hispanic whites."

PROGRESSIVE PRESCRIPTIONS: A "hallmark of high-quality primary care is an emphasis on preventive care, counseling, and awareness of patients' health concerns." The United States continues to be plagued by preventable diseases -- such as asthma and Hepatitis B -- with proven preventive services remaining largely unused. "About 70 percent of deaths and costs in the U.S. are attributable to chronic diseases like cardiovascular disease, diabetes and cancer -- diseases that can be prevented or controlled." A new approach is needed. The Center for American Progress has proposed a progressive prescription for a healthy America, a "practical approach to guaranteeing an American right to affordable, quality health coverage," while improving the health of Americans. A key component of this plan is the Wellness Trust, a groundbreaking proposal that would ensure that all Americans receive preventive care through an expanded delivery system. This system would include doctors, schools, workplaces, and communities.
--AmericanProgressAction

I think the last number on the uninsured is about 47 million, not 45.

This is maninly type II diabetes and is found primarily in the overfed, overweight American couch sitter.

I am proud to report that my brother (a physician) - the vice chairman of the health committee - in the California legislature is backing Gov Ahnold's health care reform. So far, he's the only republican backing Ahnold. This opens the door for a bipartisan agreement. HURRAH!

I would love to see a poll taken getting the views on this issue of physicians, especially those of retired ones (who would not have an iron in the fire). They have a first-hand view of how our system is working.

My brother is not "retired," and his daugher, several nieces and a nephew are also physicians.

I have always advocated for a universal health care system in the US. Our county, Santa Clara County, in northern California, has universal health care for all children.

It's the right thing to do. I"m not so sure polls on retired physicians make any difference.

Most MDs posting today on medical blogs are against Universal Health Care Coverage via a singler payer system.

What's the % of the population of California that's illegal and getting free health insurance, paid for by the taxpayers, those lucky stiffs?

Miller, That's a federal law; hosptials cannot turn away anyone showing up in the emergency room of a hospital.

The law as written is to "stabilize the patient".

CI, the sunday NYTimes had a major article in the Business section today on the company, you used to work for.

(SHOES)