The conservative blog Hot Air claims that a letter mailed by the Congressional Budget Office to a Republican Congressman contradicts Harry Reid's numbers regarding the proposed health care bill that he has been quoting this week.
Only one problem. Reid's numbers (also from the CBO) are about the bill he is proposing that the Senate take up, while the letter is about the House version of the legislation, HR 3962.
Well, if you want to claim that someone's numbers are wrong, go find a different number that is different because it is measuring a different bill, right? Who will notice?
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Thursday, November 19, 2009
Wednesday, October 14, 2009
The 'world's greatest health care system' and Winslow hospital are failing my daughter
My 13 year old went to Winslow hospital on Monday because she is experiencing flu-like symptoms.
Did they actually bother to test her? No.
They said that the CDC has told them not to bother with the blood work but that people should 'assume' it is the swine flu and drink plenty of fluids. UPDATE: AS OF TODAY (OCT. 15) THE STATE FLU LAB IS REFUSING TO TEST ANY MORE SAMPLES except for people who have already died or who are very very sick. They can't keep up with the demand.
Did they admit her? No.
They said she should just stay home and sent her away.
Did they give her any medicine? No.
What happened to all that Tamiflu that was supposed to be being stockpiled for when people actually need it? I know that Senator Collins cut the pandemic preparedness funding out of the stimulus, but the least they could do would be to give her a prescription that we could shop around for it.
They told her to follow up with her doctor. But the doctor's office is overwhelmed, and they can't get her in until Thursday.
So is what they told her to do working? No.
Despite taking tylenol and ibuprofen, her fever has gone up, last night it was at 103 degrees. This morning she was coughing and having trouble just breathing.
So this is how the World's Best Health Care System is supposed to function (and by the way, we DO have health insurance) ???
Did they actually bother to test her? No.
They said that the CDC has told them not to bother with the blood work but that people should 'assume' it is the swine flu and drink plenty of fluids. UPDATE: AS OF TODAY (OCT. 15) THE STATE FLU LAB IS REFUSING TO TEST ANY MORE SAMPLES except for people who have already died or who are very very sick. They can't keep up with the demand.
Did they admit her? No.
They said she should just stay home and sent her away.
Did they give her any medicine? No.
What happened to all that Tamiflu that was supposed to be being stockpiled for when people actually need it? I know that Senator Collins cut the pandemic preparedness funding out of the stimulus, but the least they could do would be to give her a prescription that we could shop around for it.
They told her to follow up with her doctor. But the doctor's office is overwhelmed, and they can't get her in until Thursday.
So is what they told her to do working? No.
Despite taking tylenol and ibuprofen, her fever has gone up, last night it was at 103 degrees. This morning she was coughing and having trouble just breathing.
So this is how the World's Best Health Care System is supposed to function (and by the way, we DO have health insurance) ???
Tuesday, July 21, 2009
Now is the time the President's supporters need to step up
Much has been made about the President's stepping up and taking on Sen. Jim DeMint who pretty much came out and said that the plan is to delay, then defeat the Obama health care proposal so that it could become Obama's 'Waterloo.'
The President was exactly right to shine a spotlight on DeMint's remark since it makes it very, very crystal clear that the focus of Republicans in Washington is not to reform anything but to defeat the President, pure and simple.
And considering that we have a for-profit health system in which sick people and their very lives are treated as a commodity and bought and sold like stocks and bonds, and in which those who are uninsured and can't pay are sent to the back of the line and often receive worse health care than in many third world countries, there needs to be some serious reform.
But here is my question: WHY DID THE PRESIDENT HAVE TO CALL OUT SENATOR DEMINT PERSONALLY? Where the HECK are his supporters?
Sure, he could have sent Joe Biden out, as the traditional job of the Vice President is to get his hands dirty taking on the opposition. However sending out the Gaffe-prone Biden, who was chosen mainly because he is qualified to be President (imagine that) if something should befall Mr. Obama, would be taking a big risk in itself. So not finding any other supporters willing to call out Senator DeMint, the President decided he had to do it. And he did it very effectively, no question about that. But it makes one wonder why he had to do it at all. Come on, Democrats-- quit standing on the sidelines. This will only get done if everyone, especially elected office holders, get behind reform.
The President was exactly right to shine a spotlight on DeMint's remark since it makes it very, very crystal clear that the focus of Republicans in Washington is not to reform anything but to defeat the President, pure and simple.
And considering that we have a for-profit health system in which sick people and their very lives are treated as a commodity and bought and sold like stocks and bonds, and in which those who are uninsured and can't pay are sent to the back of the line and often receive worse health care than in many third world countries, there needs to be some serious reform.
But here is my question: WHY DID THE PRESIDENT HAVE TO CALL OUT SENATOR DEMINT PERSONALLY? Where the HECK are his supporters?
Sure, he could have sent Joe Biden out, as the traditional job of the Vice President is to get his hands dirty taking on the opposition. However sending out the Gaffe-prone Biden, who was chosen mainly because he is qualified to be President (imagine that) if something should befall Mr. Obama, would be taking a big risk in itself. So not finding any other supporters willing to call out Senator DeMint, the President decided he had to do it. And he did it very effectively, no question about that. But it makes one wonder why he had to do it at all. Come on, Democrats-- quit standing on the sidelines. This will only get done if everyone, especially elected office holders, get behind reform.
Tuesday, October 28, 2008
Obama health care plan is about getting people insured, not about running hospitals
In my last post, about health care, I got a critique in which the poster pointed out that the hospital that had kept an injured and uninsured woman waiting for nineteen hours was a county hospital, and then suggested that the Obama plan would put all hospitals under government control. I responded by pointing out that privately run hospitals have the same kinds of problems (I referenced, for example this post about a person who died after more than a day in the waiting room of a privately managed (though government owned) hospital.
However there is a far more fundamental misconception on the part of people who like to bash the Obama plan. The misconception is that it involves some kind of nationalization of the health care industry. It does not. There is nothing at all in the Obama plan about taking over the private hospitals and making them part of the government.
The Obama health care plan is about insurance. Right now, most hospital emergency rooms have a two tiered system for serving customers. Those who have insurance stand first in line. The uninsured are the equivalent of 'stand by,' being seen only when and if there are no insured customers waiting to be seen.
Given this reality, and the fact that there are around fifty million uninsured Americans (this is more than the population of California) the Obama health care plan is pretty basic-- it wants to make sure that everyone has access to insurance they can afford. The plan does achieve this goal by heavily subsidizing health insurance that is offered to people who might otherwise not be able to afford it-- be they too poor to be able to afford it, or be they cancer survivors or other people at high risk who might otherwise not be able to purchase insurance.
The program is voluntary for adults. It is mandatory that parents purchase insurance for their kids. There is precedent for this though-- we require drivers to purchase car insurance so they are covered against any damage they may inflict upon other drivers by their own negligence, so it is hardly irresponsible for us to require that they purchase insurance to cover their own kids (not doing so would indeed be negligent.) But under the Obama plan, if they insist they don't want any inurance, they don't have to buy any for themselves. Adults have every right to be stupid, and the Obama plan recognizes this. But they don't have the right to by their stupidity endanger other people (especially children, theirs or anyone else's.)
Incidentally, there is one other industrialized country-- Japan-- which has achieved universal coverage via private insurance with a partial government subsidy. And the Japanese have among the longest lifespans in the world, so it seems to work pretty well.
But to jump from Obama's plan to help people purchase insurance, to arguing that Senator Obama plans to take over and run private hospitals, is ridiculous and represents the kind of paranoid thinking that seems to have hijacked otherwise reasonable people on the right.
However there is a far more fundamental misconception on the part of people who like to bash the Obama plan. The misconception is that it involves some kind of nationalization of the health care industry. It does not. There is nothing at all in the Obama plan about taking over the private hospitals and making them part of the government.
The Obama health care plan is about insurance. Right now, most hospital emergency rooms have a two tiered system for serving customers. Those who have insurance stand first in line. The uninsured are the equivalent of 'stand by,' being seen only when and if there are no insured customers waiting to be seen.
Given this reality, and the fact that there are around fifty million uninsured Americans (this is more than the population of California) the Obama health care plan is pretty basic-- it wants to make sure that everyone has access to insurance they can afford. The plan does achieve this goal by heavily subsidizing health insurance that is offered to people who might otherwise not be able to afford it-- be they too poor to be able to afford it, or be they cancer survivors or other people at high risk who might otherwise not be able to purchase insurance.
The program is voluntary for adults. It is mandatory that parents purchase insurance for their kids. There is precedent for this though-- we require drivers to purchase car insurance so they are covered against any damage they may inflict upon other drivers by their own negligence, so it is hardly irresponsible for us to require that they purchase insurance to cover their own kids (not doing so would indeed be negligent.) But under the Obama plan, if they insist they don't want any inurance, they don't have to buy any for themselves. Adults have every right to be stupid, and the Obama plan recognizes this. But they don't have the right to by their stupidity endanger other people (especially children, theirs or anyone else's.)
Incidentally, there is one other industrialized country-- Japan-- which has achieved universal coverage via private insurance with a partial government subsidy. And the Japanese have among the longest lifespans in the world, so it seems to work pretty well.
But to jump from Obama's plan to help people purchase insurance, to arguing that Senator Obama plans to take over and run private hospitals, is ridiculous and represents the kind of paranoid thinking that seems to have hijacked otherwise reasonable people on the right.
Thursday, October 23, 2008
Woman gets a hospital bill-- for not being seen.
Amber Milbrodt broke a bone in her leg playing volleyball and made it to the emergency room at Parkland Hospital in Dallas.
She waited for nineteen hours to see a doctor and was never seen, and so she finally left in disgust and still in pain. She did finally get some attention from the hospital though: a bill for $162.
She spent all night and the next day in that position, waiting to see a doctor.
Finally, she gave up and hobbled out in disgust.
Two weeks after her Sept. 24 visit, she received a bill from Parkland for $162.
"It should have been more like them paying me for having to sit in the emergency room for 19 hours," she says. "That's just sad. It's not proper. It's almost not moral, what I went through."
Parkland officials, already on the defensive about wait times after a man died in the ER following a 19-hour wait last month, say the charge was appropriate because a nurse spent time assessing Ms. Milbrodt for triage.
I've never been to the ER and had a nurse take my vital signs that lasted more than a few minutes.
It is appalling that she would have to wait this long in pain and still not be seen, but it is even more appalling that they would have the gall to send her a bill for it.
And we wonder why people in most other developed countries live longer than we do (well, I don't wonder, but doctrinaire conservatives who continue to stick their fingers in their ears will continue to wonder or come up with torturous logic to try and explain it all away).
It's time for the Obama health care plan. Now.
She waited for nineteen hours to see a doctor and was never seen, and so she finally left in disgust and still in pain. She did finally get some attention from the hospital though: a bill for $162.
She spent all night and the next day in that position, waiting to see a doctor.
Finally, she gave up and hobbled out in disgust.
Two weeks after her Sept. 24 visit, she received a bill from Parkland for $162.
"It should have been more like them paying me for having to sit in the emergency room for 19 hours," she says. "That's just sad. It's not proper. It's almost not moral, what I went through."
Parkland officials, already on the defensive about wait times after a man died in the ER following a 19-hour wait last month, say the charge was appropriate because a nurse spent time assessing Ms. Milbrodt for triage.
I've never been to the ER and had a nurse take my vital signs that lasted more than a few minutes.
It is appalling that she would have to wait this long in pain and still not be seen, but it is even more appalling that they would have the gall to send her a bill for it.
And we wonder why people in most other developed countries live longer than we do (well, I don't wonder, but doctrinaire conservatives who continue to stick their fingers in their ears will continue to wonder or come up with torturous logic to try and explain it all away).
It's time for the Obama health care plan. Now.
Tuesday, August 19, 2008
Tragically, it happened again. In a different hospital the same sad story.
Remember this post, Death while waiting to be seen about a patient who died in a waiting room after being there for nearly 24 hours while hospital staff just ignored her?
Well, unfortunately something similar happened again, this time at a North Carolina mental hospital.
(CBS/ AP) Investigators say a North Carolina mental patient died after nurses at a state mental hospital left him in a chair for 22 hours and failed to feed him or help him to the bathroom....
Video showed hospital staff watching television and playing cards while Sabock was in the same room. One technician hugged and kissed another staff member and appeared to be dancing.
The staff, who were supposed to be helping him, were making out and playing cards!
Just remember that we had a chance to change the system in 1994. But we lost that battle. Remember? What we got was the Republican-and-insurance-industry alternative. We got it, warts and all. Insurance headaches, bean counters making decisions about your health based on cost, three or four separate bills for the same procedure, massive bills for both insured and uninsured particularly when they are sick, full day long waits in emergency rooms, and (especially and) a system in which patients are just commodities to milk for money, and when they are unprofitable of no more worth than a worn out piece of clothing, and treated accordingly.
True the New York case I discussed in July was at a private hospital and this one was at a state hospital, but the philosophy that led to each death was the same. It is a poisonous philosphy that if a patient is a financial burden, then they don't deserve the time of day, let alone even a minimal level of treatment.
And THIS is supposed to be the best health care in the world?
Well, unfortunately something similar happened again, this time at a North Carolina mental hospital.
(CBS/ AP) Investigators say a North Carolina mental patient died after nurses at a state mental hospital left him in a chair for 22 hours and failed to feed him or help him to the bathroom....
Video showed hospital staff watching television and playing cards while Sabock was in the same room. One technician hugged and kissed another staff member and appeared to be dancing.
The staff, who were supposed to be helping him, were making out and playing cards!
Just remember that we had a chance to change the system in 1994. But we lost that battle. Remember? What we got was the Republican-and-insurance-industry alternative. We got it, warts and all. Insurance headaches, bean counters making decisions about your health based on cost, three or four separate bills for the same procedure, massive bills for both insured and uninsured particularly when they are sick, full day long waits in emergency rooms, and (especially and) a system in which patients are just commodities to milk for money, and when they are unprofitable of no more worth than a worn out piece of clothing, and treated accordingly.
True the New York case I discussed in July was at a private hospital and this one was at a state hospital, but the philosophy that led to each death was the same. It is a poisonous philosphy that if a patient is a financial burden, then they don't deserve the time of day, let alone even a minimal level of treatment.
And THIS is supposed to be the best health care in the world?
Tuesday, July 01, 2008
Death while waiting to be seen
It's hard to even know what to say about this story:
NEW YORK (AP) -- City hospital officials said they were shocked by surveillance footage showing a woman falling from her chair, writhing on the floor and dying as workers failed to help for more than an hour.
Esmin Green, 49, had been waiting in the emergency room for nearly 24 hours when she toppled from her seat at 5:32 a.m. June 19, falling face-down on the floor.
She was dead by 6:35, when someone on the medical staff, flagged down by a person in the waiting room, finally approached, nudged Green with her foot and gently prodded her shoulder, as if to wake her...
And this is really galling:
Security guards and a member of the hospital's staff appeared to notice her prone body at least three times but made no visible attempt to see whether she needed help. One guard didn't even leave his chair, rolling it around a corner to stare at the body and then rolling away a few moments later.
Yeah. We have the best healthcare money can buy in America. IF you can afford it. Otherwise, our healthcare system is becoming medieval at an accelerating pace.
The hospital is run by the New York Health and Hospitals Corporation, a private entity that contracts with the state.
"We are all shocked and distressed by this situation," HHC's president, Alan Aviles, said in a statement. "We express our deep regrets to the patient's family and will ensure a thorough investigation to answer any questions that remain."
That doesn't ring true, considering what has been found in the past at this hospital:
A state agency, the New York State Mental Hygiene Legal Service, filed a lawsuit a year ago, calling the psychiatric center "a chamber of filth, decay, indifference and danger."
Patients, the suit said, "are subjected to overcrowded and squalid conditions often accompanied by physical abuse and unnecessary and punitive injections of mind-altering drugs."
"From the moment a person steps through the doors," it added, "she is stripped of her freedom and dignity and literally forced to fight for the essentials of life."
The suit was especially critical of the hospital's emergency ward, saying it is so poorly staffed that patients are often marooned there for days while they wait to be evaluated.
Sometimes, the unit runs out of chairs, according to the lawsuit, forcing people to wait on foam mats or on the waiting room floor. The suit also claims that bathrooms are filthy and filled with flies, and that patients who complain too loudly are sometimes handcuffed, beaten or injected with psychotropic drugs.
I have only one question. Why doesn't the state just take over and run this hospital as a public entity? It's hard to imagine that it could be run any worse than it is now, and at least if the state were running it then we could collectively fire the management if they continued to run this kind of apalling institution.
NEW YORK (AP) -- City hospital officials said they were shocked by surveillance footage showing a woman falling from her chair, writhing on the floor and dying as workers failed to help for more than an hour.
Esmin Green, 49, had been waiting in the emergency room for nearly 24 hours when she toppled from her seat at 5:32 a.m. June 19, falling face-down on the floor.
She was dead by 6:35, when someone on the medical staff, flagged down by a person in the waiting room, finally approached, nudged Green with her foot and gently prodded her shoulder, as if to wake her...
And this is really galling:
Security guards and a member of the hospital's staff appeared to notice her prone body at least three times but made no visible attempt to see whether she needed help. One guard didn't even leave his chair, rolling it around a corner to stare at the body and then rolling away a few moments later.
Yeah. We have the best healthcare money can buy in America. IF you can afford it. Otherwise, our healthcare system is becoming medieval at an accelerating pace.
The hospital is run by the New York Health and Hospitals Corporation, a private entity that contracts with the state.
"We are all shocked and distressed by this situation," HHC's president, Alan Aviles, said in a statement. "We express our deep regrets to the patient's family and will ensure a thorough investigation to answer any questions that remain."
That doesn't ring true, considering what has been found in the past at this hospital:
A state agency, the New York State Mental Hygiene Legal Service, filed a lawsuit a year ago, calling the psychiatric center "a chamber of filth, decay, indifference and danger."
Patients, the suit said, "are subjected to overcrowded and squalid conditions often accompanied by physical abuse and unnecessary and punitive injections of mind-altering drugs."
"From the moment a person steps through the doors," it added, "she is stripped of her freedom and dignity and literally forced to fight for the essentials of life."
The suit was especially critical of the hospital's emergency ward, saying it is so poorly staffed that patients are often marooned there for days while they wait to be evaluated.
Sometimes, the unit runs out of chairs, according to the lawsuit, forcing people to wait on foam mats or on the waiting room floor. The suit also claims that bathrooms are filthy and filled with flies, and that patients who complain too loudly are sometimes handcuffed, beaten or injected with psychotropic drugs.
I have only one question. Why doesn't the state just take over and run this hospital as a public entity? It's hard to imagine that it could be run any worse than it is now, and at least if the state were running it then we could collectively fire the management if they continued to run this kind of apalling institution.
Saturday, February 23, 2008
Obama literature appears fair on health care but not on NAFTA; I think he should get rid of it anyway.
I was a bit distressed today to see a story out about campaign literature sent by the Obama campaign in Ohio, which Hillary Clinton is calling 'shameful' and comparing to Karl Rove type-tactics, saying bluntly that the literature falsifies her positions on NAFTA and health care. The Obama campaign has responded that the literature is correct.
Now, I've been clear in my support for Obama, for whom I voted. And I still believe he is the best nominee for our party and would make the best President in the general. But that doesn't mean that I support a sudden shift towards negative campaigning, if that is what this is. Obama will win the nomination if he continues doing what he has been, and if he does then he will need a united party and needlessly antagonizing supporters of Hillary (many of whom are very passionate in their support) would be a serious mistake. At the same time if the literature is accurate and points out a matter of record then she should respond on the issue and not complain about the fact that he is sending it out.
On NAFTA, she takes issue with a line in the literature that says that she was a champion of NAFTA when it was signed but now wants to make adjustments in it. This I believe is an unfair attack. For one thing, when NAFTA was signed she was the first lady and her husband was signing it, and it would be very difficult to gauge what her true feelings were on the subject from public statements she made at the time. First ladies don't undermine their husbands in public, and I wouldn't expect that she would do so even if she didn't agree with it-- she might tell him behind closed doors but neither I nor anyone from the Obama campaign would know whether she did or not. So that line should not be included in the literature.
On healthcare, the charge is that her plan would force people to buy health insurance even if they could not afford it (as opposed to Obama's plan which still gives people the right to not buy health insurance.)
So I decided to test his charge by downloading her plan from her website here it is and I find that he may well be justified in his concern.
On page 4 she states that
• Individuals: will be responsible for getting and keeping insurance in a system where insurance is affordable and accessible. (which she reiterates on page 8).
Of course we knew that already, that she proposes mandates while Obama does not. Further down on page four she indicates that
• Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.
I'd feel a lot more sanguine about this if it was defined somewhere what a 'crushing burden' is. Many people live paycheck to paycheck and therefore any additional cost at all would be such a burden.
She then goes on to explain how she will do this:
• Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.
Something similar is in John McCain's plan as a matter of fact, and he spells out the amount ($5000 per family.) She does not, but given that the cost right now of premiums for an average family exceed $12,000 it is clear that she would need to more than double McCain's proposal (which is disastrously low) to match the cost of premiums. Of course even if this were the case, there are some problems here. Tax refunds (including refundable tax credits) come once per year, and even if the tax credit were given the year before initially, there would be some people who would be unable to pay their premiums because it would be more than the tax credit for them (for example if they are cancer surivors or have a chronic illness or otherwise have much higher premiums.) Also, many people's tax refunds (and presumably refundable tax credits) are tied up in collections, bankruptcy proceedings, old IRS debt, child support and a whole host of other issues. If a family is barely making ends meet but one of the spouses owes child support to a previous spouse (or to the state for payments made to a previous spouse), or has a judgement against them from a creditor or bankruptcy court, then that is where any kind of tax refunds go, and suddenly the family (which may also have children) is stuck being mandated to pay for insurance without having any additional money with which to pay for it. You can rail against so-called 'deadbeat parents' or 'bankruptcy bums' if you want to, but it is a fact that there are millions of people, including current family members of people with a judgement against them who may have nothing to do with the reason for the tax garnishments, but who could be stuck in a situation where this plan would require them to spend money they don't have while the money that is supposed to help them pay for it would be directed by the government and the courts to go to someone else.
Further in the Clinton plan it says
Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.
What percentage? Right now the $12,000 I referred to above is about a quarter of the average family income in the United States. Is 25% the figure that will be used? Will it apply to everyone (i.e. would someone earning $100,000 have to pay $25,000 in premiums so that a family earning $8,000 per year would only be charged $2,000?) There are no numbers here, which causes me to wonder. Obama's plan is similarly short on numbers (there are some) but since there is no mandate that is less of a concern (if you don't like his numbers then you still have the right to decline the option to purchase the insurance.) This is sometimes compared to mandatory auto insurance but the differences are that 1. some people don't have a car (which is a choice for some of them at least, though not all) and 2. the price of auto insurance, especially if you drive a car that is only designed to get you around with no frills is far, far less than what health insurance costs.
So having looked at this, I have to conclude that the Obama campaign's claim is right on target-- clearly there will be some people who would be mandated to buy health insurance by Clinton's plan but who won't be able afford it.
But I still think he should consider pulling the literature and keep on running the positive, uplifting campaign that has made many in the country, including myself consider him the better candidate. She hasn't found a way to beat Obama yet when he does.
Now, I've been clear in my support for Obama, for whom I voted. And I still believe he is the best nominee for our party and would make the best President in the general. But that doesn't mean that I support a sudden shift towards negative campaigning, if that is what this is. Obama will win the nomination if he continues doing what he has been, and if he does then he will need a united party and needlessly antagonizing supporters of Hillary (many of whom are very passionate in their support) would be a serious mistake. At the same time if the literature is accurate and points out a matter of record then she should respond on the issue and not complain about the fact that he is sending it out.
On NAFTA, she takes issue with a line in the literature that says that she was a champion of NAFTA when it was signed but now wants to make adjustments in it. This I believe is an unfair attack. For one thing, when NAFTA was signed she was the first lady and her husband was signing it, and it would be very difficult to gauge what her true feelings were on the subject from public statements she made at the time. First ladies don't undermine their husbands in public, and I wouldn't expect that she would do so even if she didn't agree with it-- she might tell him behind closed doors but neither I nor anyone from the Obama campaign would know whether she did or not. So that line should not be included in the literature.
On healthcare, the charge is that her plan would force people to buy health insurance even if they could not afford it (as opposed to Obama's plan which still gives people the right to not buy health insurance.)
So I decided to test his charge by downloading her plan from her website here it is and I find that he may well be justified in his concern.
On page 4 she states that
• Individuals: will be responsible for getting and keeping insurance in a system where insurance is affordable and accessible. (which she reiterates on page 8).
Of course we knew that already, that she proposes mandates while Obama does not. Further down on page four she indicates that
• Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.
I'd feel a lot more sanguine about this if it was defined somewhere what a 'crushing burden' is. Many people live paycheck to paycheck and therefore any additional cost at all would be such a burden.
She then goes on to explain how she will do this:
• Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.
Something similar is in John McCain's plan as a matter of fact, and he spells out the amount ($5000 per family.) She does not, but given that the cost right now of premiums for an average family exceed $12,000 it is clear that she would need to more than double McCain's proposal (which is disastrously low) to match the cost of premiums. Of course even if this were the case, there are some problems here. Tax refunds (including refundable tax credits) come once per year, and even if the tax credit were given the year before initially, there would be some people who would be unable to pay their premiums because it would be more than the tax credit for them (for example if they are cancer surivors or have a chronic illness or otherwise have much higher premiums.) Also, many people's tax refunds (and presumably refundable tax credits) are tied up in collections, bankruptcy proceedings, old IRS debt, child support and a whole host of other issues. If a family is barely making ends meet but one of the spouses owes child support to a previous spouse (or to the state for payments made to a previous spouse), or has a judgement against them from a creditor or bankruptcy court, then that is where any kind of tax refunds go, and suddenly the family (which may also have children) is stuck being mandated to pay for insurance without having any additional money with which to pay for it. You can rail against so-called 'deadbeat parents' or 'bankruptcy bums' if you want to, but it is a fact that there are millions of people, including current family members of people with a judgement against them who may have nothing to do with the reason for the tax garnishments, but who could be stuck in a situation where this plan would require them to spend money they don't have while the money that is supposed to help them pay for it would be directed by the government and the courts to go to someone else.
Further in the Clinton plan it says
Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.
What percentage? Right now the $12,000 I referred to above is about a quarter of the average family income in the United States. Is 25% the figure that will be used? Will it apply to everyone (i.e. would someone earning $100,000 have to pay $25,000 in premiums so that a family earning $8,000 per year would only be charged $2,000?) There are no numbers here, which causes me to wonder. Obama's plan is similarly short on numbers (there are some) but since there is no mandate that is less of a concern (if you don't like his numbers then you still have the right to decline the option to purchase the insurance.) This is sometimes compared to mandatory auto insurance but the differences are that 1. some people don't have a car (which is a choice for some of them at least, though not all) and 2. the price of auto insurance, especially if you drive a car that is only designed to get you around with no frills is far, far less than what health insurance costs.
So having looked at this, I have to conclude that the Obama campaign's claim is right on target-- clearly there will be some people who would be mandated to buy health insurance by Clinton's plan but who won't be able afford it.
But I still think he should consider pulling the literature and keep on running the positive, uplifting campaign that has made many in the country, including myself consider him the better candidate. She hasn't found a way to beat Obama yet when he does.
Thursday, January 24, 2008
Comparing Hillary Clinton to John McCain-- and the contrast is stark.
I've decided to swear off of criticizing Hillary Clinton. That's because of not only the glee I've heard from the right every time a Democrat (especially Barack Obama) says something negative about her, but also because I want to remind readers of this blog that while Hillary Clinton is my last choice (for reasons I've enumerated several times recently) I also wrote several months ago why I will support her if she is the nominee. I won't go into the points I made in that post here (though I thought I made them very well,) but would like to instead compare side by side Hillary Clinton's major positions on issues linked here on her website with the same issues as viewed by current GOP frontrunner John McCain from his website, linked here.
On Iraq (since this issue has formed the root of why so many Democrats who consider ourselves progressive like myself are disappointed with Hillary):
Hillary Clinton: America is ready for a leader who will end the war in Iraq. Hillary's roadmap out of Iraq, the Iraq Troop Protection and Reduction Act of 2007, is a plan to end the war before the next president takes the oath of office. But if the Bush administration won't end the war, as president and commander in chief, Hillary will.
John McCain: John McCain believes that we must not fail in Iraq. Succeeding in the cause of helping the Iraqi people build a stable, secure, representative state is essential to achieving an enduring peace in a region of the world central to American prosperity and national security.
McCain is using exactly the same words as George Bush has been using for five years in this quote, and recently said it would be fine with him if America stayed in Iraq for a hundred years.
Health Care:
Hillary Clinton: America is ready for universal health care. Hillary has the vision and the experience to make it a reality. This is a battle Hillary has fought before -- and she has the scars to prove it. She knows better than anyone how to fight and build the political support to get the job done.
John McCain: His initial blurb said nothing substantive so I had to click on the 'read more,' where he gives the standard GOP lines about promoting competition and choice (which as we know is a red herring because hospitals provide practically no information about their price structures, certainly not in time to allow anyone to make an informed decision no matter how much research they do), tort reform, and some other blather. He does suggest developing a protocol for re-importation of drugs, but that is about the only thing he said that I somewhat could support. On the other hand he plans to revise the tax structure in a way that would in effect phase out employer-provided health insurance (which would leave people on their own and leave the people with the most health issues stuck without anyone who would sell them insurance at an affordable rate-- ironic coming from a cancer survivor.)
Economy:
Hillary has a plan to help people who need help right now. John McCain proposes corporate tax cuts.
Hillary: For freedom of reproductive choice, energy independence and improving public schools.
McCain: For slashing spending (he's been against 'pork' for years, even when it does a lot of good) and praises NCLB and school 'choice' (which is a term that is traditionally used by backers of vouchers for private school tuition). The only time he ever hinted that he might support the right to an abortion was when a reporter asked him during the 2000 campaign what he would do if his own daughter had an unwanted pregancy. But he has consistently been against the right to reproductive freedom for women he's not related to.
I began supporting Richardson, and since he dropped out I've been moving steadily towards supporting Obama. But these reasons make it clear that Hillary Clinton, despite being my last choice among Democrats, is far, far better than what we will have if John McCain is ever elected President.
And what if the GOP nominee is not John McCain? Well, it's hard to see how Rudy or Mike or Mitt would be any better.
Oh, and just in case you need one more reason why we have to come together behind the nominee, even if it is Hillary: Do you really want to gamble that Justice Stevens' fragile heart (though a noble heart it has been) will hold out for another four years?
On Iraq (since this issue has formed the root of why so many Democrats who consider ourselves progressive like myself are disappointed with Hillary):
Hillary Clinton: America is ready for a leader who will end the war in Iraq. Hillary's roadmap out of Iraq, the Iraq Troop Protection and Reduction Act of 2007, is a plan to end the war before the next president takes the oath of office. But if the Bush administration won't end the war, as president and commander in chief, Hillary will.
John McCain: John McCain believes that we must not fail in Iraq. Succeeding in the cause of helping the Iraqi people build a stable, secure, representative state is essential to achieving an enduring peace in a region of the world central to American prosperity and national security.
McCain is using exactly the same words as George Bush has been using for five years in this quote, and recently said it would be fine with him if America stayed in Iraq for a hundred years.
Health Care:
Hillary Clinton: America is ready for universal health care. Hillary has the vision and the experience to make it a reality. This is a battle Hillary has fought before -- and she has the scars to prove it. She knows better than anyone how to fight and build the political support to get the job done.
John McCain: His initial blurb said nothing substantive so I had to click on the 'read more,' where he gives the standard GOP lines about promoting competition and choice (which as we know is a red herring because hospitals provide practically no information about their price structures, certainly not in time to allow anyone to make an informed decision no matter how much research they do), tort reform, and some other blather. He does suggest developing a protocol for re-importation of drugs, but that is about the only thing he said that I somewhat could support. On the other hand he plans to revise the tax structure in a way that would in effect phase out employer-provided health insurance (which would leave people on their own and leave the people with the most health issues stuck without anyone who would sell them insurance at an affordable rate-- ironic coming from a cancer survivor.)
Economy:
Hillary has a plan to help people who need help right now. John McCain proposes corporate tax cuts.
Hillary: For freedom of reproductive choice, energy independence and improving public schools.
McCain: For slashing spending (he's been against 'pork' for years, even when it does a lot of good) and praises NCLB and school 'choice' (which is a term that is traditionally used by backers of vouchers for private school tuition). The only time he ever hinted that he might support the right to an abortion was when a reporter asked him during the 2000 campaign what he would do if his own daughter had an unwanted pregancy. But he has consistently been against the right to reproductive freedom for women he's not related to.
I began supporting Richardson, and since he dropped out I've been moving steadily towards supporting Obama. But these reasons make it clear that Hillary Clinton, despite being my last choice among Democrats, is far, far better than what we will have if John McCain is ever elected President.
And what if the GOP nominee is not John McCain? Well, it's hard to see how Rudy or Mike or Mitt would be any better.
Oh, and just in case you need one more reason why we have to come together behind the nominee, even if it is Hillary: Do you really want to gamble that Justice Stevens' fragile heart (though a noble heart it has been) will hold out for another four years?
Saturday, December 22, 2007
The price of no insurance, or of Scrooge-like insurance companies:DEATH
A report has come out using data gathered by the American Cancer Society showing that lack of insurance is directly correlated with an increased number of deaths in cancer patients.
Not that this is surprising, as the lack of health insurance influences everything from the decision of people to seek treatment or get screenings that they may have a hard time paying for, to the decisions by hospitals and healthcare providers not to provide more than the minimum amount of care they can knowing they may not get paid for it.
ATLANTA: Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling medical care obstacles.
People without insurance are less likely to get recommended cancer screening tests, the study found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.
The new research, analyzing information from 1,500 U.S. hospitals that provide cancer care, is being published in CA: A Cancer Journal for Clinicians.
It is true that only about four percent of cancer deaths actually occur in patients who lack health insurance (whereas the overall percentage of Americans without health insurance is around sixteen percent and rising) but that figure is misleading since the vast majority of fatal cancers occur in people over 65, all of whom are covered by medicare.
Of course, as we tragically saw in the case last week of Natalie Sarkisyan*, a seventeen year old who died needing a liver transplant even though one was available because her HMO, Cigna health, refused to authorize payment until the case hit the national media and by then it was too late, even having health insurance may not save you if the insurance company simply decides that they'd rather have you dead than cut the check.
Now, there are those who will continue to advocate that we should have the system we have now, where people can 'choose' to buy (or not to buy) health insurance. They conveniently ignore the fact that most people who don't have health insurance are not without it because they don't want it, but because they can't afford it. It is still true that for those who can afford it, there are more high tech, specialized treatments available in America than elsewhere. For those who can't, it might as well be a trip to the moon. The truth is, we have no real options available for the uninsured to get adequate treatment, other than don't get the treatment, or go far into debt to pay for it (so far that most hospitals, when they see that a patient is uninsured, will automatically 'fast-track' them out of the hospital with the minimum treatment they can, knowing that the large majority of them won't be able to pay.)
However, you may be one of those who will defend to the hilt the present system and say that the choice not to buy insurance, for whatever it's drawbacks are, outweighs all other alternatives.
Fine. But be advised that we now have hard data, in the form of this cancer study, indicating that one of those drawbacks is the increased numbers of deaths in Americans without insurance. If the death of other Americans is an acceptable price for maintaining the system we have now, then go ahead and advocate for it. But don't pretend that it is a benign system, or is something that it is not.
*-- On a personal note, I might add that I am an organ donor, should that ever occur. But the circumstances surrounding the Sarkisyan case cause me to wonder whether I should be, or how I should discuss organ donation with my kids. I've always felt that if I (or one of my kids, one of whom has said she would be willing to be a donor) were ever in a position in which my organs could save a life, then to do so. But I feel uncomfortable now, given what happened in this case, knowing that my organs could simply become available, not based on need but based on who is insured and whether their insurance company would pay. That would be one criterion I would absolutely NOT want used to determine who received my liver or other organs, or those of my family members.
Not that this is surprising, as the lack of health insurance influences everything from the decision of people to seek treatment or get screenings that they may have a hard time paying for, to the decisions by hospitals and healthcare providers not to provide more than the minimum amount of care they can knowing they may not get paid for it.
ATLANTA: Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling medical care obstacles.
People without insurance are less likely to get recommended cancer screening tests, the study found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.
The new research, analyzing information from 1,500 U.S. hospitals that provide cancer care, is being published in CA: A Cancer Journal for Clinicians.
It is true that only about four percent of cancer deaths actually occur in patients who lack health insurance (whereas the overall percentage of Americans without health insurance is around sixteen percent and rising) but that figure is misleading since the vast majority of fatal cancers occur in people over 65, all of whom are covered by medicare.
Of course, as we tragically saw in the case last week of Natalie Sarkisyan*, a seventeen year old who died needing a liver transplant even though one was available because her HMO, Cigna health, refused to authorize payment until the case hit the national media and by then it was too late, even having health insurance may not save you if the insurance company simply decides that they'd rather have you dead than cut the check.
Now, there are those who will continue to advocate that we should have the system we have now, where people can 'choose' to buy (or not to buy) health insurance. They conveniently ignore the fact that most people who don't have health insurance are not without it because they don't want it, but because they can't afford it. It is still true that for those who can afford it, there are more high tech, specialized treatments available in America than elsewhere. For those who can't, it might as well be a trip to the moon. The truth is, we have no real options available for the uninsured to get adequate treatment, other than don't get the treatment, or go far into debt to pay for it (so far that most hospitals, when they see that a patient is uninsured, will automatically 'fast-track' them out of the hospital with the minimum treatment they can, knowing that the large majority of them won't be able to pay.)
However, you may be one of those who will defend to the hilt the present system and say that the choice not to buy insurance, for whatever it's drawbacks are, outweighs all other alternatives.
Fine. But be advised that we now have hard data, in the form of this cancer study, indicating that one of those drawbacks is the increased numbers of deaths in Americans without insurance. If the death of other Americans is an acceptable price for maintaining the system we have now, then go ahead and advocate for it. But don't pretend that it is a benign system, or is something that it is not.
*-- On a personal note, I might add that I am an organ donor, should that ever occur. But the circumstances surrounding the Sarkisyan case cause me to wonder whether I should be, or how I should discuss organ donation with my kids. I've always felt that if I (or one of my kids, one of whom has said she would be willing to be a donor) were ever in a position in which my organs could save a life, then to do so. But I feel uncomfortable now, given what happened in this case, knowing that my organs could simply become available, not based on need but based on who is insured and whether their insurance company would pay. That would be one criterion I would absolutely NOT want used to determine who received my liver or other organs, or those of my family members.
Saturday, December 01, 2007
A critical component to any health care reform plan: Mental Health Coverage.
I am, like everybody else, glad that the hostage situation involving a mentally ill man at Hillary Clinton's New Hampshire headquarters is over, and that it ended without any bloodshed. New Hampshire law enforcement officials did a superb job of bringing it to a peaceful resolution, and the Senator was right not to negotiate with the man, identified as Leland Eisenberg. Eisenberg had asked to speak to Clinton about the difficulty he was having with getting treatment for his mental health issues.
However, while Senator Clinton was right not to negotiate or accede to the demands of someone who was holding hostages, now that it is over we must pressure her or whoever the Democratic nominee is (and I am still supporting Bill Richardson, for the record) to include mental health in any comprehensive healthcare reform bill. The brain is an organ in the body, and it is just as susceptible to disease and dysfunction as any other organ in the body. Yet people are far more likely to get fully covered by their insurance plans for treatment for heart disease, digestive disease, bone disease or pretty much any other part of the body than they are to get fully covered for treatment for mental disease.
The health insurance industry has gone to great lengths to avoid treating mental illness with the seriousness it should be, of course for the reason that it is an easy way to cut corners. Patients who have cancer, AIDS, diabetes or other ailments can sometimes embarrass the health insurance industry by speaking out about their problems in the national or local media. Mental health patients however cannot as easily speak out if they get screwed over by their insurance providers. One reason is because of the stigma still attached to mental illness, a second is that the glare of the spotlight and the publicity may in fact be exactly what they don't need if they are suffering from mental illness, and the third and most damning reason why they cannot speak out is because just by virtue of their having a mental illness, many people will consider them 'crazy' and won't take them seriously, including many in the media.
Yet mental illness strikes millions of Americans every year, ranging from mild depression to completely disabling conditions that destroy otherwise healthy human beings.
Now that mental illness is in fact recognized as a real illness (and it took a couple of generations just to get that far, which it did thanks to biochemistry and some tireless advocates) the health insurance industry has changed their tactics, but not their goal of trying to dodge coverage for mental health treatment. At the moment they are opposing H.R. 1424, the 'Mental Health Parity Act of 2007,' with the goal of preventing passage of a bill that will require insurance companies to cover treatment for a number of well-defined and recognized mental health disorders.
I once wrote a post about 'favors' that Arizona legislators receive from a variety of lobbyists and while researching that post I discovered that if not openly allied, the insurance industry has been getting some help with their dirty work from the Church of Scientology (a cult that opposes clinical treatment for mental health care) I wrote:
Others have been wined and dined by a group calling itself by the appealing sounding name, 'Citizens' Commission on Human Rights.' A check of the group's web site reveals something less appealing. They are affiliated with the Church of Scientology. If you don't know who the Church of Scientology is, they are the group that Tom Cruise belongs to, that was founded by former science fiction writer L. Ron Hubbard and believes in 'dianetics,' a medicine-free path to good health, and in particular to good mental health (and at a higher level to a release of untapped mental energy). That is the fundamental cornerstone of their belief system, so by necessity they also believe in all sorts of conspiracy plots, mostly involving psychiatrists and the mental health system. By forming CCHR, they have moved beyond the fringe and have tried to get their views accepted by people who make laws, not just in Arizona but around the country. In fact, this is a strange case of where big business and a loony religious cult have come together to shaft the little guy (as represented by a person who has a mental illness and needs affordable treatment that works). For a long time, health insurance companies have not reimbursed mental health providers or reimbursed them at much lower rates than other health care providers. Once their justification for doing so, that mental conditions were in general not diseases but purely were voluntary conditions or conditions which were produced by voluntary actions (such as drug or alcohol abuse), was proven false by biochemical researchers, they had to change their reasoning. In fact, the brain is just like any other organ in the body, subject to disease (as evidenced by chemical imbalance, even in otherwise healthy people) and psychiatrists (my father was one before he died fifteen years ago) are simply trained medical doctors who went to the same medical schools as other doctors, and specialized in the treatment of diseases of this organ. Because scientologists believe as an absolute truth and matter of religious conviction that mental illness is something that can be treated by their own (non-medical) methods, much like the old view of it, the insurance industry, while still taking mental illness less seriously (in terms of payment) than they do other kinds of illnesses, have been able to step back and let the religious cult do their dirty work for them. In fact, I have to wonder why CCHR has been so well funded. I know that Tom Cruise gets a pretty good paycheck and undoubtedly donates quite a bit of it, but the rate that this organization (CCHR) has grown is very suggestive that they may be getting some serious behind the scenes money, and if so.... well I can suggest a conspiracy theory just as well as they can.
Ultimately it does not matter what the justification is, while I do not agree with Mr. Eisenberg's methods, he does have a valid point that many people who need it don't get the mental health care they need. With the likelihood that the next President will include health care reform as part of his or her agenda, we must make it clear that mental health is just as important, if not more important, than making sure that we cover health problems involving other parts of the body.
However, while Senator Clinton was right not to negotiate or accede to the demands of someone who was holding hostages, now that it is over we must pressure her or whoever the Democratic nominee is (and I am still supporting Bill Richardson, for the record) to include mental health in any comprehensive healthcare reform bill. The brain is an organ in the body, and it is just as susceptible to disease and dysfunction as any other organ in the body. Yet people are far more likely to get fully covered by their insurance plans for treatment for heart disease, digestive disease, bone disease or pretty much any other part of the body than they are to get fully covered for treatment for mental disease.
The health insurance industry has gone to great lengths to avoid treating mental illness with the seriousness it should be, of course for the reason that it is an easy way to cut corners. Patients who have cancer, AIDS, diabetes or other ailments can sometimes embarrass the health insurance industry by speaking out about their problems in the national or local media. Mental health patients however cannot as easily speak out if they get screwed over by their insurance providers. One reason is because of the stigma still attached to mental illness, a second is that the glare of the spotlight and the publicity may in fact be exactly what they don't need if they are suffering from mental illness, and the third and most damning reason why they cannot speak out is because just by virtue of their having a mental illness, many people will consider them 'crazy' and won't take them seriously, including many in the media.
Yet mental illness strikes millions of Americans every year, ranging from mild depression to completely disabling conditions that destroy otherwise healthy human beings.
Now that mental illness is in fact recognized as a real illness (and it took a couple of generations just to get that far, which it did thanks to biochemistry and some tireless advocates) the health insurance industry has changed their tactics, but not their goal of trying to dodge coverage for mental health treatment. At the moment they are opposing H.R. 1424, the 'Mental Health Parity Act of 2007,' with the goal of preventing passage of a bill that will require insurance companies to cover treatment for a number of well-defined and recognized mental health disorders.
I once wrote a post about 'favors' that Arizona legislators receive from a variety of lobbyists and while researching that post I discovered that if not openly allied, the insurance industry has been getting some help with their dirty work from the Church of Scientology (a cult that opposes clinical treatment for mental health care) I wrote:
Others have been wined and dined by a group calling itself by the appealing sounding name, 'Citizens' Commission on Human Rights.' A check of the group's web site reveals something less appealing. They are affiliated with the Church of Scientology. If you don't know who the Church of Scientology is, they are the group that Tom Cruise belongs to, that was founded by former science fiction writer L. Ron Hubbard and believes in 'dianetics,' a medicine-free path to good health, and in particular to good mental health (and at a higher level to a release of untapped mental energy). That is the fundamental cornerstone of their belief system, so by necessity they also believe in all sorts of conspiracy plots, mostly involving psychiatrists and the mental health system. By forming CCHR, they have moved beyond the fringe and have tried to get their views accepted by people who make laws, not just in Arizona but around the country. In fact, this is a strange case of where big business and a loony religious cult have come together to shaft the little guy (as represented by a person who has a mental illness and needs affordable treatment that works). For a long time, health insurance companies have not reimbursed mental health providers or reimbursed them at much lower rates than other health care providers. Once their justification for doing so, that mental conditions were in general not diseases but purely were voluntary conditions or conditions which were produced by voluntary actions (such as drug or alcohol abuse), was proven false by biochemical researchers, they had to change their reasoning. In fact, the brain is just like any other organ in the body, subject to disease (as evidenced by chemical imbalance, even in otherwise healthy people) and psychiatrists (my father was one before he died fifteen years ago) are simply trained medical doctors who went to the same medical schools as other doctors, and specialized in the treatment of diseases of this organ. Because scientologists believe as an absolute truth and matter of religious conviction that mental illness is something that can be treated by their own (non-medical) methods, much like the old view of it, the insurance industry, while still taking mental illness less seriously (in terms of payment) than they do other kinds of illnesses, have been able to step back and let the religious cult do their dirty work for them. In fact, I have to wonder why CCHR has been so well funded. I know that Tom Cruise gets a pretty good paycheck and undoubtedly donates quite a bit of it, but the rate that this organization (CCHR) has grown is very suggestive that they may be getting some serious behind the scenes money, and if so.... well I can suggest a conspiracy theory just as well as they can.
Ultimately it does not matter what the justification is, while I do not agree with Mr. Eisenberg's methods, he does have a valid point that many people who need it don't get the mental health care they need. With the likelihood that the next President will include health care reform as part of his or her agenda, we must make it clear that mental health is just as important, if not more important, than making sure that we cover health problems involving other parts of the body.
Thursday, October 18, 2007
Empty Words
A few months ago during the Michael Vick imbroglio, basketball player Stephon Marbury defended dogfighting as 'a sport.' I took Marbury to task for his choice of words, and wrote,
Well, I suppose that you can call anything a 'sport,' no matter how barbaric it is, even dwarf-tossing or Russian roulette.
And I suppose you could refer to a Volkswagen as a Rolls Royce, but at the end of the day it remains a Volkswagen.
Marbury's comments were however a tiny transgression compared to what we have heard from both the Bush administration and from wordsmiths on talk radio and elsewhere on the far right.
I don't have to, but I will remind you of the unfunded mandate that has resulted in schools encouraging underachieving students to drop out for fear of the budgetary consequences of that child remaining in class, that is called, 'no child left behind,' and of the legislation that increases the amount of pollutants in our air called, the 'clear skies act' or in the water that is called the 'clean water act,' or of the clear-cutting bill called, 'the healthy forests act.'
We've seen 'support the troops' become a buzzword for 'support the President's foreign policy,' even while the same administration works feverishly to cut funding for the VA and denies disability claims for thousands of vets wounded in Iraq, who come home with life-altering injuries.
And recently we've seen that the right likes to refer to the U.S. healthcare system as 'the best in the world.' But that is simply not true. People in other industrialized countries such as Canada live longer than we do, have lower infant mortality and in fact, as I wrote about recently, avail themselves of our so-called 'superior' system in vanishingly small numbers, while many, many times as many Americans have bought prescription drugs from Canadian sources, despite the best efforts of our government to prevent it. Of course Americans can't use Canada's healthcare system because they bar us from it. In fact, our healthcare system is worse than those in Europe or Canada, plus it is much more expensive in terms of our GDP, but those on the right continue to delude themselves that they can call a turkey an eagle.
And today, the house will certainly vote not to override the President's veto on SCHIP. All along, they've been questioning the income limits. But here is the dirty little secret: the income limits are the same as they are in the current authorization of the program. And for that matter, the number bandied about ($83,000 for a family of four) is not the federal limit on income, that is the maximum that a state can request be eligible for the program but the President has to approve the request. Other wise the eligibility cap remains where it is at the Federal level, about fifteen thousand dollars less than that. But you won't hear that on right wing radio, they'd much rather smear a twelve year old whose family, despite what they make, will soon lose their home because of medical bills.
But I suppose all this wordsmithing works well for conservatives who don't want to spend a dime on anything.
Words are cheap.
Well, I suppose that you can call anything a 'sport,' no matter how barbaric it is, even dwarf-tossing or Russian roulette.
And I suppose you could refer to a Volkswagen as a Rolls Royce, but at the end of the day it remains a Volkswagen.
Marbury's comments were however a tiny transgression compared to what we have heard from both the Bush administration and from wordsmiths on talk radio and elsewhere on the far right.
I don't have to, but I will remind you of the unfunded mandate that has resulted in schools encouraging underachieving students to drop out for fear of the budgetary consequences of that child remaining in class, that is called, 'no child left behind,' and of the legislation that increases the amount of pollutants in our air called, the 'clear skies act' or in the water that is called the 'clean water act,' or of the clear-cutting bill called, 'the healthy forests act.'
We've seen 'support the troops' become a buzzword for 'support the President's foreign policy,' even while the same administration works feverishly to cut funding for the VA and denies disability claims for thousands of vets wounded in Iraq, who come home with life-altering injuries.
And recently we've seen that the right likes to refer to the U.S. healthcare system as 'the best in the world.' But that is simply not true. People in other industrialized countries such as Canada live longer than we do, have lower infant mortality and in fact, as I wrote about recently, avail themselves of our so-called 'superior' system in vanishingly small numbers, while many, many times as many Americans have bought prescription drugs from Canadian sources, despite the best efforts of our government to prevent it. Of course Americans can't use Canada's healthcare system because they bar us from it. In fact, our healthcare system is worse than those in Europe or Canada, plus it is much more expensive in terms of our GDP, but those on the right continue to delude themselves that they can call a turkey an eagle.
And today, the house will certainly vote not to override the President's veto on SCHIP. All along, they've been questioning the income limits. But here is the dirty little secret: the income limits are the same as they are in the current authorization of the program. And for that matter, the number bandied about ($83,000 for a family of four) is not the federal limit on income, that is the maximum that a state can request be eligible for the program but the President has to approve the request. Other wise the eligibility cap remains where it is at the Federal level, about fifteen thousand dollars less than that. But you won't hear that on right wing radio, they'd much rather smear a twelve year old whose family, despite what they make, will soon lose their home because of medical bills.
But I suppose all this wordsmithing works well for conservatives who don't want to spend a dime on anything.
Words are cheap.
Wednesday, October 03, 2007
The 'flood' is a trickle.
Conservatives love to berate the Canadian health care system, ignoring such inconvenient but documented facts as the fact that Canadians live longer than we do. They claim that if Canadians are in good health, it is likely because of the flood of Canadians pouring across the border to get elective procedures in the United States that they can't get in Canada.
How much of a flood is this?
Well, I ran across an answer while perusing shrimplate's blog earlier today. In his post he cites Kate Steadman's health care blog in which she links to a study done in 2002 of how widely Canadians availed themselves of the opportunity to cross what is still an open border and have their health care needs taken care of here in the good ol' U.S. of A. The study concentrated on border areas of Quebec, but there is no reason to suppose that Canadians in Quebec love their health care any more than Canadians in other parts of the dominion.
The results are eye-popping-- for what they show isn't happening.
A 2002 Health Affairs paper examined hospitals near the border, as well as national surveys to tease out how many Canadians actually visit the U.S. to receive elective procedures.
In terms of hospitals along the border offering advanced treatments or special diagnostic technology (i.e. CT scans and MRIs), about 640 Canadians were seen, along with 270 for procedures like cataract surgery. They compare this to about 375,000 and 44,000 similar procedures in the region of Quebec alone during the same period. If you divide the total number of Canadians seeking those treatments in the US, divided by the number in Quebec alone that's about 0.09%. Not even a tenth of a percent.
Steadman goes on to cite data from 1996:
But the most striking stats come from the Canadian National Population Health Survey (NPHS). From the article:
Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received care in the United States during the previous twelve months, and only twenty had indicated that they had gone to the United States expressly for the purpose of getting that care.
Only 20 of 18,000 sought care in the United States. (apparently less than those who were treated in the U.S. without seeking it, such as those involved in accidents or experiencing a medical emergency while visiting the U.S.)
Now, 1/10 of one percent is after all, one in a thousand. This is indeed a flood. I mean, I bet you could probably find one person in a thousand who given a choice would prefer driving a Yugo to a Cadillac. Or perhaps one person in a thousand who believes that the Apollo landings were all filmed on a stage in Hollywood, or maybe one person in a thousand who believes that Britney Spears is a good role model. Now, I don't mean to suggest that one person in a thousand is unimportant, but this hardly constitutes the 'flood' that the right would have you believe it is.
Steadman also gives us some context involving a poll of Americans who buy prescription drugs:
polling data from 2003 (approximately a year after the Health Affairs article) indicates that 8% answered YES to the following question:
"Have you ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price?"
If 8% of the 18,000 Canadians polled in NPHS had expressly sought care in the United States, that would be 1,440. Not 20, as the survey showed.
In other words, we have 72 times the number of Canadians seeking care in the US going to Canada (or at least calling there) to get prescriptions.
Maybe that explains why pharmaceutical companies found it necessary to (successfully unfortunately) lobby Congress and the President to find ways to prevent Americans from buying the same drugs from the same factories from Canadian sources that they buy at twice the price in America. Note that the concerns of Canadians about not being able to come into the U.S. without a passport if/when we ever close the border because they will be inconvenienced in seeking American medical care haven't even come up in the debate. That is because it is such a vanishingly small number of Canadians who even come to the U.S. for elective procedures.
How much of a flood is this?
Well, I ran across an answer while perusing shrimplate's blog earlier today. In his post he cites Kate Steadman's health care blog in which she links to a study done in 2002 of how widely Canadians availed themselves of the opportunity to cross what is still an open border and have their health care needs taken care of here in the good ol' U.S. of A. The study concentrated on border areas of Quebec, but there is no reason to suppose that Canadians in Quebec love their health care any more than Canadians in other parts of the dominion.
The results are eye-popping-- for what they show isn't happening.
A 2002 Health Affairs paper examined hospitals near the border, as well as national surveys to tease out how many Canadians actually visit the U.S. to receive elective procedures.
In terms of hospitals along the border offering advanced treatments or special diagnostic technology (i.e. CT scans and MRIs), about 640 Canadians were seen, along with 270 for procedures like cataract surgery. They compare this to about 375,000 and 44,000 similar procedures in the region of Quebec alone during the same period. If you divide the total number of Canadians seeking those treatments in the US, divided by the number in Quebec alone that's about 0.09%. Not even a tenth of a percent.
Steadman goes on to cite data from 1996:
But the most striking stats come from the Canadian National Population Health Survey (NPHS). From the article:
Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received care in the United States during the previous twelve months, and only twenty had indicated that they had gone to the United States expressly for the purpose of getting that care.
Only 20 of 18,000 sought care in the United States. (apparently less than those who were treated in the U.S. without seeking it, such as those involved in accidents or experiencing a medical emergency while visiting the U.S.)
Now, 1/10 of one percent is after all, one in a thousand. This is indeed a flood. I mean, I bet you could probably find one person in a thousand who given a choice would prefer driving a Yugo to a Cadillac. Or perhaps one person in a thousand who believes that the Apollo landings were all filmed on a stage in Hollywood, or maybe one person in a thousand who believes that Britney Spears is a good role model. Now, I don't mean to suggest that one person in a thousand is unimportant, but this hardly constitutes the 'flood' that the right would have you believe it is.
Steadman also gives us some context involving a poll of Americans who buy prescription drugs:
polling data from 2003 (approximately a year after the Health Affairs article) indicates that 8% answered YES to the following question:
"Have you ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price?"
If 8% of the 18,000 Canadians polled in NPHS had expressly sought care in the United States, that would be 1,440. Not 20, as the survey showed.
In other words, we have 72 times the number of Canadians seeking care in the US going to Canada (or at least calling there) to get prescriptions.
Maybe that explains why pharmaceutical companies found it necessary to (successfully unfortunately) lobby Congress and the President to find ways to prevent Americans from buying the same drugs from the same factories from Canadian sources that they buy at twice the price in America. Note that the concerns of Canadians about not being able to come into the U.S. without a passport if/when we ever close the border because they will be inconvenienced in seeking American medical care haven't even come up in the debate. That is because it is such a vanishingly small number of Canadians who even come to the U.S. for elective procedures.
Tuesday, October 02, 2007
Leading from a weak hand.
One of the hallmarks of George W. Bush has been his stubborn refusal to change course no matter what, even when he is clearly way off track. We have seen it over the years in everything from his legislative agenda to his steadfast and unswerving determination to invade and then remain in Iraq, no matter what it has cost us.
It has even occasionally won him political victories, such as in the continuing funding of the Iraq war over this past summer (after all, arguing with Bush about this is a little like playing a highway game of chicken with a blind man.) But such victories have been pyrrhic. The cost to his presidency, his party and the nation have far outweighed the dubious benefits of whatever he believes he has gained.
And so we see now with the SCHIPS program, which President Bush promises to veto. He certainly will veto it, and claim that he is therefore standing for 'fiscal responsibility.' Of course vetoing a five year, $35 billion expansion of the program that covers medical costs for poor and uninsured children is dwarfed by the half trillion dollars he has already poured down a real rathole in Iraq, not to mention the nearly $200 billion in new Iraq spending he is seeking.
In fact, it is a good thing that the college aid bill that I wrote the last post on passed at about the same time as the SCHIPS fight was gearing up. The President, while expressing reservations, signed it. And the reason is clear-- he had a choice of either standing against the SCHIPS bill OR the college bill, but he did not have the political capital left, even within his own party, to be able to make a veto stand on both. So he quietly signed the college aid bill even though it is certainly a bill which would never have either been passed nor signed during the past six years of Republican control over the House.
That is however why I am optimistic that regardless of what this President thinks, sooner or later he will lose on Iraq and have to bring the troops home. His party would not support him on two vetoes, and the one he chose was arguably the more politically damaging of the two-- despite attempts to falsely spin it as an attack on the elderly (though most elderly are smart enough to remember which party it was that actually did try to privatize Social Security two years ago) there is no question that Republicans will have to answer why they were unwilling to increase the tax on a cigar anywhere upward from a nickel in order to pay for kids health care. Certainly not a question they will want to have to answer.
Iraq funding will certainly come up as well next year. And as the election draws closer it will be harder and harder for wavering war supporters to stick with their Hawkish President. And sooner or later they may well abandon him when it matters most. His unwillingness to bend dooms many in his own party.
Well, when it happens I will just heat up some popcorn and enjoy the show.
It has even occasionally won him political victories, such as in the continuing funding of the Iraq war over this past summer (after all, arguing with Bush about this is a little like playing a highway game of chicken with a blind man.) But such victories have been pyrrhic. The cost to his presidency, his party and the nation have far outweighed the dubious benefits of whatever he believes he has gained.
And so we see now with the SCHIPS program, which President Bush promises to veto. He certainly will veto it, and claim that he is therefore standing for 'fiscal responsibility.' Of course vetoing a five year, $35 billion expansion of the program that covers medical costs for poor and uninsured children is dwarfed by the half trillion dollars he has already poured down a real rathole in Iraq, not to mention the nearly $200 billion in new Iraq spending he is seeking.
In fact, it is a good thing that the college aid bill that I wrote the last post on passed at about the same time as the SCHIPS fight was gearing up. The President, while expressing reservations, signed it. And the reason is clear-- he had a choice of either standing against the SCHIPS bill OR the college bill, but he did not have the political capital left, even within his own party, to be able to make a veto stand on both. So he quietly signed the college aid bill even though it is certainly a bill which would never have either been passed nor signed during the past six years of Republican control over the House.
That is however why I am optimistic that regardless of what this President thinks, sooner or later he will lose on Iraq and have to bring the troops home. His party would not support him on two vetoes, and the one he chose was arguably the more politically damaging of the two-- despite attempts to falsely spin it as an attack on the elderly (though most elderly are smart enough to remember which party it was that actually did try to privatize Social Security two years ago) there is no question that Republicans will have to answer why they were unwilling to increase the tax on a cigar anywhere upward from a nickel in order to pay for kids health care. Certainly not a question they will want to have to answer.
Iraq funding will certainly come up as well next year. And as the election draws closer it will be harder and harder for wavering war supporters to stick with their Hawkish President. And sooner or later they may well abandon him when it matters most. His unwillingness to bend dooms many in his own party.
Well, when it happens I will just heat up some popcorn and enjoy the show.
Monday, September 03, 2007
After burying one daughter, family will pay an arm and a leg for the other.
There is a tragic story out of Chloride, in the northwestern part of the state, today about two sisters, ages 10 and 13 who were riding an ATV and fell into a mine shaft, over 100 feet deep. After spending the night in the mine one girl was found dead while the other was transported to a Las Vegas hospital where she is recovering from serious injuries from the accident. It is likely that the mineshaft, which was obscured by brush, is about a hundred years old (when prospectors often dug mines and simply abandoned them when they either didn't find what they were looking for or it ran out.) There has never been a comprehensive map or attempt made to fence off (or at least mark) the locations of these hazards-in-waiting. So most probably, nobody can be held legally responsible for this accident.
Not much is known about this situation yet, but it is known that the girls' family live in a small trailer among several others-- in other words, they are not wealthy. I don't know if they are covered by a health insurance plan or not(*- in the comments a commenter indicates that they ARE NOT insured), but even if they are, this tragedy will certainly cost them thousands of dollars. If they are not, then they will likely have to go bankrupt and still be on the hook for enormous hospital costs. Forget any possibility of paying for college-- in falling down that mineshaft, the cost was quite likely the surviving girls' future. In any other developed country (and even most developing nations) her cost of treatment would be covered or at least affordable. But in America, if her parents had any college savings it will go to pay the bills.
Right now, a small business in the town I live in is collecting change, mostly in nickels and dimes to pay the hospital costs of one of their employees. She was involved in a horrible accident last month in which her father was fatally injured and her mother is still hospitalized. The woman who works at the small business herself suffered a broken back, was in the hospital for a couple fo weeks and faces months of rehab. And her health insurance is of the cheap variety (what her employer offers), so they won't pay much of it. The change jar has collected so far about $900 in small change, nickels and dimes. Maybe that will pay for one night of hospitalization. But while recovering herself, burying her father and doing everything she can for her mother, she will get bills arriving likely in the tens of thousands of dollars.
Several years ago, a family here had to sell their farm to pay for the cost of cancer treatment for the patriarch of the family (who died of the disease despite the treatment.)
That's the worst part about medical bills. Not only are they a financial nightmare, but they hit people when they are down.
We need universal coverage that sets a maximum limit on the potential cost, NOW!
UPDATE: A commenter who appears to know about the family personally indicates that (as noted above) they are uninsured, with both parents working-- which they will have to take time off to care for their surviving daughter (Casie Hicks). A neighbor will help pay for the funeral for the other daughter, but today funerals (though still expensive) cost much less hospital bills.
Not much is known about this situation yet, but it is known that the girls' family live in a small trailer among several others-- in other words, they are not wealthy. I don't know if they are covered by a health insurance plan or not(*- in the comments a commenter indicates that they ARE NOT insured), but even if they are, this tragedy will certainly cost them thousands of dollars. If they are not, then they will likely have to go bankrupt and still be on the hook for enormous hospital costs. Forget any possibility of paying for college-- in falling down that mineshaft, the cost was quite likely the surviving girls' future. In any other developed country (and even most developing nations) her cost of treatment would be covered or at least affordable. But in America, if her parents had any college savings it will go to pay the bills.
Right now, a small business in the town I live in is collecting change, mostly in nickels and dimes to pay the hospital costs of one of their employees. She was involved in a horrible accident last month in which her father was fatally injured and her mother is still hospitalized. The woman who works at the small business herself suffered a broken back, was in the hospital for a couple fo weeks and faces months of rehab. And her health insurance is of the cheap variety (what her employer offers), so they won't pay much of it. The change jar has collected so far about $900 in small change, nickels and dimes. Maybe that will pay for one night of hospitalization. But while recovering herself, burying her father and doing everything she can for her mother, she will get bills arriving likely in the tens of thousands of dollars.
Several years ago, a family here had to sell their farm to pay for the cost of cancer treatment for the patriarch of the family (who died of the disease despite the treatment.)
That's the worst part about medical bills. Not only are they a financial nightmare, but they hit people when they are down.
We need universal coverage that sets a maximum limit on the potential cost, NOW!
UPDATE: A commenter who appears to know about the family personally indicates that (as noted above) they are uninsured, with both parents working-- which they will have to take time off to care for their surviving daughter (Casie Hicks). A neighbor will help pay for the funeral for the other daughter, but today funerals (though still expensive) cost much less hospital bills.
Saturday, June 30, 2007
Fact Check: facts in 'Sicko' are accurate
Last time Michael Moore released a movie, Fahrenheit 9/11, critics on the right accused him of lying about the mismanagement of the War on Terror and how we got into Iraq. So, he offered a $10,000 reward to anyone who could document an error in the whole movie. To date, despite righties crawling all over it like ants on a dead bird, only a single inaccuracy was ever found-- an inadvertent one at that, in which a newspaper headline was transposed with the wrong date in a way which was of minor significance to the movie itself.
So it should come as no surprise that a fact check of 'Sicko,' while at times criticizing Moore for not putting some things in context (see my last post) verifies that his facts are pretty accurate.
The right can and will criticize Moore as biased (which most of us on the left will readily admit, just I would say this blog is biased because it reflects my own views), as motivated by profit (funny that the right has suddenly decided that being rich is a sin, at least when it is Michael Moore who has become rich), and as quoting facts out of context (though when he quotes facts like the Institute of Medicine's figure that 18,000 people per year die in America as a direct cause of not getting adequate health care because they are uninsured, it's hard to imagine what 'context' exactly would make that an acceptable number.) But if they criticize him by calling him a 'liar,' then you can be sure that they don't know what they are talking about.
So it should come as no surprise that a fact check of 'Sicko,' while at times criticizing Moore for not putting some things in context (see my last post) verifies that his facts are pretty accurate.
The right can and will criticize Moore as biased (which most of us on the left will readily admit, just I would say this blog is biased because it reflects my own views), as motivated by profit (funny that the right has suddenly decided that being rich is a sin, at least when it is Michael Moore who has become rich), and as quoting facts out of context (though when he quotes facts like the Institute of Medicine's figure that 18,000 people per year die in America as a direct cause of not getting adequate health care because they are uninsured, it's hard to imagine what 'context' exactly would make that an acceptable number.) But if they criticize him by calling him a 'liar,' then you can be sure that they don't know what they are talking about.
Wednesday, May 09, 2007
Soaking the Poor
Yesterday's print edition of the Arizona Republic featured an article about how hospital charges are more unequal than even I had thought, with hospitals routinely billing uninsured patients as much as three times what they bill insurance companies for the same thing for patients who have insurance.
Conservatives will suggest that it is the uninsured patients' fault, for not shopping around.
This of course is ridiculous. If you need emergency bypass surgery or for that matter have to go to the ER, you won't have time to compare costs. And even if you are going in for say, elective surgery, they won't quote you a price, certainly not until they have diagnosed you. And unlike asking a plumber or a roofer for an estimate, the diagnosis itself will likely carry a significant price tag-- and if you want a second opinion (not that I'm against getting one if one can do so) you will have to pay for that as well. Further, the article indicates that the extreme overcharges extend across hospitals, so even if an uninsured person did comparison shop, they would still likely end up paying two or three times what an insurance company was charged.
To be sure, there are a number of reasons that play into this. The most obvious is the fact that because some people don't pay at all, and medicaid often pays hospitals less than they spend to treat the indigent, they lose money there and so have to charge more to those who can pay. Insurance companies of course can spot bogus or inflated charges (i.e. upwards of $40 for a 'mucous recovery system' which turns out to be an eighty-nine cent box of kleenex-- and yes, that is a real charge that some patients have been charged.) Consumers may not understand technical or official medical sounding names and just go ahead and pay an outrageous charge like that.
Another factor, closely related to the first, is likely to be that even when hospitals are doing well, they know they can take advantage of uninsured patients so the temptation to gouge just becomes hard to resist. And those who can't pay, they send to collection agencies and after squeezing out every drop they can they ruin the patient's credit and move on to the next victim. The concern they actually have for the poor has been amply demonstrated by (as I've blogged on several times by now) the practice of just dumping poor homeless people in the middle on the street and drivng off.
And this is why we do indeed need universal coverage. Very few, if any patients without insurance are trained enough to really understand their bills and dispute it. For that reason, wouldn't it be better if every hospital bill was reviewed by someone whose job it was, to know what was in it and how much it should cost?
Conservatives will suggest that it is the uninsured patients' fault, for not shopping around.
This of course is ridiculous. If you need emergency bypass surgery or for that matter have to go to the ER, you won't have time to compare costs. And even if you are going in for say, elective surgery, they won't quote you a price, certainly not until they have diagnosed you. And unlike asking a plumber or a roofer for an estimate, the diagnosis itself will likely carry a significant price tag-- and if you want a second opinion (not that I'm against getting one if one can do so) you will have to pay for that as well. Further, the article indicates that the extreme overcharges extend across hospitals, so even if an uninsured person did comparison shop, they would still likely end up paying two or three times what an insurance company was charged.
To be sure, there are a number of reasons that play into this. The most obvious is the fact that because some people don't pay at all, and medicaid often pays hospitals less than they spend to treat the indigent, they lose money there and so have to charge more to those who can pay. Insurance companies of course can spot bogus or inflated charges (i.e. upwards of $40 for a 'mucous recovery system' which turns out to be an eighty-nine cent box of kleenex-- and yes, that is a real charge that some patients have been charged.) Consumers may not understand technical or official medical sounding names and just go ahead and pay an outrageous charge like that.
Another factor, closely related to the first, is likely to be that even when hospitals are doing well, they know they can take advantage of uninsured patients so the temptation to gouge just becomes hard to resist. And those who can't pay, they send to collection agencies and after squeezing out every drop they can they ruin the patient's credit and move on to the next victim. The concern they actually have for the poor has been amply demonstrated by (as I've blogged on several times by now) the practice of just dumping poor homeless people in the middle on the street and drivng off.
And this is why we do indeed need universal coverage. Very few, if any patients without insurance are trained enough to really understand their bills and dispute it. For that reason, wouldn't it be better if every hospital bill was reviewed by someone whose job it was, to know what was in it and how much it should cost?
Wednesday, February 28, 2007
Death by no Insurance
Once again we see another disturbing example of why we need some kind of universal coverage:
A twelve year old boy dies of a toothache with insurance complications.
WASHINGTON - Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.
If his mother had been insured.
If his family had not lost its Medicaid.
If Medicaid dentists weren't so hard to find.
If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth.
By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.
Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.
And because we as a society were unwilling to provide him with the $80 treatment, we are in the end left with a tab for a quarter of a million.
That's 'conservative fiscal management' for you.
A twelve year old boy dies of a toothache with insurance complications.
WASHINGTON - Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.
If his mother had been insured.
If his family had not lost its Medicaid.
If Medicaid dentists weren't so hard to find.
If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth.
By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.
Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.
And because we as a society were unwilling to provide him with the $80 treatment, we are in the end left with a tab for a quarter of a million.
That's 'conservative fiscal management' for you.
Wednesday, January 24, 2007
Net effect: 'tax cuts' are GOP code for 'tax shifts.'
Last night in his State of the Union address, the President suggested taxing some people's health care benefits to help pay to make health insurance more affordable for some other people.
What is remarkable is not that his vapid proposal about health care marks the first time he has addressed the problem of the uninsured in six years of his presidency, nor the fact that he suggested a tax increase.
No, it is that he is trying to do something that conservatives were very successful at twenty years ago. Shift taxation away from the wealthy onto the middle class.
The President did not say we should hurry up and get rid of his massive tax cuts that favored the wealthy. Nor did he say we should borrow the money, as he has done for everything from Iraq to the medicare presecription drug scam. No, he wants to fund his program by taxing people with employer provided health insurance. The threshhold sounds high enough, $7,000 per individual and $15,000 per family of health care benefits, but in fact with the rate of increase in premiums it is not unusual for people to receive this much in benefits and he didn't say whether this would just be the threshhold for premiums of whether actual payments made to health care providers would also figure into it.
To understand how profound this is, let's begin with the observation that Republicans are not against government spending, despite all their rhetoric. They have different spending priorities, such as funding wars and major military purchases, and multitrillion dollar giveaways in to already profitable companies in the pharmaceutical and energy sectors, to name a couple, but in the end they are even bigger on spending than the Democrats are (one reason why overall spending exploded under Bush much more quickly than it had had grown under Clinton.)
And if you spend, then there will be taxation. Either it will come now, as Democrats tend to feel, believing that we should pay for what we propose, or it will come later, for future generations to pay off our debt (as we've seen with the massive borrowing over the past few years.)
But what this does is, without revoking a penny of the previous tax cuts, create a new tax on people who may not be the ones who received the Bush tax cuts earlier this decade. So the net effect is that this is a tax shift. So when conservatives talk about 'tax cuts,' over a period of several years it will turn out not to mean 'cuts,' but rather 'tax redistribution.'
And it's not the first time this has worked for the GOP. For example. the 1981 Reagan tax cuts blasted a hole in the deficit that continued to grow throughout the 1980s until Bush I started to get things under control in 1991. Then the Clinton tax rates were set in 1993 with another tax hike (leading to a budget surplus and the most prosperous economy in decades, suggesting that conservatives who predicted a recession were way off the mark.) But the 1991 and 1993 tax hikes were 'across the board.' What this meant was that compared to 1980, the wealthy were still paying far less in taxes while the poor and middle class, who had not benefitted much from the 1981 cut, were now paying more.
And so it is here. I don't dispute the idea that taxing health care benefits to pay for what is officially being billed as an increase in the number of people covered is politically adroit, but in the end let's see how it, combined with the 2001 tax cuts, affects who pays taxes in America. My expectation is that taxes will as a net effect hit the middle class harder while the wealthy will still come out ahead on the exchange.
Why do we keep falling for this 'sucker punch?'
What is remarkable is not that his vapid proposal about health care marks the first time he has addressed the problem of the uninsured in six years of his presidency, nor the fact that he suggested a tax increase.
No, it is that he is trying to do something that conservatives were very successful at twenty years ago. Shift taxation away from the wealthy onto the middle class.
The President did not say we should hurry up and get rid of his massive tax cuts that favored the wealthy. Nor did he say we should borrow the money, as he has done for everything from Iraq to the medicare presecription drug scam. No, he wants to fund his program by taxing people with employer provided health insurance. The threshhold sounds high enough, $7,000 per individual and $15,000 per family of health care benefits, but in fact with the rate of increase in premiums it is not unusual for people to receive this much in benefits and he didn't say whether this would just be the threshhold for premiums of whether actual payments made to health care providers would also figure into it.
To understand how profound this is, let's begin with the observation that Republicans are not against government spending, despite all their rhetoric. They have different spending priorities, such as funding wars and major military purchases, and multitrillion dollar giveaways in to already profitable companies in the pharmaceutical and energy sectors, to name a couple, but in the end they are even bigger on spending than the Democrats are (one reason why overall spending exploded under Bush much more quickly than it had had grown under Clinton.)
And if you spend, then there will be taxation. Either it will come now, as Democrats tend to feel, believing that we should pay for what we propose, or it will come later, for future generations to pay off our debt (as we've seen with the massive borrowing over the past few years.)
But what this does is, without revoking a penny of the previous tax cuts, create a new tax on people who may not be the ones who received the Bush tax cuts earlier this decade. So the net effect is that this is a tax shift. So when conservatives talk about 'tax cuts,' over a period of several years it will turn out not to mean 'cuts,' but rather 'tax redistribution.'
And it's not the first time this has worked for the GOP. For example. the 1981 Reagan tax cuts blasted a hole in the deficit that continued to grow throughout the 1980s until Bush I started to get things under control in 1991. Then the Clinton tax rates were set in 1993 with another tax hike (leading to a budget surplus and the most prosperous economy in decades, suggesting that conservatives who predicted a recession were way off the mark.) But the 1991 and 1993 tax hikes were 'across the board.' What this meant was that compared to 1980, the wealthy were still paying far less in taxes while the poor and middle class, who had not benefitted much from the 1981 cut, were now paying more.
And so it is here. I don't dispute the idea that taxing health care benefits to pay for what is officially being billed as an increase in the number of people covered is politically adroit, but in the end let's see how it, combined with the 2001 tax cuts, affects who pays taxes in America. My expectation is that taxes will as a net effect hit the middle class harder while the wealthy will still come out ahead on the exchange.
Why do we keep falling for this 'sucker punch?'
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