Healthcare Reform

Affordable, accessable healthcare. It seems to me that all the current reform bills will only address, in a meaningful way, one of those two goals...accessability. The affordability needle will not be moved much under any of the recommendations be it a public option or existing plans operating across state boundaries. The root cause of healthcare inflation is the consumers desire for unlimited access to care and providers all to willing to give it (fee for service). Insurance companies are the go betweens, yes they make profits, but those profits compared with the total health care spend are insignificant.

Rationing care, in some reasonable manner will, at some point, become the answer. Remember HMO's? HMO's tamed the rate of health care inflation for years. Consumers revolted because it did what it set out to do, ration care. At some point consumers and business will revolt again, this time against the cost of care which is already excessive and will continue to get worse. A tipping point will be reached where some rationing will become the lesser of the two evils.

Dear Terry,
On June 22,2009 you wrote a column expressing your view on the health care debate,firstly the comments on the system in Toronto are not true in the sense that someone with cancer will get treated right away in the U.S., I had to wait from May-October for treatment and was refused a new procedure because the insurance company would not pay for it, so I have a post-operative scar about a foot long and an ugly bulge because the incision went through all the layers of my stomach. I worked in Canada and they're health care system is a rolls royce compared to ours.I've also been approved for two procedures with the Doctors on the phone to get a payment conformation number. Get approval,have the procedures done and then have the insurance company refuse to pay the Doctors. So I do agree something needs to be done, and if the American people believe the insurance companies will have any compassion for them I have a piece of desert to sell them.
Sincerely,
Ezzard Donahue

I used to work in healthcare. While right now I'm currently unemployed, which scares the hell out of me. I was laid off as a "reduction of labor" due to someone elss mistake. I used to work at a hospital, the emergency room doctors were the worst, it seems their medical training was test everything and see if something is wrong. The amount of needless tests and retestiung was astronomical.
I used to have healthcare when I was unemployed, but now I do not. I could pay for it out of my own pockets, COBRA was only about 500 a month, and it wasn't even that good of coverage.
The only thing I can understand about the new health care policy is that everyone will have to have healthcare,, either through work or buy your own. And if you don't you get fined.

I saw sure healthcare is important, but if people still had their jobs they'd still have their healthcare, and the problem would be a little smaller.

Something needs done, with double digit increases in costs, it's looking like the financial industry crash all over again. I remember when the goverment looked at doing something about costs in the past and and the Insurance Industry promised to fix the problem. And HMO's were born, companies offered choices of Insurance which offered lower prices for less coverage and wanted you to think you were in charge and actually getting something. Everything is fine if you do not get sick and need to use it.
It seems our system is broken and no one in Washington cares. The sound bites I here on the news are telling me that a lot of our elected officals do not have a clue, or are bowing to special intrest money

Terry
RE: Healthcare Reform
I am not in favor of the Government running healthcare. Let the private section companies continue providing health ins. to their employees. A thorough investigation of medicare/insurance fraud should bring millions back into the mix. Instead of spending trillions, the gov't could spend millions to give insurance to those people who do not have it and should have it. Do not federally fund aboritons (either US or abroad). Also tort reform is needed - cut back on malpractice law suits. People who are hurt due to negligence deserve compensation but I am sure there is fraud in many malpractice suits. The thought of the government rationing health care is terrifying.
The U.S. has the best healthcare in the world...people from other countries come here to get medical care. This speaks volumes!!! Socialized or government run healthcare does not work. Look at Canada or the U.K.

Terry:

Thanks so much for this opportunity to give you my input regarding healthcare reform. My website, www.HonestMedicine.com, is devoted to my (and other people’s) commentary on our healthcare system. And, I am now in the process of writing a book about some lifesaving medical treatments that I fear will NOT be included in the new healthcare model, even though All of these treatments would greatly help to keep costs down. But since they are not regularly written about in the mainstream media, not enough people know about them.

Some of these treatments are Pharma-based; others are nutrition-based. ALL of them are effective, non-toxic, and less expensive than the "standard" treatments. But none are widely prescribed by doctors -- most probably because these treatments don’t have costly randomized double-blind clinical trials to back them up. Why no randomized trials? Because only Big Pharma can afford to pay the freight for this kind of research. And frankly, these are not the kinds of treatments that would make Big Money for Big Pharma. Has there ever been a circle “more vicious”?

I’ve written about some of these treatments -- including intravenous Alpha Lipoic Acid for terminal liver disease; low dose naltrexone for Multiple Sclerosis, Lupus, and other autoimmune diseases; and the Ketogenic Diet for pediatric epilepsy -- on my website at http://tinyurl.com/cspj99. These are the same so-called “anecdotal” treatments -- along with some others -- that I will feature in my book.

I highly doubt that these very innovative, less expensive treatments (and others like them) will be included in the Obama healthcare plan. This is a shame, since their use would save our system a huge amount of money. A similar worry to mine was expressed by Sen. Tom Harkin and integrative physician, Mark Hyman, MD, during Senate Hearings in late February. They both expressed concern with regard to Comparative Effectiveness Research (CER), which is being implemented to help doctors choose the most cost effective and efficacious treatments for their patients. Dr. Hyman expressed a fear that the only treatments that will be studied and compared will be those that are "within the allopathic model,” or restated, “within the old model” -- meaning, of course, those treatments that are already being routinely used by doctors. Sen. Harkin said that he, too, was worried that this would be the case.

The video of this hearing may be viewed at http://help.senate.gov/Hearings/2009_02_26/2009_02_26.html ; the interchange I describe between Sen. Harkin and Dr. Hyman may be listened to here, from 142:00 to 142:36.

You are welcome to quote me by name in future columns.

Again, thanks, Terry!

Julia Schopick
http://www.HonestMedicine.com

Kill this health care bill now. Talk to a Canadian, let them tell you how bad it is. They come over here for surgery. HMO's are no better here.

Dear Terry, I just read your column about health care and felt compelled to add my percerption. I am an RN with an MSW desgree and have worked in the field for 55 years and, yes, I still work because hospitals never had financial benefits for nurses in many small towns years ago. You mentioned visiting Toronto and the long wait for cancer surgery. That has nothing to do with an American system of care. To me it means merely that Canada needs to do something to ensure more timely care. The excuse that it doesn't work in Canada so it won't work here is only that, an excuse to keep us from having a one-payor system in this country. Sorry. I don't buy it.

Would you rather purchase your fresh fruits and vegetables from a farmer's market, knowing that you're getting fresh, quality items, possibly organic, at a reasonable price, or do you like going to the super market and paying a higher premium for fruit and vegetables that were picked days and weeks earlier, stay in refrigerated trucks or trains and finally got to you with many fewer nutrients? I equate that with our health care system. Why do we need a middle man to reap the profit, chose what we can purchase and charge more for the privilege of having poorer care? Yes, I am talking about the insurance industry. They decide who needs care, from whom, how much and at what cost. And then they make a larger profit by refusing care, regulating the care and who provides it and for how long. They also regulate what medication doctors can order, the cost and how long you can take it.

The huge amount of money paid to the insurance companies to ensure that we get lousy care, expensive medication and limited benefits would certainly make a huge difference if the money was actually used for care. People are being told their taxes will go way up. Well, if the insurance companies weren't getting all the money, people wouldn't have much of a tax increase at all. Proprietary hospitals, physicians, medical suppliers, pharmaceutical companies (did I miss anyone?) are also reaping the benefits of our current system. Sure, many doctors have huge loans, but if we clean up the educational system (dare I say free education?) then they wouldn't feel they had to command such huge salaries. Why should doctors receive so much more money than other workers? Because they set themselves up to do that. Years ago, the AMA restricted the number of graduating physicians to ensure high pay (supply and demand). Today everyone is a specialist and gets paid accordingly. Wasn't that a great idea! And the insurance companies charge double the co-pay for us to see a specialist while medicare allows only 1 physical exam at age 65 and none thereafter. Great prevention technique.

Pharmaceuctical companies are now allowed to advertise and boy! do they!. I never knew so many men had such a problem with erectile dysfunction. Or so it would seem if you watch all the ads. The money spent to get people to convince their physicians they need all these drugs could be well used on lower drug costs. But that wouldn't be the American way. People should be kept informed, yes, literature is made available in many ways. To me, the ads for medications in magazines, TV, internet, etc. is no different than cigarette ads. Doctors often prescribe the drugs because they know patients will doctor-shop until they find someone who will give them what they want. And it is so easy to slip across the border to Mexico and get them anyway, if you live close to the border as I do.

If you have gotten to this part of my letter without tossing it in the basket, I apologize for the length of my rant. I believe in a one-payor system. I believe Americans deserve the same priviledged health care provided to our representatives in Washington. We need to focus on getting the profit out of the system. I don't think ANYONE should make a profit out of the illnesses of others. Medical professionals should make a decent living, just as anyone else, but not to the extent that they can buy million dollar houses, $50,000+ cars, etc. There are just as many unscrupulous doctors out there as there are finacial advisors on Wall St. Why not? That's where the big bucks are.

Our financial system is corrupt. THE POLS ARE CORRUPT. This so-called
democracy doesn't work anymore. Revolution is the only way.

Terry,

Here’s my two cents on healthcare coverage.

Healthcare Rant

Everyone should be required to purchase a minimal level of health care insurance. Twenty somethings don’t want to pay for health insurance that they may not use, but if they have an accident they want others to then pay their medical bills.

The only way to pay for this coverage is through a general tax. It's a scary thought but a minimum VAT tax to cover this minimum coverage is the best of all bad choices. The downside is its WAY too easy for additional VAT taxes to be raises to cover other nonsense items. Remember what happened to Lottery proceeds for education? Actuarial analysis will determine the VAT rate. All funds must stay in the pool and are invested like any other health insurance company premiums. Stopping Benefit Creep which killed Social Security must be vigorously defended.

I would like this minimal health care coverage which has a payment co-pay and a small deductible to be run by an insurance company. I don't care which one. The insurance company would do a better job of administering such a program than any government agency.

The coverage would include preventative health care and the genetic lottery diseases which a person has no control over. Life style tax credits and penalties would be instituted.

A REASONABLE payment schedule which compensates doctors and treatment centers for services provided is necessary. The rate schedule needs to be published. In addition, a cap on “pain and suffering” malpractice judgments is needed.

Like Medicare, a person can buy additional coverage beyond the basic coverage.

The simpler the program guidelines, the better chance the program will succeed. Simple programs reduce the social engineering.

I have been in healthcare accounting for over 30+ years. Medicare and Medicaid do not pay COST of providing care so other health insurances are higher to offset these losses (a hidden tax on us). The government is trying to point out that healthcare is too expensive and causes US companies to be at a disadvantage. This is true but what is even worse is corporate taxes compared to other counties. I believe US is the third highest. Maybe less government and lower taxes is the answer?.

As for health care expense, yes we need to be controlled but how do you limit people to use healthcare. Do we tell Medicaid and Medicare patients you need to wait in line and this is the only healthcare facility you can use. I hope that does not happen.

We need to educate and make our citizens healthy so as to use less acute healthcare. We need to let insurance companies compete around state lines. Maybe some controls on cost of drugs. Something I don't like but may need to look into.

SAVAGE SAYS: Great comments. Thanks!

Retired from NYPD 1975,and became a registered Nurse in 1974. I became a Malpractise Risk Manager 1n 1978. First attacked was the Police in the 60s.Next were the teachers and the School system. Then came the doctors who were next to be attacked. On almost every pending Law Suit the doctors woud say I now give uneeded test to patients for fear of a Law Suit.The waste of money was unbelievable and to me that was a major reason for the Health Care situation of today..

big problem with healthcare delivery is the patient. most have poor compliance following medical advice. appears many patients are engaged in self destructive behavior involving tobacco, food, alcohol/drugs. a system that will promote illness prevention and reward positive behaviors is needed for long term success.

Having been a hospital employee in the laboratory sector for many years and
understanding the need for facilities for minor illnesses, it is my belief
that what is needed is for the county/state health departments to hold
clinics to help the disadvantaged populous. The poor and uninsured could
"join" these clinics by a minimal ongoing payment plan for their health
insurance, subsidized by the feds, and obligated to use these clinics as a
clearing house to more intensive treatment. This would eliminate inundating
the emergency rooms, and acute cases would be handled efficiently in the
emergecy rooms. So many of the patients filling emergency rooms have sore
throats, sprains and flu symptoms that do not require all the high tech
equipment necessary in acute care. Of course the litigation teams would
have to be kept in check. I can see them salivating at the clinic doors.