Physician Urges Caution on McCain Health Care Plan

Dr. James Mitchiner, President of the Washtenaw County Medical Society, writing in the Ann Arbor News, analyzes the details of  John McCain’s health-care proposal. Mitchiner’s concludes that McCain’s proposal will cost more and cover fewer Americans than other proposals for reform.

An excerpt

The time has come for us to stop pretending that we can reform American health care through incremental tweaks in the current system. I really see no way to accomplish the three goals of reform – expanded access, consumer choice and cost control – without ending the hegemony of the for-profit insurance industry.

This means we have to replace our shamefully inefficient multipayer system with a national, single-payer alternative, one that creates affordable access to medical care for those who are locked out, eliminates racial and ethnic disparities, and allows Americans (rather than insurers or the government) to choose their own physicians and hospitals. Doing so will not come fast and will not be easy. But when it does come, and I believe it will, the result will be well worth the effort expended.

Look before you leap into McCain’s idea of health coverage, Other Voices, The Ann Arbor News September 11, 2008 10:06AM

Obama and McCain: Do They Have Real Differences on Health Care Plans?

Michael van der Galien, Editor-in-Chief of PoliGazette, writes about a new analysis of the health care plans of the two major candidates for President in 2008.

Excerpt:

In a newly released report, the nonpartisan Tax Policy Center concludes that Senator John McCain’s health care plan would add only 2 million uninsured to the ranks of the insured, whereas that of Senator Barack Obama would add 34 million.

Van der Galien notes that both candidates’ plans would cost taxpayers more than is now spent on health care.  Senator Obama’s plan would cover those additional 34 million Americans at a cost of $1.6 billion over 10 years, while Sen. McCain’s would cost $1.3 billion over the same period to cover 2 million more Americans.

The article also notes that details are sketchy in both candidates’ plans, but analysts had enough detail to make projections for both coverage and costs.

The Difference on Health Care, PoliGazette, September 16, 2008

Democratic and Republican Platforms

New page on this blog:  the Democratic and Republican party platforms are now posted in the pages in the right-hand column.  It’s the last page listed, but not the least important by any means.

Health Care, Poverty, Disparity and Politics

Achieving health care for all Americans by 2010, the goal of RESULTS advocates, requires understanding a whole complex of issues and asking some difficult questions. Such as: Why does the U.S. have such a low ranking in life expectancy — just ahead of Cuba’s — despite spending more on health care than any other developed nation? Why do we have such high infant mortality rates? Why is there such a disparity between health outcomes for rich and poor in this country?

A long post from Maggie Mahar’s Health Beat blog digs into health care disparity and starts with examining a report recently released by the U.S. Census Bureau. Media reported a drop in the number of uninsured in the U.S., which the report does show. However, the reasons for that drop are not necessarily good news.

An excerpt:

The Census Bureau report attempts to put a happy face on U.S.healthcare by announcing that the percentage of Americans who are uninsured declined in the last year–from 15.8 percent of the population to 15.3 percent. But as Jonathan Cohn points out over at The New Republic:

“. . . .before anybody gets the idea that we no longer need health care reform, take a closer look at the numbers. Enrollment in private insurance continued to decline in percentage terms, mostly because the percentage of people with employer-sponsored coverage fell from 59.7 to 59.3 percent. The reason the overall numbers look good is rising enrollment in public insurance programs, particularly Medicaid.”

The rest of the post has plenty of graphs, statistics and links to journal articles that show, unsurprisingly, that being poor in the U.S. is bad for your health and for the likelihood that you will be involved in health care advocacy.

“Poverty, Health and Political Priorities: 2000 to 2007″, Health Beat, August 27, 2008

New York Times: Millions With Chronic Disease Get Little to No Treatment

A disturbing side-effect of the growing number of uninsured adults in this country is the growing number of middle-aged individuals who lack insurance and who don’t get regular medical treatment for major chronic diseases.

An analysis of government health surveys of adults ages 18 to 64 years old, estimated that about 11 million of the 36 million people without insurance in 2004 — the latest year of the study — had received a chronic-condition diagnosis, such as diabetes or high blood pressure, but many of them don’t have a doctor and use emergency rooms for medical care.

The study refutes an assumption about those who are uninsured — that they are young and relatively healthy.  Many of the uninsured with chronic conditions are middle-aged, not yet old enough  to qualify for Medicare, and without any other form of coverage.

An excerpt:

The study describes harsh consequences for neglecting easily treatable diseases in so many people. “For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result,” the study’s authors said.

Millions With Chronic Disease Get Little to No Treatment, New York Times, August 5, 2008

25 Million Americans Are ‘Underinsured’

Working to build consensus on the need for health care reform, advocates may have overlooked the growing number of middle- and upper-middle income families who are going without medical care because it’s just too expensive — even with health insurance. 

Business Week reports on a study, authored by Karen Davis and Cathy Schoen of the Commonwealth Fund, that says the number of American adults who had inadequate health insurance to get needed medical treatment rose 60 percent from 2003 to 2007, from 16 million to more than 25 million people.

An excerpt:

The researchers found that people who were underinsured were more likely to go without needed health care and have problems paying medical bills, compared with people who have adequate health insurance.

In fact, 53 percent of the underinsured and 68 percent of those without health insurance had to forgo needed medical care, such as not seeing a doctor when sick, not filling prescriptions, and not getting recommended diagnostic tests or treatments. “The underinsured look a lot like the uninsured,” Schoen said.

25 Million Americans Are ‘Underinsured’: Middle- and upper-income families find it harder to get needed medical care, report says (Steven Reinberg, Health Day, Business Week, June 10, 2008)

2008 Presidential Candidate Side-by-Side Summary

The Kaiser Family Foundation has published a great tool for comparing the health care plans of the remaining (and former) Presidential candidates.  You can either compare on-line, or download the PDF file.  And the Kaiser Family Foundation does a great job of keeping this document up-to-date as the candidates continue to update their own health care proposals.

Candidates Side-by-Side Comparison (Kaiser Family Foundation, posted May 23rd, 2008)

Dodd: Nation desires universal health

RESULTS activist Ginnie Vogts recommended this article covering a keynote address by Sen. Chris Dodd at the regional action summit of Latino Voices in Universal Healthcare. Other speeches had covered “racial and ethnic disparities in health care, in what some speakers called a ‘health care apartheid’ and ‘enforced poverty.’”

An excerpt:

Many at the summit expressed frustration with the fragmentation of the current health care system, which is split into 1,500 separate health plans and lags behind other industrialized countries in terms of efficient spending, according to Dr. Jaime Torres, president of Latinos for National Health Insurance.

Health Care for Latinos, (PNHP Resources, posted May 5, 2008)

Americans Fear Losing Health Insurance More than Terrorism

RESULTS activist Marjorie Triffon suggested this article by Ezra Klein of The American Prospect, covering the obvious problems in our current health care system as well as the challenges to achieving reform.

An excerpt:

The most intractable policy problem is not, fundamentally, the 47 million uninsured or the fact that insurers have a business model right out of Dickens. It’s cost. In 2006, the average family policy cost $13,600. This is why one out of six Americans are uninsured; they can’t afford the premiums. An October 2007 Kaiser Family Foundation poll found that more Americans were “very worried” about being priced out of their health insurance than feared losing their job, their house, or being in a terrorist attack. And with good reason: Premiums have gone up 98 percent since 2000. Wages have not.

More Americans Fear Losing Their Health Insurance Than Being in a Terrorist Attack, (Ezra Klein, posted in Alternet, May 21, 2008)

Removing the profit motive from health care

Reader Kris Hermes calls for not-for-profit health care:

The fundamental point being missed in much of the debate over “single-payer” versus “market reform” is that the largest dysfunction in our health care system is the profit motive. If we can successfully remove the profit motive in health care financing, it matters less exactly how we design the framework of care and service delivery.

With not-for-profit health care financing in the U.S., we will still need an administration system. But, since taxes will be collected nationally and costs will be disbursed widespread for doctors, health workers, equipment, hospital costs, etc., the administration of financing (not health care services) might as well be centralized.

The red herring that competition brings innovation is really only true for research and development. A not-for-profit system actually breeds greater competition among physicians and health care workers since they would be vying for patients more equally and based more on merit. Currently, in our HMO-dominated health care system, competition among HMO physicians is nearly non-existent, as they are typically guaranteed to see a set number of patients registered with their particular HMO.

Because of the resources of the insurance industry (not physician groups), the federal government is pressured to maintain the status quo, or at most offer slight changes to the for-profit system. As a result, the information provided to most U.S. citizens via the media is heavily skewed to downplay the benefits to tens of millions of people that a not-for-profit system would bring.

For these reasons, we must get better at speaking about the fundamental difference between all of the proposals for systematic health care change in the U.S.: Profit versus not-for-profit health care financing.

It’s not just that every industrialized country in the world has universal health care (with the exception of the U.S. and south Africa), it’s that they all have a not-for-profit health care financing system. It is not enough to call a plan “universal;” more accurately, it’s because of the not-for-profit financing that these systems can function effectively.

From Health Care: Single Payer or Market Reform?, 2008/05/09 at 12:17 PM