Saturday, October 31, 2009

The Defining Moment - Krugman


"But this time, broadly similar health-care bills have made it through multiple committees in both houses of Congress. And on Thursday, Nancy Pelosi, the speaker of the House, unveiled the legislation that she will send to the House floor, where it will almost surely pass. It’s not a perfect bill, by a long shot, but it’s a much stronger bill than almost anyone expected to emerge even a few weeks ago. And it would lead to near-universal coverage."
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This column lays out the conundrum we are in concerning whether or not to support what is now coming out of that huge sausage machine in D.C.

Friday, October 30, 2009

Tears and fears flood Congress on health care | StarTribune.com

Tears and fears flood Congress on health care | StarTribune.com: "Representatives for lawmakers on both sides of the aisle say the calls and letters on health care dwarf those on other issues and have taken a distinctly personal tone. In Sen. Al Franken's office alone, the phone rings about 100 times a day with personal stories."
Keep the calls and letters coming!

Driving down the cost of health care: What would actually work? - Healthcare Futurist: Joe Flower

Driving down the cost of health care: What would actually work? - Healthcare Futurist: Joe Flower: "If competition actually drives the cost of health care up rather than down, what would bring lower costs? What provisions in a “health reform act” would actually drop costs in health care? Let’s leave aside for the moment all the myriad other arguments - some might be seen as too much government intrusion, some would destroy the health plan industry, some would be cripplingly difficult for providers, and so on - and just focus on cost. Given the real structure of health care markets in the United States at this moment, what could be written into federal law and regulation that would actually reduce cost?
Some of these changes are massive, some would be invisible to those outside the industry, but all could be legislated or regulated, and all would “bend the curve” toward lower costs. Choose any you like, though some are “and” choices, others are “or” choices:"

Congressman Grayson Wins Another Round in Healthcare Debate | CommonDreams.org

Congressman Grayson Wins Another Round in Healthcare Debate | CommonDreams.org
"Grayson, who has taken the lead in highlighting a Harvard study that shows 44,000 Americans die annually because they have no health insurance, told the House and the nation: "I think it dishonors all those Americans who have lost their lives because they had no health coverage, by ignoring them, by not paying attention to them, and by doing nothing to change the situation that led them to lose their live."

With that in mind, he announced the launch of a Names of the Dead website. "

Thursday, October 29, 2009

'Public option' gets a boost from ex-UNH exec | StarTribune.com

'Public option' gets a boost from ex-UNH exec | StarTribune.com
"The insurance industry's actions in the current health care reform debate have too often just been wrong. Their opposition to a public option, and the efforts to protect themselves, rather than Americans, are simply wrong."

Sunday, October 25, 2009

Public Option Annie


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Is there a translator in house? RX for bills | StarTribune.com

Is there a translator in house? RX for bills | StarTribune.com
This is a wonderful argument FOR single payer. It is written by a finance columnist and is intended to be a helpful 'how to' article. I think it shows one of the main reasons we need single payer - to simplify and cut all that expensive red tape for us and the vendors.

Health coverage 'plan' was no insurance at all | StarTribune.com

Health coverage 'plan' was no insurance at all | StarTribune.com
"No one knows how many customers have fallen into this trap. But dubious health plans are "spreading like poison oak all over the country," says James Quiggle of the Coalition Against Insurance Fraud, a nonprofit watchdog in Washington, D.C."

Friday, October 23, 2009

Cross-border cooperation: Walz, Kind seek to link Medicare payments to better care

Cross-border cooperation: Walz, Kind seek to link Medicare payments to better care
This is the No Child Left Behind version of Health Care Reform:
The article on Walz and Kind working to link payment to care outcomes raises concerns. This article points to some nice sounding rhetoric. It is not backed up by good science. All would agree that MN/WI providers should not get short changed. All would agree that good providers should not get paid less. The devil is in the details. Encouraging, if not requiring, a hospital to use process improvement practices to create high quality, cost effective methods of delivering care is a great idea. Paying them for patient health outcomes will create the wrong incentives unless there is some cost effective way to control for all the other variables that affect the patient’s health outcome. Location is everything. Who your patients are and where they come from is everything. If you are located in a poor area, in an area with pollution that is causing more illnesses, in an area with little or much poorer coverage for poor people, you will have worse outcome results. Cherry picking healthy people is already done by insurance companies. We don't need to set up an incentive system for docs and hospitals to do the same.
Again, quality improvement as meaning process improvement is important and will result in better outcomes. But you cannot compare health outcomes without adjusting for all the other variables and that is a very expensive endeavor. You can make dramatic changes in hospital costs if you:
Make them all non-profit.
Put them all on a budget. That means an independent entity would approve an annual budget and they would be paid out of the $ pool to cover that budget. They would submit annual audits and requests for any changes. There would cease to be incentives to over build, etc. and eliminating all of the time spent on those horrendous itemized bills would cut costs dramatically. No longer would they feel obligated to create the exec. jobs with pay and perks set to be like the big U.S. companies who pay ridiculous amounts for top level corporate management. They can focus on providing health care to their service area instead of focusing on making money. (Mayo is in a world of its own in terms of service area since they serve the whole world.)
And, they must provide services and tech. offerings that are approved by the independent entity. No more having two hospitals next to each other buying the same big buck items and then competing to get the tests ordered to pay for them. No more closing a unit like an ER , even though desperately needed, just to satisfy the stockholders' bottom line.

Thursday, October 22, 2009

Girl's case turns up heat on UnitedHealth Group | StarTribune.com

Girl's case turns up heat on UnitedHealth Group | StarTribune.com
"UnitedHealth Group, the nation's biggest health insurer, found itself in a touchy sideshow to the great health care debate Wednesday after a Colorado family came forward with a poignant story about how their 2-year-old daughter had been denied coverage."
This is a great personal story that helps show why we need to change our current private helath insurance model and to get away from the employer based coverage model.

Sunday, October 11, 2009

Health Insurers Threaten Rate Hikes

Consortiumnews.com: "Though looking forward to millions of new customers who would be compelled by the U.S. government to buy health insurance, the insurance industry is threatening to raise premiums across the board if more of its demands are not met."

Friday, October 9, 2009

Op-Ed Columnist - Let Congress Go Without Insurance - NYTimes.com

Op-Ed Columnist - Let Congress Go Without Insurance - NYTimes.com
Kristof does a good job of hitting the moral/ethical issues that are really at the core of our we/they debate in this country. When you take out the greedy insurance companies you mostly have the underlying feelings of citizens afraid of losing something and that history in this country seeing others as either "deserving/worthy" versus those lazy good for nothings we are not about to help. I believe that attitude is eroding but it sure is a slow process.

Thursday, October 8, 2009

For best healthcare, location matters: study | Health | Reuters

For best healthcare, location matters: study | Health | Reuters

"Hawaii followed Vermont, and Iowa was ranked third on the scorecard. Neither state has a plan to reform healthcare, but Minnesota, which has created public-private collaborations on healthcare, ranks fourth, followed by Maine, which has also implemented sweeping reforms. Massachusetts -- the Vermont neighbor that recently began a universal health insurance program -- was seventh.

At the other end of the spectrum, Mississippi has the worst healthcare, according to the scorecard. Oklahoma fares mildly better, followed by Louisiana and Arkansas.

Generally, the report found, states in the South, Southwest and lower Midwest have worse insurance rates and less access to good medical treatment."

Monday, October 5, 2009

The Public Imperative

Op-Ed Columnist - The Public Imperative - NYTimes.com

Some interesting comments by Cohen. An excerpt below. Whole column at NYT.

" Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.

Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.” "

Ralph Nader Talks To Portland | Willamette Week | Monday, October 5th, 2009

Ralph Nader Talks To Portland | Willamette Week | Monday, October 5th, 2009
This is the link to the story out of Portland and his speech on YouTube.

Sunday, October 4, 2009

A question of health and women’s equality - The Boston Globe


A question of health and women’s equality - The Boston Globe
Strange bedfellows? This Ellen Goodman column shows how it is very likely that anti-abortion groups could join in the push for passage of health care reform as long as it means that ALL insurance companies would be banned from paying for abortion. We must be very careful of the hidden agendas.

Saturday, October 3, 2009

Michael Moore: Why the Current Bills Don't Solve Our Health Care Crisis

Michael Moore: Why the Current Bills Don't Solve Our Health Care Crisis
"Now we know why they've stopped calling this health care reform, and started calling it insurance reform. The current bills advancing in Congress look more like rearranging the deck chairs on the insurance Titanic than actually ending our long health care nightmare."

See the list of 13 by following the link.

Read more at:
http://www.huffingtonpost.com/michael-moore/why-the-current-bills-don_b_302483.html

Don't Get Sick - The New Health Care Plan