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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

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    Wednesday, September 26, 2007

    The Universal Pander: There's nothing like a presidential election to bring out the healthcare crisis. And, since the presidential primary process is stretching into a two year long spectacle, there's been no shortage of proposals on how to fix our current system. Recently, Dennis Kucinich pointed out that his ideas are the closest thing to what the American people want:

    In a CNN poll this spring, 64 percent of respondents said the government should "provide a national insurance program for all Americans, even if this would require higher taxes," and 73 percent approve of higher taxes to insure children under 18. Those results track New York Times and Gallup polls last year, in which about two-thirds of respondents said it is the federal government's responsibility to guarantee health coverage to all Americans.

    Such polls allow Kucinich to joke that, far from being in the loony left, "I'm in the center. Everyone else is to the right of me."

    Ask the American public a different question about the healthcare system, and you'll get a different answer:

    For the fifth time in six years, Harris Interactive has asked the insured public to rate their own insurance plans. Two thirds of them continue to give their plans an A or a B, with only 10% giving them a D or an F. Substantial but not overwhelming majorities continue to say that they would recommend their own health plans to family members who are basically healthy (76%) or who have a serious or chronic illness (68%).

    Health insurance companies are like politicians. We dislike all but our own. We should be careful what we wish for, however, for it won't just be our own politicians designing a nationalized health insurance plan; it will be all the others that we dislike, including politicians who believe hospital pork is a public service, that healthcare and personal autonomy are mutually exclusive, and that the right to earn a living takes second place to health insurance.

    What are people really wishing for when they say they wish for a single nationalized health insurance program? Security. Our current employer-provided system means that most of us are just a pink slip away from losing our insurance coverage. It also means that, deprived of the bargaining power of large corporations and unions, the self-employed are left with fewer choices and higher premiums. Handing over the whole kit and kaboodle to the government is a seductively simple solution. But it would also be a very expensive solution.

    The British are often held up as the standard to which we should aspire. But we don't live under a British style of government. We live under a government that's truly government of the people, by the people, for the people. And what the people want, the people get. Witness the influence of disease activism even now on disease specific government funding and treatment mandates. In England, the government only pays for colonoscopies to check for colon cancer if there are symptoms suggestive of cancer or a family history of colon cancer. In the United States, the Medicare pays for a colonoscopy every ten years for everyone over 50, regardless of symptoms or risk. So do many insurance companies., sometimes if not by choice, by mandate. In England, mammograms are only covered for women between the ages of 50 and 70, and then only every three years. In the United States, we pay for mammograms beginning at age 40, yearly, and with no upper age limit. We just don't have the heart for rationing that they have in other countries.

    A common theme in politician crafted health care schemes is that by paying for prevention we will save money, and thus be able to offer limitless healthcare services without bankrupting the country. Both Hillary Clinton and John Edwards have explicitly emphasized the importance of preventive healthcare in their plans- even to the point of patient-directed mandates in the case of Edwards. But if preventive services save money and lives, then why is the United Kingdom, which offers less expansive preventive services than the United States, both healthier and cheaper? (Hint: Dead people neither spend health insurance dollars nor complain about their health.)

    Don't be fooled by the promises of health and wealth to be found in government-provided, or even mandated, health insurance coverage. It may bring you health, but it will be at a very steep price - both in money and liberty.

    (Note: Next installment, a look at the Republican candidates approach to "universal coverage.")

    posted by Sydney on 9/26/2007 08:09:00 AM 5 comments


    Commented here.

    I look forward to the Republican approach to universal coverage post. Should be a short one.

    By Blogger shadowfax, at 4:07 PM  

    Thank you for blogging about Health Care Reform! The growing number of uninsured, now at over 47 million, the high cost of insurance and the release of the 2008 presidential candidates health care plans have brought the topic of health care reform to national headlines and prime time news.

    But what about the individual stories of American citizens facing a health care crises today? How do they navigate the broken health care system? At Outrageous Times.org we talk about the issues concerning individuals and small businesses. In addition to reporting on pending legislation and the record profits of pharmaceutical and insurance companies, we address the real life stories -- emergency room care, mental health issues, drug abuse, obesity, preexisting conditions and children's health. By letting our voices be heard-together we can find common sense solutions to reduce health care costs and increase access to quality health care for all.

    Outrageous Times is our monthly grass roots newspaper, dedicated to health care reform now and is distributed to over 20,000 readers in Mercer County, WV and Tazewell County, VA. The web site www.OutrageousTimes.org is a both a local and national health care resource. We would like to invite you and your readers to submit your stories, experiences, observations and opinions to OutrageousTimes.org. Comments posted on OutrageousTimes.org are often reprinted in the Outrageous Times.

    Thanks in advance for your contributing your knowledge to OutrageousTimes.org.

    Brenda Turner
    Outrageous Times

    By Anonymous Brenda Turner, at 6:25 PM  

    I am getting tired of plugs for other websites in the comment section. Stop junking up a wonderful blog.

    By Anonymous Dara, at 10:15 AM  

    I would like to comment about your quote regarding the good health care outcomes in England despite their practice of providing fewer mammograms and colonoscopies.

    "Hint: Dead people neither spend health insurance dollars nor complain about their health."

    Although this comment is flippant and might add a bit of pizazz to your blog, it is woefully inaccurate. Dead people certainly contribute to measured health care outcomes - such as by cause mortality, average lifespan, and infant mortality - and these are reflected in America's relative poor health when compared with the United Kingdom. As for your preposition that the health system in the UK is so bad it culls the sickest people, only leaving those that don't cost "insurance dollars", I hope this was only an offhanded comment and not something you seriously believe. The UK provides exceptional care for all it's citizens, from continuity with a primary care provider to the most technologically advanced critical care. In addition, the National Institutes of Clinical Excellence (NICE) guidelines ensure that doctors practice evidence based medicine and that resources are allocated efficiently and fairly.

    Perhaps the real reason for the apparent disconnect between preventative care and health outcomes is that living in America we have very little frame of reference for how preventative care should work. Looking at mammograms and colonoscopies is not a reliable metric for the quality of preventative care given to the patient population of each country. England's newly instituted Quality and Outcomes Framework for primary care is one of the most advanced systems for providing preventative care and good disease management in the world. Our system for providing preventative care - apart from a few screening tests which aren't proven to be clinically appropriate in the groups for which they are mandated - is haphazard and illogical. The result is poor health.

    By Blogger Anne, at 2:39 PM  

    The British are often held up as the standard to which we should aspire. But we don't live under a British style of government. We live under a government that's truly government of the people, by the people, for the people.

    You are kidding? There's a hell of a lot fewer millionaires in the UK parliament than over here in the US Senate and House of Representatives (where almost everyone is in the top 1 percent in terms of wealth). There's a hell of a lot less purchasing of influence by the wealthy, too (free speech, don't you know!).

    Washington right now is a totally corrupt, unrepresentative mess.

    By Anonymous Ian B Gibson, at 8:45 AM  

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