Early Signs of Rationing Health Care

First it was a government panel saying that mammograms are not necessary before the age of 50 and every other year is sufficient.  Advice to women not to do self examinations because it might lead to false positives goes against years of encouragement to check yourself.  Now it’s Pap Smear every other year.  Of course those opposed to health care reform will grab these two declarations as proof of health care rationing.

The prostate-specific antigen (PSA) test does result in many false positives.  This could be another test a government agency will say is not reliable and so won’t be recommended at all or not so often.

Let’s be honest here.  Every test that can be delayed another year means more money in the pockets of the insurance companies.  Kaiser Permanente gives a Sigmoidoscopy every 5 year to its senior patients. A Colonoscopy (a very unpleasant procedure) every 10 years unless there is indications that closer monitoring is appropriate.  Is this a form of rationing or is it sensible health care?

Annual physical exams seem to rarely detect an issue.  Perhaps every other year is sufficient.  After all the determination that I had a hernia was not made as the result of an annual exam.  For that matter most health problems I have ever had were not determined at an annual physical.

We already have health care rationing but aren’t willing to admit it.

The High Cost of American Health Care

I took a book out of the library on mutual fund investing titled “100 Best Mutual Funds.”  Just inside the first few pages was the author’s argument for making investments in equities (another word for stocks) rather than bonds or CDs.  The contention is that stocks are responsive to inflation thus are the better investment.  To indicate the significance of inflation the author provided these startling facts on the costs of things we all want or need.

	Year	Amount
First-class stamp	1934	3 cents
	1980	15 cents
	2002	34 cents
	Increase	1,133%
A new car	1934	$1,436
	1980	$6,200
	2002	$19,175
	Increase	1,335%
A day in the hospital	1934	$12
	1980	$344
	2002	$2,854
	Increase	23,783%

Sources: U.S. Postal service, U.S. Census Bureau, and the Wall Street Journal, April 2002

I was astonished to see that the cost of hospitalization had inflated at a rate of 17 times faster than the cost of cars.  There is no doubt that health care has become an extraordinary burden on our country.  The question is how do we bring this ballooning expense under control?

The Los Angeles Times article about a woman’s need for surgery that would have taken a waiting time of 39 months in Canada as opposed to two days in the United States tells me that nationalized health care will not provide the solution we need.

Forget the plans for health care that have been discussed in the House and Senate.  This nation has a serious problem.  No single person and no political party has all the answers.  We need people of good will and intent to meet together to stop this outrageous theft of income.  The sad fact is that we do not have the kind of people in our congress that will sit together to find a reasonable solution.  Is it the people we elected, the political parties, or the lobbyists who are stopping the process?

Political parties do not matter.  Electing people to office that really care about America’s needs ought to be job one.

Obama is not Afraid of Public Opinion

Many in the American public hold views that are very different from our new president.  The honeymoon is not only over, the divorce proceeding is now in full force.  It’s obvious that President Obama came to office with the intent of making over many things that Americans hold dear.  Conservative commentators have successfully upset the public on many issues that are not well understood.  We didn’t understand the meaning of his campaign words.  Too few asked what “change” meant.  The color of the president’s skin has only added to the fear.

He is determined to reform health care.  He wants to convince the majority that his views are the best for this nation.  To accomplish this end he will appear on television networks that are at least not openly opposed to his ideas.  The result is his media appearances this Sunday, September 20 on NBC’s “Meet the Press”, ABC’s “This Week”, CBS’ “Face the Nation” and CNN’s “State of the Union“.  Fox’s “News Sunday” is being  skipped because the entire network opposes the president on every single issue.  Fox’s commentators have repeatedly expressed their hope for Obama’s failure.

Nancy Pelosi is correct in being concerned about the president’s safety.  In a nation where people are murdered for expressing their views the secret service needs to be extra vigilant. Protection for the president ought to include banning of guns at town hall meetings where he will appear.              

The president’s appearance on many shows is not overexposure.  After all he is the person we elected to lead our country.  He is doing an outstanding job of conveying his ideas on a variety of issues.  It’s not just health care.  He is responding to public concern.  His appearances on a variety of programs and answering questions is precisely what the country needs.  He is someone who is not afraid of public opinion.

Society’s Responsibility to Senior Citizens

Personally I have had more medical treatment since turning 60.  It’s no fun getting old!  I am not alone.

I do not need a study to tell me that the people receiving the most medical care are senior citizens.  All I have to do is go to local medical care facilities and this fact is quickly verified.  Most of the handicapped parking is full.  Seniors are more prevalent in the hallways and elevators.  So it is no surprise that Medicare is an expensive program.

This week’s Newsweek cover story is “The Case for Killing Granny.”  I think it accurately tells the story of most elderly people who have reached the end of life.  Families are trying to make the correct decisions and where possible respecting the wishes of that loved one.

The article fairly identifies the fact that doctors and hospitals in the big cities do have high earnings.  The fees they charge are not posted anywhere and that is causing government programs to put caps on fees.  I do not know any middle income doctors in Los Angeles.  Their cries about high malpractice insurance costs run afoul of their propensity for living in high income neighborhoods and driving high end cars.  

My own mother is now in a skilled nursing facility.  It’s really an extension of the hospital where she stayed for four nights.  She has dementia but that is really her only disease.  Her entry into the hospital was the result of neglect at a board and care facility.  She weighs 96 pounds and that is an improvement from last week’s weight of 93 pounds.  She really doesn’t want to eat more food.  She is on an intravenous line that hydrates her.  This is most likely the end of her life.  Her medical power of attorney says take no extraordinary steps to preserve her life.  She seems to be happy and so we are visiting her daily.  My sister hopes she will recover but that is an unlikely event.  A higher power will decide when she will take her final breath.

If we are the highly moral society that is our claim then it is essential that each family decide the measures to be taken to preserve life.  This cannot be a determination of government.  The federal government took on the responsibility when Medicare was implemented.  If Medicare, or Social Security, runs short of money then it is society’s responsibility to ensure we are all provided a comfortable retirement and health care too.

Health Insurance for Illegal Aliens

The debate about no health insurance for illegal aliens is too one dimensional.  This issue has many implications that have not been discussed at all.  Even a non-expert can ask some very important questions that are not easily answered.

1. An illegal alien has a communicable disease.  One member of the family comes to a hospital looking for care.  In the process of treatment a doctor concludes that the entire family is most likely infected.  The family has already come in contact with many other people.  Who will the government treat and who will pay for the treatment?

2. To ensure that no medical care is given to illegal aliens everyone will have to be issued an identity card.  Won’t those who oppose national identity cards see the issuance of these medical ID cards as a step toward systems of identity that so many Americans oppose?  

3. A female illegal alien is pregnant and has no money for health care.  Will the government provide the care needed for the mother and later for the child or will they be put out onto the street?

4. If an illegal alien child comes to a hospital with a broken limb or other non- communicable ailment will he/she be turned away?

5. Will public clinics and hospitals that now do not ask about citizenship not provide services to illegal aliens?

6. If we provide a “path to citizenship” for illegal aliens, will those following regulations be included in a national health insurance plan?  If they are low wage earners where will the money come from to pay for their care?

These are all difficult moral questions that will be debated long and hard.  Local government agencies throughout the country are now providing these services.  Where is this situation going?  Who wants to say “no” to the least able among us?

Health Care By Barack Obama

Nothing New Here

President Obama is an outstanding speaker.  Tonight’s health care presentation to Congress was no exception.  The reaction of both political parties was predictable.

The president wisely did not draw any lines that could not be crossed.  He did throw a few bones to the Republicans in the hopes of winning the support of some moderates in that party.   The outstanding of those was tort reform.

The often repeated goals of a revised health care system is

1. lower costs
2. cover all Americans
3. drive quality
4. and be paid for (without impacting the federal budget)

Unfortunately the number one goal was mostly ignored with the exception of the president’s contention that insurance companies are making added profits in the Medicare system.  He did not say Medicare Advantage programs but that is most likely the target of his comment.

There was no discussion about actually lowering costs of health care.  There was no discussion about improving the quality of care.   Mr. Obama’s focus was on ensuring that no one would be denied health care and that everyone has affordable health care by setting maximum out of pocket payments.

Unless moderate Democrats and Republicans reach a compromised plan there will be no changes in our health care system.  Today my bet is on “business as usual.”

Isn’t Health Care Rationed Now?

A sixty year old gentleman, who works for a pest control company, comes to my home every other month to spray around the outside of the house to reduce the invasions of bugs.  He was hospitalized from June 30 to July 4.  He had a blood infection in one leg.  The doctor wanted him to stay in the hospital another week.  He wanted to go home and enjoy some vacation time.  The doctor relented and he went home.  He went back to work a week later and although the leg is sore he is recovering.

He was hospitalized for four nights.  His medical insurance is denying him coverage for two nights.  The insurance company contends that two nights care was sufficient time for his recovery.

Is this a case of rationing health care?

Going Postal on Health Care

I almost forgot that Tom Purcell is supposed to be writing humorous columns. Today’s piece was definitely was not one of those. It is a very serious column that has at least one significant flaw. Healthcare insurance has been in the hands of private enterprise since insurance was invented. The postal service was included in our Constitution. Fed Ex is a recent development. So why hasn’t private enterprise done a better job? Could the answer be greed? The United States is the only industrialized nation in the world that does not provide its citizens with universal health care. That isn’t funny.

Bill George’s column in BusinessWeek does a very good job of highlighting some areas that need attention now. Mr. George is correct in saying that “Obama has surrendered policy to politics.” His proposal for health-care reform is worthwhile considering. Trying to get our senators and congressmen to listen to our ideas is nearly impossible. Many of those representatives are receiving donations from health industry companies for their re-election. It’s unlikely they will be listening to the voting public.

Update on Health Insurance Company Profits

This information was obtained from Yahoo’s financial reports site (http://finance.yahoo.com).  This is Operating Income.  You could argue that their income per share is low.  I would argue that the job they fulfill in our society requires that their profits remain even lower given their purpose.    

Quarter ending   6-30-09:	Aetna	$2.475 billion
	Coventry Health Care	$619 million
	CIGNA	$378 million
	Humana	$1.073 billion
	UnitedHealth	$859 million
	WellPoint (Blue Cross/Blue Shield)	$3.592 billion

A Real Need for Health Care in America

There really is a need for no cost or low cost medical care in the United States.  Remote Area Medical (RAM), an organization that provides health care in third world countries came to Los Angeles, California.  Stan Brock, the founder of this organization was named “person of the week” on ABC World News.

About 1,500 (revised to 6,000) people were provided with dental, optical and other care.  Hundreds are being turned away.  One man interviewed on local television drove 80 miles for dental care.  He is employed and does have medical coverage from his employer.  He has no dental coverage and the cost of a root canal and bridge of $5,000 was more than he could afford.  The local newspaper had an item asking for more volunteer doctors.

NPR and the Los Angeles Times both had articles on the event.  It’s obvious America does have a health care problem.