"Clinton to Propose Universal Health Care"

It's about time.

WASHINGTON, Sept. 15 — Senator Hillary Rodham Clinton on Monday will lay out a plan to secure health insurance for all Americans while severely limiting the ability of insurers to deny coverage or charge higher premiums to people with chronic illnesses and other medical problems, her aides and advisers say.

. . .

Mrs. Clinton will not try to impose an overall limit on national health spending, the aides said. But she is prepared once again to do battle with insurance companies, which she has said “spend tens of billions of dollars a year figuring out how not to cover people” and “how to cherry-pick the healthiest persons, and leave everyone else out in the cold.”

. . .

[Clinton's aides] said . . . that Mrs. Clinton would amplify a comment in March when she declared, “We could require that every insurance company had to insure everybody, with no exclusion for pre-existing conditions.” . . .

The insurance companies are of course ready for this fight:

Karen M. Ignagni, president of America’s Health Insurance Plans, the chief lobby for insurers, said they endorsed the goal of universal coverage. But Ms. Ignagni said that insurers denied only 3 percent of claims, and that many of those were for experimental procedures that employers did not cover.

Mary Nell Lehnhard, senior vice president of the Blue Cross and Blue Shield Association, said, “Some of Mrs. Clinton’s proposals, while trying to make insurance more affordable for older, sicker people, could unintentionally drive up costs for young, healthy people and ultimately for everyone.” . . .

Denying even 3% seems to me a lot (I'll read more on this), and why should employers be in a position to make life-or-death decisions about their employees, especially if an experimental procedure might work and prove beneficial to other sick people as well?

Also, does Blue Cross then expect older, sicker people to pay higher premiums (when, because they're old and sick, they're probably least likely to be able to afford to)? The whole purpose of insurance is to spread the risk among a large pool of people, with everyone paying a reasonably affordable premium. Eventually the young, healthy people are going to get old and sick, too (I know this from experience), and their expenses will need to be covered by the premiums everyone (including themselves) has been paying.

The bottom line here is, the insurance companies just want to cover young, healthy people in order to maximize their profits to pay for their myriad bureaucracies and expensive executives and have some money left over for their shareholders. To hell with sick people. I personally think it's immoral for companies to operate in this way, let alone be in control of a nation's health care delivery system. (May I add that my doctor agrees on this.)

I'm all for Hillary if she has the guts to set this situation right. I'm glad to hear she's getting into the fray, and she of all the candidates has the experience under her belt for this whale of a confrontation.

Article here.

Guardian Article on Health Care in the U.S.

"Expensive and divisive: how America is losing patience with a failing system / Onus on workers to buy health insurance as rising costs force firms to end perk"

The US spends about 16% of GDP on healthcare, a proportion expected to climb to 20% by 2015, according to the National Coalition on Health Care. At present spending levels of $1.6 trillion a year, which works out at $6,700 per capita, is double what is spent in countries such as France. And yet that still leaves some 47 million Americans entirely without health coverage, and tens of millions of others under-insured, according to latest census figures.

It also fails to guarantee a better service to those Americans with access to healthcare. The US ranks last or near the bottom on quality, access, efficiency, equity and healthy lives, according to a report in May 2007 from the Commonwealth Fund, which studies healthcare.

"The US healthcare system is considered a dysfunctional mess," writes Ezekial Emanuel, chairman of the department of clinical bioethics, in a recent issue of the Journal of the American Medical Association. . . .

Full article here. I found this paragraph telling:

However, the US has - with [the British] government's encouragement - made inroads here. United Health, a US healthcare provider based in Minneapolis, arrived in the UK in 2004 to develop a scheme which had succeeded in keeping frail and elderly people out of hospital in the US, although an evaluation in November showed it had reduced neither the number of admissions nor deaths.

(But I'll bet you the company made money on the "scheme" nonetheless.)

It's Really Time to Get Lobbyists Out of the Election Game

Especially vis-a-vis the need for a national healthcare program. See here. Hillary Clinton has already been bought, and so will not be proffering a realistic solution to our healthcare dilemma.

Almost TGIF

I did go to the gym tonight on foot and went shopping afterwards. I'll deal with the truck this weekend maybe. There's a Publix in the same shopping center where the gym is. Bought some "GreenWise" chicken Italian sausages (never saw them before)--raised without antibiotics; no artificial ingredients; air-chilled; and with natural preservatives. I just hope that when one of these chickens gets sick, they do give it antibiotics if necessary, rather than let it suffer.

I read the ingredients on the package. I guess the natural preservative is salt. These are hot Italian sausages, so I figure the hot spice also acts as a natural preservative. There was also some sodium lactate in it, but my research indicates that this enhances the flavor.

I'll make a nice spaghetti sauce with these for the weekend and also use some regular ground sirloin (which I assume has antibiotics in it).

We watched "Queer As Folk" on Logo tonight. (I'd never seen all the installments.) Last week they bumped it for the presidential debates. We were very disappointed. I already know where the candidates stand on almost every issue, but I'm still a little worried about Hillary's stand on healthcare, now that she's getting big financial backing from the healthcare industries. As far as I know, John Edwards still has the best plan, but obviously he's not going to win the nomination.

No more vitriol from this podium. As angry and frustrated as I get sometimes, it's not worth it to sit here and lash out when frankly I should be going to bed. Plus, if I've had a cocktail or two (as I do on occasion), it comes across as a freakish, paranoid rant. Then I have to delete it the next day. I'm tired of doing that!

"U.S. Lags Behind 41 Nations in Life Span"

From Salon:

By STEPHEN OHLEMACHER Associated Press Writer

August 11,2007 WASHINGTON -- Americans are living longer than ever, but not as long as people in 41 other countries.

For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands.

"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington.

A baby born in the United States in 2004 will live an average of 77.9 years. That life expectancy ranks 42nd, down from 11th two decades earlier, according to international numbers provided by the Census Bureau and domestic numbers from
the National Center for Health Statistics.

Andorra, a tiny country in the Pyrenees mountains between France and Spain, had the longest life expectancy, at 83.5 years, according to the Census Bureau. It was followed by Japan, Maucau, San Marino and Singapore.

The shortest life expectancies were clustered in Sub-Saharan Africa, a region that has been hit hard by an epidemic of HIV and AIDS, as well as famine and civil strife. Swaziland has the shortest, at 34.1 years, followed by Zambia, Angola, Liberia and Zimbabwe.

Researchers said several factors have contributed to the United States falling behind other industrialized nations. A major one is that 45 million Americans lack health insurance, while Canada and many European countries have universal health care, they say.

But "it's not as simple as saying we don't have national health insurance," said Sam Harper, an epidemiologist at McGill University in Montreal. "It's not that easy."

Among the other factors:

-- Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.

"The U.S. has the resources that allow people to get fat and lazy," said Paul Terry, an assistant professor of epidemiology at Emory University in Atlanta. "We have the luxury of choosing a bad lifestyle as opposed to having one imposed on us by hard times."

-- Racial disparities. Black Americans have an average life expectancy of 73.3 years, five years shorter than white Americans.

Black American males have a life expectancy of 69.8 years, slightly longer than the averages for Iran and Syria and slightly shorter than in Nicaragua and Morocco.

-- A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.

Forty countries, including Cuba, Taiwan and most of Europe had lower infant mortality rates than the U.S. in 2004. The U.S. rate was 6.8 deaths for every 1,000 live births. It was 13.7 for Black Americans, the same as Saudi Arabia.

"It really reflects the social conditions in which African American women grow up and have children," said Dr. Marie C. McCormick, professor of maternal and child health at the Harvard School of Public Health. "We haven't done anything to eliminate those disparities."

Murray, from the University of Washington, said improved access to health insurance could increase life expectancy. But, he predicted, the U.S. won't move up in the world rankings as long as the health care debate is limited to insurance.

Policymakers also should focus on ways to reduce cancer, heart disease and lung disease, said Murray. He advocates stepped-up efforts to reduce tobacco use, control blood pressure, reduce cholesterol and regulate blood sugar.

"Even if we focused only on those four things, we would go along way toward improving health care in the United States," Murray said. "The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does."

Sad Week

Two nights ago I found out from a friend in Canada, who used to live here, that his younger brother of 44 years is terminally ill. He had a thrombosis in an artery supplying blood to his intestines and, despite losing weight and being in pain over a period of several months, never went to the doctor about it. Finally, when he did go to the doctor, and they ultimately cut him open, his intestines were necrotic and had to be removed. Plus his blood vessels in that region were destroyed.

This is a very rare condition for a person of his age, a textbook case. To survive, he would not be able to eat--he would have to be fed intravenously for the rest of his life (and he's a gourmet cook). He has two ostomy bags. Furthermore, the chances of his survival with an intestine implant are very slim. So, in accordance with his own wishes, he probably won't be around much longer.

Paul Krugman

From today's article, "The Substance Thing", wherein he derides the Republican candidates for their lack thereof and further states:

Whatever the fate of the Edwards candidacy, Mr. Edwards will deserve a lot of the credit if and when we do get universal care in this country.

Mr. Edwards has also offered a detailed, sensible plan for tax reform, and some serious antipoverty initiatives.

Four months after the Edwards health care plan was announced, Barack Obama followed with a broadly similar but somewhat less comprehensive plan. Like Mr. Edwards, Mr. Obama has also announced a serious plan to fight poverty.

Hillary Clinton, however, has been evasive. She conveys the impression that there’s not much difference between her policy positions and those of the other candidates — but she’s offered few specifics. In particular, unlike Mr. Edwards or Mr. Obama, she hasn’t announced a specific universal care plan, or explicitly committed herself to paying for health reform by letting some of the Bush tax cuts expire.

For those who believe that the time for universal care has come, this lack of specifics is disturbing. In fact, what Mrs. Clinton said about health care in February’s Democratic debate suggested a notable lack of urgency: “Well, I want to have universal health care coverage by the end of my second term.”

On Saturday, at the YearlyKos Convention in Chicago, she sounded more forceful: “Universal health care will be my highest domestic priority as president.” But does this represent a real change in position? It’s hard to know, since she has said nothing about how she would cover the uninsured.

And even if you believe Mrs. Clinton’s contention that her positions could never be influenced by lobbyists’ money — a remark that drew boos and hisses from the Chicago crowd — there’s reason to worry about the big contributions she receives from the insurance and drug industries. Are they simply betting on the front-runner, or are they also backing the Democratic candidate least likely to hurt their profits? . . .

Paul Krugman

From his column on Friday ("A Test for Democrats"), wherein he discusses the hedge fund loophole, inter alia. According to Air America, even John Kerry has backed off on closing this loophole. It's time for some of that campaign finance reform.

It’s been a good Democrats, bad Democrats kind of week. The bill expanding children’s health insurance that just passed in the House makes you want to stand up and cheer. Reports that Senator Charles Schumer opposes plans to close the hedge fund tax loophole make you want to sit down and cry.

Let’s start with the good news: The House bill, which the Congressional Budget Office says would provide coverage to five million children who would otherwise be uninsured.

The bill is so good that it has Republicans spluttering. “The bill uses children as pawns,” declared Representative Pete Sessions of Texas. Yes, the Democrats are exploiting children — by providing them with health care.

The horror, the horror!

What’s especially encouraging is the way House Democrats were willing to take on the insurance companies. The bill pays for children’s health care in part by cutting subsidies to Medicare Advantage, a privatization scheme that yields big profits for insurers, but that the budget office estimates would cost taxpayers $54 billion in excess payments over the next five years.

Earlier this year I worried that many Democrats would be taken in by the insurance industry’s disinformation campaign in support of its subsidies, which included the pretense that Medicare Advantage offers big benefits to minority groups. In the end, however, House Democrats refused to be rolled.

All in all, the bill is both a fine piece of legislation and a demonstration that Democrats can stand up to special interests. Happy days are here again.

Or maybe not.

The hedge fund tax loophole is a crystal-clear example of unjustified privilege. Because of a quirk in the law, the people who run these funds don’t pay taxes like ordinary mortals.

For example, the salaries that pension fund employees receive for managing other peoples’ money are taxed as ordinary income, at rates up to 35 percent. But if that money is invested with a hedge fund — and 40 percent of the money in hedge funds comes from public, corporate and union pension plans — the fees the hedge fund manager receives for his services are mainly taxed as capital gains, with a maximum rate of 15 percent.

The arguments usually made on behalf of this unique privilege make no sense. We’re told that the tax rate on hedge fund managers has to be kept low to encourage risk-taking. But the managers aren’t risking their own money. The only risk they face is the uncertainty of their fees — and as any waitress who depends on tips or salesman who depends on commissions can tell you, most people with uncertain incomes don’t get any special tax breaks. . . .

Paul Krugman: An Immoral Philosophy

From today's New York Times.

When a child is enrolled in the State Children’s Health Insurance Program (Schip), the positive results can be dramatic. For example, after asthmatic children are enrolled in Schip, the frequency of their attacks declines on average by 60 percent, and their likelihood of being hospitalized for the condition declines more than 70 percent.

Regular care, in other words, makes a big difference. That’s why Congressional Democrats, with support from many Republicans, are trying to expand Schip, which already provides essential medical care to millions of children, to cover millions of additional children who would otherwise lack health insurance.

But President Bush says that access to care is no problem — “After all, you just go to an emergency room” — and, with the support of the Republican Congressional leadership, he’s declared that he’ll veto any Schip expansion on “philosophical” grounds.

It must be about philosophy, because it surely isn’t about cost. One of the plans Mr. Bush opposes, the one approved by an overwhelming bipartisan majority in the Senate Finance Committee, would cost less over the next five years than we’ll spend in Iraq in the next four months. And it would be fully paid for by an increase in tobacco taxes.

The House plan, which would cover more children, is more expensive, but it offsets Schip costs by reducing subsidies to Medicare Advantage — a privatization scheme that pays insurance companies to provide coverage, and costs taxpayers 12 percent more per beneficiary than traditional Medicare. [See here on Medicare Advantage.]

Strange to say, however, the administration, although determined to prevent any expansion of children’s health care, is also dead set against any cut in Medicare Advantage payments.

So what kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?

Well, here’s what Mr. Bush said after explaining that emergency rooms provide all the health care you need: “They’re going to increase the number of folks eligible through Schip; some want to lower the age for Medicare. And then all of a sudden, you begin to see a — I wouldn’t call it a plot, just a strategy — to get more people to be a part of a federalization of health care.”

Now, why should Mr. Bush fear that insuring uninsured children would lead to a further “federalization” of health care, even though nothing like that is actually in either the Senate plan or the House plan? It’s not because he thinks the plans wouldn’t work. It’s because he’s afraid that they would. That is, he fears that voters, having seen how the government can help children, would ask why it can’t do the same for adults.

And there you have the core of Mr. Bush’s philosophy. He wants the public to believe that government is always the problem, never the solution. But it’s hard to convince people that government is always bad when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed. . . .

There are arguments you can make against programs, like Social Security, that provide a safety net for adults. I can respect those arguments, even though I disagree. But denying basic health care to children whose parents lack the means to pay for it, simply because you’re afraid that success in insuring children might put big government in a good light, is just morally wrong. . . .

P.S.

We do NOT have the most advanced health care system here in the U.S. See the movie "Sicko" or the many articles I have referenced here. The U.S. is rated 37th in health care in the entire world, which is pretty sad, considering. We could be the best if we tried.

"The Medicare Privatization Scam"

Article by Trudy Lieberman in the July 16/23 issue of The Nation. (You might wish to subscribe.) This is something about which to contact your representatives in Washington.

[A]fter 2003 the government began shoveling huge sums of money into the Medicare Advantage plans [created under the Medicare "Part D" drug benefit] to entice seniors to leave the traditional program--in effect subsidizing privatization even more and bringing right-wing think tanks like the Heritage Foundation closer to their objective of ending Medicare as social insurance. The ultimate goal, of course, is to make seniors bear future costs, sparing their benefactors the need to pay more taxes to keep Medicare afloat. This year the government will pay insurers on average 12 percent more than it costs to provide the same benefits to people who stay in the traditional program, according to the Medicare Payment Advisory Commission . . ., an independent group that advises Congress. HMOs will get 10 percent more, but private fee-for-service plans will get a whopping 19 percent more, a subsidy that lets them offer rock-bottom premiums and lots of extras--at least for now. . . .

A report issued earlier this year by California Health Advocates and the Medicare Rights Center found that [health insurance] agents had misled beneficiaries about private fee-for-service plans. Although agents told them they could go to any doctor, many have had trouble finding doctors who would accept their coverage. In June seven insurance companies said they would suspend the marketing of private fee-for-service plans until they can prove to Medicare officials that agents understand the policies and their sales materials are accurate, a voluntary move unlikely to hurt the bottom line. Humana released a statement saying the suspension would affect 2007 earnings by no more than 2 cents a share. The move, of course, is a ploy to deflect attention from the real issue of overpayments. Pete Stark, who chairs the House Ways and Means Committee's health subcommittee, said the move "will do virtually nothing to protect Medicare beneficiaries and is a pathetic attempt to pre-empt Congressional action."

The story of Humana is emblematic of a major transition in healthcare, to a more privatized system in which insurance companies can discard policyholders when they are no longer profitable. This raises the question: If the private market doesn't provide long-term, effective and efficient care, why does the government have $50 billion to subsidize companies while claiming not to have the same $50 billion to pay for care directly?

What a mess.