Saturday, August 29, 2009

Atomic Anniversary

Sixty-four years ago this month, the United States dropped atomic bombs on Hiroshima (August 6th) and Nagasaki (August 9th). A letter to the editor of the Wall Street Journal (Friday, August 28th) stated that not only did dropping the bombs save lives, including, remarkably, Japanese lives, but it "demonstrated the need for future restraint."

Friday, August 21, 2009

Doing nothing is not an option

Just finished attending a virtual town hall on health care. With all the misinformation that's being bandied about by those opposed to reform in any form, it was interesting to learn these facts:

The health care system we have now is unsustainable, among other things:

  • Medicare will be running in the red in 8 years

  • Medicaid already pays physicians and hospitals less than the cost of services they provide and thus doctors are refusing Medicaid patients

  • Health insurance premiums are rising 3 times faster than wages and employers are increasingly limiting or dropping their employee plans

  • Americans pay 5 - 6 times more per person for health care than any other developed nation and we have lower quality outcomes

  • If we do nothing, health care spending will rise to $4.4 trillion by 2018; 20% of the economy
  • So doing nothing is not an option. Looking at what's being considered:

  • No health care reform bill being considered has any provision to provide health insurance to illegal aliens.

  • No health care reform bill being considered has any provision to provide federal coverage for abortions (actually, it's illegal to do so).

  • No health care reform bill being considered has any provision to require seniors to undergo "euthanasia" counseling (interestingly, end-of-life counseling was inserted in the Social Security Act of 1990 by then President George H.W. Bush, but without any provision to pay for it).

  • No health care reform bill being considered has the government "taking over health care" -- there is no universal single-payer system (like Canada's) being formulated. The public insurance option is just that, an option, but it will give private insurance companies a run for their money.
  • Overhaul of our health care system is essential, it's complicated, it deserves rationale thought and lively (not angry) debate. Don't be fooled, the only interests that want the status quo are special interests. Don't let them decide the matter for you.

    Sunday, August 16, 2009

    Republican Richard 'Doc' Hastings Pulls the Euthanasia Rabbit Out of the Hat

    The congressman for my district, District 4 in eastern Washington State, is Richard 'Doc' Hastings. Hastings, despite his nickname, is no doctor. His biography says he, "studied business administration at Columbia Basin College and at Central Washington University." Doc's lack of medical expertise hasn't stopped him from waxing poetic on health care reform. Like his fellow Republicans, Doc is against anything the Democrats may be for. At a Tri-City Regional Chamber of Commerce lunch on Wednesday, August 12th, Hastings responded to a question about how health care reform proposals will affect seniors by saying, "The biggest issue is the euthanasia part of this. If they are mandated to have euthanasia consulting ... I'm not for anything mandatory." You mean like seat belts, Doc?

    The fact that there is no "euthanasia" consulting, mandatory or otherwise, seems to have escaped Doc's notice. Republicans, looking for things to scare us poor old folks with, found a provision on end-of-life care counseling in Section 1233 in the health bill passed by three House committees. The original provision on end-of-life planning was inserted in the Social Security Act by George H. W. Bush in 1990, and covered things like living wills, and durable powers of attorney, only meeting with a doctor to discuss such matters wasn't covered for seniors under Medicare. The new health care bill would have Medicare cover it. Scary, huh?

    Where you hear Republicans coming up with this kind of malarky, you've got to ask,

    Wednesday, August 12, 2009

    The Socialized Medicine Boogeyman

    When it comes to health care reform, Republicans are yelling about everything and anything as they pursue their campaign of ‘just say no.’ One of their rants claims that proposed health care reforms will constitute ‘socialized medicine.’

    Many Americans see any form of socialization as inherently bad, not realizing perhaps, that learning to live satisfactorily within one’s culture requires socialization. Of course, there are members of the far right that object to even that form of socialization, worried that it will deny them their right to carry assault weapons into national parks.

    But what ‘just say no’ Republicans are yelling about is socializing America’s health care system. Surprisingly, a substantial number of older Americans are joining the chorus, spurred on by politicians and talk show hosts telling them that the government will force them to meet “death panels” that will decide on whether they live or die – shades of ‘Soylent Green.’ Of course these same old folks are pretty damn strident about keeping their Medicare benefit, which they seem to think is provided by the tooth fairy.

    Speaking of socialized medicine, some three million American military men and women have their health care needs met by government salaried doctors and nurses, in government owned buildings, using government owned equipment. When they leave the military, they may be treated at Veteran’s Health Administration facilities. The VHA employs more than 239,000 staff at over 1,400 sites, including hospitals, clinics, nursing homes, domiciliary facilities, and Readjustment Counseling Centers. In addition, the VHA, a $47 billion government program, is the Nation's largest provider of graduate medical education and a major contributor to medical research.

    Republicans are good at saying no, and they’re saying no to change, period, because, as yet, there’s no House and Senate agreed-upon bill on health care reform. The question is, to whom are the Republicans pandering; special interests in the insurance industry, big pharma, the religious right, the xenophobic immigration extremists, the ‘birthers,’ or just the vapid, blathering idiots (yes, I mean you Rush 'Limblah') that care more about seeing President Obama fail, than seeing Americans get better health care.

    Monday, August 10, 2009

    Sarah Palin to Medical School

    Erstwhile Alaska Gov and John McCain running mate Sarah Palin shown wearing a latex glove she’s just used to perform a digital rectal exam on a surprised supporter. “I believe in responsible health care for all Alaska’s citizens,” she pronounced, at the same time she told the red-faced woman that she should have a prostate biopsy.

    Palin, who recently lamented that her parents and baby with Down Syndrome will have to step in front of a “death panel” under President Obama’s health care bill, has yet to reveal her future plans, but one can only assume she’s headed for medical school where, in all likelihood she’ll specialize in 'foot in mouth' disease.

    Sunday, August 9, 2009

    If it ain't broke, don't fix it. If it is, fix it!

    Factoring in costs borne by the government, the private sector, and individuals, the United States spends over $1.9 trillion annually on health care expenses, more than any other industrialized country.

    Based on OECD analyses, the United States spends more per capita on health care than any other country, and has one of the highest growth rates in per capita health care spending since 1980 among higher income countries. The U.S. spent by far a higher share of its gross domestic product (GDP) on health care than any other industrialized country. Since 1980, the U.S. also has had among the highest average annual growth rates in per capita spending on health care. Despite this relatively high level of spending, the U.S. does not appear to provide substantially greater health resources to its citizens, or achieve substantially better health benchmarks, compared to other developed countries.

    The United States spent 16 percent of its GDP in 2007 on health care, higher than any other developed nation. The nonpartisan Congressional Budget Office (CBO) estimates that number will rise to 25 percent by 2025.

    A lot of people seem to believe that the reason the U.S. spends more than other countries is because we're a litigious society, i.e., they blame malpractice law suits. Others believe our health care costs more because it's more readily available (to those who can afford it). They claim people living in places with "socialized medicine" have to wait forever to see a doctor or have a procedure done. And yet a recent study by the John Hopkins School of Public Health found that neither one of these factors explain more than an insignificant fraction of the difference in health care costs. This study also showed that the U.S. citizens are paying more for comparable, or worse outcomes.

    U.S. businesses, finding the cost of health care benefits for their employees too onerous, are out sourcing jobs overseas, and access to employer-sponsored health insurance has been on the decline.

    No wonder it went bankrupt. General Motors covered more than 1.1 million employees and former employees, and the company said it spent roughly $5.6 billion on health care expenses in 2006. GM said health care costs added between $1,500 and $2,000 to the sticker price of every automobile it made.

    There are some 43 million Americans without health insurance. Uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. The absolute number of people using emergency rooms has gone up as much as 20 to 30 percent in the last six to eight months due to the recession and people losing their jobs. Handling health care in the ER is the most inefficient, lest effective way of addressing America's health needs. The cost of ER care for uninsured patients doesn't disappear. It strains hospital budgets and can be indirectly shifted onto families and individuals that do have insurance coverage in a "hidden tax" of higher premiums. Estimates put the hidden tax somewhere between $1,000 and $1,300.

    Of course the true cost of a broken health care system is in the quality of care that's afforded American citizens. Yes, it's broken. Let's fix it!

    Friday, August 7, 2009

    Voting their Conscience

    Just nine Republicans joined majority Democrats and the Senate's two independents to support Sonia Sotomayor's confirmation Thursday as the nation's first Hispanic Supreme Court justice. They included the Senate's few GOP moderates and its lone Hispanic Republican, retiring Sen. Mel Martinez of Florida, as well as conservative Sens. Lindsey Graham of South Carolina and Lamar Alexander of Tennessee, the party's third-ranking leader.

    The National Rifle Association, which hadn't weighed in on Supreme Court nominations past, strongly opposed her and threatened to downgrade its ratings of any senator who voted to confirm Sotomayor. Republicans who were initially considered possible supporters later announced their opposition, citing gun rights as a key reason.

    Of the GOP senators standing for re-election next year, all 12 voted against Sotomayor.

    Of the seven GOPers likely to retire between now and '10, four -- Sens. Kit Bond (R-MO), Judd Gregg (NH), Mel Martínez (FL) and George Voinovich (OH) -- voted yes. Retiring Sens. Sam Brownback (R-KS), Jim Bunning (R-KY) and Kay Bailey Hutchison voted no. Brownback and Hutchison intend to run for GOV in their respective states.

    Thursday, August 6, 2009

    Killing Grandma

    In fact, section 1233 of the House bill would allow Medicare for the first time to cover patient-doctor consultations about end-of-life planning, including discussions about drawing up a living will or planning hospice treatment. Patients would, of course, seek out such advice on their own -- they would not be required to. The provision would limit Medicare coverage to one consultation every five years.

    But that's not what the Republicans are telling you.

    Former Republican lieutenant governor of New York Betsy McCaughey said on a radio show on July 16, that she had read the health care bill and discovered that "Congress would make it mandatory... that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go into hospice care... all to do what's in society's best interest... and cut your life short."

    House Republican Leader John Boehner (R-Ohio) and Republican Policy Committee Chairman Thaddeus McCotter (R-Mich.) put out a statement on the section of the bill in question, Section 1233, that said, "This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law."

    And then there's Rush Limbaugh. Here's what he said on his July 28th radio show, “People at a certain age with certain diseases will be deemed not worth the investment, and they will just as Obama said, they’d give them some pain pills, and let them loop out till they die and they don’t even know what’s happened." Well, Rush is someone we've got to pay attention to when it comes to popping pills.

    End-of-life planning is critical. Everyone should be knowledgeable about things like directives to physicians/living wills, do not resuscitate orders, medical powers of attorney, and the like.

    It's completely irresponsible of Republicans to fear monger about this.

    Wednesday, August 5, 2009

    Health Care in the United States of America

    America's health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, medical mistakes, and inappropriate care, waste and fraud.

    Middle class Americans can't keep up with rising health insurance costs and even those with insurance dread the prospect of some serious/prolonged medical event that ends up bankrupting them. People without health insurance flood hospital emergency rooms where hospitals are only reimbursed for the cost of care by charging their insured patients more.

    The cost of employee health care plans hurts the competitiveness of America's business and industry, and drives jobs overseas.

    The US spends more on health care by far than any other industrialized nation, and yet health outcomes for Americans are no better and in many case far worse that nations with universal coverage for their citizens. Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France. It was 17% of GDP in the United States and it continues to grow.

    You'd think that our leaders in Congress, Democrats and Republicans alike, would be working hard to correct this situation. Not the Republicans, who are playing to the fears of their fringe constituencies. Thus, the misleading and even patently false claims about the Obama health care reform plan:

    Under the Obama plan, our "grandmothers will be encouraged to commit suicide." Give me a break! The bill includes a provision to cover minimal counseling on directives to physicians for end of life care and other helpful planning provisions to ensure people get the information they need to make sound decisions about their care.

    "The Democrats want the government to pay for abortions." Absolutely false. Where do these people get these crap? None of the health care overhaul measures that have made it through the committee level in Congress say that abortion will be covered, and one of them explicitly says that no public funds will be used to finance the procedure.

    The Obama plan will "lead to rationing of health care." No reasonable analysis leads to that conclusion, but rational isn't what these claims are about.

    Republicans are working hard to defeat health care reform, any health care reform, because, and Republican leadership has said this, they want to make health care reform President Obama's "Waterloo." That's right; they're more concerned about getting back at Obama than getting Americans decent health care. Shame on them!

    Be sure to fact check anything you hear from the GOP (The Party of 'No') by going to Factcheck.org.