I’m thinking about how my tax dollars are going to buy proton pump inhibitors for people who not only don’t have ulcers, don’t have raging gastric reflux– but people who tell me their stomachs are just fine!
I’m outraged. My religion, which I re-name weekly, forbids over-prescription of drugs of dubious benefit to people who don’t actually have a disease. My philosophy is called ‘evidence based’. It’s a minority religion, I’ll admit, but reality does have a way of sticking around whether it fits our narrative or not.
I demand that insurance companies stop funding proton-pump inhibitors for people who would do just fine with an occasional Tums. I demand that the secular authorities bow down to my authority as High Priestess (self-ordained) and re-arrange everyone’s insurance immediately.
Don’t whine to me that your stomach hurts. I have conscience, and I’m exercising it on you.
AARP released a statement about the newly passed legislation on the debt ceiling. While in the first two paragraphs, it’s clear they are trying to be nice, by the third paragraph, they are getting down to business about what is wrong with this legislation. From the statement:
“We are relieved that Congress has acted on a bipartisan agreement to address the debt ceiling and prevent default to ensure that seniors will continue to receive their Social Security checks and have access to health care. We are also gratified that after hearing from millions of AARP members, the President and Congress did not cut Social Security, Medicare and long-term care in the first round of deficit reduction.
“Going forward, we are pleased that Social Security, Medicaid and Medicare benefits are protected if the so-called “super committee” fails to reach an agreement later this fall, but we will remain vigilant in our efforts to protect the health and retirement security of seniors and future retirees. We are concerned that a fast-track committee process will deny Americans a voice in the discussion about critical tax, health and retirement issues. We also are concerned about the potential use of a trigger that would arbitrarily cut provider payments under Medicare, which could unfairly shift costs to seniors.
“Seniors have worked their entire lives to achieve a level of health and economic security in retirement. As the deficit debate continues, AARP will continue to impress upon Congress the need to protect Medicare and Social Security from harmful cuts. With the compounded effect of loss of retirement savings and home equity, high unemployment and rising health care costs, cuts to the benefits seniors have earned could undermine the standard of living of not just those with limited incomes, but middle class seniors who have median incomes of only $18,500.
“AARP will continue to raise the voices of millions of Americans who rely on their Social Security and Medicare benefits and oppose benefit cuts for deficit reduction. Americans want a broader conversation around health and economic security, not one focused solely on deficit reduction.
“AARP believes that the American public deserves a seat at the table in any forum, including the newly created super committee, that discusses potential changes to these critical programs. We believe that our nation’s leaders should work together to strengthen health and retirement security for current and future generations.”
Who is going to be on this “Super Committee”? Is this “Super Committee” going to supplant Congress? How many seats on the Super Committee are going to be reserved for the already-super-influential corporations?
As the public debate over health care reform rages on, the private battles with health insurers for essential coverage continue on, as well. While some fight for political advantage, others fight for their lives. The triviality of the former should be obvious to even the most insensate, particularly when contrasted with the high stakes of the latter. Individually, each tale of medical hardship rends the heart and evokes sorrow and sympathy. Collectively, the tales make a compelling case for the desperate necessity of reform. Consider the following two stories:
Houston Tracy, a 12-day-old boy, has already survived a rare birth defect, a feeding tube and open heart surgery. Now his family is waiting to see how the battle with an insurance company will fare.
Last week, Houston’s parents found out that the term “pre-existing condition” can apply the moment someone is born.
“When he came out, he made one little cry and he didn’t really cry much,” said Houston’s father, Doug Tracy, 39, of Crowley, Texas.
Tracy cut the umbilical cord and watched the hospital staff clean his son. But before his wife Kim Tracy, 36, could touch their son doctors got worried. “We could tell there was something wrong by the way they [the doctors] were acting,” Doug Tracy said.
Houston’s skin wasn’t turning a shade of pink like most newborns because, somehow, his blood wasn’t getting enough oxygen. Doctors rushed Houston, with Tracy riding by his side, in an ambulance to Cook Children’s Medical Center in Fort Worth, Texas.
Within hours the Tracy family would learn their son was born with a heart condition called d-transposition of the great arteries, meaning the aorta and pulmonary artery are transposed where they should meet the heart. Doctors wanted to operate within days to save his life….
Houston was born on Monday, March 15. By Friday that week, doctors operated successfully….But by March 24, the Tracy family formally heard their son was denied health insurance.
“We don’t have health coverage on ourselves because it’s too expensive these days and because of the economy,” Doug Tracy said. The couple are small business owners and would have to buy individual policies, which they have for their other children Cooper, 4, and Jewel, 11.
Doug Tracy said the family had no idea there was something wrong with Houston before he was born.
“Prenatal, every doctor visit was perfect, his heart beat was fine,” he said. But Tracy said he called Blue Cross and Blue Shield of Texas twice in preparation of Houston’s birth, and he asked if they could get a policy on his son before he was born.
“They said we can’t do that because he wasn’t born yet, but as soon as the baby’s born go online and fill an application out,” he said. Doug Tracy applied for Houston’s insurance March 18, and the first month’s premium of $267 was charged to his credit card, he said.
“Wednesday, the 24, is when I got a letter of decline — they declined it the day after the [health insurance] bill was signed,” Doug Tracy said. [full article]
And about 1,000 miles away in Wisconsin:
For nearly a decade, Paula Oertel’s brain tumor was kept at bay by a drug that was not approved to treat her condition.
Then Oertel did something she never imagined would jeopardize her good health. She moved. Less than 30 miles – from one county in Wisconsin to another.
The move triggered a review of her health insurance from Medicare, which eventually led to a loss of coverage, including the drug. And the tumor returned within four months.
What happened to Oertel stunned her doctor, Mark Malkin. Nothing he learned in medical school prepared him for what now is too often a sad and frustrating part of his job as a cancer specialist: fighting Medicare and private insurance companies over life-or-death decisions.
Doctors aren’t supposed to get emotionally involved in the cases of their patients, but tears well up in Malkin’s eyes when he talks about Oertel, the 40-year-old Oshkosh woman he has been treating for several years.
“I wish Paula would have a second chance,” he said, choking up.
Oertel and Malkin are facing an ailment no drug can cure: a complex health insurance system that can overwhelm a seriously ill patient unequipped to deal with its complicated rules.
As America debates health care reform, cases such as Oertel’s illustrate how important decisions made between doctors and patients can be overruled, leaving patients with no options and the likelihood of dying in a matter of months. [full article]
Meanwhile, those who profit from a system that denies or restricts coverage are digging in their heels. The New York Times reports that, “just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.” Their stance is clear. They will resist change, to the detriment of us all. It’s sickening.
For those who are concerned about health care, health care costs, and health care reform, I highly recommend Atul Gawande’s report from McAllen, Texas, where Medicare spending is twice the national average. From The New Yorker:
It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here.
McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.
The explosive trend in American medical costs seems to have occurred here in an especially intense form. Our country’s health care is by far the most expensive in the world. In Washington, the aim of health-care reform is not just to extend medical coverage to everybody but also to bring costs under control. Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It’s also devouring our government. “The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.” [full text]
I saw Elizabeth Roberts at a fundraiser we attended this past weekend. She said that the numbers showing up for the Healthy RI sessions increased from the first session to the second, and they are hoping for even greater attendance tomorrow. Details of tomorrow’s session are as follows:
PROVIDENCEâ€”Lt. Gov. Elizabeth Roberts will convene the third session of Mission: Healthy RI this Friday, December 7th from 7:30 to 9:00 a.m. at the Business Innovation Factory located at the Rhode Island Economic Development Corporation’s headquarters on Valley Street . This week, participants will hear from Christine Ferguson, the former director of the Rhode Island Department of Human Services under Governor Lincoln Almond and an expert in the state’s use of federal funds for health care, including RIte Care. Ferguson will lead a discussion on the current state of the Rhode Island Medicaid programs, the future of federal health funding, and the potential for leveraging public health care dollars as we move forward toward covering all Rhode Islanders.
Mission: Healthy RI is an advisory work group of representatives from the medical community, the insurance industry, hospitals, business owners, labor leaders, patients, and other stakeholders. The group will work with Roberts as she moves the state toward a plan to ensure that all Rhode Islanders have access to the highest quality health care at a cost they can afford. Roberts plans to introduce a package of health care reform legislation during the 2008 session.
Over the next two months, Lt. Gov. Roberts’ Mission: Healthy RI advisory work group will focus closely on specific issues that surround the complicated process of comprehensive health care reform. The deliberations and dialogue during each session will be framed by presentations from national and local experts who have experience in specific areas surrounding reform.
Mission: Healthy Rhode Island is open to the public. Invitations were sent out to key stakeholders and members of the public are encouraged both to attend and participate. All sessions will be on Friday morning and will start promptly at 7:30 a.m. and end by 9:00 a.m., with media availability of both the speaker and Lt. Gov. Roberts directly following the session. Sessions are scheduled for December 7th, 14th, 21st, January 4th, 11th, and 18th.
Who: Lt. Gov. Elizabeth Roberts; attendees of the Mission: Healthy RI advisory work group; members of the public
What: Lt. Gov. Elizabeth Roberts to host second session of Mission: Healthy RI
When: Friday, December 7, 2007
7:30 a.m.- 9:00 a.m.
Where: Economic Development Corporation Headquarters
Business Innovation Factory
American Locomotive Works Development
555 Valley Street, Providence
Though I am not able to attend tomorrow’s session, I hope to get to at least one of these and bring up some ideas on how to increase quality and decrease costs in health care. As I discussed in an earlier post, USA Today recently did a series of articles called called “Prescription for Change” which outlined a number of ways we could decrease costs and increase quality such as:
Advance Directives: One way is to allow states to give people the option of limiting their end of life care, helping them with forms that clarify advance directives. Some states are already doing this to good effect, and Rhode Island could follow their lead.
Reduce Costly and Ineffective Surgeries: Another way is for doctors to perform less surgeries that are costly and often ineffective. Government could support this practice by providing more public information online and in print for people to review the research on effectiveness for controversial surgeries.
Use Generic, Safer Medicines First: Another practice guideline that could be supported by government is better effectiveness and safety research on medicines before they are put on the market (i.e. regulations and guidelines that reduce corporate influence of the FDA). Generic, cheaper medicines should be given first consideration when the newer, expensive options are not proven to be more effective and may have more dangerous side effects.
This past Saturday, November 17th saw the dedication of the Rhode Island Irish Famine Memorial. I was glad to be there, being the descendant of Irish immigrants. The Memorial is a bronze monument; three figures that represent the suffering of the Irish during the Famine of 1845-1852 and the mass emigration that resulted. The Memorial is infused with the pride of the Irish and our love of America. A low wall bears plaques relating the events that led to the deaths from starvation and disease of an estimated million Irish, and the emigration of a million more.
The history of indifference to suffering, abetted by prejudice, bad religion and the politics of greed is unfortunately not unique to that time or place. The inscription on the Memorial has a resonance today.
[British Prime Minister, Lord John] Russell, and Sir Charles Trevelyan, his chief economic advisor for Ireland, believed that their government should take only a limited part in relieving disasters like the Great Famine. They thought that the private charity of individuals and philanthropic organizations should shoulder the burden of Famine Relief. Accordingly, religious groups such as the Society of Friends (the Quakers) came forward to offer unconditional aid to Ireland.
Above all, Russell believed in protecting the rights of private property owners and in the promotion of a free market economy in both Britain and Ireland. In fact, the Government believed so strongly in the economic principle of noninterference in trade that it allowed the export from Ireland of abundant supplies of meat and grain during all the Famine years.
–Donald Donovan Deignan, PhD
You got that right. As their children starved, Irish workers were forced to sell their crops or face eviction from their rich, absentee landlords. There was no safety net, only the life of a homeless refugee.
The Irish had been disadvantaged for a long time. The British occupied the best of their land and took the best of their crops, but they could and did get by on a cheap diet of potatoes and milk. When the potato crop suffered a catastrophic blight there was no alternate source of food unless foreign aid and debt forgiveness were put in place. At first, there was some crisis relief, but a new election brought a change in politics under ministers like Charles Trevelyan.
As Assistant Secretary to the Treasury [Trevelyan] was placed in charge of the administration of Government relief to the victims of the Irish Famine in the 1840s. In the middle of that crisis Trevelyan published his views on the matter. He saw the Famine as a “mechanism for reducing surplus population”. He described the famine as “The judgement of God sent the calamity to teach the Irish a lesson, that calamity must not be too much mitigated. The real evil with which we have to contend is not the physical evil of the Famine, but the moral evil of the selfish, perverse and turbulent character of the people”.
I don’t know if Trevelyan would have been so serene about the suffering and death of a million people on his watch if he hadn’t had the consolation of religion.
Governor Carcieri is also a religious person. Here’s from the Providence Journal.
Benefit dinner: The Mother of Life Center, of Providence, a nonprofit pro-life facility offering free counseling and testing services, and the Little Flower Home for unwed mothers, will host their annual Rose Dinner fundraiser at the West Valley Inn in West Warwick on Saturday, Nov. 10. Cocktails are at 6:30 and dinner at 7:30 p.m. The Governor and Mrs. Donald Carcieri are the honorary chairpersons. Tickets are $65 each, $120 for a couple, and $600 for a table of 10.
The Governor is dealing with a budget crisis, his Big Audit never turned up the zillions of dollars he promised to find. His response is to cut programs for children’s health, students, the elderly, schools, and families. When an after-school program is closed or a grandmother doesn’t get Meals on Wheels the middle class will feel the strain. The businessman’s response is to go for the short-term gain and hope to swing a deal, the politician’s response is to find a scapegoat.
“Frankly, I think from the state’s perspective we’ve been enabling and continue to enable a lot of bad decisions,” he said Sunday on WJAR-TV’s 10 News Conference. Asked to define ‘bad decisions’,he said: “Most of the people on our welfare programs are single women, unmarried with multiple children.”
“I think it is a bad decision to have children you can’t support–I am not making a moral judgment,” he said. “What I am saying is that we as taxpayers and citizens of the state are being asked to finance and support those decisions.”
Going a step further yesterday on WHJJ-radio’s Helen Glover Show, Carcieri said: “When I look at our rolls of people receiving ‘family-independence’ [benefits] whether it be RIte Care, whatever, the vast majority of these are women with children and they are not married and this is not a good situation.”
With all due respect to the Little Flower Home, I don’t think they can fill the gap left when hundreds of infants and children are thrown out of their health insurance. This Governor is one of the most callous and short-sighted we have ever had. He may think he’s channeling Ronald Reagan, but we’ve heard the ‘welfare queen–Murphy Brown’ routine before. All his sanctimony about welfare mothers isn’t fooling the elderly I work with, or the hard working home health aides who save the state money by keeping people out of the emergency room. It won’t fool the students who are trying to afford their tuition, or young people who are just one health emergency away from financial ruin.
The Monument dedication was an occasion for many eloquent speeches about the burden of poverty and the struggle of immigrants for a better life. Governor Carcieri’s absence was noted.
The Irish had every mark of the undeserving poor, and every virtue of the deserving poor. They came here just looking for a chance. In the twenty first century we still need to welcome immigrants, we still need to feed the hungry. We need to be true to the best of America and have faith in what we can be.