Written by
There are two parties to blame: the drug companies and the insurance companies. The fact of the matter is, healthcare is simply not a commercial enterprise by nature and America's reluctance to see things otherwise has left enormous holes in the system where millions of people continue to fall. The drug companies focus on reactionary drugs rather than preventative because that's where the money is. Why is it ok for a drug company to spend hundreds of millions of dollars advertising a prescription drug? Isn't that money better spent on more research or - God Forbid - lowering the price of medicine? Is it not the doctor's duty to prescribe a drug anyways? The government should regulate this as they have with alchohol and cigarettes. This will be a step towards reducing costs of drugs and therfore insurance. The insurance companies have very slowly started moving towards preventative treatments but only for higher plans and mainly in baby steps such as gym credits and health coaches. This is a great start, however, we need to see more. I don't see universal healthcare as the solution as I know first hand that anything operated by the governement is incredibly slow and inneficient. However, regulation is key. I think that the government should set up a gov't sponsored insurance for those who don't qualify for affordable coverage. It would be very easy to fund, you simply require all the private ins companies to contribute a certain amount of money in relation to the number of people using the gov't system. This would result in fewer and smaller cracks in which people find themselves without insurance, and it would encouarage ins companies to find ways to insure those who they previously would not and lessen the load on the gov't ins option. The power to fix the healthcare crisis rests with Congress. Unfortunately for us, their plate is filled with too much muck to even think about fixing healthcare at the moment.
Nice response Leighton! I agree with your comment on prescription drug advertising, I have friends who are doctors, who tell me how hard it is to prescribe a different medication when a patient has gotten it into their mind they need a drug they saw in an ad on tv!
I also question universal healthcare to be the answer for us. And I agree fixing it rests squarely with congress, and yes their plate is full. One of the reasons I wrote the blog was to kick around the ideas for what change we want and what we would/should vote for! While congress works on the bailout bill, which I don't understand the attachment of 200M for rum growers in Puerto Rico(!?), I think it will give us time to determine what we value as solutions for healthcare. Elected officials will actually have to focus on the issues that face Americans and the effect the current financial crisis has on jobs and families here, and not terrorism and war.
Why is it that we always have to look at other countries as "doing the right thing." This is classic "the grass is always greener over the fence." The USofA has always been a country based upon freedom and liberty. It is not perfect but that is it's basic tennent, not royalty, not the worker or Marx or even Smith. We have blended our own version of a life worth living based upon several influential documents, whose fundemental belief is that people should live with freedom and liberty. Once you take those away we will be just like Europe or Japan or some other place.
Last I looked my neighbors were from South Africa, Canada and Germany. Guess it is not so bad here.
So move this philosphy to healthcare and you ask the question "who makes the decision to do a liver transplant for Mrs. Jones." Right now it might be an insurance company - which is only fair if the doctor and patient both get what they want - the new liver. So with socialized medicine who makes the decision? The goverment? Maybe it goes something like this:
Agent 1: "Should Mrs. Jones get the liver transplant?"
Agent 2: "I think so she is fairly young - 42 with teenagers."
Agent 1: "Well she is an alcoholic, you that right?"
Agent 2: "No didn't know that, she might destroy her new liver too. That is a waste."
Agent 1: "But she became an alcoholic after her husband, a marine, died in Iraq."
Agent 2: "Ohh, she is the widow of a veteran. I think she deserves it."
on and on and on.
It may be easy for Michael Moore to play God with his viewers and editing machine but real life is never so simple. "Which system is most fair?" is not the question I feel is most important to answer. "Which system best reflects the ideals and principles Americans consider most important, and has made the US the Earth's most influential country?" I say it is a capitalist system where the doctor makes the decision. One must remember that when doctors were not subject to such scrutiny and made the decisions about 20% of their work was gratis plus service was better (remember Dr. Wade making house calls in his little MG!) Today the highest growth areas in medicine are eye surgery and plastic surgery, which many times are not covered by insurance but done at the patient's decesion.
Hi Ann,
I'm glad that I stumbled upon your blog entry here. I blog over at the MultipleSclerosisCentral site, in addition to my own person blog.
The issue of health insurance is very important to me. Like you, I live in Virginia (within the DC Beltway). As a self-employed person, I purchased the very best insurance policy available to me in 2000. Healthy enough to pass the underwriting process, I acquired a PPO policy with Carefirst BCBS.
I was satisfied enough with this plan until being diagnosed with MS in 2005. My original paperwork indicated that the 10% coinsurance would kick in after reaching the $1500 prescription limit. NOT!!!
A major limitation of Individual health insurance plans (at least in our area) is in prescription coverage. Carefirst pays $1500 then stops. My MS drugs cost around $30,000 each year. That's a problem.
Ironically, I was interviewed on camera for Sicko but was edited out near final production in an attempt to get the film under 2 hours. Basically, my story centered around individal policies, limited prescription coverage, and huge gulleys in the current safety net systems. Bits of my story can be found here and here. I think Sicko would have made a different impact, if stories like my own had been kept in the film.
Anyways, just wanted to let you know I appreciate your post and wanted to share a tiny bit of my insurance story. Thanks.
Lisa
Lisa,
Thank you for sharing! It is another problem with health care coverage. As my husband said last night "the candidates are talking about portability across state lines how about portability across route 123!" BC/BS Anthem has a prescription drug policy more comprehensive then Carefirst, but we aren't eligible because we don't live in the right area to participate in the program.
Additionally, I have clients who are lobbyists for healthcare. Last year one of them took on a Pharmacists group that wanted to charge higher prices since the prescription drug plan that crossed pushed through a few years ago has tied up finances for the pharmacies. Under that policy, the pharmaceuticals pay pharmacies in one lump some at the end of the month and many small pharmacies struggle to make ends meet. This client lobbied to raise the prices to offset the problem for the pharmacies. It was thrown out of court. She is still being paid to work on behalf of pharmacists to raise prices.
Could this get anymore stupid?
The second part of this blog should go up today.
Again thank you for sharing with us Lisa!
Ann
E.F. (Fritz) Schumacher, an English economist, in his book "A Guide for the Perplexed", argued that there are two types of problems convergent and divergent. Convergent problems are those in which proposed solutions and experiments eventually converge on a single solution. Certain inventions show this evolution quite clearly, such as inventing a human powered vehicle or a heavier than air craft. Both the bicycle and the airplane went through many different phases and variations before settling on a common solution that looks much that same today as they did when invented.
A divergent problem as you can imagine does not settle on a single solution. They require accommodating irreconcilable things in ways that challenge our convictions. Divergent problems require us to know that what we believe can only be resolved by a higher level of reasoning grounded in goodness, beauty, and truth; all of which are subjective entities. In other words, solving a divergent problem is not going to be 2+2=4, or the square root of 2. Solving divergent problems first and foremost requires an honest and articulate discussion between honorable people. Just ask any parent or watch any movie about families to see divergent problem solving at work. Good luck with finding those honorable people.
Obviously health care in a society is a divergent problem. There is no single solution because every individual has different health needs and makes different lifestyle choices. It is similar to the discussion in education – Is it better to learn through discipline or freedom? Well that depends on the learner. Education researchers have been discussing this topic since Plato and there is no firm solution because the problem is divergent.
This is important to understand because governments can be good at convergent problems such as linking two communities (canals, railways or highways), bring technology to remote communities (rural electrification, post office and telephone), or other single focused problems (man on moon, Manhattan Project). Recent events show a convergent problem and resulting solution morphing into a divergent problem; the toppling of Saddam Hussein proved to be a convergent problem but the subsequent problem of building a nation has proved to be divergent. Governments tend to be poor solution providers for divergent problems which is why a "Manhattan Project" for health care is simply a waste of time.
Solving divergent problems in society is best accomplished by allowing individuals to make their choices and learn from the consequences of their decisions. In this way the government does not impose a solution but provides resources enabling the individual to carry out the decision making process towards a solution set best for them. Many governments use vouchers as a means to provide access to resources; a debate the USA is having right now with education and one that Sweden adopted years ago.
** Not just government - Insurance industry tries to provide a convergent solution to a divergent problem.
** Doctors trained in divergent problem analysis.
** Access to varied resources is crucial for solutions to divergent problems.
It seems that a first good step would be to increase competition by allowing consumers choice across state lines. As to the VA system...many patients/families that I speak to aren't exactly thrilled with that "choice." One disabled American (Iraqi) war vet's wife I recently spoke with said she hopes very much the rest of the country doesn't get the type of care they are having to "endure." There have been more negatives from patients than positives about the system mainly related to lack of responsiveness to patients with regard to needs, lack of attentiveness, and many have attributed this to it being the only place these folks have to go (they understand competition creates an environment for people to perform better). Our vets deserve better; our country deserves better than a beaurocratic mess. I used to decry the business end of healthcare, particularly after visiting over 80 nursing homes, 8 hospitals, many patients, and hearing healthcare business executives speak at my State's Capitol about how "healthcare and profit do not mix (!)" (one apparent concession by a for profit...for why, in theory, non profits should work better). I don't believe the answer lies with "socializing" the system. Give competition across state lines a go first. If we can purchase other items thus, why not something as important as healthcare insurance? Having worked in both for both governmental and for profit entities...I'd say give the private sector every chance to compete...plus increase accessiblity by doing away with those ineligibilities for coverage (as for type I diabetics). Tort reform also. Say it a gazillion times. Tort reform...caps on damages, tort reform!
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
Socialized medicine is inevitable- all the other industrialized countries do it, and have cheaper plans, more extensive coverage, and better outcomes. The US is good at treating disease, but a failure at disease prevention. And all the uproar about pinkos forcing you to go to a certain doctor is propaganda. Under socialized medicine, you can always opt out and buy your own coverage. The analogy to Wall Street is apt- the HMOs want no regulation, so that they can cover the healthy (and privatize the profits from their coverage), while abandoning the chronically ill, who are forced into medicare (socialized risk). And the HMOs crying cost while their CEOs takes millions out of the public health care fund is the same as the investment bank CEOs taking millions out of the public mortgage fund, while their banks demand a bailout. The bottom line is common sense: health care is NOT a business. The function of a healthcare system is to keep people healthy, not maximize profit while doing it.
"jogging shown to prevent health care indignation"- cute very cute!
So to play a little devil's advocate: Do you really think that socialized medicine will be an improvement? And what makes you have such blind faith in it?
No need to have faith- just look at the facts. We pay about twice as much for healthcare with no better empirical results. And it's not only about socialized medicine overseas. Our own socialized system, the VA, outperforms private plans as well. I'm forced to note the irony- McCain rails against socialized medicine even though he has been on socialized medicine his entire adult life!? So it seems to me that the "blind faith" of Americans in the HMO propaganda that our privatized health system is superior flies in the face of the facts- Americans pay the most (to private insurance company profits) and receive no better care, for far fewer citizens, and certainly no better prevention. But as I said, it doesn't really matter- socialized medicine is inevitable- it's the only tenable model to rein in cost. If you don't believe it, wait until the boomers hit their 70s- BIG time funding meltdown ala the Wall Street implosion. So the 'free market' system will have led to socialized banking and socialized healthcare!?
oops- sorry- 1st link is here
oh well, look under "socialized medicine" and look at the article "Rudy and socialized medicine" for the graphs