Healing Our Fractured Health Care

  • Fresh Medicine provides a compelling and rational solution to the mess we're in with health care. The author itemizes the steps we need to take to change the system for the better.

    Philip Bredesen is the Democratic governor of Tennessee. He claims we need to establish systems of care that are continually reviewed and upgraded by an independent monitoring body to ensure that they deliver best practices medicine. These systems would be paid for with a trust fund similar to the social security tax on workers. Each person would get a voucher to choose the system of care he or she felt would provide the best services to them.

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    Like with any insurance: younger people would pay in for older people and the poor would be subsidized by those of us making more money.

    Gone would be the days when our runaway health care spending was fueled by the overuse of risky and costly medical procedures that aren't effective and can harm people if not kill them.

    A basic plan would be established that is run by the government and employers could offer expanded services if they chose to.

    Do we really need to take out loans from China that our future generations will have to pay off just so we can pay for these risky surgeries and other procedures that aren't best practices medicine?

    Fresh Medicine makes sense. It is clearly thought out and the only truly sane approach to managing our health care costs. Yes, it will be a single payer system. Does that spook you? Would you rather the U.S. be leveraged to China for billions of dollars because our elected officials can't come together to agree on a solution that is as lucid and effective as the one Bredesen outlines in his book?

    The House voted to repeal the Affordable Health Care Act without creating a new bill to replace the law with a better version.  What this means to you as a person with an MHD (mental health diagnosis): you will be denied coverage for mental health visits under your employer's health insurance plan.

     

    We've rolled back progress so that health insurers can do the following once again:

    Deny coverage to people with pre-existing conditions.
    Terminate coverage for those who get sick.
    Deny coverage to women because they are pregnant.

    What's more:
    Seniors would lose new guarantees including free preventive care and lower cost prescription drugs.
    Parents would lose the ability to keep their adult children on their health care plans.
    Small business owners would lose tax credits that help them provide coverage for their workers.
    Workers would lose the freedom to change jobs without worrying about losing health care coverage.

    In Fresh Medicine Bredesen rightly argues that introducing economic tension into the health care marketplace is the only best way to keep down costs. Reducing the deficit was the straw man in instituting the current reform as the new Act actually incurred greater costs in the long-term.

    The author knows that the true unchecked cost is that our government doesn't negotiate the prices of prescription drugs like other countries do. The runaway cost of drugs is what will bankrupt the U.S.


  • The governor makes the case-as does The Treatment Trap-that unnecessary and risky, dangerous if not life-threatening treatments drive up the cost of health care.

    The high cost of disease management overshadows illness prevention in our health care as well. His doctor claimed Bredesen could take a cholesterol-lowering drug to reduce his high cholesterol and still be able to eat cheeseburgers. He decided to forego the French fries and nix the drug.

    As someone who hasn't eaten a cheeseburger in two years: I'm a big fan of these kinds of books.

    The governor also make the distinction that Americans believe in providing access to health care to the poor and others who can't afford it but we draw the line at the inequity between health plans: why should one person get his medical needs totally covered while others shoulder an unfair cost and have coverage that doesn't include everything?

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    You might claim people living in poverty can't afford to pay for treatment. The reality is: Medicaid is leveraged in debt to the tune of trillions.

    I agree that economic tension needs to be introduced into the health care market. It would winnow out the providers who are in it to make a buck and don't care about the harm they're inflicting on their patients with unnecessary treatments. The author understands that a $40K procedure is often the same as a $20K procedure.

    Imagine this: my friend refused to give up his Medicaid because he needed a new set of choppers-complete false teeth. Why should Medicaid pay $4,000 when it could pay $2,000 to the provider of the choppers?

    If I needed a new set of false teeth, my employer's health insurance would barely cover the cost.

    As long as there is a financial incentive to jack up prices, health care will remain costly. Also: the archaic system of billing per claim and having multiple people coordinate and process the individual claims is a great cost.

    The governor is no fan of the newly-created exchanges. He also criticizes the trend that health plans cover the costs of things previously not considered medical in nature. He doesn't want to pay for a woman's sleeping pills.
    Latuda-the new SZ drug now available in the U.S.-will be priced higher than its competitors like Zyprexa.

    We don't need to pay $14-per-pop for another pill.

    The drug company set that price because it knows Latuda has greater efficacy. So patients continue to be held hostage to the high cost of treatment.

    We should feel like lobsters now: steamed.

    The other book that is a must-read: The Treatment Trap talks about the overuse of risky and unnecessary surgeries and medical treatments that actually wreck your health or could even kill you. It doesn't sensationalize the topic: it draws on real people's accounts and some of them did not live to tell it in their own words.

    The reason this should raise a red flag in your mind is that we're billions of dollars in debt to China because the U.S. among other expenses like the unnecessary wars needs exorbitant amounts of money to pay for health care. Mind you: these risky medical treatments drive up the cost of health care.

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    Doctors who are in it for the money and want to make mortgage payments on their McMansions will regularly perform spinal fusion surgery that is not proven to be any more effective than other non-invasive back pain treatments.  Women are given hysterectomies that are not needed and yes, yes, yes, doctors recommend chemotherapy and other treatments for cancer that does not exist in the patient's body. Oh: and heart bypass surgeries and heart transplants that aren't always needed either are routinely recommended.

    Does this not make you angry that we don't have a single-payer health system? Now you see why I've made the claim in here that the health insurance reform didn't go far enough.

    As long as doctors are not held legally accountable for harming the patients they kill or wreck the lives of: these practices will continue. Yes: you read that right: 99 percent of the doctors who practice bad medicine are never brought up on charges of harm the only charge that sticks is that of fraud.

    Medicare and Medicaid services are the number-one hunting expedition for these corrupt doctors.

    As long as doctors have a financial incentive to perform these risky surgeries and treatments it will be business as usual in America. A single payer health system would reward the doctors who actually want to heal people. It would narrow the field of Lamborghini-driving specialists who get rich by recommending these practices.

    Go on the informed medical decisions web site to arm yourself with unbiased information.  It's the home of the Foundation for Informed Medical Decision Making and they have no financial incentive and do not recommend products or treatments.

    The horror stories in The Treatment Trap are real and all too frequent occurrences.


    Now: take it from me the U.S. should not have to go into debt to provide these risky and dangerous treatments.

    Have I alarmed you too much? This would be a good point at which to wind down, right?

    I'm not saying that surgery or treatment is never necessary. I gave you the web site link because the crucial difference is: informing yourself so that you can make better decisions. Most of the patients who discovered the real facts and real risks of certain treatments opted for less invasive and less costly procedures.

    I'll leave you with the number-one reason I'm a fan of universal health care as outlined by Bredesen: people with MHDs would always have health benefits even if we worked at paid jobs.  We wouldn't lose our health insurance if we decided we wanted to work.

     

    Now: with that being the ultimate truth: what's the resistance to a single payer system?

    I'd love to hear your comments.

Published On: February 20, 2011