IT'S ALL OUR FAULT!
No, Debbie Stabenow did not say that it's all our fault. All she was trying to do was de-politicize the debate about healthcare. So she invited a bunch of industry executives to what was supposed to be a non-political discussion of her idea: Rather than setting up a Medicare for All plan, we should allow people 50-65 to buy into Medicare. You would think that this was -- politically speaking -- fairly tame, right? Apparently not so. In the Modern Healthcare March 30 issue...
...we read what went on at the meeting. We read of the assertion of Rick Pollack -- CEO of the American Hospital Association -- that there wasn't enough money in M4A to cover the cost of treating patients, some of whom would be denied care as a result of it.
Chip Kahn, CEO of the Federation of American Hospitals, said that the ACA shouldn't be abolished entirely, and asked, “Why do we want to turn everything upside down when we know we then open ourselves up to a whole new set of problems?”
The businessmen agreed that policy reforms could only go so far. Banner Health CEO Peter Fine said. “I don’t know how you manage cost in healthcare until you manage usage.”
Anthony Barrueta, senior vice president of government relations for Kaiser Health Foundation Health Plan. said "Countries like Australia and New Zealand are essentially willing to say no to manufacturers of exorbitantly priced drugs. “The question is whether we can build that kind of dynamic into the American system … or is it impossible because of our culture because people are never willing to say no? Healthcare’s problem is related to behavior, Fine said. Everyone wants what they want instantaneously. You can change a business model, but changing a culture is way more difficult,” he said.
In other words, according to them the high expense in healthcare is not because of the profit motive driving eight-figure salaries of the CEOs, and it's not because they have to keep shareholder dividends competitive to attract investors, not because of the inflated bureaucratic overhead or the costly TV advertising, certainly not because of all the money spent on bribing legislators to vote their way, -- no no! It is because too many people want healthcare. And those pesky people want it whenever they get sick! That can cut into profits drastically! The solution is to "manage usage," or in plain English, ration it, make it less accessible to people, so they'll be "encouraged" to seek medical care less often, resulting in less healthcare for them, and more money for the shareholders, the CEOs, and others high on the food chain who would like to feed on us undisturbed by the higher taxes which would surely result from every sick person being treated.
You see, dear reader, as these corporate big-wigs see it, the problem is not their greed.
The problem is us.
Dio
PS: If you'd like to leave a comment -- and I encourage you to do so -- simply click on the "number of comments" area, and share your thoughts in the "comment rectangle" that appears.
PPS: We know that there are plenty out there who have stories to tell -- stories of your trying to cope with our dysfunctional healthcare system. Trouble is, we don't know what these stories are! That's where you come in. If you have a story to tell, you can email me at indivisible12401@gmail.com. You can be as anonymous as you like. Thanks!
PPS: We know that there are plenty out there who have stories to tell -- stories of your trying to cope with our dysfunctional healthcare system. Trouble is, we don't know what these stories are! That's where you come in. If you have a story to tell, you can email me at indivisible12401@gmail.com. You can be as anonymous as you like. Thanks!
Let's face it...the priority is WEALTHCARE not healthcare.
ReplyDelete
ReplyDeleteThe NEW ENGLAND JOURNAL of MEDICINE
https://www.nejm.org/doi/full/10.1056/NEJM198010233031703
Special Article Archive
October 23, 1980
N Engl J Med 1980; 303:963-970
DOI: 10.1056/NEJM198010233031703
The New Medical-Industrial Complex
Arnold S. Relman, M.D.
10 References
313 Scholars Citing this work in their Articles
Abstract
The most important health-care development of the day is the recent, relatively unheralded rise of a huge new industry that supplies health-care services for profit.
WRITING IN 1980,Dr.Arnold S, Relman stated bluntly:
"A final concern is the one first emphasized by President Eisenhower in his warning about the
"military-industrial complex": "We must guard against the acquisition of unwarranted influence."
A private health-care industry of huge proportions could be a powerful political force in the country and could exert considerable influence on national health policy. A broad national health-insurance program, with the inevitable federal regulation of costs, would be anathema to the medical-industrial complex, just as a national disarmament policy is to
the military-industrial complex.
I do not wish to imply that only vested interests oppose the expansion of federal health-insurance programs (or treaties to limit armaments), but I do suggest that the political involvement of the medical-industrial complex will probably hinder rather than facilitate rational debate on national health-care policy."
He added:
"The new medical-industrial complex is now a fact of American life. It is still growing and is likely to be with us for a long time."
The private health-care industry is primarily interested in selling services that are profitable, but patients are interested only in services that they need, i.e., services that are likely to be helpful and are relatively safe.
"Furthermore, everything else being equal, society is interested in controlling total expenditures for health care,
whereas,
the private healthcare industry is interested in increasing its total sales."
(and he concluded with this statement):
"How best to ensure that the medical-industrial complex serves the interests of patients first and of its stockholders second will have to be the responsibility of the medical profession and an informed public."
The Hippocratic Oath — Corporate Version
ReplyDeleteThe New England Journal of Medicine (Archive) 1996:
This article has no abstract; only the first 100 words appear below.
To the Editor: Lecturing recently in our medical-ethics class, I discussed what I regard as the several good and important ethical sentiments of the Hippocratic oath. Some of the students expressed the opinion that the oath is so outdated it now has no relevancy.
Sadly, I turned to the task of devising this modernized version of the oath:
I swear by Humana and the American Hospital Supply Corporation and health maintenance organizations and preferred-provider organizations and all the prepayment systems and joint ventures, making them my witnesses, that I will fulfill according to my ability and judgment
this oath and . . .
January 2, 1986
N Engl J Med 1986; 314:62
DOI: 10.1056/NEJM198601023140122
https://www.nejm.org/doi/full/10.1056/NEJM198601023140122
IRONICALLY...you can Purchase this article
The Hippocratic Oath — Corporate Version
http://www.pbs.org/healthcarecrisis/history.htm
ReplyDelete1940s
Penicillin comes into use.
Prepaid group healthcare begins, seen as radical.
During the 2nd World War, wage and price controls are placed on American employers.
To compete for workers, companies begin to offer health benefits, giving rise to the employer-based system in place today.
President Roosevelt asks Congress for "economic bill of rights," including right to adequate medical care.
President Truman offers national health program plan, proposing a single system that would include all of American society.
Truman's plan is denounced by the American Medical Association (AMA) ,
and is called a Communist plot by a House subcommittee.
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1950s
At the start of the decade, national health care expenditures
are 4.5 percent of the Gross National Product.
Attention turns to Korea and away from health reform;
America will have a system of private insurance for those who can afford it
and welfare services for the poor.
Federal responsibility for the sick poor is firmly established.
Many legislative proposals are made for different approaches to hospital insurance,
but none succeed.
Many more medications are available now to treat a range of diseases, including infections, glaucoma, and arthritis, and new vaccines become available that prevent dreaded childhood diseases, including polio. The first successful organ transplant is performed..
---------------------------------------------------------------------------------------------
1960s
In the 1950s, the price of hospital care doubled.
Now in the early 1960s, those outside the workplace, especially the elderly,
have difficulty affording insurance.
Over 700 insurance companies selling health insurance.
Concern about a "doctor shortage" and the need for more "health manpower"
leads to federal measures to expand education in the health professions.
Major medical insurance endorses high-cost medicine.
President Lyndon Johnson signs Medicare and Medicaid into law.
"Compulsory Health Insurance" advocates are no longer optimistic'.
The number of doctors reporting themselves as full-time specialists
grows from 55% in 1960 to 69%.
President Richard Nixon renames prepaid group health care plans as health maintenance organizations (HMOs), with legislation that provides federal endorsement, certification,
and assistance.
Healthcare costs are escalating rapidly,
partially due to unexpectedly high Medicare expenditures,
rapid inflation in the economy,
expansion of hospital expenses and profits, and c
hanges in medical care including greater use of technology, medications, and conservative approaches to treatment.
American medicine is now seen as in crisis.
http://www.pbs.org/healthcarecrisis/history.htm
ReplyDelete1970s
President Nixon's plan for national health insurance
rejected by liberals & labor unions,
but his "War on Cancer" centralizes research at the NIH.
==================================================================================
1980s
Corporations begin to integrate the hospital system
(previously a decentralized structure),
enter many other healthcare-related businesses, and consolidate control.
Overall, there is a shift toward
privatization and corporatization of healthcare.
Under President Reagan, Medicare shifts
to payment by diagnosis (DRG) instead of by treatment.
Private plans quickly follow suit.
Growing complaints by insurance companies that
the traditional fee-for-service method of payment to doctors is being exploited.
"Capitation" payments to doctors become more common.
-----------------------------------------------------------------------------
ADD ON: NOT IN PBS ORIGINAL
"CAPITATION"
Word Origin and History for capitation
capitation
n.
1610s, "counting of heads," from Late Latin capitationem (nominative capitatio ),
noun of action from past participle stem of a verb derived from caput "head" (see capitulum).
Meaning "levying of a poll tax" is from 1640s.
Capitation definition, a numbering or assessing by the head;
a poll tax.
a fee or payment of a uniform amount for each person.
Nearby words
capitalize; capitalized;capitaliztion:
: a capitated health-care system
A type of a health care payment system in which a doctor or hospital is paid a fixed amount per patient for a prescribed period of time by an insurer or physician association. A capitated contract is a healthcare plan that allows payment of a flat fee for each patient it covers. Under a capitated contract, an HMO or managed care organization pays a fixed amount of money ...
PREMISE:
1) Capitation, at its best, both improves health care and cuts costs.
— Adam Davidson, The New Yorker, "A Bipartisan Way to Improve Medical Care,"
29 May 2017
DISCOVERY:
2) The law was poorly written, and led to a proliferation of H.M.O.s that failed to cut costs
and deprived people of care, putting many off the idea of capitation.
— Adam Davidson, The New Yorker, "A Bipartisan Way to Improve Medical Care,"
29 May 2017
https://www.newyorker.com/magazine/2017/05/29/a-bipartisan-way-to-improve-medical-care
Adam Davidson, The New Yorker, "A Bipartisan Way to Improve Medical Care,"
29 May 2017
A proliferation of "H.M.O.s failed to cut costs and deprived people of care."
https://www.dictionary.com/browse/capitation
https://www.merriam-webster.com/dictionary/capitation
https://www.investopedia.com/terms/c/capitation-payments.asp
https://www.investopedia.com/terms/c/capitated-contract.asp
=====================================================
1990s
FACTCHECK:
Health care costs rise at double the rate of inflation.
Expansion of managed care helps to moderate increases in health care costs.
Federal health care reform legislation
fails again to pass in the U.S. Congress.
By the end of the decade there are 44 million Americans,
16 % of the nation, with no health insurance at all.
Human Genome Project to identify all of the more than 100,000 genes in human DNA gets underway.
By June 1990, 139,765 people in the United States have HIV/AIDS,
with a 60 percent mortality rate. .
Health care costs are on the rise again.
Medicare is viewed by some as unsustainable under the present structure
and must be "rescued".
Changing demographics of the workplace lead many to believe
the employer-based system of insurance can't last.
Direct-to-consumer advertising for pharmaceuticals
and medical devices is on the rise.
https://www.pbs.org/healthcarecrisis/healthinsurance.html
ReplyDeleteHealth Insurance
"Compulsory sickness insurance...is a variety of socialized medicine or state medicine and possesses the evils inherent in any politically controlled system. It is contrary to American tradition and is the first and most dangerous step in the direction of complete state socialism. The American Medical Association rejects any such scheme as a method of the distribution of medical care."
- Editorial from The Journal of the American Medical Association, Dec. 1948
https://www.pbs.org/healthcarecrisis/healthinsurance.html
ReplyDelete"How much does health insurance cost? The cost of health insurance has increased dramatically over the past decade, far surpassing the general rate of inflation in most years. Between 1989 and 1996, the average amount an employee had to contribute for family coverage jumped from $935 to $1,778. In 1990, American companies spent $177 billion on health benefits for workers and their dependents; that number rose to $252 billion by 1996, or more than double the rate of inflation.
Who pays for the rising costs of health insurance? Employees, consumers and taxpayers pay. Businesses pass along a portion of rising premiums to their workforces in the form of lower wage increases. Companies add the cost of the fringe benefits, including health insurance, to the price of their products and services. Government programs pay 47 percent of the health care tab in the U.S.; spending on health care makes up 20 percent of the federal budget, and most state budgets too. If you paid $5,000 in taxes last year, around $1,000 went to health care programs. (source: http://www.nchc.org)"
Gail R. Wilensky, PhD
ReplyDeleteWhat are some of the dangers we're facing now?
https://www.pbs.org/healthcarecrisis/Exprts_intrvw/g_wilensky.htm
" I don't know very many people who would today advocate starting an employer-based insurance system. Economists, such as myself, believe that the employer contribution is just part of the compensation package which would otherwise go to the employee. So it's really the employee's money that the employer is spending. They do so because of tax provisions that encourage part of the compensation to be provided as this kind of fringe benefit. It tends to have the employee think it's free and not care about what happens."
http://www.pbs.org/programs/money-medicine/
ReplyDelete"The Affordable Care Act that the Supreme Court recently upheld extends health care coverage to over 30 million uninsured Americans but actually does very little to make health care affordable. Since 1970, health care spending has grown 9.8% annually, more than twice the rate of inflation. Medical costs now consume 17.3% of our gross domestic product. That’s $8,086 for every American or about twice as much per capita as most developed countries spend. Although we pay more for medical care than any other country, America currently ranks 19th in the world in preventable death, 26th in life expectancy, and 31st in infant mortality."
"The trillion-dollar question is how can we reduce unnecessary medical spending so that we can afford to provide affordable, high quality health care to all Americans?"
ReplyDeleteMedicare for All Divides Democrats but Might Unite the Nation
April 15, 2019 Interview excerpt from the Real News Network Podcast transcript
Share: https://therealnews.com/stories/medicare-for-all-divides-democrats-but-might-unite-the-nation
Michael Lighty speaks on Sanders' Medicare for All bill, the corporate-fueled war inside the Democratic Party, and the battle for American minds
MARC STEINER
[00:12:06] MARC STEINER So finally, the last question you’ll hear on this issue for today anyway, Michael, is if Medicare for all becomes one of the key platforms of the Democrats in the coming election. In the general election, if that actually happens, then you’re going to set up a battle royale again in this general election and the Republicans will, all the insurance care money, industry money, will be focused on defeating this candidate and this idea. So it becomes a question of perception and how you sell it and that to me will be key whatever happens in this election— beyond all the politics, ideology, and analysis.
MICHAEL LIGHTY
[00:12:41] MICHAEL LIGHTY That’s right. I think you’re exactly right, Marc. Here’s the problem. We have to make sure that any politician wanting to promote Medicare Extra, or Medicare for America, or some other scheme, that uses our tax dollars to subsidize private insurance, therefore must defend the practices of that industry: the denials of care; the $66 million that the United Health CEO earns annually; the $35 billion in profit the private insurers earned last year. You have, if you’re going to say I want to keep private insurance, then defend it. And those practices frankly, are indefensible from my point of view, but that’s what’s kind of defined the politics of this debate. Which side are you on— the profit and model of the private insurers, or guaranteeing healthcare for all people in this country? That to me is a debate we can win."