by L.A.S.
When Minnesotan Bob McIntosh moved to Victoria, British Columbia, two years ago, he expected long waits for medical attention. But to his surprise, he was shown to a doctor's office after only 20 minutes in the waiting room of a local walk-in clinic.
Service was not only fast but friendly. The building is less imposing than most facilities in the U.S., and clinic rooms might be described as spartan. Yet patients can depend on everything that counts where medical services are concerned, and so it merits serious consideration as a basis for an American plan.
Contrary to what most sources would have you believe, the coverage is not exactly free and excludes some allied health services.
Mr. McIntosh reports that Canadians there pay a monthly premium of just $100. That premium is waived for those who cannot afford it. The national health plan, called Medicare, does include clinic visits, annual checkups, and most lab work. Not covered are a PSA test ($30), eyeglasses, dental care, acupuncture, physiotherapy, massage, chiropractic, non-surgical podiatry, and the like.
The Medicare program is administered by the provinces. That means if a resident of British Columbia travels to another province or country, he needs supplemental insurance. McIntosh found such a plan for another $88 a month, but many people get such coverage provided by their employers.
Why can't the powers-that-be in this country accept the irresistible logic of a national healthcare plan? Perhaps they like seeing huge, luxurious hospital wings with their names on a plaque up front. And they like even better the large inflow of money each month from insurance policyholders and annual bonuses for denying medical care to those who need it.
Showing posts with label national health care. Show all posts
Showing posts with label national health care. Show all posts
Sunday, September 27, 2009
Monday, August 24, 2009
Health Co-ops Are Making Medicine Fun Again
by L.A.S.
Another option when it comes to dispensing health care is the health co-op, where the patient members are in control of the entity.
One example is the Group Health Cooperative in Oregon. It was created way back in 1947 by farmers and loggers who pooled their resources to cover the most basic primary care. Since that time, the co-op has grown to over a half million members, the third largest insurer in Oregon.
It operates similar to an HMO. It has premiums and co-pays. Patients have to see providers who are in the network. Doctors work for the company and are paid a salary. This means they are not forced to cram twenty or more patients into their daily schedules.
They have more time with each patient and can be more proactive.
One of the great features of the Oregon co-op is that they have invested in electronic medical records which reduces errors, enables doctors to coordinate care, and also lets patients check their charts online. Whether it was this innovation or the emphasis on primary care, the result has been a drop in emergency room costs by 29 percent.
But replicating the success of Group Health is a real challenge. Many health care co-ops were born in the Great Depression and folded later when government funding was withdrawn.
However, HHS Cabinet Secretary Kathleen Sebelius has signaled that the Obama administration might support the idea of co-ops as an option to reduce the cost of health care.
It is an option worth serious consideration, even with all the challenges of starting one from the ground up.
An article on health co-ops ran in USA Today and you may read it here: http://www.usatoday.com/money/industries/health/2009-08-20-group-health-insurance_N.htm
Another option when it comes to dispensing health care is the health co-op, where the patient members are in control of the entity.
One example is the Group Health Cooperative in Oregon. It was created way back in 1947 by farmers and loggers who pooled their resources to cover the most basic primary care. Since that time, the co-op has grown to over a half million members, the third largest insurer in Oregon.
It operates similar to an HMO. It has premiums and co-pays. Patients have to see providers who are in the network. Doctors work for the company and are paid a salary. This means they are not forced to cram twenty or more patients into their daily schedules.
They have more time with each patient and can be more proactive.
One of the great features of the Oregon co-op is that they have invested in electronic medical records which reduces errors, enables doctors to coordinate care, and also lets patients check their charts online. Whether it was this innovation or the emphasis on primary care, the result has been a drop in emergency room costs by 29 percent.
But replicating the success of Group Health is a real challenge. Many health care co-ops were born in the Great Depression and folded later when government funding was withdrawn.
However, HHS Cabinet Secretary Kathleen Sebelius has signaled that the Obama administration might support the idea of co-ops as an option to reduce the cost of health care.
It is an option worth serious consideration, even with all the challenges of starting one from the ground up.
An article on health co-ops ran in USA Today and you may read it here: http://www.usatoday.com/money/industries/health/2009-08-20-group-health-insurance_N.htm
Saturday, July 25, 2009
The Truth Comes Out About Insurers Fighting National Healthcare for Years
The truth has come out at last about how the big insurers mounted large campaigns to defeat previous attempts to institute a national healthcare plan. If you have not seen or read Bill Moyers' interview with Wendell Potter, a former exec with Cigna health care, then go there now.
Mr. Potter tells of how he finally had an epiphany in mid-2007, after years of working for Cigna. "I was beginning to question what I was doing as the industry shifted from selling primarily managed care plans, to what they refer to as consumer-driven plans. And they're really plans that have very high deductibles, meaning that they're shifting a lot of the cost off health care from employers and insurers, insurance companies, to individuals. And a lot of people can't even afford to make their co-payments when they go get care, as a result of this. But it really took a trip back home to Tennessee for me to see exactly what is happening to so many Americans."
He heard about a health care expedition that was being held down the road, while he visited relatives back in Wise, Virginia. He decided to go there, and take pictures. He had no idea what he would see, but he had a vague idea that it would be a public clinic for people without insurance.
What he saw were people being treated in animal stalls at a Wise County Fairground. Some patients were on gurneys. People had come from miles around, from Georgia, Kentucky, South Carolina, Tennessee. "There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me. It was absolutely stunning. It was like being hit by lightning. It was almost-- what country am I in? I just it just didn't seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me."
Nevertheless, Potter did not know what to do about the fact that real human beings had no health care access.
Potter also related what happened when the film "Sicko", by Michael Moore, came out. He saw the film himself and felt that Moore was pretty accurate in depicting the situation as it really is. However, he participated in the industry effort to dampen political reaction to the film for fear that it would fuel a real effort to institute a national health care plan.
(from the interview)
BILL MOYERS: And there was a political strategy. "Position Sicko as a threat to Democrats' larger agenda." What does that mean?
WENDELL POTTER: That means that part of the effort to discredit this film was to use lobbyists and their own staff to go onto Capitol Hill and say, "Look, you don't want to believe this movie. You don't want to talk about it. You don't want to endorse it. And if you do, we can make things tough for you."
BILL MOYERS: How?
WENDELL POTTER: By running ads, commercials in your home district when you're running for reelection, not contributing to your campaigns again, or contributing to your competitor.
This is the truth about why, in spite of poll after poll that shows the majority of Americans favor a national healthcare program, we still have none and Europe and other countries have had national healthcare for nearly a century.
The full story and links to more is at Moyers' PBS website, at http://www.pbs.org/moyers/journal/07102009/watch2.html
You can also view Wendel Potter's congressional testimony online or read the text. At Commerce Dept. site on dot gov: http://commerce.senate.gov/public/index.cfm?FuseAction=Hearings.LiveStream&Hearing_id=6f02dcc8-ad5b-445c-81ca-36c9b06ebdd5
In addition, the Frank Lutz memo strategizing opposition to health care reform Bill Moyers mentions in the interview. -- RAN in Politico: www.politico.com/static/PPM116_luntz.html
Mr. Potter tells of how he finally had an epiphany in mid-2007, after years of working for Cigna. "I was beginning to question what I was doing as the industry shifted from selling primarily managed care plans, to what they refer to as consumer-driven plans. And they're really plans that have very high deductibles, meaning that they're shifting a lot of the cost off health care from employers and insurers, insurance companies, to individuals. And a lot of people can't even afford to make their co-payments when they go get care, as a result of this. But it really took a trip back home to Tennessee for me to see exactly what is happening to so many Americans."
He heard about a health care expedition that was being held down the road, while he visited relatives back in Wise, Virginia. He decided to go there, and take pictures. He had no idea what he would see, but he had a vague idea that it would be a public clinic for people without insurance.
What he saw were people being treated in animal stalls at a Wise County Fairground. Some patients were on gurneys. People had come from miles around, from Georgia, Kentucky, South Carolina, Tennessee. "There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me. It was absolutely stunning. It was like being hit by lightning. It was almost-- what country am I in? I just it just didn't seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me."
Nevertheless, Potter did not know what to do about the fact that real human beings had no health care access.
Potter also related what happened when the film "Sicko", by Michael Moore, came out. He saw the film himself and felt that Moore was pretty accurate in depicting the situation as it really is. However, he participated in the industry effort to dampen political reaction to the film for fear that it would fuel a real effort to institute a national health care plan.
(from the interview)
BILL MOYERS: And there was a political strategy. "Position Sicko as a threat to Democrats' larger agenda." What does that mean?
WENDELL POTTER: That means that part of the effort to discredit this film was to use lobbyists and their own staff to go onto Capitol Hill and say, "Look, you don't want to believe this movie. You don't want to talk about it. You don't want to endorse it. And if you do, we can make things tough for you."
BILL MOYERS: How?
WENDELL POTTER: By running ads, commercials in your home district when you're running for reelection, not contributing to your campaigns again, or contributing to your competitor.
This is the truth about why, in spite of poll after poll that shows the majority of Americans favor a national healthcare program, we still have none and Europe and other countries have had national healthcare for nearly a century.
The full story and links to more is at Moyers' PBS website, at http://www.pbs.org/moyers/journal/07102009/watch2.html
You can also view Wendel Potter's congressional testimony online or read the text. At Commerce Dept. site on dot gov: http://commerce.senate.gov/public/index.cfm?FuseAction=Hearings.LiveStream&Hearing_id=6f02dcc8-ad5b-445c-81ca-36c9b06ebdd5
In addition, the Frank Lutz memo strategizing opposition to health care reform Bill Moyers mentions in the interview. -- RAN in Politico: www.politico.com/static/PPM116_luntz.html
Kucinich Supports Single-Payer Plan
by L.A.S.
With all the news coming out of Washington this week regarding Obama's national health care proposal, it is difficult to focus on just one or two threads for an article or discussion. But one major thread is that Dennis Kucinich is again taking the lead regarding national healthcare, and has come out in support of a single-payer plan.
The alternative news site AlterNet has been very enthusiastic about his version of healthcare reform. You may read their article here: www.alternet.org/blogs/politics/141404/how_dennis_kucinich_may_save_the_health_reform_battle/
Kucinich would allow states to create their own single-payer programs. This is a positive step. However, in the current economic climate, I doubt that many states are in any shape to start up a new public benefit program. Some states, like California, are dropping eligible people from the public healthcare programs that they already have.
Perhaps Obama's plan is meant merely as a transitional phase from the present multi-payer, all-private (except for Medicare) situation to a true single-payer plan such as one finds in many European countries and Canada. I could live with that, but I think that the insurance companies are bound and determined to avoid covering the people that they do not want: those who have pre-existing conditions, and those who run up large bills.
We saw when Medicare first was rolled out as a result of the President Johnson initiative under his "Great Society" programs, that the insurance companies could not dump the seniors fast enough. In fact, they terminated policyholders even before they had been formally enrolled into Medicare! Let us hope that someone has thought to insert verbiage to prevent a similar fiasco this time around.
One approach to reducing the cost of medical care that is not used enough is to manage cases for improved drug therapy (and other management of chronic conditions) so that patients spend fewer days in the hospital. This requires a progressive attitude!
One may read a rather long article on the Nursing Center website about interventions with high-risk or at-risk families on Medicaid, or on a public health plan in other countries. Typically, visiting nurses make regular home visits and help to educate parents and monitor the progress of children in the studies. Overall, such intervention returns about $17,000 per family in the program (they take into account not only hospitalizations that have been avoided, but also crime and domestic violence, and other costs to society: "Cost-benefit analysis of the NFP reveals that there is a $17000 return to society for each family served by the program.13 These benefits were calculated on the basis of the program's impact on societal outcomes such as crime, substance abuse, teen pregnancy, child abuse and neglect, and domestic violence.")
Let's hope that such relatively low-cost interventions will be the norm, and produce better management of childhood asthma and other chronic conditions.
With all the news coming out of Washington this week regarding Obama's national health care proposal, it is difficult to focus on just one or two threads for an article or discussion. But one major thread is that Dennis Kucinich is again taking the lead regarding national healthcare, and has come out in support of a single-payer plan.
The alternative news site AlterNet has been very enthusiastic about his version of healthcare reform. You may read their article here: www.alternet.org/blogs/politics/141404/how_dennis_kucinich_may_save_the_health_reform_battle/
Kucinich would allow states to create their own single-payer programs. This is a positive step. However, in the current economic climate, I doubt that many states are in any shape to start up a new public benefit program. Some states, like California, are dropping eligible people from the public healthcare programs that they already have.
Perhaps Obama's plan is meant merely as a transitional phase from the present multi-payer, all-private (except for Medicare) situation to a true single-payer plan such as one finds in many European countries and Canada. I could live with that, but I think that the insurance companies are bound and determined to avoid covering the people that they do not want: those who have pre-existing conditions, and those who run up large bills.
We saw when Medicare first was rolled out as a result of the President Johnson initiative under his "Great Society" programs, that the insurance companies could not dump the seniors fast enough. In fact, they terminated policyholders even before they had been formally enrolled into Medicare! Let us hope that someone has thought to insert verbiage to prevent a similar fiasco this time around.
One approach to reducing the cost of medical care that is not used enough is to manage cases for improved drug therapy (and other management of chronic conditions) so that patients spend fewer days in the hospital. This requires a progressive attitude!
One may read a rather long article on the Nursing Center website about interventions with high-risk or at-risk families on Medicaid, or on a public health plan in other countries. Typically, visiting nurses make regular home visits and help to educate parents and monitor the progress of children in the studies. Overall, such intervention returns about $17,000 per family in the program (they take into account not only hospitalizations that have been avoided, but also crime and domestic violence, and other costs to society: "Cost-benefit analysis of the NFP reveals that there is a $17000 return to society for each family served by the program.13 These benefits were calculated on the basis of the program's impact on societal outcomes such as crime, substance abuse, teen pregnancy, child abuse and neglect, and domestic violence.")
Let's hope that such relatively low-cost interventions will be the norm, and produce better management of childhood asthma and other chronic conditions.
Tuesday, June 30, 2009
A Must-Read from Mother Jones on Healthcare Proposal
Not as lengthy as some of the more important Mother Jones articles, but nevertheless it was very insightful.
Please click this link to an article titled: Congress's $1.2 Million a Day Drug Habit—and Pharma's Phony "Gift" to Health Care Reform at http://www.motherjones.com/mojo/2009/06/pharmas-phony-gift-seniors
Many seniors on the Medicare Part D plan go on generics as they enter the "donut" phase of the plan -- and never go back onto the brand-name drugs after exiting the donut.
Under this proposed plan seniors may decide they are better off staying with the brand name drug through the whole year. Big Pharma will like that.
Please click this link to an article titled: Congress's $1.2 Million a Day Drug Habit—and Pharma's Phony "Gift" to Health Care Reform at http://www.motherjones.com/mojo/2009/06/pharmas-phony-gift-seniors
Many seniors on the Medicare Part D plan go on generics as they enter the "donut" phase of the plan -- and never go back onto the brand-name drugs after exiting the donut.
Under this proposed plan seniors may decide they are better off staying with the brand name drug through the whole year. Big Pharma will like that.
Sunday, June 28, 2009
Some States Already Refusing National Healthcare
Arizona is one state that has made it clear it wants no part of a national healthcare plan. It has refused other federal programs before, so this is not a sudden policy change.
EXCERPT: Right on the heels of a successful state-by-state nullification of the 2005 Real ID act, the State of Arizona is out in the forefront of a growing resistance to proposed federal health care legislation.
This past Monday, the Arizona State Senate voted 18-11 to concur with the House and approve the Health Care Freedom Act (HCR2014). This will put a proposal on the 2010 ballot which would constitutionally override any law, rule or regulation that requires individuals or employers to participate in any particular health care system.
HCR2014, if approved by voters next year, also would prohibit any fine or penalty on anyone or any company for deciding to purchase health care directly. Doctors and health care providers would remain free to accept those funds and provide those services.
Finally, it would overrule anything that prohibits the sale of private health insurance in Arizona.
Five other states — Indiana, Minnesota, New Mexico, North Dakota and Wyoming — are considering similar initiatives for their 2010 ballots.
You may read the whole article at this forum page: http://usfreestar.newsvine.com/_news/2009/06/26/2972841-arizona-hcr2012-national-health-care-nullification -- We has lots of good discussions on this site so you might want to browse awhile.
EXCERPT: Right on the heels of a successful state-by-state nullification of the 2005 Real ID act, the State of Arizona is out in the forefront of a growing resistance to proposed federal health care legislation.
This past Monday, the Arizona State Senate voted 18-11 to concur with the House and approve the Health Care Freedom Act (HCR2014). This will put a proposal on the 2010 ballot which would constitutionally override any law, rule or regulation that requires individuals or employers to participate in any particular health care system.
HCR2014, if approved by voters next year, also would prohibit any fine or penalty on anyone or any company for deciding to purchase health care directly. Doctors and health care providers would remain free to accept those funds and provide those services.
Finally, it would overrule anything that prohibits the sale of private health insurance in Arizona.
Five other states — Indiana, Minnesota, New Mexico, North Dakota and Wyoming — are considering similar initiatives for their 2010 ballots.
You may read the whole article at this forum page: http://usfreestar.newsvine.com/_news/2009/06/26/2972841-arizona-hcr2012-national-health-care-nullification -- We has lots of good discussions on this site so you might want to browse awhile.
How Would Your Life Be Different if We Had National Healthcare?
A provocative article ran recently in the pages of AlterNet regarding the writer's experience living in Canada for a while. Her five years in Canada were a real eye-opener in how a healthcare system could work, sparing people the economic drain of continual insurance and medical bills.
She wrote:
This was one of the things that struck me hardest when I arrived in Canada five years ago. The swamp-blindness was so dark and deep that it took a while to adjust to a world without alligators. It's almost impossible to describe to folks back home how different life is when health insurance simply doesn't factor at all into how you choose to live your life. There's almost no language for it. Rather than even attempt it, I sometimes just ask my American friends and relatives to open up their imaginations, and answer the question for themselves:
* How would your life be different if you never had to worry about getting, keeping, or affording health care again?
* What other choices might you have made?
* Where else would you be right now?
* How would it change your plans for the future?
You can read the whole article here at http://www.alternet.org/healthwellness/140918/what_did_you_sacrifice_to_afford_health_care_/?page=entire -- AlterNet is a wonderful website with many such interesting and provocative articles. I hope you like it.
She wrote:
This was one of the things that struck me hardest when I arrived in Canada five years ago. The swamp-blindness was so dark and deep that it took a while to adjust to a world without alligators. It's almost impossible to describe to folks back home how different life is when health insurance simply doesn't factor at all into how you choose to live your life. There's almost no language for it. Rather than even attempt it, I sometimes just ask my American friends and relatives to open up their imaginations, and answer the question for themselves:
* How would your life be different if you never had to worry about getting, keeping, or affording health care again?
* What other choices might you have made?
* Where else would you be right now?
* How would it change your plans for the future?
You can read the whole article here at http://www.alternet.org/healthwellness/140918/what_did_you_sacrifice_to_afford_health_care_/?page=entire -- AlterNet is a wonderful website with many such interesting and provocative articles. I hope you like it.
Wednesday, April 8, 2009
An E.R. doc makes a documentary prescribing tough medicine for "Our Ailing Healthcare System"
(reprinted by permission of Minnie Apolis, from her Newsvine column)
A documentary made by an emergency room physician would seem have an edge at giving viewers an up-close look at the pressures faced by doctors from insurance and drug companies. And this film, titled Health, Money and Fear by Dr. Paul Hochfeld is an intelligent and incisive analysis of the myriad problems facing the healthcare industry in the United States.
The documentary is ninety minutes of well-done analysis and interviews with physicians and other health care professionals about the reasons why healthcare costs are out of control. The list includes:
*Insurance and Administrative Expenses: Processing costs eat up too many healthcare dollars and are inefficient.
*Malpractice Issues: Fear of being sued leads most doctors to order unnecessary tests just to cover themselves.
*Medical Records Chaos: Paper records are prone to errors and are not shared in a timely fashion with emergency or other providers.
*Pharmacy Costs: Pharmaceutical companies claim that drug prices are high because they need to recoup research expenses, yet marketing expenditures are twice what is spent on research.
*End of Life Care: If an elderly person develops a grave illness like a brain tumor, should we spend a half million to a million dollars on surgery and therapy, or just make them comfortable?
*Primary Care Crisis: The lack of new doctors going into primary care means that no one is encouraging positive lifestyle changes that could keep symptoms from becoming chronic diseases.
And the completely rational proposals to solve each of these problems are:
*Adopt a Single-Payer Health Plan
*Liability Reform
*Electronic Medical Records
*Disallow Mass Marketing of Prescription Drugs
*Public Education
*Funding of Primary Care
Stay tuned to the end of the DVD where the single-payer plan is compared to a Prom Committee that can negotiate better prices, and more efficiently, than many payers each trying to contract for different services from a plethora of providers.
More information on the Single-Payer plan is available online at: Health Care Meltdown by Bob Lebow from Amazon.com, Single-Payer FAQ from pnhp.org/facts/singlepayer_faq.php, and Campaign for a National Health Program at cnhpnow.org.
The 48-minute DVD, Health, Money and Fear is by Dr. Paul Hochfeld and produced by Dr. Graham Walker. It is dated February 2009. Dr. Hochfeld can be reached at phochfeld @ msn.com. More information is available at ourailinghealthcare.com.
A documentary made by an emergency room physician would seem have an edge at giving viewers an up-close look at the pressures faced by doctors from insurance and drug companies. And this film, titled Health, Money and Fear by Dr. Paul Hochfeld is an intelligent and incisive analysis of the myriad problems facing the healthcare industry in the United States.
The documentary is ninety minutes of well-done analysis and interviews with physicians and other health care professionals about the reasons why healthcare costs are out of control. The list includes:
*Insurance and Administrative Expenses: Processing costs eat up too many healthcare dollars and are inefficient.
*Malpractice Issues: Fear of being sued leads most doctors to order unnecessary tests just to cover themselves.
*Medical Records Chaos: Paper records are prone to errors and are not shared in a timely fashion with emergency or other providers.
*Pharmacy Costs: Pharmaceutical companies claim that drug prices are high because they need to recoup research expenses, yet marketing expenditures are twice what is spent on research.
*End of Life Care: If an elderly person develops a grave illness like a brain tumor, should we spend a half million to a million dollars on surgery and therapy, or just make them comfortable?
*Primary Care Crisis: The lack of new doctors going into primary care means that no one is encouraging positive lifestyle changes that could keep symptoms from becoming chronic diseases.
And the completely rational proposals to solve each of these problems are:
*Adopt a Single-Payer Health Plan
*Liability Reform
*Electronic Medical Records
*Disallow Mass Marketing of Prescription Drugs
*Public Education
*Funding of Primary Care
Stay tuned to the end of the DVD where the single-payer plan is compared to a Prom Committee that can negotiate better prices, and more efficiently, than many payers each trying to contract for different services from a plethora of providers.
More information on the Single-Payer plan is available online at: Health Care Meltdown by Bob Lebow from Amazon.com, Single-Payer FAQ from pnhp.org/facts/singlepayer_faq.php, and Campaign for a National Health Program at cnhpnow.org.
The 48-minute DVD, Health, Money and Fear is by Dr. Paul Hochfeld and produced by Dr. Graham Walker. It is dated February 2009. Dr. Hochfeld can be reached at phochfeld @ msn.com. More information is available at ourailinghealthcare.com.
Saturday, August 30, 2008
Maybe a French-style National Healthcare System Might Be More Compatible With Ours?
A proposal for a Canada-style healthcare system has been floundering around our Congress for several months, (Rep. John Conyers National Health Insurance Act --HR 676) but shouldn’t we ask if a French-style system might be a less disruptive solution?
Let me compare the Canadian and French systems briefly --
Canada has a SINGLE-PAYER system, in which the government pays the bills according to a fee structure it negotiated with health care providers. Patients can still choose their own doctor. The doctor in turn may be either paid by the government or in private practice. (Patients who are in a hurry might choose a private-pay doctor; the government physicians are often overworked and months-long delays to get an appointment are common.) The United States’ Medicaid and Medicare are most similar to single-payer systems.
By contrast, in the British style of socialized medicine, the doctors are actually government employees. Hospitals are run by the government. Hospitals are run comparable to the Veterans Administration. Given the repeated VA scandals in healthcare and hospital conditions, one would much prefer any private hospital over the VA. This is a sad thing to say, although to be fair, the VA facilities are just showing their age and need a great deal of renovation.
The French system is called a non-profit MULTI-PAYER. Clinics and hospitals are all private, and may be either non-profit or for profit. Medical providers are paid according to a negotiated fee structure. The funds come from payroll contributions from both employers and employees.
This is somewhat similar to what we have now in the private sector. A major difference is that the French government has far better leverage in negotiating what the fees are than any single employer has, and unlike the U.S. federal government, it uses that leverage.
French payroll taxes replenish a sickness fund which covers 75% of the medical bills. The balance comes from patients, government and supplementary insurance.
Coverage is universal under all three templates -- British, Canadian, and French. By contrast, the current American system has nearly 50 million of us completely uninsured -- 9 million of the uninsured are children.
The patient has the ultimate power to choose his or her doctor under all three plans displayed here. Popular American plans commonly limits our choice of providers to those who are part of a given network.
The average cost of medical care per Briton is $2,389, and the average Briton ranks 24th on WHO‘s health ranking. For a Canadian it is $2,989, and he ranks 35th. For a Frenchman it comes to $2,902, who marches all the way up to 4th on WHO‘s list. And for an American, it comes to a whopping $5,711, and in return for that, he places 72nd on WHO’s ranking.
Recent years have seen several so-called reforms, with limited results. In 2004, consumers were given the option to create Health Savings Accounts. These allow pre-tax dollars to be set aside for any medical or health expense not reimbursed by insurance. The downsides: they require more paper handling by both consumers and insurance companies, and some discourage preventive care.
States such as Massachusetts have moved to require insurance coverage, with a government subsidy to those who cannot afford it. While it does not result in universal coverage, it has cut the numbers of uninsured by nearly two-thirds.
When you add up all the co-pays, premiums, deductibles, etc., even those with insurance often pay the full cost of the medical care. There is little downward pressure on medical expenses.
Allowing the poor to buy into Medicaid, Medicare, or SCHIP has become controversial even tho it seems very direct and logical. This proposal came from a plan studied by the National Coalition on Healthcare. Consumers pay in according to a sliding scale, with subsidies for the poor.
Everyone gets covered. The monetary savings can be significant. NCHC says in the first decade health care savings would total $320.5 billion; businesses that now provide health insurance would save $848 billion, and families who currently buy insurance would save $309 billion.
Since the end of the 1960s, the number of doctors in France increased from 60,000 to more than 185,000 at the beginning of the 21st century. There are three doctors for every 1,000 habitants, which is a superior ratio when compared to other Western nations (Great Britain 3:1800, USA 3:2700, Germany 3:3400 and Italy 3:5900).
A sector of the French healthcare system consists of not-for-profit private hospitals. Private hospitals were originally denominational and provide 14% of the inpatient services among French Medical Care Institutions. They are financed through endowments like public hospitals, but they still have the right to privacy like private clinics.
A positive feature of the French healthcare system is the cooperation between the public and private sector. The long waiting lists for surgery that everyone associates with socialized medicine are avoided here. Indeed, private medical care in France provides more than 50% of surgeries.
Yes Magazine has an online chart - http://www.yesmagazine.org/article.asp?ID=1515
More specifics of the French plan is at FrenchEntree.com -- http://www.frenchentree.com/fe-health/DisplayArticle.asp?ID=197
Let me compare the Canadian and French systems briefly --
Canada has a SINGLE-PAYER system, in which the government pays the bills according to a fee structure it negotiated with health care providers. Patients can still choose their own doctor. The doctor in turn may be either paid by the government or in private practice. (Patients who are in a hurry might choose a private-pay doctor; the government physicians are often overworked and months-long delays to get an appointment are common.) The United States’ Medicaid and Medicare are most similar to single-payer systems.
By contrast, in the British style of socialized medicine, the doctors are actually government employees. Hospitals are run by the government. Hospitals are run comparable to the Veterans Administration. Given the repeated VA scandals in healthcare and hospital conditions, one would much prefer any private hospital over the VA. This is a sad thing to say, although to be fair, the VA facilities are just showing their age and need a great deal of renovation.
The French system is called a non-profit MULTI-PAYER. Clinics and hospitals are all private, and may be either non-profit or for profit. Medical providers are paid according to a negotiated fee structure. The funds come from payroll contributions from both employers and employees.
This is somewhat similar to what we have now in the private sector. A major difference is that the French government has far better leverage in negotiating what the fees are than any single employer has, and unlike the U.S. federal government, it uses that leverage.
French payroll taxes replenish a sickness fund which covers 75% of the medical bills. The balance comes from patients, government and supplementary insurance.
Coverage is universal under all three templates -- British, Canadian, and French. By contrast, the current American system has nearly 50 million of us completely uninsured -- 9 million of the uninsured are children.
The patient has the ultimate power to choose his or her doctor under all three plans displayed here. Popular American plans commonly limits our choice of providers to those who are part of a given network.
The average cost of medical care per Briton is $2,389, and the average Briton ranks 24th on WHO‘s health ranking. For a Canadian it is $2,989, and he ranks 35th. For a Frenchman it comes to $2,902, who marches all the way up to 4th on WHO‘s list. And for an American, it comes to a whopping $5,711, and in return for that, he places 72nd on WHO’s ranking.
Recent years have seen several so-called reforms, with limited results. In 2004, consumers were given the option to create Health Savings Accounts. These allow pre-tax dollars to be set aside for any medical or health expense not reimbursed by insurance. The downsides: they require more paper handling by both consumers and insurance companies, and some discourage preventive care.
States such as Massachusetts have moved to require insurance coverage, with a government subsidy to those who cannot afford it. While it does not result in universal coverage, it has cut the numbers of uninsured by nearly two-thirds.
When you add up all the co-pays, premiums, deductibles, etc., even those with insurance often pay the full cost of the medical care. There is little downward pressure on medical expenses.
Allowing the poor to buy into Medicaid, Medicare, or SCHIP has become controversial even tho it seems very direct and logical. This proposal came from a plan studied by the National Coalition on Healthcare. Consumers pay in according to a sliding scale, with subsidies for the poor.
Everyone gets covered. The monetary savings can be significant. NCHC says in the first decade health care savings would total $320.5 billion; businesses that now provide health insurance would save $848 billion, and families who currently buy insurance would save $309 billion.
Since the end of the 1960s, the number of doctors in France increased from 60,000 to more than 185,000 at the beginning of the 21st century. There are three doctors for every 1,000 habitants, which is a superior ratio when compared to other Western nations (Great Britain 3:1800, USA 3:2700, Germany 3:3400 and Italy 3:5900).
A sector of the French healthcare system consists of not-for-profit private hospitals. Private hospitals were originally denominational and provide 14% of the inpatient services among French Medical Care Institutions. They are financed through endowments like public hospitals, but they still have the right to privacy like private clinics.
A positive feature of the French healthcare system is the cooperation between the public and private sector. The long waiting lists for surgery that everyone associates with socialized medicine are avoided here. Indeed, private medical care in France provides more than 50% of surgeries.
Yes Magazine has an online chart - http://www.yesmagazine.org/article.asp?ID=1515
More specifics of the French plan is at FrenchEntree.com -- http://www.frenchentree.com/fe-health/DisplayArticle.asp?ID=197
Friday, August 29, 2008
Health Care: The Time Is NOW To Get Healthcare Equity Bill Thru Congress
We need your help to get MORE Sponsors and MORE support for The Health Equity and Accountability Act. This important proposal (H.R. 3014) will deal with the disparities and discrimination in our nation's health care system. It is sponsored by Rep. Hilda Solis (D-Calif.). While the issue of America’s record numbers of uninsured is complex and has many causes, this bill is an important first step to ensuring that everyone has health care.
Action is needed now!
We know that minorities have higher rates of infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer, and lower rates of immunizations and cancer screening. LEGAL immigrant children are denied health care! Millions of families in poor, rural communities have little or no health care at all.
We cannot write off millions of children and adults, in rural areas and cities, among the poor and working classes and sometimes even among people who thought they were middle class. They all need the basics, and here they cannot even get an appointment because the clinics and doctor offices will not accept patients without insurance.
Where did this bill come from? Rep. Hilda Solis (D-Calif.) has introduced the Health Equity and Accountability Act (H.R. 3014), a bill to provide health care to the underserved and uninsured. Versions of this bill have been stalled for the last 6 years, but H.R. 3014 is now gaining support with recent hearings in the Health subcommittees of both the House Ways and Means and House Energy and Commerce Committees.
Keep the momentum going! Contact your Representative and ask them to cosponsor this bill NOW. If they are already one of the 113 cosponsors, ask them to take a leadership role in promoting and passing this legislation. The higher the visibility and the larger the support for this bill in the House, the better chance we have for getting it passed, for getting an identical counterpart in the U.S. Senate and then getting the bill signed into law.
It isn't only high cost that keeps people from having health insurance and getting health care. We have reports that as many as 25% of all Latinas haven't even seen a doctor in the past year! Health care is almost unavailable in rural areas because of the shortage of rural doctors combined with the long distances to find medical services.
Do you know that poor areas are often targeted as “ideal” sites for dumping grounds for hazardous materials and waste? Minorities and those living in poor rural areas suffer exposure to environmental health hazards far out of proportion to their numbers. All too often, power plants and waste dumps are built in low income areas; they expect that residents are too ignorant and weak to protest these health hazards. Frankly my dear, your zip code should not determine your life expectancy!
The Solis bill provides grants to eliminate racial and ethnic health care disparities. It requires health-related programs of the Department of Health and Human Services (HHS) to collect basic data on race, ethnicity, and primary language. Imagine -- HHS does not even know for sure how many of us Americans are at home in which language!
This bill will also establish “health empowerment zone” programs in at-risk communities. Plus it includes Immigrant Health Improvement Act (ICHIA) proposals; these provide health care to legal resident children of immigrant parents (who have been denied coverage under the SCHIP program).
Contact your Representative TODAY and urge them to sponsor and support this bill! You can go to NOW.org and they have an easy link to a contact form that goes to your representative. You can also go to https://forms.house.gov/wyr/welcome.shtml for a contact form.
Action is needed now!
We know that minorities have higher rates of infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer, and lower rates of immunizations and cancer screening. LEGAL immigrant children are denied health care! Millions of families in poor, rural communities have little or no health care at all.
We cannot write off millions of children and adults, in rural areas and cities, among the poor and working classes and sometimes even among people who thought they were middle class. They all need the basics, and here they cannot even get an appointment because the clinics and doctor offices will not accept patients without insurance.
Where did this bill come from? Rep. Hilda Solis (D-Calif.) has introduced the Health Equity and Accountability Act (H.R. 3014), a bill to provide health care to the underserved and uninsured. Versions of this bill have been stalled for the last 6 years, but H.R. 3014 is now gaining support with recent hearings in the Health subcommittees of both the House Ways and Means and House Energy and Commerce Committees.
Keep the momentum going! Contact your Representative and ask them to cosponsor this bill NOW. If they are already one of the 113 cosponsors, ask them to take a leadership role in promoting and passing this legislation. The higher the visibility and the larger the support for this bill in the House, the better chance we have for getting it passed, for getting an identical counterpart in the U.S. Senate and then getting the bill signed into law.
It isn't only high cost that keeps people from having health insurance and getting health care. We have reports that as many as 25% of all Latinas haven't even seen a doctor in the past year! Health care is almost unavailable in rural areas because of the shortage of rural doctors combined with the long distances to find medical services.
Do you know that poor areas are often targeted as “ideal” sites for dumping grounds for hazardous materials and waste? Minorities and those living in poor rural areas suffer exposure to environmental health hazards far out of proportion to their numbers. All too often, power plants and waste dumps are built in low income areas; they expect that residents are too ignorant and weak to protest these health hazards. Frankly my dear, your zip code should not determine your life expectancy!
The Solis bill provides grants to eliminate racial and ethnic health care disparities. It requires health-related programs of the Department of Health and Human Services (HHS) to collect basic data on race, ethnicity, and primary language. Imagine -- HHS does not even know for sure how many of us Americans are at home in which language!
This bill will also establish “health empowerment zone” programs in at-risk communities. Plus it includes Immigrant Health Improvement Act (ICHIA) proposals; these provide health care to legal resident children of immigrant parents (who have been denied coverage under the SCHIP program).
Contact your Representative TODAY and urge them to sponsor and support this bill! You can go to NOW.org and they have an easy link to a contact form that goes to your representative. You can also go to https://forms.house.gov/wyr/welcome.shtml for a contact form.
Monday, August 4, 2008
Singapore an Interesting Case Study in Healthcare
Singapore has made it a point to guard against a glut of expensive technology, high-volume care, too-long hospital stays, and an excess of physicians and specialists. These reforms helped Singapore reduce its per capita health care spending from 1997 to 2001 by 13 percent—even as the United States increased its per capita health spending by 24 percent over this same period. Today Singapore spends one-seventh what the U.S. does per capita on health care.
The above excerpt is from a very good article on the Singapore system of health care. They do some things very well, altho there are some ways in which their society is different from ours. A major difference is that Singaporeans are on average much younger than Americans or Europeans. That figures into the demand for health care, surgery, and hospitalizations.
Read the whole article in Health Beat at http://www.healthbeatblog.org/2008/07/health-care-in.html#more
Kudos for a great article on world health care.
The above excerpt is from a very good article on the Singapore system of health care. They do some things very well, altho there are some ways in which their society is different from ours. A major difference is that Singaporeans are on average much younger than Americans or Europeans. That figures into the demand for health care, surgery, and hospitalizations.
Read the whole article in Health Beat at http://www.healthbeatblog.org/2008/07/health-care-in.html#more
Kudos for a great article on world health care.
Tuesday, July 15, 2008
The Dutch appear most satisfied with their system and Americans the least satisfied, according to a new survey of 10 industrialized countries
Harris Interactive combined results of three different polls to come up with citizen ratings of their national health care system (or lack of it).
The Dutch rated their system tops although 70% of their French said their system was the envy of the world.
The Dutch system is rather new -- they contribute payroll taxes into a central fund, then receive a voucher to buy coverage from nonprofit or for-profit private insurers. This actually sounds a lot like some of the proposals in this country for a voucher system.
France has a very expensive healthcare system which costs 11% of it GDP. There is a high priority on good access to both primary care and specialist care, with an accent on patient choice. Their system is financed largely from taxes but patients also chip in copays with no deductibles.
Americans spend much more in terms of GDP (16%) and yet feel that they are not getting their money’s worth. Prices are high, the number of uninsured is high, and even those with insurance must dip deep into their own pockets to pay bills. They are also stressed by the prospect of losing health coverage if they lose their jobs -- in the current recession, that is a justifiable fear. While they generally love their doctors, the hassles of buying insurance and handling claims makes them lose confidence in the whole private pay scenario.
Countries polled included, the U.S., Holland, France, Great Britain, Italy, Germany, Spain, Canada, New Zealand and Australia.
The full story is at MarketWatch here -- http://www.marketwatch.com/News/Story/Story.aspx?guid=86f29d04fc2d466fadf62435468ce406&siteid=nwtpf&sguid=LlmgTGWqaUW33IjDVFDo2Q
The Dutch rated their system tops although 70% of their French said their system was the envy of the world.
The Dutch system is rather new -- they contribute payroll taxes into a central fund, then receive a voucher to buy coverage from nonprofit or for-profit private insurers. This actually sounds a lot like some of the proposals in this country for a voucher system.
France has a very expensive healthcare system which costs 11% of it GDP. There is a high priority on good access to both primary care and specialist care, with an accent on patient choice. Their system is financed largely from taxes but patients also chip in copays with no deductibles.
Americans spend much more in terms of GDP (16%) and yet feel that they are not getting their money’s worth. Prices are high, the number of uninsured is high, and even those with insurance must dip deep into their own pockets to pay bills. They are also stressed by the prospect of losing health coverage if they lose their jobs -- in the current recession, that is a justifiable fear. While they generally love their doctors, the hassles of buying insurance and handling claims makes them lose confidence in the whole private pay scenario.
Countries polled included, the U.S., Holland, France, Great Britain, Italy, Germany, Spain, Canada, New Zealand and Australia.
The full story is at MarketWatch here -- http://www.marketwatch.com/News/Story/Story.aspx?guid=86f29d04fc2d466fadf62435468ce406&siteid=nwtpf&sguid=LlmgTGWqaUW33IjDVFDo2Q
Sunday, June 29, 2008
Political Forecasts & Protests @ Health Insurers' Mtg.
Prognostications galore as America's Health Insurance Plans, the tradegroup of private health insurers, turned the stage over to former lawmakers and presidential advisers to discuss the future of U.S. health care during the group's annual meeting in San Francisco on last week. There were voices for a national health plan from working people -- here’s a sampling:
‘Alphonso Pines, 55, a union representative for United Here Local 2, was one of many raising his voice for a single-payer health-care system and against the for-profit multi-payer one. “If everybody’s covered then costs would have to go down,” he said.
Pines blamed health insurers for suppressing workers’ wages. “They’re greedy. They keep raising rates….They’ve had a good time under the Bush administration without no checks and balances.”
‘Mark Fisher, a non-union plumber in San Francisco, said he heard about the rally on the radio and wanted to join the protest on behalf of people who can’t get insurance — even though he has no beef personally with the care he’s received. Health insurers drive costs up, and a Canadian-style system would be more efficient, he argued.
‘“They’re a middle man,” he said of private health insurers. “They serve no useful purpose.”
‘“The American system works very well for me,” said Fisher, 65, who pegged his annual income at $100,000. “But morally the system is corrupt. It’s very unfair to the person who works for an hourly wage.”’
See the Health Matters blog, link given below. http://blogs.marketwatch.com/healthmatters/2008/06/20/health-insurers-meeting-abuzz-with-political-forecasting-and-protests/?siteid=nwtpf
‘Alphonso Pines, 55, a union representative for United Here Local 2, was one of many raising his voice for a single-payer health-care system and against the for-profit multi-payer one. “If everybody’s covered then costs would have to go down,” he said.
Pines blamed health insurers for suppressing workers’ wages. “They’re greedy. They keep raising rates….They’ve had a good time under the Bush administration without no checks and balances.”
‘Mark Fisher, a non-union plumber in San Francisco, said he heard about the rally on the radio and wanted to join the protest on behalf of people who can’t get insurance — even though he has no beef personally with the care he’s received. Health insurers drive costs up, and a Canadian-style system would be more efficient, he argued.
‘“They’re a middle man,” he said of private health insurers. “They serve no useful purpose.”
‘“The American system works very well for me,” said Fisher, 65, who pegged his annual income at $100,000. “But morally the system is corrupt. It’s very unfair to the person who works for an hourly wage.”’
See the Health Matters blog, link given below. http://blogs.marketwatch.com/healthmatters/2008/06/20/health-insurers-meeting-abuzz-with-political-forecasting-and-protests/?siteid=nwtpf
Friday, June 27, 2008
Great Book Review, "American the Uninsured"
Please go read this great book review on the history of the American health insurance industry and just it is that ours is the only major country WITHOUT national health care. We could have instituted a national program back in 1919 but..Oh, I'll let you read it yourselves.
I found it on a wonderful website called Newsvine that has lots of good articles, seeds, and commentary on lots of current events. Go here to read the review. Ciao!
I found it on a wonderful website called Newsvine that has lots of good articles, seeds, and commentary on lots of current events. Go here to read the review. Ciao!
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