In offering solutions for medical insurance, politicians of all stripes keep reassuring voters about their right to be treated by "the doctor of your choice" rather than some faceless bureaucrat in a white coat under socialized medicine.
There are problems with this argument. Most Americans are now covered by HMOs, which present them with lists of "in-network" physicians either on their payroll or who have agreed to pre-set fees and, in many cases, face pressure to make life-and-death decisions on what's best for the insurers' bottom line.
In California, this divided loyalty recently came into focus with Blue Cross' attempt to enlist doctors in reporting patients who fail to disclose previously existing conditions.
"We're outraged, "the President of the California Medical Association responded, "that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality."
The Blue Cross backed off, but the sanctity of the doctor-patient relationship is definitely showing symptoms of stress. New York Attorney General Andrew Cuomo is suing UnitedHealth for operating "a defective and manipulated database that most major health insurance companies rely upon to set reimbursement rates for out-of-network medical expenses.”
Translation: If you see "the doctor of your choice," your insurer will stiff you on how much of his or her bill they will pay.
That aside, there is the question of how Americans pick their physicians when they can. From all evidence, most do so more casually and with less information than they gather before buying a car or trying a new restaurant.
There is no Zagat guide to medical services, and consulting the "best doctors" lists of regional magazines only leads to the discovery that most are not taking new patients. Too often, the decision is based on the casual advice of a friend or neighbor.
The US Department of Health & Human Services has a few rudimentary suggestions for getting information, but for the most part, finding the right doctor is no more fact-based than finding the right mate. You have to trust your instincts and hope for the best. No politician can help with that.
Showing posts with label HMOs. Show all posts
Showing posts with label HMOs. Show all posts
Monday, February 18, 2008
Thursday, August 30, 2007
Middle-Class Health Care Crisis Gets Worse
The newest Census figures put a statistical face on the sickening truth about health care in America. Even as household incomes go up, so do the number of uninsured. The creeping crisis has moved beyond the poor into the middle class.
A record high 47 million Americans were priced out of health care, even as the poverty rate went down and median household income rose to $48,200 in 2006. Uninsured families earning more than $75,000 a year increased by 1.4 million.
As profits of HMOs, health insurers and drug companies soar, more and more employers are cutting down or eliminating coverage as a job benefit, leaving families to fend for themselves in a market of rising premiums and discrimination against the most vulnerable.
“Middle income Americans are now experiencing the human suffering that comes with being uninsured. It makes any illness a potential economic and social catastrophe,” says Dr. Steffie Woolhandler, of the Harvard Medical School, a co-founder of Physicians for a National Health Program.
Yet politicians keep tinkering with the current system. Of all the Presidential candidates for ’08, Dennis Kucinich is the only one proposing a single-payer system to eliminate the one out of every three dollars spent on health care that goes to insurers’ overhead and profits.
But rumblings of revolt can be heard. In California,
a new statewide poll shows voters rejecting moderate health-care reforms proposed by Gov. Arnold Schwarzenegger and Democratic legislators and leaning, instead, toward a state-managed "single-payer" system.
But it will take much more public demand to overcome the largest lobbying expenditures in American history to keep the system as a cash cow for companies that profit from it.
A record high 47 million Americans were priced out of health care, even as the poverty rate went down and median household income rose to $48,200 in 2006. Uninsured families earning more than $75,000 a year increased by 1.4 million.
As profits of HMOs, health insurers and drug companies soar, more and more employers are cutting down or eliminating coverage as a job benefit, leaving families to fend for themselves in a market of rising premiums and discrimination against the most vulnerable.
“Middle income Americans are now experiencing the human suffering that comes with being uninsured. It makes any illness a potential economic and social catastrophe,” says Dr. Steffie Woolhandler, of the Harvard Medical School, a co-founder of Physicians for a National Health Program.
Yet politicians keep tinkering with the current system. Of all the Presidential candidates for ’08, Dennis Kucinich is the only one proposing a single-payer system to eliminate the one out of every three dollars spent on health care that goes to insurers’ overhead and profits.
But rumblings of revolt can be heard. In California,
a new statewide poll shows voters rejecting moderate health-care reforms proposed by Gov. Arnold Schwarzenegger and Democratic legislators and leaning, instead, toward a state-managed "single-payer" system.
But it will take much more public demand to overcome the largest lobbying expenditures in American history to keep the system as a cash cow for companies that profit from it.
Tuesday, August 21, 2007
The War Bush Is Winning
Things may not be going too well in Iraq or against Al Qaeda in Pakistan, but there is one front where the Bush Administration is prevailing--in the war to keep American children without medical coverage to protect the HMOs and private insurers who have given us one of the worst health care systems in the world at the highest cost.
Yesterday the Administration announced new policies that will make it harder for states to insure all but the lowest-income children under the government-subsidized State Children's Health Insurance Program.
President Bush has said he is opposed on “philosophical grounds” to any expansion of the program that might keep families from buying private insurance. As always, his priorities are cockeyed, but his determination to stay the course is unshakable.
Yesterday the Administration announced new policies that will make it harder for states to insure all but the lowest-income children under the government-subsidized State Children's Health Insurance Program.
President Bush has said he is opposed on “philosophical grounds” to any expansion of the program that might keep families from buying private insurance. As always, his priorities are cockeyed, but his determination to stay the course is unshakable.
Monday, August 06, 2007
Michael Moore's Ann Coulter
Today’s San Diego Union-Tribune carries a rebuke to the “Sicko” maker for extolling Britain’s National Health Service by Liz Mair, a writer and political consultant who “serves the needs of center-right political organizations, political leaders and candidates.”
Ms. Mair seems to have a thing for Mr. Moore. Her web site recently savaged him for attacking CNN’s Dr. Sanjay Gupta phonetically by pronouncing his name “‘Dr. Saaanjay Guuuupta,’"laying incredible emphasis and vitriol on his foreign name. Without doubt, it was an oblique comment on the reporter-cum-doctor's ethnicity. What a crazy and unacceptable way to discredit a foe.”
A former resident of London, Ms. Mair wants us to know that “no matter how great socialized medicine may sound, the best that it achieves is dishing up very poor care for all, as opposed to good care for all, or even most.”
The main point of Ms. Mair’s indictment is health care for all at times involves longer waiting for services, which is presumably a horror not visited on U.S. patients since so many of the riff-raff have no coverage and are not clogging up the waiting rooms. They go to hospital emergency units.
While Ms. Mair keeps harpooning Michael Moore, elsewhere she has advice for Republican Presidential candidates. Attacking Mitt Romney for attempting universal coverage in Massachusetts, she suggests to the others: “Since excess regulation contributes greatly to skyrocketing costs--which in turn makes it tough to buy insurance if you're among the working poor--rather than proposing more regulation, Republicans might consider pursuing deregulation of the insurance market.”
While Ms. Mair keeps harpooning Michael Moore, she is busy trying to dismantle the pitiful controls that do exist on HMOs and private insurers. It makes one wonder if she consults for clients other than politicians. Or is she just idealistically wrong-headed?
Ms. Mair seems to have a thing for Mr. Moore. Her web site recently savaged him for attacking CNN’s Dr. Sanjay Gupta phonetically by pronouncing his name “‘Dr. Saaanjay Guuuupta,’"laying incredible emphasis and vitriol on his foreign name. Without doubt, it was an oblique comment on the reporter-cum-doctor's ethnicity. What a crazy and unacceptable way to discredit a foe.”
A former resident of London, Ms. Mair wants us to know that “no matter how great socialized medicine may sound, the best that it achieves is dishing up very poor care for all, as opposed to good care for all, or even most.”
The main point of Ms. Mair’s indictment is health care for all at times involves longer waiting for services, which is presumably a horror not visited on U.S. patients since so many of the riff-raff have no coverage and are not clogging up the waiting rooms. They go to hospital emergency units.
While Ms. Mair keeps harpooning Michael Moore, elsewhere she has advice for Republican Presidential candidates. Attacking Mitt Romney for attempting universal coverage in Massachusetts, she suggests to the others: “Since excess regulation contributes greatly to skyrocketing costs--which in turn makes it tough to buy insurance if you're among the working poor--rather than proposing more regulation, Republicans might consider pursuing deregulation of the insurance market.”
While Ms. Mair keeps harpooning Michael Moore, she is busy trying to dismantle the pitiful controls that do exist on HMOs and private insurers. It makes one wonder if she consults for clients other than politicians. Or is she just idealistically wrong-headed?
Thursday, August 02, 2007
Health Care: Good vs. Evil
This should be just the kind of battle the President loves, right against wrong, no nasty little nuances to fog the mind, but here he is on the side of darkness, threatening to veto a bill passed by the House that would extend health insurance to five million more children of the working poor.
The proposal, according to the Washington Post, is backed by “Republican and Democratic governors, the American Medical Association, AARP, the March of Dimes, the Catholic Health Association, the American Academy of Pediatrics, and even cyclist Lance Armstrong. And the prospects are good in the Senate, where a key Republican, Orrin G. Hatch (Utah), said, ‘It's difficult for me to understand how anyone wouldn't want to do this.’"
George Bush doesn’t--on “philosophical” grounds. "When you expand eligibility,” he argues, “you're really beginning to open up an avenue for people to switch from private insurance to the government."
In his opposition, the President may be opening the wider debate on American health care and what some of his loyal supporters yesterday denounced as the first step toward “socialized medicine.”
If so, it would only be a baby step, but the discussion is long overdue. If “socialized medicine” is the only alternative to lining the pockets of HMOS and health insurance companies at the expense of sick kids, so be it. If “socialized” means humane rather than rapacious, what’s so scary about it? Socialized doesn’t mean Socialist.
Even doctors, the presumed victims, seem to be in favor of scrapping the current system. A recent survey by the Minnesota Medical Association found that “64% favored a single-payer system, 25% HSAs, and 12% managed care. The majority of physicians (86%) also agreed that it is the responsibility of society, through the government, to ensure that everyone has access to good medical care. Less than half (41%) said that the private insurance industry should continue to play a major role in financing health care.” (Source: Sustainable Middle Class blog.)
It’s time to talk frankly about what’s good and what’s evil in our health care system, and President Bush may just be leading the way.
The proposal, according to the Washington Post, is backed by “Republican and Democratic governors, the American Medical Association, AARP, the March of Dimes, the Catholic Health Association, the American Academy of Pediatrics, and even cyclist Lance Armstrong. And the prospects are good in the Senate, where a key Republican, Orrin G. Hatch (Utah), said, ‘It's difficult for me to understand how anyone wouldn't want to do this.’"
George Bush doesn’t--on “philosophical” grounds. "When you expand eligibility,” he argues, “you're really beginning to open up an avenue for people to switch from private insurance to the government."
In his opposition, the President may be opening the wider debate on American health care and what some of his loyal supporters yesterday denounced as the first step toward “socialized medicine.”
If so, it would only be a baby step, but the discussion is long overdue. If “socialized medicine” is the only alternative to lining the pockets of HMOS and health insurance companies at the expense of sick kids, so be it. If “socialized” means humane rather than rapacious, what’s so scary about it? Socialized doesn’t mean Socialist.
Even doctors, the presumed victims, seem to be in favor of scrapping the current system. A recent survey by the Minnesota Medical Association found that “64% favored a single-payer system, 25% HSAs, and 12% managed care. The majority of physicians (86%) also agreed that it is the responsibility of society, through the government, to ensure that everyone has access to good medical care. Less than half (41%) said that the private insurance industry should continue to play a major role in financing health care.” (Source: Sustainable Middle Class blog.)
It’s time to talk frankly about what’s good and what’s evil in our health care system, and President Bush may just be leading the way.
Tuesday, July 10, 2007
Health Care, Seriously
“Sicko” aside, health care is moving front and center as the domestic issue for Democrats while Republicans still maunder about keeping us safe from terrorists.
A Washington Post headline today sums up their approach: “For Democrats, Pragmatism On Universal Health Care”
It’s a little like saying, “There are burglars in the house, but let’s be cautious about getting them out.”
The burglars are private insurers who take almost one out of every three dollars we spend and give us the most expensive and some of the worst care in the world. But no one wants to get them out, lock the doors and start over.
Whenever good sense enters the debate, lobbyists for the thieves yell “socialized medicine” and politicians duck for cover. But when the rest of America complains about anti-social medicine, they turn deaf.
The situation is neatly summed up by Jonathan Gruber of MIT, who has become, according to the Post, “possibly the party's most influential health-care expert and a voice of realism in its internal debates.” But even the realist knows better.
"Plans which minimize the disruption to the existing system are more likely to succeed than plans that rip up the existing system and start over," said Gruber, a consultant for the three leading Democrats. "It doesn't take a genius to see that. That's not to say that plans ripping it up wouldn't be better--I just think they're political non-starters."
The “non-starters” are variations of a single-payer system which, according to the more than 8,000 physicians who back it, would save $350 billion a year, “enough to provide comprehensive, high-quality coverage for all Americans.”
Opponents raise the terrible specter of a government bureaucracy that would replace the private one that spends so much time and effort finding ways to deny claims rather than facilitate them.
We get most of our mail through “a self-supporting postal corporation wholly owned by the federal government” while those who can afford it use FedEx and other private providers. Why not our medical care? We have the example of Medicare which is far from perfect but works reasonably well for older Americans.
As we gird ourselves for the headache-inducing health care plans of the Presidential candidates, someone should stand up for the “non-starter,” a potential cure that none of them has the courage to propose.
A Washington Post headline today sums up their approach: “For Democrats, Pragmatism On Universal Health Care”
It’s a little like saying, “There are burglars in the house, but let’s be cautious about getting them out.”
The burglars are private insurers who take almost one out of every three dollars we spend and give us the most expensive and some of the worst care in the world. But no one wants to get them out, lock the doors and start over.
Whenever good sense enters the debate, lobbyists for the thieves yell “socialized medicine” and politicians duck for cover. But when the rest of America complains about anti-social medicine, they turn deaf.
The situation is neatly summed up by Jonathan Gruber of MIT, who has become, according to the Post, “possibly the party's most influential health-care expert and a voice of realism in its internal debates.” But even the realist knows better.
"Plans which minimize the disruption to the existing system are more likely to succeed than plans that rip up the existing system and start over," said Gruber, a consultant for the three leading Democrats. "It doesn't take a genius to see that. That's not to say that plans ripping it up wouldn't be better--I just think they're political non-starters."
The “non-starters” are variations of a single-payer system which, according to the more than 8,000 physicians who back it, would save $350 billion a year, “enough to provide comprehensive, high-quality coverage for all Americans.”
Opponents raise the terrible specter of a government bureaucracy that would replace the private one that spends so much time and effort finding ways to deny claims rather than facilitate them.
We get most of our mail through “a self-supporting postal corporation wholly owned by the federal government” while those who can afford it use FedEx and other private providers. Why not our medical care? We have the example of Medicare which is far from perfect but works reasonably well for older Americans.
As we gird ourselves for the headache-inducing health care plans of the Presidential candidates, someone should stand up for the “non-starter,” a potential cure that none of them has the courage to propose.
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