Impeding changes to our Health Care system

[TheMercenary]

Most people, insured people, have no idea how insurance works until they use it and find out what is not covered. My wife has become an expert on this criminal industry over the years and how they don't work for you. All the while my employer is tooting their horn over what great coverage we have and how much better it is going to be while they raised our rates $3000 a year.

[TheMercenary]

This could certainly be a good change if inacted:

Like many other people, Ms. Krinsk thought that her prescription information was private. But in fact, prescriptions, and all the information on them — including not only the name and dosage of the drug and the name and address of the doctor, but also the patient’s address and Social Security number — are a commodity bought and sold in a murky marketplace, often without the patients’ knowledge or permission.

That may change if some little-noted protections from the Obama administration are strictly enforced. The federal stimulus law enacted in February prohibits in most cases the sale of personal health information, with a few exceptions for research and public health measures like tracking flu epidemics. It also tightens rules for telling patients when hackers or health care workers have stolen their Social Security numbers or medical information, as happened to Britney Spears, Maria Shriver and Farrah Fawcett before she died in June.

“The new rules will plug some gaping holes in our federal health privacy laws,” said Deven McGraw, a health privacy expert at the nonprofit Center for Democracy and Technology in Washington. “For the first time, pharmacy benefit managers that handle most prescriptions and banks and contractors that process millions of medical claims will be held accountable for complying with federal privacy and security rules.”

http://www.nytimes.com/2009/08/09/bu...ivacy.html?hpw

[classicman]

Whether Republicans or Democrats are in charge, this kind of budget trickery is nothing new to Washington, said Brian Riedl, a budget expert at the conservative Heritage Foundation.

"It's the best way to do business in Washington," he said. "You inflate the baseline [of a bill] to make it seem like you're spending less."

[TheMercenary]

Looks like Rahm it Through's plan may have backfired on this one...

Georgia Democrat yells at local doctor over health care

Tensions are running so high at town hall meetings that Rep. David Scott, a Georgia Democrat, yelled at a local doctor concerned about health care after mistaking him for an "astroturf" political operative looking for a fight.

Mr. Scott became visibly agitated when one of his constituents, a practicing doctor, asked a few questions about health care reform during a town hall meeting. The meeting was held to discuss a road project, but was opened up for questions near the end. That's when Dr. David Hill stood up to speak.

Dr. Hill asked Mr. Scott why he was going to vote for a health care plan similar to that implemented in Massachusetts "that is shown not to work" and if he supported a government-provided health care insurance option.

The congressman replied by accusing the doctor of "hijacking" his event.

"I'm listening to my constituents, OK?" Scott said, "These are people who live in the 13th Congressional district, who vote in this district. That’s who I’ve got to respond to … So what you’ve got to understand, those of you who are here, who have taken and came and hijacked this event we dealing with here, this is not a health care event."

"You chose to come and to do it on your own," he yelled. "Not a single one of you had the decency to call my office and set up for a meeting." He went on, in a threatening voice, "You want a meeting with me on health care, I'll give it to you!"

The outburst is yet another example of how confrontational town hall meetings have become over recent weeks, as constituents are becoming more forthright in asking their elected representatives challenging questions. These actions and other forms of protest have been encouraged by limited government advocacy groups opposed to the stimulus package, the Democrats favored health care reforms and other big spending government proposals.

http://www.washingtontimes.com/weblo...doctor-over-h/

[TheMercenary]

Drug Industry to Run Ads Favoring White House Plan

WASHINGTON — The drug industry has authorized its lobbyists to spend as much as $150 million on television commercials supporting President Obama’s health care overhaul, beginning over the August Congressional recess, people briefed on the plans said Saturday.

The unusually large scale of the industry’s commitment to the cause helps explain some of a contentious back-and-forth playing out in recent days between the odd-couple allies over a deal that the White House struck with the industry in June to secure its support. The terms of the deal were not fully disclosed. Both sides had announced that the drug industry would contribute $80 billion over 10 years to the cost of the health care overhaul without spelling out the details.

http://www.nytimes.com/2009/08/09/he...lobby.html?hpw

You can bet some deal lucrative to the big Pharm had to be done to get them on board.

[DanaC]

what would you like to see happen instead Merc?

[TheMercenary]

On the big Pharm or on the overall plan?

On Pharm I would like to see them not have secret meetings at the White House and make behind the scenes deals that favor bussines as usual where they make huge profits on everyone who can pay or has insurance.

[DanaC]

In terms of widening affordable access to healthcare, or in terms of tackling the problems of the ininsured/under insured?

[TheMercenary]

Originally Posted by DanaC

In terms of widening affordable access to healthcare, or in terms of tackling the problems of the ininsured/under insured?

I completely support widening affordable access to healthcare and figuring out a way to support the under or uninsured. The problem I have with the approach is the way they plan to pay for it. If the majority of the population wants it, everyone needs to pay into it. Either through some sort of flat percent of every income, regardless of income, or through user taxes in sales tax or something similar to a VAT. The approach they are Rahming through Congress is fraught with missteps and pitfalls, combined with back door deals with the industry. If you go back years, I have always said we have a health insurance crisis. The current plan in Congress may eventually bankrupt this country and place the burden of paying for it on a minority of taxpayers.

[TheMercenary]

Originally Posted by DanaC

In terms of widening affordable access to healthcare, or in terms of tackling the problems of the ininsured/under insured?

Keeping my previous response in context, and my 30 plus years in the business of healthcare, I am not at all confident that the government can successfully implement a program of government sponsored insurance or a single payer plan (I fully understand that this is currently not on the table but there is no doubt that this is where Obama and many other liberal democrats want to go in time). Nor any plan which encourages the mass migration of those with private insurance, or employers who provide insurance to employees to a government run plan.

People cannot draw parallels between countries the size of Sweden, France, the UK, or other small economies and populations and extrapolate those plans to a country the size of the US with ease. The US is much more complex in its relationships with business and insurance as we now know it. But given what we have seen about the potential back door deals the Obama administration is making with various special interest groups, I am futher discouraged that implementation of a national coordinated effort to provide insurance to some 30 million people can actually work. I believe that care will continue to be rationed but to a greater degree than it is now with a greater emphasis on cost containment spread over a greater number of people. This form of rationing is slowly creeping into the care of Medicare, Medicaid, and other government programed patients. Various more expensive techniques and procedures are not offered to these patients because the insurance will not pay. A procedure that can cost 1/10th the cost in a free-standing surgical center is passed over for a much more expensive procedure which the insurance company will pay for in a hospital. That is detrimental to the system as a whole increasing costs for the patients and other insured people, not to mention the public whom ultimately is paying for it all. The current government run program is broken and fiscally inefficient. What makes anyone think they can expand it by 1000 fold and do a better job?


The issue of illegal aliens must be addressed to eliminate a weakness and further drain on any national program for the uninsured.

The issues of reimbursement fro providers must be addressed, and they are not.

The issues of payment for catastrophic care must be addressed and they are not.

The issues of chronic expensive care and treatment of rare and complex disease needs to be addressed.

The issue of how all this is going to be paid and by whom has not been exposed to the fullest in any plan and those issues must be on the table with adequate time for debate. I do not believe, as history has shown us in this Congress, that this will happen.

What ever plan is developed, Congress should pledge to enter the same plan as the "government option", including Ted Kennedy, and the same level of care should be given to them as should be given to the homeless person on the street.

[TheMercenary]

Wow..

The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing.

Barbara Wagner
(Paul Carter/Register-Guard)The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

http://abcnews.go.com/Health/story?id=5517492&page=1

[richlevy]

Originally Posted by TheMercenary

Wow..
http://abcnews.go.com/Health/story?id=5517492&page=1

But under the insurance plan, she can the only receive "palliative" or comfort care, because the drug does not meet the "five-year, 5 percent rule" -- that is, a 5 percent survival rate after five years.
A 2005 New England Journal of Medicine study found the drug erlotinib, marketed as Tarceva, does marginally improve survival for patients with advanced non-small cell lung cancer who had completed standard chemotherapy.
The median survival among patients who took erlotinib was 6.7 months compared to 4.7 months for those on placebo. At one year, 31 percent of the patients taking erlotinib were still alive compared to 22 percent of those taking the placebo.

So, going by averages, if you take the drug for 6 months until you die, you have gained 2 months at a cost of $24,000.

Including the death option in the same letter as the denial was insensitive, but I can see where someone would want the information. I heard John Wayne tried to commit suicide during his final months.

[TheMercenary]

Originally Posted by richlevy

So, going by averages, if you take the drug for 6 months until you die, you have gained 2 months at a cost of $24,000.

Including the death option in the same letter as the denial was insensitive, but I can see where someone would want the information. I heard John Wayne tried to commit suicide during his final months.

Any way you look at it, it is a form of rationing care. It happens now and will have to happen to a greater degree under any government run plan.

[Undertoad]

What ever plan is developed, Congress should pledge to enter the same plan as the "government option", including Ted Kennedy, and the same level of care should be given to them as should be given to the homeless person on the street.

Yessir, that's the acid test: if they have developed a public insurance plan that cuts costs AND works well, they can demonstrate faith to the public by signing up for it.

[Undertoad]

What ever plan is developed, Congress should pledge to enter the same plan as the "government option", including Ted Kennedy, and the same level of care should be given to them as should be given to the homeless person on the street.

Yessir, that's the acid test: if they have developed a public insurance plan that cuts costs AND works well, they can demonstrate faith to the public by signing up for it.