November 6, 2007.
OUR HEALTHCARE SYSTEM SUCKS. Part 2.
I posted on our messed up healthcare system and the total lack of leadership to do anything about it and got a lot of responses reaffirming how pissed off people are about this country. A lot of you said that Bush and the Republicans were to blame and I couldn’t agree more. I mean, Bush has got a pretty good insurance plan. In fact he has his own personal doctor. Is this an ENTITLEMENT? And for the Republicans, getting sick has become equivalent to moral weakness or lack of patriotism. How messed up is that?
You have may have seen Michael More’s film Sicko and remember the guy doing handstands in England who dislocated his shoulder and got free and excellent healthcare in England. Well his name is Eric Turnbow and I actually went to High School with him in Olympia, Washington. And amazingly enough I had an almost identical experience in Denmark.
You see after giving a lecture in Aarhus, Denmark, I was walking down one of the streets of the city and my attention was caught by a pretty Danish girl across the street (thank goodness my wife doesn’t read this blog, please don’t tell) and tripped over a scaffolding on the sidewalk. After getting back to my hotel room I pulled up my pant leg and was freaked out when I saw a huge gash cutting through to the bone. What was my first thought? You guessed it: how much is this going to cost me in a country that doesn’t take Blue Cross/Blue Shield?
Well I dragged my sorry ass over to the medical school where I was to attend a dinner in my honor and there was an ER conveniently located across the street. There I was attended by an attractive but very professional Danish doctor who neatly sewed me up. Afterward I stood up and asked the inevitable question.
“How much do I owe?”
“Nothing,” she said. “We have National Healthcare here.”
“Even if I am a foreigner?” I asked, incredulous.
“Nothing at all,” she said.
Well I couldn’t believe it, I didn’t even have to fill out any paperwork.
Afterward as I limped across the street I wondered, do we really have the best healthcare in the country?
Hmmm. Probably not. And definitely not the prettiest doctors.
November 2, 2007. 7:11 p.m.
OUR HEALTHCARE SYSTEM SUCKS.
Well I can see from the comments to my last blog about the messed up healthcare plans of our presidential candidates (or their flaunting of the fact that they have no plans) that a lot of you are pissed off about the healthcare system. So am I. In fact, I think that it is criminal that someone like Mitt Romney can sit there and say that we have universal healthcare because if you break your arm they are going to take you to the ER even if you don’t have insurance.
McCain says that Hillary’s healthcare plan is “putting lipstick on a pig,” but I think the real pig is the current healthcare system. And the people putting the lipstick on it are the Gang of Four (pharmaceutical industry, doctors groups, hospitals, and insurance companies). They’ve got us all so mesmerized with their propaganda that we all think it looks like a pretty sexy pig. Why don’t we all just hold hands now and sing “We’ve got the best healthcare in the world” to the tune of “I’d like to teach the world to sing”.
Yesterday an article in the journal Health Affairs reported that 37% of Americans didn’t go to the doctor when they were sick or didn’t buy needed meds or treatments because they couldn’t afford it. Half of all bankruptcies were found to be due to medical illness. You’re not happy with this situation, either, in spite of what the media (who can’t get over their excitement about all the wonderful medical breakthroughs we’re having) is telling you that you are feeling. In fact, the survey showed that one third of you thought the system was completely dysfunctional, and needed to be redone from scratch, making you one of the most unhappy group of health care consumers in the world.
And doctors aren’t happy about it either. They found a safe place to bitch to each other about the healthcare system at a doctors-only web site called sermo. When Pfizer bought a piece of it they had a virtual conniption fit, literally.
And what should we do about it? I’ll have to think about it and get back to you later. Right now I have to go see some patients. You see, the healthcare system I work for has been running in the red for some time now, and they’re considering a merger with…
October 30, 2007. 11:30 a.m.
ARE THESE PEOPLE COMPLETELY OUT OF THEIR MINDS?
Yesterday it was reported that Hillary Clinton was out in front of the pack of presidential
candidates in terms of political contributions from the healthcare industry. She’s got a whopping
$2.7 million in contributions, ahead of Obama with $2.2 million, Romney $1.6 million, Giuliani $1.4
million, McCain $0.9 million, Edwards $0.6 million, and Richardson $0.6 million. You see, in spite
of the fact that during the time of BILL she was ready to take a hatchet to the insurance companies
(a tap which they surely deserved), now the insurance companies (as well as the other Gang of Four,
which includes the AMA, hospitals, and pharmaceutical companies), are falling over themselves to
shower her with dollars. You see they have figured out that she may win, and that the democrats may
take over Congress and the Senate. Then they would really be up that proverbial creek without a
Republican paddle. So the Gang of Four have decided to plug their noses and start shoveling money
up the most distasteful of channels.
Hillary had some wonderful dreams about reforming American healthcare during the time of BILL.
But after getting creamed by the Gang of Four during the last Democratic administration she has
woken up and is smelling the ipecac. Hillary’s plan says that they will give tax credits to working
families (translation: poor people) and that insurance companies can’t deny coverage if you
have a pre-existing condition or if you change your job. But she still keeps on the slough of
overpriced insurance companies and the tangle of disconnected healthcare systems that won’t allow
doctors to communicate and share records electronically as they should. Bottom line? Keep those
donations coming, honey.
Obama similarly says don’t exclude for pre-existing conditions, cover all essential medical
services, have subsidies for poor people who don’t fit into current programs, and provide the
ability to change jobs without changing plans. He emphasizes quality and efficiency, easy enrollment,
and simplifying paperwork. Is he going to ask for an act of Congress to get insurance companies to do
this? Bottom line? He doesn’t have the guts to tell his wife to shut up, let alone get the Gang of Four in order.
Mitt Romney’s mutton-headed plan (What me worry?) says who cares about universal health care, we already have it.
If you break your arm go to the ER, someone will take care of you. It you have cancer they will take care of you.
But what if you have a house, Mitt? Did you ever consider the fact that that they will charge you TWICE as much
as your brother-in-law from Utah who has insurance? HELLO? Bottom line? This guy was on track when he came up with
universal health care for Massachusetts, but at this point we should flip this flip-flopper back to Massachusetts,
or if they won’t have him the land of Joseph Smith and Brigham Young.
Rudy calls Hillary’s plan a “nanny state”. He wants health insurance to reflect an “ownership society” where
people would buy their own insurance with the help of tax incentives instead of getting it through their employer.
He wants to emphasize free market competition. I mean like, come on, Rudy, do you really expect me to believe
that comparing my employees Aetna and United Healthcare plans represents the same kind of competition as being
able to buy a toothbrush at Walgreen’s or CVS? Critics correctly point out that his plan will lead to cherry picking,
where insurance companies will pick individuals who are less sick. In fact, it’s not clear exactly what he wants,
but it sure sounds good (if you are a member of the John Birch Society). And has anyone ever asked, what if he was
ever actually in charge of the post 9/11 recovery operation? (Instead of just standing there yacking like an idiot
with a fireman’s cap on his head).
McCain says that Hillary’s plan is a throw back to the time of BILL. He says it is like “putting lipstick
on a pig, but it is still a pig.” So what would he do? He emphasizes containing costs. He states that the
uninsured are a symptom of the problem of runaway costs. He thinks that the pay of doctors and hospitals
should be linked to performance. Drug companies should tell us how much drugs cost (isn’t that the
capitalistic way?) and there should be more competition with generic drugs. He wants to give a
tax credit to poor people who buy their own insurance. Chronic diseases should be contained to
prevent increasing costs, and overall he thinks that individuals should be accountable for
providing for their own health care. OK, I am a doctor, so if you are patriotic and want to
help solve our health care crisis, stop smoking, eat right and start exercising (go figure).
John Edwards is the power advocate for the little guy and he wants universal health insurance for
everyone. He will provide affordable health care for the uninsured and require businesses to pay
for insurance for their employees. He will expand government programs like Medicaid and the State
Child Health Insurance Program (SCHIP) and will take steps to contain health care costs, but
doesn’t really say how.
Overall the Republican plans are like shouting at a sick person to get up off the ground
and run a marathon. Hillary is so in bed with the Gang of Four it makes me nervous. If
she believes that God is directing her political activity (as she does) does that mean that
God is a President of an HMO? As for Obama I don’t know what he is talking about. Overall
John Edwards has probably spent the most time actually thinking about health care and has
provided the most detail. But all of these plans skirt the fact that our system of insurance
companies and multiple bureaucracies is cumbersome and inefficient. I think true universal
healthcare is the solution, but as the French say it will probably never happen in this country,
so the next best option is to just go without insurance at all.
October 7, 2007. 10:31 a.m.
Private Insurance Company Abuses Associated with Bush's
Medicare Drug Benefit Program Are Not a Surprise.
An article in today's New York Times
("Medicare Audits Show Problems in Private Plans") describes the abuses of private insurance companies of the government's
Medicare Drug Benefit Plan. This was long expected by us.
You see, Bush got a lot of donations from pharmaceutical companies
and their allies, so in order to pay them back, he got
the Medicare Drug Plan passed. The plan states that the government
cannot negotiate the costs of these drugs, which means down the
road the costs of this benefit are going to be immense. Another
bone thrown to the advocates of free markets was to
have private insurance companies administer the plan on behalf
of the government. This was to assuage those afraid of having the government
involved in health care. But it adds another layer of administration and makes no sense.
Now these private companies are kicking people with HIV off their lists,
ignoring people's petitions for off-formulary drugs, and calling up
little old ladies at home and saying they represent Medicare and
they have to sign up for their expensive plans to retain their
insurance.
I say, don't pay these goons a dime. Who says we have to buy
health insurance, anyway? But more on that another day.
October 7, 2007. 9:53 p.m.
Psychiatric Drugs Given to Small Children.
Today on pharmalot.com was the following sad article ("Massachusetts to Track Meds Given to Kids") about a four year old who died after being given psychiatric meds.
The issue is the diagnosis of bipolar disorder in kids and
whether that is an appropriate diagnosis. I think there are much bigger
issues and I posted the following comment.
"President Bush has promoted drug treatment of psychiatric conditions from the time he
was Governor of Texas using his Texas Medication Algorithm Project (TMAP) in which
he advocated all children being screened for mental
illness and receiving ‘appropriate treatments’ (i.e. medications).
This was payback for the support he
received in his re-election campaign from Big Pharma.
In Pennsylvania and Illinois there were ‘extensions’ of the TMAP model.
This led to several deaths of incarcerated
children given antipsychotics. When a psychiatrist working for the state of
Pennsylvania talked to bmj.com about this he was fired."
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