Category: Health Care

Scared of Ebola? Then you haven’t heard about THIS!

People are freaking out–right now my news feed is blowing up because somebody barfed in the Pentagon parking lot, causing officials to seal off one entrance, and quarantine a busload of people headed to some jarhead’s change of command ceremony.

While we’re spazzing out about whether or not to buy online this year, because the person at the shipping dock might have had Ebola (seriously–I’ve seen this concern!  I’m afraid these folks might just starve to death if they figure out the same problem could occur at the store.  “THIS JUST IN:  Walmart might be an Ebola vector!”)-  If we’re taking such drastic action to protect against the spread of this deadly virus, the CDC should be proactive to prevent THOUSANDS of deaths this year alone from a much more heinous killer, that’s already breached our shores.

Barricade all KFCs.

I’m serious!  Ebola has killed ONE person in the US, and TWO MORE are infected because of DIRECT contact with the deceased victim.  Meanwhile, an average of SIX HUNDRED THOUSAND Americans die ANNUALLY from heart disease!  The three leading contributors to heart disease are high blood pressure, high LDL cholesterol levels, and smoking.

Six. Hundred. Thousand. Per. Year.  That’s the equivalent of the entire population of Portland Oregon or Milwaukee, Wisconsin.

Wait, you don’t care about people dying, as long as it’s not you?  Ok, then choke on this number:  the CDC estimates that heart disease costs $108.9 BILLION per year!

Now, we can’t outlaw tobacco, because, well, it’s too big to fail.  But the smaller fast food chains like KFC are nothing more than disease-dispensers.

This whole Ebola scare in the US is a prime example of irrational thinking driving imbecilic behavior.   If we really were worried, we’d start outlawing fried foods.  Ebola is a real problem in West Africa.  In the US, it’s just fodder to feed our irrational need for drama.

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Health Care Reform Bibliography

I promise to publish part 2 of the substance of this multi-part thread soon, but I wanted to get this out there, as a general link to some good sources for more information on health care and the Affordable Care Act.  I’m sure there are many more sources, but these are some I’ve found to be quite helpful.  I’m including a short description to help you understand the source, so that you can consider  the source’s bias as you’re reading.  I encourage everyone to always read skeptically, and always to consider the source, so you can determine their bias and weigh their message accordingly.

So, in no particular order (man, it’s great to be out of Grad School!  No rules!):

The Affordable Care Act of 2010.  The whole thing (actually, this is a compilation of the ACE and the Patient Protection Act.)..  All 900+ pages (don’t let it intimidate you, there’s lots of white space) in searchable PDF format.  I have not read it all; I am somewhat skeptical of pundits who claim they have.  I’ve had many years of practice at reading government regulations and laws, so I’m somewhat immune to the boredom they bring, and I couldn’t do it, and quite honestly didn’t find it fruitful to try.  For those who are not in the business of health care who claim to have read the whole thing, I would love to test their comprehension of what they read.  I found it much more productive to drill down into topics I was wanting more info on, either through the table of contents, or through PDF search functionality.  Some search hints:

  • If you look for “Death Panels” you’ll come up empty.  What Sarah Palin refers to by that catchy moniker is titled the “Independent Payment Advisory Board.”  Search the PDF by that term instead.
  • Brown Shirts:  Not there.  There is a section on page 543 (Sec 203) titled “Commissioned Corps and Ready Reserve Corps” that modifies existing law authorizing the existing US Public Health Service Commissioned Corps, which has been around in current form since shortly after the Civil War.  (If you think this is Obama’s secret army, akin to Hitler’s Brown Shirts, I wouldn’t worry too much.  Their “commanding officer” is the US Surgeon General; and the few interactions I’ve had with these folks have clearly demonstrated that Bill Murray’s platoon in Stripes had more military discipline.  These guys may be good doctors, nurses, and health care professionals, but I’m more intimidated by Girl Scouts selling cookies at my door than I am by the threat of any of these folks.).  More recently, people are linking Obama’s Brown Shirts to FEMA, but that’s outside the scope of the ACA or this post.

The Kaiser Family Foundation: This is a great site with a ton of information, and their data is good enough that their pricing indexes are used in some places as an industry standard (this is from my personal experience in labor contract negotiations, where we needed a health insurance price index to include in contracts.  I can’t comment as to how widely spread this usage is).  They bill themselves as trying to be a trusted source of information in a space where most sources have a vested interest.  They’re set up to try to minimize outside influence.  I’m not going to claim they’re unbiased, but they seem to do a very good job of providing the facts, and presenting the data so one can analyze it for oneself.  They certainly are thorough in their coverage and analysis; you could get lost for days on this site, and learn more than you ever wanted to know.  They also keep it very fresh, with current insight and analysis.  This page details their CEO’s perspective on KFF’s approach to the ACA–if you want to dig a little deeper.

Centers for Medicare and Medicaid Services website.  This link actually takes  you to their National Health Expenditure Data page, but this is a good site to get federal government “official” data on health care information.  Yes, they’re the federal government.  I’m not asking you to blindly trust the government, but I don’t recommend blindly dismissing them either.  They’re a good source of data.  If you’re convinced that their data is corrupt and deliberately skewed to deceive, I’m not sure what to tell you, other than you should be as skeptical of every other source.

Health and Human Services Agency for Healthcare Research and Quality Another federal government website, but a source for data on health care in the US.  Some pretty detailed data here, and it’s not the easiest site to navigate, but if you want to find a particular nugget, it’s probably here somewhere.

Health Affairs (online journal):  Quote from their “About” page:

Health Affairs is the leading journal of health policy thought and research. The peer-reviewed journal was founded in 1981 under the aegis of Project HOPE, a nonprofit international health education organization. Health Affairs explores health policy issues of current concern in  domestic and international spheres. Its mission is to serve as a high-level, nonpartisan forum to promote analysis and discussion on improving health and health care, and to address such issues as cost, quality, and access.

Good info from a peer-reviewed journal; problem is that only the content from more than three years ago is free.   Unfortunately, most of the pertinent info on health care reform and the ACA has been published in the past 3 years, and I didn’t want to pony up $144 to read it.  However, you can get the key talking points of those more recent articles from the abstracts.

“The Clock is Ticking. More Americans Losing Health Coverage”  Families USA: Washington DC, July 2009.    I pulled some statistics from this report, that gives data on the status of private health insurance access prior to adoption of the ACA.  This site is definitely supportive of the ACA.

I’ll probably embed more specific article links within the text of the posts, but this ought to get you started in your research.  I’m not claiming all of these are perfect, and that you should trust them blindly, but instead that they are good starting points to inform yourself, rather than just believing sound bites, emails, and blog posts (even mine!).

Seek first to understand…

With fear and trembling…

I’ve been preparing to write this post for months, and putting it off for the last several weeks.  Truthfully, I don’t want to write it, because I’m actually expecting a lot more backlash and disapproval than I expected (but surprisingly, didn’t get) from my most-read post:  “The Post That May Just Offend Everybody.”  But I’ve been alluding to writing about this for some time, and have done a lot of research in preparation, in hopes that I can present a clear, detailed perspective that just might clarify one of the biggest issues facing our nation right now.  That, and I think this is one of those ones that God told me to write (OK, truthfully I know God leads me to write all of these, but this one seems to be one he won’t let up on).  So, with that ominous introduction, I will attempt to share my understanding and position on the Affordable Care Act (ACA). (1)

Bear with me on this one, I beg.  I know it’s all over the news, but I’m hoping I can provide some reasonable perspective.  I won’t claim to be totally objective, or unbiased, because I’m not.  I’m getting kind of passionate about the topic of health care reform.  What I hope to do, though, is to be clear what my biases are (as I understand them), as well as trying to address other perspectives as objectively as possible.  I’ll lay out my biases and motivations shortly, but my objective in tackling this controversial subject is to try to advance a reasonable dialog that might just provide an impetus to achieving real, productive improvement to our nation’s health care system.

I’m going to have to break this up over several posts, because it’s a complex subject, and trying to cover it in People magazine-style, let alone TV news sound bites, or Tweet-format, is not only impossible, but also a recipe for inaccuracy (see, for example, “you can keep your plan”).  Part of my reluctance to start has been simply that I wasn’t looking forward to all the disagreement, but I would hope that we can have a more reasoned discussion here, among friends, than is taking place in the media, or the halls of Congress.  The rest of delaying has been in trying to figure out how to organize this thing.  I’m probably going to tax WordPress.com’s publishing capabilities (I’m certainly going to exceed my abilities to use the site to organize a complex document), but I want to ensure that I provide good jumping off points for further research, or to at least demonstrate the due diligence I’ve performed in my research.  To that end, I’ll be posting a “bibliography” of sorts.  I’ll try to link to specific sources for statistics or quotes I reference.  I’m also going to provide my definition the problem as I understand it.  I will describe several possible approaches to solving the problem, and how those approaches are incorporated within the ACA.  Either embedded in that discussion, or separately (depending how all this comes together for organization purposes and readability) I’ll identify what I see as the strengths and the shortcomings of ACA.  Finally, I hope to talk about what I believe is the best path forward.  Somewhere in all that, I’m going to try to tackle a lot of the misperceptions that are out there today.

I mentioned earlier that I’m biased, and indeed passionate about the topic of  health care reform.  I guess the passion comes from the fact that I used to be pretty strongly biased against anything that smacked of government assistance.  I wrote papers in my undergrad days decrying the need to provide health care, unemployment, welfare, or any other type of handout.  I’m guessing my old Econ professor has probably departed this earth by now, but if he hasn’t, and were to read this today, he’d probably be dead from shock before he finished.  At one point, while acknowledging that the welfare system had become a multi-generational issue, I went so far as to advocate for systematically and forcefully removing all children from these dysfunctional welfare homes in order to break the generational cycle (one of the reasons I don’t get too excited about what any public figure over the age of 40 wrote, studied, or read while in college!).  As the saying goes, though, there’s nothing worse than a reformed smoker, or in this case, reformed ultra-conservative.  I believe that in the richest country in the world, that spends more per capita on health care than any other nation in the world, that people should not be impoverished because of catastrophic health issues, nor should they be forced to go forego necessary treatment because they can’t afford it.

So what happened to bring about this radical change in my thinking?  Several things.  First, somewhere along the way, I figured out that I had been the beneficiary of blind luck (ok, I don’t believe in luck, but providence gave me something that I never once sought or planned for).  I have had (virtually) free health care for all of my adult life, courtesy of the US government.  Even when I retired from the military, my annual expenditures for health care for my entire family, including annual premiums, co-pays, etc, was less than the monthly premium most people paid for private sector health insurance, not even considering deductibles, co-pays, and other out-of-pocket expenditures.  I wasn’t some genius who planned out how to achieve this level of health care security; I just joined the Army to jump out of airplanes.  Free health care came with the package–not that it meant anything to me when I signed the contract.

But my free government health care alone wasn’t enough to reform me; for many years my mantra was that I earned it through my service.  What really started me doubting my convictions that anybody could pull themselves up by their own bootstraps, was when I started discovering friends who had worked way harder than I had, and were much stronger than me, whose bootstraps had broken.  I have a friend who owned a construction company, who literally built million dollar homes.  His work was amazing, and his business skills were quite good, but he lived in a rented duplex, and couldn’t afford health insurance for his family.  He wrenched his shoulder one day helping me get my snowmachine unstuck, and still has problems many years later, because he never went to the doctor to get the damage repaired.  He couldn’t afford it.  He eventually had to shutter his business, and go to work at a large company that offered benefits, just to take care of his family’s health needs.  I have another friend who is an amazing mechanic, and worked for many years on military vehicles as a civilian contractor.  Bouts with cancer and other medical issues, even with employer-provided medical insurance, bankrupted him, and continues to wreak havoc with his finances.  I just recently discovered that since he was medically retired, he no longer has the insurance he needs to pay for his liver transplant, and has been removed from the list.  Neither one of these guys were welfare bums; heck, they work harder than I do!  They are both smart, talented, and hardworking; they just ended up on a different life path than me; not through destructive choices, but because they decided to open their own business, in one case, or contracted some nasty disease in the other.

The final straw was when I started studying Christianity–that belief system that I have devoted my life to trying to live by.  The Bible says that man is created in the image of God; that all human life has intrinsic value.  Jesus didn’t give us the option to pick and choose who we would love or show Christian charity to; in fact in response to a religious legalist, who was looking for justification that he was loving his neighbor, and thereby obeying God and earning eternal life, Jesus told a health care parable.  Around the same time I was confronted with my own hypocrisy, the health care reform debate was going on in earnest, and I’d started blogging.  I wanted to engage in the discussion, but I wanted to do so from an informed position, so I started researching the issue, and writing about it.  (If you click on the “Health Care” category in the right column, you’ll get a list of posts I wrote starting back in 2009 on this topic, before ACA became law).  The more research I did, the more I discovered that our health care system in our country isn’t getting the job done, and lives are lost, and ruined, because of it.

Jesus said that I’m supposed to care for “the least of these,” and through his life and teaching demonstrated that I don’t get to pick and choose who is worthy of my love and my care.  I don’t get to decide who doesn’t deserve adequate health care because they don’t meet my expectations of supporting themselves, or because they had too many babies, or whatever other reason I find for them to be unworthy.  The Bible is VERY clear that judging others is outside my scope.  I’m just supposed to love them.  That doesn’t mean think fuzzy puppy thoughts about them, that means meet their needs.  Jesus was in the healing business.  Unfortunately, too many folks in the US think us Pentecostals are crackpots, so although the same healing power that Jesus used is available to his followers today (see John 14:11-14, despite the desperately twisted hermeneutics John MacArthur and his friends try to employ to deny it), until such time as more Christians of this country are all filled with the Holy Spirit, we’re going to have to go to plan B or plan C.

More on those in the next installment.

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1.  The Affordable Care Act is the name for the 2010 legislation commonly (and derisively) referred to as “ObamaCare”.  I’m going to refrain from using that term, and instead stick to “ACA,” to try to take some of the venom out of the discussion. 

What if…?

What if there was a way to add $17.6 BILLION per year to provide health care for the uninsured in America…with no tax increase, no federal deficit increase?

A few weeks ago I asked the question “How much would you give to help your neighbor?”. I didn’t get much response, but that may have been because folks were afraid I was going to ask for monetary gifts.

I’ve been thinking a lot about health care lately. I’m not a fan of the bill passed by Congress earlier this year. But I’m also not a fan of junking everything and starting over. There’s too many people in real need, and I know some of them. More than 3/4 of the uninsured in America are members of working families who cannot access health care, either because their employer doesn’t offer health insurance, or the costs are too high.

To recap a key point from my blog a few weeks ago: Americans are giving people. The whole world knows this! We give BILLIONS every year in response to needs, be it natural disaster relief, charitable contributions to third world countries, etc.

As the recent election indicated, many Americans are also tired of the government telling them what to do. I contend that the reason the government has assumed this role, is we, the people, have stopped voluntarily helping each other to the extent we used to. I’ve got some theories as to why, but they’re not germane to this discussion. The point is, we’ve got neighbors in need, and we can do something about it.

So, here’s my hair-brained idea: If every tax-filing entity in the US (that’s 144 million individuals/families, and 2.5 million corporations) were to voluntarily give $10 per month, that would provide $17.6 billion per year to health care for the uninsured. $10 per month! Even for my high-school daughter working part time jobs, that’s do-able.

If we, the people, were to inject $17.6 billion into health care for the uninsured, I believe we’d make a big dent. Would we solve it? Probably not. But it’s a start. And just like any of the big issues facing our nation/world today, there’s no single or easy fix. We’ve got to start chipping away at it.

What if…? Thoughts?

How much would you GIVE to help your neighbor?

Americans are giving people. Look at the response of Americans in response to recent natural disasters:

*Hurricane Katrina, Rita, Wilma (2005): $5.3 billion ($4.3 B from individuals)
*SE Asia Tsunami (2004): $1.8 billion
*Haiti Earthquake (2010): $1.4 billion

In response to the 2005 Gulf Coast hurricanes, 63% of US households made some sort of monetary contribution to the relief effort. 36% of that group gave between $26 and $99; 33% gave more than $100.

In 2004, the US gave a total of $248.5 billion dollars; 75% of that came from individuals.

So how much would you GIVE to help your neighbor in need? Could your household spare $100 over the course of 1 year? That’s less than $10 a month. I think few of us would have a hard time handing $8.33 to our neighbor each month, if they really needed it.

Thoughts?

Seriously, I’m NOT going to ask you for money, and I’m not setting up some sort of Ponzi scheme. I’d be interested in some feedback. Help me out here. How much would you FREELY GIVE to your neighbor, if it would make his or her life substantially better?

Health Care Reform: What’s the PROBLEM?

Don’t read that title wrong–I’m not saying there isn’t a problem. I firmly believe there is. But I’m not sure we’re going about solving it properly.

In any problem-solving process I’m familiar with, the first step is defining the problem. This step is critical, but often not properly performed. Poorly defined problems result in misguided solutions.

Our politicians are presenting lots of solutions, but I’ve yet to hear a clearly defined problem statment. “America’s health care system is broke” is not a problem statement. What’s broke? What are we trying to fix? What will it look like when we fix it?

Without a clearly defined problem statement, we’re almost assuredly going to fail in any attempt to fix the problem. So, What’s the PROBLEM???

To get the discussion started, here’s my attempt:

Adequate, affordable health care is not readily available to all US citizens.

Lots of weasel words in there, that need further definition. That would be the next step of clearly defining the problem. However, I don’t think we start with a solution (universal health insurance, government provided medicine, tort reform, etc) until we’ve agreed on the problem we’re trying to solve.

So, have at it. Take my attempt at a problem statement apart; post your own.

Health Care Reform-what WON’T work!

So what’s the answer? I know what’s not the answer: Demonizing either side, disruptive scare tactics, pithy sayings and talking points, or solutions concise enough that you can Tweet them. The rhetoric is nauseating. A real, positive solution is impossible to achieve the way the conversation has proceeded to this point. I’m talking to both sides.

I honestly think the President is doing a relatively good job trying to move a major issue forward, and trying to do so in a constructive way. Does he have an agenda–OF COURSE HE DOES! If he didn’t have one, what good would he be as a leader? Is it an evil agenda, a negative agenda–I don’t think so. Am I saying he’s right? No! (I’m not saying he’s wrong either–I’m saying I disagree with his proposals as presented. That’s fundamentally different than saying he’s wrong). He’s at least trying to have an intelligent conversation. Is he engaging in the mudslinging? Yes, but it’d be hard to avoid. When the nitwit Republican Senator DeMint made the statement “If we are to stop Obama on this, it would be his Waterloo. It will break him”, it’s pretty hard to fault the President for fighting back.

I mean, come on…what’s the priority here??? Fix health care, or “break” the President? If it’s the latter, we may have bigger problems than health care reform. Who among us, when trying to do our job overheard someone saying “this is our chance to break him” wouldn’t fight back? That statement wasn’t about health care, it was about the ugliest form of party politics–not standing for anything, simply opposing the person currently in power in order to depose him in order to gain that power for yourself.

The proponents of the President’s plan don’t get a pass from me either. Speaker Pelosi, among others, has characterized those who express an opposing opinion as uninformed, and even unpatriotic. Both sides appear to be focused more on defending their position and attacking those who disagree, than they do about solving problems.

Let’s get back to discussing the details, honestly evaluating the pros and cons, and proposing possible solutions, instead of calling the other side names, and labeling their ideas with inflamatory words that don’t add any value to the debate.

Health Care Reform: Part 2

The other side of the coin: As stated in my previous post, I think what we have now needs some fixing. However, I’m not at all convinced that government-run health care is the answer. As a recipient of government-run health care for all my adult life, I appreciate the price, but it’s not the best service you can receive. Not to badmouth military health care at all, just acknowledging the limits of what they can do given their budgets, regulatory constraints, etc. And I believe the military does a much better job running their health care than any other government agency would–DoD is strongly incentivized to take good care of their most valuable resource (servicemembers), and the people in military treatment facilities take a great deal of pride in honoring our retirees’ service by treating them well. I don’t thing you’re going to get that same kind of service from the Federal Health Care Bureaucracy, whose charter would be to take care of Joe SixPack. I don’t think there’s too many good examples of socialized medicine providing better care than what we have in the US today for the majority of people.

I also don’t believe the government can be more efficent at running a business than the private sector. I’m not saying that the market should be allowed to resolve this itself. A pure market will achieve maximum efficiency, but it’s ruthless, and health care is not the place for ruthless. Also, what we have today is far from a pure market. There’s already a lot of government regulation, insurance expense, welfare programs, etc, that keep the market from resolving this issue itself. But I think this is not an instance where the government needs to take over the operation. That makes sense for certain services (national defense, interstate commerce, primary education, fire protection, etc). I think a strong argument can be made that medical care doesn’t fit that the criteria to justify government operation.

Let’s talk about Health Care Reform! Yaay! :)

OK, I’m really frustrated on this one. I’m torn in different directions.

On the one hand, The system’s not working well. Costs are out of control; and it’s a death-spiral. A lot of people can’t afford quality health care, so they go without. And they continue to go without until their health deteriorates to the point they have to do something about it. Then they’re often forced to destroy their finances, or take advantage of treatment policies that say that hospitals can’t turn away critically ill, or rely on government programs. It’s demoralizing, depressing, and it’s destroying lives, physically and emotionally. It’s also a drag on our economy. Preventative health care, like preventative car maintenance, is much cheaper than catastrophic treatment. And ultimately others pick up the cost of that catastrophic treatment for those who can’t afford their own care.

This one is kinda personal. I’ve got a very close friend who’s battling for his life. He DOES have insurance, but his out of pocket expenses are still bankrupting him. And he’s too proud to take help from others, so he’s probably going to take himself off the transplant list. His reasoning? He can’t afford the debt himself, and if he keeps working till he dies, his employer-paid life insurance will take care of his current debt load, instead of burdening his family even further to get the life-saving operation. Not at all rational, but it shows what this kind of long-term stress can do to an intelligent human being.

Our nation should be able to provide better health care to our citizens (note I said “nation”, not necessarily “government”).