Never Be Silent

azspot:

The first rule of medicine is, “Do no harm.” The post-Joe Lieberman version of the Senate healthcare bill fails that basic criterion. Unless Democratic leadership steps up to fix this misguided proposal, our only recourse will be to kill it.

The fundamental failing of the newest Senate proposal is that it requires individuals to purchase health insurance, but does nothing to rein in what insurance companies charge. There is nothing to stop spiraling health costs from eating up an ever-increasing percentage of our national productivity.

The House bill has two major cost-control mechanisms: the public option and the 85% medical-loss ratio requirement. The Senate bill is on track to have neither, and nothing new to replace them. The Senate bill is a recipe for national disaster. If it’s that bill or nothing, I prefer nothing.

We all know America’s current healthcare system is failing — and it’s failing everyone, not just the uninsured. It is far too expensive: Americans spend 16% of GDP on healthcare and get worse results than countries that spend half that. Literally.

We need health reform that expands access to quality healthcare, abolishes unjust practices of insurers, improves value to the country, and puts us on a trajectory to continue to improve our healthcare system over time.

But the Senate has systematically stripped out nearly everything I liked about what was proposed in the early, heady days of healthcare reform. They have done so in order to please a handful of so-called centrists who care more about protecting corporate profits than protecting the people they claim to represent.

From the Huffington Post, excerpt:

A CIGNA employee gave the finger — literally — to a woman whose daughter died after the insurance giant refused to cover her liver transplant.

Hilda and Krikor Sarkisyan went to CIGNA’s Philadelphia headquarters, along with supporters from the California Nurses Association, to confront the CEO Edward Hanway over the death of her 17-year-old child.

In 2007, Nataline Sarkisyan was denied a liver transplant by the company, on the grounds that the operation was “too experimental” to be covered. Nine days later it changed its mind, in response to protests outside its office. It was too late: Nataline died hours later.

“CIGNA killed my daughter,” Nataline’s mother Hilda told security. “I want an apology.” Sarkisyan was not able to speak to Hanway; a communications specialist talked to her instead. After their conversation, employees heckled the group from a balcony; one man gave them the finger. CIGNA called the police and had the family and their friends escorted from the building.

From the Washington Post, (and stolen from a friend’s Google Reader feed) excerpt:

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation’s 200 private health insurance plans — a broader choice than any American has. If a German doesn’t like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don’t get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as “in-network” lists of doctors or “pre-authorization” for surgery. You pick any doctor, you get treatment — and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as “stressed,” medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations — Germany, Britain, Austria — outperform the United States on measures such as waiting times for appointments and for elective surgeries.

In Japan, waiting times are so short that most patients don’t bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. “Why don’t you just drop by?” the receptionist said. That same afternoon, I was in the surgeon’s office. Dr. Nakamichi recommended an operation. “When could we do it?” I asked. The doctor checked his computer and said, “Tomorrow would be pretty difficult. Perhaps some day next week?”

From Nicholas Kristof of the NY Times, excerpt:

Here’s a paradox.

Health care reform may be defeated this year in part because so many Americans believe the government can’t do anything right and fear that a doctor will come to resemble an I.R.S. agent with a scalpel. Yet the part of America’s health care system that consumers like best is the government-run part.

Fifty-six to 60 percent of people in government-run Medicare rate it a 9 or 10 on a 10-point scale. In contrast, only 40 percent of those enrolled in private insurance rank their plans that high.

Multiple surveys back that up. For example, 68 percent of those in Medicare feel that their own interests are the priority, compared with only 48 percent of those enrolled in private insurance.

In truth, despite the deeply ingrained American conviction that government is bumbling when it is not evil, government intervention has been a step up in some areas from the private sector.

Until the mid-19th century, firefighting was left mostly to a mishmash of volunteer crews and private fire insurance companies. In New York City, according to accounts in The New York Times in the 1850s and 1860s, firefighting often descended into chaos, with drunkenness and looting.

So almost every country moved to what today’s health insurance lobbyists might label “socialized firefighting.” In effect, we have a single-payer system of public fire departments.

We have the same for policing. If the security guard business were as powerful as the health insurance industry, then it would be denouncing “government takeovers” and “socialized police work.”

Throughout the industrialized world, there are a handful of these areas where governments fill needs better than free markets: fire protection, police work, education, postal service, libraries, health care. The United States goes along with this international trend in every area but one: health care.

Reminder— Nicholas Kristof’s new book Half the Sky: Turning Oppression into Opportunity for Women Worldwide will be released September 8th.