Monday, July 27, 2009

Ok, So Do You Really Want To Fix Healthcare?

The OECD, is a cooperative organization of 30 countries (including the United States), that are focused on economic growth. Their mission statement reads as follows:

  • Our mission
    OECD brings together the governments of countries committed to democracy and the market economy from around the world to:
    - Support sustainable economic growth
    - Boost employment
    - Raise living standards
    - Maintain financial stability
    - Assist other countries' economic development
    - Contribute to growth in world trade

    The Organisation provides a setting where governments compare policy experiences, seek answers to common problems, identify good practice and coordinate domestic and international policies.

Okay, so why a reference to OECD on a blog post regarding Health Care? Well, the reason I point you toward the OECD (check out their site by clicking the link above), is that it is an organization focused on economic development and growth. They have excellent statistics on a wide array of subjects, including Health Care Spending.

Let us look at some reference points.

1. The United States has the most expensive Health Care "system" in the world.

2. The United States has almost 50 million of its citizens without health insurance. These people have to exercise "last resort" options when they are ill. Examples include people taking their children to Hospital Emergency Rooms for basic infections. Another 17 - 20 million people are estimated to be "under-insured" (as of 2003), which means their coverage is not adequate for their needs and typically they will have to make up the cost for the gap in their coverage.

3. The United States does have a public health care option, it is just not "universal" in that not just anyone can join. Medicare and Medicaid, have been providing service to the elderly and the impoverished since the late 1960's, and it has been working very well. Our country is one of the few industrialized countries that lacks an overall public option.

4. Our Health Care system has not improved infant mortality rates, the average life-span of its citizens, nor provided better preventative care regarding chronic illness such as diabetes, asthma, etc. than countries who have a Public Option.

Why do we have the most expensive system in the world and one that is not as effective as other countries like Canada and the UK? Well, there are many opinions and possible answers to that question and this post is not going to attempt to answer the "Why" question. However, there is likely only one way to gain control over the costs and improve the overall quality of service of our Health Care system. We must provide a public option system that sets the stage for a "single-payer" system on the model of the Canadian and British system. I do not believe we need to eliminate private, for-fee insurance and health care. If you have the money and elect to exercise that option, it should be your choice. However, no one should have to make a decision on whether or not to pay rent or get their medications. We have a crisis in the country with more people uninsured than make up the entire population of Canada.

Those of us with jobs who have decent health care (me included), often unintentionally ignore the plight of others who don't have good coverage. While sympathetic, we are also apathetic and complacent. It is a complex problem that most of us get overwhelmed with and look to the government to solve the problem. Then, opponents of government intervention will castigate the efforts to resolve the problem as attempting to bring evil "socialism" to our shores, which will "destroy our American Way of Life". If you think there aren't crazies out there (in congress as well (See Michelle Bachmann)) who think if we provide health insurance to everyone, we will all fall from God's good grace, you are fooling yourself.

More insidious are the Industry lobby. They are spending over $1.5M per day in efforts to lobby against health care reform. That's half a billion dollars in a year! Think of how many people that could treat who don't have coverage! Why are they fighting this so strenuously? Well, why do they keep building hotels in Las Vegas? 'Cause there is money in this business; Big, Big money. Insurance companies are fighting this with everything they have, and don't want reform. Too much money is at stake.

So, it falls to us, the well insured, to step up and say enough. I've had it with the system. We must see massive change in order to treat everyone equally. I'm not a religious man, but I do recognize the wisdom in the following statement: From Matthew 25:40 - "The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me." Simply put, let's treat the least among us the way we'd like to be treated. It is an obligation those of us fortunate enough to be able to afford good health insurance must take on.

The way change comes is when those who are well served by the system recognize it has faults and elect to make a change for the greater good.

I'm a "dyed in the wool" capitalist who checks his stock portfolio every morning. I do not subscribe to the notion that making money is necessarily bad. However, when profit takes precedent over treatment, I must re-think our approach to a system that is focused on making money over treating illness.

Here is some more data for you. If you have to consider the reason why the compensation for CEOs of the Top Health Insurance companies is so robust, you might think that it is because of the excellent care and products they offer. You would however be wrong. The reason their compensation is so high, is that the companies' boards of directors and compensation committees set the salaries by and large based on the financial performance of the company versus any positive result of care given. See the list below for compensation levels from 2007 and 2008:

Ins. Co. & CEO With 2007 Total CEO Compensation
Aetna Ronald A. Williams: $23,045,834
Cigna H. Edward Hanway: $25,839,777
Coventry Dale B. Wolf : $14,869,823
Health Net Jay M. Gellert: $3,686,230
Humana Michael McCallister: $10,312,557
U.Health Grp Stephen J. Hemsley: $13,164,529
WellPoint Angela Braly (2007): $9,094,271L. Glasscock (2006): $23,886,169

Ins. Co. & CEO With 2008 Total CEO Compensation
Aetna, Ronald A. Williams: $24,300,112
Cigna, H. Edward Hanway: $12,236,740
Coventry, Dale Wolf: $9,047,469
Health Net, Jay Gellert: $4,425,355
Humana, Michael McCallister: $4,764,309
U. Health Group, Stephen J. Hemsley: $3,241,042
Wellpoint, Angela Braly: $9,844,212

Now, I don't have a quarrel with people making a lot of money. I really don't. If the money earned is based on a reasonable metric focused on the improved health care of it's customers versus one that is unfortunately engineered to do harm to the community it serves that it intends.

The current method of making money by the insurance companies requires decisions that run into direct conflict with care giving. Denying coverage is not done because the companies are mean and want the patient to stay sick or die. It's because providing the coverage is expensive and will reduce their profits. That's it. That's the entire reason the Health Care system is as fucked up as it is. Profits before treatment.

Check out Michael Moore's brilliant "Sicko" for an example of what happens with the big Insurance companies like Humana, Aetna, etc. etc. His documentary discusses people with insurance coverage who wind up bankrupt simply because they had the temerity to get sick.

If you really want to fix health care, you have to remove Profit as the overriding reason a health insurance company is in business. Find another way to reward your shareholders or executives. Earnings Per Share = Denial Of Coverage, and it's about time this equation changed. Wouldn't it be cool if a company made half a billion dollars because it was able to reduce the rate of cancer or obesity or diabetes in the country and it was rewarded not by profits of drugs or denial of service, but because of the results of a service provided that improved the lives of its customers?

Tell me what you think,



Sunday, July 26, 2009

How Idiotic We Must Look

While this nonsense started prior to the election, the so-called "Birther Movement" has garnered quite a lot of attention recently. Most recent, is Lou Dobbs, the venerable CNN newsman who regularly bemoans all the illegal aliens coming into the country giving this ridiculous matter his attention. Come on Lou, please don't get on the express train to Crazy Town along with the other nut jobs out there who think the President is not a natural born citizen.

The picture of his birth certificate included here was provided by the campaign well before the election took place and even his chief rival for the top-job, Mr. John Sidney McCain, has said this is utter bullshit.

A wide array of lunatics that include Jerome Corsi, the author of the John Kerry hit-job for the Swift Boaters, and Alan Keyes an absolute whacked out guy whom I can't understand why he continues to get press. Others assisting in the nonsense are the aforementioned Dobbs, Liz Cheney and Sean Hannity, who in the wake of reporting that a US Soldier refused orders on the basis that the President is not a citizen had this to say:

We told you Tuesday about an Army reserve soldier who challenged his
deployment orders on the grounds that President Obama has not proven he is a
U.S. citizen. Major Stefan Frederick Cook, who was supposed to deploy to
Afghanistan in the coming days, has had his orders revoked. According to his
lawyer, "They just said 'order revoked.' No explanation. No reasons. Just
revoked." Major Cook and his lawyer expressed joy at this outcome and took it as
an admission on the part of the military that the president is not in fact a
legitimate citizen by birth.
—Sean Hannity

Why is this even discussed? Well, for one thing, there are a lot of nut-jobs out there with too much time on their hands. Conspiracy theorists abound, whether it's the 9/11 Truthers, or the ones who think Castro killed JFK, we've always had them and always will. Those who think that Obama is some sort of "Manchurian Candidate", need to see Jon Stewart's response to their prattle.

OK, so the title of this post is "How Idiotic We Must Look". The point of the post is that if you are from pretty much anywhere else in the world, looking at all the problems out there, then turn on essentially any US based news outlet, whether CNN, Fox, MSNBC, or the main networks, you will see time wasted on this. We have a wrecked economy, soldiers still being killed in Iraq and Afghanistan, 50 million people without health care, and this is what they see.

This isn't a liberal versus conservative issue. It's not a Democratic or Republican issue. It's a sane or insane issue. Those who legitimately believe that Obama is not a US citizen in spite of all the "facts", and as John Adams said: "Facts are Stubborn Things", are indeed insane on the issue. Those who know it is bullshit but are flogging this to gain political advantage are just opportunistic bastards playing on the imagination of a few sick people and they should be ashamed of themselves.

I've seen the best of America. I watched the moon landing, (oh and for you moon landing conspiracy theorists: Piss Off). I've seen communities band together to find missing children, to help after disasters like Katrina or the tsunami in Indonesia. I've seen people come together regardless of skin color to demand equal rights and protection under the law. The Birther movement, along with the crazies who think the President is actually a stealth Muslim is the worst in America. A childish group of people, who are over fed a diet of idiotic innuendo and rumor and don't have the intelligence to know they are believing utter nonsense.

Tell me what you think (Birthers, don't bother, I already know what you think)



Tuesday, July 21, 2009

Justice Delayed, Justice Betrayed?

In a recent Newsweek article, investigative reporter Michael Isikoff describes how the task force set up by the Obama administration to develop a plan for closing the detention facility at Guantanamo Bay, Cuba will be delayed "a few months". Orginally scheduled to be published today, the task force will not publish it's recommendation because members can not agree on the legal, and political footprint required to come up with a recommendation.

The issue is fairly complex. Countries of origin do not want the detainees back. Congress is having a collective cow at the notion of "them terrrerrists" being housed in prisons in their states. (Of course, no one has ever escaped from a SuperMax prison, and it houses some fairly scary inmated)

Ok, all of this is fairly predictable. That's the delay part. What troubles, me, no, what really pisses me off is the Obama administration starting to sound like the Bush administration. This excerpt from the article is the most disconcerting to me:

"Three administration officials familiar with the process said the detention task force, which is jointly run by aides to Attorney General Eric Holder and Defense Secretary Robert Gates, did agree that the Obama administration should continue to claim the right to hold some Guantánamo inmates indefinitely as "combatants" under the "laws of war," without charging them either in criminal courts or in military commissions."

I mean, What The Fuck?

tell me what you think.


Monday, July 20, 2009

What A Glorious Day

"Houston, Tranquility Base here. The Eagle has landed." Nine words. Just nine words culminate the most impressive undertaking by humanity. Neil Armstrong's terse confirmation that the Lunar Module known as the "Eagle" touched down on the lifeless, colorless, completely desolate satellite of the Earth known to all of us simply as "The Moon". Tranquility Base (geez the space program is good at naming stuff), was the location. The day was July 20, 1969. I was ten years old, and thought that "boy, after this, we can do anything".
The importance of the Apollo program and its predecessors, Mercury and Gemini, is lost on many people born after we quietly backed away from deeper human exploration and focused on more utilitarian space missions. Oh, the Hubble is terrific, the pictures beautiful, and we have learned so much with it's launch. The International Space Station is cool, as are the various unmanned missions to Mars.
Apollo was different though. Human beings, like Magellan ventured off into territory unknown and unfriendly. Not only did they achieve the goal of reaching the moon, they came back safely. A youthful president exhorted this nation to achieve this goal only 8 years earlier and we did it!
Think of what we can do when we try. You don't have to think hard, just think two words. Apollo 11.