Monday June 29 | Health Care Reform

June 25, 2009 at 11:00 am | Posted in Coming Up | 26 Comments

The topic of health care reform is being debated in every corner of Washington, DC as President Obama continues to announce initiatives and proposals. What would health care reform mean to Carolinians and what are the proposals most likely to gain passage? We’ll assemble our own panel of experts to find out more about health care reform and what form it may take in the near future.
Michael Thompson – Asst. Professor, Public Health Sciences, UNC Charlotte
Meredith Ledford – Private Consultant, Health Policy Analyst
Dr. C.L. Gray – Founder, Physicians for Reform

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  1. If we invest in a public health care system we will all invest more care about public health.

  2. Both my 10 month old son, who has had three major surgeries in his short life. I would be concerned that a national healthcare reform might run off some of our best doctors that are close to retirement and to discourage new doctors. If national healthcare reform does happen, no one can determine the impact one, three, five, ten, twenty years from now. Who is watching out for his future?

  3. Obama’s plan frightens me to death. The provisions already passed in the Stimulus Plan lay the groundwork for large scale rationing of healthcare. And rationing is where I believe Obama plans to find his cost savings. When one combines the electronic medical record provision with “comparative effectiveness” research and a centralized health advisory board, you have a perfect recipe for rationing, and for the Government to step in and tell doctors what they can and cannot do for patients.

  4. Insurance companies ration health care based on profit, not good medicien. My LDL cholesterol is far too high high yet my insurance company is denying payment for blood tests my cardiologist does to be sure my cholesterol medication is not harming my liver. Since this insurance is through my company I do not have the choice to change companies.

    For-profit insurance companies’ main goal is to as much money as possible for their shareholders, not to look out for the best interest of their customers. That is why we need a government plan.

    • Governments ration care based on their budgets, not good medicine. Just last week, a family in Hamilton, Ontario, could not find a neonatal intensive care unit (NICU) bed for their premature baby anywhere in the entire province of Ontario. The baby is now in Buffalo, but the parents cannot visit because they need passports to cross the border.

      Quadruplets have also had to be delivered in the U.S. because Canadian hospitals could not handle the birth.

  5. Mike, great show. Thank you.

    Anything that creates a burden on someone other than the recipient is NOT a right. Free speech, life, a pursuit of happiness are all rights. Health care requires technology and doctors, neither of which will ever be both FREE and HIGH-QUALITY despite what some people hope for. I am self-employed and pay a monthly premium to Blue Cross Blue Shield for major medical expenses. I have accepted the responsibility because I cannot, do not, and should not expect someone else to take care of me. I abhor the idea of a government-run system of any kind.

    • The writer does not wish to be a burden to others – an admirable sentiment – and fears that less responsible parties will be a burden to her in some new system. But those who can’t or won’t pay for their own health insurance are already a burden to the those who are covered. One way or another, they get treatment. That’s why health insurance should be mandatory, like car insurance, but with subsidies for those at some percentage of the poverty level.

      • Three problems with mandatory insurance
        1. Who defines what counts as insurance? In Massachusetts, people have been deemed by the government connector board not to have insurance even though they’ve had the same policy for years.

        2. As a matter of principle, mandatory car insurance leaves people the option to go without a car. Mandatory health insurance leaves no option.

        3. Practically speaking, mandatory does not mean mandatory. Uninsured motorists are often in line with the rate of those without health insurance by state. Hawaii has had mandatory insurance for years and still has 10% uninsured.

      • Thanks to Joseph Coletti for his thoughtful objections to my proposal. His first and third points address difficulties of implementation. The state would define what is insurance, as is true today, no? As to non-compliance, some penalty involving suspension of tax refunds, driver’s license renewal, public university registration or some other public service could be used to bring in the stragglers. The second point addresses a more fundamental objection – that one can’t opt out. Abridging individual liberty in this case serves the common good in this case, just as it does in the case of car insurance. If people could opt out, it would take more cold-bloodedness than I possess to deny them medical treatment when they needed it.

  6. The fact of the matter is that the Healthcare options we have now do not work many people and certainly not for EVERYONE. My insurance company seems to spend more money and time on finding ways to deny my claim than it does on treating me. The “private option” has had it’s chance, it’s time for universal coverage and a public option. I would rather work with someone who, out of their own altruism, wants me to be healthy, than someone who’s looking to make a buck.

  7. Europeans pay more in taxes to have health insurance, but we pay far more per person in total costs – partly through taxes but also in higher health insurance costs to cover the uninsured, and in higher prices for goods and services as a result of health care expenses paid by businesses.

    Other countries insure all of their people for much less per person. Some, like Germany even have a choice of plans offered by different companies. Contrary to conventional “wisdom”, their care is not inferior to ours and their health outcomes are as good or better on a wide range of measures.

  8. The insurance industry is doing what it can to prevent a public option, claiming “unfair competition” with the government. If insurance companies offer a high-quality product, then why are they nervous about government competition?

  9. RE: Mike’s question about health care savings accounts. These accounts are in effect subsidized by taxpayers because they are deductible. If people are allowed to deduct unnecessary care it costs the rest of us through the reduce taxes paid by the person taking the frivolous deduction.

    • By the Dora’s logic, any time a taxpayer gets to keep their own money, it is a subsidy from other taxpayers. Donations to churches, WFAE, and other charities could be considered frivolous and therefore a cost to the rest of us.

      I trust individuals a lot more to spend their own money appropriately on care, than I trust insurance companies or government overseers.

      Insurance provided by employers is currently exempt from any taxation. This is what Obama complained that McCain was going to tax in exchange for a tax credit and that Obama is now willing to tax without giving any back to individuals.

      Health Savings Accounts (HSAs) are like Individual Retirement Accounts (IRAs) in that the contributions to them are deductible from taxable income. If purchased by an individual, the premiums are completely taxable.

  10. Mike asked where all the scare stories about health care systems in other countries are coming from. That information is from insurance companies and drug companies that do not want to see their profits reduced. They have spent millions to keep the public in the dark.

    We Americans are too easily bamboozled. (Just look at how many of us were scammed by the banks.) If our corporate media did a better job informing the public this would not be the case. Thankfully we have NPR and PBS.

    Everyone needs to inform themselves about this critical issue. I recommend you start by checking out Frontline’s documentary “Sick Around the World”. It is well worth taking the time to watch. The background information at their website is also good.

    To get a better idea of how the media fails to do its job reporting on health care, I strongly urge everyone to read the article from the Atlantic Monthly, “A Triumph of Misinformation” by James Fallows:

    Until the public wakes up we will continue to be bamboozled by the monied interests. No democracy can survive unless it has an informed citizenry. It is our obligation to take the time to get the facts.

  11. Defining a “right” as not creating a burden on someone else is incorrect.
    If we used that definition then we would not have public education, public safety (police etc.) public health that assure immunizations that protect the general public or public roads. I pay for these because I am a citizen and believe that their is a cost to belonging to a community. It would be difficult to pursue “life” without a quality of life. Health Care is a basic human right. In America we have low-income, uninsured going to free clinics because they are going blind from cateracts and losing legs from diabetes because their company can not or does not provide healthcare for their employees. We must change and have significant change in healthcare for the security of nation.

    • No, sorry, Nancy, you’re wrong. Public education — and public safety, etc. — are not rights. They are services that (as of now) the majority of citizens have decided it is best that government oversee. If that is what we decide for health care, then so be it. But health care cannot accurately be called a right. Rights are inherent and, again, do not place a burden on others for their fulfillment.

      • I agree with Nancy, but sorry, I posted below.

      • Mindy – The example of education might have been a poor one, but your definition of a right as not costing another is incorrect … as in “You have the right to an attorney. If you cannot afford one, one will be provided to you at no expense…” — Public defenders are paid through tax funds.

        Rights are defined by our social contracts (constitutions, treaties, and the like). Under international treaties to which the US is a party, access to high-quality healthcare is a right. Governments must ensure that appropriate facilities and services are available to all residents (where access includes geographic and financial abilty to receive high quality, appropriate services).

  12. Health care is rationed in Europe. My Family in Norway (one of the wealthiest countries on earth per capita with the accompanying higher taxes and cradle to grave welfare services) frequently sends family members to the US or the UK to get help.

    My cousin successfully sued the Norwegian govt in court b/c they refused to treat her vitiligo. She happened to meet a dermatologist while vacationing in the US in the 1990s. This chance encounter led to basic treatment and eliminated 95% of the visible Vitiligo. B/c this is not essential, she could not even pay for it in her country. In fact, several govt physicians told her it was not treatable. We have been treating it with success in the US since the 1950s.

    My uncle’s father in law suffered from a heart condition 6 years ago. He required expensive open heart surgery. The Norwegian government refused this service due to his age (72 at the time). Fortunately, my uncle was able to pay for him to go to the UK and have the surgery. My uncle’s father in law is still alive and vital and able to participate in the lives of multiple grand children.

    If Norway, with a public used to a social welfare state and the means to support it (Norway has a large Sovereign Wealth Fund and is generally creating huge government surpluses after paying for its welfare state services and is significantly more wealthy on a per capita basis than the US) has to resort to these types of sensible rations to make central health care work, what makes us think that we can get both the welfare state services and escape inevitable rationing? Americans have to decide if they will accept rationing and loss of choice. If Americans decide this is the way to go, then they will compromise. The current debate is not honest b/c it does not explain those hard choices.

  13. Interesting show. A short comment: Nurse Practitioners provide preventative health care as a major piece of our clinical primary care practice and patient education. Now that medicine has “seen the light”, preventative health care will be seen as a radical new MD-driven invention. (sigh) I look forward to any future program that includes NPs and PAs as participants in these discussions.

  14. I was also upset that the program ended with an email stating that health care is not a right. If it is not a right, it is a commodity, and that leaves it open to exploitation for profit, not person. We the people are the rulers of this nation, and we shall decide our rights.

    From the Universal Declaration of Human Rights, Art. 25:

    (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

    Our nation provides health care for all…if we admit that publicly and restructure the system accordingly, it could actually be CHEAPER. Heath Care is a right, and a majority of the nation believes that.

  15. After reading some of these comments I must say I am appalled at what some of these poster’s have to say.

    First of all, get off of your almighty individualistic high horses you so called patrons of liberty. Have you no passion for helping another human being in need? Last time I checked the health insurance industry does everything in its power to deny coverages and claims. When one of your relatives kids’ gets CANCER and has to go through red tape hell to get any sort of reasonable , don’t pretend that you think that health care isn’t a right.

    People love to claim “individual liberties” as long as it isn’t them who have hundreds of thousands of dollars in doctor’s bills that their insurance provider tries to snake out of. I’m willing bet these same folks who cherish their “individual liberty” would be universal health advocates when they’re sick and broke. Remember, we’re all just one accident or tumor away from financial ruin thanks to this wonderful health care system we currently have.

    The funny thing is most of these conservatives/libertarians who preach about “individual liberties” are the same folk who attend church every week where, forgive me if I’m wrong, one of the central message of their good book is to HELP OTHERS IN NEED. I’ll even be so bold as to take this one step further: I’m willing to bet that most of these “church going” folk would rather tithe to their $10 million dollar religious organization than contribute money to build an inner-city clinic. It’s funny how many charities there are but we still have plenty of sick children and elderly in the inner cities of the U.S. Glad to see the Christianity is flowing in that direction.

    Oh and by the way, I’m all for healthy, rational choices when it comes to our bodies and minds. We’re supposed to eat right, exercise, and not abuse our bodies with excess alcohol or drug abuse. When you live in a society that absolutely bombards our children with ads for sugary foods and soda it puts parents into a no-win situation when it comes to basic nutrition, which then leads to health problems later in life. I think there could be another show about how toxic our food industry is and how it relates to America’s ever deteriorating health. I’m sure the health insurance companies will start denying claims to all of us because we saw an ad for Coca-Cola when we were six and still drank it, just give them some time for that to come into fruition.

  16. I belong to the VA hospital, do not recommend govt run health care. I get second rate meds, long lines, long waits on pre scheduled appointments and wait 30 to 90 minutes to get a prescription filled. Doctors are not the best quality either. Visit my conservative blog for more.

    • Would you feel diffeently if you were in a medicare-like system where you could be treated anywhere, not just in a special VA facility?

      Insurers have it made… the govt runs healthcare for the groups that are high costs – the poor, the elderly, and disabled veterans.

      Right now the govt pays >50% of every health dollar spent (military, VA, & dependents; medicare, medicaid, govt workers), but each is in a different system with its own bureacuracy/advocates/funding challenges and no effort to use this buying power to manage costs/improve quality)across the entire system. Why should a veteran get care inferior to that of someone on medicare?

      Under a ‘medicare for all’ type approach to health reform, separate VA facilities would not be needed in the same way they are now … perhaps allowing them to focus on delivering specialized services unique to verteran’s needs while allowing the private system to provide basic care — at better quality and with lower travel burden, coordinator of care, etc. on veterans like yourself.

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