The Amazing Maze of US Health Care

Is health care reform dead?  Doubtful?  What will it look like?  Not nearly enough.

So I want to get a head start on the next round.

Moving ahead

Because whatever happens in this round, round 2 cannot come soon enough.  It is unrealistic to expect health care reform to be a once and done proposition.  The Model T was not invented with 4 wheel anti-lock disk brakes or fuel injection.

So over the next few weeks, I would like to take a look at some of the issues that will still remain even after health care reform legislation is passed.

But first let’s give some thought to what we want from our  health care system. Read the rest of this entry »

Dear President Obama

You seem to think that the reason the Dems did not do well in Massachusetts has to do with jobs. Maybe, but not quite.

It’s about how you don’t get it.  And the people in Massachusetts see that in the way you have handled health care.

Now look at the mess you created.  Your health insurance program is at risk.  The Supreme Court just handed your opponents a blank check and the likelihood of changing that court now is very much in question.

Massachusetts was a bad model for reform

ERISA ties the hands and the feet of state governments that want to solve their uninsurance problem.  The Commonwealth of Massachusetts came up with one of very few ideas left over to them.  If it works at all in Massachusetts, and people will argue that, it is because Massachusetts is a relatively high-income state with relatively few people uninsured.

To try and apply that model to states like Louisiana, Texas, or Nebraska is misguided at best.  To be blackmailed by the likes of Sen. Ben Nelson (D-NE) is insulting.  To ask the people of Massachusetts to pay for it?  Oops. Read the rest of this entry »

By Jordan Rau

Kaiser Health News
Tuesday, January 19, 2010

RICHMOND — Five months into pregnancy, Jodi Lemacks discovered that her unborn son had a severe heart defect and would require a complex operation as soon as he was born. But the local pediatric heart surgeons didn’t inspire confidence.

One surgeon “had just lost a baby with the same defects,” Lemacks says, “and he only did six of these surgeries a year, which is not a really good number.”

So Lemacks and her husband, Mark, selected a Philadelphia surgeon who was one of the most experienced in the nation at performing the challenging operation. It involved draining the heart of blood while the surgeon reconstructed the aorta, which in a newborn is thin as a string. Even in the best of hands, Joshua had only a 5 percent chance of surviving to the second surgery he would need six months later, several specialists told the Lemackses.

Insurer okayed out-of-network care for heart patient but family faces huge bill – washingtonpost.com

When you are up to your neck in alligators, its hard to remember that someone needs to drain the swamp.

The American Alligator

Last week, I wrote about the tax on “Cadillac plans”.  This past week, BHO reached an agreement with labor unions, the primary voice of the opposition to taxing so-called “Cadillac plans”.  The tax is still there.  My suggestion didn’t seem to make it into the discussion.  I was busy dealing with alligators.  That’s my day job.

One of our carriers had a computer glitch (a nice euphemism) that disrupted coverage for many people.  Here is a typical example of the kind of fires we had to put out – a woman went to the doctor’s office and the doctor could feel a lump in her breast but would not order a mammogram because the office had contacted the insurance carrier and had learned (incorrectly) that she had no coverage.

These incidents prompted me to wonder.  If we had a single payer health care system, couldn’t we have the same problems?

After all, we will certainly still have computers.

But we won’t have people moving from plan to plan because they changed jobs.  We won’t have people losing coverage because they lost their job, or because they got sick, lost their paycheck and therefore could not afford their health insurance premium.

Doctors and hospitals will know who is paying their bills and therefore might show a bit more patience with administrative errors.  After all, if a computer error like that should occur in a single payer system, it likely would affect a high percentage of their patients.

There would hopefully be a sense of shared crisis, not one that abandons people in a time of acute need.

Oh, and the tax compromise reached recently.  It is still a bad idea.  Now it is just an acutely complicated bad idea.

And it will do absolutely nothing to make our health care system less fragmented, less chaotic, and more humane.

It just lets in more alligators and stops up the drain even more.

By ROBERT PEAR – NYTimes.com

January 10, 2010

DENVER — Donny Seyfer, the manager of an auto repair shop here, had high hopes when President Obama and Congress tackled health care as their top priority early last year.

“This is good,” Mr. Seyfer remembers thinking. He expected Congress to “find out what Americans wanted.” But, he said in an interview at his shop, the Congressional debate deteriorated into a partisan brawl, and Congress has virtually ignored his biggest concern: holding down health costs.

“I am an automotive diagnostician,” Mr. Seyfer said. “We look for the root cause of problems. If we treat the symptoms, the problem always comes back. With health care, we are not treating the root cause: Why does it cost so much?”

Colorado Voters Craving Reform of Health Care and Congress – NYTimes.com