Cross-Examine

BLOGGING FOR HEALTHCARE REFORM

And maybe more...

Deaths from Uninsured or Underinsured 2

How You Can Show Your Support

ATTEND AN AUGUST EVENT If you see healthcare reform as an important issue, perhaps the most important issue in decades, you may be getting frustrated and wondering how you can make your views known. One way is to contact your lawmakers (see sidebar). Another is to attend an event. Opponents of healthcare reform are organizing to show up at town hall meetings all over the country, and where they are in the minority, they sit in strategic spots in the audience and interrupt the speaker. They've already caught the attention of the media. Free speech is fine, but we can't allow a minority of shouters to monopolize the debate. Go to the above site and commit to attending one event in the month of August.

Blogging About Healthcare and maybe more...

How does that ad go? "This isn't a liberal or conservative issue, it's a human issue." They're talking about the environment, but it could apply to healthcare reform as well, at least in the US. That's not altruism for the 48 million and counting uninsured. It's good old American "what's in it for me" thinking for both the uninsured and the currently insured who could find themselves uninsured at any moment.

Even if you've already taken sides on healthcare reform––especially if you have––I urge you to read these posts and simply consider these points. I have a writing blog and a book review blog, and I swore I'd never add my voice to the cacophony of angry voices blogging on politics. Only there are so many people adding their voices who don't have a clue what they are talking about, that I figured my more than 10 years experience working in benefits––most of it looking for ways to contain costs without cutting benefits––might actually add something to the conversation (if you can call it that).

I promise not to make statements I can't back up with experience or research. In return I ask that you approach my posts with an open mind, and when you comment, which I hope you will, make the comments civil so that they invite further discussion. Also, please comment on this blog rather than dragging the discussion to your own blogs, so that we can all take part.

I'm open to guest posts on either side, so long as they are well-informed and cite sources. Contact me

Wednesday, September 30, 2009

Olympia Snowe, Abortion, and the Public Option

It's been some time since I posted here, and I must admit much of it is out of frustration. It's bad enough that Congressional Republicans practice obstructionist politics, but Max Baucus seems set on being a one-man show, developing his own healthcare bill that does not include a public option, just because. And now, big surprise, Republicans are trying to eliminate coverage for abortions from any plan that is part of the pool from which uninsureds and small business will purchase coverage.

Orrin Hatch's proposed amendment denying abortion coverage was defeated in the Senate Finance Committee by a vote of 10-13. Abortion is legal, so I wish these folks would get over it. Frankly, I think it's absurd that Medicaid does not cover abortions, meaning those who need it most must figure out a way to pay out of their own pockets. Proponents of healthcare reform have danced around the issue by saying that only amounts attributable to individual premiums can be used to fund abortions. Of course, that's impossible to do administratively, but honestly, saying women have the right to seek an abortion while at the same time allowing state and federal laws to make it all but impossible, is like saying every accused has a right to a fair trial only if your state doesn't want to build a courthouse and hire judges they have the right to just put you in jail. Expect more screaming and yelling from the nut jobs on the right, but this time I really hope the Dems will treat this as the non-starter it is.

In other interesting news, it turns out according to a Poll by Democracy Corps the majority of Senator Snowe's constituents in Maine support the public option. I can't help but think Ms. Snowe, like Mr. Baucus, just enjoys having her name in the news and being courted by both sides. Both want to come up with that "compromise" plan that will mesh both sides of the aisle. The American people long ago realized that was a pipe dream, and that there's no value in compromise for compromise sake. It's becoming more and more obvious that Congressional Republicans represent no one but themselves. So if Ms. Snowe wants to break from the pack and represent the people who voted for her, she's going to have to warm to the public option.

Finally, my favorite amendment comes from Senator Charles Grassly who proposed that members of Congress should have to purchase their medical coverage from the same pool they establish for uninsured Americans.

“My interest in having members of Congress participate in the exchange is consistent with my long-held view that Congress should live under the same laws it passes for the rest of the country.”



Short of the public option, I think that's the best idea they've come up with yet.

Wednesday, September 23, 2009

Senate Finance Committee Dems Rebuff Republican Attempt to Delay Vote

House Democratic leaders are looking to blend the three House Healthcare Reform bills together by next week, though Speaker Nancy Pelosi prefers to postpone a vote until the Senate Finance Committee does before bring their bill to the House floor.

In the meantime, a Republican member of the Senate Finance Committee, Jim Bunning of Kentucky, sought to delay the SFC's vote until the bill was put into "actual legislative language" as opposed to the "plain English" version, and the Congressional Budget Office had made its final estimate of cost. Olympia Snowe (R-Maine), whom the Dems are courting as the possible only Republican vote, agreed that she wanted to know the final numbers as well.

The request didn't fly as Dems pointed out that Republican committee members had, in the past, voted on plain English versions of legislation and based on general but not final CBO estimates, in particular the Medicare prescription drug plan and the Bush tax cuts. No wondering why the Republicans pushed those through without final estimates. I can't say I blame Democrats for doing the same. We can't cut back on this bill anymore anyway.

Information from CQ Politics Sept. 23, 2009 Midday Update.

Tuesday, September 22, 2009

Baucus v Snowe

As noted in the sidebar, Senator Baucus wants to send his healthcare bill to the Senate floor by the end of the week. However, Olympia Snowe wants more time. Senator Snowe is under fire from an ad by MoveOn. Org and other members of the coalition fighting for a public option.

Will Ferrell Adds a Little Humor on Behalf of MoveOn.Org

Will Ferrell stands up for the real healthcare victims.

Monday, September 21, 2009

Employer Paid Heathcare at $30,000?

Here are some sobering statistics from Drew Altman at the Kaiser Family Foundation. In 2009 average healthcare premiums for family coverage will hit $13,375. I already knew that since that's what I would pay if my daughter hadn't graduated to a separate policy. (Come to think of it, that is what I pay since she can't afford to pay her own premiums.) But here's something I didn't know. If premiums continue to rise at only the relatively modest rates they have over the last five years, by 2019, the average family premium will reach $24, 180. If prices rise at the average rate they have over the last 10 years, family premiums will average $30,803.

Let's add some perspective in addition to what Mr. Altman notes. According to the US Census Bureau the real median household income for 2008 was
$50, 303. So let's say in 2008 the average family premium was $12,500, since that's what I was paying. That amounts to nearly 1/4 of the median family income. What is even more frightening in terms of healthcare costs is that between 2007 and 2008 real household median income declined by 3.6%.

These are household statistics, not individual income statistics. So what this says is that by 2019, healthcare costs for employers could amount to more than the cost of hiring another employee. Is it any wonder that, already, many companies that provide medical benefits are hiring more part-time, and consequently ineligible, employees?

In my second post on this blog, "It's Your Problem Too" I noted the many ways the currently insured can find themselves unexpectedly uninsured. So what do you think will happen to your employer provided healthcare when costs go that high?

Under most of the current bills, employers will be penalized for dropping coverage, but with costs like that it may be worth it to just pay the tax. That's why we need cost containment as well as universal coverage, and that's where the hard part comes in.

As Altman points out, cost containment has been cut back or eliminated from most bills. This same issue has arisen every time any attempt has been made toward healthcare reform since the '80s. Somewhere along the line we, as consumers, bought into the idea––as we did with housing and cars––that more has to be better and side-effects be damned. But the side-effects of too much healthcare, like the side-effects of too much oil consumption, can be detrimental to your health as well as your wallet.

Statistics show there is no correlation between the greater number of tests and procedures Americans undergo as opposed to other nations, and better health. As I've pointed out in more than one post, our overall health outcomes are not the same as countries with more streamlined healthcare delivery, they are actually worse.

Opponents of healthcare reform since the first Clinton attempt have used the word "rationing" as a scare tactic. Rationing in today's political lexicon connotes something necessary being withheld. In reality we are talking about elimination of wasteful spending on unnecessary services that could harm your overall health.

Let's take as an example the proliferation of CT scans and MRIs. In this blog post by Judith Graham of the Chicago Tribune on the need for data sharing to cut down on unnecessary testing, a physician points out how too many of these imaging tests can be harmful.

There’s the rub. If the physician had access to the [original] MRI, he wouldn’t need to order three CT scans that expose the young woman to radiation and potential complications associated with the chemicals used to produce color contrast in the scans, Anastos said. The MRI would have been enough to determine whether the tumor was benign.

Another post at KevinMD points out:

The problem is that these scans are so sensitive, incidental findings are often found. In many cases, they may not be the true cause of the symptoms, and worse, can necessitate more invasive testing that can have serious side effects.


I can personally attest to the back pain issue he mentions later in the article. The first time I experienced a pain down my right thigh, I went to my PCP who sent me for an MRI and then to an orthopedist, who had me return regularly for appointments where he'd do no more than ask me to bend this way and that. One day, I noticed the pain subsiding and canceled my next appointment. Two years ago, suffering from more severe pain that I traced to a new exercise I had added to my regimen, I considered seeing my PCP again. Treatment had changed by then, and I figured he'd send me for physical therapy. Instead I went online first and read exactly what Dr. Kevin said, wait six weeks and, in the meantime, stretch your hamstrings whenever possible. I continued my exercise regimen but eliminated anything I could feel in the back area. In six weeks it was gone, and I had saved my insurance company thousands of dollars while saving myself the dangers of another MRI.

This isn't rationing. It's good practice that benefits everyone. Changing healthcare delivery is also the only way we can make healthcare affordable to all, but it will never happen if opponents whip up a frenzy of fear and politicians continue to pander to the uninformed.

Sunday, September 20, 2009

Baucus Plan Falls Short––No Surprise

The Baucus plan for healthcare reform––more accurately the Senate Finance Committee plan–-has been unveiled. It puts me in mind of the much awaited Iraq Study Group report a few years ago. Everyone, including the President and Congress, took a holiday from voicing any Iraq policy until the report came out. As though it would actually turn up something new that everyone didn't already know.

The Baucus plan comes in as far less expensive than the House plan––$774 billion over ten years vs. 1.042 trillion over the same period.

Paul Krugman outlines the problems better than I can, but the biggest and most important issue–-and the one probably responsible for the lower price tag––is the replacement of a public option with those useless non-profit insurance cooperatives that will never happen.

Thursday, September 17, 2009

Pelosi Says House Bill WILL Include a Public Opton

House Speaker Nancy Pelosi says the bill the House will send to the President this fall will include the Public Option.

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