November 2009 Archives

White House Pushes for Passage of Senate Health Care Bill

The article explains how Senate Majority Leader Harry Reid has quite the job this month of pushing along the Senate Health Care Bill in hopes of it passing. Along with Harry Reid, the Obama administration is coordinating a health care message with Democratic leaders in the Senate. Joe Biden is also getting in on this, asking the question "Who do you trust?" in a recent video. The video also had physicians and nurses advocating. I think this is a really awesome thing for them to do! I think that just by having Dr. Rude in our class, we learned a lot and got a lot of insight into what goes on behind the scenes and problems that just any citizen probably wouldn't be aware of. This technique, using nurses and physicians, will likely really benefit the push for the passage of this bill. Many of us consider nurses and physicians trustworthy people, and they obviously are very exposed to the inner-workings of the healthcare system, so they really should be go-to people when considering reform. The article mentions that the White House has been working furiously behind the scenes. This is important for the public to know, as sometimes people assume that just because they aren't  being imformed of every bit of progress, it isn't happening. This is obviously untrue, and the fact that so much is being done behind the scenes will hopefully heighten the probability of this bill being passed. I personally am in favor of reform, and articles like this give me hope on the issue!

Home Sick: Another Case Where Work Incentives Matter


The article, "Home Sick: Another Case Where Work Incentives Matter" shows the difference in the number of sick leaves between the U.S. and workers in the Netherlands, Sweden, and Norway. The biggest difference here is that workers in those specified European countries stay home much more often than U.S. workers. Here in America, we are on a totally different system, and Casey Mulligan, the author, believes that ours is more effective and refers to the others' system as "sick." His main push is that incentives matter. In these other countries, the sick people are much more likely to stay home from work when sick with paid leave, but the problem that Mulligan points out with that is healthy people are much more likely to stay home claiming they are sick. In our system, many people go to work anyway, because most of us are on a system of a given amount of sick days, and that is all. 

I decided to also read through some of the responses Mulligan got after posting this article. I agreed with one man who said, "Perhaps HE would rather sick workers go to work under threat of losing their jobs rather than risk some free riders staying home illegitimately but his is a value judgment not a cost-benefit analysis." I agree with this, as people are always going to try and "beat the system." Also, as this article points out, these European countries are healthier than Americans by every measure. I believe there are always going to be trade-offs, and it really is a value judgment.

Would Adding Residency Slots Solve the Primary-Care Shortage?

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This article was about the possible amendment to the Senate healthcare bill being introduced by Senator Chuck Schumer that would allow for 2,000 more residency slots. The thought behind adding more residency slots is that there would end up being more general surgeons and primary care doctors. The author of this article doesn't believe that this amendment won't help create more general care doctors. He states that doctors who go through residencies generally choose to go into a more specialized category. They do this because they want to make more money, have a higher status and better hours. 

After reading this article and thinking back to our visit from Dr. Rudd I think that this issue of not having enough primary care doctors and general surgeons is a real problem. Although this solution of adding more residency slots is one view of how we could add more doctors I'm not sure it is the best option. As the author of this article stated doctors who go through residencies in surgery or internal medicine usually go into more specialized sub categories. I don't know what would help create more primary care doctors but I do believe this is a very important topic to discuss throughout this healthcare reform process. As far as I'm concerned there needs to be more incentive for doctors to want to be general surgeons rather than go into a certain sub-specialty.

Seeking the Best Medical Care Prices


This article talks about a common problem for all health care consumers - figuring out how much their specific health care procedures cost. The doctor's rarely make the information readily available and the pricing often varies among different consumer groups. This "price mystery" is just one of the obstacles standing in the way of efficient US healthcare. Since pricing information is usually not posted, people without healthcare are at a disadvantage - unsure of what certain procedures would cost, they could be hesitant to go in to the doctor when they don't know what they will be charged. The varying prices among consumers also adds to the mystery of the healthcare system. Unlike systems abroad, where prices are set by the government, the varying prices in the US could lead to those who are uninsured being at an even greater disadvantage, with higher prices on procedures.  

Although there is also the other side of the story that Dr. Rud mentioned - consumer demand.The vagueness of procedure costs could possibly contributes to consumer demand - people on insurance don't really look at prices, knowing that someone will foot the bill. If you don't know the extent of the bill then there is nothing stopping you from demanding more and more tests. and other online sources will help consumers become more knowledgeable about prices - making the healthcare process more transparent will benefit consumers and also might reduce consumer demand on doctors. 

Article from Dr. Rud

Sorry this article is so late, but here is the article Dr. Rud suggested

DeParle Video

As you read American Dream you may want to see the profiled women. Here is a link to an interview with DeParle. This video does NOT substitute for reading the book.

Video for Wednesday - Happy TG

Hi Everyone

In case you did not get my email. Here is the video that we have in lieu of class tomorrow. We will discuss the video on Monday the 30th.

Reminder: I have extra OH tomorrow and so will be around from 10-1215 in my office. We are discussing DeParle next week. Make sure to read it - the discussion won't work if you don't read it.

Sen. Franken talks down angry mob while referring to Gawande

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Hope everyone is excited for Mayor Rybak tomorrow! I talked to him the other night and kinda told him what we were looking for, hopefully it will be beneficial!

2 Arkansas men reflect national divide over health reform

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I found this article very interesting. I really liked how within the one article it talked about how two typical Americans would feel about healthcare reform on the two different sides of the political spectrum. It was nice not to read an article that was completely one sided but one that let you form your own opinion at the end of the article. It gave the reader real life scenrios that impact typical Americans and then let the reader take from it whatever they pleased. I think sometimes we are fed to much from the media just telling us one side of the healthcare issue,whether that be the Conservative side or the Liberal side, but what we really need to hear is both sides. Without seeing both sides of an arguement there is no way any sensible person can come to their own conculsion. I think this is why so many Americans are split on this healthcare issue.

New Breast Cancer Screening Guidelines

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The first entry in the Wall Street Journal Health Blog talks about one of the new reccomendations from the U.S. Preventative Services Task Force that women no longer need to do self breast examaniations in awareness of breast cancer. The second talks about the other new regulation they set out, that women should wait until 50 years old for their first mammogram instead of the previously reccommended age of 40.

This announcement comes at an ironic time--when legislators are trying to reform health care. Are the new recommendations out in an attempt to cut costs for the government? I agree with Gary Lyman's comment on the blog, "Gary Lyman of Duke University tells the Health Blog: 'There's really no downside in my opinion" to doing self-exams, which are cheap and have minimal to no risk. '" It doesn't make sense to me to not recommend something that is virtually free unless a woman were to find something suspicious. In addition, I would say that the potential extra incurred costs outweigh the benefits of catching cancer in an early stage. This news worries me that under the new health care system, we may face medical rationing.

Failed Clinton plan and Current HC - public opinion compared

Poor Communication

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After reading the blog posts, I see there is a lot of complicated stuff included in the bills. I think the Obama administration has done a poor job of explaining even the key points of the bills. The lack of communication has allowed for talk of death panels and government funded abortions. If the truth got out, less people would believe the lies being spread. Also, more people would be in favor of reform. As far as the bill goes, I see this as trying to compromise between the private market and universal health care. It cleans up somethings but why can't we just go the whole way with Universal health care?

We can't go the whole way because somehow the American Public thinks it would be an act of socialism and putting government in between them and their doctor. Some people need to wake up and see that the government can do great things and is (usually) working for the people's best interests. I really don't understand the lack of trust in the government.

Lobbying - an interesting article from the NYT

Bill would reduce senior care

The first thing I thought upon reading this was, "wow, what a perfect example of political suicide." We've talked numerous times in class how Medicare is a very well respected and popular program here in the US. I previously could only imagine Medicare being expanded through increasing the DRGs, especially after Dr. Rud explained how hospitals are having a hard time making money off of Medicare and Medicaid patients. I would have thought the government would be more inclined to increase DRGs so as not to reduce quality coverage or access to care for senior citizens. In my opinion, taking from the old and giving to the poor IS NOT healthcare reform. It's dodging the issue of making healthcare affordable, not solving it. I'm disappointed.

Winners and Losers in the House Bill

An interesting blog post on some of the winners and losers in the House bill in the insurance, pharma and devices industry

An argument for the House bill

Here is an oped from a few weeks ago arguing for the benefits of the House bill over the Senate bill. It may be of some interest to you in comparing the two

High Costs in the US - an interview with Kaiser Permanente CEO

This may be of interest, he explains some of the reasons why procedures cost more in the US than elsewhere, one of the questions has that came up in class.

The Other Public Option


                In Tom Schaller's blog titled "The Other Public Option", he discusses the government's defense sector as another option. The military is pressed to meet quotas, so in return they offer several benefits such as health care to individuals that sign up to enter the army. Where he goes on to provide examples of individuals who have joined the army to help support their families. One man ends up joining the army because his wife had cancer and he needed health care insurance to help pay for his wife's many medical treatments to help save her life.  And Schaller continues to support his claim by providing data of increased numbers enrolling in the US army along with the reduced requirements to join the army.

While I think this blog makes an excellent argument I am not so convinced that every American without health care is running to join the army. I agree that there needs to be a low cost government provided health care options for individuals in whom their jobs do not provide healthcare (often small businesses, or people who work for themselves). But not every individual is simply going to walk up and sign themselves up for the army because they do not have health care. He claims as of right now that is the only way to get "public option" health care offered by the government.  Yet the government does offer many other available services for individuals without health care, they just require a few more restrictions and are harder to obtain.  

Not so Fast, Says Harry

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Senate Majority Leader Harry Reid says there will be delays in getting a health care reform bill to the president's desk before the end of this year.  I'm not surprised by this by how complex the American political system is and especially how complex this bill is. I don't envy his job one bit as it would be very frustrating getting 60 people to agree on all parts of a bill. He is also waiting for a report from the Congressional Budget Office to see finances behind all this.

There are two upcoming breaks for Veteran's Day and Thanksgiving. Then a holiday break as well.  Time is running out on this year.   Something else to consider is that Reid is losing popularity in his home state and might try to pander to his Nevada voters. 

Goodbye meaningful health care reform!

       As I read this article today, all I could see is an end to the possibility of a real, revolutionary health care bill. The article says that if both houses could pass something before the end of the year, it's possible that a bill could make it through early in 2010. I just don't think that this is the case. Our nation, including our legislators, has a very short attention span, and something else is bound to come up and steal media attention before any bill is passed. The end result will be either a failed bill, or a bill that is watered down even more which, in the end, really does nothing to help the overall state of health care in this country. I know that I'm being pessimistic, but I think that it is the plain truth.

John Boehner talks about the GOP healthcare bill

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I'm glad the GOP is "working on" a healthcare bill. Why can't they actually complete one? As John King points out, the Democrats have a 1900 page bill being considered right now. Just posting ideas on your party website does not by any means count as drafting a bill. Besides my frustration with their inability to act, I strongly disagree many of Rep. Boehner's points of a potential GOP bill. He talks about funding "innovative programs" that have been implemented on the state level. That isn't healthcare reform at all. That's paying someone else to do your job. Besides, a provision such as that would only increase the healthcare gap among states. He also talks about funding high risk pools for people with chronic conditions to make their insurance affordable and about making it easier for groups of people to create insurance pools (much like unions do). I have a better idea - pool everyone together. If a union of 1,000 members can get affordable health insurance, just imagine what a pool of 3,000,000 (approximately the number of Americans) would pay.

The Worst Bill Ever?...

This is an article from the Wall Street Journal. The major claim is that the house bill on health care reform is the worst bill after the New Deal. A couple of things are particularly important to note.

If Pelosi is telling others that she is willing to give up seats in 2010, what is that saying? Does she already expect to lose seats? If the Democrats lose seats in 2010, obviously the public does not approve of what congress has accomplished in the past two years.  That statment makes health care sound like a personal agenda to her.

One of the taxes from the bill includes an 8% increase on payroll taxes for businesses that don't offer health insurance. This concerns me on both sides. If the business is incurring higher costs, that will transfer to higher prices on goods and services. It could also cause businesses to hire less workers, raising the already high unemployment rate.

One of the last comments was that this bill is just a stepping stone that Pelosi is hoping a future congress will take further. It appears that this is just a strategic move for the Democratic Party and that they may not be listening to the public.

How I spent my Halloween

I know this isn't a blog or in print, but I came across this video recently that made by blood boil. Allen Quist is a former MN state rep. who is now running for Congress in the 1st CD, my home district.

Here is my response:

I would like to say a few words pertaining to this video message that I think will resonate with millions of Americans, and millions of Minnesotans. 

First off, it's good to see people like Mr. Quist step up to the plate and try to take on some of the most daunting issues of our day. It takes courage and a lot determination to begin to engage in such tasks. There are some details about this video I would like to address. He speaks of how his son-in-law, who works as an auto mechanic on the north shore, frequently sees Canadians who come to the US for health care, but rarely witnesses American citizens who travel to Canada for medical reasons. His use of anecdotal evidence suggests his lack of understanding on the subject at hand. Using second-hand evidence from his son-in-law working as a mechanic is simply unreasonable and logically irresponsible. There are many reasons to explain this occurrence even as it doesn't relate to health care, one being that the hospital nearest to the border with Canada may be in the US. Mr. Quist poorly views the Canadian health care system. Mr. Quist presumptuously says that the current house bill will provide us with Canada's health care system. He says this as if this is the worst possible outcome. It seems a little odd he would jump right into talking about how terrible Canada's health care system is. According to the World Health Organization, Canada ranks ABOVE the United States when it comes to the overall care of industrialized countries. Canada ranks 30th, while the US ranks 37th.

After haphazardly jumping to an unrelated quote by W.H. Chief of Staff Rahm Emanuel, Mr. Quist says that the bill's public option would eliminate all options and create this "façade" of choice. On the contrary, the public option creates, rather than eliminates, another branch of competition that will lower the overall costs of insurance. In fact, this "façade" Mr. Quist speaks of is taking place right now with the insurance companies competing with none other than themselves. There is no major incentive among the insurance companies to provide reasonable coverage or lower costs. 

"In this bill, the government limits us". By "setting up committees that tell us what treatments we can and cannot have". It sounds like someone is trying to bring up the "death panels" and "rationing" claims we saw earlier in this debate that have been since debunked. Mr. Quist tells us that the government will "limit" our freedoms. Here's a little piece of advice, most people actually TRUST the government. It is the artificial fear of government that you impose on us, that is what we shall fear the most.

Mr. Quist may also want to consider that aligning oneself with Congresswoman Michelle Bachman may win support from the base of the Republican party, it is most definitely not going to win you any votes among citizens down in the 1st Congressional District.

Mr. Quist is right, every generation has had to fight for some kind of freedom. We wouldn't be the country we are today if that wasn't true. Every generation of Americans since the beginning of the 20th Century have fought for the basic right to Health Care. Let me be clear, we are still fighting that fight, and we will continue fighting until every single American gets what they deserve: a system where people don't go bankrupt because of medical bills, a system where every man, woman, and child can walk into any given hospital on any given day, and receive the attention they deserve without being asked if they have insurance or if their insurance covers their visit, where patients don't get discriminated against because they are too sick or their condition happened to be "pre-existing", a system where the richest country in the World still lets tens of millions of their citizens live without health insurance, and ranks behind 36 others industrialized countries in terms of care and accessibility.

Mr. Quist, this is not the time to begin another session of partisan bickering. If you want to take your run for Congress in the 1st Congressional district seriously, I would suggest you change your approach on the current health care debate for the betterment of all Americans.

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This page is an archive of entries from November 2009 listed from newest to oldest.

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