I have little tolerance for health-advise pseudoscience or sophistry, but I like how “Miss Nurse” takes a critical but educated view of personal health. Her posts don’t treat the reader as an idiot, and have no easy answers.
As I know, and am close to, numerous nurses who work with high-risk groups and have yet to receive the Pig Flu (H1N1) Vaccine, I would like to know the answer to the following questions
1. What is the correlation between an individual’s contributions to the Obama campaign and his or her probability of having received a Pig Flu vaccine shot?
2. What is the correlation between the average size of individual contributions to the Obama campaign for an organization, and the fraction of that organization’s workforce that have received a Pig Flu vaccine?
In most businesses, customers are presented with a selection of goods or services which are for sale, and then charged for which ones they select.
Medical offices do not operate under such a buyer-and-seller business model.
Instead, medical offices (clinics and hospitals) do not disclose which services they are charging for, and do not disclose the costs of these services. Instead, patients sign a vague agreement to pay all fees.
This system doubtless passes contract law muster, but doctors (as a regulated profession) should be held to a higher ethical standard. Patients should be informed, procedure-by-procedure, test-by-test, of total costs. Alternatively, patients may be informed of a flat-rate (say, so much per hour for a doctor’s time).
While learning about Canada’s horrific health care system prevented me from complaining for the rude wait time last month, Canada has nothing on the United States with regard to undisclosed fees.
(As readers may have guessed, the aggrevation comes from a fee for the service that resulted in the wait! The injustice!)
The Wall Street Journal is upset, though I am glad. These are good moves:
Democratic Stealth Care – WSJ.com
Initially designed for children of working-poor families, this new Super-Schip will be double in size, and even kids whose parents make $65,000 a year will be eligible. The program will also now cover pregnant women and automatically enroll their new arrivals. The Congressional Budget Office estimates 2.4 million individuals will drop their private coverage for the public program.
Still, it’s the “stimulus” that has proven the real gift horse — a behemoth that has allowed Democrats to speed up the takeover of health care under cover of an economic crisis. They initially claimed, for instance, the “stimulus” would provide Medicaid money to states struggling to pay existing bills. What in fact it does is dramatically expand the number of Americans who qualify for Medicaid.
Under “stimulus,” Medicaid is now on offer not to just poor Americans, but Americans who have lost their jobs. And not just Americans who have lost their jobs, but their spouses and their children. And not Americans who recently lost their jobs, but those who lost jobs, say, early last year. And not just Americans who already lost their jobs, but those who will lose their jobs up to 2011. The federal government is graciously footing the whole bill. The legislation also forbids states to apply income tests in most cases.
House Democrat Henry Waxman was so thrilled by this blowout, it was left to Republicans to remind him that the very banking millionaires he dragged to the Hill last year for a grilling would now qualify for government aid. His response? A GOP proposal to limit subsidies to Americans with incomes under $1 million was accepted during markup, but had disappeared by final passage. In this new health-care nirvana, even the rich are welcome. CBO estimates? An additional 1.2 million on the federal Medicaid dime in 2009.
The “stimulus” also hijacks Cobra, a program that lets the unemployed retain access to their former company health benefits — usually for about 18 months. The new stimulus permits any former employee over the age of 55 to keep using Cobra right up until they qualify for Medicare at age 65. And here’s the kicker: Whereas employees were previously responsible for paying their health premiums while on Cobra, now the feds will pay 65%. CBO estimates? Seven million Americans will have the feds mostly pay their insurance bills in 2009.
If Barack Obama can use the financial crisis to bring about a better national health care system, I will be very impressed. I wish him well!
The government interferes in the economy in two basic ways: to plan it and to socialize risk. In general, the political economy of the 20th century was the decline of economic planning and the rise of the socialization of risk. Planned economies such as the Soviet Union, post-War Britain, and post-War China collapsed in on themselves, ending with Winters of Discontents, failed coups, or economic revolution.
The socialization of risk, however, has been the basis of much of our economic growth. Public pensions such as social security allowed families to leave their farms and businesses, knowing that they would not starve in old age. The Federal Deposit Insurance Corporation families reinvest in the economy, rather than storing their cash under their mattresses. We seem to be on the verge of a Federal Bond Insurance Corporation, which will socialize much of the risk of bond markets away from large private institutions such as AIG. The solution may even be international.
If there is a silver lining to the financial cloud over Wall Street, it is hopefully a greater acceptance of the socialization of risk in our economy. While we should minimize moral hazard where possible, we must also realize that programs such as social security and FDIC are part of the solution, not merely a burdensome federal responsibility. The next step will probably be national health care.
Reading recommendation: A Future Perfect, by John Micklethwait and Adrian Woolridge.
Half Sigma: Republicans should support socialized medicine
The current system sucks. Itâ€™s not free market medicine. No sector of the economy is more heavily regulated than medicine. For the typical working American, itâ€™s almost as if medicine is socialized. Your healthcare plan is chosen by someone else, your employer. No matter how many healthcare services you consume, it doesnâ€™t cost you any extra money (or only nominally more money). The government is already paying for part of your healthcare in the form of a tax break.
Socialized medicine would be a government benefit that helps the middle class. Poor people already get free healthcare in the form of Medicaid and free emergency care whenever they show up at a hospital emergency room. Old people get nearly free healthcare in the form of Medicare. Fully socialized medicine would merely give middle class wage earners some government benefits for the taxes they are already paying.
Would people still want to go to medical school under the new plan? Yes, because the government should provide free medical school education for anyone who qualifies. If doctors get paid the highest salary in the GS system, which is around $150,000 per year, there will be a lot of takers. Also, we can institute reforms here, such as combining medical school with undergraduate school in order to accelerate education and lower costs. Anyway, doctors aren’t really the system’s biggest cost.
The novel system allows individuals with disabilities to operate a computer, control a powered wheelchair and interact with their environments simply by moving their tongues. The tongue-operated assistive technology, called the Tongue Drive system, was described on June 29 at the 2008 Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) Annual Conference in Washington, D.C. An article about this system is also scheduled to appear in an upcoming issue of the Journal of Rehabilitation Research and Development. This research was funded by the National Science Foundation and the Christopher and Dana Reeve Foundation.
Of course, some people will be against this new technology. The fact that those disabled who choose to have the treatment can do more with their lives naturally put those who choose not to at a disadvantage. This “new source of inequality within society” is the argument that some use against gene therapy, so I imagine it will soon be applied against other forms of therapy, as well.
After months of provocation, Mayor Giuliani has finally responded to Governor Romney’s attacks. Sadly, one of his counter-attacks misses the mark, badly.
â€œThe one thing heâ€™s known for is health care,â€ Giuliani said, referring to Romneyâ€™s signature initiative aimed at insuring all Massachusetts citizens. â€œAnd the health care is the thing heâ€™s now abandoned for the rest of the country. It contained a very big mistake, which he realizes is a very big mistake, the mandate.â€
The Massachusetts health care plan compels citizens to sign up for their choice of coverage and levies what Giuliani deemed â€œa taxâ€ on those who donâ€™t. The health care proposal Romney has laid out in the presidential contest includes no such mandate.
â€œThatâ€™s not the way to expand health care,â€ Giuliani continued. â€œThe way to expand health care is through the program that Iâ€™ve talked about, which Mitt Romney has now adopted.â€
While I previously applauded Giuliani on health care, here Rudy misses the point of insurance: the pooling of risk. Better and better bioscience, however, will reveal more and more risk, either allowing health care companeis to discriminate against the riskier, or allowing the less risky to opt-out of the system all together, or both. While this has always happened, this will be happening with a far higher degree of precision in the future as the cost of genome sequencing falls to around a thousand dollars.