Tuesday, September 15, 2009

Neutral Analysis of Obama's Health Care Reform

September 15, 2009

People do care about health care reform! I've heard from many of you over the past week. One of the best emails I received is from Robert Vizza a brilliant marketing strategist and former work colleague. He's sent the following note:

I hope this email finds you well, enjoying the remainder of summer. I had the week off and decided to spend a few days looking at the health care reform issue because 1) I was fed up not knowing what was going on with such an important topic, 2) I was fed up with all of the sensationalist sound bites coming from both camps, and 3) I figured that you might be in a similar situation. By no means did I “complete” the analysis, but I do feel like I gathered some good information and have come away with an educated opinion on the topic. At the risk of offending all of my friends, I humbly submit my analysis to you with the hopes that you become more aware of the issue and, selfishly, educate me where I may have missed the point.


While I'm sad that Robert spent some of his hard earned vacation time on writing a health care analysis, I'm happy to benefit from his hard work. Click the link below for a .pdf an easy-to-read analysis of some of the proposed reforms. "Boring?" Not at all. Robert is an excellent writer and he includes many interesting facts that you may not know. For a ten minute investment of your time, you can cut through the media and political rhetoric, and be better informed. My sincere thanks to Robert.

Friday, September 11, 2009

Frightened into Submission, Terrorizing America

September 11, 2009

Thanks for all your thoughtful responses to my last blog. Carri Bugbee replied, "...It makes me wonder, yet again, if those screaming against change are primarily the uneducated and easily duped. This wouldn't be the first time that politicians have convinced people to campaign against their own best interests."

I wonder the same thing. How have people become so terribly misinformed on healthcare? The insanity and paranoia that poured forth in the town hall meetings astonished me. Look at a few basic facts prompting the need for change:

  • Over 40 million uninsured
  • Healthcare costs are the number 1 cause of bankruptcy in the US
  • Healthcare is 17.6% of our GDP -double that of the top 18 industrialized countries
  • The World Health Organization ranks the US 37th in healthcare and 24th in total life expectancy
  • According to the UN, the US is 33rd in infant mortality and our own CIA fact book actually ranks us lower, an astonishing 46th

America's system by any objective standard is an embarrassment. It seems like people just aren't paying attention. Even the "I've got mine, so screw you" crowd has to admit that this problem is rapidly eroding the basic fabric of our society.

One friend wrote me that in the past two years his health insurance premiums shot up to be 30% more than his home mortgage payment. Indeed, heath care premiums are rising much faster than wages. That is unsustainable.

Why then are people acting against reform, against their own self-interest? Perhaps they haven't had the misfortune of a catastrophic health event and don't have the foresight that it will happen to them. The brutal truth is that everyone gets sick and dies. Despite what Aubrey De Gray says, our generation will not solve "the death problem" and become immortal.

What is happening here is that people who are making healthy profits (so to speak) and have investment in our current system spend $1.4 Million dollars a day to scare the shit out you. I'm not making this up. This is according to the Washington Post http://voices.washingtonpost.com/health-care-reform/2009/07/health_care_continues_its_inte.html. There health industry has created "war rooms" where their best and brightest marketers figure out how to label issues and turn the conversation completely back on itself. Sound absurd? Have you heard any of the following in the past month:

"Death Panels," rationed care, "socialism," government take-over of healthcare, long waiting times for services, can't choose your own doctor, you will lose your current insurance, illegal immigrants will get free healthcare...and so on.

Some of these are legitimate concerns that the reform plans must address. However, civilized conversations are scarce. The tone of the dialog is from those who are against reform boils down to, "The government and our president are liars who want to control your life and turn the US into Nazi Germany." This is utter garbage meant only for one purpose, to get you and those who have the slightest distrust of government to be afraid and act against their self-interest. It is a form of political terrorism.

The only way that you can avoid becoming a victim is to take responsibility to educate yourself on the issues. Healthcare reform is the most critical issue of our lifetimes. Knowledge is power. We fear what we don't know or understand. Don't be a victim, read, ask questions, raise your voice, and demand change that's best for you.

Tuesday, September 8, 2009

Silence = Death

September 8, 2009

It's diabolical, really. The people who most need healthcare reform are the least able to lobby for it. If you’ve been following my blog, it’s no secret that I have kidney failure. I work fulltime in order to have health insurance to pay for dialysis and, hopefully one day, a kidney transplant. You may have noted this is my first blog in several months. Why? For the same reason I have not paid my way in the healthcare reform debate; I have a limited bank of energy and truthfully, I’m overdrawn.

Speaking of “overdrawn,” please allow me to use a personal example of the absurdity of our current system. My dialysis provider charges my insurance $10,000 a week, or $520,000 a year for my treatments. For the exact same services, my dialysis provider charges a Medicare patient around $1,000 dollars a week, or $52,000 a year.

Did I lose you yet? That’s $520,000 versus $52,000 a year for the exact same services. Ten to freaking one? How can this be? In what universe does this make any sense?

What’s happening here is that the dialysis company doesn’t make profit from Medicare patients. They break even. Therefore, the 10x from my insurance company provides the profit and subsidizes the Medicare patients. Sound absurd? Why would my health insurance company tolerate this? They tolerate this because at the end of a 30 month “coordination period” they get to turf me to Medicare. With the average transplant waiting list time up to 5-7 years and transplant costs averaging $250,000, thirty months of being overcharged is almost equitable. See http://www.transplantliving.org/beforethetransplant/finance/costs.aspx.

Folks, this is how the system distributes the pain of critically ill people. They call this “cost shifting” and this is just one of a thousand examples that reveal the house of cards used to construct our health care system. Cost shifting hides the true cost of illness, creates billing hot potatoes, and, last of all, it still fails the uninsured, the poor, and the unlucky. What’s worse is that cost shifting causes insurance companies, doctors, pharmacies, etc to raise premiums, prices and service fees. The truth is you pay for Medicare and the uninsured regardless of what you think. The money hides as fat in your premiums and payments. Pundits and industry wonks constantly debate cost shifting and its relation to Medicare. Some companies who have figured out how to work the system to their advantage have hired economists to bust the myth of cost shifting or discount it as a very small problem. Here’s my one word response: bullshit. Cost-shifting is real and pervasive.

You may have missed a tidbit from my true-to-life example above. Yes, I am 42 and am on Medicare. Does this surprise you? In 1972, the Social Security Act extended Medicare to anyone with End Stage Renal Disease as long as they paid into the Social Security system. A public option does exist today. You just need to be a special case to get it before you are 65. Truthfully, isn’t everyone a special case? Legally, aren’t we all of equal value? A lackey from my dialysis center actively discouraged me from signing up for Medicare early. She said “the company” wouldn’t like it. I’m sure they wouldn’t - they’re like all other companies whose sole purpose is to maximize profits and return dividends to investors.

Why shouldn’t you have the opportunity to choose the public option? The public option seems to be very good at setting price ceilings and eliminating excessive profits. It incentivizes efficiency. Let me be clear, profit can be a good thing that spurs innovation. However, it needs to be above board and visible. Why do we allow medical finance to hide behind all these twists and turns?

Matt Tiabbi of Rolling Stone has an excellent article on the whole health care reform disaster, at http://www.rollingstone.com/politics/story/29988909/sick_and_wrong/1. He brings up the point that America has 1300 different insurance companies all with different billing procedures and policies. They estimate a single-payer system would eliminate 350 billion dollars of needless overhead. This is more than enough money to pay for healthcare reform.
Why are we allowing the House, Senate and President Obama to take the single-payer system and the public option off the table? There will be no true reform without both. You know and I know it. The time for silence is over. It’s time for the sick to rise up and speak before it’s too late.