Personal experience is powerful.
When a trusted colleague shares an experience of having multiple family members die at the hands of a Nationalized Health Care system, you no longer have the right to waver. When that same colleague tells you her Canadian docs encouraged her to come to the states before having a child because of the care level, it further hits home.
Those of us who are private contractors have an added stake being responsible for our own health care and insurance. Yes, the American system of access and affordability in the world of health care absolutely needs adjustment. But when the house has termites, you don’t burn it down, you treat it.
Tossing out the finest quality of care in the world for a system that has FAILED everywhere else the world is idiotic. Making punching bags out of the insurance companies? Wrong. They make an average of 2.28% profit by providing HC insurance. Penalize big pharma? You can pretty much count out ground breaking drugs from the research money they’ll lose. If we’re going to fix it, it certainly isn’t going to be from the currently proposed legislation. We had all better educate ourselves and speak up…before it’s too late.
Joe Loomer
October 25, 2009 at 9:02 am
Upon my father’s death, my mother – a US State Department employee – elected to return to the country of her birth – England – since we’d travelled all our lives and had never put down roots anywhere in the United States. She – a dual citizen – was fortunate to have her last diplomatic posting in in London, and she bought a modest flat and retired at 65.
On October 17th, 2008 she passed away from a Deep Vein Thrombosis event. She was actually killed by the UK’s National Health Service (NHS). Now she was 80 years old – had diabetes, and had endured several mini strokes and a mild heartattack years earlier. She was not, however – frail in any way. She travelled here to see me, took cruises in the North Sea and Mediterranean, and had recently visited the Pyramids at Giza.
Last fall, her General Practitioner elected to take her off her Cumidin to try out a new insulin delivery system. He did not consult with her Cardiologist or Neurologist, nor make a notation in her medical record of this decision.
When – in the proccess of speaking to the Pathologist about obtaining her death certificate (you must do so in the UK before you’re “allowed” to have a funeral), I asked if the blood thinner medication would have prevented just such an event. Of course it would.
Yes I’m bitter, yes, I’m biased, and yes, my dear mother WAS 80 years old, and yes, she’d had a great and storied life (she survived the German onslaught on London – the Battle of Britain, and several coup de etats in various dung-heaps across Africa and South America). But the bottom line is if their system worked, this would not have happened, my mother would more than likely still be here today, and I could look forward to an Easter trip to London to see her.
I am a retired NCO – and when I first entered the Navy in 1982, our medical care was free, and promised to be so “for life.” This is no longer the case, although my cost is admittedly 1/3rd that of a private policy. I get most of my medical care in the socialized military medical complex, wait my turn, and encounter stupidity at various levels (to include someone else’s X-rays in my chart just before a shoulder surgery). Such is the nature of the already-existant socialized medical care in this country (hello – anyone remember the Walter Reed stories? What kind of health care do you think THAT is?). I ask for referrals whenever possible now – happy to pay the co-pay at a private facility out in town.
Tort reform should be done now – leave the rest for two years – and see if the insurance company profits increase enough to mandate lower fees. THEN try something universal.
Navy Chief, Navy Pride
Bruce Lemieux
October 25, 2009 at 10:33 am
Love your videos Greg. On your worse day, you’re better than me on my best day.
Our current health care system fails in so many ways. I wish I knew the answer to fix it, but there doesn’t appear to be one single thing to fix. NPR just broadcast a piece about the history of our health care system which describes how we got what we’ve got. It’s a fantastic summary for anyone who follows this dialog – https://bit.ly/1Z5chF
Joe – I’m sorry about your Mother. My wife’s family live in England. I can’t begin to describe the incompetent f-ups that my mother-in-law has endured with NHS. It’s a miracle they haven’t killed her. My experience of NHS says this isn’t the best model either.
This debate makes me angry, then depressed. We should be able to do so much better in this country.
Greg Cooper
October 25, 2009 at 11:04 am
I’m sorry for your loss Joe. I am convinced that if EVEYONE knew the realities of this, 2/3 would oppose and the other 1/3 (idealogues) wouldn’t want to be troubled with the ‘facts.’
BTW for those who doubt the profits of HC companies could be so low, here’s the piece about their profits over the last year (normally about 6%, barely over 2% in the last 12 months): https://apnews.myway.com/article/20091025/D9BI4D6O1.html
Lani Rosales
October 25, 2009 at 2:17 pm
@gregcooper, I’m with you- I know that someone somewhere in the chain of command has good intentions, but with what a clusterfck this plan has proven to been across the globe year after year, this can NOT happen here.
Tort reform is my hot button too- if practitioners could afford to practice without such IDIOTIC overhead, health care would be affordable to the point that the majority of people could afford it, alleviating the pressure.
WTF is wrong with these people? Canada as a model? Are you fcking kidding me? Russian roulette, sounds just as good of an idea to me. Jeez.
Bob
October 25, 2009 at 2:49 pm
There is one change that needs to be done before we can get legislation for anything that passes on its own merits. We need a bill to bot have any riders for unrelated issues. This would eliminate the bribery that goes on in Congress whereby pet projects are added on in exchange for votes.
One bill – one issue would make these clowns have to vote up or down on the merit, and be held accountable for that vote. At present, many will justify a vote for one thing by pointing to the rider.
Dan Connolly
October 25, 2009 at 4:09 pm
My Mom went to an American hospital (with great insurance) and was having what turned out to be a heart attack in the hospital, was not diagnosed and died shortly after she got home (age 67). American medical care sucks, right along with the rest of the world’s.
Lani Rosales
October 25, 2009 at 6:01 pm
Dan, I find that misdiagnoses are far different from a systematic crapfest. My grandfather was sent home after a surprise quadruple bypass and was given a respirator that no one explained to him or even mentioned (short of handing it to him upon discharge), so he thought it was optional and didn’t use it. 48 hours later, he died in the living room as a result of not using the machine.
I don’t blame our healthcare system, I blame the stupid ass nurse who was supposed to give basic instructions before releasing a patient. I don’t blame our healthcare system, I blame the retarded lazy doctors who diagnosed him with “severe asthma” for 15 straight years before finally realizing he’s a fat old Texan who ate barbeque and Mexican food daily for 68 years and they should PROBABLY check his heart (which was almost completely clogged).
You can’t avoid stupidity, but you don’t have to systematize it.
MIssy Caulk
October 25, 2009 at 7:49 pm
Fix the things that are wrong…leave the rest alone.
Doctors are people, they make mistakes wherever they live. Realtors are people they make mistakes, last I heard we all make mistakes on our journey called life.
This so called “reform” is a complete take over by the government, that is full of political policies.
Start with Tort Reform…which isn’t even in the bill. Why should Dr.s who have been sued, have to pay such outrageous premiums.
My OBGYN who delivered 4 of my 5 children went from 30K a year to over 120K, never been sued. He finally sold his practice back to the hospital and is now an employee.
Ruthmarie Hicks
October 26, 2009 at 12:32 am
Guys, It’s NOT a takeover by the government. I worked at the sidelines of the healthcare arena for 15 years. I worked with physicians from many countries in western & eastern Europe, India, China, and parts of the mid-east. They were all horrified by the American system of health insurance. All, including the American physicians agree that the FOR-PROFIT insurance system has GOT TO GO. I agree.
I went through this with my father. Medicare offers HMO’s for a reduced price. They are for-profit and absolutely terrific – until you get sick. He was on one of these when he was diagnosed with Stage 4 colon cancer. The oncologist didn’t mince words – following surgery he needed to immediately go on chemo or he would be gone in about 3 months. The HMO didn’t want to treat his cancer because if the treatment worked, he’d be costing them money till the day he died. Their plan – if you could call it that – was to delay chemo with red tape until he was dead.
When the treatment protocol was presented was standard. His condition was too poor to take multiple drugs – so the oncologist prescribed a commonly used drug called 5-FU. The insurance company was trying to convince me that 5-FU was not standard treatment. They couldn’t OK it because it was a specialty drug. Um….not so much. That is a LIE – plain and simple. When I was an undergrad we studied the molecular mechanisms of several anti-cancer drugs including an anti-metabolite 5-Fluorouracil (aka 5-FU.) For the record, I got my B.S. in 1987. In 1987 5-FU had been in use for nearly 30 years for colon cancer. So how is this a specialty drug?
It took the full weight of my doctorate to get him into treatment. After three weeks of a runaround – I finally lost it. We were running out of time as his liver function worsened I realized we had maybe four weeks and he would be dead.
So, I used my title and a tape recorder. I had been bounced to just about every person answering the phone that there was so there was a groan when they heard my voice yet AGAIN. This time I said – “This is Dr. Hicks – as you know my father has stage 4 colon cancer. Let me tell you that you are being recorded and that this will be released to the following people in the news media if I don not get a response in 24 hours.” I named the people who would get copies of the tape. I said that although I was Ph.D. (not an M.D.) I still required some professional courtesy and wished to speak with a physician so he/she could explain what their accepted protocol for treating stage 4 colon cancer was since 5-FU was considered standard treatment and was being denied as a “specialty drug.”
The treatment was Ok’d in 24 hours, my father started treatment in 48 hours. with many apologies and they begged me not to release the tape to the news media. He is still alive – though the tumors are now growing again – chemo has given him two good years.
Sorry but this system is a MESS. It isn’t a system that prevents illness or even treats the sick. The system is now set up to make money for shareholders and that is IT. For-profit systems do NOT WORK FOR EVERYTHING! We need to stop worshiping at the alter of “free markets” as if it is a solution to literally everything. It is NOT.
I worked as an academic for many years. Now I work as a Realtor. For profit works for cloths, shoes, real estate etc. It simply isn’t appropriate for medicine and in many cases doesn’t work well for science either. The trouble is that you won’t get from point A to point B using a free market system for these areas. The point of medicine is to treat the sick and prevent illness before it strikes. Both cost money. A for-profit insurer has no incentive to provide any of this. Hence, they dump sick patients, limit treatment options and have ceilings on care. They aren’t selling insurance, they’re selling snake oil. For science free market forces are a bit pointless as well. Science involves taking educated stabs at things. The experiment might work, or it might not – that’s why its an experiment. If we knew the result, there would be no point. New drugs can’t be discovered without this rather awkward and unprofitable process. So we have academe. The blood pressure medicine and the antibiotics that have saved your lives were discovered initially in a not-for-profit setting.
Greg Cooper
October 26, 2009 at 8:54 am
Ruthmarie….on a personal level I certainly have huge empathy for anyone who’s going through what your family has and is. I understand the system is broken but I think from looking at Medicare and the story Steve Croft did on it last night on 60 minutes, government oversight of the health care industry has ZERO chance. The fraud that has been going on for years in the TRILLIONS of dollars has yet to be stopped. The perps are basically laughing at the system. As Croft admitted, ‘hardly a track record that begs for the government to take over the entire system.’ I think we need reform but there must be a hybrid and one that keeps government control to a minimum, controls tort claims and allows for companies to innovate and grow for the sake of our country’s health and the jobs of those who provide that care.
Stefanie N
October 26, 2009 at 9:02 am
The “finest quality of healthcare in the world” is a bit of a stretch, when you consider Americans pay more and are less healthy than our European and Canadian counterparts. I’m not saying that what is being proposed will solve the problem (it’s about more than health insurance), but our perspecitve on the situation needs to be realistic.
Ruthmarie Hicks
October 26, 2009 at 10:24 am
There are places in Europe where the system works well. In fact that is why most of the European docs I worked with were so stunned and horrified. You need to take the publicly traded insurers OUT of the loop. Private systems in health care only work only where there in concert with very heavy regulation. Switzerland has a private system, but the insurance industry isn’t on the stock exchange for God’s sake and it is HEAVILY regulated. However, people get care – good care and they get it for less than we pay here.
Also, you guys are out of the mainstream. HEY!!! YOU LOST A MAJOR ELECTION because you free market cowboys made a total MESS of things with your anti-regulatory paranoia. What we’ve had for the last 30 years or so is not capitalism – it was (and still is) free-for-all bordering on anarchy where a bunch of robber barons are at the controls. The public – myself included – finally said “ENOUGH!” The American people voted for a more regulated capitalism and you guys LOST – than God!
Regulation is not a bogey man. If done correctly it has the capacity to save capitalism from its own rapacious and destructive tendencies. Yes, there will be waste, but isn’t that what we have now? I call a CEO’s and top executives getting millions if not billions while John Q. Public loses his home to medical costs a tremendous waste. I’m not paying premiums to line their pockets in that way. I pay premiums to be insured in case of a medical disaster. Also, I find hiring thousands of employees whose main job is to override the physician and deny care an enormous waste of my insurance dollars – yet I pay for that too! I find the billions in profits that go to shareholders rather than towards insuring those who pay for it a monumental waste. This is not just wasteful – its immoral or perhaps closer to amoral.
You repubs don’t get it. The middle class wants its country back and that requires REGULATION so that Wall Street, the banks, CEO’s etc. don’t run us into the ground. The middle class is now (wisely) less responsive to all the social conservative wedge issues and smoke an mirrors the methuglicans threw in the way of sensible discussion. The pocketbook issues such as losing your home or being unable to get medical care make those issues a sideline so you no longer have their ear. You may think this is socialist claptrap. But actually it is a more moderate capitalism that is trying to save you from yourselves. You see, capitalism as a free-for-all devoid of all real regulatory constraints is doomed. As CEO’s and executives move in to fill the void government created, a natural oligarchy is created – which results in two classes – rich and poor. The middle class sinks into the abyss. Eventually the masses that have been crushed will revolt. You would have another American Revolution on your hands. I’m not being melodramatic here. Eventually that’s what you would get.
So when you take that heart medication or when you look at the label on your antibiotic – remember this: that product, which prolonging or perhaps saving your very life would not exist if EVERYTHING were done on a for-profit basis. I couldn’t because its very discovery would never have been cost-effective. Some very good things come from outside free-market forces. Health care needs to be one of them.
Tort claims are a red-herring. Study after study has shown that the effectiveness of tort reform in controlling costs is minimal. States that have tough tort reform in place have some of the highest premiums in the country – so looking to tort reform as a panacea is foolish. The facts are stacked against you.
You also need to address the fact that an insurer was WILLFULLY trying to hasten the death of my father in order to preserve profits. This wasn’t a careless “mistake” this wasn’t a miscommunication or error. It was a deliberate attempt to kill someone so that they didn’t have to pony up. That isn’t merely immoral it is CRIMINAL – or at least is should be. Also, unfortunately, it is quite common as I knew from my previous work experience.
Greg Cooper
October 26, 2009 at 11:09 am
I’m going to be brief. You CAN cut taxes and provide health care to your poorer populus. My state has done it…without throwing out the free market system:
https://washingtontimes.com/news/2009/oct/26/the-reform-minded-conservative/
Joe Loomer
October 26, 2009 at 1:02 pm
I don’t think this whole Greg Cooper expirement is catching on AT ALL!
Again with the “you repubs don’t get it” – what I don’t get is how you think 53% of the popular vote is some huge mandate for change. Take a look at the election results map – the country is literally divided in two – split right down the middle by a wave of red states (with Florida, Colorado, and New Mexico the lone blue). Last time I checked, I’m middle class too. Every Southern State south of North Carolina (minus your pseudo-Southern Floridians), Most of the northern midwest, the grain, the farmers, the oil, the producers of the land.
Don’t say we don’t get it when the very fabric that feeds this country gets it pretty good in the polling stations. We’re middle class, humble, Christian, hard working, and we showed how we vote.
If you fix tort reform, then Ruthmarie’s point will be proved or disavowed on the basis of logic and hard-numbers, not on party affiliation.
Benn Rosales
October 26, 2009 at 1:32 pm
I’m not sure what Republicans have to do with anything here. I’ll absolutely give voice to opposing view points by anyone that wants to step up with one, but so far, no one on the so called ‘side that gets it’ has been willing to step up with a Sunday column. My invitation stands.
Ruthmarie Hicks
October 27, 2009 at 2:56 am
Here are a few links….
https://prescriptions.blogs.nytimes.com/2009/08/31/would-tort-reform-lower-health-care-costs/
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=995270
https://www.nber.org/papers/w15371
https://washingtonindependent.com/55535/tort-reform-unlikely-to-cut-health-care-costs
https://www.thefreelibrary.com/Report:+Premiums+Are+Higher+Despite+Texas+Tort+Reforms-a060043873
Basically, even the one study that supports tort reform recognize that the effects on insurance premiums are minimal – There seems to be rough agreement as to the amount 1.5-2%. Further, this is a one shot deal as the health care costs related to malpractice have remained relatively stable over the past 20 years – while health care premiums have skyrocketed.
Texas which has enacted strong tort reform STILL has skyrocketing insurance premiums. The rate of increase has not been impacted.
The other issue raised is that HMO’s have eliminated most of the “defensive medicine” practiced by doctors by simply denying coverage…but I could have told you that without the studies.
The point is that tort reform being held up as this ridiculous panacea that will make the problem of skyrocketing costs just go away. Given that premiums are rising at almost 10% a year in some states, the one time 1.5-2% reduction in costs is a drop in the bucket. Further, there is the issue of what such reform does to someone who had permanent damage due to medical negligence. Such damage can ruin a person’s life and easily leave them impoverished. So that issue is not a trivial one.
Another issue which was brought up in circles I was in during my life as a dweeb, but I found no references on in a google search was this: If tort reform would be effective in lower health insurance premiums, cost increases that we are seeing for medical care should be concentrated in fields where malpractice insurance is particularly high. These would most notably be in Ob-Gyn and Anesthesiology. This has not happened. Costs have risen across the board and are not concentrated in these areas. If cost control was significantly tied to a need for tort reform, this would not be the case.
Now will someone also address how anyone can possibly justify a system where an insurance company literally sets out to kill a patient by deliberately creating a bureaucratic runaround regarding a standard lifesaving treatment? Btw, if I didn’t have specialized knowledge about the drug protocols, he would have died because I wouldn’t have had the essential knowledge to fight for him. No one wants to take that on? Hmmmm.
Joe Loomer
October 27, 2009 at 3:33 pm
Some other links:
https://www.kellogg.northwestern.edu/faculty/dafny/personal/Documents/Working%20Papers/ADS_9_09w_ack.pdf
https://www.sfexaminer.com/opinion/columns/oped_contributors/Tort-reform-must-be-part-of-health-care-reform-53083662.html
https://www.healthleadersmedia.com/content/240318/topic/WS_HLM2_FIN/Adding-Tort-Reform-to-Healthcare-Reform-Could-Lower-Costs.html
The other side of the aisle is claiming doctor’s premiums in Texas are down over 27%, and the numbers of doctors applying to practice in Texas has jumped 57% – all since tort reform was enacted. I quote Governor Perry:
“And what about the money that used to go to defending all those frivolous lawsuits? You can find it in budgets for upgraded equipment, expanded emergency rooms, patient safety programs and improved primary and charity care.
Success stories like ours need to be told and need to be remembered as we continue this national debate.
Instead of handing down one-size-fits-all mandates on how it’s going to be, Washington, D.C., should be enabling states to set their own agendas and solve their own problems when it comes to health care.”
Someone once told me you could prove an elephant can hang from a cliff by an eyelash using statistics – and my links admittedly are full of the same (as are yours, Ruthmarie).
I think there is a middle ground – but unfortunately none of that will bring your father or my mother back. Bad medicine and bad insurance companies suck and it sucks more when you’re on the a** end of it. The grief abates over time, but for some reason the nagging anger against the perpetrators persists.
Ruthmarie Hicks
November 2, 2009 at 12:31 am
There is no direct correlation – the very evidence you link to is so riddled with holes that I could drive a truck through them.
1. In “The Impact of Tort Reform on Employer-Sponsored Health Insurance Premiums” they readily admit that all the benefits the rambling on and on about have much less impact where there is heavy HMO penetration. That’s almost EVERYWHERE now. PPO’s were popular until they became totally unaffordable. HMO penetration..has increased and has stopped paying for most of these tests. So the impact of tort reform is not nearly as great.
“They conclude that tort reform and managed care are partial
substitutes. Tort reform reduces the incentives of doctors to supply defensive medicine,
while managed care may actively prevent doctors from undertaking defensive medicine.
Thus we anticipate that tort reform will have a smaller impact on premiums for managed
care plans, a hypothesis we can test directly because our data identifies plan types.”
In the final discussion the said that in a managed care environment tort reform had no real impact.
This is from your own reference.
2. Your second reference is opinion only and has yet to be MEASURED. It goes into great depth on how nicely malpractice insurance has gone down but is strangely silent about about what it does for health care costs and getting the uninsured CARE. All they have is a hand-waving answer that a lot of new equipment was bought. Show me hard numbers that more people were insured. But in as state like TexASS that actually dumb enough to Bush as governor twice – I’m not holding my breath.
Even though the reference is from a right-wing rag – that’s the BEST they could do. I’m not impressed.
3. More of the same. They also admit that in managed care situations tort reform has no impact.
The other thing that this does NOT address is that tort reform is a fixed cost. It is not increasing dramatically at all. Insurance premiums are out of control but the number of lawsuits has been stable. That’s why tort reform is a red herring.
The issues that urgently need to be addressed are skyrocketing costs and the fact that so many are uninsured or can’t be insured due to pre-exisiting conditions. The issue of dumping patients off of insurance as soon as they cost real money also requires reform. Tort reform does NOTHING to address any of this.
The real problem here is one of philosophy Most of you are obsessed with the “free market” fixing EVERYTHING. This blinds you to common sense on this issue. Folks NOTHING fixes everything. There are places where the free market approach is not appropriate or beneficial. When profits are at odds with the care and management of patients – you’ve got a big problem. And yes we need MORE regulation. Both in our banking system and in health care. The insurers need to be put on a very short leash.
Ruthmarie Hicks
November 2, 2009 at 12:32 am
And you still don’t address how deliberately delaying care that was supposed to be covered is OK? Yet in a for -profit medical care system where shareholder needs trump patient needs – that’s simply NOT OK.