Jimmy Higgins

I'm 25, I've got virtually no medical costs, yet in my paycheck last week, I was the proud person to learn that my, and well everyone else in the company as well as in this country, medical contributions have gone up over 80%. That's like in one year. Can't wait for 2004!!!

Yeah, that's right, 80%. In a meeting before we learn this information, we were notified that our contributions were going to experience a "significant increase". 80%!!! I'd say that is significant.

And knowing that this has or will happen to all of you at your companies in the US, I can't help but wonder how many days its going to take Congress to start to act on the millions of phone calls they are about to receive.

Now I understand why this had to be done, and I can accept that, however, how many more 80% increases need to happen before the American public, mainly the conservative part, will have it finally dawn on them that there is a problem, a rather significant problem, with the American Health Care system?

Godbert

there you go

Loren Pechtel

Originally posted by Jimmy Higgins
I'm 25, I've got virtually no medical costs, yet in my paycheck last week, I was the proud person to learn that my, and well everyone else in the company as well as in this country, medical contributions have gone up over 80%. That's like in one year. Can't wait for 2004!!!

Two reasons.

1) Even at 25 you could still have a serious accident. Those aren't cheap.

2) Because health care is part of employment we don't base premiums on age. Thus the young, healthy and not well off end up paying far more than the true cost of coverage, whereas the older guys (who generally have more money) get a break.

Note that your companies' contribuutions going up 80% doesn't mean everyone's has gone up that much. Health care per se hasn't gone up 80%, your employer obviously passed on more of the actual increase. (Suppose the company was paying $100 and you were paying $20. Premiums increase 16% but the entire increase is passed on. You now pay $40 for a 100% increase.)

And knowing that this has or will happen to all of you at your companies in the US, I can't help but wonder how many days its going to take Congress to start to act on the millions of phone calls they are about to receive.

It's not going to happen--most people's didn't go up 80%.

Now I understand why this had to be done, and I can accept that, however, how many more 80% increases need to happen before the American public, mainly the conservative part, will have it finally dawn on them that there is a problem, a rather significant problem, with the American Health Care system?

But there's no magic wand to wave to fix the problem. We use a lot of health care. That's expensive.

My observations:

Base pain and suffering on tables based on the injury rather than medical bills. There are a *LOT* of doctor visits that basically are running up the bill to increase one's settlement.

Prohibit ads of anything a doctor needs to get for you, other than ads of a "a treatment for xxxx is available" type.

Government licensing of the big diagnostic imaging equipment other than that run by a business that does only that. This licensing would only exist to keep too many of the units from being installed. (A company that does only diagnostic imaging isn't a problem--they can't generate their own business.)

Sanity to formularies. Insurance companies do have good reason to require trying the cheaper drugs first, and in fact they probably should do more of it. (So often the patient comes wanting the fancy new one they've heard of. Insurance company rules take the heat off the doctor.) However, the flip side is that they should take the patient's medical history into account, don't make them try things that are known not to work. Also, in the case of disease take the local situation into account. If there's something going around resistant to the base antibiotic, don't waste time trying it when the doctor thinks it's another case of the same thing. They should also cover the expensive drug if that's the only thing that works.

Government mandate of coverage of things which are good in a long-term preventative sense. Example: There's a new vaccine coming for genital warts. It's only useful in someone who has never been exposed--it should be given something like at puberty. However, no insurance company has an economic incentive to cover it--the condition it's meant to prevent (cervical cancer) won't strike for many years by which time the child will be out on their own and with a different insurance company.

They should pay the doctors a reasonable fee for their work. Too often these days they pay too little for the doctor (or especially hospital) to manage. This provides a *STRONG* incentive to find ways to run up the bill. The insurance company answer was capitation, which instead provided a strong incentive to sweep things under the rug (and the contracts were written so the one on the liability hook was the doctor, not the insurance company.) Neither is good for the patient.

There should be a lot more effort expended on studying and publishing information on outcomes.

Many years ago my wife had a chest x-ray. The machine wasn't working right, the first film was washed out and unusable. The big problem: They *KNEW* the machine was giving trouble and was likely to produce an unusable film, especially on someone as small as my wife. As far as I'm concerned, that was malpractice.

Now, I don't buy the scare stories of 100k deaths due to medical errors. From what I've seen there are statisitical problems with that and it's also counting a lot of cases where the error merely speeded up the inevitable a little bit.

Coleman Smith

Loren Pechtel said, "Now, I don't buy the scare stories of 100k deaths due to medical errors. From what I've seen there are statisitical problems with that and it's also counting a lot of cases where the error merely speeded up the inevitable a little bit."

One can presume that it was not your mother, father or child who was �speeded up a little bit�

Coleman Smith
+++++++++++++++++++++++++++++++++
The assertion that the universe is surround in grape jelly is more creditable than the assertion that we are the immortal pets of some deity.

Dr Rick

An excerpt from an editorial in the NEJM almost 10 years ago on healthcare reform, cost-containment, and accessibility; it's depressing that things have actually gotten much worse since it was published and yet there still is no real chance that this Congress or administration will even address the issue:

"First, we would need to place a global cap on health spending. This could be set by Congress as a percentage of the gross domestic product, and allocated to regions or states according to relevant demographic variables, such as the age of the population. Such a cap would control costs at the level of overall funding, not through intrusive micromanagement at the level of the individual doctor-patient interaction.

Second, we would need a Canadian-style single-payer system to fund the delivery of health care. A single-payer system is not only more efficient than multiple payers, but it also eliminates cost shifting. Those who doubt the capacity of the government to collect and distribute money efficiently should remember that Medicare's administrative costs are far less than those of the private insurers. Where would the money come from? It is already in the system, and all of us are the ultimate payers. We pay for health care through our paychecks, deductibles, copayments, and the prices of goods and services. Although the notion of funding health care through an earmarked tax on income is politically perilous, such a system might well be less costly (and ultimately more acceptable) to most Americans than the present relatively inefficient and regressive methods of funding, including employer-based methods.

Third, we need to minimize price competition rather than increase it. This seems counterintuitive if the aim is to contain costs, but when prices for health care are determined by the market, costs nearly always rise, and the type of care provided reflects financial incentives rather than human needs. It would be preferable to keep prices constant and compete on the basis of patient satisfaction.

If we had such a system -- with a global budget, a single payer, and competition on the basis of quality and not price -- then we might for the first time really get our money's worth., and since we are spending far more per citizen than any other country, that would mean Americans would have the very best medical care in the world. There would be no need for the queues or de facto rationing experienced in some countries that spend much less on health care. The assumption that an expanded health care system would necessarily cost more money, then, is simply not true; what it would cost is the political will to redesign the system."

John Hancock

Jimmy:
Health cost have skyrocketed for multiple reasons:
Properly accedited from Kansas Work Beat:

Lott to Frist? - Racism to Medical Fraud

by Nathan Newman



A question to ask is how the GOP ended up with a stupid racist like Trent Lott as Majority Leader? Maybe it's because the backup bench of acceptable rightwingers are worse-- Nickles with his anti-civil rights record or McConnell's corporate whoring against campaign finance reform.

But the fair-haired choice of the White Houseappears to be Tennessee's Bill Frist. Who is supposedly the GOP's point person on health care issues.

Which is as appropriate as having Trent Lott be their point man on civil rights.

Frist is literally the child of corporate medical fraud and union-busting. While he bills himself as a heart surgeon, his relevant position was as member of the family which founded what became the massive HCA/Columbia health care hospital chain. Bill Frist's personal stake in the Frist�s Voting Record


family fortune is unknown exactly (in the tens of millions), but his brother's shareaccording to Forbes is $950 million. See this older article about the family's role in HCA and GOP politics.

And how did HCA/Columbia get rich? Raiding nonprofit hospitals, dumping the poor previously served and turning them into profit mills for the family bottom line. See here. Oh yeah, and massive fraud against the Medicare system, a fact that led to a $745 million criminal fine against the company back in 2000. (See the update below for late-breaking news of a new massive settlement by HCA for fraud).

What was the nature of the fraud? The worst possible in corrupting the patient-client relationship to the point of endangering lives. Marc Gardner was a vice-president at HCA/Columbia where he says he "committed felonies every day." Here is a story on medicare fraud generally where Gardner ~described his role:

Marc Gardner, the former vice president of the country's largest chain of for-profit hospitals-the Columbia/HCA Health Care Corporation-recently broke the silence on what he called "an arrogant corporate culture in which meeting demands for profits became far more important than caring for patients or obeying the law." In a recent interview conducted by ABC News, Gardner said that doctors with the most patients were given paid positions as medical directors in Columbia hospitals. Columbia claimed that that these were legitimate compensation to doctors for their extra administrative work. However, according to Gardner, the payments were a way for hospitals to funnel illegal payments to doctors for sending their patients to Columbia hospitals. Not only were doctors paid for getting more patients, they were also paid for performing extraneous surgeries. In other words, the hospitals encouraged doctors to get more patients, offer more unnecessary hospitalization, and to perform more unnecessary surgeries.
The company also has a history of unionbusting against its employees. See this ruling by the National Labor Relations Board that HCA/Columbia engaged in illegal union-busting against workers in their hospitals. See the full decision of the NLRB in 2000.
For a more complete history of the HCA/Columbia story, see this timeline of the Columbia/HCA Rise and Fall.

This is the corporate culture within which Frist grew up and funded his political career.

Unsurprisingly, this is reflected in policy positions on behalf of corporate medicine, from opposing real health care reform to sponsoring the legislation on behalf of Eli Lilly to kill the ability of parents to sue the company for harm to their children from the drug Thimerosal. See Hesiod.

Trent Lott denied he personally participated in the racism of his youth, which of course he did, but Lott without question benefitted from it in pursuing his political career. Similarly, Frist would no doubt deny personal involvement in the pervasive corporate crime and fraud at HCA/Columbia, but his personal fortune that got him into the Senate derived from profits of that corporate abuse.

And, more importantly, just as Lott's policies on civil rights reflected his racist history, Frist's public policy of pimping for corporate medicine has reflected his family's corporate criminal background.

LATEBREAKING UPDATE: HCA has agreed to pay an additional $880 million dollars to the federal government over its long-running medical billing fraud. HCA would pay $630 million in fines and penalties to resolve all outstanding civil litigation with the Justice Department, the report said. It would pay another $250 million to the Medicare programme to resolve expense claims submitted by the company to the government.

Combined with its previous settlements, including its 2000 guilty plea to 14 felonies -- the company will pay a total of more than $1.7 billion in civil and criminal penalties, the most ever secured by federal prosecutors in a health care fraud case.







Frist's Rightwing Voting Record



Now that Bill Frist's is replacing Trent Lott as Senate Majority leader, Nathan Newman takes a look at Frist's record. And it's not pretty. Across the board, Frist is a hard-line rightwinger, voting against labor rights, civil rights, women's rights and the environment at almost every opportunity.

Here is a sample of his voting record:

Environment

League of Conservation Voters
107th - 0%
106th - 0%
105th - 27%
Voted for drilling in ANWR, against renewable energy, against increased fuel standards for cars (2002)
Voted for drilling in the Gulf of Mexico, for oil and gas drilling in national monuments and to give the President unilateral power to block agriculture-related environmental regulation (2001)
Voted to subsidize corporate timber cutting in Tongass forests, to allow unlimited mine waste by corporations on public leases, supported cut-rate pricing for oil leases on public land, and voting to exempt all coal mining operations from the Clean Water Act. (1999-2000)

Labor

AFL-CIO Rating
Lifetime rating- 3% (2 pro-labor votes out of 64 votes measured since first election in 1995)
Voted against workplace ergonomic standards, for school vouchers, against a real patient bill of rights, against prescription drug benefits for all seniors, to restrict the free speech of unions versus other groups on firm premises, against giving collective bargaining rights to police and firemen nationally, for Bush's tax cuts for the wealthy. (2001)
Voted against refugee status for Central America refugees, for permanent normalized trade status for China without human rights review, for massive cuts in National Labor relations Board funding, to weaken wage standards for federal construction projects, and against minimum wage legislation. (1999-2000)

Civil Rights

NAACP Rating 15% (2002)
Voted against sanctions for predatory lending abuses, against a series of NAACP-supported education amendments, against technology centers for poor and minority communities, against expanding higher education grants, to override Home Rule decisions by the District of Columbia, against restoring the right to vote to ex-felons, to decrease voting registration through purging voter rolls, and against increased global AIDS funding. (107th Congress)

National Hispanic Leadership Conference
18% (2001) 25% (2000) 0% (1999)

Voted against bilingual education and a series of supported education funding amendments, against minimum wage increases, against confirming a latino Court of Appeals judge, against federal hate crimes legislation, against legalization of various groups of latino immigrants, and against strong community reinvestment requirements for banks.

Leadership Conference for Civil Rights
0% (2001) 43% (2000) 11% (1999)

Voted against predatory lending protections, against community technology centers, to block alternative voting verification methods, against hate crimes legislation, against confirming a Missouri black judge for the Court of Appeals, and for harsh criminal measures against juveniles.

Abortion

National Abortion Rights Action League 0% (2001) 20% (2000) 0% (1999)
National Right to Life Committee 100% (2001) 100% (2000) 100% (1999)

See a range of other ratings for Frist at Project Vote Smart

Following the Money: As for where Frist's money comes from-- having heavily self-financed his own election back in 1994, his reelection in 2000 was heavily indebted to the corporate medical industry. See Open Secrets for his industry support.

In fact, Frist in 2000 was a top recipient (#1 to #4 among Senators) from
$260,373 Pharmaceutical/Health Products (#2)
$75,707 Pharmaceutical manufacturing (#3)
$825,504 Health Professionals (#3)
$267,075 Hospitals/Nursing Homes (#4)
$32,250 Medical supplies manufacturing & sales (#1)

See the post on Frist and the endemic medical fraud in his family's medical mega-corporation.

Posted by Nathan at December 20, 2002 02:36 AM

and Also as the astute Loren Points out advertising costs for medication. Advertising costs are nearly that of R&D and are rising at very faster level. Jimmy me lad it's a case of kissing the ass that sits on you.

Martin Buber

Edited to add: Nathan has a great website NathanNewman.org

Jimmy Higgins

Yeah, that's why I'm keeping it while shopping around for maybe a better deal.

Like I said before, I understand that. However, everybodies premium went up. Imagine if your car insurance went up 80% in one year and you had a perfect record?

Not really, atleast we don't think that is the case here. We'll see what happens at the other companies.

What did they go up by?

Nice observations. I realize the fix is expensive. That the fix is going to require alot of different people making cuts and sacrifices for the system to work the way it needs to. The largest problem is that no matter what system you have, someone with manipulate it to gain something. Just like the insurance companies will do anything for a buck, the pharmaseutical companies would do the same, as would the patient themselves.

You left out one tiny little issue. Take people for instance. Take a person who needs (and when I say needs, I mean has to) to take certain medications for their mental health to remain stable. I'm not talking about grandma feeling depressed. I'm talking about Joe Smoe who needs to take a few $100 a month prescriptions in order to be able to fit in with society. But Joe Smoe can't afford this medication because Joe Smoe doesn't have a very high paying job.

The system we have today is in bad shape. In 20 years it could be collapsing. My major problem is that this isn't a priority with Congress while the problem is staring us right in the face.

Loren Pechtel

The point is that if someone died this week instead of next week it's not nearly the issue that a guy who died this week instead of 20 years from now would be.

Loren Pechtel

Originally posted by Dr Rick
Second, we would need a Canadian-style single-payer system to fund the delivery of health care. A single-payer system is not only more efficient than multiple payers, but it also eliminates cost shifting. Those who doubt the capacity of the government to collect and distribute money efficiently should remember that Medicare's administrative costs are far less than those of the private insurers.

It seems to me that Medicare is a good argument against putting a single-payer system in. Don't want to spend as much? Fine--cut payments to doctors. So what if you are ordering them to operate at a loss? We're the government, economics don't matter!

Coleman Smith

Loren Pechtel said, "Now, I don't buy the scare stories of 100k deaths due to medical errors. From what I've seen there are statisitical problems with that and it's also counting a lot of cases where the error merely speeded up the inevitable a little bit."

Perhaps Loen can direct our attention to the studies he is criticizing and point us to the peer reviewed studies offering contrary evidence.

Surely he has the studies and the peer review analysis since he has referred to the statistical problems.

One would hope that the poster is not proceeding on hunches or faith .

Coleman Smith
+++++++++++++++++++++++++++++++++
No church has ever used an intelligence test to screen its membership, and none ever shall.