Author: cmh

Experts See Peril in Bush Health Proposal – New York Times

Experts See Peril in Bush Health Proposal – New York Times

The economic rationale for Mr. Bush’s proposal is that too many people
have “gold-plated, deluxe” health insurance, which encourages them to use
excessive amounts of health care, driving up costs for everyone.
Many economists agree. But they doubt that Mr. Bush’s proposal would do much to hold
down costs or cover more people.

Really? Is that it? Too many people running up excessive bills for their healthcare?

Mr. Bush’s proposal differs radically from President Bill Clinton’s plan for universal coverage, but experts on health benefits said they were similar in one respect: In an effort to help the uninsured — about one-sixth of the population — they would upend the system that covers most Americans.

We have a system?

Representative John D. Dingell, the Michigan Democrat who is the chairman of the Committee on Energy and Commerce, said, “The president’s proposal would do little to help the uninsured, but would undermine the employer-based system through which 160 million people get coverage.”

Almost tempting to pass whatever Bush sends down the pike, let the system implode, and then start over. Of course, that’s sort of how we got the country where it is right now, isn’t it?

Cheers.

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times
By CLIFFORD KRAUSS
Published: February 26, 2006

Article about waiting times in Canada: below are responses from Physicians for a National Health Plan’s Nicholas Skala:

1. This writer is well known for peddling fake data, and this story is no exception. For his outrageous waiting time estimates, he uses data supplied by the Fraser Institute, an ultraconservative PR firm that masquerades as a legitimate research institution. Dr. Robert McMurtry, the Canadian orthopedic surgeon who is a former dean of a Canadian medical school and served on the national waiting times commission tells me that not even the right wing Canadians take them seriously. Their “scientific” method of determining wait times consists of bulk-mailing a list of pro-privatization physicians and asking them how long they think their patients will have to wait to see them. If they return the mailing they are entered in a drawing to win a $2,000 cash prize. It’s pathetic. Unsurprisingly, Fraser comes up with outrageous waiting time estimates (17.8 weeks last year, as I recall), and is quite adept at publicizing them in the American media. Wait times are scientifically measured every year by Statistics Canada (the counterpart to the U.S. Census Bureau). I’m sure most Americans would be surprised at the results of scientific measurement: In 2005, median wait times were 4 weeks for elective surgery, 4 weeks for specialist care, and 3 weeks for diagnostic tests.

http://www.statcan.ca/Daily/English/060131/d060131b.htm

Also, the Canadian Health Services Research Foundation has done a short, scholarly critique of Fraser’s methods and compared them with real studies. (In fact, I think they’re far too kind to Fraser).

http://www.chsrf.ca/other_documents/newsletter/qnv1n4p4_e.php

2. The Supreme Court decision was bad for a number of reasons, and since has been near universally derided in the Canadian press. Follow this link:
http://www.pnhp.org/single_payer_resources/Canadian%20Supreme%20Court%20Ruling.pdf

3. As far as proposals to create a parallel private system, compelling evidence shows that more private participation leads to longer waiting times and lower quality care because 1) private insurers “cherry pick” healthy and profitable patients and leave the sick and poor to the public system and 2) physicians have a perverse incentive to move to the private sector (where they make more money), draining the public system of capacity and resulting in lower-quality care (and eventually creating a self-fulfilling prophecy for the right wing, because they then say the public sector can’t do anything right).

The Canadian Health Services Research Foundation has a couple of great fact sheets on this too.
http://www.chsrf.ca/mythbusters/pdf/myth17_e.pdf
http://www.chsrf.ca/mythbusters/pdf/myth13_e.pdf
http://www.chsrf.ca/mythbusters/

Finally (and kind of philosophically), there is a reason that rationing in Canada gets so much attention in the media. Its because the Canadian health system is held publicly accountable. Grievances aired in public are likely to be addressed by policymakers (and in many cases have, as waiting times for many procedures have dropped dramatically). This is a foreign idea to us in the U.S., where the operation is exactly reverse: no one is ultimately accountable, and the forces that profit from the system have every reason to keep problems quiet. And so, although rationing (based on the ability to pay) in the United States kills at least 18,000 Americans every year (according to the Institute of Medicine’s most conservative data…Himmelstein and Woolhandler estimate it may be 10 times that many), our media acts as though Canada’s the place with the problems.

Hope this helps.

nick

Nicholas Skala
PNHP Staff

JAMA — Lives at Risk: Single-Payer National Health Insurance Around the World, January 19, 2005, Orient 293 (3): 369

JAMA — Lives at Risk: Single-Payer National Health Insurance Around the World, January 19, 2005, Orient 293 (3): 369: “by John C. Goodman, Gerald L. Musgrave, and Devon M. Herrick (National Center for Policy Analysis), 263 pp, with illus, $70, ISBN 0-7425-4151-7, paper, $22.95, ISBN 0-7425-4152-5, Lanham, Md, Rowman & Littlefield Publishers, 2004.”
The link is to the review of the book in the Journal of the American Medical Association by Jane Orient.
[Jane M. Orient, MD, Reviewer Association of American Physicians and Surgeons University of Arizona College of Medicine Tucson jorient@mindspring.com ]

and a reply…
JAMA — Single-Payer Health Systems and Statistics, July 6, 2005, Starfield and Morris 294 (1): 43

and a response…
JAMA — Single-Payer Health Systems and Statistics–Reply, July 6, 2005, Orient 294 (1): 44

And who is Jane Orient? http://en.wikipedia.org/wiki/Jane_Orient
and the AAPS : http://en.wikipedia.org/wiki/Association_of_American_Physicians_and_Surgeons
“The motto of the AAPS is omnia pro aegroto which means “all for the patient.”

Your moment of Zen.

AMA Policy Finder – The “Case” Against Single Payer

AMA Policy Finder – American Medical Association:

H-165.888 Evaluating Health System Reform Proposals
Our AMA will continue its efforts to ensure that health system reform proposals adhere to the following principles:
…”(2) Unfair concentration of market power of payers is detrimental to patients and physicians, if patient freedom of choice or physician ability to select mode of practice is limited or denied. Single-payer systems clearly fall within such a definition and, consequently, should continue to be opposed by the AMA. Reform proposals should balance fairly the market power between payers and physicians or be opposed. “

Awfully dogmatic, isn’t it?

AMNews: Oct. 24/31, 2005. Canadian tide turns as residents return home … American Medical News

AMNews: Oct. 24/31, 2005. Canadian tide turns as residents return home … American Medical News

Experts say an improving climate for physicians in Canada and an increasingly hostile one in the United States are driving the change.
By Myrle Croasdale, AMNews staff. Oct. 24/31, 2005.
Deepening administrative burdens from managed care insurers and rising medical liability rates are some of the reasons more of Dr. Warner’s Canadian colleagues are returning home after training or practicing in the United States.
The shift also is attributed to the Canadian government’s efforts to reinvest in upgrades, such as new operating rooms, under the single-payer system. In some provinces, physicians are being offered higher reimbursements. All of this is to stem a growing shortage of doctors and increase access to quality care. Such stability follows deep cutbacks in Canada’s reimbursement and health care infrastructure during the 1980s and 1990s.
—-
Recent surveys from the Medical Group Management Assn. showed that physician pay is flat or declining in many specialties. Canadian salary figures were not available at press time, although CIHI data indicate that Canadian physicians have average billings about 25% less than their U.S. colleagues.
But doctors in Canada do not have the paperwork of multiple insurers or the steep increases in liability insurance premiums. In Ontario, considered a high-risk province, an ob-gyn would pay the equivalent of $65,000 for coverage, while in Florida, also considered high-risk, insurance would cost $277,000. Liability costs are increasing in Canada, though they’re blunted by a tort-based compensation system, with compensation limited to cases in which fault is proven or settlement is made.

More from Open Secrets

More from Open Secrets
Top Contributors to Federal Candidates and Parties: Health: “Health: Top Contributors to Federal Candidates and Parties “

Donor Profiles: The American Medical Association (AMA) represents medical doctors across the country, promotes standards in care, and publishes a number of medical journals. The association has traditionally supported Republican candidates, agreeing with the GOP on such issues as medical malpractice reform. But over the last few years, the AMA has also begun to shift support to the Democrats, favoring their attempts to pass patients’ rights legislation and expand Medicare payments. “

And just for fun:
Top Contributors to Federal Candidates and Parties: Misc Business:
“Misc Business: Top Contributors to Federal Candidates and Parties “