John McCain's Healthcare Plans

John McCain writing in Contingencies, the magazine of the American Academy of Actuaries (pdf):

Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation. [Emphasis mine - CK]

You read it here. John McCain is promising to do for healthcare what he (and his fellow Republicans) have done for finance.

Obama's response:



Game. Set. Match.

[H/t Steve Benen]

California Universal Healthcare

I've been tied up with work and family, and so haven't had an opportunity to review the governor's proposed healthcare plan.

And while I'd be amazed if I end up supporting the totality of his proposal, the important thing, as others have noted, is that the recognition of the need for SOME sort of universal healthcare is becoming much more widespread.

And that's a very good thing.

Conservative dog slapped on nose

I caught this quote the other day but didn't comment on it, though it truly deserves some.

This is conservative columnist John Derbyshire whining on his blog ay the conservative National Review:

"My health insurer has just notified me, in a brief form letter, that my monthly premiums are to rise from $472.33 to $857.00 on January 1st. That's an increase of 81 percent. ***E*I*G*H*T*Y*-*O*N*E* *P*E*R*C*E*N*T*** Can they do that? I called them. They sound pretty confident they can. Ye gods!"

He seems to have the hurt expression a dog gets when its master slaps its nose with a newspaper for (to the dog) no good reason.

Dontcha just love it when the vaunted free market's "invisible hand" slaps one of its own?

Blogging at Obsidian Wings, hilzoy has a nice rundown of some of the reaction and a few trenchant remarks herself.

Go read them here.

Newsflash: Congress not entirely in thrall of religious right

By passing the Castle-DeGette bill removing restrictions on federal funding for embryonic stem-cell research, the House demonstrated that it is not yet entirely insane. Good for them.

BushCorp™ scientist-in-chief George Bush has threatened to veto the law.

"This bill would take us across a critical ethical line by creating new incentives for the ongoing destruction of emerging human life," Bush said. "Crossing this line would be a great mistake."

On the House floor, Majority Leader Tom DeLay (R-Texas) likened embryonic research to "killing some in the hopes of saving others."

Killing "some"? Killing what? Let us be clear. Yes embryos are destroyed in the process, but be clear, these embryos are not the cute little mini-humans of the famous Life magazine series:

The embryos being destroyed are called blastocyts. They consist of about 120 cells, and look like this:

So yes, I'm in favor of killing, murdering, assassinating any number of microscopic organisms if it means saving the lives of one of these:

Universal Health Coverage: In Our Genes?

In today's NYT, Doctor and author Robin Cook argues that advances in genomic medicine will eventually demand the end of private health insurance. His argument is that as we increasingly succeed in using our understanding of human genes as a predictor of illness, the statistical models used by insurance companies to assign risk will become meaningless, or rather, too meaningful:

"Another, and possibly more important, negative consequence of this new ability to predict illness is the potential for discrimination in one form or another if confidential health information is released. Unfortunately the chances of such a breach of privacy occurring, despite lip service by politicians to prevent it legislatively, are probably inevitable. Not only is microarray technology easily accessible, but for-profit private insurance companies have strong incentives to use it to protect their bottom lines by denying service, claims or even coverage.
…
In this dawning era of genomic medicine, the result may be that the concept of private health insurance, which is based on actuarially pooling risk within specified, fragmented groups, will become obsolete since risk cannot be pooled if it can be determined for individual policyholders. Genetically determined predilection for disease will become the modern equivalent of the "pre-existing condition" that private insurers have stringently avoided."

And if everyone has a genetic pre-disposition for something, then private insurers would have to cover the insured ONLY for conditions they're unlikely to contract. (And don't think it mightn't come to that.)

But with the end of pooling risk within defined groups, there is only one solution to the problem of paying for health care in the United States: to pool risk for the entire nation…Although I never thought I'd advocate a government-sponsored, obviously non-profit, tax-supported, universal access, single-payer plan, I've changed my mind: the sooner we move to such a system, the better off we will be. Only with universal health care will we be able to pool risk for the entire country and share what nature has dealt us; only then will there be no motivation for anyone or any organization to ferret out an individual's confidential, genetic makeup.

So, in addition to being more cost-effective, fairer, and something a nation which thinks itself great should clearly provide its citizens, universal health coverage is an imperative of, if not genetics, genetic science.

Meanwhile

In his continuing efforts to bring about the decline and fall of the American Empire, BushCorp™ chairman and chief science officer George "the jury's still out on evolution" Bush, has declared that he'll veto any legislation funding increased exploration of stem cells.

"I made it very clear to the Congress that the use of federal money, taxpayers' money, to promote science which destroys life in order to save life — I'm against that," Bush told reporters in the Oval Office. "And therefore, if the bill does that, I will veto it."

Since the blastocysts destroyed to generate stem cells have the same level of consciousness as is found in a typical potato, Bush is also vowing to ban fries, whether the French, or even Freedom variety.

In a related story, South Korean scientists have announced that they've discovered an improved method for growing the potentially miracle-inducing stem cells:

THIS WEEK SOUTH Korean scientists announced an impressive breakthrough in the promising but still nascent field of "therapeutic cloning." Using donated human eggs and skin tissue from multiple patients suffering from various diseases or injuries, they were able to generate genetically individualized stem cell lines for each of the patients. These lines are capable of generating the specific types of cells that may be used in promising therapies for devastating conditions.

Which all goes to demonstrate that in its futile efforts to keep the US from falling into also ran status, BushCorp™ has been killing the wrong brown people.

And, apropos of nothing: OMG clones?! Best we grant Dear Leader unlimited power so he can fight this phantom menace!

More Krugman on healthcare

I'll probably have some comments later, but in the meantime go read it.

Paying retail for healthcare

Americans pay double what Canada and France due for health care. And astoundingly the US government alone already contributes more to this cost per capita than either of those countries. And yet in the US infant mortality is higher and life expectancy is shorter. We are obviously not getting the most bang for our healthcare bucks.

Paul Krugman, in his continuing view of the broken American health care scheme has some suggestions as to why:

Why is the price of U.S. health care so high? One answer is doctors' salaries: although average wages in France and the United States are similar, American doctors are paid much more than their French counterparts. Another answer is that America's health care system drives a poor bargain with the pharmaceutical industry.

Doctors overpaid? I'm willing to argue that another time. Big pharma gougeing us? No surprise there. Congress has been in their pockets for years.

But the big offender? Money quote here:

Above all, a large part of America's health care spending goes into paperwork. A 2003 study in The New England Journal of Medicine estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada.

Nearly a third of medical spending goes to cover admin? Sure. Think of all those medical insurance companies with their presidents and CEOs and vice-presidents of marketing all doing the same jobs as all the other presidents and CEOs and vice-presidents of marketing ad, almost, infinitum.

And it doesn't take a Ph.D. in economics to see that as long as corporations can turn a profit of the sick and dying prices for US healthcare will continue its exorbitant growth.

[UPDATE] Kevin Drum has some very interesting observations on American healthcare satisfaction:

In America, where the elderly are covered by a national system and others aren't, the elderly are more satisfied [than the general population] by a whopping 27 percentage points.

Second, even the poor are more satisfied with their healthcare than the rest of us. The poor generally rely on a combination of Medicaid, emergency rooms, and free clinics for their healthcare, a system that's hard to beat for sheer inefficiency and appalling service. But even at that, the rest of us, who are mostly covered by employer-provided health insurance, are less satisfied than the poor. The system of health coverage provided to the vast majority of American citizens is so bad that we like it even less than the jury-rigged system the poor are forced to use.

Hmmm, now why IS that?

Boomers and healthcare

Your CaliBlogger prompted a lively discussion over at Daily Kos with the x-post of Death and the whiniest generation (astute readers will note I changed the title a bit for kos, gotta keep it punchy to catch people's eyes over there). It's a great discussion and I highly recommend the article, but more importantly the many astute comments it sparked.

One of the ideas I posted later in the discussion was my hope that as the boomer generation ages it will begin to truly begin to recognize the need for fairly radical health care reform. Just to show that I'm a good day and a half of the news cycle, tomorrows New York Times will be featuring a piece by the redoubtable Paul Krugman announcing the need for health care reform and announcing it as his major focus for an impending series of articles:

Those of us who accuse the administration of inventing a Social Security crisis are often accused, in return, of do-nothingism, of refusing to face up to the nation's problems. I plead not guilty: America does face a real crisis - but it's in health care, not Social Security.

Well-informed business executives agree. A recent survey of chief financial officers at major corporations found that 65 percent regard immediate action on health care costs as "very important." Only 31 percent said the same about Social Security reform.

That Mr. Krugman is turning his very keen eye is very good news indeed. Not only is he a distinguished economist (bio here), he has also proven to be able to cut through the typical political blather and frame his points in clear and understandable terms, an ability he has amply demonstrated by taking apart brick by brick, the Republican noise machine's misrepresentation and manipilation of the Social Security debate.

And it is readily apparent the Mr. Krugman's vision is quite clear as he focuses on healthcare, a true crisis:

So what's the problem? Why not welcome medical progress, and consider its costs money well spent? There are three answers.

First, America's traditional private health insurance system, in which workers get coverage through their employers, is unraveling. The Kaiser Family Foundation estimates that in 2004 there were at least five million fewer jobs with health insurance than in 2001. And health care costs have become a major burden on those businesses that continue to provide insurance coverage: General Motors now spends about $1,500 on health care for every car it produces.

Second, rising Medicare spending may be a sign of progress, but it still must be paid for - and right now few politicians are willing to talk about the tax increases that will be needed if the program is to make medical advances available to all older Americans.

Finally, the U.S. health care system is wildly inefficient. Americans tend to believe that we have the best health care system in the world. (I've encountered members of the journalistic elite who flatly refuse to believe that France ranks much better on most measures of health care quality than the United States.) But it isn't true. We spend far more per person on health care than any other country - 75 percent more than Canada or France - yet rank near the bottom among industrial countries in indicators from life expectancy to infant mortality.

So those are the issues that need to be addressed, others might be listed, but Mr. Krugman's next point, and why its so important for progressives to get vocally on board. The money quote:

To get effective reform, however, we'll need to shed some preconceptions - in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.

The fact is that in health care, the private sector is often bloated and bureaucratic, while some government agencies - notably the Veterans Administration system - are lean and efficient. In health care, competition and personal choice can and do lead to higher costs and lower quality. The United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results. [Emphasis mine]

So that's the battle, and if progressives and the Democratic Party have the balls to take it on, it can be the defining moment of this generation of the enlightened. But it's a battle that will make the Social Security piratization skirmishes look like mere dust devils compared to the tornado the regressive will whip up against what needs be done: remove our country's healthcare from those who's over-riding goal is profit.

In that battle I believe progressives have unaccustomed allies, most notably the (non-insurance) business community which increasingly faces the choice of paying exhorbitant health insurance costs, or face increasing losses from un-insured workers absent due to health problems that go unaddressed until they reach emergency room status.

But my main hope, God help me, is that the enormous mass of the boomer generation will, as they typically do, act in their own self interest, and support rational health care solutions.

Prescription malpractice

Mrs. CaliBlogger has two herniated discs and so suffers chronic back pain. Because of this she has been prescribed various pain-relievers and other medications over the years. It's been our experience that the many pharmacists we've dealt with over the years have been unfailingly helpful and sympathetic when dealing with her prescribed medications.

But will it always be so? What if a pharmacist decides that the opiates or derivatives she's been prescribed are morally wrong? Far-fetched? I might once have thought so. But I do so no longer.

In yet another attack by the hypocritical immoral moralists of the "religious" right, an increasing number of pharmacists are refusing to fill prescriptions for contraceptives. These are the same sort of people who, if the woman became pregnant, would scream murder if she then sought an abortion. But then logic has never been their strong suit.

Happily, in another "why I'm glad I live in California" moment, the legislature here has before it two bills which would require pharmacists to fill prescriptions or face penalties for not doing so.

Two Democratic bills pending in the Legislature would require druggists to dispense all lawful drugs. Both proposals would allow California's 25,000 pharmacists to demur only if the store could ensure that the prescription would be filled by another without excessive inconvenience to the patient.

What amazes me is the silence of the medical community in the face of this attack on their professional credibility.

What amazes me further is the silence of pharmacists themselves. Clearly those who are refusing to fill orders for prescribed medicines are just a tiny fraction of the many ethical professionals who assist those in need. Were I a member of that profession I'd be working tirelessly to weed out those individuals who are not fulfilling their professional obligations and I would certainly not be leaving it to potentially wayward governmental regulation.

We've all seen the chaos that can arise when government gets too involved with medical treatment. The American Pharmaceutical Association is doing its upstanding members a disservice by remaining silent on this issue.