09 January 2007

Today's health blog news

Kevin Drum comments, without enthusiasm, on Gov. Schwarzenegger plan for California healthcare reform. Drum admits his bias against any plan that cobbles together reforms but keeps the health insurance industry underpinning the system.

Here's his description of the plan:

"Basically, it's an individual mandate (i.e., everyone is required to buy health insurance, the same way everyone who drives is required to buy auto insurance) with state subsidies for those too poor to afford coverage. There's a new tax on doctors and hospitals, and small employers are required to either provide insurance for their employees or else pay a 4% payroll tax. Insurance companies, for their part, are required to offer insurance to everyone, regardless of medical history, age, or occupation (aka "community rating," meaning everyone in a particular community gets the same rate.)"

Drum says that Safeway execs have said it would be cheaper to pay the 4 percent payroll tax than to continue to pay the 7 percent that health insurance costs them.

This is exactly why keeping the insurance industry in the game won't fly. They're too expensive a price to pay just to satisfy ideology.

Read the whole post regarding Schwwarzenegger's plan.

Ezra Klein links to Over My Med Body, which has a list today of 50 conditions that can cause insurers to reject you. Including allergies, bed wetting, breast implants, impotence, working with chemicals, roofing, lumber work, window-washing and war reporting. How does that serve our economy, not to insure those folks?

Klein also has an post about mandated insurance, such as Schwarzenegger proposed for California yesterday. Klein says he's heard criticism that such a system "criminalizes the uninsured," evidently from single-payer advocates, and he notes that single-payer is also mandated insurance. His criticism seems to be that single-payer advocates are complaining about government coercion when single-payer would also coerce: force people to have health insurance via their taxes.

Klein seems to think that as long as government subsidizes the private, for-profit system — up to 400 percent of poverty with Sen. Wyden's proposed plan and up to 300 percent in Massachusetts, that such a system would be fine. The Schwarzenegger proposal only subsidizes up to 250 percent; not enough in Klein's view.

This entire avenue of reform proposes wasting our dollars in order to continue a wasteful system. The problem with mandated insurance as in Massachusetts or Schwarzenegger's proposal isn't the mandate, it's what it's for: subsidizing an inefficient system with poor quality built in because of its fragmented structure. It's going to continue to be a drag on our economy as a whole and on our individual households. But yes, better than what we have now.

Andrew Sullivan provides a great link to Psychology Today Magazine and an article on ideology and fear:

"We tend to believe our political views have evolved by a process of rational thought, as we consider arguments, weigh evidence, and draw conclusions... Among the most potent motivators, it turns out, is fear... The fear of death alone is surprisingly effective in shaping our political decisions—more powerful, often, than thought itself."

This is potent. The powerful pharmaceutical/health insurance/for-profit medical industry counts on it. We on the side of the angels need to do a better job of understanding it.

Health Affairs blog reminds us that New York's Elliot Spitzer also is moving to reform that state's healthcare system. Or not — maybe he's just going to tinker with it, as in Massachusetts and along the lines of Schwarzenegger.

The top 25 articles from 2006 are available online free at Health Affairs until January 19. Go to the blog for that link.

Health Care Renewal has a post from Sunday about MBA-think screwing up all kinds of businesses, with the idea that every business is basically the same.

There's been a lot of news about Home Depot's CEO retiring after six years with a $210 million golden parachute, but Health Care Renewal points out that Pfizer's CEO got an even bigger package after being forced out after Pfizer's stock took an even bigger hit than Home Depots.

"So we see hospitals with fewer nurses, primary care physicians over-worked, under-paid, demoralized, and threatened with replacement by nurses and physicians' assistants, and the hiring of drug representatives not with pharmacology doctorates, but with experience as cheer-leaders. (Meanwhile, we see hospital, managed care, and pharmaceutical executives, many with little previous experience in actually providing health care, clinical research, or making pharmaceuticals, hauling in ever higher compensation.)"

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