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Hurricane Stan crashed into Mexico today, just one more storm
threatening the energy-producing Gulf Coast and further undermining a sense of insecurity.
Not a natural disaster, the looming health care crises has been described as a
tsunami that could wreak havoc with the US economy. The GOP agenda includes eliminating more Medicaid coverage nationwide
and denying hurricane victims temporary Medicare access. Many of the storm’s
evacuees did not have flood insurance, and without savings, even small businesses
and homeowners in two income families are facing financial ruin, now harder to
recover from with the new bankruptcy law, in which the GOP refused to exclude
victims of natural disasters. While anti war protestors point to the madness of spending $5 Billion a
month losing a war in Iraq versus national security needs and reconstruction
efforts in the Gulf states (“Make Levees, Not War”), the crises of more than 45
million uninsured and millions more underinsured continues to be ignored, to
our peril. These two opinions below are from featured NYT columnists, now hidden
behind an online subscription firewall - though still available in web
newsletters - but first here’s an excerpt from a third commentator, to put this
problem in focus: The average cost of
family health coverage is now $10,880, surpassing the gross earnings of someone
working full time at the federal minimum wage. In the Bush years, the cost of health insurance has
skyrocketed by 73 percent. While Bush has given vastly disproportionate shares of
his tax cuts to corporations and wealthy individuals under the guise that the
rich will create jobs, not only has there been no rise in income for the
average American; business firms, especially small ones, are cutting workers
out of healthcare. Since
Bush took office, the percentage of companies that offer health insurance has
dropped from 69 percent to 60 percent. Healthcare spending in the United States is
expected to grow from $1.4 trillion last year to $3.1 trillion a year by 2012.
Yet virtually nothing on a large scale has been done about it, with insurance
companies, drug companies, and major medical associations lobbying forcefully
on Capitol Hill and in state legislatures against cost controls and
single-payer coverage. The travesty of the hospitals in New Orleans is only a
prelude to the disaster that is about to strike healthcare in America. Derrick Jackson, Boston Globe http://www.boston.com/business/healthcare/articles/2005/09/21/healthcare_swept_away/ Medical costs are just one reason why there are so many more Americans
in poverty this year than last year.
In addition to the social injustice of millions not receiving medical
care, the budget-cutting decisions of “just in time” operations made the crises
management of hospitals an acute case study in a failing economic agenda. The
bottom line is that the longer this problem festers, the harder and more
expensive it will be to resolve. kwc Medicine's Sticker
Shock In the aftermath of
Hurricane Katrina, we have an opportunity to construct something far more
important than higher levees - a national health care system that looks less
like a tightrope and more like a safety net. A dozen years after Bill Clinton's health reform efforts
were destroyed by the insurance industry's duplicity, it's worth trying again.
The health care system is steadily becoming more gummed up in ways that are
impossible to hide. One of the bumper
stickers attacking the Clinton plan read: "If You Like the Post Office,
You'll Love National Health Insurance." That wouldn't work today: the Postal Service runs a system that
is manifestly more rational and efficient than our health care system. For
starters, imagine a postal system that refused to deliver letters to or from 45
million Americans - except on rare occasions, by ambulance. "This is one of
those fleeting opportunities where a catastrophe creates an opportunity to
rebuild something better than before," says Dr. Irwin Redlener, president
of the Children's Health Fund and associate dean of the Mailman School of Public
Health at Columbia University. In a sign of the
growing disenchantment with our health system, 13,000 doctors have joined Physicians
for a National Health Program, which lobbies for a single-payer government-financed health
program. There are four main problems with the
existing system: §
First,
it leaves out 45 million uninsured Americans, and their number is rising. §
Second,
it is by far the most expensive in the world, costing 15 percent of our
national income, yet our outcomes are awful - U.S. life expectancy is worse
than Costa Rica's. §
Third,
our business competitiveness is undermined when, for example, medical expenses
add $1,500 to the sticker of each General Motors car. §
Fourth,
our system is catastrophically inefficient: according to a study in The New England Journal of Medicine,
health administrative costs are $1,059 per capita in the U.S., and just $307 in
Canada. A single-payer system
would be most efficient but probably is not politically feasible at the moment.
The smart new book "The Health Care Mess" suggests a variety of more
gradual approaches that would face less opposition. Whatever the
mechanism, all children should be covered. It's a disgrace that we use public
funds to save the lives of nonagenarians but not those of 9-year-olds. And kids are a bargain: per capita medical
spending is $1,525 for children less than 5, and $9,000 per person aged 65 to
74. A second principle is
that we should put less emphasis on curative medicine and more on public health
and prevention - everything from preparing for avian flu to encouraging
exercise. Sure, we can buy more "left ventricular assist devices,"
which cost $210,000 per patient installed, or buy Erbitux for colon cancer, at
$17,000 per month of treatment. But as a wise new book, "Prescription for
a Healthy Nation," argues, you get more bang for the buck when you promote
healthier lifestyles - fighting obesity, cigarette smoking and the like. Raising cigarette
taxes saved far more American lives, for example, than an army of neurologists
ever could. In the same spirit, I'd like to see a French-fry tax. And imagine
the health gains if we banned potato chips and soda from schools. Reforming the health
system won't be easy. In the real world, poor kids don't see doctors not only
because they're uninsured, but also because Mom doesn't have a car, can't
easily get time off from work, or doesn't speak English. Those are hard nuts to
crack - but one reason to think that we can do better is that much of the world
does better. I've been thinking of
health care partly because of something that happened when I was on vacation in
August. My kids and I were stacking firewood for my parents on the Yamhill,
Ore., farm where I grew up, when suddenly the seven-foot stack collapsed - on
top of my youngest. She was knocked down and pinned, her face bleeding, under a
pile of logs. I had insurance, and a
car to get to the emergency room - and in the end the logs (stained with blood)
turned out to be in worse shape than my daughter. She's just fine. But that
instant was heart-stopping in its terror - and the system routinely does fail
such children in need. Isn't it worth fighting one more time for reforms, so
that we Americans can get health care every bit as good as Canada's? Article found at http://www.truthout.org/docs_2005/100205G.shtml Excerpts from P. Krugman: Miserable by
design Federal aid to victims of Hurricane Katrina is already
faltering on two crucial fronts: health care and housing. Incompetence is part of the problem, but
deeper political issues also play a crucial role.
Start with
health care, where
conservative senators, generally believed to be acting on behalf of the White
House, have blocked bipartisan legislation that would provide all low-income
victims of Katrina with health coverage under Medicaid. …Local hospitals and doctors will often treat Katrina victims even if
they can't pay. But this means that communities that have welcomed Katrina
refugees will, in effect, be financially punished for their generosity -
something local officials will remember in future crises. (The administration
has offered vague, unconvincing assurances that it will do something to
compensate medical caregivers. It has offered much more concrete assurances
that it will reimburse religious groups that provide aid.) What about housing? These days, both conservatives and liberals agree that
public housing projects are a bad idea, and that housing vouchers - which help
the poor pay rent - are much better. In the aftermath of the 1994 Northridge
earthquake, special housing vouchers issued to victims worked very well. But the administration has chosen,
instead, to focus its efforts on the creation of public housing in the form of
trailer parks, which have been slow to take shape, will almost surely be more
expensive than a voucher program and may create long-term refugee ghettoes.
Even Newt Gingrich calls this "extraordinarily bad policy" that
"violates every conservative principle." As for the administration's odd insistence on providing public housing
instead of relying on the market, The Los Angeles Times reports that Dept. of
Housing and Urban Development officials initially announced plans to issue rent
vouchers, then backed off after meeting with White House aides. As the article
notes, the administration has "repeatedly sought to cut or limit" the
existing housing voucher program. This suggests that what administration
officials fear isn't that housing vouchers
would fail, but that they would succeed - and that this success
would undermine the administration's ongoing efforts to cut back housing aid. So here's the key to understanding post-Katrina policy: Mr. Bush can't avoid helping Katrina's victims,
but he doesn't want to legitimize institutions that help the needy, like the
housing voucher program. As a result, his administration refuses to use those
institutions, even when they are the best way to provide victims with aid. More generally, the administration is
trying to treat Katrina's victims as harshly as the political realities allow,
so as not to create a
precedent for other aid efforts. As the
misery of the hurricane's survivors goes on, remember this: to a large extent,
they are miserable by design. article
found at http://www.truthout.org/docs_2005/100305N.shtml Also see Ronald Brownstein’s Health care crises goes untreated, but the cancer
spreads http://www.latimes.com/news/nationworld/nation/la-na-outlook3oct03,1,1583583.column?coll=la-headlines-nation |
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