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29 April 2005

Florence Nightingale has morphed into Vampira

The state of the American health care system.
Healthcare costs are sucking the blood out of the economy, for one thing. Consider poor General Motors, once the nation's flagship corporation and now sinking under the weight of its employee health benefits which account for $1,500 of the sticker price of each new vehicle. As GM contemplates bankruptcy, other companies thrash around frantically trying to shed their insurance-needy American employees. They downsize and outsource anything to escape the burden of health costs. The result? Our "jobless recovery": Companies don't want to assume responsibility for their workers' medical bills and this being the global temple of free enterprise neither does the government.

Then there are the U.S. health system's toxic effects on individuals, and I'm not referring to Vioxx or the approximately 200,000 people who die each year as a result of "medical mistakes," but to its financial effects. Harvard's Elizabeth Warren recently co-wrote a study showing that more than half of all personal bankruptcies are triggered by medical costs, and it's easy enough to see how. If you lose your job through, say, downsizing or outsourcing you lose your health insurance, and the uninsured are routinely charged up to three times more than those who have an insurance company to negotiate their hospital bills. As for emergency rooms, which the hardhearted or incurious imagine absorbing all the poor and uninsured well, the average visit to an ER now costs a little over $1,000, which is a high price to pay for an asthma attack or an infant's fever.

4 April 2005

Towering contradictions and hypocrisy in the controversy over the tragic plight of Terri Schiavo

John A. Kitzhaber, a physician and former governor of Oregon, points out how Congress involved the federal courts in the life of one individual, while making another decision to deny thousands of other Americans access to healthcare. Some of whom who may die as a result.
To understand this point is to understand the insidious form of implicit rationing practiced by legislative bodies throughout the nation - starting with the Congress. When the Congress cuts Medicaid funding, it is a direct cost shift to the states that administer the program. However, unlike Congress - which has run up a $7 trillion national debt over the past four years - states are required to operate within a balanced budget. So they respond to cuts in Medicaid by dropping people and/or services from coverage.

In 2003, for example, in an effort to balance the budget in the face of falling revenue due to the recession, the Oregon legislature discontinued prescription-drug coverage for certain categories of citizens covered by the state's Medicaid program. This action was apparently based on the assumption - widespread in legislative circles - that if we just stop paying for the healthcare needs of the poor, they'll somehow go away and the public sector can avoid the cost.

As a consequence of this decision, Douglas Schmidt, a man in his mid-30s suffering from a seizure disorder, was no longer able to afford to purchase the medication that controlled his seizures. He subsequently had a grand mal seizure and suffered severe brain damage. He was put on a ventilator in a Portland hospital, where he remained for several months. Eventually he was transferred to a long-term care facility where he died after life support was withdrawn - following a court order to do so.

The cost of his antiseizure medication was $14 a day; the cost of his hospital care was over $7,500 a day - a total medical bill exceeding $1 million. The legislature saved no money through its implicit rationing decision, yet Mr. Schmidt died of political and budgetary expediency based on a policy that said, in effect, we will not pay pennies for medication to manage a seizure disorder, but will pay thousands of dollars to keep an individual on life support after that unmanaged seizure disorder causes severe brain damage.

So, in another words, the act of Congress was one of mere ceremonial nature, and that they care not, in the aggregate, for the lives of Americans who are denied healthcare because they have no way to pay. And all of you who side with Tom DeLay (who applies a different set of standards for his own family), Bill Frist (who oversees a managed care corporate entity that he has defended such hospital made decisions) and George W. Bush (who signed a law in Texas to take these life support decisions away from the family), but yet are not in favor of universal health care envelope yourself in a giant contradiction.