I Call BS!

By Val Willingham

Nearly half the respondents in a survey of U.S. primary care physicians said that they would seriously consider getting out of the medical business within the next three years if they had an alternative.

The survey, released this week by the Physicians’ Foundation, which promotes better doctor-patient relationships, sought to find the reasons for an identified exodus among family doctors and internists, widely known as the backbone of the health industry.

By ROBERT CARROLL

The McCain health-care insurance tax credit may well be one of the most misunderstood proposals of this presidential election. Barack Obama has been ruthless in his attacks. But the tax credit is highly progressive and will provide a powerful incentive for people to purchase health insurance. These features under normal circumstances should endear Democrats to the proposal.

There has been a lot of rhetoric and misstatements, but what exactly does Sen. McCain have in mind? He would replace the current income tax exclusion for employer-sponsored health insurance with a refundable tax credit — $5,000 for those who purchase family coverage and $2,500 for individual coverage. Mr. McCain would also reform insurance markets to stem the growth in health insurance premiums.

By Anthony J. Brown, MD

The results of a survey in Oregon suggest that the Death with Dignity Act enacted in the state in 1997 does not always prevent patients with depression, a treatable condition, from receiving a prescription for a lethal drug.

The findings indicate that “most people in Oregon who request physician aid in dying do not have clinical depression,” but yet there are “small number of patients with clinical depression who are able to access lethal medications,” lead investigator Dr. Linda Ganzini, from Portland Veterans Affairs Medical Center, told Reuters Health.

“The Oregon law,” she explained, “requires that if the prescribing physician is concerned that the patient might have depression influencing their judgment, that they be evaluated by a psychiatrist or psychologist. The proportion of requesting patients who are evaluated by a mental health professional has been dropping over the last decade and last year no mental health assessments occurred among the 46 people who died by physician-assisted suicide in Oregon.”

For someone running as the tribune of “change,”Barack Obama showed again in last night’s debate that he sure is comfortable with the status quo on health care. He continued his recent assaults on John McCain’s health reform even though it is precisely the kind of plan that someone of Mr. Obama’s professed convictions ought to support.

The attacks include swing-state TV spots and Joe Biden’s multiple distortions, though the most over-the-top come from the candidate himself. Over the weekend, Mr. Obama called the McCain plan “radical,” “out of line with our basic values” and, in case he wasn’t clear, “catastrophic for your health care.” Since Mr. McCain offered only a once-over-lightly defense of his plan, allow us to give it a try.

Presidential candidate Barack Obama is touting a health care reform plan that sounds very familiar. It includes:

The 2006 Massachusetts health care reform plan “expanded the state’s Medicaid program, offered qualified residents financial assistance to purchase insurance, created a new state agency to connect residents with affordable plans and - perhaps the most talked-about change - required all residents with access to affordable coverage to enroll in a plan or incur financial penalties. For employers with more than 10 employees, the law requires that those who do not make a “fair and reasonable” contribution toward worker health coverage, pay up to $295 per employee per year into a state fund.”

And how is that plan working out for Massachusetts?

Well, strictly in terms of coercing encouraging people to get insurance it has been a great success.

Among adults with incomes below 300 percent of the poverty level, the study found uninsurance dropped by almost 11 percentage points, and among adults at less than 100 percent of the poverty level - those eligible for fully subsidized coverage - uninsurance rates dropped by more than two-thirds.

That’s pretty impressive. At least until you compare it to the problems the plan is facing:

And the future is looking a little scary:

The only REAL solution to the health care crisis is to allow the free market to work freely.

Get employers out of the equation - there is NO reason why we should be limited to whatever few (often inferior) healthcare plans are offered by our employers. There is NO reason why our employers should be held responsible for our health insurance (think of it this way…would it make sense for your only affordable option for car insurance to be whatever two or three plans your employer signs up for? Giving you NO choices regarding the amount of your deductible, the amount of coverage, or the areas of coverage, and therefore NO choice regarding the amount of the premium or the reputation of the insurance company?)

Under the current system doctors and patients alike are held hostage by the insurance company, who really calls all the shots. Under universal health care doctors and patients are held hostage by the government, who would really call all the shots. Only in a truly free relationship, where patients can choose their own medical plans, their own doctors, their own course of care, and how much they are willing to pay for it, and where doctors make their medical choices based on what is best for their patients, where they can choose how many patients to care for and what to charge for their services, can the market truly work as it’s supposed to.

Certainly there should be regulations to protect patients from unscrupulous doctors, standards for medical care, and safety nets for the needy. But those objectives can be achieved without creating another government behemoth that will inevitably go the same route as Social Security and Medicare into an unaffordable and unwieldy money pit that is the epitome of inefficiency.

From Junkfood Science we learn [all emphasis added]:

Compulsory medication and monitoring of diets and lifestyles by the State is now a reality for workers in Alabama who are older or have certain genetic physical characteristics.

Despite efforts to paint this in rosy euphemisms, under a new plan just approved by Alabama’s State Employees’ Insurance Board, if workers don’t agree to be subjected to lifestyle and health screening and blood tests for specific hereditary characteristics, they will be penalized $25 a month or be denied health insurance coverage.

Healthcare decisions will no longer be those for individuals and their personal healthcare providers to make. Workers found to have high BMIs, cholesterol levels, glucose levels, or blood pressures will be required to enroll into wellness programs with their integrated disease management, along with weight loss targeting those with BMIs ≥35, and be given one year to improve, or be penalized $25/month. Those who are thin and have approved numbers will be exempt.

According to the State Employee’s Insurance Board, the program, which will cost taxpayers $1.6 million next year alone, is about improving health and saving insurance costs for the State.

And it gets worse:

The requisite employee “wellness” and weight loss programs have not proven long-term effectiveness, but to put employees at increased risks. Nor to they actually lower healthcare costs. Achieving ideal numbers invariably requires prescription medications and other invasive measures, especially, as has been shown, for those over age 50.

In reality, these health risk factors are primarily measures of genetics and aging, and hence, using them is discriminatory, but hiding behind euphemisms of being about promoting healthy lifestyles.

The full article is here. It will be interesting to watch this progress. Perhaps abject failures of nanny state health care programs in Alabama and Massachusetts will finally get more people to question the wisdom of universal health care.

or, How I Learned to Stop Worrying and Love Insurance

Local herb farmer Rose Loveall-Sale says that if her health insurance premiums continue rising she’ll have to consider a career change. It’s a plight shared by farmers and ranchers statewide, a new survey shows.

Okay, rising health care costs, including the premiums, are hurting a lot of people and certainly farmers are a necessary part of our nation’s economy. But, as usual, the devil is in the details.

A new The Access Project report that surveyed more than 1,700 California family farmers and ranchers, found about one third have no access to group health coverage and must buy expensive individual insurance.

Maybe I’m just ignorant, but why don’t those 1,700 form a group and buy group health insurance?

The person featured in this article - and understand, I’m not criticizing her in any way, I’m criticizing the reporter’s choice of her to be featured in this article - does not even represent what she should represent based upon the topic of this article - a farmer without group insurance. She has group insurance through her husband’s employment.

Loveall-Sale said she and her husband pay $300 in monthly health insurance premiums, and it’s already a stretch.

“When you’re working with a narrow profit margin, another few hundred dollars a month for health care costs is huge,” she said.

$300 a month is pretty average for those with group insurance. And yes, when money is tight a few hundred dollars can make a huge dent in the monthly budget (and when is the last time our Congresspeople - who essentially control the insurance and health industries through heavy regulation - experienced THAT?) But that narrow profit margin is a fact of life for many of the country’s small business owners. Why did this reporter focus on farmers and ignore all other small business owners? To be fair, all such articles are better assimilated when a personal face is put on them, and maybe this is even part of a series, although the article makes no mention of such. But to imply that health care costs ALONE are the cause of grief for small farmers is disingenuous. There are many more issues threatening our nation’s small businesses, and many more problems in our health care system than just the rising cost of insurance premiums.

I note that this article mentions not at all whether these farmers are providing health care coverage for the 1.1 million jobs they support. Calls for more health care coverage to be provided by small employers routinely ignore this critical factor - that small business owners who can barely pay for their own insurance will lose their businesses if required to insure others.

Why do we even expect employers to foot the bills for health insurance? This whole scheme was started by - you guessed it! - Congress: “The history of health insurance is that people began receiving coverage as a “non-cash” benefit during World War II because of wage controls. A few years later Congress confirmed that health insurance was exempt from taxable wages. The effect of this regulation meant that coverage received in lieu of wages was more affordable than using after-tax wages to purchase health insurance. The same was true of funds used to pay for incidental medical needs. Thus began the trend of purchasing health coverage through your employer and paying third parties to manage all your health care spending — including data-to-day medical needs.” Testimony before the House Select Committee on State Health Care Expenditures, March 24, 2004.

“Paying third parties to manage all your health care spending — including data-to-day medical needs”…such as dictating the co-pay for medications? choosing which medications are covered at all? Deciding which medical procedures are necessary, and therefore covered, and which are not?

All efforts both by government and as called for by grass-roots movements focus almost exclusively on providing health insurance to the uninsured. If anything, this article amply demonstrates why providing health insurance coverage alone isn’t the answer.

Isn’t it about time we end this way of managing health care?