Watson is blunt and to the point, the article is like a 5 minute version of Sicko.
Rod Watson: Don't expect health reform any time soon
By Rod Watson
Updated: 05/08/08
The richest and smartest nation in the world has the dumbest health care system, one that leaves out 47 million people while spending far more than any other nation.
It's a system in which those on Medicaid - like a father who lost his 4-month-old daughter - get shunned or wonder if they're getting substandard treatment.
Yet you won't hear Sens. Barack Obama, Hillary Clinton or John McCain talking about the obvious solution: a national, single-payer system that could preserve private doctors and hospitals, yet stop wasting money on health insurers who give no shots and perform no surgeries.
Full article, check it out, it's a quick read
Rod Watson is my new Buffalo Hero
sorry lib, don't take me the wrong way. I'm not condemning cuba- their health care, from what I know, is quite good.
and- any tips on quitting NRT? My mom has been chewing the gum for, oh, 5 years now. I know it's better than smoking, but I wish she'd quit that, too.
I used to work for the woman that Watson is quoting. "Single-payer is not a panacea. Monroe cautioned that it would have to be structured with the right incentives." I definitely agree with her on this one. Cuba shouldn't really be condemned when it comes to health care. They are doing tremendously well in comparison to other third world countries. If I were to have cancer I would rather be here, but if I didn't have health insurance I would rather be there. There infant mortality is less than ours. This is due to the emphasis on prevention. There prenatal care for everyone beats what the majority would receive here. You should see all the old people in Cuba exercising in big groups. I have never seen that here ever. These are state sponsored classes to keep them active and heatlhy. When it comes to our own socialized medicine, Medicare, they lack in prevention. My work in smoking cessation can be very frustrating. People that only have Medicare and no secondary insurances get no help in quitting smoking. Smoking is the biggest health crisis in the country and world and they won't provide nicotine replacement therapy to their clients. People on Medicare are worse off than those on Medicaid. Some of the quotes that Watson used are complaining about Medicaid and really they get a lot in comparison to those who have there own private insurance, at least when it comes to drug coverage and nicotine replacement. Nicotine replacement is proven to double peoples chances of quitting. You can't imagine how frustrating it is to speak to Medicare patients and tell them "sorry I know you have quit smoking for two weeks using the nicotine replacement we sent you but you are going to have to buy the rest on your own." People need NRT for sometimes up to 12 weeks. This stuff costs $50 for a two week supply. Many of these people just don't have enough to pay for them and return to smoking. You tell them to use the money that they save from not smoking and then they tell you that they bought their "Smokin Joe's" at the reservation for $10 a carton. What are you supposed to tell them? Usually I say "Sorry, if it were up to me I would give it to you." New York State is the only state that I know of that offers free nicotine replacement. Every other state people are having a hard time quitting because a proven, effective and relatively safe product is not within reach of those who need it. I also should say that in Cuba they do not put things in the cigarettes to make them more addictive. My Aunt Anne has Lyme Disease. Her doctor, the only one so far to be able to help her, has rejected insurance companies because they refuse to pay him for treating his patients. These insurance companies are not doctors yet they decide who is going to live and who is going to die. My Aunt is very sick and I wish she didn't have to pay for all of this herself. She has insurance!
Joshua: you mention the relation between life expectancy and lifestyle. Preventative medicine is covered lots of other countries but unless you are on the most expensive insurance plans here you are not covered.
Additionally, health education in this country is a joke. For example, during the Atkins craze I was in a grocery store. They had roasted chickens for sale with with a big label "Low Carb!". The very fact that a collection of proteins and fat necessitates such a label makes me sick. Why do we pump money into programs telling kids that the drugs they will do in high school are bad when there is no nutrition education? Ultimately, Americans are going to die earlier, require more expensive treatments, and miss more days of work because they don't know that chicken is low in carbs.
Oh my god, I am about to run screaming into the wilderness pulling my hair out.
I agree- for-profit private insurers who care about nothing more than their bottom line are not helping the situation. For example- there's a great machine called a wound vac. It really helps nasty wounds heal. The thing is, it's expensive, so insurance companies often refuse to pay for it once a patient goes home. What they don't seem to realize is that if they say the patient can't have it, it's not like we take it off and give the patient something cheaper. No, we make them stay in the hospital longer to keep getting it. Which is FAR more expensive than just paying for the damn thing. Or there are some oral antibiotics that are VERY expensive. But when you compare that the cost of a PICC line (special IV), plus the cost of having a nurse come to your house twice a day to give medicine, or to simply staying in the hospital a few extra weeks- the pill is way cheaper. But insurance never sees that. it makes me crazy.
My other brilliant solution- make tobacco disappear from the planet. Don't just make it illegal, b/c that opens a whole different can of worms. Make it gone. If I'm not mistaken, tobacco-related illness is the #1 preventable cause of death in the US. Health care expenditures would probably go down 50% if people didn't smoke. There are days where it's so frustrating, I almost think "you don't deserve medical care if you smoke." Obviously that's extreme. But at the same time- the 100K spent to treat a smoker's cardiac disease could treat a LOT of uninsured children, etc. I've heard that some nations are instituting age limits. Like if you're 95 and come in with some horrible condition that CAN be treated, but only with a $100K operation, they say "we're sorry. you're 95. It's not worth it."
sorry... I'm getting all fired up here. I'll stop.
and josh- thanks for the bday wishes. :)
Oh, and it may warm the cockles of your heart to know that this was the same company that flooded the market with 1 billion solid doses of generic Plavex for $4 a pill - Pfizer sued them and tried to get an injunction but it failed because the drugs were already being distributed. =D
Yes that is a good point - its true that a lot of the money that goes into drug production ends up part of the marketing ploy to get the drug on the market. Whether not that is wasteful I can't say one way or another - I'll leave that for people to decide on their own. If a drug works, shouldn't the doctor know about it? Personally I would never be that presumptuous. I don't know if our everyday doctors really pay that much attention so I wouldn't dare comment on that, but I'd guess that the marketing budgets for drugs pale in comparison to what they spent to research and create the drug.
I've actually audited Canadian drug manufacturers - the largest out there, as a matter of fact. You would be absolutely astounded at the amount of resources on hand to do what they do. Just one machine I saw was about the size of a PC tower and it costs $220k per unit... and there were rooms full of them.
DC its interesting you've brought it up, since this is one of my gripes. People often cite birth rates/death rates or similar statistics as a criticism of not having enough health care. In my view thats not a health care problem, that is a lifestyle problem.
The reason why we are less healthy than other countries is fairly obvious to me - we are generally fatter and lazier than our foreign counterparts and live more stressful lifestyles. We largely eat like shit. We are less healthier because we are a fast food nation that thrives on having things quickly and easily at the expense of making choices that would be wiser in the long run.
The thing is, when people say we should be healthier given our status I think they are right. Given our lifestyle what concerns me is that if we create a nationalized system, how is any of it going to fix the problems that make people have to visit the doctor in the first place? As I said earlier the natural consequence of this is what we are seeing in England now, where reputable government and non-governmental people are batting around the idea of rationing the care. The least healthy would actually be exempt from coverage if they had their way. At that point the idea that the prime concern is the health of the country would be ludicrous - it would be about dollars and dollars only.
So why can't we fix the financial problem first? This is why I think some elements of free market capitalism will have to be present in an American system.
PS How Much of the cost of Plavex goes to their TV commercials? And how much goes to the free crap they hand out in hospitals all day? is it half their budget? then how much goes to political contributions? I'm just saying... seems like we're paying for a lot of waste here too. if a drug works you use it, and drugs work differently on each person. Why should they tell me to I ask my doctor about __Rx____ if it works, the doctor should know, right?
Well i think we can all agree that if we are spending almost double what any other country spends on healthcare per capita, we should be the healthiest. But we're not, by the WHO's ranking in 2000 we're number 37. Now that is an outrage.
Why is it fair for employers to foot the bill for healthcare? How can we compete against Japanese automakers when they are saving all that money that we spend on healthcare?
In America we can learn from other countries mistakes and create our own model. I don't know if our healthcare facilities are the 'best' or not, but the issue is not the facilities it's how we pay for Americans to have access to it.
I don't think we should nationalize hospitals, doctors, or research in general. But having an insurance company serve as a middleman for every procedure is wasteful. We set up HMOs to help keep costs down, didn't happen. How about we minimize waste, minimize the amount of hours people spend on the phone or filling out paperwork to get approval from someone who has never seen the patient, or the hospital.
Medicare works, and older people tend to be more costly to take care of. Why not triple the size of Medicare and cover everyone. I'm not saying I know what the perfect system is, but I see a lot of problems, and a lot of waste. The layer of insurance providers is unnecessary, and I see that as a problem that makes sense to solve through single payer coverage.
(e:jenks) - wasabi girl? I'm sorry I missed your birthday so I'll say it now - happy birthday!
I'm not necessarily against the idea of health care for all - David and I have talked about this for a few months now. Based on the evidence I'm skeptical, and to be fair I think its justified skepticism. We have to find a way to make it work for us. Any politician that wants to mimic Europe will never get my support.
One of my tangentially related concern is medical costs. Insurance is one thing but controlling medical costs is a knot that I don't think can be unraveled. $16 for a dose of Plavex is ludicrous, but isn't the medical industry entitled to recoup the billions they spend on the R&D it took to produce the drug in the first place? What if the drug companies simply tell the government, as they've done with flu vaccines, that they will not produce life saving drugs anymore? Its cynical but that is a very real possibility.
Having the government pay for the Plavex instead of my dad (not that dad takes Plavex) ultimately isn't solving anything. Oh, by the way, in Canada unless you are elderly or on social assistance (also "first nations" folks are included I think), or ironically, if you are an inmate in a federal prison, drug coverage is not part of the package. Prisoners get drug coverage but you would not. When you see any references to "group coverage" in foreign countries that provide socialized medicines they are talking about supplemental health insurance that their company provides. Despite the vast bureaucracy and heavy taxation, individuals and companies are still forced to provide for themselves.
Not enough people read the fine print.
good point josh. Sure I'm biased, but I think the health CARE in this country is pretty excellent. It's the health INSURANCE and ACCESS issues that are the problems.
I mean if you have cancer, do you want to be treated here, or in cuba? Even if cuba does have lower infant mortality rates, etc...
As I've said before, the application of nationalized health care has never worked as advertised. In Britain they are actually talking about rationing it off and denying access to fat people.
By the way, in Canada companies *still* subsidize a large amount of health care that the government does not cover. Having visited dozens of Canadian manufacturers at this point I can tell you from first hand experience how cynical most of the people I've talked to are about their system.
McCain's solution is crap, but we are no closer to national health care then we are with dissolving the military. Really the ONLY opinions I'm interested in at this point are those of the doctors, because they know first hand the merits of such an idea. Some crunchy granola hippie NGO employee sitting at a computer is going to know jack fucking squat in comparison.
The problem is not the health care here, but the access to it. We have the best and most comprehensive medical facilities in the world. The question is, do we want to keep it that way or are we going to dilute our resources, nationalize our system and give everybody health care that was actually worse than it was the year before? The answer is somewhere in the middle.
ya know, I hear this stuff about long lines for equipment in other countries. But, despite lower infant mortality rates and a longer life expectancy than in the US, that seems to be a problem with healthcare and not health insurance.
What I find fascinating about the national dialogue on health care is that in 2004 if John Kerry mentioned universal health care in the vein of Obama and Clinton, he would have been booed off the stage of his own party's convention. Four years later those concepts are not only apart of the campaigns vocabulary, but the Republican's solutions seem quaint and ridiculously old fashioned. On this issue John McCain seems like the grandfather who's crazy ideas we tolerate because he is old.
One has to wonder whether unaffordable health care and people having to choose between gettng medical treatment and paying their mortgage has substantially contributed to the current financial crisis. If that's the case, then nationalized heath care probably would have cost less than this crisis is going to cost us.
I will read the article, but a "national single-payer system" is not always all it's cracked up to be. (insert here the usual comments about the 6mo wait for a CT scan in Canada, etc. And my personal experience with Canadian patients coming to Buffalo fairly often if they want anything done in a timely fasion.)
Yes, our healthcare is expensive and wasteful and a mess. I'm not arguing that, and I certainly don't know the answer. I figure if there were a nice simple answer, it would have been implemented years ago. It's not like no one has proposed nationalized health care before...