Yes We Can Reform Healthcare

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During the past few months I’ve tried to research and write about healthcare reform in the U.S. in a way that would clearly explain the need for government intervention. Most U.S. citizens are living in denial when it comes to healthcare cost and just how horribly the U.S. ranks in the world compared to other developed, industrialized nations.

Given the fact that we had a baby in June, I haven’t done quite the job I had hoped I’d be able to do to make an ironclad case for reform. The issue of healthcare reform is top of the list for me and my family. It’s one of the reasons we voted Obama/Biden in 2008.

Yesterday, we took Marlo to the doctor to get her check up and be vaccinated. She’s doing great. We had an intense day on top of that with repairmen (long story for another day), FedEx (longer story for another day) and visits from extended family. Given all of this, I didn’t have a lot of time today to check Twitter and at 1:30 am this morning when Marlo awoke for her feeding (and I couldn’t sleep), I hit Twitter to catch up. I was blown away by what I saw.

Backstory: A couple of days ago The White House hit two million followers on Twitter and asked what people wanted to see from the White House feed on Twitter

I responded:

“@whitehouse it is time for the President to bust out some charts and graphs showing where US is in the world on healthcare.” (click here to see it on twitter)

I didn’t think the people behind the White House Twitter feed would listen. I was wrong:

“@blurb says “bust out some charts and graphs” Busted: Hidden costs http://bit.ly/yfBJB Coverage denied http://bit.ly/mFtJo” (click here to see it on twitter)

We are living in wonderful times! I’m still giddy about being responded to! What about those links? The first link in the above response goes to:

Hidden Costs of Healthcare: Why Americans are paying more and getting less

“Americans are spending more than ever on their monthly premiums while simultaneously being forced to pay higher out-of-pocket costs as a result of rising deductibles, copayments, and other cost sharing mechanisms.”

“In fact, a person with employer-based coverage paid an average of $1,522 on health care (not including premiums) in 2006, compared with $1,260 in 2001. When including the added burden of higher premiums, out-of-pocket costs rose even more sharply, with a 30 percent increase from an average of $2,827 in 2001 to $3,744 in 2006.”

(Ed. note: there are footnotes for sources and numbers on the linked page)

It’s a great start to explain just how crazy the inflation in healthcare costs are for the U.S.

The second link from the White House tweet goes to:

Coverage Denied: How the current health system leaves millions behind

Of note:

“Thirty-five states offer a high-risk pool for people who have been denied coverage in the individual insurance market or otherwise cannot obtain insurance. However, high-risk pools generally charge significantly higher rates than they charge for a healthy individual in the individual insurance market, meaning that only relatively high-income people can afford the coverage. One study estimated that only eight percent of the uninsurable population is able to enroll in high-risk pools, mainly because of high premiums.”

“Benefits through a high-risk pool are also not guaranteed. Some state high-risk pools have annual caps on enrollment, or limit eligibility only to people who had prior group health coverage in the preceding 63 days. And one state high-risk pool has been closed to new beneficiaries since 1991.”

“All high-risk pools also impose pre-existing condition exclusions for six months to one year, during which time care for the very condition that made someone uninsurable is not covered.”

Ed. note: there are footnotes for sources and numbers on the linked page)

Long-time readers will note that this “high risk” coverage provided by a state (not on a federal level) is the kind of insurance that I, Heather and Leta have. As individuals, not a family. Everything in the above quoted paragraphs is true for us. It’s expensive, but fortunately we live in a state that has such a “high risk” pool and thanks to your continued support, we can afford such insurance.

I want more charts and graphs, because they quickly tell a sobering story of healthcare in the U.S.

I am going to restate the obvious because I’m still in a state of giddy shock: The White House responded to a tweet of mine!

Angie

I don’t know what my husband pays monthly for our medical. But I will say.. we have blue cross (through his job). And we have to pay a yearly deductible of $1,000.00 per person (there are 4 of us) before they will cover 80% of our medical costs. And then we still have to pay 20%.

So if there is a way for Obama or Congress or someone with a brain in their head to fix this we would be for ever greatful. It really sucks. I haven’t been to the doctor in 2 years because i absolutely refuse to pay full price for my visits until my deductible is paid off. I am glad our kids don’t get sick very often. Because that is A LOT of money we don’t have to blow. So I’m sure when my deductible gets paid off it will be because I was hospitalized. Because I really hate having to pay 200 bucks or more to see my doctor … whats between 3 and 8 visits before my deductible is paid off. And then we still have a deductible per kid and my husband as well..how stupid is that?
wvrwmn

I found this article by Paul E. Barber about his experience within the Canadian healthcare system especially helpful:

http://www.huffingtonpost.com/paul-e-barber/my-brain-and-the-ontario_b_268128.html

The perspective from Canadian healthcare practitioners shows the commonsense and calm approach that I’ve come to expect from our neighbors to the north. Check this out:

BTW, pretty exciting to hear back from the White House. I sent them an email to encourage leadership for the public option. Anyone can do it, and who knows, you just might get a response!

http//www.whitehouse.gov/CONTACT/
Elizabeth

I’m an American living in Jordan (married to a Jordanian) and we have state health insurance. I can go into any government hospital, any time I want, and get free care. My husband pays nothing for prescription drugs, and for me, he pays the equivalent of 30 cents for each prescribed drug. Two months ago, I gave birth for free. My doctor was educated in the US, and while the decor of my room was non-existent, the delivery room was fully equipped. My baby and I are happy, healthy and the experience went fine.

Of course, the system has it’s flaws. Because Jordan is poor, the state hospitals are underfunded. This means that, for example, the entire hospital may have the older ultrasound machines (black and white) and share one 4D imaging machine. Also, the rooms are definitely not beautiful. Amazingly, all of the doctors I have ever had speak great English, and have usually been educated in the US, UK, or Europe. So you have great minds working with rather strained resources.

Jordan also has a private system of health care, so if you can afford it and feel like it, you can go to a private hospital, doctor, or specialist any time you want. Even then, it’s not necessarily that expensive. For my entire pregnancy I went to see a private specialist, and we paid the equivalent of $14 for each visit. And, if you can’t afford anything, there are free public clinics for things like vaccinations.

To date, I’ve tried the government and the private systems (but not the public). I’ve never had to wait for an appointment.

I consider myself very lucky. When I lived in the US, we wouldn’t have dreamed of going to the emergency room, and any visit to a doctor was evaluated by true necessity–we would ask ourselves, “Am I dying or not?” My father had cancer and was on COBRA, and it was horribly expensive.

Healthcare is truly a deciding factor when we ponder moving back to the US. Like, is it worth it? Can we make enough money to afford it? Our situation begs the most obvious question of all–if a small, poor country like Jordan can manage a system like this, why can’t the US put something together?
aaron

Passionate and moving post…

Yet the question is — are you providing the people here with facts or propaganda?

I happen to be a registered Democrat who thinks this nation is falling deeper and deeper into it’s own demise. My discontent with how radical my party has become has hit a limit and I have begun showing my and having my voice heard at town hall meetings in my district.

Enough about me.

Someone sent this blog post to me — Such is what I had replied to the sender —

Sigh…this guy is a drone. He repeats propaganda as though it is fact…yet the fact is that his propaganda has been proven false time and again and as a result the people in this country have risen up to protest the proposed government takeover.

The fact is that 85% of America is insured and enjoys their coverage while 15% of people in America (included in here are illegal immigrants) are not.

Common sense dictates — That to overhaul an entire system for a mere 15% is ridiculous and irresponsible.

The fact is that the Government is supported by the taxes which people pay to them. People hate paying taxes — Elected officials know this and therefore must limit taxes according to what their constituents will begrudgingly accept. Hence government is limited in their income. As a result — in countries where the government provides health care to the people, what happens is the government must ration their resources and give to those who THEY deem will contribute most to society the treatment that they require.

Under such a system — If one such as a senior (like what happened with my grandfather) will need a triple-bypass at the age of 80, the government rationing body then convenes and discusses whether or not this man is worth being treated…Such a practice is ILLEGAL in America.

On the other hand — Pharmaceutical companies which are not owned by the government, and hospitals which are not owned by the government are not limited in their income. Hence they are not limited in their resources. People will always need their services and products, and will always be willing to pay whatever it is.

Do note — In America it is illegal to deny lifesaving treatment to anyone — Period. In other countries — it happens all the time.

The point is — If the government wants to make health-care more affordable for people in this country perhaps they should stop taxing them so much and let them keep the money they earn so that they have the ability to appreciate the fruits of their labor. In addition to this they should enact TORT reform so that people will not have a chance to sue doctors and insurance companies for millions of dollars for some frivolous reason (a major cause for high prices — insurance companies had to protect themselves).

The problem is not the system — it’s the government and their policy.

http://blurbomat.com blurb

I’ve been waiting for this claim.

Thanks.

aaron

Oh and in regards to the comment in which he claims that America’s health-care system is inferior to that of the other nations — Perhaps you should read this study done by an independent group.

http://www.hoover.org/publications/digest/49525427.html

MEDICINE AND HEALTH:
Here’s a Second Opinion

By Scott W. Atlas

Ten reasons why America’s health care system is in better condition than you might suppose. By Scott W. Atlas.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

* Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).

* Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.

* More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).

* Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid– 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries.

This essay appeared on the website of the National Center for Policy Analysis on March 24, 2009. An earlier version was published in the Washington Times.

Available from the Hoover Press is Power to the Patient: Selected Health Care Issues and Policy Solutions, edited by Scott W. Atlas. To order, call 800.935.2882 or visit http://www.hooverpress.org.

Scott W. Atlas is a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.

http://blurbomat.com blurb

Where does Mr. Atlas get his numbers? There is no source listed.

And why are you claiming to be a registered Democrat?

Maygirl

Uh, Aaron — as a member of the Stanford community (and informed consumer of information) I assure you that NO ONE (including Hoover) considers Hoover to be an “independent group”. It is one of the most well-recognized conservative think tanks, consistently offering top dollar for massive information manipulation. Nice try.

http://theviewfrommacy.blogspot.com Macy

Like Leanne above I live outside the US (in the UK in fact) and am astonished at the US’s inability to provide healthcare for all its citizens. Although your republican’s arguments (see Hawkings would have died reports) never fail to amuse.
Our NHS is far from perfect, but from a smaller population and tax base, we do manage to provide cradle to grave care for everyone, with higher life expectancies and lower per capita costs for chronic illness than the US.
Currently nursing my kid’s father through terminal cancer. I couldn’t imagine coping at all without the support from our nationalised service — , not just medicine but therapy and homecare.
Interesting discussion re increased medical costs in the US through higher litigation. Is it because people/ insurers who can afford healthcare can also afford lawyers?
chloe

really shocked at some of the stories here. Almost as shocked at the misinformation of the british (NHS) system. Yes, I’m British. It’s a long way from being perfect, but the fact remains that if i, or any of my family, are taken ill, I can be seen pretty much straight away, for free. Yes, there’s triage, yes there can be delays, but… there’s also private healthcare, so that if you have the money / inclination, you can jump the queue.

Really don’t get why so many americans are getting so aerated about ‘socialised’ healthcare (where the hell did that phrase come from anyway — not one anyone here recognises. Evidently it’s been used to put the wind up the more reactionary types), when it seems so many in the US aren’t covered by the existing system. Like pregnant women. and small children with respiratory problems. WTF?

Having been on the receiving end of a lot of NHS care, I have no complaints. None. I know many do, but not here.

Also, would love to know where they unearthed Daniel Hannan. The man is clearly a loon.

Loving your work Jon (and that of your lovely wife) — keep it up.
http://rwjfblogs.typepad.com/healthreform Minna Jung

Hi:

I’ve been a (quiet) follower of dooce for a very long time, and was excited to hear that you’re getting involved in this issue. So I’m going to de-lurk in my work mode, not personal mode, and recommend the following blog entry for you: http://rwjfblogs.typepad.com/healthreform/2009/08/do-we-really-have-the-best-health-care-in-the-world.html

I work at the Robert Wood Johnson Foundation, a foundation devoted to improving the health and health care of all Americans, and we’ve been working on health care reform for a very long time. My job focuses on communications, and helping people understand what’s wrong with American health care today, and what needs to change. Health care can be a very complex issue to talk about, so I’m recommending our health reform blog as a good starting point (the link above) for people who want to understand some of the relevant issues that are heating up the debate. Health care reform is also a complex topic to talk about because there’s so much that needs to change about how we deliver and pay for health care, and how much emphasis we put on helping very sick people instead of helping people stay healthy to begin with, but when talented writers/bloggers like you and Heather start writing about this issue, in ways that make the connections between these important issues and our daily lives, that helps enormously. Congratulations on getting the ear of the White House!
theonlymagpie

We need more people as a voice in supporting this very important need in our country. I write about this (mostly satirically) at http://www.theonlymagpie.wordpress.com But, regardless, whether it is satirically written or not, facts are facts and, just as the right is causing a major ruckus all over the country with their lies on healthcare (including death panels, forced abortions, etc.), we need to be just as vigilant with the truth.
A_Peach

Regarding the Hoover article, I’m guessing Mr. Atlas got some of his data (specifically the preventive services numbers) from this article referencing a paper in progress:

http://healthcare-economist.com/2007/10/02/health-care-system-grudge-match-canada-vs-us/#comment-86100

And that data was based on: “The authors’ main data set used is The Joint Canada/U.S. Survey of Health (JCUSH). Collected between the fall of 2002 and spring of 2003, this data set includes 3,505 Canadian and 5,183 American individuals.”

I don’t know where the data regarding seniors comes from.
http://greatdayinmaine.blogspot.com leesavee

Regardless of anyone’s political opinions on healthcare reform…DUDE, how totally cool that you can tweet the White House and get a response!
the-evangelist

For those who haven’t seen it yet, do check out Dan Roam & Dr. Tony Jones’ contribution to diagramming the debate on the HuffingtonPost: http://bit.ly/1DSpbA
http://loraleeslooneytunes.com Loralee

I had to mosey on over and see what the incoming hits were about and I’m glad I did. I love this post.

I did not vote for Obama (or McCain). I am a moderate Republican that is passionate about Gay Marriage rights and Health Care reform.

The thing that I love about this administration, is that they talk to people. I have people running around me saying that they don’t want to listen to the average person, but they DO. Your tweet proves it. My story proves it. (Nutshell: After a lunch with Valerie Jarrett, my conservative husband spoke on the phone with her, we blogged, she linked me to whitehouse.gov and now we’re both going to The White House.)

They listened to what BOTH of us had to say. Us. A he said/she said couple with totally opposite views on this story from tiny little Cache Valley, Utah AND THEY LISTENED TO US. I’m simply gobsmacked.

And not only that? I was bracing for a shit storm but 2,000 comments, emails later (mainly emails, people get gun shy) and not one hateful comment. NOT ONE. It was a civil, rational, passionate discussion. It restored my faith in humanity and that WE CAN DO THIS.

Anyway…I loved this. Thanks for posting it.

http://blurbomat.com blurb

Loralee, thanks for stopping by! I love that you and your husband both got to share your views and did so on your blog as well as with the Obama administration.

Despite all the crazy talk, I really think the ideas that the administration has put forth as well as what’s in the HR 3200 is not going to bring the U.S. to its knees or destroy civilization. I’m so glad to hear from somebody else at how the Obama administration has reached out to here opinions, stories and even opinions from super fringe conservatives.

Thanks for leaving your comment and I can’t wait to read about your visit!

http://loraleeslooneytunes.com Loralee

Blurb.

This eases my mind. I commented before reading the original comment and, while the guy has a good heart, I was afraid I looked like an opportunist asshole.

I totally agree with you. I also don’t think that the US will blow up if gay marriage is instituted, but that is a subject for another day.
CarolinaCK

I think it is sad that a middle class family can be derailed by lack of insurance coverage. That’s what happened to us. We had private-pay insurance for 10 months before my husband had a stroke. He was hospitalized and then the insurance company dragged their feet. After a while we were told we’d be responsible for the $75,000 citing “pre-existing condition.” Before I was married, as a single mom, my son and I were on Minnesota Care, which was a good program. Only you couldn’t get in to see a dentist. All that was out-of-pocket. I thought when we got married the private-pay insurance would work for the three of us, since he made too much money for us to qualify for MN Care. Well, $75,000 later … That, coupled with 4 other things, has driven us into bankruptcy and now we have lost it all, but I am keeping a positive attitude. I am back to driving a 1964 Mercury Comet, like the one I had in college, so I hearken back to my college days, and it makes me feel so young in ways I nearly forgot. My husband’s driving a 1969 Ford Ranger for his work vehicle, so he gets points for looking cool. We’ve gone from being contributers, “taxpayers”, on our way to being burdens on society! I think we qualify for MN Care again but, on the news today they announced a giant backlog of applicants.
When I researched Bankruptcy I found out that even the insured are not immune to carrying medical-related debt load. On the average, according to what I read, people with medical insurance still carry a debt. My question is how did all this get so expensive in the first place? But it’s good that people like you are getting to the bottom of this and finding out all these answers and facts, and sharing them in this context. My point is, people are closer to getting financially ruined than they would like to think. You couldn’t have told me 12 months ago that I would be losing my house & my car and that my life would be totally changed, but it has, and I’ve learned to be grateful for what the bank can’t take away.
http://ecoecoamerica.blogspot.com/ southerngirl

Cool, Jon! Now that you have their attention, tell them we must have a public option or it’s not real health care reform!
HeadacheSlayer

When that popped up on my phone, all I could think was “DUDE! Is there anyone who *doesn’t* know Dooce & her husband?” LOL

Congrats, I am happy for you (and totally share your views on HCR!)
http://bipolarbearsohmy.blogspot.com jodie

As your wife said, YOU ROCK! That’s so cool. I don’t have time to tweet because I barely have time to do personal email and a bit of blog reading and facebook in my 1 or 2 hours at home per day after you count sleeping, commuting 1 hr each way to Dallas, eating, getting ready for work etc. But I do have my own insurance story. I got laid off in January from a very large Texas based Fortune 500 company. My Blue Cross Blue Shield insurance with a 300 deductible cost me $144/mo for me and my spouse. I didn’t know how great that was until I lost it. I had worked for them for 20 years. NOW as a city gov’t employee my options were overpriced, high deductible, bad United Health Care coverage OR get the same coverage I had as an employee for > $700 per month for me and my spouse as a “retiree” since I had 20 years on the job. I’m 49 my spouse is 57 and disabled. He just got a Medicare card… My severance medical coverage at the low low price of $144/mo just ran out. SO we’re trying to decide between the retiree option and the City insurance. This city was recently in the news about a police officer whose insurance refused to care flight him home… United Health Care! We’re young and can’t find enough info about Medicare and supplimental insurance to MAKE a GOOD decision. Life outside the big corporation… healthcare wise s*cks!
http://michaelhickey101.wordpress.com/ michaelhickey101.wordpress.com/

Probably not much of a chance of this being read, but my two cents are these:
I voted for our President. I believe in him. But right now I’m absolutely furious with him. When did the Obama team forget just how important it is to step up and actually frame the conversation? Since the beginning of the health care debate the WH has been playing defense and getting mired in the absurd — think “death panels” — and the only real numbers I’m seeing broadcast are that X amount of Americans are uninsured. Okay, sure — that’s an important number, but it’s hardly the entire story.
When does he get up in front of America and break it down the way those links did? When do Democrats get in front of America and say that regardless of what many Republicans are saying, the truth is actually X? That comparing President Obama to Hitler is not only horrible (as much as it was when Dems were doing the same) but it has nothing to do with the conversation we should be having?
ninapurpleton

A glimmer of hope: http://www.oregonhealthstudy.org/en/home.php

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Yes We Can Reform Healthcare