Healthcare CEOs Shoot Themselves in the Foot

And a few more stories like the one appearing in the WSJ today of the 10 year old boy whose pediatric endocrinologist cancelled the boy's appointment the day before he was due to see him in December because he no longer accepted medicare patients will put a kabosh on government run healthcare. The boy had to stop his growth hormone treatments because the only other endocrinologist in Las Vegas to accept medicare couldn't see him until March.

18% of doctors won't accept medicare- mostly specialists- and 11% more are saying they will stop soon. So much for moving towards a government run Canadian style of healthcare. Of course the government can always force Doctors to see patients.

Oh ya, that will do the trick.

The first step- at a minimum- in healthcare reform ought to be to allow insurance companies sell policies across state lines. We need a Geico, an Allstate and a Safe Auto of health insurance allowing for national health insurance competition. Let the 21 year old buy one type of policy and the 55 year old buy something different- they have different needs. Then lets see how how many companies cancel coverage due to pre-existing conditions.

Does this practice not open these executives and their companies to charges of manslaughter?

Their intentional neglect directly contributing to deaths.

is extortion, as practiced by the mafia. The fact that the insurance companies are parasitical monsters in this case never seems to get mentioned, perhaps because it is a profitable practice which is spread by lobbyists to all potential reformers in congress.
Extending the mafia by giving it interstate scope in the name of competition is such a perverse notion that no doubt the commenter who suggested it is an accessory to the crime. RICO laws should be applied sooner than later.

The above examples are just pure evil. (Doubly so that the one customer was never informed by his doctor.) Mother Jones is doing us a disservice by not disclosing which insurance companies were involved. LA Times: WellPoint Inc. (Blue Cross/BC of Calif.), UnitedHealth Group and Assurant Inc

Sad.

I have no choice in health care. Like most Americans, I have to accept whatever my employer will give me.

Considering that I have major health issues in my family, that's not good enough. It means the labor market is distorted.

I can't be an independent consultant. Health care for my family would cost, as an individual buyer on the "market", $36k/yr. The premium for being a consultant - which is not guaranteed - might amount to $10k. Maybe $20k. So, instead, I'm a fucking serf, dependent on the crumbs the Lord of the Manor sweeps off his table.

I'm only one of tens of millions trapped in this situation. America is a "free" country. Unless you are sick, or might someday get sick.

We are the wealthiest country in the world with hordes of smart people. Does anyone seriously think we can't do better than Canada, especially if we continue to spend at the level we do currently?

It's ironic that nay-sayers continually bring up Canada and England as bugaboos, but never France, where "socialized' medicine really works . I've been there, I know. No system is perfect, but they spend less money on healthcare and have better outcomes in France. Plus, nobody goes bankrupt because of a medical crisis. Their taxes are higher, but we pay the equivalent in lower wages and higher premiums AND live under the possibility that our health insurance might be cancelled or that it won't cover our medical expenses.

I can't be an independent consultant. Health care for my family would cost, as an individual buyer on the "market", $36k/yr. The premium for being a consultant - which is not guaranteed - might amount to $10k. Maybe $20k.

That's what I don't understand about the conservative argument against single payer. The current system is stifling entrepreneurship. There are a lot of people who would be willing to risk starting their own businesses if they didn't run into the fear of losing health insurance. Example: a friend of mind suffered a bout of cancer a few years ago. She was recently laid off her job as a writer during this current swathe of cuts by the journo industry. She is now thriving as a freelancer -- but she still has to look for a new job because she needs the health insurance. (right now she's on stimulus supplemented COBRA). She can't get health insurance on her own because of her cancer history.

If the federal government or the state governments create a tax based insurance entity, the people running such a creation would most likely be the same executives from the Health Insurance corporations. Government is nothing more than people, who are flawed just like people in private business.

When we have a tax based insurance entity, the political battles regarding abortion, medication, procedures and other things will be enormous and costly. Also, the mandate of a government insurance entity would not be to pay the amount owed, but to limit payments just the same as a private insurer. Medicaid pays at below sustainable rates, depending upon the private insured patients to make up the balance. We would not have an improvement.

Another point against a government insurance entity is that there is no effective authority that can kill it or improve it. When it is run by a "Health Czar", we get exactly what the title implies. Social Security is a flawed system, but we have no path or hope it will be killed or even changed. We would create a monster that will devour us.

I feel that in our society, we eat what we hunt. Work hard, save money, make good decisions to prepare for the future. Stealing money away from workers to give to less capable people doesn't seem right. Charity is the answer, if people want to give money.

I know there is bad luck, I could be struck with cancer, but I am willing to accept that it is fate/nature and I can only do what is in my power to relieve it.

The fundamental issue is the role of taxes to pay for what you want. Is it reasonable to ask for a tax based program to provide all taxpayers with all life services? Should taxes pay for guaranteed housing, a set menu of food, clothing, transportation, security and healthcare? Will I be able to purchase a premium level of healthcare and insurance? Will the government force all health Providers to give equal treatment to standard and premium patients? What makes the government a better manager of policies when the government is run by people? People are the same, in government or in private business. Government isn't a logical machine who only makes good decisions. Would we make it worse with tax based programs? I think yes, because the politicians will be involved and the voters will want more and more entitlements to the point of paying your entire paycheck for taxes and then receiving government services. America is based on freedom, responsibility, individuality. Government is the antithesis of that ideal.

This is the American Healthcare system? You need to ask insurance executives to allow doctors to treat you? I may be a little naive [I have only worked in UK healthcare my entire career] but that's got to be the stupidest thing I have every heard.

I have always found it difficult to even believe, never mind understand, just how mind-bendingly idiotic the US system is, and stories like this just make me question why there has not yet been a mass uprising and revolution to sort that BS out.

Your move, people.

undeadbydawn

E
WHAT'S WRONG WITH U.S. HEALTHCARE
AND HOW TO REMEDY IT

INTRODUCTION

Over a million people die unnecessarily each year in the United States. Four hundred thousand deaths are attributable to smoking tobacco, three hundred thousand stem from alcohol abuse and its sequela, another hundred thousand are the result of iatrogenic mishaps-doctors' errors, another two hundred thousand are the result of nursing mistakes and hospital generated diseases. Eighteen thousand come from lack of insurance coverage and twenty thousand from hard drugs. A Republican friend of mine asked, “What would we do to support all those people if they were to live instead of die?” Fie on such thinking. Feh. Better to think like a Jew. Saving one life is as if the whole universe is saved. Over ten years more than ten million of our bothers and sisters will die needlessly. You, reader have a good chance of being one of them. So stop thinking abstractly. Think what you would want for yourself. Stop concerning yourself about costs, peripheral schemes, livelihoods, business concerns, economics or political theory. Think with the clarity and passion of those who oppose abortion. You will help to save real human lives.

This death toll amounts to mass killings. Because human beings could prevent most of them it is tantamount to mass murder. Who are the tantamount mass murderers?
All people who oppose the reforms that would save these lives. Most immediately, directly and specifically responsible are that portion of the 535 members of congress who are preventing reforms. They and their colleagues who favor reform have it in their hands to prevent these deaths, to prevent these murders.

It doesn't matter what their constituents want, what their corporate bosses want. Congressmen and women have the egos to run and be elected to these controlling congressional offices. They have taken the controls and the responsibility in their hands. Let them act in accordance with the value that each human life is sacred and should be saved from death. People who prevent reforms, are perpetrating deaths as surely as the murderers of Darfur, Rwanda, Cambodia and Germany. They should be labeled Mass Murderers until they save lives instead of destroying them.

In the current debate these murderers are the hypocritical killer whores who oppose a government provided health care option; they would rather see millions die than lose their masters' cash and backing. Rather than be in office that permits them to inflict so much injury and death on us they should be in prison and out of our way to saving lives.

THE REMEDIES

What could prevent most of these deaths?

I.Healthcare in the U.S. is not a system; it's a chaotic, dysfunctional hodge podge.
Remedy is to plan and implement a comprehensive, flexible, empirically self-correcting system.
Define goals including affordable costs to society and individuals. Designate all variables in system that need to be designed in interaction with all other variables.
Design each variable. Model all variables in interaction with the others. Adjust each variable to permit attainment of goals. Implement variables over a sufficient but limited period of time to enable businesses and individuals to adapt to new conditions. A healthcare system will comprise but not be limited to:
A. Preventive education and action from pre-pregnancy to grave including ultimate elimination of all forms of drug abuse and dependancy, optimal nutrition, stress minimization and exercise, optimal self healthcare and self medication.
B. A national information system
C. A national research system on the etiology of disease, the treatment and medication for disease and accidents covering, facilities, devices, medication, practice.
D. A national or a nationally subsidized education and training system for all doctors, nurses, technicians, aides, administrators, and all others involved in delivery of healthcare.
E.A national evaluation, policing and enforcement system.
F. A national planning system based on research and evaluation.
G. A national, regional or state run healthcare implementation system.
II.There are currently too few crackerjack doctors, nurses and aides and too many under intelligent, undertrained healthcare personnel.
Remedy: Increase number of medical and nursing schools and other training facilities for technicians and aides. Raise selection standards for entry, stressing intelligence, personality stability and motivation as well as cognitive preparation.
Make medical and nursing professions more attractive to brilliant people. Raise income levels, relieve inimical burdens such as insurance paperwork and justifications, Rationalize training, for example, by eliminating sleep deprivation, maximizing personally supervised apprentice practice by crackerjack personnel in each field. Help doctors to establish new practices where society needs them by subsidizing needed plant and equipment for individuals and for nearby clinics and hospitals. Healthcare should be done in an unhurried and unharried personal practice not subject to extraneously imposed tension or stress. Whatever stress in integrally involved in practice should emanate from concern for proper diagnosis, treatment and medical vicissitudes.
III.Business competition generates a burden of waste and want. In affluent urban areas hospitals compete for patients and usage by overbuilding plant, over installing equipment and overusing plant and equipment in order to amortize them, and by over advertising. Meanwhile rural and poor urban areas go under served.
Remedy: Federal, regional or state healthcare systems with planning, research, evaluation and adaptation activities as well as operating activities. There should be a comprehensive federal information system, a federal research department, a federal evaluation system and a federally subsidized adaptation system. It may be that a federal operational system may also be best. Regional or state systems may afford scope for innovation and cost containment that are not possible in a single system.
IV.Fraud and other criminality waste resources.
Remedies: Complete Ethics training as part of all healthcare education and training. Frequent periodic peer ethics discussions in operational settings. A federal oversight, policing and enforcement system with unannounced inspections, warnings, suspensions, criminal trials, fines and imprisonment.

V.Ignorance, negligence and inadvertent malpractice.
Remedies: Proper education and training. Non-stressful practice conditions. Every doctor's office, hospital, clinic and medical training facility should be equipped with one or more crackerjack medical information specialists who constantly search the national information system and the world wide web for information on new research findings, treatment practices, medications, education and training. These specialists should provide doctors, nurses and other practitioners with the gists of their findings every day, whenever feasible and ad lib as required by patients complaints and conditions. Drug detailing, drug advertisements and insurance shit should be totally eliminated.
Too little empirical disease, accident, and healthcare research is done.
Remedies: Research funded by the federal government, the states, foundations and the private sector should be vastly expanded. Personnel now involved in insurance, advertising and salesmanship should be retrained and absorbed into the healthcare research, training, administration and implementation systems. All healthcare findings should be routinely published in easily accessible on line and paper media. Health care facilities should be cleaned up and kept clean.

VI. Practice should be done in unstressed, unhurried settings. There should be enough practitioners for this to happen.
Remedy: Instead of becoming lawyers, financial schemers and advisers, insurance personnel, medical device, drug and equipment salesmen and advertisers, people should be trained and employed at the levels appropriate to their capabilities in the healthcare system and should be paid handsomely for their services Training and education facilities will need to be expanded.

VII.Doctors and other practitioners should be immune to suits. Committees of peers and outside scientific and legal experts should review errors and poor healthcare outcomes. They should decide on the status, training needs and supervisory needs of practitioners and on the remedies and compensation for victims of errors. The government should set up a fund to pay victims of health care errors and malpractice.

There is no way costs can be contained or lowered as long as we pay for useless insurers, wrongful competition that spends wastefully on plant, equipment, supplies and advertisements, fraudulent charges and overcharges, and defensive prescriptions and referrals. Further, as long as we pay for health care needed because people behave badly as a consequence of poor education and information, and as long as non evidentiary treatment is practiced we will be unable to limit costs to the lowest possible.

A final point. The financial system should be simplified to provide loans and equity capital needed for productive and constructive purposes, rather than money made on fancy financial instrumentation. Incomes derived from financial creativity and manipulation should be severely capped, probably commensurate with teaching at schools and universities. This will motivate many brilliant people who are attracted to the riches of finance to use their brilliance to improve health care research and practice and other productive endeavors like engineering, manufacturing and environmental services. This will not only free up and divert money to add to improved health care, but also, put us on a competitive path with Japan, Korea, Israel, China, India and the other smart nations.