Doctors support universal health care: survey

[George Gervin's Afro]

http://www.reuters.com/article/healthNews/idUSN3143203520080331?feedType=RSS&feedName=healthNews&rpc=22&sp=true


Doctors support universal health care: survey


WASHINGTON (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.

The survey suggests that opinions have changed substantially since the last survey in 2002 and as the country debates serious changes to the health care system.

Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.

The 2002 survey found that 49 percent of physicians supported national health insurance and 40 percent opposed it.

"Many claim to speak for physicians and represent their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support national health insurance," said Dr. Aaron Carroll of the Indiana University School of Medicine, who led the study.

"As doctors, we find that our patients suffer because of increasing deductibles, co-payments, and restrictions on patient care," said Dr. Ronald Ackermann, who worked on the study with Carroll. "More and more, physicians are turning to national health insurance as a solution to this problem."

PATCHWORK

The United States has no single organized health care system. Instead it relies on a patchwork of insurance provided by the federal and state governments to the elderly, poor, disabled and to some children, along with private insurance and employer-sponsored plans.

Many other countries have national plans, including Britain, France and Canada, and several studies have shown the United States spends more per capita on health care, without achieving better results for patients.

An estimated 47 million people have no insurance coverage at all, meaning they must pay out of their pockets for health care or skip it.

Contenders in the election for president in November all have proposed various changes, but none of the major party candidates has called for a fully national health plan.

Insurance companies, retailers and other employers have joined forces with unions and other interest groups to propose their own plans.

"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," Ackermann said in a statement.

The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan.

The researchers said they believe the survey was representative of the 800,000 U.S. medical doctors.


I feel sorry for the GOP. They are going to actually try and convince the public that less is more and that we should just trust the free market with healthcare costs..as people's 401(k) plans are shrinking by the day... :lol

[101A]

Damn, you've convinced me.

The government can fix it. They're GREAT at controlling costs!

[ChumpDumper]

My physician brother is about as conservative as one can get, and he sees universal health care as inevitable and necessary.

[fyatuk]

It's natural that doctors would support a plan to make sure everyone has insurance. The growth of the health insurance industry has allowed doctors to charge a lot more for their services than they could otherwise. With their own costs rising (ie education, medmal, and equipment), it makes sense they'd turn to a guaranteed payor system.

I can't stand the concept of a national insurance system, personally. It will do nothing to curb medical spending, will actually increase the amount of money spent on medical care, but hide it under the auspices of tax collection instead of medical expenditure.

Until someone proposes reducing the cost of medical education or medmal to go along with it, I think it's a waste to create a national system.

Then again, I'd rather see a per state system of health care (not insurance, care), since while I may be socialist on some things, I firmly believe in the 10th amendment no one wants to pay any attention to any more.

[SPARKY]

The government has fucked up our health care industry, so let's hand them the keys.

[101A]

It's natural that doctors would support a plan to make sure everyone has insurance. The growth of the health insurance industry has allowed doctors to charge a lot more for their services than they could otherwise. With their own costs rising (ie education, medmal, and equipment), it makes sense they'd turn to a guaranteed payor system.

I can't stand the concept of a national insurance system, personally. It will do nothing to curb medical spending, will actually increase the amount of money spent on medical care, but hide it under the auspices of tax collection instead of medical expenditure.

Until someone proposes reducing the cost of medical education or medmal to go along with it, I think it's a waste to create a national system.

Then again, I'd rather see a per state system of health care (not insurance, care), since while I may be socialist on some things, I firmly believe in the 10th amendment no one wants to pay any attention to any more.Good post.

I would add, however, that much of the rising cost of medical care is simply part and parcel of the major advancements at life-elongating technologies that have been developed. We cure people of serious illnesses/injuries; which is expensive, at which point they live longer to get more of those...it's an expensive cycle.

[fyatuk]

Good post.

I would add, however, that much of the rising cost of medical care is simply part and parcel of the major advancements at life-elongating technologies that have been developed. We cure people of serious illnesses/injuries; which is expensive, at which point they live longer to get more of those...it's an expensive cycle.

Quite true, but there's no solution to those costs except either letting people die or waiting for the cost of those treatments to reduce naturally, at which point there's more new treatments, etc.

Medical expenditures per capita SHOULD increase nearly every year. It not increasing shows a stagnation in the health services industries that is a serious problem, such as reduced life expentency or more people just not getting treatment.

Hopefully they'll figure something out to reduce the base cost of medical treatment. Most people tend to think covering up the problem with insurance is a fix, but its more like a painkiller. It doesn't fix the problem, only dulls the symptoms. We have the same problem with SS in that the system just does not work with an exponentially growing population, but instead of attempting fundamental changes to improve the system, they stick with the "raise taxes/reduce benefits" model to hide its deficiencies.

[101A]

Quite true, but there's no solution to those costs except either letting people die or waiting for the cost of those treatments to reduce naturally, at which point there's more new treatments, etc.

Medical expenditures per capita SHOULD increase nearly every year. It not increasing shows a stagnation in the health services industries that is a serious problem, such as reduced life expentency or more people just not getting treatment.

Hopefully they'll figure something out to reduce the base cost of medical treatment. Most people tend to think covering up the problem with insurance is a fix, but its more like a painkiller. It doesn't fix the problem, only dulls the symptoms. We have the same problem with SS in that the system just does not work with an exponentially growing population, but instead of attempting fundamental changes to improve the system, they stick with the "raise taxes/reduce benefits" model to hide its deficiencies.Also, a MAJOR contributing factor of increasing healthcare costs is the baby boomer bubble aging; older people cost $$$$$$$$ more than younger ones.

[Wild Cobra]

My physician brother is about as conservative as one can get, and he sees universal health care as inevitable and necessary.
Does he support it though?

[fyatuk]

Does he support it though?

You would think the use of "necessary" shows at least a little support...

[Wild Cobra]

You would think the use of "necessary" shows at least a little support...
Well, the way I see it is that doctors are people, just like us, and are simply looking out for themselves.

Think about how many people doctors have a difficult time collecting from. Not everyone has insurance. Then, some plans have high deductible. Doctors often have a hard time collecting and must enlist the aide of collection agencies at times. I'll bet more most those doctors wanting the single payer system, they see it as a simpler means of collecting money.

My question is, do they really think it's better if they can take their personal bias out of the equation?

[Clandestino]

I feel sorry for the GOP. They are going to actually try and convince the public that less is more and that we should just trust the free market with healthcare costs..as people's 401(k) plans are shrinking by the day... :lol

market is higher than it was under clinton. market has ups and downs. why are you so dramatic> :dramaquee

[Wild Cobra]

I feel sorry for the GOP. They are going to actually try and convince the public that less is more and that we should just trust the free market with healthcare costs..as people's 401(k) plans are shrinking by the day... :lol
Less is more right now for 401k contributors...

First of all, if you are near retirement, you are foolish to have your 401k in stocks. They should have been moved some time ago to something more stable.

For those in a 401k now, mostly in stocks, this is an awesome buying opportunity. Let's say your stocks are at 75% of the level they should be at. That means for every three shares value, you actually buy four. When the dollar stops dropping and investors come back top the USA market, those still contributing in stocks in their 401k's will be very happy!

[Don Quixote]

I agree. As Buffett once said, "Bulls make $$, bears make $$, and pigs get slaughtered." In other words, you can still make money when Wall St. is doing badly -- you will just have to pick your investments accordingly.

And ... when the bottom comes, that's a great opportunity to buy good stocks.

[BonnerDynasty]

Less is more right now for 401k contributors...

First of all, if you are near retirement, you are foolish to have your 401k in stocks. They should have been moved some time ago to something more stable.

For those in a 401k now, mostly in stocks, this is an awesome buying opportunity. Let's say your stocks are at 75% of the level they should be at. That means for every three shares value, you actually buy four. When the dollar stops dropping and investors come back top the USA market, those still contributing in stocks in their 401k's will be very happy!


Please. No common sense allowed in this section.


Replace with


America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy!


Thank you.

[boutons_]

"reduce the base cost of medical treatment"

Too many large corps and others are pocketing those costs as their revenues. That's why the system is so expensive for delivering so little care. They've figured how to make $Bs and gouge the system. They'll fight like hell now and forever to keep their cheese, just like they did when they killed Hillary's plan in the 90s, quite apart from the good or bad of that plan.

Even minimal change will be extremely difficult. The private insurers won't even come to the table if they can't reserve the right to refuse or cancel customers. That's 100 of $Ms in savings every year. They serve the low-cost young and healthy, and refuse to handle the high-cost old and sick.

[Wild Cobra]

Please. No common sense allowed in this section.


Less is more right now for 401k contributors...

First of all, if you are near retirement, you are foolish to have your 401k in stocks. They should have been moved some time ago to something more stable.

For those in a 401k now, mostly in stocks, this is an awesome buying opportunity. Let's say your stocks are at 75% of the level they should be at. That means for every three shares value, you actually buy four. When the dollar stops dropping and investors come back top the USA market, those still contributing in stocks in their 401k's will be very happy!

Replace with


America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy! America is doomed. Attack the wealthy!

Thank you.
LOL...

You are right, at least if I want to be a proud member of the Main Stream Media, Communistic Propagandists, or their Liberal Lemmings...

Sorry, I try to stick with the facts. It wasn't an April Fools joke.

[Wild Cobra]

"reduce the base cost of medical treatment"

Too many large corps and others are pocketing those costs as their revenues. That's why the system is so expensive for delivering so little care. They've figured how to make $Bs and gouge the system. They'll fight like hell now and forever to keep their cheese, just like they did when they killed Hillary's plan in the 90s, quite apart from the good or bad of that plan.

Even minimal change will be extremely difficult. The private insurers won't even come to the table if they can't reserve the right to refuse or cancel customers. That's 100 of $Ms in savings every year. They serve the low-cost young and healthy, and refuse to handle the high-cost old and sick.
Really? Any facts to back those claims up?

How about picking some providers and look at the financial statements through Yahoo, or another source. Look at the net profit margin.

There is plenty of competition out there. The problem is, they really are costly. How about some real tort reform so medical malpractice insurance premiums can be reduced, hence, reducing the cost of business? There are other root issues too, but you don't fix a problem by putting a bandage on a symptom. The problems need to be addressed.

[Wild Cobra]

And ... when the bottom comes, that's a great opportunity to buy good stocks.
Absolutely. I met a good bottom fisher once. Man, I wish I had his talents.

[fyatuk]

"reduce the base cost of medical treatment"

Too many large corps and others are pocketing those costs as their revenues. That's why the system is so expensive for delivering so little care. They've figured how to make $Bs and gouge the system. They'll fight like hell now and forever to keep their cheese, just like they did when they killed Hillary's plan in the 90s, quite apart from the good or bad of that plan.


There are a lot of ways to reduce the costs without dealing with the corps at all. Increasing grants and scholarships, as well as instituting loan forgiveness, for medical education would help. Punitive damage limits on med-mal and increasing regulation of professional liability insurors would help. Tax breaks on the purchase of medical equipment would help. Every single one of those should provide more help then their cost.

Now in a capitalist society, more likely than not costs won't ever decrease, but it should lessen the rate of growth of prices. A side effect is that health insurance rates would not increase as much as well since their liability would not be increasing as much.


Even minimal change will be extremely difficult. The private insurers won't even come to the table if they can't reserve the right to refuse or cancel customers. That's 100 of $Ms in savings every year. They serve the low-cost young and healthy, and refuse to handle the high-cost old and sick.

And that's why programs like Medicare were created.

[George Gervin's Afro]

Less is more right now for 401k contributors...

First of all, if you are near retirement, you are foolish to have your 401k in stocks. They should have been moved some time ago to something more stable.

For those in a 401k now, mostly in stocks, this is an awesome buying opportunity. Let's say your stocks are at 75% of the level they should be at. That means for every three shares value, you actually buy four. When the dollar stops dropping and investors come back top the USA market, those still contributing in stocks in their 401k's will be very happy!


Where will the extra money some from? You know those who live paycheck to paycheck? Those who are having a hard time saving any money your suggesting they go out and buy stocks! Brilliant.. when you get back to the real world le t me know...Let's see who has the disposable income to buy more stocks..... hhmmmmm ..Those who have the financial standing to do so!

No knock on the upper income levels but just the facts..so now the income gap can continue to grow.. great plan ! now you and boner di-nasty can go nut hug each other.. :rolleyes

[George Gervin's Afro]

Really? Any facts to back those claims up?

How about picking some providers and look at the financial statements through Yahoo, or another source. Look at the net profit margin.

There is plenty of competition out there. The problem is, they really are costly. How about some real tort reform so medical malpractice insurance premiums can be reduced, hence, reducing the cost of business? There are other root issues too, but you don't fix a problem by putting a bandage on a symptom. The problems need to be addressed.


Gee the numer of uninsured in Texas has risen since tort reform was passed be the state legislature 4 or 5 yrs ago..capped those damage claims so the evil trial lawyers can't gouge those poor innocent insurance companies.. :rolleyes

you guys are ridiculous.

[boutons_]

"The problems need to be addressed."

I'm saying the "problems" won't be solved, because the "problems" make $Bs in profits from the current "solution" they have created, and have the $power to block those attacking the "problems".

No candidate is talking about reducing costs, only how to pay the costs. If they talked about reducing costs, the "problems", the providers, would attack them, sooner or later. The providers will counter-attack to maintain the status of their profits, that's why they exist, and why for-profit health system is a disaster. Never fear, the "free market" gave us the current system and will "self-correct", just it does on Wall Street.

[BonnerDynasty]

Bottom Line: Will health care quality decrease? Yes or No?

I can stomach the 55 hour waiting period among hundreds of ____________ as long as the quality is still there. My father almost died from necrotizing facitis 2 months ago but luckily there were some great doctors who knew what they were doing.

After seeing how quickly you can go from fine to 12 hours away from death over some random bullshit I will put good health insurance at the top of my list as soon as I can afford it :depressed

[BonnerDynasty]

Where will the extra money some from? You know those who live paycheck to paycheck? Those who are having a hard time saving any money your suggesting they go out and buy stocks! Brilliant.. when you get back to the real world le t me know...Let's see who has the disposable income to buy more stocks..... hhmmmmm ..Those who have the financial standing to do so!

No knock on the upper income levels but just the facts..so now the income gap can continue to grow.. great plan ! now you and boner di-nasty can go nut hug each other.. :rolleyes


We should increase long term capital gains tax to really stick it to the wealthy too right?

Making it harder for a lower income investor to make it to the "wealthy class" over a long-period of time would just be an inconvenient effect. :clap

[RandomGuy]

My physician brother is about as conservative as one can get, and he sees universal health care as inevitable and necessary.

The problem is when you ration preventive care by price, too little of this good/service is "consumed", especially if you are looking at the wider economy.

Think about the consequences of missing cancers or other problems.

1) Shorter working lives of people = less contribution to the economy
2) Increased curative costs = more unproductive costs to the economy
3) More absenteeism on the part of the sick= more costs for business
4) More absenteeism on the part of those who have to care for sick loved ones = more costs for business.
5) More sick uninsured = more bankrupcies from medical bills

Balanced against all of this is the ONE argument:

"But the government will waste all that money".

(shrugs)

Ok, for the sake of argument, let's assume that the government will waste a good chunk of money doing this. The costs of doing nothing are increasing at a rather alarming and measurable rate. How long before those costs are greater than the costs of this government waste?

the economic arguments for single payor systems far outweigh those stacked against it, from what I have seen.

[RandomGuy]

Man, can I kill a thread on health care reform or what?

[RandomGuy]

4) More absenteeism on the part of those who have to care for sick loved ones = more costs for business.

#4 is the kicker.

If I get sick, wife must stop working and care for me, and vice versa, and the same goes for either of our children.

We lose two incomes with no reserves if my wife or I get sick, and at least one income if it is one of our children.

I have insurance to mitigate these risks, but that insurance must be ultimately paid for, and is still probably inadequate.

Imagine the consequences for those who have no such insurance...

[boutons_]

Where is anybody, except the truly wealthy, gonna find the $$$ to pay for for-profit medical care?


================

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April 14, 2008
Co-Payments Soar for Drugs With High Prices

By GINA KOLATA (http://topics.nytimes.com/top/reference/timestopics/people/k/gina_kolata/index.html?inline=nyt-per)
Health insurance (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/index.html?inline=nyt-classifier) companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions (http://health.nytimes.com/health/guides/specialtopic/getting-a-prescription-filled/overview.html?inline=nyt-classifier) for medications that may save their lives or slow the progress of serious diseases.

With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.

The system means that the burden of expensive health care can now affect insured people, too.

No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis (http://health.nytimes.com/health/guides/disease/multiple-sclerosis/overview.html?inline=nyt-classifier), rheumatoid arthritis (http://health.nytimes.com/health/guides/disease/rheumatoid-arthritis/overview.html?inline=nyt-classifier), hemophilia (http://health.nytimes.com/health/guides/disease/hemophilia/overview.html?inline=nyt-classifier), hepatitis C (http://health.nytimes.com/health/guides/disease/hepatitis-c/overview.html?inline=nyt-classifier) and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.

Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer (http://health.nytimes.com/health/guides/disease/cancer/overview.html?inline=nyt-classifier) and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year.

But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.

The system, often called Tier 4, began in earnest with Medicare (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier) drug plans and spread rapidly. It is now incorporated into 86 percent of those plans. Some have even higher co-payments for certain drugs, a Tier 5.

Now Tier 4 is also showing up in insurance that people buy on their own or acquire through employers, said Dan Mendelson of Avalere Health, a research organization in Washington. It is the fastest-growing segment in private insurance, Mr. Mendelson said. Five years ago it was virtually nonexistent in private plans, he said. Now 10 percent of them have Tier 4 drug categories.

Private insurers began offering Tier 4 plans in response to employers who were looking for ways to keep costs down, said Karen Ignagni, president of America’s Health Insurance Plans, which represents most of the nation’s health insurers. When people who need Tier 4 drugs pay more for them, other subscribers in the plan pay less for their coverage.

But the new system sticks seriously ill people with huge bills, said James Robinson, a health economist at the University of California, Berkeley. “It is very unfortunate social policy,” Dr. Robinson said. “The more the sick person pays, the less the healthy person pays.”

Traditionally, the idea of insurance was to spread the costs of paying for the sick.

“This is an erosion of the traditional concept of insurance,” Mr. Mendelson said. “Those beneficiaries who bear the burden of illness are also bearing the burden of cost.”

And often, patients say, they had no idea that they would be faced with such a situation.

It happened to Robin Steinwand, 53, who has multiple sclerosis.

In January, shortly after Ms. Steinwand renewed her insurance policy with Kaiser Permanente, she went to refill her prescription for Copaxone. She had been insured with Kaiser for 17 years through her husband, a federal employee, and had had no complaints about the coverage.

She had been taking Copaxone since multiple sclerosis was diagnosed in 2000, buying a 30 days’ supply at a time. And even though the drug costs $1,900 a month, Kaiser required only a $20 co-payment.

Not this time. When Ms. Steinwand went to pick up her prescription at a pharmacy near her home in Silver Spring, Md., the pharmacist handed her a bill for $325.

There must be a mistake, Ms. Steinwand said. So the pharmacist checked with her supervisor. The new price was correct. Kaiser’s policy had changed. Now Kaiser was charging 25 percent of the cost of the drug up to a maximum of $325 per prescription. Her annual cost would be $3,900 and unless her insurance changed or the drug dropped in price, it would go on for the rest of her life.

“I charged it, then got into my car and burst into tears,” Ms. Steinwand said.

She needed the drug, she said, because it can slow the course of her disease. And she knew she would just have to pay for it, but it would not be easy.

“It’s a tough economic time for everyone,” she said. “My son will start college in a year and a half. We are asking ourselves, can we afford a vacation? Can we continue to save for retirement and college?”

Although Kaiser advised patients of the new plan in its brochure that it sent out in the open enrollment period late last year, Ms. Steinwand did not notice it. And private insurers, Mr. Mendelson said, can legally change their coverage to one in which some drugs are Tier 4 with no advance notice.

Medicare drug plans have to notify patients but, Mr. Mendelson said, “that doesn’t mean the person will hear about it.” He added, “You don’t read all your mail.”

Some patients said they had no idea whether their plan changed or whether it always had a Tier 4. The new system came as a surprise when they found out that they needed an expensive drug.

That’s what happened to Robert W. Banning of Arlington, Va., when his doctor prescribed Sprycel for his chronic myelogenous leukemia (http://health.nytimes.com/health/guides/disease/chronic-myelogenous-leukemia-cml/overview.html?inline=nyt-classifier). The drug can block the growth of cancer cells, extending lives. It is a tablet to be taken twice a day — no need for chemotherapy (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/chemotherapy/index.html?inline=nyt-classifier) infusions.

Mr. Banning, 81, a retired owner of car dealerships, thought he had good insurance through AARP (http://topics.nytimes.com/top/reference/timestopics/organizations/a/aarp/index.html?inline=nyt-org). But Sprycel, which he will have to take for the rest of his life, costs more than $13,500 for a 90-day supply, and Mr. Banning soon discovered that the AARP plan required him to pay more than $4,000.

Mr. Banning and his son, Robert Banning Jr., have accepted the situation. “We’re not trying to make anybody the heavy,” the father said.

So far, they have not purchased the drug. But if they do, they know that the expense would go on and on, his son said. “Somehow or other, myself and my family will do whatever it takes. You don’t put your parent on a scale.”

But Ms. Steinwand was not so sanguine. She immediately asked Kaiser why it had changed its plan.

The answer came in a letter from the federal Office of Personnel Management, which negotiates with health insurers in the plan her husband has as a federal employee. Kaiser classifies drugs like Copaxone as specialty drugs. They, the letter said, “are high-cost drugs used to treat relatively few people suffering from complex conditions like anemia (http://health.nytimes.com/health/guides/disease/anemia/overview.html?inline=nyt-classifier), cancer, hemophilia, multiple sclerosis, rheumatoid arthritis and human growth hormone deficiency (http://health.nytimes.com/health/guides/disease/growth-hormone-deficiency/overview.html?inline=nyt-classifier).”

And Kaiser, the agency added, had made a convincing argument that charging a percentage of the cost of these drugs “helped lower the rates for federal employees.”

Ms. Steinwand can change plans at the end of the year, choosing one that allows her to pay $20 for the Copaxone, but she worries about whether that will help. “I am a little nervous,” she said. “Will the next company follow suit next year?”

But it turns out that she won’t have to worry, at least for the rest of this year.

A Kaiser spokeswoman, Sandra R. Gregg, said on Friday that Kaiser had decided to suspend the change for the program involving federal employees in the mid-Atlantic region while it reviewed the new policy. The suspension will last for the rest of the year, she said. Ms. Steinwand and others who paid the new price for their drugs will be repaid the difference between the new price and the old co-payment.

Ms. Gregg explained that Kaiser had been discussing the new pricing plan with the Office of Personnel Management over the previous few days because patients had been raising questions about it. That led to the decision to suspend the changed pricing system.

“Letters will go out next week,” Ms. Gregg said.

But some with the new plans say they have no way out.

Julie Bass, who lives near Orlando, Fla., has metastatic breast cancer (http://health.nytimes.com/health/guides/disease/breast-cancer/overview.html?inline=nyt-classifier), lives on Social Security disability payments, and because she is disabled, is covered by insurance through a Medicare H.M.O. Ms. Bass, 52, said she had no alternatives to her H.M.O. She said she could not afford a regular Medicare plan, which has co-payments of 20 percent for such things as emergency care, outpatient surgery and scans. That left her with a choice of two Medicare H.M.O’s that operate in her region. But of the two H.M.O’s, her doctors accept only Wellcare.

Now, she said, one drug her doctor may prescribe to control her cancer is Tykerb. But her insurer, Wellcare, classifies it as Tier 4, and she knows she cannot afford it.

Wellcare declined to say what Tykerb might cost, but its list price according to a standard source, Red Book, is $3,480 for 150 tablets, which may last a patient 21 days. Wellcare requires patients to pay a third of the cost of its Tier 4 drugs.

“For everybody in my position with metastatic breast cancer, there are times when you are stable and can go off treatment,” Ms. Bass said. “But if we are progressing, we have to be on treatment, or we will die.”

“People’s eyes need to be opened,” she said. “They need to understand that these drugs are very costly, and there are a lot of people out there who are struggling with these costs.”


==============

Get sick, or injured, in USA and you, even with expensive insurance, very often are
fucked out of every last penny.

"studies have shown" that people with a serious sickness, even cured, never recover financially.

[101A]

The problem is when you ration preventive care by price, too little of this good/service is "consumed", especially if you are looking at the wider economy.

Think about the consequences of missing cancers or other problems.

1) Shorter working lives of people = less contribution to the economy
2) Increased curative costs = more unproductive costs to the economy
3) More absenteeism on the part of the sick= more costs for business
4) More absenteeism on the part of those who have to care for sick loved ones = more costs for business.
5) More sick uninsured = more bankrupcies from medical bills

Balanced against all of this is the ONE argument:

"But the government will waste all that money".

(shrugs)

Ok, for the sake of argument, let's assume that the government will waste a good chunk of money doing this. The costs of doing nothing are increasing at a rather alarming and measurable rate. How long before those costs are greater than the costs of this government waste?

the economic arguments for single payor systems far outweigh those stacked against it, from what I have seen.
There is no correlation to a preventive care benefit and decreased claims.

There is no correlation (state by state) to number of doctors per capita (access to care) and life expectancy or health.

The only correlation is the more doctors, the more claims, the more cost - no subsequent increase in health.

I pay less than one third per capita to insure my over 65 employees than the govenment spends on Medicaire - and they opt for my plan because it has better benefits.

As soon as the United States Government gets involved you can toss out any type of "economic" benefit. There will be none. As expensive and out of control it is now; it WILL be worse. You know it, I know it, you just won't admit it.

There are other arguments for single payor, most of them on a equity based moral ideology (everybody ought to have the same healthcare) - but economics is one that only works in theory.

[101A]

The problem is when you ration preventive care by price, too little of this good/service is "consumed", especially if you are looking at the wider economy.

Think about the consequences of missing cancers or other problems.

1) Shorter working lives of people = less contribution to the economy
2) Increased curative costs = more unproductive costs to the economy
3) More absenteeism on the part of the sick= more costs for business
4) More absenteeism on the part of those who have to care for sick loved ones = more costs for business.
5) More sick uninsured = more bankrupcies from medical bills

Balanced against all of this is the ONE argument:

"But the government will waste all that money".

(shrugs)

Ok, for the sake of argument, let's assume that the government will waste a good chunk of money doing this. The costs of doing nothing are increasing at a rather alarming and measurable rate. How long before those costs are greater than the costs of this government waste?

the economic arguments for single payor systems far outweigh those stacked against it, from what I have seen.Also, since it is MY money you are spending - my personal and business taxes are going to pay for this panacea you are espousing. I guarantee you that I can insure my employees (probably with better coverage), and deal with all of that absenteeism (they all get Short AND Long Term Disability Insurance) you are concerned about for FAR less than the government is going to coersively take from me to pay for YOUR system.

[Wild Cobra]

Gee the numer of uninsured in Texas has risen since tort reform was passed be the state legislature 4 or 5 yrs ago..capped those damage claims so the evil trial lawyers can't gouge those poor innocent insurance companies.. :rolleyes

you guys are ridiculous.

OK, show me the evidence that it just isn't coincidence. Each has it's own cause and effect. Tort reform is not going to increase the numbers of the uninsured. What else did the government do? What else changed?



Where will the extra money some from? You know those who live paycheck to paycheck? Those who are having a hard time saving any money your suggesting they go out and buy stocks! Brilliant.. when you get back to the real world le t me know...Let's see who has the disposable income to buy more stocks..... hhmmmmm ..Those who have the financial standing to do so!

I was talking about those who already had 401K's to show the fear of loss wasn't right.

Different argument. Please keep up.



No knock on the upper income levels but just the facts..so now the income gap can continue to grow.. great plan ! now you and boner di-nasty can go nut hug each other.. :rolleyes
My God man.

Yes, you are knocking upper income people by insisting their tax dollars are fairly given to programs that help your desires.

Get off your jealousy rant. It's not healthy, it's divisive, it's unethical.

This is the land of opportunity. You have to make it happen for yourself. Nobody's going to hold your hand. Stop looking for hand-outs, and be your own man.

[FromWayDowntown]

Doctors are the root of all problems in America and this survey just cements my belief that doctors support the terrorists.

[Aggie Hoopsfan]

croutons sits here and bitches about the insurance companies making big profits, screams for universal health care as a 'solution', and seems oblivious to the idea that if we have universal health care the insurance companies will make even more bank - they'll be getting everything they get now for 'premium' care for those who can afford it, and will take the money the government is passing on so as to not have to deal with the paperwork of dealing with hospitals and docs.

[boutons_]

Like in other countries, the would be a national insurance plan, and expanded Medicare, that is receives mandated national health payments from everybody. If you're on welfare, part of your welfare check is taken for health coverage.

There would a national health care provider, an expanded Veterans' Administration. The staff would work for the govt, be salaried, no pay-for-piece work like now. Their priority is to provide health care, NOT make money. They may money from their salary, not from lab tests, prescriptions, etc like now.

If people wanted to afford private insurer, they buy additional insurance privately. They would still have to participate in the national plan.

All of this stuff exists in other countries and works a hell of a lot better than the US system and costs a hell of a lot less. It ain't pioneering rocket science.

Drug research/discovery/testing would be separate from mfring and mkting. New drugs would be bid upon by mfrs, sorta like the frequency spectrum auctions.

When I'm elected, I will do all of the above (but I can't because of dubya's deficits and debt service)

[Yonivore]

I suggest they survey doctors in countries where they already have a single-payer system; Britain or Canada, for instance.

[xrayzebra]

For all of you who want UHC I would like you to see this video.
It will no affect me but for your younger people you have a long
row to hoe. You better get someone elected who has a little fiscal
responsibility. Now you know why Bush and his domestic programs
are not one of my favorite things.We are going broke (http://www.youtube.com/watch?v=OS2fI2p9iVs)

[RandomGuy]

There is no correlation to a preventive care benefit and decreased claims.

Link?

Further, my post was about health outcomes in general, not claims in particular.

If you are trying to make the argument that preventive care is somehow not cheaper than curative care, you will have to provide a LOT of substantiating evidence to support that.

[RandomGuy]

Also, since it is MY money you are spending - my personal and business taxes are going to pay for this panacea you are espousing. I guarantee you that I can insure my employees (probably with better coverage), and deal with all of that absenteeism (they all get Short AND Long Term Disability Insurance) you are concerned about for FAR less than the government is going to coersively take from me to pay for YOUR system.

I have already provided arguments that point out that you are currently paying for the uninsured anyways even without government taxing you to do so.

Do you understand how? (honest question, no sarcasm intended)

[RandomGuy]

Yes, you are knocking upper income people by insisting their tax dollars are fairly given to programs that help your desires.

Get off your jealousy rant. It's not healthy, it's divisive, it's unethical.

Is it ethical to benefit from something but not pay back into it, i.e. to take but not give?

[101A]

Link?

Further, my post was about health outcomes in general, not claims in particular.

If you are trying to make the argument that preventive care is somehow not cheaper than curative care, you will have to provide a LOT of substantiating evidence to support that.
Underwriters set it as such, that's how I know.

If I take a standard medical plan:

$500 Deductible/80% Co-Insurance/$1,500 Out of Pocket Maximum/$20 Doctor's Visit Co-Pay, etc.

and send that plan, along with census data on the group I want covered, and include any "serious" conditions in my report (diabetes, active cancer, heart disease and if it is at least 200 people), they will send me back an estimation as to what that group is going to cost for that benefit package for the next year. Their software and methodoligy is amazingly accurate, and is usually going to hit the target within 1 - 2 % points.

If I add a $500 - $1,000, or even unlimited, "wellness" benefit (which is the standard, and the norm, btw - almost all plans have them), the cost goes UP not down.

Not sure I can provide documentation to you, but it's what I do. I know it's counterintuitive, but those are the facts.

Now, if the government took control; it could do something the insurance companies are not allowed to do: Mandate well care (people HAVE to go get physicals, etc. by force of law). That MIGHT help; but usually, if you go into a physical, and tell the doctor you feel fine, he isn't going to find anything, even if it's there. My dad went to the doctor in October of '03 for a physical, and was given a clean bill of health. In April '04 he died of cancer (ran up $750,000 in bills in the interim).

[xrayzebra]

Hey, maybe I should stand corrected. Maybe there is more to
this Universal Health Care than I was aware of. Seems that
they take care of everything. Nawh, it wouldn't work here,
someone would complain.






Call Girls at Nursing Home Fuel Debate in Denmark (Update1)

By Christian Wienberg

April 16 (Bloomberg) -- When a male resident at Kildegaarden nursing home in Denmark made an indecent sexual proposal to a member of the staff, the home's director, Inger Marie Kristensen, told a nurse to telephone for a prostitute.

``There was a considerable change in his demeanor after the escort girl had paid him a visit,'' Kristensen said in an interview. ``We do this for our clients just as we offer them other services that they need as human beings.''

Kildegaarden, located 100 miles (160 kilometers) west of Copenhagen in Skanderborg, has about 100 residents, including victims of Alzheimer's disease and strokes. Nurses arranged visits by call girls three times in the past three years.

While Welfare Minister Karen Jespersen says Denmark's 98 municipalities are free to let nurses call prostitutes, some lawmakers are stepping up efforts to pull women out of the profession, which has been legal in the country since 1999.

``I don't want to contribute to keeping this industry in business,'' said Mie Bergmann, an elected official with the Social-Liberal Party in Skanderborg, who led a failed vote to end prostitution at Kildegaarden.

Denmark is doubling spending to 80 million kroner ($17 million) over the next three years to get women out of the sex trade. The government estimates that 6,000 women work in the profession in the Scandinavian country of 5.5 million.

`Discriminating'

Copenhagen forbids contact with call girls in nursing homes. Other towns don't publicize their policies.

In a poll posted last week on the Web site of national broadcaster DR, 46 percent of 1,982 readers said nursing home staff should be able to organize visits by prostitutes, 45 percent were against the practice and 8 percent were undecided. A margin of error wasn't given.

Denmark's Society for Women started a campaign in March called ``Take a Position, Man'' urging men to sign up at a Web site to protest against prostitution. So far, 1,887 women and men, including the editor-in-chief of newspaper Politiken Thoeger Seidenfaden, have signed.

The Copenhagen-based Danish Sex-worker Association was established last month in a bid to protect the industry. The leader, who gives her name only as Susanne on the association's Web site, said prostitutes ``often'' visit Danish elderly homes.

``To forbid vulnerable customers from obtaining the services of a legal business is discriminating, both against the sex workers and the people who need help to get the services,'' Susanne said in an e-mailed response to questions.

Ban Proposal

An increasing number of Danes oppose prostitution, a December 2006 opinion poll by newspaper Politiken showed. Forty- two percent of 1,180 said prostitution was unacceptable compared with 25 percent four years earlier. A majority of 54 percent approved of prostitution, compared with 66 percent in 2002.

``I don't want a society where some people are used as a vehicle for others to live out their desires,'' Ozlem Sara Cekic, a Danish Turkish member of parliament for the Socialist People's Party, said in comments posted on her Web site.

The Danish People's Party, which backs the minority Liberal- Conservative government in parliament, said earlier this year it may join opposition lawmakers to form a majority in favor of a ban on the sex trade.

The parliamentary committee for social affairs announced this year that it's planning a trip to neighboring Sweden to investigate how that country has handled legislation it passed in 1999 that criminalized paying for sex.

For Kristensen, residents at the Kildegaarden home have rights under the current laws, no matter how old they are. And Danes are getting older. According to the Danish government Web site, on Jan. 1, 2007, 715 people were 100 years of age or more.

``Basically this is a matter of respecting the elderly and their needs,'' she said.

To contact the reporter on this story: Christian Wienberg in Copenhagen at [email protected]
Last Updated: April 15, 2008 20:44 EDT

[101A]

O.K. Ray, I'm SOLD!

Let's get us some universal coverage (then maybe 93 year olds in Cali. wouldn't be picked up for solicitation)

[George Gervin's Afro]

OK, show me the evidence that it just isn't coincidence. Each has it's own cause and effect. Tort reform is not going to increase the numbers of the uninsured. What else did the government do? What else changed?


I was talking about those who already had 401K's to show the fear of loss wasn't right.

Different argument. Please keep up.


My God man.

Yes, you are knocking upper income people by insisting their tax dollars are fairly given to programs that help your desires.

Get off your jealousy rant. It's not healthy, it's divisive, it's unethical.

This is the land of opportunity. You have to make it happen for yourself. Nobody's going to hold your hand. Stop looking for hand-outs, and be your own man.

So all of those commercials run by the GOP during the election cycle that brought us tort reform were incorrect? I don't seem to remember any caveats to the advertisements rather I distinctly remember the reform was to lower malpractice insurance and punish evil trial lawyers. So now you are telling me that those adds were bullshit..we were lied to?

Your second question related to what the govt did? Uh skippy Texas has been blood red for a while so I guess if the republican dominated legislature and governorship were out to get those insurance companies they did. Of course it was the same govt who passed the legislation.... The free market has slowly shrunken the pool of insured AS IT IS and you want to give the market free rein?


You speak of the land of opportunity.. well mechanics are hard working productie citizens but on avg they may not make enough to afford insurance? So I guess your response is that they chose to ne mechanics and if they can't afford coverage then they should hit the emergency room..

[RandomGuy]

bump. cause it's relevant again.

[boutons_]

"it's relevant again."

... was never irrelevant, will be relevant forever, because the people whose _INCOME_ is the $3T/year national health will never permit cost (their revenue) reductions, will only continue to organize the health care industry to generate more profits from delivering less care to fewer people.

So the media talks about the highly relevant ... fist bumping.

[RandomGuy]

So the media talks about the highly relevant ... fist bumping.

Beats the hell out of listening about Britney Spears 24/7 :lol


I am a news junkie but I have a 2 second rule when it comes to listening to someone blather about their opinions on this or that in politics and the news.

That's why I try to get all of my news direclty from AP/Reuters and the source.

All cable news does is just read those and maybe send their own reporters to look into stuff that someone else reported on anyways.

[RandomGuy]

it's unethical.


Is it ethical to benefit from something, but never give back into the system that you benefitted from?

[xrayzebra]

Beats the hell out of listening about Britney Spears 24/7 :lol


I am a news junkie but I have a 2 second rule when it comes to listening to someone blather about their opinions on this or that in politics and the news.

That's why I try to get all of my news direclty from AP/Reuters and the source.

All cable news does is just read those and maybe send their own reporters to look into stuff that someone else reported on anyways.

yeah sure, AP/Reuters are really unbiased. Not that there is anything wrong with bias. Everyone is. And I like my news biased, you get a clearer
picture of what is really going on. From both sides. Although I like Drudge, not his reporting, but his website and links.

[TeyshaBlue]

Damn, you've convinced me.

The government can fix it. They're GREAT at controlling costs!

For years, I was a contract analyst and a gatekeeper for DOD, TMOP and VA pharmaceutical contracts. The Feds are absolutely ruthless in their pricing and contract demands. There isn't a GPO on the planet that can touch their contract pricing and woe be unto the company that screws their pricing up. Hell, they'd give WalMart a run for their money when it comes to negotiating pricing. The government can be damned effective when they want to be.

[GaryJohnston]

I enjoy my quality of healthcare now. I went to school and have a good job now. I've made something of my life. I do not want to my quality of healthcare to decrease because Obama wants universal healthcare. Moving towards universal healthcare will decrease the quality of heathcare for all americans. Tough shit if you threw your life away and now can't afford decent healthcare.

[ElNono]

I enjoy my quality of healthcare now. I went to school and have a good job now. I've made something of my life. I do not want to my quality of healthcare to decrease because Obama wants universal healthcare. Moving towards universal healthcare will decrease the quality of heathcare for all americans. Tough shit if you threw your life away and now can't afford decent healthcare.

Lets just hope you don't get a chronic condition that prevents you from working or driving, like a retina detachment or so. By the time you are done with surgery and treatment, you'll be knee deep in debt and living off social security.
I sincerely hope that day never comes, but if it does, you can kiss your bright future, college degree and arrogance goodbye. When stuff like that happen to you or people near you, you get some degree of perspective on why Me, Me, Me and screw everybody else doesn't work.

[jochhejaam]

Lets just hope you don't get a chronic condition that prevents you from working or driving, like a retina detachment or so. By the time you are done with surgery and treatment, you'll be knee deep in debt and living off social security.
I sincerely hope that day never comes, but if it does, you can kiss your bright future, college degree and arrogance goodbye. When stuff like that happen to you or people near you, you get some degree of perspective on why Me, Me, Me and screw everybody else doesn't work.

Emergency health care is out there for everyone who is uninsured. Top-notch health care for every American is not affordable. Let's set up vote for a National Health Care program, and tax those that vote affirmative, to the extent that A1 health care for all is properly funded (It's gonna be a whopper of a tax). It's a "put your money where your mouth is" vote. Voluntary Socialism, if you will.
Any guesses as to what percentage of voters are still in favor of National Health Care?

I personally don't need Big Brother taking control of every facet of my life in a so-called effort to provide for me, and protect me from the day to day maladies that may come my way. The government, through massive entitlement programs (I'm for a limited amount of Government assistance) has already removed much of the incentive for many to attempt to extract themselves from poverty. Many are completely satisified living off of entitlements, that is, living off of the monies taken from those that choose to work hard to earn a living.
National Health-Care cuts two ways; it increases the tax burden for those that work hard, while increasing the percentage of individuals who are content to let the Government give them a free ride through life (read, let hard working taxpayers give them a free ride through life).

Life is full of risks, you take the good with the bad, and at times, the bad puts some of us down, or takes some of us out. Such is life.


"The sun rises on evil and good, and it rains on the just and the unjust"

[TDMVPDPOY]

Well my old man is in hospital atm, and yes we dont have private health care....thank god theres medicare....

[jochhejaam]

Well my old man is in hospital atm, and yes we dont have private health care....thank god theres medicare....
Yep, medicare's good.

[ElNono]

Life is full of risks, you take the good with the bad, and at times, the bad puts some of us down, or takes some of us out. Such is life.

I'm not talking emergency services here. So basically what you're telling me is that if I have a chronic condition that lasts years to treat, preventing me from working and having insurance, I should just jump in front of a train and save everyone some money? Is that the capitalism way?
You know, some people would *LOVE* to get back to work and start making their own money, and can't. What do we do with those?
Plus if you have the means, you can always go in a private system.
I lived a good 17+ years in a country with state-funded healthcare. The care wasn't the greatest, but if you had the means, you could always get private insurance and go to the more fancier hospitals or clinics.
The thing is, if you did NOT have the means, at least you had something to fall back to. And no, there was no long lists of anything there. Just the care didn't have all the bells and whistles, technologically speaking, that the fancy places had.

[xrayzebra]

I'm not talking emergency services here. So basically what you're telling me is that if I have a chronic condition that lasts years to treat, preventing me from working and having insurance, I should just jump in front of a train and save everyone some money? Is that the capitalism way?
You know, some people would *LOVE* to get back to work and start making their own money, and can't. What do we do with those?
Plus if you have the means, you can always go in a private system.
I lived a good 17+ years in a country with state-funded healthcare. The care wasn't the greatest, but if you had the means, you could always get private insurance and go to the more fancier hospitals or clinics.
The thing is, if you did NOT have the means, at least you had something to fall back to. And no, there was no long lists of anything there. Just the care didn't have all the bells and whistles, technologically speaking, that the fancy places had.

Well for one thing. If you have a condition that makes you disabled and unable to work their is a thing called Social Security and with that, after two years, comes a thing called Medicare. And yes, it doesn't matter how old you are, if you qualify for disability you also qualify for Medicare, after the waiting period. If you cant afford to pay bills while on disability there is a program called medicaid. And believe me, medicaid pays for much more than most insurance policies and medicare.

One other question, why did you leave the good life after 17+ years? Just curious.

[GaryJohnston]

Lets just hope you don't get a chronic condition that prevents you from working or driving, like a retina detachment or so. By the time you are done with surgery and treatment, you'll be knee deep in debt and living off social security.
I sincerely hope that day never comes, but if it does, you can kiss your bright future, college degree and arrogance goodbye. When stuff like that happen to you or people near you, you get some degree of perspective on why Me, Me, Me and screw everybody else doesn't work.

Actually, I won't ever be living off of social security. I work in healthcare myself and have exceptional healthcare insurance. Im doing okay.

[ElNono]

Well for one thing. If you have a condition that makes you disabled and unable to work their is a thing called Social Security and with that, after two years, comes a thing called Medicare. And yes, it doesn't matter how old you are, if you qualify for disability you also qualify for Medicare, after the waiting period. If you cant afford to pay bills while on disability there is a program called medicaid. And believe me, medicaid pays for much more than most insurance policies and medicare.

One other question, why did you leave the good life after 17+ years? Just curious.

I know how the whole system works. A person very close to me had to go through the whole ordeal, that's why I know it pretty up close. My point was that some individuals think that bad shit can't happen to them, and everyone on medicare/medicaid is a freewheeler, and that's not always necessarily the case.
About why I left the good life, it had to do with the market I specialize in. There were very few interesting/challenging jobs in the technology field back then. So about 9 years ago I got offers to work in the Netherlands and the US. I've been to Europe before (I have Italian citizenship), and I figured I'll give the US a try. Specially since the Internet bubble was in full swing here.
Eventually I married a US citizen, and the moving around had to stop.
I like this country. I think the justice system, when it works, it's the best you can get around the globe. Work wise, things didn't develop as I had hoped, but you always have the sensation that you could hit a home run sooner or later. I think the health care part needs work. I'm not sure if it necessarily has to be the universal health care system or health insurances need regulation, or something in between.
I work with doctors a lot, and they're not happy. And like I said earlier, we have gotten screwed up by insurance quite a few times.
Obviously something needs to be done about it. Otherwise this wouldn't be the hot topic it is, like illegal immigration, etc.

[RandomGuy]

Actually, I won't ever be living off of social security. I work in healthcare myself and have exceptional healthcare insurance. Im doing okay.

Do you have income replacement insurance?