Monday, December 28

(Even more) things we need for real HCR

1. A ban on pharmaceutical advertising to consumers.

It's not impossible. Despite huge pressure from big pharma, every industrialized nation except the US and New Zealand has this ban in place. They also have publicly funded single payer health insurance for all. Coincidence? No.

One thing single payer advocates underestimated is the extent to which the status quo in health insurance/care benefits so many special interests. When Meet the Fricking Press cuts to commercial, three to one it's for some pill. As I've pointed out before, GE sells credit card services to doctors. There is a huge unseen revenue stream from health care in the United States that stacks up against real reform. Until we expose those who benefit from people NOT having access to care due to expense, we will not change the system that allows them this profit.

2. An understanding that the US cannot be the sole source of profit for health care companies, and that this is an international issue.

I really don't know why Lou Dobbs and his minions of anti-foreigner bigots don't get on this band-wagon. One of the main reasons patented pills in the US are so expensive is because they are not ALLOWED to be this expensive in other industrialized nations, whose governments have the common sense to set prices on medicines at the national level. So Americans are not only paying the profit margins for our own consumption, but for those damn Canadians and Scandinavians, too. Don't get me started about the French.

But seriously, companies that manufacture these pills need enough profit to stay in business (and they do employ a lot of people so this is economic, I get that). But the profit needs to be reasonable not outrageous and it needs to be spread out to all nations who make those drugs available. Drug prices need to be negotiated internationally, and the US needs to tell other nations as well as big pharma to get a grip on their greed. Good luck with that.

3. An understanding that insurance does not equal health CARE.

We're coming to this understanding right quick now that health CARE reform is being watered down to INSURANCE reform. I know it's a call-to-arms for the pro-reformers, but I have to mention a caveat on the "so many people die without health insurance" argument, simply because so many people die WITH health insurance, too. And insurance is a terrible, terrible healthcare "provider."

There is something very screwed up when a doctor tells a middle class American woman that one course of treatment is not available to her (as happened to someone I know) because "your insurance won't pay for it."

"How much is it?" the way-too-educated-and-assertive (ha) woman asked the nurse.

"Seventy-five dollars."

She picked up her purse. "I'll take it."

Many, many people don't have this luxury, and that is the pathetic state of healthcare in America. But what if the woman, who COULD afford it, hadn't asked? This situation wasn't life-threatening, but still. The health care system is not only broken because some people don't have insurance. It's broken by a system where insurance or lack thereof makes the medical decisions.

4. A calmer, more rational approach in our own psyches to aging, death, and dying.

This is personal, and we all have to do this work at some point. I'm so tired of hearing the death panel argument, and the "grandma couldn't get a hip replacement because Medicare wouldn't pay for it" (see above on insurance making health CARE decisions). No one who loves an elderly parent wants to Google "surgical risk for morbidity after age 80" but there's lots of hits there, folks. And whether Sarah Palin can use it for her propaganda or not, there are lots of doctors having 'the conversation' with mournful adult kids about how the better part of love is not forcing Grandma into the operating theater.

Of course, as all of US middle-aged types continue to age, it becomes even more personal. I wish fundamentalist Christians would actually take the lead on this, since so much of their effing international policy is based on Jesus coming back to earth, the rapture, etc. Why not come to more of an acceptance of "passing on"?

Too much to hope for?

image from here updated by me.

12 comments:

  1. Very good list.

    I really don't know why Lou Dobbs and his minions of anti-foreigner bigots don't get on this band-wagon.

    But - but - brown people in America might get health care, then! Perhaps for Dobbs the competing bigotry you mention might win out, but it would still be one helluva cognitive dissonance for him – if he ever bothered to think.

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  2. Come onnnnn.

    Please. Give yourself a break.

    Lou Dobbs is making money.

    So is everyone else.

    And the public is still watching "American Idol" Masterpiece Theatre. (At least what Americans think is Masterpiece Theatre.)

    Sorry to sound so cynical, but naivete just plays into their hands.

    This will not change until a real reform movement begins to use its own power against the powerful who are deeply entrenched.

    And this will not occur in our lifetime it looks like - no matter the tears shed over the incompetence of our leaders.

    Thanks for your reporting.

    S

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  3. Shared Humanity6:20 PM

    This makes a hell of a lot of sense.

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  4. On the "death panels", the fundy Christian side of my family got a crash course with the death of one of my uncles. They prayed and prayed, sent money to Oral Roberts and Billy Joe Daugherty, and said "do anything". They saw what that meant, quite literally. It really affected my mom and my aunts and uncles. They didn't want to die that way, and yet they made my uncle Pete be tortured for the last 72 hours of his life (at enormous cost). I'm thinking maybe that some health education and easy access living wills could do a whole lot of good, prevent shitloads of pain, and provide a dramatic cost reduction.

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  5. love this. i reposted it to my blog. it is so true.

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  6. Excellent post, BG --

    Why the US gouges its citizens on pharmaceuticals is just one more way to subsidize Third-World nations or near failed states,like Mexico, where I have gone countless times to pick up medications.

    Medications for my family and pets are a fraction of the cost on this side of the border. A fraction. ALL of which are produced, manufactured and distributed by the same companies.

    It's cheaper to drive cross-country (or in my case, cross-state), stay a week on the border, cross over to buy a year's supply of meds than it is to cross the street and buy at home. What's wrong with this picture?

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  7. Wow! Full serving of reality check here.

    Pharma: Remember the commercial:
    "Ask YOUR Doctor about the purple pill"
    They did not even tell you what the damned purple pill was for-- but just gave the impression if you take prescription meds, you should probably be taking the full spectrum of the rainbow!

    The other aspect you never hear mentioned, is that Doctors can buy stocks in prescription med companies... therefore could effect which meds the Doc chooses to prescribe. There may be a hidden conflict of interest going on.

    And OH! Those Rx commercials... usually with the prozac voice lady saying with confidence, the potential side effects- "may cause your heart to stop beating, your head to fall off, and you may turn into a green alien- notify your doctor right away if you have any of these or other symptoms."

    COST OF MEDS: It is disgusting that south of the border people pay pennies on the dollar for Rx meds. Even Canada enjoys much better prices for meds, the same meds made by the same manufacturers. They do need to have bids for the best rate to win bulk contracts, rather than the current sky is the limit program. My elderly Mom w private insurance & medicare pays $500 out of pocket per month for her meds. That's $6000 bucks a year, just for meds. Furthermore, there is NO dental coverage whatsoever.

    INS DOES NOT EQUAL HEALTHCARE: As the movie SICKO pointed out, many who have coverage are screwed... CT scan co pay will be $300 bucks, plus more for someone to read the scan, plus the co pay for the Doctor's visit, plus the monthly premium. Who knew a 5 mm kidney stone would cost so much??
    Yes it would cost more if you had no coverage.... but for a low paid person like myself, all those extras are a real budget buster. How much does that CT scan cost in Mexico?

    AGING, DEATH & DYING: Right on-- taking invasive & extraordinary measures when natural end of life is not even desirable for many. they now have different tiers of the DNR (do not resuscitate)- you can choose to make the patient comfortable w/o prolonging the inevitable. Many are opting for quality of life.
    Being bedridden & ill, in pain & suffering is cruel. The Death Panel conversation is not rational. It is totally rational @ end of life to say I have no chance of recovery, use the resources for someone who does. It is compassionate & respectful of life.

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  8. One more thought on the end of life issue--

    Why is it we have compassion for our beloved pets, and have them put to sleep to end their suffering...

    But Grandma has to tough it out?

    I agree, it should be that individual's choice.... but I am glad I live in a state where we have physician assisted suicide.
    If you are terminally ill, you can work with your Doctor. Safeguards are in place.... waiting period, multiple diagnostics, counseling.
    Actually, the better term is Death with Dignity.

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  9. I wish fundamentalist Christians would actually take the lead on this, since so much of their effing international policy is based on Jesus coming back to earth, the rapture, etc. Why not come to more of an acceptance of "passing on"?

    Excellent question, Fran, but imo fundamentalist Christians will be the very last ppl to get real about death. To begin with, most of them are unwitting secularists; they simply haven't met God. Thus they are unmitigated cowards when it comes to their own death and dying. Having invested most of their "faith" in dogma and doctrine drenched in fear, anger, and self righteous hate, rather than true spiritual values— truth, beauty, and goodness— they remain completely fearful and and in denial about their personal mortality.

    The central teaching of Jesus is simply, "Love one another, as I have loved you." And that teaching, when seriously applied to others— all others— cannot help but lead to the brotherhood of all mankind under the Fatherhood of God.
    But it will never happen as long as the religionists who claim to follow Jesus do not truly love their fellows.

    And on that note, wishing you and yours all the best of life to come. ;-)

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  10. Fran, you're lucid to the degree that no comment of mine would add to the discourse, except if I say, "Thank you."

    So, Thank You.

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  11. We're based too heavily on selfish concerns and egocentric gain to ever be comfortable with the idea of death. We don't take death to mean the end of a long life, we mean it as a means of stealing something we covet and feel entitled to.

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  12. None of the health care reform ideas do enough to control overall costs. Why don't more of us ask "How much does this cost?" I got a kick out of this fun, short video. Check it out. It makes you wonder why our health care system is set up the way it is.
    www.whatstherealcost.org/45secondstoshare

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