Wednesday, January 07, 2009

Book Review #2. I Read Wonky Health Care Texts So You Don't Have To.

Here we go again. A new president is moving into 1600 Pennsylvania Avenue, and one of the things he's pledged to do is take a shot at solving this country's health care crisis. Most of you have seen this act before, but some of you may not realize it goes back further than Bill Clinton. Much further. As former Senate majority leader and president-elect Obama's incoming Secretary of Health and Human Services Tom Daschle notes in his new book "Critical; What We Can Do About The Health Care Crisis" Harry Truman wrote in his memoirs:

I have had some bitter disappointments as president, but the one that troubled me most, in a personal way, has been the failure to defeat the organized opposition to a national compulsory health insurance plan

If you were born when Harry Truman was fighting that fight, you will soon qualify for Medicare, but only because Lyndon Johnson fought the same fight for the oldsters almost 20 years later. Which was almost 30 years before Clinton tried to fight the fight for the rest of us. All that's old is new again my friends, which makes Senator Daschle's book not only relevant but almost perfectly timed. 

Daschle begins by defining the problem. The American health care system is on the verge of collapse. You know it, I know it, hell, even John McCain admitted there was a problem here that needed to be solved. We spend more (over $7,400 per person, more than twice the average of the rest of the industrialized world) and get less (they cover everyone, we have 47 million people with no health insurance) than any country in our peer group. The book is full of many of the heart wrenching tales that those of us in the professions are so familiar with, such as the story of Monique White, a woman diagnosed with Lupus at age 21, and therefore uninsurable. Eventually she qualified for Medicaid, and her medical care stabilized. Tennessee then had the good sense to cut its Medicaid program to save some money though, meaning Monique lost her coverage, and couldn't afford the care needed for her chronic condition. 

She could always go to the Emergency Room though. That's what Republicans love to say when you say people  don't have health coverage in this country. That they can always go to the Emergency Room.  Most medical experts agree that going to the Emergency Room only when there's a crisis is the best way to keep a handle on a long term disease like Lupus. I'll let Daschle take up Monique's story from here:

In November 2005, Monique had a seizure and had to be rushed to Wellmont Bristol Regional Medical Center. Doctors there found that her kidneys had failed, her liver was failing, and her intestines were perforated. in the next ten weeks, doctors at Bristol Regional performed more than two dozen operations to clean up recurring dead tissue. The nonprofit hospital absorbed the $900,000 cost of her care, and she seemed to be recovering.

In February, however, doctors found a fungal growth near her heart valve. Bristol Regional wasn't equipped to perform the necessary surgery, so Monique was transferred to Duke University Medical Center in Durham, North Carolina. On May 28, two weeks after she suffered a stroke, her heart stopped.

About a week later, Tennessee sent a latter to Monique notifying her that it had put her back on the Medicaid rolls. 

I'm sure what is far more upsetting to our Republican friends though, is the effect our health care crisis is having on corporations. General Motors pays nearly $1500 per vehicle in health care costs, BMW $450 for every vehicle produced in Germany thanks to its national health care system, and Honda $150 per vehicle in Japan. I have a feeling that fact will do a lot more to get us a solution to this problem than the fact Monique literally got screwed to death by the clusterfuck we call a health care system here. 

Daschle's solution involves two bold proposals; building on the current employer/government hybrid we have now with the expansion of the Federal Employee Health Benefits Program, and the creation of a Federal Health Board modeled on the Federal Reserve. The idea behind the expansion of the FEHBP being to provide a floor of basic benefits to those falling through the cracks of our current system, and the idea behind The Federal Health Board proposal being that 1) This problem is of such scale that only the Federal Government can solve it, and 2) You can't trust our elected representatives to manage health care policy. Think of it this way: as fucked up as things are in the economy at the moment, we're better off with Ben Bernanke trying to run the money system than we ever would be with 535 people with giant egos who don't know anything about money and can't see past the next election, and we would be better off with people who know something about health care, appointed by the president and confirmed by the Senate overseeing an improved American health care system than we ever would be with 535 people with giant egos being lobbied by Big Pharma.

Plus, if we wanted to, we could make the head of The Federal Health Board testify before Congress twice a year the way we make the head of the Federal Reserve do. Imagine if we could make the CEO of Humana Health Care haul his ass before Congress twice a year to explain his job performance. That would rule. 

Does that mean I agree with everything Daschel's proposing? Nope. I am an unapologetic left-wing radical, and in my health care world, private health insurance companies would be banished to the depths of hell forever. I tell you what though, Tom Daschle's health care world beats the living snot out of what we have now, and in the end, I was happy just to read a serious, thoughtful proposal to solve one of our nations problems by someone who will soon be part of the executive branch of our government. Because in case you haven't noticed, there hasn't been a lot of serious, thoughtful anything coming from the executive branch of our government in the last eight years. 

Thirteen days my friends.  

5 comments:

Jake Mock said...

+1

jOoLz said...

thirteen days that'll seem like an eternity.

my husband and i are among the 47 million uninsured, and i have a couple issues i've been putting of dealing with from lack of funds.

thank you for being such an unabashed left-winger, drug monkey.

Scritches.com said...

I get chills when I count the days to January 20. Life will return to the nation.

Anonymous said...

"About a week later, Tennessee sent a latter to Monique notifying her that it had put her back on the Medicaid rolls. "

My Aunt died in 2000 and we still get a letter every year notifying her that she will be covered. My mom has tried three times to notify them that she's deceased. She finally gave up. They've been covering a dead person for over eight years.

Anonymous said...

"Private health insurance companies would be banished to the depths of hell forever."

Right on, DrugMonkey!