Carpetbagger has an excellent reminder that a bill conceived in the most underhanded possible manner probably won’t result in good legislation:
The program was passed in 2003 under unusual circumstances that included bribes on the House floor. Before lawmakers agreed to the plan, the administration went to great lengths to deceive Congress about the cost estimates for the plan. Once it became law, and seniors started to learn about the new program, everyone was completely confused and couldn’t figure out what to do.
Steve (aka Carpetbagger) neglects to mention that the bill only passed after House Republicans flouted standing rules and kept voting open through the night. Recall how Republicans reacted when House speaker Jim Wright held voting open for all of 15 extra minutes in 1987:
Republicans denounced this as an outrageous departure from regular order. Then-Rep. Trent Lott (R-Miss.) railed against “Jim Wright and his goons.” And a Republican congressman named Dick Cheney denounced the move as “the most arrogant, heavy-handed abuse of power I’ve ever seen in the 10 years that I’ve been here.”
Ye gods, how today’s Congress must wound his conscience. Cut to Dick Cheney, today, standing on a windswept field observing Tom DeLay’s congress and, silently, shedding a single tear.
Anybody who could read predicted that the implementation would be a disaster. The White House said that they’re on it, which obviously turned out to be complete bullshit:
It’s a Government Accounting Office report, issued in December, warning that the Bush administration hadn’t done enough to make sure the most medically and financially vulnerable Medicare beneficiaries could actually get their drugs.
If you do get around to reading it, make sure to check out the part where Mark McClellan, director of the Center for Medicare and Medicaid Services, says the GAO has it all wrong — the part where he insists that “CMS has established effective contingency plans to ensure that dual-eligible beneficiaries will be able to obtain comprehensive coverage and obtain necessary drugs beginning January 1, 2006.”
Carpetbagger (same post) and practically everybody else have first-draft surveys of the ongoing train wreck. Take the time to read Hilzoy’s post at Obsidian Wings:
So: what would Medicare Part D mean for me? For starters, this business about not being able to get medication for days would be, for me, a very serious problem. As I said, it seems to take four days after I stop taking medication for me to have a seizure. Predictable as clockwork. If I couldn’t get medication, I would probably have one. That being the case, if I had the money to buy some, I would, even if it meant not eating for a while. And if I didn’t, I’d probably have my first seizure in 21 years.
Let’s assume I had this seizure in optimal circumstances: while lying in bed, for instance. It would still be a very big deal for me. You see, the only reason I am allowed to drive is because I haven’t had a seizure for so long. If I had one, I’d lose my license, and for good reason. As it happens, I live outside Baltimore, and without my car I would, essentially, be marooned. That would be a serious problem, to put it mildly. I would absolutely have to move. No question about it. And I’d be thanking the Republicans in Congress who designed this program all the way.
Let’s suppose, though, that I was lucky enough not to have any problems with enrollment. Would I be OK? No. It turns out that the medication I take — Mysoline/primidone — is not covered by almost any plan. (And for some unfathomable reason, prescription drug programs are barred by law from covering barbiturates, which are also used to treat epilepsy.)
Worth reading in full. This bill simply can’t be explained away as something that government just does. Every clause of the bill was written for somebody’s sake. If not for the patients, then for whom? No point in being coy. We all know for whom. Banning certain generics and banning the government from negotiating lower prices spells it out pretty clearly. I guess the theory is that some of that Pharma/insurance company wealth will trickle down to the medicare recipients after they’re dead.
slide
are there any doubts anywhere that this is the most incompetent administration imaginable?
Jill
This was a mess from the beginning. No one should be surprised by any of this chaos. This Administration NEVER does the right thing, especially when it involves low income citizens. The real beneficiaries of this deal are big Pharma, and that was predicted from the beginning.
Jill
Can we find one thing this Administration has touched that hasn’t turned to s**t?
Lines
When the press starts pointing out that this Administration is giving every appearance of failing on purpose, that they are designing everything they do to fail spectacularly, then maybe America can start to recover from it. Failing just to make the point that they believe the Federal government is incapable of managing its citizens and responsibilities is juvenile and reprehensible.
How much evidence does there have to be to prove this is exactly what they are attempting to do?
Mike
I wonder how many seniors will eventually die because of this cluster? Most.Incompetant.President.Ever.
Doctor Gonzo
This administration never cared about a working program. Like everything they do, it’s to get votes, to win one more election. Come up with a good-sounding program, use it to make Republicans look good and to demonize Democrats, and forget about it once it has served its political purpose. The consequences? Who cares?
Ancient Purple
I wonder how long it will take before someone comments on this thread about how we just need to be patient and everything will work out and, besides, the states can pick up any slack like they are doing now.
Yup. Primo legislation, compliments of DeLay, Hastert, and Bush.
Kudos.
Jill
I hope there are enough digruntled low-income seniors still alive when November rolls around this year.
Jimmie
Just another example of why a ginormous government program is exactly the wrong way to deal with health care. Is anyone at all surprised that this has turned into such a boondoggle?
Pb
Yes, Tim F., no point in being coy, although you probably do have to spell it out for some people.
Flashback:
Why, indeed.
I’ll assume you meant, “somebody like Gore”.
Jill
Ths program was never set up to be a success and the critics of the plan have stated that from the beginning. Using a poor plan to say that government doesn’t work is pure hypocrisy.
Steve
Jimmie aptly illustrates why DougJ is such a successful parody. If you put the two of them in a line-up, you couldn’t tell them apart.
Let me break things down to a pretty basic level in hopes of making a point some people may not have thought about.
When you handle insurance through a “ginormous government program,” to use Jimmie’s words, you’re obviously going to get some amount of bureaucracy and inefficiency.
But on the other hand, a large program has much more market power. A large private insurance carrier has the ability to negotiate better prices for its customers, by flexing its market power. They can go to a big pharma company and say, “Look, your drug normally sells for $200, but we only want to pay $100 when our clients use it. If you don’t like that, then we’ll take it off our list of approved drugs and you’ll lose business from our millions of clients.”
But when you write a law that prohibits Medicare from negotiating lower prices, you completely eliminate this benefit – one of the major reasons why you would want to do business with a “ginormous” insurer in the first place. It’s nothing more than a huge, huge giveaway to the pharmaceutical companies, who get to charge far more than what the negotiated rates would be in a free and competitive marketplace.
So it’s no accident that in a Republican-sponsored plan, where free-market principles are abandoned in favor of this statutory giveaway to Big Pharma, the plan participants end up getting a raw deal. It has nothing to do with Big Government and everything to do with the fact that Republicans wrote the plan.
Jimmie
So you say, Jill. Some would say that we have ample examples of just how bad a government-managed health care system is and this is just another one.
Really. An enourmous government program turns out almost immediately to be incompetent and inefficient? Why I’m simply shocked and appalled. Next you’ll be telling me that there’s no such thing as the Tooth Fairy.
Krista
I would say that we also have ample examples of how a government-managed health care system can be much better, and more beneficial to citizens, than by everybody relying on private insurance (and that’s if they can afford it.)
Don’t get me wrong, I’m usually quite skeptical of government’s ability to tie their own shoes. But when it comes to my health, I have a lot more trust in the government than I do in corporations.
Jorge
Funny, Medicare and Medicaid worked just fine before Bush. They were actually leaner than most insurance and had a much lower overhead. The big elephant in the room for Republicans is that programs like Medicare, Medicaid and Social Security have been very successful and very efficient. Now is the time when someone mentions that if the economy underperforms to about half the rate of the past 100 years that these programs will not be able to fully fund themselves sometime in the next 25 to 50 years.
Steve
There are some businesses that it just makes sense for the government to be in. Insurance is one of them, if you know anything about how insurance works.
Pb
Hey Jimmie, some (enormous or otherwise) government programs can be incompetent (FEMA) or inefficient (The Department of Defense), but others–like Social Security and (regular) Medicare–can be both quite competent and efficient. The reasons for this vary, as reasons often do (although lobbying, corporate influence, and corruption are big ones), and in stark contrast to your simplistic generalizations. And Krista, I agree, the only thing I find less credible than “we’re from the government and we’re here to help” would be–for example–“we’re from Monsanto and we’re here to help”. Then again, it doesn’t make as much of a difference when they’re all in it together anyhow.
D. Mason
This is about as transparent as it gets. The huge pharma industry is ready to reap it’s rewards for helping put this crook in the white house. Smearing public figures and silencing political opponents is expensive and the’re ready to collect some dividends on their investment.
Jimmie
Krista, exactly how has the government given you a reason to trust that they can handle your health any better than they can handle…say…the War on Drugs, Disaster Management, the War on Poverty, collecting taxes (how much, exactly doesn’t get collected every year because the IRS has just flat failed?), educating your children, or managing your retirement (a 2 percent return? WooHoo…call me Mr Moneybags!)?
I’ve been using private insurers my whole life, even when I was but a poor college student and had to pay for it myself and I’m doing very well.
No, when it comes to my health, I’ll make my own choices, thank you very much and I’ll get a better and, more importantly, competent deal than any government entity can ever get for me.
Larry
If a medication is not listed in a plan’s drug list, you can request that it be included. I called AARP on behalf of a friend, and asked if they would cover a specific drug he needed. The rep said, “You have to sign up for the plan, and then we inform you of our decision.”
I told him that was insane, and he said that was the policy of ALL the plans. Well, that had to be bullshit, so I called three other plans, and by golly, he’s right.
Oh, the companies can also eliminate any drug from their covered list at any time.
Any questions about who wrote this law?
btw – The VA drug program works just fine, and they negotiate prices with Big Pharm.
Lines
Jimmie appears to be someone that believes that a government that can’t take care of its citizens through a workable prescription drug plan is one that can fight an effective battle against terrorism.
Why, Jimmie? What evidence do you have to that effect? That America hasn’t been hit with a terror attack in 4 years? We had NEVER been attacked before that, who’s plan kept us safe for 200 years?
Why do you believe that a govenment that puts Brown in charge of FEMA, lies and covers up its failures, an administration that can’t even write up a decent post-war plan, can keep you safer from terrorists?
Oh wait, its just because you’re a liberal bashing partisan hack.
If you can give up on the partisanship, I’d love to hear your excuses.
ppGaz
Take it from a Medicare-equippped household …. this thing is a giant clusterfuck of Katrina-like proportions, a good example of what happens when government is owned lock stock and barrel by corporations.
And we knew it the first time we heard about it. And the potatoheads were warned. Again, in Katrina-like fasion. It’s not like they “could not have anticipated” the problems.
If the Dems fail to make this a winning issue in 2006, then they don’t deserve to get the government back.
Lines
Larry:
No! The VA program doesn’t work, and neither does Social Security or Medicare. Where is my proof? Well Jimmie says so!
Krista
Just because your government is run by an incompetent, who posts similar incompetents to run vital government programs, doesn’t mean that government programs can’t work. They can, if they’re run by someone who doesn’t have his head firmly lodged up his ass.
Seeing as I’ve been using a public medicare program since day 1 of my existence, which includes a few visits to the ER and a major surgery, and have not had to pay anything for them, then I’d say that government-run medicare programs can work just peachy-keen. I would not be able to afford private insurance right now. And I don’t think I’m wrong in saying that there are a substantial number of Americans who can barely afford food and housing, let alone health insurance. It’s obscene for a civilized, first-world nation to have ANY of their populace unable to afford necessary health care.
I used to work for a private health insurance company, and believe me, when assessing claims, they look for a reason to reject, not a reason to accept, your claim. So if you, or anybody, wants to go through a private insurer, great. Nobody’s going to stop you…it’s your choice. But should there not be something in place for those who do not have that option?
ppGaz
Exactly right, and a lesson that the right is learning slowly, but unfortunately …. at our expense.
It isn’t like we didn’t tell them this would happen. Who thought that having health care decisions accountable to stockholders was a better idea than having them accountable to voters? Because that’s the choice that we’re talking about here. Stockholders, or voters?
Is this the United States of Corporations? Then it’s time to re-write the Constitution.
Jill
You know when we’ll get universal health care from our government?…When big business finally gets behind it. It won’t be long before big business realizes that they need the government to provide health insurance for their employees because and frankly I’m surprised this hasn’t happened already.
Pb
Jill,
Well, Wal-Mart thought it had it all figured out at least, although Maryland has caught on to their tricks.
Larry
YessireeBob
And allowing them to act as ‘Persons’ is complete and utter bullshit.
Barry
Jimmie, the faux-libertarian schtick is pretty much passe, this far into the GOP administration.
Jill
PB,
This is exactly why insurance companies cannot run health care. Profits and health care do not mix.
ppGaz
This article will point you to an excellent series
… on the whole subject, from a surprising source: A Gannett newspaper, in Arizona. The series started on Sunday and runs through at least this coming Sunday.
Read it all, as they say. It’s eye-opening and thought-provoking.
Lines
hey, trickle down pharmacuticles, that could be like the homeless being sold the urine of rich people that are on the same medications they themselves need.
Faux News
I think an article in The Onion best sums up the whole situation:
http://www.theonion.com/content/node/44455
ppGaz
Once again, The Onion shows the way. That material is gold.
Darrell
Govt healthcare doesn’t work no matter who is in charge Krista. Your country has far fewer MRI machines per capita and your citizens don’t have access to many drugs available here because of rationing.
Longer wait times for surgery, etc has been the modus operandi in your country for a while now.
ppGaz
You’re going to have to do better than copy and paste Pfizer talking points, Darrell.
There’s a national crisis going on and it’s the direct result of intense lobbying and manipulation of government by large corporate interests. If you just repeat their bullshit, how exactly are you helping to solve the problem?
Krista
Granted. I will freely admit that our system has problems, and that a government-run system is not likely to be perfect. However, I still firmly believe that a government-run system is better than a free-market health-care system. We might have the long wait times for surgery, but at least we can afford to actually HAVE the surgery.
Darrell
ppgaz, did it ever occur to you that someone who disagrees with you is disagreeing based on logic and principle rather than parrotting the corporate line?
I’m well aware of the fact that there will be winners and losers no matter what decisions are made. I think Canada’s system is proof positive that the government “solution” is worse than the problems we experience now.
Krista is of course correct pointing out that everyone is covered. My problem is with the quality of that coverage, which is significantly below US standards now for those who have insurance coverage
Krista
Not necessarily.
Exactly, for “those who have insurance coverage.” So you’ve got my country, where everybody has at least decent coverage, and those who want better coverage have the option of purchasing private coverage to top-up their public coverage. Or, you’ve got your country, where the ones who can afford insurance have great coverage, but the ones who can’t afford insurance have NO coverage.
I think I’ll stick with my system, thanks. :) But I do think that there exists a possibility for combining the best of both systems. It’s starting to happen here, with private MRI clinics becoming available. Some people here are vehemently opposed to any privatization of health care. I’m a bit more pragmatic, and figure that if someone has enough money to “jump the queue” and go get it done privately, well…that makes the queue that much shorter for everybody else, doesn’t it?
Darrell
Krista, I though private insurance was prohibited in your country. When did it change?
Krista
I don’t know that it’s ever been prohibited. Not in my lifetime, anyway. A lot of larger companies offer group medical and dental to their employees. And a couple of insurance companies offer private (non-group) coverage. It winds up working out quite well for a lot of people. I used to have group coverage through my old workplace, and it would basically just cover a bunch of things that provincial coverage did not, like prescription meds, eyeglasses, massage therapy, CPAPs, prostheses, etc. My mom and my stepdad purchased Blue Cross for themselves, and between that and his provincial coverage, they do all right. I can’t afford private coverage right now, and my workplace doesn’t have group coverage, so any meds aren’t covered, but at least my regular doctor visits are, and if I had to have surgery, or go to the ER, or have a baby, I wouldn’t have to pay anything.
Pooh
Someone? Yes. You, based on past experience? No. Maybe try a different handle for when you are posting original thoughts and use “Darrell” for Powerline screen-captures?
Krista
The only rule is that any medical expenses HAVE to go through the provincial coverage first. They’re first payer. Always. Then, your private plan is your second payer, and then, if a spousal plan is applicable, it’s third-payer.
Krista
Sssshhhh guys. Darrell’s being nice. Stop poking him, and let’s just enjoy a nice reasonable discussion about healthcare, ok?
Pooh
My bad. Consider it retracted.
Faux News
.
Ah, that reminds me of the postings of a dittohead named “Call of the Right” (COTR) on F*company.com. It was amusing to watch COTR literally cut and paste talking points from every right wing and wingnut organization. God forbid you try to actually engage COTR in a real discourse. Not possible, he would literally melt down if so engaged.
Good times, good times.
Darrell
My understanding is that in Canada, you can’t use private insurance for any healthcare service already provided by the govt, no matter how slow or crappy that govt healthcare service may be.
Am I mistaken about that?
ppGaz
Which is why I opened to door, at the end of my slam, to you actually coming up with a solution to the problem.
If you do that, then I don’t care where your other idea came from, whether it was Pfizer or whether it was original, because the solution is what counts.
So ignore the Pfizer blast and come forth with your solution to the problem, and let’s have a go.
ppGaz
No, I can’t agree. Just because someone has “coverage” doesn’t mean that he is ahead of his Canadian counterpart.
How much is he paying for that coverage? How much does his employer pay? What are the restrictions, and what obstacles were placed in front of him wrt preexisting conditions? Can he change jobs and take the coverage with him … without spending his grocery money to do it?
In the US, you can be employed, and insured, and still screwed. You can be trapped in your job.
Read the series of articles I pointed to earlier, and you’ll see that this problem has a lot of faces and a lot of angles. It’s not as simple as “I can get my surgery in 3 weeks but my Canadian friend has to wait 3 months.”
Three months or no, people in Canada are not filing bankruptcy to pay for medical bills, or clinging to bad jobs in order to have health coverage, are they? They aren’t risking their families’ financial underpinnings by moving to a new job and going without health coverage for a while, are they? Or choosing between groceries or their prescriptions, are they?
Krista
It doesn’t really work that way. Using your private insurance wouldn’t make any kind of a difference in your level of care provided, or in your wait time. Using private insurance wouldn’t allow you to jump the queue. You’re talking about privately-funded vs. publicly-funded healthcare. I’m talking about privately-funded vs. publicly-funded insurance. Bit of a diff. there.
At the moment, in Canada, there are very, very few sources of privately-funded healthcare. As I mentioned before, there are a few private MRI clinics available, and I don’t doubt that demand will grow. But if I needed knee surgery, for example, and if I had private insurance on top of my provincial insurance, my wait would be no less. The only difference would be that my private insurance would probably cover things like a knee brace, an upgrade to a private room, and my painkillers afterwards.
Steve
The typical source of privately-funded health care in Canada is called “the United States.”
I used to have an argument about this with a friend in law school. He would point out that when rich people in Canada need surgery, they come to the United States. I would point out that when poor people in the United States need surgery, they often go nowhere. That’s basically how the whole argument went for three years.
He works for the IRS now, so I don’t argue with him any more.
Krista
Steve, you’re not wrong. I don’t doubt it one bit. I’m sure it bothers some people, as they don’t like the idea of people getting treatment sooner, just because they have money. But the way I see it is this: if the rich people want to go to the U.S. because they don’t feel that they should wait like the rest of us peons, well, so be it. They’re making the queue shorter for the rest of us.
Of course, there are people in Canada right now who see the potential cash cow in this, and are desperate to open up private surgeries, MRIs, and other services here. I can see a couple of things that people would quibble with about that, but on the whole, I think it’s fine, as long as their services are regulated through the CMA, and everything is above-board and properly done.
Krista
And some poor people in the U.S. do come up here, namely for cheaper meds. I can sympathize with them, but it does grate on me a bit to have people who don’t even live here benefiting from my tax dollars.
Darrell
US citizens have to pay for medical treatment in Canada. Are the prices cheaper in Canada for some drugs because of govt. subsidies?
Darrell
No, but they are suffering and dying because of long waits for surgery, lack of availability of life saving drugs, and lack of diagnostic equipment for early detection of health problems
ppGaz
I’m going to need a little more than your say-so, Darrell.
Are you suggesting that in a country with 15-20 uninsured and another 20 percent underinsured, people are not going without critically needed care and services?
You DO have the comparative stats handy, right?
And your proposed solution …. forthcoming?
ppGaz
That’s “15-20%”
Steve
Our goal should not be to ensure absolute equality of services although I understand why some people in Canada think that sounds fairer. Money always gets you more and that’s a basic tenet of capitalism.
The ideal is that everyone gets the same basic, sufficient level of services, and then people with more money get to do better. The most important thing is that no one goes without.
Easier said than done, of course, but that’s the aspiration. It seems to work pretty close to that in Canada. Arguing that things aren’t perfect isn’t really a response.
Darrell
Not perfect? How about near-catestrophic. People are dying on wait lists for surgery. Many drugs aren’t available, shortages of MRI’s and other diagnostic equipment
In other words, at least 192 people (probably more like 400+ if you include a reasonable percentage of those too instable for surgery and the ‘unspecified reasons’ for dropping off the list) either died or became too sick to have surgery before they could work their way to the front of the line.
Steve
Near-catastrophic? If I tried to characterize any health care issue in the US as near-catastrophic you’d laugh me off as a hysterial lib.
In Canada, we can assemble precise statistics for these eventualities because the people are all within the system. Do we even have the ability to determine what comparable numbers would be for the US? Because unless you have something else to compare to, there’s no benchmark whatsoever for deciding if these numbers are really “near-catastrophic.”
ppGaz
According to the Ministry of Health, in a summary dated Januray 10, 2006, and not seven years old like your example, persons who need emergency surgery are not placed on wait lists, but are treated immediately.
Darrell
Well then, those hundreds of patients in Ontario who died while waiting for surgery must not have qualified then as “emergencies”
ppGaz
Well, the document you cited was nearly seven years old. We might expect that there has been a change since then?
Morbidity from cardiac illness is a pretty complex subject. I know this because I’m a cardiac event survivor and surgery patient myself, and I pay rather close attention to these things.
I’m not finding that people are dying because they are waiting for surgery. Still looking.
But meanwhile, people suffering health problems for lack of care are suffering whether they are waiting on a Canadian list, or just left out because they can’t get care at all in the US. Without comparative stats, your info doesn’t mean much.
Did you read the materials I cited earlier?
searp
Germany seems to have a mixed healthcare system. My brother in law is in practice there.
He loves patients with private insurance, and I am sure that they get some extra efforts – they are much more important to his financial health.
Having said that, 3/4 of his patients have public insurance, and they get the same treatment. Same doctor, same equipment, same drugs.
German public health stats are better than ours, I believe, and the healthcare system costs a lot less.
I think the waiting line arguments only apply to those that have a lot of money. Those folks get accomodated one way or another. Always.
Krista
Got it in one.
Wait times are an issue. It has improved of late, though. And anybody who needs emergency surgery gets it pretty darned quickly. They’re really trying their best to make sure that everybody whose life depends on the care, gets the care quickly. It’s the other stuff that tends to have to wait — hip replacements, knee surgery, things like that.
I will admit that there’s room for improvement. One problem is that a lot of our doctors are heading down the U.S. to work, where they can make the big bucks. They make VERY generous salaries here, but a lot of them figure that if they go to the U.S., they’ll make enough to quickly pay off their student loans, and then come back. Well…that doesn’t happen, because they then get settled in, make friends, maybe meet someone special, and that’s the end of any thoughts of coming home. So the doctor shortages are contributing to the waiting times.
I had to go through a major surgery about 12 years ago, and yes, I had to wait about 6 months before it could be done. But if I lived in the U.S., I would not have been able to afford it.
Darrell
Assuming you didn’t work for a company providing insurance, or if you were under 18, that your parents had no insurance either. Even then, many people come in for surgery here in the US and either don’t pay, or negotiate payment terms with the hospital.
ppGaz
So, is it fair to say that the delays in care are due to resource shortages? Or is that an over-generalization?
Darrell
Yes, but not for the better
Maybe things have temporarily improved in Canada for those who meet the definition of emergency, but I would imagine that a lot of non-emergency waiting results in emergencies later
Steve
Still not a word from Darrell about any kind of comparative statistics. Just the argument that, as long as some people are dying in Canada, their health care system must be horrid.
Krista
I’m sure that’s a large part of it. And I’m also sure that there are many other factors of which I’m not aware.
Well, if they negotiate payment terms, that’s still probably a rather large monthly obligation for some people, and it would take a long time to pay off that bill. And how would anybody get away with just not paying? They must go to collections, and then their credit ratings are royally screwed for the next 7 years.
No, Darrell…our system has it’s flaws. There’s room for improvement. But, I still think that we’re on a better track than you are. I’ll have to dig around sometime to see if there are any U.S. stats on how many people have died due to not being able to afford treatment. I think that if you compare it to the Canadian people who have died while waiting for treatment, it’ll really be no comparison at all, even once you adjust the per capita figures. I won’t do that now, though. The Office is on. :)
via
“Mark McClellan, director of the Center for Medicare and Medicaid Services, says the GAO has it all wrong — the part where he insists that “CMS has established effective contingency plans ”
You know who this guy is? Scott McClellan’s brother.
February 20th, 2004 – WASHINGTON, D.C. – U.S. Senate Majority Leader Bill Frist (R-TN) today made the following statement in support of President Bush’s decision to appoint Mark McClellan as the new administrator of the Centers of Medicare and Medicaid Services (CMS):
“Dr. McClellan is the brightest, most capable person I know in formulating and implementing health care policy. In selecting Dr. McClellan, the President has clearly picked the best man for the job.”
Heckuva job, Markie.
ppGaz
Is that the British, or American, edition?
I’ve read that the British version is superior, but our show is just funny as hell.
ImJohnGalt
[sigh]
I’m going to be calm, and point out that context is everything. Just because some people died waiting for treatment doesn’t mean our healthcare is worse. How about this:
According to the World Health Organization’s report in 2003, Canada’s life expectancy at birth is 79.8 years, vs. 77.3 for the US. The OECD reported that maternal mortality at birth is 3.4 deaths per 100k births in Canada vs 9 per 100k in the US. More than half of Canadian receive mental health treatment vs about 1/3 of the US, according to the May 2003 issue of Health Affairs.
“By all measures, Canadians’ health is better,” says Dr. Barbara Starfield, a university distinguished professor at Johns Hopkins Medical Institutions. Canadians “do better on a whole variety of health outcomes,” she says, including life expectancy at various ages.
Add to this ppGaz’s points that nobody is trapped in a job because if they leave that can’t take their insurance with them, and won’t be covered for pre-existing conditions if they have to go to a new one. Throw into the mix the fact that *everyone* is covered, and I’ll take the system that seems to have better overall outcomes. Sure, you’re going to have instances where people put on waiting lists died. Triage happens in every medical system. The most severe cases are moved to the front – it’s not first in, first out. The government is working on wait times seriously for the first time in years and is already testing alternative methods that are showing some strong results.
Could we do better? Sure. I just read a few days ago a 10-country study that showed that there are a number of countries with single-payer health care that do not have long wait times, cost a lot less than the US and have significantly better outcomes (in terms of the typical macro health indicators). Interestingly, the major difference between them and Canada is that they allowed direct access to specialists, where Canada in fact requires your primary physician to issue a referral. Curious. I’ve been trying to find that health care study to post here.
I’d appreciate a cite Darrell for your claim that we don’t have access to drugs up here that you do in America. Unless they are experimental, I doubt there are many. You may recall that just a while ago, Canada promised to provide Tamiflu to the US, because there wasn’t enough.
In fact, I know personally of several drugs available OTC up here are only available by prescription down there. Oh, and the government does not *subsidize* drugs to keep the prices so much lower here. The government has negotiated low prices with drug makers, demanding lower prices for access to the market. You know, the sort of thing a responsible Medicare drug program would have allowed for in the US. Hell, border cities up here are inundated with *BUS TOURS* run by us companies ferrying seniors up to pharmacies in Canada to fill their prescriptions.
To me, it’s a matter of basic humanity, and much like Republican tax policy, if you’re rich, it’s all gravy, all the time. You can afford great insurance and the best doctors, and pay for it with the tax cuts that mostly benefited you. If you’re poor, you’re either not covered or trapped because you are too scared to leave an employer with coverage. If you aren’t insured and you have a catastrophic health event, you can’t even declare bankruptcy (thanks Joe Biden! [D-MBNA])
Kimmitt
Um, people die waiting for surgery all the time, if they’re too unwell to be operated on. You need to check your stats and make sure that you aren’t seeing someone messing with you.
Steve
Oh, there are certainly zillions of drugs that are available OTC in Canada and Europe that are prescription-only in the US. I don’t see how anyone could dispute that. Depending on who you talk to, it’s either because the US is the only country that cares about the health and welfare of its people, or because the government is bought and paid for by Big Pharma.
Krista
ppGaz – it was the American version of The Office. Steve Carell is absolutely brilliant. He’s almost painful to watch.
ImJohnGalt
Krista, I was actually reasonably surprised at Carell’s job. The US version of the office is one of the few remakes of a British sitcom (Upstair, Downstairs, anyone?) that approaches the brilliance of the original. It could be because Ricky Gervais (who played in the original the part Steve Carell plays in the new version) is a producer. If Carell is making you cringe, then he’s nailed it – there were times I watched the UK version through my fingers, it was so uncomfortable to watch.
If you get a chance, do try to see the original as well. Ricky Gervais also wrote and acted in a show call “Extras” post-The Office (which he also co-wrote), where he played an extra trying to find a working gig as an actor – lots of great cameos by Kate Winslet, Samuel L. Jackson, Patrick Stewart and Ben Stiller.
Also, he and his writing partner have free podcasts available from the Guardian’s website.
ppGaz
In case you are following the Arizona Republic healthcare series, or haven’t seen it at all, this link is handy
The series continues at least through Sunday the 22nd. It looks at many aspects of the problem and exposes how the middle class — and their employers — are being injured by a dysfunctional system.
Krista
ImJohnGalt said:
Steve said:
I’ve told you a million times…stop exaggerating!
There are certain drugs that are available OTC in Canada that aren’t in the U.S. And there are certain drugs that are available in the U.S., which have not yet been approved by Health Canada. Two different regulatory bodies…it’s going to happen.
ImJohnGalt – thanks for the correction about whether Canada subsidizes drugs. I was under the wrong impression. The price differences are pretty amazing. I was reading that the average cost of the Pill in the U.S. is $30 USD. I’m still looking for a Canadian average, but personally, I pay $26 CAD for two months’ worth. Big difference.
ppGaz
Just in case you needed any more evidence of just how badly they have fucked this program up ….
GTinMN
Oh, they’re on it, in fact they’re all over it. But the agenda here, as always, is about utterly discrediting government as a means of addressing the common good, while simultaneously looting the country for their ultra-rich supporters and themselves. They’re doing a heckuva job, too.
I used to think Darrell was a paid shill, and that’s of course not provable. His obsessiveness, utter paranoia and the lashing out is disturbing in any event, even more so if he’s doing out of some emotional need.
There’s no use having a dialogue with someone like that, believe me. My father is a classic example, and there’s no getting through to him. Ironically he has an IQ of 150+, used to be obsessed about the Commies, still goes on and on about the dozens of murders the Clintons committed. He listens to Rush and O’Reilly every day, and simply cannot process any evidence that his parroted views about anything might be untrue. He’s spouting conspiracy theories all day long unless you he gets distracted by his hobbies for awhile. Any attempted conversation about ANYTHING turns into a political diatribe about why the left is out to get him personally by the second sentence out of his mouth.
ppGaz
Darrell is your father?
Far North
The single biggest flaw IMHO in the US healthcare system is easy to see (for anyone with an open, objective mind).
Doctor, nurses, lab techs, pharmacists respiratory therapists, hospital administrators and all the other trained professionals in healthcare, all these people have a right to make a living off of our healthcare needs. But there is another group of people in America that make a living off of our healthcare needs. People in this group don’t know a damn thing about healthcare. That would be everyone associated with the medical insurance industry. The money I pay for healthcare not only goes to support medical field people, my healthcare money also pays for boats and houses, cars, college tuition and vacations and food, etc for insurance industry people. These are people that offer NOTHING towards our healthcare needs. Americans end up paying medical bills that have to be high enough of support both the medical profession and insurance industry. Is it any surprise that healthcare costs are so unreasonable in America?
Someone mentioned it earlier. Heathcare and private sector profit are not compatible. Americans can’t continue to support with their healthcare money both the medical professional and the insurance industry.