U.S. Healthcare

Health Care, North and South of the Border
(Nicholas Kristof)  … my column examines Canadian and American health care through the lens of Diane Tucker, an American who has had encounters with hospitals on both sides of the border. Canada does have health care problems, including waits and escalating costs, but the U.S. has even worse problems – including that we spend twice as much per capita and get significantly worse results.
8 June
Obama’s Health-Care Plan Would Include a Government Option
(ABC news) President Obama Wants a Health-Care Reform Bill on His Desk by August
Health insurers are skeptical of Democratic efforts that could present them with a government rival or restrict their profits. Blue Cross Blue Shield of America is planning advertisements opposing a “government plan,” without mentioning that the new plan would pose a rival to the company’s own. Republicans — left out of the administration’s planning — have already drawn battle lines.
6 June
Obama Fast-Tracks Health Care Reform
Even as the President Urges Senate Democrats to Move Quickly, a Congressional Budget Office Ruling Lowers a Hurdle that Tripped Up the Clinton-Era Reform Effort
5 June
Gawande at Harvard: Health System ‘Is Failing Our People’
“We’ve had a century of extraordinary scientific discovery about human health, but we’ve found ourselves with yawning gaps in our ability to provide it to people, here and around the globe. We have trouble managing its complexity, its costs, and its implications, for everything from how a country should structure its health systems to how we, as individuals, should manage the end of our own lives.” The Commencement Address
1 June
Atul Gawande: The Cost Conundrum – What a Texas town can teach us about health care.
(The New Yorker) McAllen … is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.
5 March
Obama’s Remarks at the White House Health Care Forum
“The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”
26 February 2009
Obama healthcare plan relies on the evidence
(Reuters) It pulls heavily from reports by the Commonwealth Fund, Institute of Medicine and others that show extending health insurance coverage to more people will save money by preventing illness or catching diseases early, before they become expensive. About 46 million Americans have no health insurance. The nonprofit Commonwealth Fund has also published studies showing that moving from paper medical records and prescribing to electronic technology can save money. Health information technology is a cornerstone of the Obama healthcare reform plan.
December 2008
Towers Perrin: Obama Health Care Reform Plan Raises Host of Questions for Employers
While President-elect Obama has made health care reform a centerpiece of his campaign platform, his proposal, to date, lacks important details. In addition, some aspects may undergo changes as the proposal develops into actual legislation introduced in Congress.
Senator Max Baucus (D-MT), chairman of the Senate Finance Committee and an influential voice on health care issues, recently released a white paper entitled “Call to Action: Health Reform 2009”, which describes an alternative vision for health care reform that bears many similarities to Obama’s proposal, but also some important differences.
18 November
Ted Kennedy Readies Universal Health Bill for 2009
Kennedy has called Baucus’s plan a “major contribution to the debate.” But Kennedy, long a leader on health issues, also “has had a head start,” as the WaPo put it, because he told his staff to start work on legislation months ago.
12 November 2008
HEALTH REFORM: Baucus Releases a Call to Action On Reform
Senate Finance Committee Chairman Max Baucus (D-MT) today released a health reform blueprint that would aspire to provide meaningful and affordable coverage to all Americans. The 98-page document—released just eight days after the election—provides further evidence of a growing coalition in Congress eager to tackle health reform in the coming year. Sen. Edward Kennedy (D-MA) promises his version before inauguration. Sen. Ron Wyden (D-OR) already has a bipartisan plan he developed with Sen. Bob Bennett (R-UT). (WSJ); NYT
1 November 2007
(NY Times Editorial) America’s Lagging Health Care System
Americans are increasingly frustrated about the subpar performance of this country’s fragmented health care system, and with good reason. A new survey of patients in seven industrialized nations underscores just how badly sick Americans fare compared with patients in other nations. One-third of the American respondents felt their system is so dysfunctional that it needs to be rebuilt completely — the highest rate in any country surveyed. The system was given poor scores both by low-income, uninsured patients and by many higher-income patients.
The survey, the latest in a series from the Commonwealth Fund, is being published today on the Web site of Health Affairs, a respected health policy journal. Researchers interviewed some 12,000 adults in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom and the United States. Given the large number of people uninsured or poorly insured in this country, it was no surprise that Americans were the most likely to go without care because of costs. Fully 37 percent of the American respondents said that they chose not to visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription in the past year because of the cost — well above the rates in other countries. Patients here were more likely to get appointments quickly for elective surgery than those in nearly all the other countries. But access to primary care doctors, the mainstay of medical practice, was often rocky. Only half of the American adults were able to see a doctor the same day that they became sick or the day after, a worse showing than in all the other countries except Canada. Getting care on nights and weekends was problematic. Often the care here was substandard. Americans reported the highest rate of lab test errors and the second-highest rate of medical or medication errors. The findings underscore the need to ensure that all Americans have quick access to a primary care doctor and the need for universal health coverage — so that all patients can afford the care they need. That’s what all of the presidential candidates should be talking about.
PAUL KRUGMAN : Prostates and Prejudices
“My chance of surviving prostate cancer — and thank God I was cured of it — in the United States? Eighty-two percent,” says Rudy Giuliani in a new radio ad attacking Democratic plans for universal health care. “My chances of surviving prostate cancer in England? Only 44 percent, under socialized medicine.”
It would be a stunning comparison if it were true. But it isn’t. And thereby hangs a tale — one of scare tactics, of the character of a man who would be president and, I’m sorry to say, about what’s wrong with political news coverage. Let’s start with the facts: Mr. Giuliani’s claim is wrong on multiple levels — bogus numbers wrapped in an invalid comparison embedded in a smear. Mr. Giuliani got his numbers from a recent article in City Journal, a publication of the conservative Manhattan Institute. The author gave no source for his numbers on five-year survival rates — the probability that someone diagnosed with prostate cancer would still be alive five years after the diagnosis. And they’re just wrong. More

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