Conservatives who want to repeal the estate tax on large fortunes ... the Frosts is that they are expected to sell their investment property ...

Meanies And Hypocrites | By E. J. Dionne Jr. | Friday, October 12, 2007; Page A17

Conservatives claim to be in favor of stable families, small businesses, hard work, private schools, investment and homeownership. So why in the world are so many on the right attacking the family of Graeme Frost?

The kids were treated, thanks to SCHIP. The Frosts spoke out so the public would know that real people lie behind the acronym.

Their reward was to be trashed on right-wing blogs and talk radio as if they were multimillionaires ripping off the system. The assault on the Frosts apparently began on the Free Republic Web site and quickly spread to National Review Online, Power Line and Michelle Malkin's blog, as well as Rush Limbaugh's radio show.
...

Most conservatives favor government-supported vouchers that would help Graeme attend his private school, but here they turn around and criticize him for . . . attending a private school. Federal money for private schools but not for health insurance? What's the logic here?

Conservatives endlessly praise risk-taking by entrepreneurs and would give big tax cuts to those who are most successful. But if a small-business person is struggling, he shouldn't even think about applying for SCHIP.

Conservatives who want to repeal the estate tax on large fortunes have cited stories -- most of them don't check out -- about farmers having to sell their farms to pay inheritance taxes. But the implication of these attacks on the Frosts is that they are expected to sell their investment property to pay for health care. Why?

Oh, yes, and conservatives tell us how much they love homeownership, and then assail the Frosts for having the nerve to own a home. I suppose they should have to sell that, too.

The real issue here is whether uninsured families with earnings similar to the Frosts' need government help to buy health coverage. With the average family policy in employer-provided plans now costing more than $12,000 annually -- the price is usually higher for families trying to buy it on their own -- the answer is plainly yes. ...

Sen. John McCain health car: Is a $5,000 tax credit going to guarantee they afford and access health insurance? Of course not

They Just Don't Get It | Submitted by Bill Scher on October 11, 2007 - 7:48pm.

Sen. John McCain rolled out his health care plan today, and said:

Right now, too many of our citizens don't have an insurance policy at all, and those who do are afraid they will lose the one they have - afraid they will get too sick, afraid to stay home and not work full-time, and afraid their benefits will disappear along with their job.

I believe that everyone should get a tax credit of $2500, $5000 for families.

Let's look again at the brave yet struggling Frost family of six.

Their combined income, before taxes, is $45,000. Mrs. Frost recently priced private insurance at $14,400 a year. And they can't even get a private company to accept them because of pre-existing medical conditions.

Is a $5,000 tax credit going to guarantee they afford and access health insurance? Of course not.

Sure, McCain paid some lip service to reducing the cost of health care, but he didn't propose much specific besides "greater competition" and caps on malpractice lawsuits (which only amount to 2% of all health care spending). The only significant reform he offered was reiterating his support for importing cheaper prescription drugs.

This is very much in line with what Joe Paduda wrote last month:

The GOP programs are not 'reform'. There is no evidence that these tax breaks will significantly improve the number of people with coverage, the quality of the care they get, or reduce the cost of insurance or medical care. None. Zippo. Nada. The GOP platforms are actually tax breaks, marketed as health care reform.

That's fine, but rather disingenuous.

It's also detached from reality.

children received appropriate medical care only 46 percent of the time when they visit health professionals, faring even worse than adults ...

U.S. children often lack quality medical care | By Tony Pugh | McClatchy Newspapers | * Posted on Wednesday, October 10, 2007

WASHINGTON — In the largest study of its kind, researchers found that America's children received appropriate medical care only 46 percent of the time when they visit health professionals, faring even worse than adults and raising serious questions about the quality of care delivered by the world's most expensive health system.
...
It followed the health care experiences of 1,536 children from 12 metropolitan areas over a four-year period. By interviewing the youngsters' parents, reviewing the children's medical records and comparing their treatments to established care standards, researchers found that even basic care was a hit-or-miss proposition for children who visit hospitals and pediatricians.

The study found only 19 percent of seriously ill infants with fevers had the right lab tests done, only 44 percent of youngsters with asthma were on the right medications and only 38 percent of youngsters were screened for anemia in their first two years of life.

In addition, only 31 percent of children ages 3-6 have their weight measured at annual checkups.
...
A 2006 RAND study found that adults get appropriate medical care about 55 percent of the time.
...
But the new study found that youngsters get appropriate care for acute illnesses, such as fevers, only 68 percent of the time and proper care for chronic conditions, such as attention deficit disorder, only 53 percent of the time.

Proper preventative care, the bread and butter of pediatric practice, was provided in only 41 percent of check-ups. Researchers gauged quality of treatment against 175 standards of care that cover 12 clinical areas.

"It is unconscionable that we spend $2 trillion on health care, more than any nation in the world, and get these results," said co-author Elizabeth McGlynn, an associate director of RAND Health. "We can do better, but this will not happen without serious sustained effort. This study tells us that it is time to begin." ...

they are willing to do their part to make it happen. 72% support the expansion of SCHIP, and 60% are willing to pay more in taxes ... for health insur

More Conservative Honesty Please | Submitted by Bill Scher on October 11, 2007 - 12:20pm.
...
I did overstate one point. I said Bush is proposing "less money" for SCHIP, which isn't quite right. He is proposing nominally more money, just not enough to maintain the number of kids currently in the program. It's essentially less money, but not literally.
...
Instead of thinking of ways for entrepreneurs to pursue the American Dream without having to worry about the basics in life, conservatives like Riehl are quick to make assumptions and mock them for their career choices -- at least, when the solution involves pooling our resources through our government to solve problems the private market hasn't tackled.

Apparently, entrepreneurs are only awesome when wealthy Americans are demanding tax giveaways.

Instead of helping Americans have more career choices, conservatives like Riehl would force more Americans to choose between their career and the health of their families. If millions of working class children remain at risk, so be it.
...
Because most Americans believe everyone should have health insurance and everyone should have a real opportunity to pursue the American Dream.

And they are willing to do their part to make it happen. 72% support the expansion of SCHIP, and 60% are willing to pay more in taxes so our government can guarantee health insurance for everyone.

The more honest conservatives are about their cold and callous vision for America, the easier it will be for American voters to make informed decisions about where we should go as a nation. ...

forms from our health insurance company inexplicably denying payment — or only partly paying — for something we believed was covered.

Hands to Hold When Health Care Becomes a Maze | By ALINA TUGEND | Published: October 13, 2007

I HAVE not dreaded thin envelopes so much since applying to college.

They are showing up with alarming regularity lately: forms from our health insurance company inexplicably denying payment — or only partly paying — for something we believed was covered.

We read the codes and try to figure out why we are paid $30 for a $300 visit; they may as well have been written in Latin.

And when we try calling, all too often we end up in a voice mail maze.
...
Mr. Claxton noted, for example, that the anesthesiologist assigned to your operation may be out of network and then “that’s extra money.” You can ask about getting one in your network, but it is not always clear whom to ask or if that request will be honored, he said.

Also, be sure to ask when making any appointment if the doctor is currently in the network. Just because it says so in your plan’s book or online does not mean the doctor is still in the plan. Avoid a nasty surprise when the bill comes.
...
Or, as happened to Karen Pollitz, a research professor at the Health Policy Institute at Georgetown University, an insurer can process a 12-year-old’s broken elbow as a workers’ compensation claim rather than as a sports accident — and then refuse to pay for it — simply because the doctor checked accident on the insurance form. ...

US has a far higher death rate than the European average: ... one in 4800 dies vs. one in 16,400 for top 10 Euro countries

U.S. maternal death rate higher than Europe's: report | Sat Oct 13, 2007 7:03pm EDT

WASHINGTON (Reuters) - The United States has a sharply higher rate of women dying during or just after pregnancy than European countries, even some relatively poor countries such as Macedonia and Bosnia, according to the first estimates in five years on maternal deaths worldwide.

The United States has a far higher death rate than the European average, the report shows, with one in 4,800 U.S. women dying from complications of pregnancy or childbirth, the same as Belarus and just slightly better than Serbia's rate of one in 4,500.

Just one out of 47,600 women in Ireland die during or just after childbirth, the report found. Bosnia had the second-lowest rate, with 1 in 29,000 women dying during pregnancy and childbirth.

"Among the ten top-ranked European and other industrialized countries, where women are guaranteed good-quality health and family planning services that minimize their lifetime risk, fewer than one in 16,400 will die from complications of pregnancy and childbirth," the United Nations, which issued the report along with the World Bank, said in a statement. ...

[Swift-boating SCHIP parents]::: "Let the parents get second jobs, let their state foot the bill or let them seek help from private charities."

Family under fire: Rush and Co. hit on healthcare | by Matthew Hay Brown

Halsey and Bonnie Frost, in front of their Butchers Hill home in Baltimore, have come under fire from conservative commentators for promoting the State Children's Health Insurance Program. Sun photo by Barbara Haddock Taylor .
...
But while the Frosts were helping a bipartisan majority in Congress sell a plan to expand the program, they were not prepared for comments such as this one, posted over the weekend on the conservative Web site Redstate:

"If federal funds were required [they] could die for all I care. Let the parents get second jobs, let their state foot the bill or let them seek help from private charities. ... I would hire a team of PIs and find out exactly how much their parents made and where they spent every nickel. Then I'd do everything possible to destroy their lives with that info."
...
It was the news coverage of that broadcast that set off the blogo- sphere. A pseudonymous contributor to Free Republic cataloged the $20,000 cost of tuition at the Park School, the $160,000 Halsey Frost paid for his warehouse in 1999 and the $485,000 for which a neighbor sold his home in March. Links were provided to photos of the Park School's 44,000-square- foot Wyman Arts Center and the Frosts' 1992 wedding announcement in The New York Times.
...
The four Frost children depend on financial aid to attend private school, the Frosts say. In addition, they say, Gemma receives money from the city for special education made necessary by her injuries.
...
The Frosts say the description of their family's circumstances now circulating is misleading. Halsey, they say, is a self-employed woodworker - he has no employees - while Bonnie works part time for a medical publishing firm. Together, they say, they earn between $45,000 and $50,000 a year.
...
Pelosi fired back yesterday.

"I think that the attack on this family is just breaking new ground and stooping to new lows in terms of what happens in Washington, D.C.," she told reporters. "I think it's a sad statement about how bankrupt some of these people are in their arguments against SCHIP that they attack a 12-year-old."

Most Americans may also have noticed that corporate bureaucracy and corruption .. are not preferable to government bureaucracy

Right-Wing Health Care Mythology | by Joe Conason Published: October 9, 2007

Once among the most frightening and effective epithets in American political culture, “socialized medicine” seems to have lost its juju. ...
...
Most Americans may also have noticed that corporate bureaucracy and corruption, which both figure largely in the present health care system, are not preferable to government bureaucracy. The same doctors who used to wail about the dangers of Medicare have learned how unpleasant it is to deal with dozens of insurance companies, each of which is creating different rules to cut costs and deny care as often as possible. So have their patients.

This corporate model is more expensive and less efficient than the government plans that provide care in every other industrialized nation.

And most Americans may have learned by now that such systems prevail in Western countries that aren’t normally categorized as “socialist,” including the United Kingdom, Japan, Spain, Canada, Germany, France, Denmark, Norway and Sweden. All these nations manage to provide their citizens with high living standards, industrial and technological innovation, and broad political and economic freedom, even after 50 years of national health insurance in some form.

Meanwhile, the credibility of conservatives has diminished steadily.

These days they seem to have trouble achieving clarity on the meaning of their favorite clichés. For instance, the president hates federalized health care, but sponsors a Medicare prescription drug program that wastes hundreds of billions on drug companies and private insurers.

Right-wing definitions no longer seem so clear, either. When the government awards a billion dollars in sweetheart mercenary contracts to a wealthy Republican family in Michigan, that’s “private enterprise.” But when the government helps a struggling middle-class family in Maryland to send its children to the doctor, that’s creeping socialism. ..

New Medicare Drug program: 10,000's victims of deceptive sales tactics, improperly denied claims ...

Medicare Audits Show Problems in Private Plans | By ROBERT PEAR | Published: October 7, 2007

WASHINGTON, Oct. 6 — Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration, a review of scores of federal audits has found.
...
UnitedHealth, which serves more than six million Medicare beneficiaries, did not have an “effective program” to supervise its marketing representatives, agents and brokers. In some cases, United improperly denied claims without giving any explanation to beneficiaries. ...

WellPoint, one of the nation’s largest insurers, had “a backlog of approximately 354,000 claims” at certain Medicare plans offered through its UniCare subsidiary. ...

In March, Sierra Health Services ended drug coverage for more than 2,300 Medicare beneficiaries with H.I.V./AIDS, saying they had not paid their premiums. In many cases, the premiums had been paid, and beneficiaries had canceled checks to prove it. ...

Humana, which covers more than 4.5 million people on Medicare, promised to investigate every complaint about its marketing practices, but it received so many complaints that it could not keep up. ...

The Sterling Life Insurance Company, a subsidiary of the Aon Corporation, did not pay claims correctly or handle appeals in a timely way. The company has “a demonstrated pattern of failure” to meet Medicare performance standards. ...

Two sponsors of popular Medicare drug plans, MemberHealth and Bravo Health, did not act on requests for coverage of specific drugs within 72 hours, as required by the government. ...

Either Bush didn't understand the bill he vetoed or he's just being petulant -- with the health of 4 million children at stake.

Bush's Veto Lies | By Eugene Robinson | Friday, October 5, 2007; Page A21

To say that George W. Bush spends money like a drunken sailor is to insult every gin-soaked patron of every dockside dive in every dubious port of call. If Bush gets his way, the cost of his wars in Iraq and Afghanistan will soon reach a mind-blowing $600 billion. Despite turning a budget surplus into a huge deficit, the man still hasn't met a tax cut he doesn't like. ... And for him to make his stand on a measure that would have provided health insurance to needy children is a punch line that hasn't left many Republicans laughing.
...
The program Congress voted to expand provides health insurance for children who fall into a perilous gap: Their families make too much money to qualify for Medicaid but don't make enough to afford health insurance. The cost of covering an additional 4 million children was estimated at around $35 billion over five years. That's a lot of money. But in the context of a $13 trillion economy -- and set against Bush's history of devil-may-care, "buy the house another round" spending -- it's chump change. ...
...
... Either Bush didn't understand the bill he vetoed or he's just being petulant -- with the health of 4 million children at stake.

Brain injuries from war worse than thought ..."These soldiers could have hidden injuries with long-term consequences,"

Scientists: Brain injuries from war worse than thought

Scientists trying to understand traumatic brain injury from bomb blasts are finding the wound more insidious than they once thought.

They find that even when there are no outward signs of injury from the blast, cells deep within the brain can be altered, their metabolism changed, causing them to die, says Geoff Ling, an advance-research scientist with the Pentagon.
...
This cellular death leads to symptoms that may not surface for months or years, Cernak says. The symptoms can include memory deficit, headaches, vertigo, anxiety and apathy or lethargy. "These soldiers could have hidden injuries with long-term consequences," he says.
...
To make matters worse, whatever damage occurred was so microscopic that it could not be found with imaging tests.
...
The microscopic damage changes brain cell metabolism, Cernak says, creating a cascading effect that leads to the premature aging and death of neurons that cannot be replaced. ...

More Profit and Less Nursing at Many Homes ... serious health deficiencies ... almost 19 percent higher at homes owned by large investment companies

More Profit and Less Nursing at Many Homes | By CHARLES DUHIGG | Published: September 23, 2007

Habana Health Care Center, a 150-bed nursing home in Tampa, Fla., was struggling when a group of large private investment firms purchased it and 48 other nursing homes in 2002.

The facility’s managers quickly cut costs. Within months, the number of clinical registered nurses at the home was half what it had been a year earlier, records collected by the Centers for Medicare and Medicaid Services indicate. Budgets for nursing supplies, resident activities and other services also fell, according to Florida’s Agency for Health Care Administration.

The investors and operators were soon earning millions of dollars a year from their 49 homes.

Residents fared less well. Over three years, 15 at Habana died from what their families contend was negligent care in lawsuits filed in state court. Regulators repeatedly warned the home that staff levels were below mandatory minimums. When regulators visited, they found malfunctioning fire doors, unhygienic kitchens and a resident using a leg brace that was broken.

“They’ve created a hellhole,” said Vivian Hewitt, who sued Habana in 2004 when her mother died after a large bedsore became infected by feces.
...
The typical nursing home acquired by a large investment company before 2006 scored worse than national rates in 12 of 14 indicators that regulators use to track ailments of long-term residents. Those ailments include bedsores and easily preventable infections, as well as the need to be restrained. Before they were acquired by private investors, many of those homes scored at or above national averages in similar measurements.
...
The Byzantine structures established at homes owned by private investment firms also make it harder for regulators to know if one company is responsible for multiple centers. And the structures help managers bypass rules that require them to report when they, in effect, pay themselves from programs like Medicare and Medicaid.
...
Some families of residents say those structures unjustly protect investors who profit while care declines.

When Mrs. Hewitt sued Habana over her mother’s death, for example, she found that its owners and managers had spread control of Habana among 15 companies and five layers of firms.

As a result, Mrs. Hewitt’s lawyer, like many others confronting privately owned homes, has been unable to establish definitively who was responsible for her mother’s care. ...
...
But in recent years, large private investment groups have agreed to buy 6 of the nation’s 10 largest nursing home chains, containing over 141,000 beds, or 9 percent of the nation’s total. Private investment groups own at least another 60,000 beds at smaller chains and are expected to acquire many more companies as firms come under shareholder pressure to sell.

The typical large chain owned by an investment company in 2005 earned $1,700 a resident, according to reports filed by the facilities. Those homes, on average, were 41 percent more profitable than the average facility.
...
The Times’s analysis of records collected by the Centers for Medicare and Medicaid Services reveals that at 60 percent of homes bought by large private equity groups from 2000 to 2006, managers have cut the number of clinical registered nurses, sometimes far below levels required by law. (At 19 percent of those homes, staffing has remained relatively constant, though often below national averages. At 21 percent, staffing rose significantly, though even those homes were typically below national averages.) During that period, staffing at many of the nation’s other homes has fallen much less or grown
...
The typical number of serious health deficiencies cited by regulators last year was almost 19 percent higher at homes owned by large investment companies than the national average, according to analysis of Centers for Medicare and Medicaid Services records. ..
====================================
September 22, 2007 | Layers of Ownership

Bush renews threat to veto children’s health legislation: SCHIP deal would raise cigarette taxes by 61 cents per pack to pay for expanded coverage

Bush renews threat to veto children’s health legislation | By Elana Schor | September 21, 2007

As negotiators closed in on a $35 billion deal to extend health insurance coverage for children, President Bush defied lawmakers with a fresh threat to veto the bipartisan bill that aggravated one senior Senate Republican.
...
Sen. Chuck Grassley (Iowa), senior Republican on the Finance Committee, had implored Bush to reconsider his veto vow. But after Bush incorrectly described the children’s health bill as providing coverage for families earning up to $80,000 a year, Grassley fired back.

“The president’s understanding of our bill is wrong,” Grassley said, his voice rising with anger. “I urge him to reconsider his veto message based on a bill we might pass, not something someone on his staff told him wrongly is in my bill.”

The SCHIP deal would raise cigarette taxes by 61 cents per pack to pay for expanded health coverage while taking aim at a Bush administration directive that would restrict states’ ability to raise income eligibility levels for the program. ...

Emergency Care Is Limited by U.S. Rule ... Bush administration ... increasingly denying state claims for federal payment for some emergency services

Immigrants’ Emergency Care Is Limited by U.S. Rule | By SARAH KERSHAW | Published: September 22, 2007

The federal government has told New York State health officials that chemotherapy, which had been covered for illegal immigrants under a government-financed program for emergency medical care, does not qualify for coverage. The decision sets the stage for a battle between the state and federal governments over how medical emergencies are defined. ...
...
Under a limited provision of Medicaid, the national health program for the poor, the federal government permits emergency coverage for illegal immigrants and other noncitizens. But the Bush administration has been more closely scrutinizing and increasingly denying state claims for federal payment for some emergency services, Medicaid experts said. ...
...
... Others, including New York, have defined an emergency as any condition that could become an emergency or lead to death without treatment. ...

no rational reason for the rising costs, and that there are huge disparities across the country ... $11,352 in Miami, #4,273 in Oregon

Expensive and divisive: how America is losing patience with a failing system | Suzanne Goldenberg in Washington | Thursday September 13, 2007 | The Guardian
...
Between the two extremes is where America's healthcare system has unravelled. A patchwork of employer benefits and government assistance for the very poor and elderly has produced distinct differences. Those with very good jobs and generous benefits packages enjoy extensive, often almost wasteful, health cover. Meanwhile, tens of millions regularly put their health on hold because they cannot afford basic treatment, prescriptions, or even a visit to the doctor.
...
The US spends about 16% of GDP on healthcare, a proportion expected to climb to 20% by 2015, according to the National Coalition on Health Care. At present spending levels of $1.6 trillion a year, which works out at $6,700 per capita, is double what is spent in countries such as France. And yet that still leaves some 47 million Americans entirely without health coverage, and tens of millions of others under-insured, according to latest census figures.

It also fails to guarantee a better service to those Americans with access to healthcare. The US ranks last or near the bottom on quality, access, efficiency, equity and healthy lives, according to a report in May 2007 from the Commonwealth Fund, which studies healthcare.

"The US healthcare system is considered a dysfunctional mess," writes Ezekial Emanuel, chairman of the department of clinical bioethics, in a recent issue of the Journal of the American Medical Association.
...
Healthcare experts say that there is sometimes no rational reason for the rising costs, and that there are huge disparities across the country. In Miami, for example, it will cost $11,352 a year to treat the average pensioner, but just $4,273 to treat one in Salem, Oregon, says the Dartmouth Atlas of Health Care. The cost of dying also varies from hospital to hospital, and state to state, the study found.

big money that drug companies spend on members of state advisory panels who help select which drugs are used in Medicaid programs

Financial ties link some docs, drug companies | Minn. law shines light into money big pharma spends on panel members | Updated: 3:54 p.m. CT Aug 21, 2007

ST. PAUL Minn. - A groundbreaking Minnesota law is shining a rare light into the big money that drug companies spend on members of state advisory panels who help select which drugs are used in Medicaid programs for the poor and disabled.

Those panels, most comprised of physicians, hold great sway over the $28 billion spent on drugs each year for Medicaid patients nationwide. But aside from Minnesota, only Vermont and Maine require drug companies to report payments to doctors for lectures, consulting, research and other services.

An Associated Press review of records in Minnesota found that a doctor and a pharmacist on the eight-member state panel simultaneously got big checks — more than $350,000 to one — from pharmaceutical companies for speaking about their products.

The two members said the money did not influence their work on the panel, and the lack of recorded votes in meeting minutes makes it difficult to track any link between the payments and policy.

But ethical experts said the Minnesota data raise questions about the possibility of similar financial ties between the pharmaceutical industry and advisers in other states. ...

The key years are early childhood -- with those children receiving the best nutrition and suffering the least illness growing the best

America Loses Its Stature as Tallest Country | By Rob Stein | Washington Post Staff Writer | Monday, August 13, 2007; Page A06
...
U.S. adults lost their position as the tallest people on Earth to the Dutch, who average about two inches taller than the typical American. In fact, American men now rank ninth and women 15th in average height, having fallen short of many other European nations.

"Americans, who have been the tallest in the world for a very long time, are no longer the tallest," said John Komlos of the University of Munich, who has published a series of papers documenting the trend. "Americans have not kept up with western European populations."
...
"We conjecture that perhaps the western and northern European welfare states, with their universal socioeconomic safety nets, are able to provide a higher biological standard of living to their children and youth than the more free-market-oriented U.S. economy," Komlos wrote in one of his latest papers, published in June in the journal Social Science Quarterly.
...
Komlos's most recent analysis excluded Hispanics and Asians to try to eliminate the effect of immigration. In another paper that has not yet been submitted for publication, Komlos produced similar findings examining military records that enabled him to exclude people whose parents were born elsewhere to further account for immigration. And another paper being published soon found identical trends among children -- height stagnated among children in the United States for several decades beginning in the 1950s but continued to increase among Europeans.

"That explains why the western Europeans overtook the Americans," Komlos said.

Height is considered a bellwether of a society's well-being. As wealth increases, often so does height. Wealth usually improves nutrition and medical care, enabling people to reach their maximum growth potential and live longer. The key years are early childhood -- with those children receiving the best nutrition and suffering the least illness growing the best. ...

Many Americans are under the delusion that we have “the best health care system in the world,”

Editorial | World’s Best Medical Care? | Published: August 12, 2007

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.
...
Seven years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations. France and Italy took the top two spots; the United States was a dismal 37th. More recently, the highly regarded Commonwealth Fund has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data. Its latest report, issued in May, ranked the United States last or next-to-last compared with five other nations — Australia, Canada, Germany, New Zealand and the United Kingdom — on most measures of performance, including quality of care and access to it. Other comparative studies also put the United States in a relatively bad light.

Insurance coverage. All other major industrialized nations provide universal health coverage, and most of them have comprehensive benefit packages with no cost-sharing by the patients. The United States, to its shame, has some 45 million people without health insurance and many more millions who have poor coverage ...

Access. Citizens abroad often face long waits before they can get to see a specialist or undergo elective surgery. Americans typically get prompter attention, although Germany does better. The real barriers here are the costs facing low-income people without insurance or with skimpy coverage. But even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room, ...

Fairness. The United States ranks dead last on almost all measures of equity because we have the greatest disparity in the quality of care given to richer and poorer citizens. ...

Healthy lives. We have known for years that America has a high infant mortality rate, so it is no surprise that we rank last among 23 nations by that yardstick. But the problem is much broader. We rank near the bottom in healthy life expectancy at age 60, and 15th among 19 countries in deaths from a wide range of illnesses that would not have been fatal if treated with timely and effective care. ...

Quality. .... high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. But we scored poorly in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting their needs and preferences, which drove our overall quality rating down to last place. American doctors and hospitals kill patients through surgical and medical mistakes more often than their counterparts in other industrialized nations.

Life and death ... United States ranked last in years of potential life lost to circulatory diseases, respiratory diseases and diabetes and had the second highest death rate from bronchitis, asthma and emphysema. ...

Patient satisfaction. ... American attitudes stand out as the most negative, with a third of the adults surveyed calling for rebuilding the entire system, compared with only 13 percent who feel that way in Britain and 14 percent in Canada. ... Americans face higher out-of-pocket costs than citizens elsewhere, are less apt to have a long-term doctor, less able to see a doctor on the same day when sick, and less apt to get their questions answered or receive clear instructions from a doctor. ...

Use of information technology. Shockingly, despite our vaunted prowess in computers, software and the Internet, much of our health care system is still operating in the dark ages of paper records and handwritten scrawls. American primary care doctors lag years behind doctors in other advanced nations in adopting electronic medical records or prescribing medications electronically. ...
...
... The main goal should be to reduce the huge number of uninsured, who are a major reason for our poor standing globally. But there is also plenty of room to improve our coordination of care, our use of computerized records, communications between doctors and patients, and dozens of other factors that impair the quality of care. ...

market based health-care: The doctor, not the patient, orders the care. There’s no easy exit from the market for patients.

Saturday, August 18, 2007 by The Toledo Blade | Tax-Financed Health Care Offers More Value | by Johnathon S. Ross

Shame on all of us, especially those of us in positions of public trust. Forty-five million of our friends, family, and neighbors, including 1.3 million Ohioans, have no health-care coverage at all.

Tens of millions more are at risk of bankruptcy even though they have insurance. Their coverage is too skimpy to protect them financially.

What do the current conservative leaders of many states and the nation have to say about the fact that we spend twice as much as any other industrial democracy in the world and yet fail to cover 16 percent of the population? To paraphrase Marie Antoinette, “Let them buy high-deductible health plans.”

But who are the uninsured? They are mainly (75 percent) lower-income working people and their kids. Most of these folks struggle to keep food on the table and the lights on. They can’t afford even bare-bones policies.

What are the facts, not the hype, on market-based reforms such as Health Savings Accounts (HSAs), high-deductible health plans, and mandated insurance (a la Massachusetts)? These represent the next bogus effort to keep private insurers in charge of our crumbling sickness care non-system. Remember how they promised that a competing insurance market of Health Maintenance Organizations was going to save American health care?

Unfortunately, despite the nostrums of the market ideologues, health-care costs have continued to soar at twice the growth rate of the gross domestic product while 10 million more have gone uninsured. Pound as they might on the square peg of market forces, health care will never be a nice round market commodity.

Why? The consumer’s not sovereign. The doctor, not the patient, orders the care. There’s no easy exit from the market for patients. When critically (and expensively) ill, you buy or die. The most expensive health care is not necessarily desired. If open-heart surgery were on sale would you have two?

There’s often inadequate information to make wise purchasing decisions. Sometimes the best doctors are unsure of the wisest course of action for a patient. It is the uncertainty of illness and its attendant costs that creates the need for insurance in the first place.

The profit motive runs contrary to the best cooperative and Samaritan traditions of medical practice and training. There are lots of natural monopolies. Should we build another hospital in Bowling Green so that the competition will leave them both half-empty? The market for medical services fails these tests of an effective market and will fail in the guise of health savings accounts.

The 10 percent of patients who are very ill generate 70 percent of the costs, averaging $39,000 per year. They will never save anything in their HSAs. Studies confirm that high out-of-pocket costs, the hallmark of HSAs, yield worse health outcomes for the poor, elderly, and chronically ill.

The health-care bureaucracy already consumes 31 percent of spending. The fees for tracking 300 million individual HSAs would only aggravate this shameful waste.

Half of personal bankruptcies are due to uncovered health-care bills, again the hallmark of HSAs. Even boosters of HSAs (Mckinsey and Co.) find 56 percent of employees less satisfied with their new accounts than their old health plans. ...
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The Institute of Medicine estimates that 18,000 Americans die each year from lack of health insurance alone. ...

“Hundreds of thousands of people suffer needlessly from preventable hospital infections and medical errors every year,”

Medicare Says It Won’t Cover Hospital Errors | By ROBERT PEAR | Published: August 19, 2007

WASHINGTON, Aug. 18 — In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients.
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Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products.

“If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm,” said Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services.
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“Hundreds of thousands of people suffer needlessly from preventable hospital infections and medical errors every year,” Ms. McGiffert said. “Medicare is using its clout to improve care and keep patients safe. It’s forcing hospitals to face this problem in a way they never have before.”

Christine K. Cahill, a registered nurse who used to inspect hospitals for the California Department of Public Health, said: “This is a great start. Infection-control specialists have been screaming for 20 years that federal and state officials should pay more attention to this problem because hospital infections hurt patients and cost money.” ...

Number of Americans without health insurance hits new high ... jumped by 2.2 million in 2006

Number of Americans without health insurance hits new high

WASHINGTON — The continued loss of job-based coverage helped push the number of Americans without health insurance to 47 million last year, the highest total on record and the sixth straight year that the ranks of the uninsured have grown.

New annual Census Bureau survey data released Tuesday showed that the number of uninsured Americans jumped by 2.2 million in 2006, from 15.3 percent of Americans in 2005 to a record-tying 15.8 percent last year. The number of uninsured children increased for the second straight year as well, spiking by more than 611,000 last year to nearly 8.7 million.
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The significant increases in the number of Americans without health insurance are unprecedented because they occurred in a fairly strong economy and at a time when health-care premium increases have been moderating, said Diane Rowland, executive vice president of the Kaiser Family Foundation, which studies health-care issues.

"I think the bad news from the statistics today is that when the economy is doing fairly well, we're still seeing a continued erosion in the ability of working families to get health coverage through the workplace, which places more and more people at risk of being uninsured," Rowland said.

With health care a top concern going into the 2008 elections, America's health-care system and the growing numbers of uninsured also have become political issues.
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The growing number of uninsured Americans during Bush's two terms in office reflects the administration's limited attention to the problem and its misguided policy proposals to address it, charged Cindy Mann, executive director of the Georgetown University Center for Children and Families.

While the president has pushed for health savings accounts and tax incentives to help people buy private coverage, those measures haven't taken off in the marketplace or won approval in Congress, Mann said.

U.S. has second worst newborn death rate in modern world: beats Latvia ... For African-Americans, the mortality rate is nearly double ...

U.S. has second worst newborn death rate in modern world, report says Research: 2 million babies die in first 24 hours each year worldwide | By Jeff Green | CNN | Wednesday, May 10, 2006

(CNN) -- An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.

American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.

Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.

"The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries," said the annual State of the World's Mothers report.

The report, which analyzed data from governments, research institutions and international agencies, found higher newborn death rates among U.S. minorities and disadvantaged groups. For African-Americans, the mortality rate is nearly double that of the United States as a whole, with 9.3 deaths per 1,000 births. ...

a child who doesn’t receive adequate health care ... or adequate education ... doesn’t have the same chances in life as children who get both ...

Monday, August 27, 2007 by The New York Times | A Socialist Plot | by Paul Krugman
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So let’s end this un-American system and make education what it should be - a matter of individual responsibility and private enterprise. Oh, and we shouldn’t have any government mandates that force children to get educated, either. As a Republican presidential candidate might say, the future of America’s education system lies in free-market solutions, not socialist models.
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The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care. It’s just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children’s medical bills “welfare,” with all the negative connotations that go with that term.

And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.

Here’s what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that. For example, N. Gregory Mankiw, the former chairman of the Bush Council of Economic Advisers, contrasts the position of liberals, who he says believe in equality of outcomes, with that of conservatives, who he says believe that the goal of policy should be “to give everyone the same shot and not be surprised or concerned when outcomes differ wildly.”

But a child who doesn’t receive adequate health care, like a child who doesn’t receive an adequate education, doesn’t have the same shot - he or she doesn’t have the same chances in life as children who get both these things. ...

Army argued it bore no responsibility for his illness and medically discharged him in 2005 without the disability benefits

U.S. military practices genetic discrimination in denying benefits | By Karen Kaplan | August 18, 2007

Those medically discharged with genetic diseases are left without disability or retirement benefits. Some are fighting back.
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Lurking in his genes was a mutation that made him vulnerable to uncontrolled tumor growth. After suffering back pain during a tour in Afghanistan, he underwent three surgeries to remove tumors from his brain and spine that left him with numbness throughout the left side of his body.

So began his journey into a dreaded scenario of the genetic age.

Because he was born with the mutation, the Army argued it bore no responsibility for his illness and medically discharged him in 2005 without the disability benefits or health insurance he needed to fight his disease.
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While genetic discrimination is banned in most cases throughout the country, it is alive and well in the U.S. military.
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"Something's wrong here when ... the one that spends the most on health care, is not able to keep up with other countries,"

U.S. life span shorter | By Stephen Ohlemacher, Associated Press Writer | August 11, 2007

WASHINGTON --Americans are living longer than ever, but not as long as people in 41 other countries.

For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands.

"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington. ...
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Researchers said several factors have contributed to the United States falling behind other industrialized nations. A major one is that 45 million Americans lack health insurance, while Canada and many European countries have universal health care, they say.
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-- A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.

Forty countries, including Cuba, Taiwan and most of Europe had lower infant mortality rates than the U.S. in 2004. The U.S. rate was 6.8 deaths for every 1,000 live births. It was 13.7 for Black Americans, the same as Saudi Arabia.

"It really reflects the social conditions in which African American women grow up and have children," said Dr. Marie C. McCormick, professor of maternal and child health at the Harvard School of Public Health. "We haven't done anything to eliminate those disparities."
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"Even if we focused only on those four things, we would go along way toward improving health care in the United States," Murray said. "The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does."