Medicare For All… It Just Makes Sense

Medicare is a system that has been in place for 50+ years. Its approval rating is well above any competition and it keeps the costs of healthcare down. Paperwork which drowns the private sector insurance is very well managed to less than half in Medicare.

mountain-660023_640.jpgSo, why should we be experimenting with other often radical solutions to our healthcare network in the U.S.?  I will admit that Obamacare was far from perfect. For one thing, it depends on the whim of private for-profit carriers. They say privatizing healthcare will spur competition and therefore reduce costs but that just isn’t happening.  TrumpCare, which is at least dead for now, wasn’t any better and seemed to be skewed towards giving the wealthy more tax breaks and abandoning care for millions now covered under Medicaid.

Why should we experiment with very risky systems when we have a time-proven system that does very well? It just makes sense to make Medicare for all of us. Can even Medicare be improved, of course it can. There is too much fraud that could fairly easily be prevented if we just allowed it to happen.  Having a law that prevents Medicare from getting discounts in the prescription drug market defies common sense.

Let’s expand a proven track winner and make it for all of us. We could then join the rest of the world in providing healthcare for all our citizens as a right, not a privilege of only those who can afford it. It would also relieve that burden from our business so that they can more effectively compete with foreign competitors. It just makes sense.

I don’t know what it will take to get all those in the beltway loony bin to understand this idea? But whatever it takes we need to work hard to make it happen. The sooner, the better.

It just makes sense…

 

My Personal Experience with Brain Trauma – Part 3

Before the surgery, I really had no idea who Dr. P was or what he looked like. (I am not using his full name here as I don’t have permission from him and don’t want to intrude on his privacy). Looking at him when he delivered the good post-surgery news I discovered he was a sixty-year-old or so guy with white hair and a neatly trimmed mustache. He came in a couple more times that day to check on me. When my wife was not there to sign for me he always grabbed the paper and pencil to give me a “normal” conversation and that is very unusual for a doctor to do. Most of the time they almost refuse to write things down for me, let alone chitchat. I don’t know why but doctors are especially bad at that, but not this one. Dr. P went out of his way to treat me like one of his friends.

I also noticed that he was wearing jeans and a regular shirt. I later found out that he was one of the most popular of the 350 doctors with the staff at my hospital. He never wears a tie or suit and drives an old pickup truck! He is unlike any other doctor I have ever had. You would never guess that he was a brain surgeon but instead maybe a farmer! It turns out that he also did the brain surgery of a good friend of mine who helps me around the homestead and like me, he simply loves Dr. P. I look forward to seeing him in the future for follow-up recuperation appointments.

Sam, short for Samatha, was my critical care daytime RN for the two days I was in that part of the hospital. We spent quite a bit of time together and I felt I got to know her pretty well. She is a “traveling RN”, that is she moves around the country working in one hospital then another. Her last stint was in Alaska. She works three twelve hour shifts in the CCU and then has the rest of the week off to explore. She is a millennial who shuns high heels and makeup but has a very natural beauty that quickly shines through. She says she wants to be known for what she does, not what she puts on her body. With people like her in charge of the future of our country, I feel confident that it is in good hands indeed.  I met a kindred spirit in Sam those two days but she was not the only one.

Keli, the night RN was very different from Sam but just as confident in her abilities to take care of herself. Being deaf, I seem to be able to draw out people with their family stories of adversity and her father has his share. He is my age and facing a very difficult time in his life. I tried to give some moral support.

I interacted with perhaps a dozen different people and every one of them was friendly and very good at their jobs  My hospital might not be the biggest one in the area but in my opinion, it is the best. The road ahead for me is not going to be particularly easy but with their support, I will handle whatever comes toward me.

I left out some interesting stories about my stay but I think that is enough for now.  I”m sure in the future I will be filling in some holes in this dramatic experience.

Off To The Operating Room For Brain Surgery

My Personal Experience with  Brain Trauma – Part 2

In the last post, I left off just before my consult with a brain surgeon. When the ER doctor told me I had a chronic brain bleed because of my fall that scared me more than I have been in a long time.  When the surgeon told me he needed to go in and fix it and to relieve the pressure, my life didn’t flash before my eyes but I was thinking this could be the end. After I agreed to the surgery I started thinking about what if these were my last hours?

I told my wife I didn’t want to scare her too much but here is the password for my computer if you need to get into anything financial.  I have paid all the bills and have for some time and since she is seven years older than me it was just assumed that she would go first so she didn’t need to know the details. From this lesson, I learned that we need to be prepared for any circumstance so in the coming days I will be laying out what is where and what needs to be done if I can’t do it.

2017-03-10_18-28-33.pngIt was about 1:30 pm when I signed the consent forms and then a couple of people came in to start IV lines. I soon discovered that one of them was an RN but the other was a  trainee. Long story short, I think they give all us seniors as practice cushions for those who haven’t learned about veins and such as this guy struggled with finding a place to put the needle. When he actually tried to insert it his hands were shaking. After several failed attempt the teacher finally took over and two IVs were in place.

As I was about to go into the operating room at 3:00 pm I told them that I have a prostate problem and my bladder would likely lock up so I suggested they put in a catheter while in the operating room to take care of that. The people taking me in kind of nodded agreement. Then it was off to the cold sterile room to be cut for the first time.  I saw several scrub nurses and the anesthesiologist but didn’t see the surgeon before I was put under. I said a quick prayer and then was out.

Of course, it seemed like I then woke immediately up with several people hovering over me mouthing words which of course I couldn’t understand. At first, I thought, “is this what heaven is like?” but quickly lost that thought and realized I had made it through the surgery. I laid in post-op it seemed like an hour or more and then it was off to a Critical Care room. Dr. P., my hero of the day, was there pretty quickly saying that everything went well and all the bleeding was taken care of and now it was on to a month-long recuperation period.

People of Faith For Resistance..

There seems to be many opportunities cropping up on this first day of a new administration for resistance to draconian change they intend for our democracy in the upcoming years. I am particularly happy to see Christians in this mode. No, not all Christians are among the 81% of Evangelicals who pushed the current administration in office.  In reality they are a small percentage of that community.

One of those orgs on the forefront of resistance is Sojourners.  Here are some words in a recent email from them.

The GOP plans for a juggernaut of action very quickly to gut many of the social programs now in place including:

  • Affordable healthcare
  • Medicaid for the poor
  • Medicare for senior citizens
  • Social Security for present and future seniors

They say they are privatizing them to make them more efficient but the reality is quite different.  It will take a mammoth effort similar to what happened when they tried to eliminate the House Ethics Overlook.  Concerned citizens need to stay active to prevent them accomplishing their intent of undoing these and many other programs.

I am not particularly promoting Sojourners, but they are a good cause, in so much as encouraging you to join the resistance in whatever form you prefer.

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GOD SAVE OUR COUNTRY….

Why Are We Crippling Obamacare with Private Insurance Companies When Medicare Can Do The Job??

2015-11-20_08-28-13A threat by the nation’s largest health insurer to pull out of ObamaCare is a sign of the industry’s growing angst about the viability of the federal exchanges, sources close to the industry say.

UnitedHealthcare’s warning sent new shockwaves across the healthcare sector after weeks of mounting anxiety among private insurers whose participation in the exchanges is critical to the viability of the president’s signature law.

In the last month alone, insurers have learned that the Obama administration has significantly lowered its expectations for new customers and will have far fewer federal dollars to help cushion insurer losses.

Source: New ObamaCare angst as top insurer threatens to bail | TheHill

I can just hear all those nay-Sayers  “Here’s proof that Obamacare is a failure!” and in some ways I agree with them. Private insurers are certainly the weakest link in the current system.

I have been on Medicare for about 5 years now and have been paying about $100 a month for that privilege.  It covers 80% of my medical costs so I must either pay  the remainder or get Medigap coverage for the other 20%. I chose a Medigap policy that started out at about $150 a month to cover that last fifth of the costs. Now that policy is up to almost $200 and will climb to over $300 in the coming years.

It doesn’t take a lot of math to figure out that I am paying a private “for profit” insurer ten time more for the same dollar coverage that Medicare provides. Yes, I know that Medicare is paid as a government expense but it has also been widely acknowledged as the most efficient insurance provider in the country. Single payer systems have proven to be the most economical way to provide healthcare to the world’s citizens. We are about the only first world country that refuses recognize that fact.

It seems obvious to this pragmatist that our country and especially our private corporations would be better off if they could shed their healthcare responsibilities and have Medicare as the country’s single payer provider of healthcare costs.  In fact there are many companies that are doing just that. With single payer systems comes economy of scale and also increased leverage over medical manufacturers and such. Aside from a law pushed through by the GOP why do we in this country pay so much more for our prescriptions than anyone else in the world?

As a side note it seems that on a regular basis veteran’s care is attacked by problems of poor implementation. Our veterans are just not getting the quality of care that they deserve under their current system.  Maybe it is time to at least fold it into Medicare instead of trying to stand alone.  Almost half of our citizens are currently on government provided single payer system. When we finally manage to get the rest there like the rest of the world we will all be better off.

 

VA Hospital Problems….

2014-05-30_09-29-20Shinseki reiterated other steps he’s taken, including putting the leadership at the Phoenix facility on leave and ordering a “nationwide audit of all other major VA health care facilities to ensure understanding of, and compliance with, our appointment policy.” Some question whether removing Shinseki would address the core problems at the VA or simply serve as a distraction for now.”Is him resigning going to get us to the bottom of the problem? Is it going to help us find out what’s really going on?,” asked House Speaker John Boehner, the chamber’s top Republican, adding that his answer so far was “no.” SOURCE: Shinseki initiating removal of senior leaders at Phoenix VA – CNN.com.

I don’t know about you but it seems I have been hearing the above type problems with the VA almost all of my life. It was pleasantly surprising to see that the top House Republican saying firing another head of that agency won’t fix the problem. If fact it would probably just delay the fixes more.

I’m just a simple guy but it seems that the solution to this problem is pretty logical. Why not just put veterans into the Medicare system? I have been on Medicare for about three years now and have never had to wait more than one month to see any specialist. The article above talks about 115 day waits in the Phoenix VA hospital!  Another fundamental question seems to be why does the VA need their own hospitals? Why can’t they go to the same hospitals as the rest of us.  If PTSD or other specialists are needed I’m sure they could be hired from the existing VA or trained by the private sector.

I’m pretty sure my conservative friends would jump on this solution as WRONG. Maybe we are reversing roles here. I say let the private sector take care of our veterans the same way as they take care of us seniors.  One thing that would be nice to carry over from the VA is for Medicare to be able to negotiate drug prices. VA can presently do that while Medicare can’t. That alone would save us billions in healthcare costs.

Eventually, probably not in my life time, all our health care will be folded into a single payer system as much of the rest of the world has already done. But until that time it just seems to make sense to once and for all get rid of these perpetual problems with VA hospitals. Our young men and women who have been traumatized by their war experiences deserve it. But then again this solution just seems to be common sense and logical so I doubt that those folks in Washington will even consider it…..

Back Door Universal Healthcare…

Medicaid Expansion 2023

Anyone who has read some of my posts know that I am an advocate for universal single-payer healthcare.  After all, it is very efficient and cost containing system used in much of the rest of the world.  Many of our citizens in the U.S. including this one are currently on a single payer system known as Medicare. After being on it for two years now I can attest that I have found it to be much better than the private insurance mode I fought with for so many years prior. Other citizens also on a single-payer system are those on Medicaid and with military healthcare systems. This makes up about 40% of the current population. The other 60% are on various employer or private systems or no insurance at all.

But to those so adamantly against Obamacare, which ended up not even be close to single-payer all of these systems are to be eliminated. Just why they believe that I really don’t know. They say those systems are socialist but why is that a bad thing?  Most of the rest of the world, at least those who no longer have the mammoth healthcare runaway costs implemented single payer systems years ago and statistically most in those countries actually live longer than we do.

When the pollsters show that 52% of the people are against Obamacare what they don’t show is that there is a significant number of those people who are like me and don’t really like Obamacare because it doesn’t go far enough. There are also a large portion in the polls who readily admit that they actually know practically nothing about Obamacare and are only parroting what their favorite talking-head has told them. They are against it because their party is against it.  So much for free-thinkers among the GOP! 🙂  Because Obamacare is such a piecemeal piece of legislation it will have to be pretty greatly changed in the future in order to be cost-effective.

Getting back to the original thoughts for this post, it seems if we are patient enough that we will eventually get to a single payer system. With all us baby boomers retiring and so many others at the other end of the spectrum becoming eligible for Medicaid the population that is in these two systems will continue to grow.  and then of course with our incessant increases in military spending that system will also expand. We might eventually work our way into a single payer system via the back door.

Wouldn’t that be something?

LOL Moment….

Medicare CardJust a quick note to say I just watched a video of a town hall meeting opposing Obamacare. There was an elderly lady who ranted on and on about it. She was totally convinced that if we allow it to be implemented that it would certainly cause the downfall of the entire country.  She finished with the following statement. “I realize that Obamacare does not directly affect me but I just want to make sure that we keep the government out of my Medicare!!”

They didn’t show if anyone had bothered to tell her that Medicare is a single payer system run exclusively by the government. Of course this just goes to show how so many on the radical right and particularly Fox News have distorted the reality of the Affordable Care Act.

I also reviewed some of the things that happened in 1965 when Medicare was enacted.  It is amazing to see the similarities with today. Most Republicans were, like today, adamantly against that too.

Why Our Health Care Lets Prices Run Wild…

SurgeonA central reason U.S. health care spending is so high is because hospitals and doctors charge more for their services and there’s little transparency about why. There is no uniformity to the system, in which public and private insurers have separate, unrelated contracts with hospitals and doctors. The result is a tangled, confusing and largely secretive collection of forces driving health care prices higher and higher.

This isn’t possible in many other countries either because governments set prices for health care services or broker negotiations between coalitions of insurers and providers. Known as “all-payer rate setting,” insurers in these systems band together to negotiate as groups. In contrast, U.S. insurers closely guard the secrecy of their contracted prices with health care providers and negotiate individually. This is why a hospital hosting five patients for knee replacements might get paid five different amounts for the surgeries.

Source: Why Our Health Care Lets Prices Run Wild | TIME.com.

There seems to be so many possible solutions to reigning in our ever-increasing healthcare costs if only those in congress would be brave enough to actually try a few. Instead they seem intent on just complaining about the situation. That’s easy, solving it is where the work begins and I am convinced that those yahoos inside the beltway are just too lazy to do the work to actually affect the problem.

After putting in quite a bit of study in this area I have come to believe that the above quote gets to the heart of the problem.  Like everything else in life if something is totally unregulated and uncontrolled it tends to move to an extreme.  I will admit that there are many doctors who are the exception to this statement but overall doctor’s pay is out of control.  When they believe that they are justified in charging me thousands of dollars for an hour of their time they need to be taught otherwise.

The way that hospitals set their rates is simply insanity. It has nothing to do with the actual cost of the service but more to do with getting the most possible. I love the quote above that “the result is a tangled, confusing and largely secretive collection of forces driving health care prices higher and higher”. As long as all of these price setting schemes are held behind closed doors our costs will inevitably grow higher and higher.  Why can’t we understand that simple fact.

Even a simple solution such as allowing Social Security to bargain for lower drug prices has been deemed not allowed by many of the so-called leaders in our government. Until we can finally realize that at some level of regulation is necessary in order to contain our healthcare dollars we will continue to complain about costs but fail to do any real action to contain them. The rest of the world discovered these solutions years ago, when will we ever catch up with them?

But I’m just a simple guy so what do I know…..

Hospital Billing Varies Wildly….

SurgeonA hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945.In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000.

In one hospital in Dallas, the average bill for treating simple pneumonia was $14,610, while another there charged over $38,000…

Source: Hospital Billing Varies Wildly, U.S. Data Shows – NYTimes.com.

I must admit that I have been lazy in regard to studying and reporting on how hospitals are at least partially responsible for the runaway medical costs in our country…..

You might think that just because a hospital charges an amount for a procedure that they actually receive that payment. Fortunately that is not the case for single payer systems like Medicare, Medicaid, and veterans.  The article goes on to say:

Medicare does not actually pay the amount a hospital charges but instead uses a system of standardized payments to reimburse hospitals for treating specific conditions. Private insurers do not pay the full charge either, but negotiate payments with hospitals for specific treatments. Since many patients are covered by Medicare or have private insurance, they are not directly affected by what hospitals charge.

Experts say it is likely that the people who can afford it least — those with little or no insurance — are getting hit with extremely high hospitals bills that may bear little connection to the cost of treatment.

Now that I have been on Medicare for a couple of years now I have been exposed to these extreme differences.  I recently had an endoscopy for an esophagus problem and when I got the paperwork from Medicare I could see that the medical facility charged about $3,500 for the fifteen minute procedure but Medicare approved less than $700 of which they paid 80% and my Medigap coverage paid the other 20%.  Since I was on Medicare and knew that they paid the same to all facilities I did not shop around for the different costs for the procedure but if I had I probably would have encountered differences like shown in the article above.

If like so many on the radical right seem to wish, I had not had Medicare I’m sure I would have been billed and expected to pay the full amount. The sad fact about it is that those who can afford it the least are the ones who actually are charged the most simply because they have no power behind them.

The rest of the developed world is for the most part on a single payer system similar to Medicare. I know that the most famous doctors tend to migrate to the U.S. because of our extreme compensations but even that fact does not give us superior care to most other countries. In fact even with our ultra-expensive way of doing healthcare many other countries are ahead of us when it come to living longer and healthier. When will we ever learn this very basic fact??

I get the feeling that if lawn mowing services were run by hospital administrators I would be charged  $1,000 for every time they mowed my lawn. Too bad someone can’t come up with DIY pace makers.