Can't get no Health Care Satisfaction

Pat LaMarche Wednesday, July 30, 2008 - Bangor Daily News A Fox News anchor said Saturday that if Mick Jagger was from the United States he’d finally qualify for Medicare. She’s kidding — right? The anchor made a pretty lame attempt at highlighting the rock star’s advancing age. She did, however, do a good job of pointing out how backward the U.S. health care system is. See, Mick Jagger’s from the United Kingdom and he’s had universal government medical benefits since he was five. That’s because 60 years ago the United Kingdom instituted their National Health Service. George Bernard Shaw once said that "England and America are two countries separated by a common language." And that distinctive terminology doesn’t just lend itself to cute little linguistic differences like how they say "lorry" when we say "truck." There is also the language used in the U.S. that doesn’t have corresponding lingo in the UK. One example of jargon unique to the U.S. is the term "redlining." In the U.S., redlining is when an insurance company denies you health care coverage because of a pre-existing condition. In the UK, redlining doesn’t exist. In fact, according to Health Affairs, "the number one cited health policy journal devoted to publishing original, peer-reviewed research and commentary," medical redlining is quantified as the "denial rate among applicants for non-group coverage." Health Affairs lists conditions frequently redlined and the rates at which people are denied access to further coverage. Two of the patient subsets most commonly redlined are breast cancer survivors, 43 percent of the time and HIV patients 100 percent of the time. There’s a neat organization in the world. It’s called the Organization for Economic Co-operation and Development, OECD. The group consists of 30 member countries that embrace the notion of "democracy" and support a "free market" economy. It used to be called the Organization for European Economic Cooperation and it began as a result of the Marshall Plan — America’s effort to rebuild Europe after World War II. The OECD compiles statistics: Statistics that illuminate the economic conditions and comparatives among their representative democracies. OECD statistics state that in 2003, the per capita out-of-pocket expenses for healthcare in the U.S. were $722; while in the UK they were only $208. The Brits aren’t just saving money, they’re living longer. Again, according to OECD, folks in the UK live about 11 months longer than folks in the U.S. This means that in Mick Jagger’s lifetime, with numbers extrapolated for inflation, the average resident of the UK would have saved somewhere around $30,000 over their U.S. counterpart. Think of it as money they could use to live on during that extra year of life. But that’s just the difference in out-of-pocket expenses. Out-of-pocket costs are nothing compared with a nation’s overall medical expenses. Here the numbers get really staggering. Again, according to the same smart data-gathering agency that we created under the Marshall Plan, the 2005 per capita cost for health care in the U.S. was $5,290 while in the UK it was only $2,230. That’s $3,060 per person per year. Over the course of a lifetime that sort of money adds up. In simple terms it means that Mick Jagger’s lifetime health needs will cost his society about $180,000 less then our own John Mellencamp will cost us. All together, between out-of-pocket and regular health expenditures, some London rocker’s health care is almost a quarter of a million dollars cheaper — again adjusted for inflation — than our rock star from Seymour, Ind. But those expenses are national averages. Ordinary people aren’t as capable of making up the difference as rock stars are. Statistics show that middle income folks still chip in their share of health care costs but go without needed services. According to a 2002 survey of U.S. taxpayers earning between $25,000 and $50,000 per year conducted by National Public Radio, the Kaiser Family Foundation and Harvard’s Kennedy School of Government, 22 percent of middle class Americans postponed receiving care. Twenty-three percent had problems paying for the care they did receive and 13 percent did not get necessary drug prescriptions filled. Remember Mick Jagger singing, "Mother’s little helper?" In the U.S. it isn’t just a "drag" getting old — it’s also a little less likely and enormously more expensive. Pat LaMarche of Yarmouth is the spokesperson for the Evergreen Mountain Resort & Casino referendum campaign. She’s the author of "Left Out in America" and may be reached at PatLaMarche@hotmail.com.

For-profit Health Care Isn't Working

MAINE VOICES The problem isn't the wealthy or the poor, it's the working families that can't get coverage. CHRISTOPHER T. BARTLETT, Special to the Press Herald June 11, 2008 about the author Dr. Christopher T. Bartlett (DoctorBartlett@mac.com) is a family physician in Portland. As a family practice physician caring for patients here in Maine, I worry that the health-care system itself is in critical condition. One would think that most of my office time and energy would be focused on patients and their medical concerns. In truth, much of the time that my nurse and I spend each day is focused on finances. In the exam room, I have to ask which drug my patient can afford. Has my patient met the deductible? How can we present a case to the insurance company to get the surgical procedure paid for? While most wealthy people and most impoverished people receive good care, a large population in the middle often has to do without any medical care. Many of my patients have worked and gone to school in an effort to get off MaineCare and welfare. When they "succeed" and get an entry-level job, they often find they no longer qualify for MaineCare and now must shoulder the burden of their health-care expenses alone. When low-income patients apply for "free medicines" through drug companies, they often send me their entire application packet, complete with personal financial details. I am uncomfortable seeing their finances laid bare to me. I can look upon naked bodies all day; I am trained for that – but I shudder when a tax form or balance sheet of such intimate, mortifying detail is laid before me. My discomfort with doing more and more accountancy instead of medicine has bothered me for years, but I realized the other day why it bothers me so. I believe that what is wrong with health care today is the profit motive – attracting entrepreneurs at every stage of health-care delivery. I believe that capitalism and free markets have made this country great. Certain essential services, however, require other kinds of solutions. To subject these essential services to market forces could compromise our well-being. Let me give you a few examples where this may be true. If your house is on fire, you call the fire department. Highly trained professional firefighters rush to your house with multimillion-dollar equipment to extinguish your fire. Nobody asks for a co-pay. Nobody asks to see your "fire insurance card," and nobody fills out paperwork for prior authorization. This is a service that we as a society have decided we each need and deserve, and we pay for it through taxes. Police protect us in the same fashion – no charge, no co-pay. Post office? Everyone pays the same rate for a stamp. Roads are built, borders secured, foods inspected, and our armed forces stand at the ready. Why is something as important as medical care treated so differently? Why do so many of our friends and neighbors go without basic health care because they cannot afford it? When you look at the many insurance companies and government programs paying for medical care, imagine how many different people it takes to push around all the different forms, publish all the rule books and pay people from CEOs to secretaries. It's no wonder our system is so expensive and inefficient. As a simple family doctor, I don't have a prescription to fix this problem. I am trained to recognize disease, and our health-care system appears to be gravely ill. We all have a stake in keeping this patient alive. My sense is that removing the duplication of services, high administrative overhead and profit motivation is a good first step. How best to accomplish this is an enormous challenge. I think we need to talk amongst ourselves, talk with our legislators and work for a system that provides a "healthy" health care system. Copyright © 2008 Blethen Maine Newspapers