"Nationalized Health Care"

It is a phrase used a lot in reference to the plans proposed by both Sen. Hillary Clinton and Sen. Barrack Obama should they attain the post of President. As Kevin Freking of the Associated Press points out in a recent article, it is an inappropriate usage of the phrase:

Last week, Sen. John McCain, the likely Republican nominee, described his challengers' health care plans as a "move closer to a nationalized health care system." But that's a stretch. To nationalize means to transfer ownership or control to the government. There's still a vast distance between what the Democratic candidates have proposed and nationalized health care.

Clinton and Obama aren't proposing government hospitals or government doctors. They want people to have health insurance, and they want people to be able to choose from a variety of policies. The menu would include private plans as well as an option similar to Medicare. Tax breaks would help lower- and middle-income people pay their monthly premiums.

In addition, proposed employer involvement and the rescinding of Bush administration tax cuts for the wealthy assure that there will be others besides the government paying into the program (whichever it ends up being) once it is enacted.

Such a system would continue the split system that the U.S. has when it comes to health coverage. The elderly, poor, disabled and many veterans would continue to get care paid for primarily by the government. Others would get coverage from private companies, usually through their employer, or through the Medicare-like option.

"Their approach is not taking any other country's system. It's building on what we have in the U.S," said Karen Davis, president of the Commonwealth Fund, which conducts health research.

Freking goes on to provide an illustrative comparison between our system here in the United States and those of Great Britain and Canada. He finds that while many more here in the U.S. chose to skip seeking care out of financial fear, residents of the other two countries tend to have much longer waits when specialist care is needed -- waits that are often a month or longer.

He also touches on economic side effects of the high cost of American health care, such as the fact that stateside manufacturers find it harder to compete in the global marketplace due to the high and rising cost of coverage.

"That's why it costs less to build a car in Canada than in the United States because you've got a bunch of money tied up in health insurance," said Steven Lewis, a Canadian health consultant.

As usual, Freking prescribes a solid dose of information for his readers, including an interesting observation about the one commonality that people in all three countries share. I'll let you read the article to find out what it is....

SOURCE: "Insurance model follows American tradition" 05/10/08
photo courtesy of *clarity*, used under its Creative Commons license

Best Health Care in The USA? Surprise! It's the VA!

The Veterans Administration, an organization that has been castigated for years on the subject of its low quality care, has made a turnaround. Be prepared, this story is replete with words and phrases that have gained a massive political charge in recent months, chief amongst them "socialized medicine."

ABC News brings us a thought provoking report (video here | text here ) on how the VA has moved from one of the worst health care programs in the country to being the best in the nation. I can sum it up in one phrase for you, electronic medical records. If you have the bandwidth I highly advise checking out the video linked above, if a picture is worth a thousand words then hundreds of them strung together as video should be worth millions.

Here are a few quick nuggets of data drawn from the text version online at the ABC News website:

Experts generally agree that electronic records are absolutely essential to significant health care reform. However, only about 5 percent of the nation's hospitals now have them.

[...] in most private hospitals 20 percent of lab tests are repeated simply because doctors can't find a patient's results.

But in the VA system, every patient's records are as close as a computer. It saves millions of dollars.

[...]Study after study puts the VA system at the very top for fewer medical errors, for effective treatments, for lower costs and for patient satisfaction. And the VA delivers all of this for at least $1,500 less per year per patient than Medicare.

Our own Mr. Halvorson is one of the experts who see electronic medial records (EMRs) as an essential part of the reform equation. The fact that the VA, has been implementing EMRs with such positive results supports the veracity of those claims. Granted, the VA system could not be implemented "as is" on a national basis, but the fundamental concept has now been proven to be sound. If a system of EMRs that follow each patient for their lifetime, as VA records do, is implemented nationwide, a significant potion of our current health care crisis can be averted.

SOURCE: "Veterans Affairs Healthcare System No. 1: How the Once-Maligned VA Healthcare System Becomes Best in Nation.
" 12/12/07
photo courtesy of scladesma, used under this Creative Commons license

Americans Study Netherlands Health Care Program

In the Netherlands universal healthcare is not only the standard but also involves a healthy amount of market competition. Kerry Weens, a senior U.S. Department of Health official, recently lead a delegation of Americans examining the Dutch health care system:

"We're intrigued by many of the ideas that we see, such as moving toward more market based solutions. In general I think there's a lot of consistency between the Dutch system and the US system."

John Tyler and Reinout Van Wagtendonk of Radio Netherlands report on the American delegation’s visit.

Mr. Weens was referring to a recent overhaul in the way Dutch people purchase health insurance which have made the Dutch system more competitive. Two years ago, a new law went into effect requiring every resident of the Netherlands to purchase their own health insurance, while the insurance companies were forced to embrace open market laws and offer competitive prices for their insurances. But unlike in the United States, for those who can't afford insurance, the Dutch state still chips in to cover part of the cost.

Insurance companies are required to provide coverage for anyone who applies for it, so no one can be refused due to pre-existing health problems. To help insurance companies cover some of the costs involved with selling coverage to all comers, the government has a formula in which it contributes to the cost incurred in certain cases.

So while competition has been introduced into the system, the Dutch system is not a completely market-based approach. The taxpayer still subsidizes a not insignificant percentage of care in the Netherlands. But competition helps keep overall costs down.

In Health Care Reform Now!, George Halvorson advocates finding a uniquely American path to universal coverage while learning what we can from other nations who already have their own systems of universal coverage. This sort of fact finding mission is exactly the type of research that needs to be done in order to synthesize our own uniquely American solution.

The Dutch approach also share’s Mr. Halvorson’s views on preventative care and transparency.

"We pay a lot more attention to prevention -- we have a coordinated, multidisciplinary approach. In Holland there's quite a lot of proactive action attached to that aspect of health care," said Nolene Berkhout, a nurse practitioner who served as one of the hosts of the American delegation.

A number of recent changes are meant to improve the quality of care here in the Netherlands. Doctors and hospitals are now required to publish information every year about their performance. That information is available to the public on a website, but it is still too soon to see how much effect it has on patients' choices.

SOURCE: "U.S. Officials Impressed by Dutch Healthcare System" 11/12/07
photo courtesy of Pear Biter, used under this Creative Commons license

Just The Facts, Please

Health care today is a massive issue. A quick glance at any news-oriented media (including this blog) will show the topic being addressed from every angle as a variety of facts, pseudo facts, and pure polemic fight for that all important mindshare -- yours.

The catchphrases and keywords of the discussion are bandied about everywhere: Hillary Care, socialized medicine, single payer plan, SCHIP, government insurance and many others. How is the average American to make any clear sense of this media barrage?

Thanks to the pioneering efforts of Annenberg Political Fact Check from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania, we have a few options available today. A pioneer in presenting non-partisan fact checking online, the APPC accepts no funding from individuals, political campaigns, businesses, unions or lobbying organizations. It also boasts a large team of researchers and journalists to assist in cutting through the rhetoric.

PolitFact, a project from the St. Petersburg Times and Congressional Quarterly, and its "Truth-O-Meter," is another site which checks the veracity of campaign videos and candidates. Particularly useful when the health care issue comes up. It is always interesting to see the myriad ways in which the same numbers can be presented by different sides.

Then there is the new kid on the block: The Washington Post. In early September the Post launched its new Fact Checker feature, helmed by distinguished staff writer Michael Dobbs and research wizard Alice Crites, the backbone of the Post's investigative department for most of the last ten years. During that decade Crites has worked on three Pulitzer-winning series. Personally I like the fact they use "Pinocchios" to rate the magnitude of factual distortion.

Let's take a look at the Fact Checker this morning, where accusations of socialized medicine levied at Senator Hillary Clinton are dissected:

According to MIT economics professor Jonathan Gruber, who advised Romney on his health care reform law and has also advised Clinton, the Massachusetts law has a lot in common with the Clinton plan. Both plans mandate universal health care coverage and subsidize health care for people on low incomes. The main difference is that Clinton's proposal permits people to switch to a Medicare-type plan and increases taxes at higher income levels.

Contrary to claims by Romney and other Republicans, the Clinton plan does not force Americans to accept "government insurance." It offers people a choice. If they are happy with their present health plan, they can keep it. Otherwise, they can switch to the plans offered to members of Congress, or a government-run plan similar to Medicare.

The column goes into great detail providing quotes and sources, as well as detailing the lack thereof. It concludes with "The Pinocchio Test."

The claim that "Hillary care" is tantamount to "socialized medicine" does not stand up to serious examination. The Clinton health care plan has more in common with the Massachusetts plan signed into law by Governor Mitt Romney than the British National Health system. We award three Pinocchios to Romney.

I wonder if anyone will win the coveted "Geppetto Checkmark," the sign denoting a complete lack of factual distortion?

SOURCE: "'Hillary Care' and 'Socialized Medicine'" 10/24/07
photo courtesy of Marc Nozell, used under its Creative Commons license

Socialist vs. Universal

John M. Schwarz, director of United Health System, published a glossary of health-care reform recently in The Star Tribune.

It's time for health-reform dialogue to move beyond ideological rhetoric[...] Commentators from all walks, including the media, are guilty of misrepresenting what single-payer and universal coverage are.

Among other things, the article offers clarification of socialized health care vs. universal health care. The word 'socialism' is "most-abused label in health-reform dialogue," according to Schwarz.

SOURCE: "A Glossary of Health-Care Reform" 07/02/07