Media blitz on Healthcare

It's obvious there's a lot of PR activity going on regarding the Healthcare reform being worked on in Congress. Recently several thought-provoking stories have popped their heads up out of the major (and even some minor) media outlets.

The first one I heard was a study released by some quasi-governmental group (possible the CDC, or at least someone using their data) that said a 50 year old with no health insurance is 40% more likely to die before he turns 80 than his co-peer who does have health insurance. Lack of insurance kills! The study cited allows proponents of healthcare reform to quantify their allegation that people are dying for lack of insurance coverage-- and the magic number is roughly one in a thousand (don't ask me where that number came from, but it's at least plausible). This puts the conservative claim that health reform will bring about government rationing into perspective. There's already fatality-causing rationing going on, it's just tilted somewhat in favor of the wealthy now. I find it interesting that most conservatives are aware that insurance companies make arbitrary decisions about their care every day, but would rather trust (or negotiate with) a private insurance company than with a governmental entity. There may be some wisdom in that.

Another recent story tells how the cost of health insurance for a family of four has doubled since 2001, from somewhere near $4,000 to closer to $8,000 today (I believe those are the numbers... again, I haven't looked at the studies, and I heard the numbers on the radio as I drove to lunch, and can't vouch for either the quality of the numbers or the accuracy of my memory). Those numbers may actually be low.

Another story making the rounds is that "administrative overhead" in the health industry-- including everything from insurance claims processing and billing systems to corporate profits-- is estimated to be $300 billion dollars per year. This number seems a bit low, in fact. But be that as it may, that's a sizeable chunk of change.

Oh, and another report I've heard is that the number of uninsured continues to balloon. Numbers through last year indicated the number of uninsured people grew by over 1 million in the previous year, to near 40 million people, and that number doesn't include all the (4-5?) millions who have lost their jobs more recently because of the recession.

There's a funny contradiction that's surfaced in the opposition, and that's how they've been forced to embrace their former shibboleth Medicare. For the 40+ years since it was signed into being during the Nixon (or maybe Johnson) administration, Medicare has been a constant target for Republicans complaining about big government and wasteful out-of-control spending. Now the self-same program, with no internal changes whatsoever, has emerged as a shining example of all that's good in traditional conservative apple-pie American healthcare, and the new administration's attempts at healthcare reform are perceived as just a vicious attempt to mess it up. There was a photo published somewhere, taken I believe outside one of the town hall meetings on the subject, with a woman holding a sign that said "Keep government out of my Medicare!," which, if you think about it is pretty damned humorous in a shrill, hysterical Glenn Beck-Foxnews kind of way.

Another interesting story was published in the Wall Street Journal this week, about the many "fixed price" contracts, for everything from routine surgical procedures to medications, that have been negotiated between insurance companies (and other private entities, apparently) various health care providers. The article explored the prices around the country for a colonoscopy, which varied from as low as $250-300 in some places, to a national average 10 times that, and to some localities (I believe they cited Arizona or New Mexico) where the price soared to $4,000 and above. For the same procedure, with the same personnel, using the same equipment, and the same patients! The article also linked those "private pricing" practices with the issue of people going to Canada to buy the same drugs there for as much as 50% less than they pay at home. Conservatives who assure us the free market will solve any cost problems are deluding themselves when the industry is rife with privately negotiated loss-leader contracts for routine procedures and medications which pervert the free market.

Another story that's been mentioned in passing, but should be emphasized more, is the number of medical bankruptcies (medical expenses are the cause of well over 60% of all bankruptcies in this country) among people who already have health insurance. This is shocking because it's non-intuitive.

Finally, there's another "pseudo-story" -- more of a meme, really-- making the rounds, that highlights the insurance industry's penchant for cancelling health insurance coverage on people after they become ill. One recent court decision in particular I heard about, awarded $10 million in damages to a young man whose coverage was cancelled after a test showed he was HIV positive. The judge in that case said the insurance company showed reckless disregard for the health of the young man. The reason it's a meme is I'm hearing the practice referenced more and more, with little or no reference to specific stories. Maybe that's because it happens so often people don't need documentation any more. That makes it a meme.

Overall there are many good reasons for Congress to pass health care reform immediately. The question is whether they're able to stay on task in the face of unprecedented lobbying on the part of the health insurance (and health industry in general). They've already caved on single-payer, which is what the majority of Americans wants. They're working on a "public option" (hence the "keep government out of my Medicare" idiocy), where some subset of people will be covered by a government program. Medicare has become the darling of the right and left. "Co-ops" (smaller, local non-profit insurance providers) have been proposed as a way to "un-Medicare" the public option. Republicans are holding their hands very close to the vest, and the Democrats are trying to make sure the Blue Dog (mostly southern, conservative, pro-business, quasi-Republican) Democrats will vote correctly, and are weighing the wisdom of enacting something by themselves, using their hard-won majority in both houses of Congress, or trying to achieve a bi-partisan bill in this time of harsh rhetoric and extreme partisanship.

Stay tuned. This is big-money, big-power politics. There's a lot at stake-- the health care industry, which is in a way America's last smokestack industry-- is set to consume fully 20% of America's GDP over the next few years. That's trillions of dollars. A lot of capital is being positioned to cash in on that money, whatever our medical industry turns out to look like. There will be blood.