Tag Archive | "medical"

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On the Health Care System We Aspire To

Posted on 10 April 2011 by Editor

Originally posted 2009-06-24 12:22:44. Republished by Blog Post Promoter

Today I got a call from my Mom. She and my Dad both live in the city I was born in – Warsaw, Poland. They are both elderly and live off of a government pension akin to the US social security system. The reason she called was to let me know of an excruciating pain she has recently been suffering from, resulting from a progressively degenerative neurological condition in her wrist. As all Poles are, she is entitled to free medical care in government health care facilities under the country’s universal health care insurance program. Trying to get help for her condition, she has visited with several general practitioners covered under her free plan, all of whom admit she needs to see a specialist. The last one finally crafted a referral for her and she is now scheduled to see a neurologist … in three months. Ouch !

Her options now include continuing to suffer the intolerable pain for the next 3 months or pay out of pocket to see a private specialist. The fee for a consultation with a neurologist in private practice exceeds two months of her pension income, but under the circumstances she will have to do just that. The costs of any resulting treatments, if not covered under the government health care plan, may have a devastating financial effect on her and my dad’s retirement lifestyle.

My parents could have opted to purchase private health care insurance coverage which provides access to services in private hospitals and clinics with the most skilled specialists but, because the government program is so dominant and pervasive, the cost of the private alternative is beyond the reach of most middle-class Poles. As a result, it is accessible to only the most affluent (or motivated by dire circumstances and lacking other options) individuals.

Interestingly enough, in many European countries the Polish medical system as a whole is actually touted as one of the better and when compared with the British system in particular, it receives accolades for efficiency and quality of care. What is underscored is the diminishing role of the public plan option and the progressively increasing percentage of services being offered under private insurance. The availability and increasing popularity of the private health care option is viewed with envy. A good summary of these changes in the Polish medical system can be found in this article from CMAJ (Canadian Medical Association Journal). With this shift, as more competition is introduced in the private sector and the dominance of the government program is lessened (or eliminated), my mom might yet one day be able to afford a private insurance plan and access to the highly skilled medical professionals in Poland, heretofore not accessible to her under her existing plan and her present means.

But in the US exactly the opposite direction is being proposed. There can be very little doubt, and certainly countless examples of dysfunctional government programs across Europe and other countries serve as an example, that a private health care system necessarily offers superior services at a competitive price. As I have written in a prior Naked Liberty article on the Dangers of Comparative Effectiveness, instead of experimenting with proven failed systems, the US should adopt targeted approaches to improving those parts of our current system which offer opportunities for improvement, such as for example the implementation of a national electronic medical records system and tax incentives to support wellness and health awareness.

What’s being proposed is like trading in your comfortable and dependable SUV for a Yugo just because you happened to have gotten a flat tire. Let’s fix the tire and get on with our lives without any more government intervening in it.

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Quotation of the Day:

“We should manage our fortunes as we do our health – enjoy it when good, be patient when it is bad, and never apply violent remedies except in an extreme necessity.“

Francois de La Rochefoucauld (1613 – 1680)

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We welcome your comments and suggestions, either directly inline, or via email to editor@nakedliberty.com. If you would like to have your article published in Naked Liberty, please contact the editor at the above email address.

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The Pain In My Wallet

Posted on 10 April 2011 by Editor

Originally posted 2010-04-25 19:42:21. Republished by Blog Post Promoter

cost of medicineby Norbert Sluzewski
Editor – NakedLiberty.com
April 25, 2010


Ouch! That was pretty much the only sound I could make getting out of bed that March morning after having overdone on the previous day’s lawn work. My back didn’t want to cooperate with what I otherwise needed to do, which included attending several business meetings and other private events. So without considering many alternatives, I dragged myself to my car, painfully scrambled into the driver’s seat of my SUV and drove off to see a local specialist.

I’ve not seen this doctor before, but he came highly recommended by my primary care physician. The office was pleasantly quiet and subdued and the chairs meticulously aligned in the waiting room were all properly hard so as to accommodate folks arriving in conditions similar to mine.

The doctor was quick to call my name and we soon found ourselves in an appropriately sterile but functional examining room, which comprised of nothing more than an examining table, wooden chair and a small supply closet. In a few quick and efficient motions, the doctor felt around my lower back, checked my knee and ankle reflexes and showed me an impressively realistic model of the human skeletal structure, exposing the nerves and arteries which criss-cross its length. I was duly impressed with the doctor’s description of my condition (a story which he likely has memorized from repeating dozens of times a day) and I was prescribed an anti-inflammatory, muscle relaxant pill and a dose of physical therapy. From arrival to departure, the entire episode lasted exactly 11 minutes.

I am fortunate to have a reasonably good medical insurance plan, so the bill for the doctor’s services went directly to the insurance company. At no time was I concerned about the amount of the fee, nor did the pleasant medical administrator in the doctor’s office disclose to me what the fee for the doctor’s services would be.

And so several weeks have passed. My back has recovered to its nimble self (at least until my next gardening adventure) and all is again well in the world. Ah, but there is more.

A letter from the doctor arrived a few days ago, which politely explained that the insurance company will be applying the doctor’s fee against my annual deductible (hmm, how conveniently I’ve forgotten about that part of the coverage provisions). As a result, they are requesting payment of the full amount of the doctor’s services which (now take a deep breath) amounted to $575.

Ok, now this got my attention. At no time was this amount disclosed to me. Frankly, at the time, I didn’t really care. I was in serious pain and, after all, I wasn’t really going to be paying for it myself, right? If I had been told, would it have changed my intention and would I have walked out of the office? I don’t know – maybe, maybe not; but perhaps I would have considered alternatives, like a hot compress or an “Icy-Hot” patch.

Now that it looks like I am going to be out of pocket a few hundred bucks, I am beginning to question the value ascribed to the services rendered. Sure, in the end they provided me with medicine to ease the pain, and the physical therapy (for which I haven’t received the bill yet, but am sure it’s en route to my mailbox) did help me get a bit more strength into those achy back muscles, but $575 for 11 minutes of service? That’s a whopping $3,136 an hour. My expensive lawyer would gasp at an opportunity to bill his clients that kind of an hourly rate. Is there any profession that can top this? (No, not even that one – and I know what you’re thinking).

So it’s clear to me that the doctor’s fee is not driven by market forces, but instead by an opportunity to “get away with it” since in most cases there is very little vested interest by any of the parties in the transaction to keep the amount of the fee consistent with the effort expended or value of service provided.

Is there something broken in this type of a fee-for-service system? You bet there is.

The answers to bring sanity back into the doctor-patient relationship (particularly the financial part of it) are so glaringly simple and have been so widely discussed. Among these the most significant and most consequential solution includes removing employer co-sponsorship of medical insurance coverage for its employees and replacing it with tax deductible health savings accumulation accounts (HSA’s, FSA’s or similar). In this case each individual is directly responsible for maintaining their personal financial reserve for medical care. Supplemental insurance could certainly be offered for extraordinary expenses and catastrophic events, including government subsidies for those not able to afford them directly. Employers could easily continue to sponsor employee health maintenance benefits for their employees by offering contributions to the employees Health Savings accounts, similarly to how they incentivize retirement savings through 401k contributions.

One thing is irrefutably true and has been tested time and time again. The best way to keep costs at a reasonable level is to have parties in a transaction directly involved in agreeing on the cost and value of the transaction itself. Whether for medical services, education, housing or groceries at the local farm stand, the market is the optimal arbitrator of the value of any transaction. The more intermediaries are introduced into the transaction, and particularly when it’s the government acting as a proxy for what it determines to be common good, the less optimal (ergo, expensive) each such transaction becomes. At the scale of a society, these incremental costs attributed to involvement of the intermediaries add up pretty quickly and dramatically.

Now that I have a strong incentive, I amwriting to my doctor to request a reduction of the fee charged to an amount that we can both agree is more reasonable for the 11 minutes of time (and yes, his 6 years of medical school and overhead, etc. etc.) he devoted to me on that painful day in March. Instead of being angry at him for the clearly inflated fee, I actually appreciate this opportunity to engage with him in a conversation about cost and value. We’ll see if he feels likewise.

Stay tuned. I’ll post an update to this article once we’ve resolved our billing differences.


Article may be re-printed with full attribution to the author and NakedLiberty.com

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An American Entrepreneur

Posted on 10 April 2011 by Editor

Originally posted 2012-04-06 01:19:42. Republished by Blog Post Promoter

It seems that every couple of days New Orleans loses one of its treasured ENTREPRENEURS:

obit

Lets get the players straight before we go on with this. Interpretation of data (not verified) but…

LARMONDO "FLAIR" ALLEN
His Companion: Kawanner Armstrong
His Sons : Christian Allen
Kwan Allen
Larmondo Allen, Jr.

His Daughters: Deidra Allen
Larmenshell Allen
Lamonshea Allen
Larmomdriel Allen
Larmerja Allen
Korevell Allen

AT AGE 25 – He had 9 Children.
(Could Kawanner Armstrong Possibly Be The Mother Of All Of His Kids?)

His Father: Burnell Thompson
His Mother: Esther Allen
His Stepfather: Bruce Gordy

His Brothers: Burnell Thompson
Edgar Thompson
Wil Willis
Danta Edwards
Reshe Edwards
Mattnell Allen
Burnell Allen
Lester Allen

His Sisters: Shannail Craig
Lekiksha Thompson
Gwendolyn Carter
Jessica Willis
Katina Gordy

Grandparents: Delors Allen
J.C. Allen
Anna Laura Thompson
Will Thompson

So, lets see now….

His Father, Burnell Thompson, fathered his brothers Burnell, Edgar and his sister Lekiksha.
His Stepfather, Bruce Gordy, fathered his Sister Katina.
His Mother, Esther Allen, must have been unwed when she gave birth to: Larmondo, Mattnell, Burnell and Lester.
We don’t know who fathered Wil Willis and Jessica Willis, or Dante and Reshe Edwards.
Lets hope sisters Shannail Craig and Gwendolyn Carter are married.

GOT THE ABOVE ALL STRAIGHT?

***********************************************

NOW, THE REST OF THE STORY

He was 25 and had 3 sons and 6 daughters.
NINE welfare recipients collecting $950 each…..
That equals $8,550 a month !!! Now add Food Stamps,
Free medical, Free school lunches, and on and on
Do the math… $102,000+ /year.
Anyone out there, sittin’ on their butt while reading this post, making A HUNDRED GRAND doing nothing?

Now that, to me, is a real Entrepreneur.

Also, because of their father’s death, all of the kids will collect social security until they are 18. Even better… if "Flair’s" thirteein brothers and sisters followd his entrepreneurial strategy — that’s an additional $1.3 million per year.

BUT WAIT…THERE’S MORE!

If all thirteen brothers and sisters can duplicate his feat of 9 welfare strategists that breeds 117 new recipients collecting $100,000 per year each!!!… or an additional $11,700,000 per year… And that’s just one family.

(To cover this requires 100% of the Taxes Paid by 1,000 avg. taxpayers)

And THAT is why America is BANKRUPT!!

ANY QUESTIONS?

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On the Hidden Dangers of Comparative Effectiveness

Posted on 10 April 2011 by Editor

Originally posted 2009-06-18 21:15:49. Republished by Blog Post Promoter

As part of the stimulus spending package approved by the government earlier this year, funding in the amount of $1.1 billion was included to sponsor research into comparing the relative effectiveness of one form of medical treatment to another. Such research, as the program’s sponsors and supporters argued, would over time reduce the net cost of medical services by determining which medical procedures offer the lowest cost treatment to address common ailments. Armed with such information, it was further argued, doctors and medical professionals would apply this additional economic data in their decision to prescribe specific medicines and treatments.

On the surface this would seem to make good common sense in that it would provide some stabilizing relief to the increasing costs to the government of operating the country’s medicaid, medicare and veteran benefit systems. However, some of the less known aspects of the research bring out a number of troubling issues. Among these is the inclusion of studies which add the dimension of patient characteristics (such as age, gender, lifestyle) into the formula of overall effectiveness. As a result, effectiveness is defined in terms of a cost-benefit ratio as applied to a specific type of individual. For example, a comparative value is placed on the benefit of curing an illness in an 80 year-old versus 20 year-old man.  When faced with limited resources the results of the research would then be intended to provide guidance as to how those limited resources should be applied and when to apply available cures relative to the cost and benefit that such cures would provide. In the case cited, the 80 year-old man has little chance of receiving priority consideration.

While such policy is widely accepted in many European countries, I dare say to any American pondering such gross delegation of power over life and death decisions this has to be deeply concerning. There are numerous specific opportunities to bring new efficiency and reduce the resulting costs associated with providing healthcare. National electronic medical records, individual (not employer) management of healthcare insurance subscription, tax incentives to support wellness and health awareness are all excellent examples.

The recipe is to make individuals more responsible for the management of their health and medical matters. Delegating this to a disinterested third part, especially a government bureaucracy is tantamount to relinquishing one’s freedom.

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Quotation of the Day:

“Liberty means responsibility. That is why most men dread it.”
George Bernard Shaw (1856 – 1950)
We welcome your comments and suggestions, either directly inline, or via email to editor@nakedliberty.com. If you would like to have your article published in Naked Liberty, please contact the editor at the above email address.

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Trust in Government and Health Care Reform

Posted on 10 April 2011 by Editor

Originally posted 2009-07-16 22:52:06. Republished by Blog Post Promoter

healthcare-reformTrust between the government and the people that elect it is the pivotal aspect of a democracy. When that trust is damaged, discontent rises. When its lost, a society faces serious risks of disintegration and chaos. Where are we in present times? To me it certainly feels like somewhere in between the two. Let me explain why.

One of the mantras which President Obama is offering in support of his (or actually it’s the Congress’) health care reform plan, is that all who are happy with their current plan will be able to keep it – seemingly a strong provision for those who would be concerned about a government mandated option. In his speech to the AMA in Chicago on June 15 he said:

“So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works.”

Read this quote a few times. What possibly could be hiding behind this simply worded, plain and direct commitment? 

Surprisingly there is. While the draft of the plan has recently been made public, its most controversial aspects have been omitted from distribution. The publicly released draft, comprising 615 pages of legal terms, conditions and constructs conveniently skips over most all of the contested issues, and particularly that of choice of health care providers. See CNS News article. The full draft comprising over 1,018 pages is yet to be made public, but several sources, including Rush Limbaugh and Rossputin.com have obtained copies (available here) where on page 16 the full draft Section 102 reads:

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
(a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
(1) LIMITATION ON NEW ENROLLMENT.
(A) IN GENERAL. Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

Translated into plain language, while the proposed plan indeed allows you to retain your current plan and coverage (“Grandfathered option”),  but starting from the day the law is enacted (i.e. “first day of Y1”) your insurrer by law would be forbidden from accepting new members. Huh? Could this really be the case? The result of such a provision is so blatently clear – the eventual elimination of the private health care option, since clearly, over time, with no new subscribers, membership in private health plans would necessarily die off. I wouldn’t use the word “devious,” but then I struggle to come up with a word more appropriate. So the President gets to keep his promise – at least in the short term – and the country’s health care system ends up being socialized a-la the Eastern block model of the 1950’s. You certainly have to give him credit for being clever.

Now of course this little known fact has not yet caught on with the public. And we don’t yet know how much more editing the existing 1018 pages will undergo, but the overt and not so transparent use of sly tactics, inclusion of major provisions injected at the last minute, attempts to subvert the spirit of what is communicated to the public – none of this can be reinforcing of our faith and trust in the government. 

Please share this article with anyone who you know cares about the truth and purity of the government “We the People” elect to serve us.

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