Archive for 'Health Insurance'
Dr. Quentin Young: Put Single Payer Back on the Table
One year after its much-ballyhooed launch, the Obama administration’s approach to health reform is now in serious disarray. The president’s health care summit on Feb. 25 is being portrayed as a last ditch bid to find some common ground with his “just say no” Republican opposition. He also faces an increasingly wary group of disgruntled Democrats, whose memory of the Massachusetts massacre — the election of a Republican to Sen. Edward Kennedy’s seat — remains fresh. The summit proceedings, which will be televised in the name of “transparency,” will no doubt be laden with a formidable amount of stagecraft. They will be preceded by the unveiling of the president’s own legislative proposal — presumably the odious Senate bill with some tweaks — a few days before. But it’s almost certain that this latest White House initiative, undertaken with the stated goal of salvaging and passing at least some elements of the stalled congressional bills, is foredoomed. The House bill, contrary to many who believe otherwise, is disastrous. And if such a thing is possible, its Senate counterpart is even worse. Both would shovel hundreds of billions of taxpayer dollars into the coffers of the private health insurance industry. Both would make it a federal offense, with fines, for a person to fail to buy the insurers’ shoddy products. Even so, at least 23 million people would remain uninsured under the new law. And those who have insurance would remain vulnerable to extort premium increases, not unlike Anthem Blue Cross’ recently announced premium hikes of up to 39 percent in California. While one could imagine the enactment of certain piecemeal measures that might ameliorate our condition — e.g., a simple prohibition of insurance company denials of coverage because of pre-existing conditions — these are precisely the stand-alone measures most stubbornly opposed by Republicans, conservative Democrats and their corporate patrons. Such concessions, in their eyes, must be linked to shoring up the very culprits who are most responsible for our health care mess. The presence of the for-profit health industry — the private health insurance conglomerate and the Big Pharma drug companies in the first place — in the legislative process has certainly been “transparent” from the get go. Through their lobbyists and campaign contributions , they shaped a bill that would enhance their domination of our health system. They are at the root of the catastrophe that passes for health care financing in the United States today. Of course, the conspicuous omission in the debate has been single-payer national health insurance proposal , an improved Medicare for All. This was assured on the Senate side when the powerful chairman of its Finance Committee, Max Baucus, D-Mont., informed the world that everything was on the table but single payer. How the chairman of a congressional committee, however powerful, can set the terms of debate in a democratic society by excluding such a popular and well-substantiated solution is hard to rationalize. Baucus did, of course, prevail, and what came out of the Senate was execrable. Like the House bill, it fails the three tests of genuine reform: universal coverage, quality improvement and cost control. One can reasonably suspect that President Obama now wants something — anything — to pass in Congress as evidence of the fulfillment of his campaign pledge to accomplish health care reform. But if he looks to the House and Senate bills as the starting point, his efforts will be in vain. It’s not too late for the president to re-embrace his earlier support for single-payer national health insurance and set the nation on the right path. Were he to lay out the facts to the American people and provide energetic leadership for this eminently rational proposal, he would get strong, grassroots support from the public. We’re now spending $8,000 per capita annually on health care, $2.5 trillion in total. That’s nearly one-fifth of our GDP . Yet our health outcomes rank among the lowest in the industrialized world. Some 45,000 people die each year chiefly because they have no health insurance , and medical bills and illness are now linked to nearly two-thirds of personal bankruptcies . This reality in the richest country in the world is unnecessary and intolerable. I suggest the president look to an improved and expanded Medicare program as the solution. Medicare, which was enacted in 1965 and which has served our elderly and the totally disabled so well, is a solid foundation to build upon. Enactment of an improved Medicare for All would save our nation $400 billion annually by eliminating the bureaucracy and paperwork inflicted on our system by the private insurers. That’s more than enough to provide universal, comprehensive care to everyone and to eliminate all co-pays and deductibles. A single-payer system would also allow us to rein in costs and better allocate resources. We have a talented health care workforce. But to fully unlock their potential, we need to get out from under the greedy dictates of the health industry. Mr. President, it’s time to put single payer back on the table. Read more: Health Care Reform , White House’s Health Care Summit , Health Care , Politics News
Full StorySahar Sepehri: President Obama, Please Hurry Up
Today President Obama unveiled new healthcare plans, but he will be talking about the details in a couple of days. This proposal supposed to help more than thirty million Americans who need healthcare to survive in the US. Healthcare, one of the President’s major presidential component and his pride has been facing challenges ever since first proposed. One of the major obstacles was losing a senate seat to Scott Brown, Massachusetts’ Republican Senator. Other challenges are how to convince a capitalist mentality, which has been practiced in the US for decades. Such issues and not moving forward faster than expected with the President’s plan has made many, including my family–especially my mother–extremely impatient. My mother suffers from variety of serious medical problems, and she has not had medical insurance in the past a couple of months. Sarcoidosis, heart disease, and two miner strokes are just the important ones. She also has high blood pressure and cholesterol. Not to forget, my mother is on heavy duty medications such as Methotrexate (a kind of chemotherapy medication) and cortisone to control the Sarcoidosis. These medications generate their own complications. She has lost some of her hair. She is constantly tired. Her face has puffed up to a “moon face,” and her back has hunched to a “buffalo hump.” These are medical terms used by her doctors. One of the strokes has made her very forgetful. So, she is practically and officially disabled. A disabled woman without health coverage, can you imagine? She has applied for Medicate, but the process has taken forever. Private insurance is simply not an option because of her medical complications and high price. So we have to wait. My mother is strong emotionally. She has always been a survivor, not knowing any better ever since she was a child. An untreated strep throat back in Iran haunted her up until now at the age of 60. I’m sure she won’t like it knowing I revealed one of her secrets. The strep throat damaged her heart which she had not been aware of until I was born. I am the last child of three. None of us, my sibling and I, could do much to prevent her illnesses from growing. My father passed away five years ago, and my sister lives in England. My brother helps her financially, paying the mortgage and for appliances. They live together. I am more like a moral support. I take her out to shop, talk to her on the phone every day, and watch a movie or two when I go visit her at her place. We are very close. However, not having medical insurance in America makes all of us live with constant anxiety and paranoia. Every time my phone rings, and it is my mother, my heart skips a beat. “I’m fine, don’t worry so much,” she tells me every time I pick up the phone. “You tell me if you don’t have any of your medication or you need to see a doctor right?” It’s my job to remind her all the time; otherwise she won’t say anything, thinking she will be a burden. Recently, we paid more than two thousand dollars for her medication, blood test, a cardiogram, and doctor visits. This is nothing. God forbid, if she needs emergency care, then we have to declare bankruptcy. The question is how many other Americans may have to face this? Today, based on the Bureau of Labor Statistics and the Census Bureau in America, one out of six Americans doesn’t have health insurance. This is a real social catastrophe in the first world power. Last year, I followed President Obama’s healthcare plan very carefully, but to be honest, I never thought this problem would knock on my door. I have always been a supporter of President Obama’s health plan, and I still am if not more so. America as a great power needs to have a stronger healthcare in which everyone will benefit from. It is one of the rarest developed countries, if not the only one, in which its people suffer from unaffordable medical bills. And now, with the rate of unemployment remaining unchanged at 10% percent since last year, people face a swamp of financial debt more than ever. We, as a family, could also fall into that swamp any moment. It could happen to you too. The day my mother calls for medical assistance is getting closer and closer. I feel it. What if she will never get the damn Medicate? Anxiety paralyzes me. I will try, though, to keep a calm face not, and to make anyone else worried. When that day comes, I see myself calling my siblings to ask them to do their best to keep our mother alive. So, before that day arrives, I am asking President Obama to please hurry up. Read more: Sahar Sepehri , Healthcare , Personal Essay , Politics News
Full StoryQanta Ahmed, MD: Movement As Medicine: Spinning And The Self-Care Movement
I recently wrote about the paradigm-shifting experience of exercise when I stumbled upon SoulCycle. I read about it when Chelsea Clinton held a Haiti fund-raising event there. I thought two things: wow, Chelsea has time to exercise? And cool, what is this exercise Chelsea does? I had to know and my discoveries are shared on HuffPost. If you haven’t already, run, I tell you, run into your nearest SoulCycle and find out what its all about. A novel and engaging form of spinning, SoulCycle engages body and brain in intense sessions which crest and soar on euphoria, guided imagery, candlelight and the unending surprise of discovering one’s inner strength. Lately, all this cycling has started the cogwheels in my brain spinning. Quite literally, all this movement (internal and external) has got me thinking about motion. Movement is medicine. And my spinning class certainly captures that, whether intentionally or not. A few days after my first class, I thought about the when I see my first patient one morning, an attractive 50-something year old who is planning gastric bypass surgery. She has been referred to me to evaluate for the presence of obstructive sleep apnea syndrome that affects nine out of 10 people going for weight reduction surgery. Finding the obstructive sleep apnea syndrome, and treating it before, during and after surgery significantly improves cardiac and lung complications related to the surgery. It’s important therefore to identify patients before surgery. I enter the room and I am about to tell her all this and much more when I see fat, ripe tears filling her eyes. Before I can even greet my patient, she is crying. I give her time to weep. After a few moments, she begins to speak. “My daughter is getting married in the summer. I have to look good for that. I can’t look like this” and she sweeps her hand in contempt towards her body. She looked at me, and promptly started crying again. “Oh, I used to look like you,” she continued, “and wear exactly the same kind of outfits. I’ll bring you a photo of how I used to look.” She cried some more. I felt vaguely guilty. Something about my appearance that day had triggered a memory of her lost self, a memory she clearly grieved. As we talked, I learned about her direct experience of 9-11 and how terrifying that had been for her. She then described the ‘August Blackout” some years later, when she found herself stranded in Manhattan unable to get home because of train outages and massive, citywide power loss. She described how she spent the night curbside without shelter, in limbo, until power had been restored. Eventually, feeling chronically unsafe, insecure, and vulnerable, she abandoned a job she loved in the City which had been her longstanding passion and moved permanently to the suburbs. Clearly, this was a loss she was still dealing with. She went from a dynamic, brisk lifestyle in the pulsing city to feeling confined and paralyzed, not only literally in the realm of her new work away from New York, but also in the figurative sense. As a result of her fears, her life and world had become much smaller. Unsurprisingly, her fears, her worries had paralyzed her. There was no movement in her life. Food quickly became a self-medication — fear a source of suffocation. The weight gain eventually devoured her old self. Now she was pinning all her hopes on this surgery. Certainly, bariatric surgery, as we term it, can be highly effective for reducing weight and reducing it abruptly. Certified centers of excellence, like the one where I work (at Winthrop University Hospital) combine a high degree of surgical expertise with an extensive medical, psychological and behavioral approach, ensuring the impacts are lasting. Many patients are greatly helped by such programs. We talked about what she had tried in terms of weight loss and the patient recounted many of the mainstream popular approaches of behavioral weight loss that we can all name without thinking. I looked at my patient and wondered what she could accomplish if only she had access to the magic captured in the SoulCycle philosophy. If only her efforts could have been supported with the intangible benefits of visualization, guided imagery and plain old fashioned psychotherapy, perhaps she would have what she needed to move through this difficult part of her life: hope and encouragement, and above all, movement. Movement is medicine. We have known that for a long time. So why then does American medicine espouse movement so poorly? We have created a surgical solution for disease which is fundamentally driven by the lack of movement in our lives, whether literal, or emotional, or oftentimes both. It really gave me pause. I have been treating patients for almost 20 years, talking to patients for 25, yet I know so little about the role of movement in health, and the way to help patients who are paralyzed by fear, difficulty, obstacles, or simply the grisly, arduous experience that is life. I talk to her about strategies for exercise, ways to weave it into a busy, challenging life. The day of her consultation with me, the patient is convinced nothing can help her the way surgery can — she has her heart set on a particular dress for the wedding and must ‘reach goal’ by then. Inside, I know she is correct. With the tools she has at her disposal, only ‘banding’ the stomach — making it abnormally small — will be the single most effective tool of managing her behavior and changing her eating in the short term. She has nothing else available to her. How sad. She had no confidence in other impacts on her behavior or her own ability to influence her own behavior. She had learned to believe she was not in control of her behavior. In her mind, only a surgeon could help. I believe classes like SoulCycle can change that. The words I heard in my first class, ‘you are stronger than you think” keep revolving in my brain like the spokes on spinning wheels. These words which I first heard my instructor Christine D’Ercole say have generated a whirring, whooshing background against which I am building a new landscape. What if Christine was right? What if this was actually true? What if I am literally stronger than I imagine? What if my patient could feel the same? When I think about this possibility, I discover my patient’s doctor is not too different than the patient herself. Like my patient struggling to ready herself for her daughter’s wedding, I also face challenges in the face of which I feel incapable — attainments toward which I am mysteriously barred, beliefs that I have been simply not strong enough to change. What if I removed these self-imposed barriers, and opened the gate to the rolling vista of possibility which lies before all of us through the empowerment of movement? This is one of the many reasons I have been wondering why can I not scribble exercise, including — for those who are healthy enough to safely tolerate it — spinning, on my prescription pad? Why is such exercise uncovered by most plans? It’s not just the 550 – 650 calories an hour one burns in these workouts that brings health. It’s impact is much more profound. Empowered movement, moving in a group, working out in a pack, can demolish the false ideas and confined measures of our own capabilities that we unhealthily hoard. Within the arrested time of a spinning class which successfully engages both mind and body we discover new inner realities. That’s where its powerful medicine lies. In sum, why is ‘modern’ medicine still so one-dimensional, so very not 21st Century? Why do insurance companies refuse coverage for what is fundamentally healing: medicine through movement and instead opt to cover what are largely intensely invasive, organ-specific interventional approaches? The answer is we as physicians haven’t educated ourselves or third-party payors to the contrary. Instead, we remain married to archaic, traditional philosophies even if our medical technology has exceeded the age of Avatar. In our practice, we remain disease-centered at a time when we need to move to being truly patient-centered. Why have we placed no value on being patient-centered in our current system, instead, choosing to accept the inordinate costs of invasive, highly aggressive organ-specific approaches removed from the patient’s actual life and function in society? These questions will remain unanswered until we, as Americans, demand answers. We are living through the tumultuous birth of HealthCare reform and what a pained, bloody process this delivery is emerging to be. I guess it’s a big baby and right now we are stuck in an intractable labor which threatens to turn into a ‘failure to progress.’ While we await the new arrival, here’s a new thought: agreed, as a nation we most certainly need intelligent HealthCare and Health Insurance reform, but what we are in just as much need of is SelfCare Reform. Americans have long abrogated their personal responsibility and, even more profoundly, their belief in being able to care for their own health and well-being . I am not referring to valuable and important screening for a malignancy, or careful measuring and monitoring of hemoglobin AIC, or a blood test for hepatitis or HIV. These are all important components to maintaining health and detecting disease. No. I am speaking to the belief that we have the ability to make ourselves, our families, and ultimately our entire lives healthier. Until we realize our abilities to engage in Self Care, and call for SelfCare Reform , we will remain static, passive, disengaged, as patients and physicians. When we do place a value on SelfCare ourselves, the market will too. Until then, I will not be able to write scripts for SoulCycle or indeed any other health-promoting self-driven patient behavior or intervention. Instead of paying physicians for performance of our procedures, at the present time we can only dream of paying physicians for enhancing our patient’s abilities to perform for themselves. What we need is not disease-centered health care, we need wellness-centered, patient-centered health care, namely SelfCare-centered healthcare . Wellness, nutrition and fitness is already a multi-billion-dollar industry. It’s time we turned these elements into a movement for medicine, and make our nation, our world, our lives healthier, more confident and more within our own control. Its time for SelfCare Reform, and my local SoulCycle on East 83rd may be just the first in many imaginative vehicles to carry us there, to carry us to a new kind of HealthCare – the SelfCare kind. How are you getting there? Read more: Selfcare Reform , Winthrop University Hospital , Chelsea Clinton , Selfcare , 9/11 , Bariatric Surgery , Health Insurance , Obesity , Guided Imagery , Christine D'Ercole , Soulcycle , Obstructive Sleep Apnea , Exercise , Gastric-Bypass , Weight Loss , Healthcare Reform , Spinning , Huffington Post , Medicine , Living News
Full StoryFeinstein Seeks To Block Insurance Rate Increases Across The Nation
Sen. Dianne Feinstein (D-Calif.) said Friday that she plans to introduce legislation that would bar insurance companies from enacting health insurance premium rate increases that the Secretary of the Health and Human Services deems to be unjustified.
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