I'm sure you've already heard about Bush's veto of the S-CHIP bill; if not, here's some coverage on the matter from the last week.
From a Post article from last Wednesday, detailing the House's passage of the S-CHIP compromise: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/25/AR2007092501474.html
Also from the Post, two days later, when the Senate passed the bill 67-29, a veto-proof majority: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/27/AR2007092701038.html?wpisrc=newsletter&wpisrc=newsletter&wpisrc=newsletter
One week after the S-CHIP bill was passed, Bush vetoed it, quietly and without fanfare: http://www.nytimes.com/2007/10/04/washington/04bush.html
An excellent Times editorial debunking counterarguments against the bill:
http://www.nytimes.com/2007/10/05/opinion/05fri1.html
And finally, the point behind this blog post:
http://www.nytimes.com/2007/10/08/us/politics/08cong.html
This bill is going to be coming back up for a potential veto override. It already enjoys a supermajority in the Senate; it still needs plenty of Republican members of the House to change their votes in order to pass over Bush's veto. The issue isn't complicated; the question is simply whether poor children should get health care, or whether they should fend for themselves.
New Jersey has three Congressmen who voted against S-CHIP, and that's one place to start applying pressure. UHCC and the College Dems are going to start canvassing, tabling, and seeking signatures for a petition to send to the New Jersey representatives--more info forthcoming tomorrow. In the meantime, check out this 30-second video made by FamiliesUSA, and please sign the e-mail petition; it will only take a minute of your time.
http://www.familiesusa.org/bushvskids/
--Jordan Bubin '09
Sunday, October 7, 2007
Thursday, September 27, 2007
Physicians make plans of their own
http://www.pnhp.org/physiciansproposal/proposal/Physicians%20ProposalJAMA.pdf
This is a group's proposal for a single payer health care system. It was written by physicians for the public and sent to me by Sabrina Lueck'10 at Cornell University.
This is a group's proposal for a single payer health care system. It was written by physicians for the public and sent to me by Sabrina Lueck'10 at Cornell University.
Sunday, September 23, 2007
From the New England Journal of Medicine
Volume 357:1173-1175
September 20, 2007
Number 12
Health Care for All?
M. Gregg Bloche, M.D., J.D.
In the summer of 1793, as Prussian and Hapsburg armies closed in on Paris, French leaders issued an unprecedented decree, ordering all unmarried men 18 to 25 years of age to take up arms, married men to make arms, women to sew tents and uniforms, and old men to "excite the courage of the warriors" and "preach the hatred of kings." France thereby transformed warfare from the business of professionals to the work of a whole nation.1
Historian and legal scholar Philip Bobbitt suggests that we owe our national social-insurance systems to this reinvention of war.1 In exchange for widespread sacrifice, citizens began looking to the state to secure their welfare. Over the next century and a half, advances in firepower and mobility made mass participation more vital — and wartime sacrifice more horrific. Bismarck gets credit for forging a compact to ensure that citizens called on to risk everything had their needs met in return. After sending a vast conscript army to take Paris in 1870, he moved to secure the welfare of German citizens by creating the first national system of social insurance and medical coverage. World War I brought a new level of ferocity — and global progress toward national health insurance.
World War II marked both the apotheosis of this social compact and its endgame. The advent of nuclear weapons changed the nature of conflict between countries that have them — barring madness, war between nuclear states is unlikely to engage whole societies in the same way. For a generation or more after the war, an ethos of reciprocal sacrifice and social obligation lingered in the United States. This ethos helped to create Medicare and Medicaid, enacted in 1965 over opposition from an array of interests. Robert Putnam's Bowling Alone documents the high plateau of public engagement achieved by the World War II generation and the steady decline in civic concern and social connectedness among Americans born later.2
The kind of sacrifice made in World War II is now difficult to imagine. Warfare has again become a craft practiced by comparatively small numbers of highly trained professionals. No longer do most Americans expect to be called on to make the ultimate sacrifice for their country, and no longer do they look to government to provide for their well-being in exchange for their readiness to do so. The failure of our political process to produce universal health care coverage underscores this fact. Our evolving public morality seems to be turning us away from the concept of health care as a right, toward treatment of health as a private matter.3
Yet there is, in our politics, a hint of something new on the old subject of extending coverage to everyone. The premise of personal responsibility for health is evolving toward an obligation to acquire coverage and to attend to wellness more generally. The idea surfaced politically in the early 1990s, in a proposal by the late Republican Senator John Chafee of Rhode Island. He urged an individual mandate to obtain coverage, accompanied by subsidies for the less well-off. Although Chafee's plan went nowhere, his lead staff member on health went to the New America Foundation, which made the individual mandate the centerpiece of its plan for U.S. health care.4
Some criticize the mandate as a political distraction. The real challenge, they say, is to make coverage affordable to people who don't have it. But over the past few years, the idea has spread. It is the moral premise for the pioneering effort to achieve universal coverage in Massachusetts and for California Governor Arnold Schwarzenegger's plan for health care reform. Democratic presidential candidate John Edwards has embraced it, and Republican Mitt Romney points to the Massachusetts plan (which, as governor, he signed into law) as proof of his presidential mettle.
That health care payers are unhappy about the use of cross-subsidies to cover care for the uninsured is part of the reason for the growing interest in the individual mandate. But the larger story, I suspect, is the resonance between the mandate and the moral calculus of the diminished state: We no longer expect the state to call on our children en masse to face fusillades of hot lead — or ask government to reciprocate with 20th-century-style public generosity. The trend instead is toward an ethic that calls on us to take care of ourselves.
Other expressions of this ethic include high-deductible coverage,5 financial rewards for regular workouts and weight control, and penalties (such as premium surcharges) for failure to comply with treatment. The federal role in furthering these initiatives has been minimal; they are spreading by swarm logic. Employee-benefits managers, consultants, state legislators, and local officials are experimenting, swapping ideas, and encouraging each other.
If the United States is to come close to universal coverage, personal responsibility will need to play a larger role than it did in the mid-20th-century welfare state. Is there room for a new compact between citizen and state along these lines? Resurgent interest in universal coverage — among state legislators, business leaders, and presidential candidates — suggests that there is.
The new compact is likely to start with an enhanced sense of individual obligation — to eat sensibly, exercise regularly, avoid smoking, and otherwise care for ourselves. It may include an obligation to buy insurance. Government, in exchange, can offer some protection against the threat of economic and social change that will disrupt people's coverage by destabilizing employment and family relationships. Not only can the state provide subsidies to enable poorer citizens to buy insurance; it can, at low cost, combine people's purchasing power and clear away obstacles to competition, empowering markets to extend coverage to tens of millions who now go without it. Government can also fashion incentives to foster evidence-based practice, health promotion, the elimination of racial disparities in care, and the reduction of medical errors.
The ideas on health care reform that are being taken seriously in state capitals and in the 2008 presidential campaign are variations on this theme. No plausible presidential candidate is urging a European-style program of generous public insurance for all. Like the Massachusetts plan, the proposals from John Edwards and Senator Barack Obama (D-IL) patch together existing public programs, employment-based coverage, insurance market reforms, and new public subsidies. Their proposals have the potential to achieve near-universal coverage and to improve the quality of care. Senator Hillary Clinton (D-NY) is expected to offer a similar package.
These ideas will disappoint proponents of more sweeping reform aimed at achieving uniformly generous coverage for all. But this strategy responds to the anxieties of working Americans, who accept that they must, in the main, depend on themselves. It supplies a safety net when self-reliance falters because of large economic and social forces. And it shields the poor from the degrading, life-endangering consequences of going without basic care because they cannot pay for it. It calls on all of us, though, to take greater personal responsibility for our health, by caring for our bodies and buying insurance. And it permits some stratification of medical care on the basis of wealth (though it softens this inequity by promoting evidence-based practice for all).
In the wake of September 11, 2001, and again after Hurricane Katrina, many Americans hoped to restore a spirit of shared sacrifice and mutual support. More able leaders might have brought us closer. But barring a catastrophe much more severe than that of 9/11, a return to a World War II ethos isn't likely. What is possible is a new reciprocity of personal and public commitment, tailored to American self-reliance and the uncertainties of a global economy. This arrangement stands a decent chance of delivering near-universal coverage. Success could cement a new understanding of government's role — not as a guarantor of easy living irrespective of striving but as an insurer of basic decency when self-reliance fails.
Source Information
Dr. Bloche is a professor of law at Georgetown University and a nonresident senior fellow at the Brookings Institution, both in Washington, DC, and an adjunct professor at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.
References
Bobbitt P. The shield of Achilles: war, peace, and the course of history. New York: Knopf, 2002.
Putnam RD. Bowling alone: the collapse and revival of American community. New York: Simon & Schuster, 2000.
Epstein RA. Mortal peril: our inalienable right to health care? Reading, MA: Addison–Wesley, 1997.
Calabrese M, Rubiner L. Universal coverage, universal responsibility: a roadmap to make coverage affordable for all Americans. Working paper no. 1. Washington, DC: New America Foundation, 2004.
Bloche MG. Consumer-directed health care. N Engl J Med 2006;355:1756-1759. [Free Full Text]
September 20, 2007
Number 12
Health Care for All?
M. Gregg Bloche, M.D., J.D.
In the summer of 1793, as Prussian and Hapsburg armies closed in on Paris, French leaders issued an unprecedented decree, ordering all unmarried men 18 to 25 years of age to take up arms, married men to make arms, women to sew tents and uniforms, and old men to "excite the courage of the warriors" and "preach the hatred of kings." France thereby transformed warfare from the business of professionals to the work of a whole nation.1
Historian and legal scholar Philip Bobbitt suggests that we owe our national social-insurance systems to this reinvention of war.1 In exchange for widespread sacrifice, citizens began looking to the state to secure their welfare. Over the next century and a half, advances in firepower and mobility made mass participation more vital — and wartime sacrifice more horrific. Bismarck gets credit for forging a compact to ensure that citizens called on to risk everything had their needs met in return. After sending a vast conscript army to take Paris in 1870, he moved to secure the welfare of German citizens by creating the first national system of social insurance and medical coverage. World War I brought a new level of ferocity — and global progress toward national health insurance.
World War II marked both the apotheosis of this social compact and its endgame. The advent of nuclear weapons changed the nature of conflict between countries that have them — barring madness, war between nuclear states is unlikely to engage whole societies in the same way. For a generation or more after the war, an ethos of reciprocal sacrifice and social obligation lingered in the United States. This ethos helped to create Medicare and Medicaid, enacted in 1965 over opposition from an array of interests. Robert Putnam's Bowling Alone documents the high plateau of public engagement achieved by the World War II generation and the steady decline in civic concern and social connectedness among Americans born later.2
The kind of sacrifice made in World War II is now difficult to imagine. Warfare has again become a craft practiced by comparatively small numbers of highly trained professionals. No longer do most Americans expect to be called on to make the ultimate sacrifice for their country, and no longer do they look to government to provide for their well-being in exchange for their readiness to do so. The failure of our political process to produce universal health care coverage underscores this fact. Our evolving public morality seems to be turning us away from the concept of health care as a right, toward treatment of health as a private matter.3
Yet there is, in our politics, a hint of something new on the old subject of extending coverage to everyone. The premise of personal responsibility for health is evolving toward an obligation to acquire coverage and to attend to wellness more generally. The idea surfaced politically in the early 1990s, in a proposal by the late Republican Senator John Chafee of Rhode Island. He urged an individual mandate to obtain coverage, accompanied by subsidies for the less well-off. Although Chafee's plan went nowhere, his lead staff member on health went to the New America Foundation, which made the individual mandate the centerpiece of its plan for U.S. health care.4
Some criticize the mandate as a political distraction. The real challenge, they say, is to make coverage affordable to people who don't have it. But over the past few years, the idea has spread. It is the moral premise for the pioneering effort to achieve universal coverage in Massachusetts and for California Governor Arnold Schwarzenegger's plan for health care reform. Democratic presidential candidate John Edwards has embraced it, and Republican Mitt Romney points to the Massachusetts plan (which, as governor, he signed into law) as proof of his presidential mettle.
That health care payers are unhappy about the use of cross-subsidies to cover care for the uninsured is part of the reason for the growing interest in the individual mandate. But the larger story, I suspect, is the resonance between the mandate and the moral calculus of the diminished state: We no longer expect the state to call on our children en masse to face fusillades of hot lead — or ask government to reciprocate with 20th-century-style public generosity. The trend instead is toward an ethic that calls on us to take care of ourselves.
Other expressions of this ethic include high-deductible coverage,5 financial rewards for regular workouts and weight control, and penalties (such as premium surcharges) for failure to comply with treatment. The federal role in furthering these initiatives has been minimal; they are spreading by swarm logic. Employee-benefits managers, consultants, state legislators, and local officials are experimenting, swapping ideas, and encouraging each other.
If the United States is to come close to universal coverage, personal responsibility will need to play a larger role than it did in the mid-20th-century welfare state. Is there room for a new compact between citizen and state along these lines? Resurgent interest in universal coverage — among state legislators, business leaders, and presidential candidates — suggests that there is.
The new compact is likely to start with an enhanced sense of individual obligation — to eat sensibly, exercise regularly, avoid smoking, and otherwise care for ourselves. It may include an obligation to buy insurance. Government, in exchange, can offer some protection against the threat of economic and social change that will disrupt people's coverage by destabilizing employment and family relationships. Not only can the state provide subsidies to enable poorer citizens to buy insurance; it can, at low cost, combine people's purchasing power and clear away obstacles to competition, empowering markets to extend coverage to tens of millions who now go without it. Government can also fashion incentives to foster evidence-based practice, health promotion, the elimination of racial disparities in care, and the reduction of medical errors.
The ideas on health care reform that are being taken seriously in state capitals and in the 2008 presidential campaign are variations on this theme. No plausible presidential candidate is urging a European-style program of generous public insurance for all. Like the Massachusetts plan, the proposals from John Edwards and Senator Barack Obama (D-IL) patch together existing public programs, employment-based coverage, insurance market reforms, and new public subsidies. Their proposals have the potential to achieve near-universal coverage and to improve the quality of care. Senator Hillary Clinton (D-NY) is expected to offer a similar package.
These ideas will disappoint proponents of more sweeping reform aimed at achieving uniformly generous coverage for all. But this strategy responds to the anxieties of working Americans, who accept that they must, in the main, depend on themselves. It supplies a safety net when self-reliance falters because of large economic and social forces. And it shields the poor from the degrading, life-endangering consequences of going without basic care because they cannot pay for it. It calls on all of us, though, to take greater personal responsibility for our health, by caring for our bodies and buying insurance. And it permits some stratification of medical care on the basis of wealth (though it softens this inequity by promoting evidence-based practice for all).
In the wake of September 11, 2001, and again after Hurricane Katrina, many Americans hoped to restore a spirit of shared sacrifice and mutual support. More able leaders might have brought us closer. But barring a catastrophe much more severe than that of 9/11, a return to a World War II ethos isn't likely. What is possible is a new reciprocity of personal and public commitment, tailored to American self-reliance and the uncertainties of a global economy. This arrangement stands a decent chance of delivering near-universal coverage. Success could cement a new understanding of government's role — not as a guarantor of easy living irrespective of striving but as an insurer of basic decency when self-reliance fails.
Source Information
Dr. Bloche is a professor of law at Georgetown University and a nonresident senior fellow at the Brookings Institution, both in Washington, DC, and an adjunct professor at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.
References
Bobbitt P. The shield of Achilles: war, peace, and the course of history. New York: Knopf, 2002.
Putnam RD. Bowling alone: the collapse and revival of American community. New York: Simon & Schuster, 2000.
Epstein RA. Mortal peril: our inalienable right to health care? Reading, MA: Addison–Wesley, 1997.
Calabrese M, Rubiner L. Universal coverage, universal responsibility: a roadmap to make coverage affordable for all Americans. Working paper no. 1. Washington, DC: New America Foundation, 2004.
Bloche MG. Consumer-directed health care. N Engl J Med 2006;355:1756-1759. [Free Full Text]
Friday, September 21, 2007
The Only Thing We Have To Fear...
Paul Krugman had another excellent editorial in the paper this morning. His point? The only thing stopping universal health care is fear.
http://www.nytimes.com/2007/09/21/opinion/21krugman.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190403219-3hLE+mhfpp0BLDi+B51WYA
Think about it: We fear the unknown. How often are the actual specifics of universal coverage discussed and described? On the flip side, how often are the specters of "federalized medicine" and "socialized medicine" raised, without either explaining why that would be a bad thing, or how, for example, S-CHIP constitutes socialism?
If people are kept in the dark about the honest costs, benefits, and ramifications of universal health coverage, then it's much easier to convince them to be against it.
One example are the objections raised on the grounds of consumer choice, claiming that with universal health care, patients would lose the ability to choose their doctor. However, not only is that not true--which people do not realize--but it also callously overlooks the fact that people without health insurance truly do not get to choose a doctor, because they do not get a doctor at all.
The single, most important step in this struggle is education, pure and simple.
http://www.nytimes.com/2007/09/21/opinion/21krugman.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190403219-3hLE+mhfpp0BLDi+B51WYA
Think about it: We fear the unknown. How often are the actual specifics of universal coverage discussed and described? On the flip side, how often are the specters of "federalized medicine" and "socialized medicine" raised, without either explaining why that would be a bad thing, or how, for example, S-CHIP constitutes socialism?
If people are kept in the dark about the honest costs, benefits, and ramifications of universal health coverage, then it's much easier to convince them to be against it.
One example are the objections raised on the grounds of consumer choice, claiming that with universal health care, patients would lose the ability to choose their doctor. However, not only is that not true--which people do not realize--but it also callously overlooks the fact that people without health insurance truly do not get to choose a doctor, because they do not get a doctor at all.
The single, most important step in this struggle is education, pure and simple.
In the world of public health care
Not long ago, well, actually it is still happening now, some people in Canada proposed going to a two-tier private/public healthcare system. Not many people were down with that but here's a good little blurb on some of the issues surrounding public health care in countries where it exists.
|
"The two tier debate continues here, and in fact we have a 'second tier' if you will. The biggest thing from a Canadian perspective is that we as a country totally endorse the concept of universal healthcare -- that is to say it is considered an absolute that everyone has a right to access the full range of healthcare services indicated by their medical condition. That’s the fundamental principle behind the Canada Health Act. The federal government enforces it fairly fiercely – and that’s the challenge for two tier here. Given the provisions of the Canada Health Act, private clinics are left to ‘augment’ the system – so you see it coming up mostly in private diagnostics and cosmetics kinds of medicine. The other big issue here though is that we have an odd sort of combination. While we all tend to think we have a universal, or publicly operated health system….there is one area that is out. Physicians remain private businessmen, operating their own practices and billing on a piece rate sort of basis. So though it is the government purse for all parties, docs can dictate their own level of work and patient flow, and make as much as they can organize making through office and procedures fees, on call billings and so forth. The rest of the system is given global budgets to operate within, which naturally rations the level of services we can provide. Case in point – A physician working out of Kelowna General is a private businessman. Can take as many, or as few patients as he or she chooses. And gets paid more for moving folks through quickly than for taking time to listen and do a thorough assessment. If a surgeon and keen to make lotsa money (or if one is more Pollyanna….to provide better service to larger numbers of needy patients J)his or her ability to do so is contingent upon getting all the OR time they are able to book. So lots of different docs all competing for OR time, in a hospital that is tight on resources and trying desperately to prioritize while they wait for government funding to expand. Which creates political pressure to keep giving the specialists what they want. Just try asking for more money for home care or preventative care in the middle of that melee. The US HMO’s were/are an attempt to meet in the middle…….create a managed ‘system’ which provides access in a sustainable way to all members of the group. Problem is in who gets to say what the client gets or who provides their care. The docs are on salary though, which is probably a good thing. It’s a sticky issue – the British NHS has some interesting lessons to look at in all this as well. Also At present 45 cents out of every tax dollar goes to health care in Most consider our system one of the best in the world. Along with a few |
Thursday, September 20, 2007
Bipartisan Morals
Today, President Bush again declared that he would veto the current bill to extend S-CHIP, claiming that Democrats were playing politics with the safety of children.
http://www.nytimes.com/2007/09/20/washington/19cnd-bush.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190320096-gkPq9CwVzHv22GlS8WOFRA
That is far from the truth. The current bill is supported by plenty of Republican Congressmen and women as well, so it's certainly not a partisan issue. In fact, the bill passed the Senate with 68 in favor, because of strong Republican support--enough to override a Presidential veto.
Also, the current bill is asking for $65 billion over six years, which, yes, is $35 billion more than current spending on the program, but is also a $15 billion compromise from what Congress had initially considered asking for.
If S-CHIP is not reauthorized by October 1st, a dozen states will run out of money, and millions of children will lose their health insurance. Two dozen more states will quickly run out of money as time passes. Bush's accusation that the Democrats are playing politics, rather than caring for the children, is hypocritical: The agreement is on the table, right now, to care for millions of our nation's children, and to expand that care to 4 million more than are currently protected. Standing in the way of that because of a trumped-up philosophical divide, isn't just politics, it's dangerous, careless, and callous politics.
Of course, there is one other argument that Bush makes to justify vetoing the S-CHIP reauthorization proposal: that the program was designed to cover only poor children. There are several things that I can think of in response to that, chiefly: Aren't all children equally worth protecting? If a child comes from a middle-class family, but is still without health care, is he any less at risk than a child from a poor family who also lacks health insurance? No--the situations are morally the same.
Second, part of the current health care problem is a symptom of the fact that employer-based health care proposals and systems are insufficient; this fact is coming home hard to millions of middle-class families. Self-employed households do not benefit from employer-based insurance; many business don't offer health insurance, in order to stay financially viable, despite the draw it would give to potential job applicants. So, middle-class families can no longer afford to pay for health insurance--are they excluded from our health system simply because they're not poor enough?
Finally, Bush himself used to be in favor of re-authorizing and expanding the program, and regardless of the explanation for that, it is entirely possible--and indeed, the point of a democracy--for things to change according to the wishes of the people. Whether or not S-CHIP was founded as a program solely for poor children, the people's representatives are trying to extend and re-authorize a program; threatening a veto on such an issue is simply stomping on the wishes of the public.
The bill enjoys enough of a majority in the Senate that it can override a veto, but not yet in the House.
Please, take two minutes on behalf of millions of children, and place a call to your Congressmen (especially if you have a Republican representative) and urge them to support the re-authorization of S-CHIP.
You can use this toll free number: 1-800-861-5343, which will ask you for your five-digit zip code in order to connect you directly to your Congressman's office. Two minutes of your time can help make a difference in the lives of literally millions of children; please make the call.
http://www.nytimes.com/2007/09/20/washington/19cnd-bush.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190320096-gkPq9CwVzHv22GlS8WOFRA
That is far from the truth. The current bill is supported by plenty of Republican Congressmen and women as well, so it's certainly not a partisan issue. In fact, the bill passed the Senate with 68 in favor, because of strong Republican support--enough to override a Presidential veto.
Also, the current bill is asking for $65 billion over six years, which, yes, is $35 billion more than current spending on the program, but is also a $15 billion compromise from what Congress had initially considered asking for.
If S-CHIP is not reauthorized by October 1st, a dozen states will run out of money, and millions of children will lose their health insurance. Two dozen more states will quickly run out of money as time passes. Bush's accusation that the Democrats are playing politics, rather than caring for the children, is hypocritical: The agreement is on the table, right now, to care for millions of our nation's children, and to expand that care to 4 million more than are currently protected. Standing in the way of that because of a trumped-up philosophical divide, isn't just politics, it's dangerous, careless, and callous politics.
Of course, there is one other argument that Bush makes to justify vetoing the S-CHIP reauthorization proposal: that the program was designed to cover only poor children. There are several things that I can think of in response to that, chiefly: Aren't all children equally worth protecting? If a child comes from a middle-class family, but is still without health care, is he any less at risk than a child from a poor family who also lacks health insurance? No--the situations are morally the same.
Second, part of the current health care problem is a symptom of the fact that employer-based health care proposals and systems are insufficient; this fact is coming home hard to millions of middle-class families. Self-employed households do not benefit from employer-based insurance; many business don't offer health insurance, in order to stay financially viable, despite the draw it would give to potential job applicants. So, middle-class families can no longer afford to pay for health insurance--are they excluded from our health system simply because they're not poor enough?
Finally, Bush himself used to be in favor of re-authorizing and expanding the program, and regardless of the explanation for that, it is entirely possible--and indeed, the point of a democracy--for things to change according to the wishes of the people. Whether or not S-CHIP was founded as a program solely for poor children, the people's representatives are trying to extend and re-authorize a program; threatening a veto on such an issue is simply stomping on the wishes of the public.
The bill enjoys enough of a majority in the Senate that it can override a veto, but not yet in the House.
Please, take two minutes on behalf of millions of children, and place a call to your Congressmen (especially if you have a Republican representative) and urge them to support the re-authorization of S-CHIP.
You can use this toll free number: 1-800-861-5343, which will ask you for your five-digit zip code in order to connect you directly to your Congressman's office. Two minutes of your time can help make a difference in the lives of literally millions of children; please make the call.
Wednesday, September 19, 2007
Read the Label
One of the requirements for a functioning free-market is informed buyers and sellers.
Of course, there are plenty of ways that health care fails even this basic litmus test--as a consumer, you don't know what ails you, and if you did, you wouldn't know what specific medicines to buy, you don't have the knowledge necessary to make informed decisions on medications and surgeries, and you don't know what exactly the effects of a given medication will be on your system.
Sure, every medication comes with a detailed packet of information on the chemical composition of the drug, along with contraindicators, and many other important pieces of information--but do you think everyone is fully informed by those dense packets?
In any case, the idea of informed consumers in the health care market crossed my mind when I read this article over the summer: http://www.nytimes.com/2007/07/31/health/31drug.html?ex=1189742400&en=cb3d2c9d5ad23d98&ei=5070
Part of the issue at hand is whether Avandia, a diabetes drug, should be allowed to remain on the market, given evidence that it may increase the rate of heart attacks. That aspect of the article is certainly fertile ground for debate regarding the legitimacy of government oversight.
Yet what was more interesting to me is the idea that here are trained medical professionals debating whether or not Avandia is actually lethal, whether it's safe to use, and whether the benefits are worth the risks.
Think about that: trained, thoroughly educated men and women who have spent decades studying medicine aren't sure whether a specific drug is safe for your consumption, and they spent plenty of time poring over studies, digging through research, and listening to arguments on both sides of the issue.
You, on the other hand, are assumed to be capable of making that same decision as an informed consumer in a market-driven insurance system.
Certainly, doctors and pharmacists can help you--but what about those who can't afford either?
Of course, there are plenty of ways that health care fails even this basic litmus test--as a consumer, you don't know what ails you, and if you did, you wouldn't know what specific medicines to buy, you don't have the knowledge necessary to make informed decisions on medications and surgeries, and you don't know what exactly the effects of a given medication will be on your system.
Sure, every medication comes with a detailed packet of information on the chemical composition of the drug, along with contraindicators, and many other important pieces of information--but do you think everyone is fully informed by those dense packets?
In any case, the idea of informed consumers in the health care market crossed my mind when I read this article over the summer: http://www.nytimes.com/2007/07/31/health/31drug.html?ex=1189742400&en=cb3d2c9d5ad23d98&ei=5070
Part of the issue at hand is whether Avandia, a diabetes drug, should be allowed to remain on the market, given evidence that it may increase the rate of heart attacks. That aspect of the article is certainly fertile ground for debate regarding the legitimacy of government oversight.
Yet what was more interesting to me is the idea that here are trained medical professionals debating whether or not Avandia is actually lethal, whether it's safe to use, and whether the benefits are worth the risks.
Think about that: trained, thoroughly educated men and women who have spent decades studying medicine aren't sure whether a specific drug is safe for your consumption, and they spent plenty of time poring over studies, digging through research, and listening to arguments on both sides of the issue.
You, on the other hand, are assumed to be capable of making that same decision as an informed consumer in a market-driven insurance system.
Certainly, doctors and pharmacists can help you--but what about those who can't afford either?
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