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talkpoliticsDuring the heated debate last summer over the proposed health care legislation, Sarah Palin and Barack Obama kept bringing to the media the phrase 'death panels', groups of people that would decide whether or not to "pull the plug on Grandma". While Palin was misguided in her analysis (as she was trying to say that end-of-life care or the living will system was the 'death panel' when it actually wasn't), she may not have been entirely off-base.
Stories have been featured recently through several media outlets of patients in Arizona and Indiana who have been denied life-saving surgeries in the past several weeks and months due to cuts in state Medicaid budgets. In Indiana, a six-month old infant named Seth Petreikis has complete DiGeorge syndrome. A surgery that was deemed "experimental" by Medicaid was denied to him, but the company that manages Indiana's Medicaid program has offered to pay for the surgery themselves. [Source]
In Arizona, 98 people who were already approved for transplants were later told they couldn't receive the surgeries because of recent cuts to Arizona's Medicaid budget. One man was set to receive a new liver, which was donated to him by a friend who'd recently passed away. Because he couldn't pay for the $200,000 surgery, the liver went to another patient. [Source] The reason for this? On October 1, 2010, the state of Arizona removed transplants from a list of medical services that can be funded through the Arizona Health Care Cost Containment System (AHCCCS). Keith Olbermann is asking viewers of his show Countdown to donate in the hopes of funding the transplants. Meanwhile, Democrats in Arizona are now using the 'death panel' analogy as an attack against Gov. Jan Brewer and Arizona Republicans, who agreed to Medicaid cuts to balance their budget, despite protests from Democrats. [Source]
The 'death panels' Palin referred to have little to do with federal government action and more to do with state government blunders. There should be some legislation on the table to mandate organ transplant surgeries be paid for through all health care providers, public and private.Transplant boards are still necessary to sort through the amount of transplant candidates but at least someone who's promised a chance at renewed life wouldn't have to worry about that promise being taken away.
Stories have been featured recently through several media outlets of patients in Arizona and Indiana who have been denied life-saving surgeries in the past several weeks and months due to cuts in state Medicaid budgets. In Indiana, a six-month old infant named Seth Petreikis has complete DiGeorge syndrome. A surgery that was deemed "experimental" by Medicaid was denied to him, but the company that manages Indiana's Medicaid program has offered to pay for the surgery themselves. [Source]
In Arizona, 98 people who were already approved for transplants were later told they couldn't receive the surgeries because of recent cuts to Arizona's Medicaid budget. One man was set to receive a new liver, which was donated to him by a friend who'd recently passed away. Because he couldn't pay for the $200,000 surgery, the liver went to another patient. [Source] The reason for this? On October 1, 2010, the state of Arizona removed transplants from a list of medical services that can be funded through the Arizona Health Care Cost Containment System (AHCCCS). Keith Olbermann is asking viewers of his show Countdown to donate in the hopes of funding the transplants. Meanwhile, Democrats in Arizona are now using the 'death panel' analogy as an attack against Gov. Jan Brewer and Arizona Republicans, who agreed to Medicaid cuts to balance their budget, despite protests from Democrats. [Source]
The 'death panels' Palin referred to have little to do with federal government action and more to do with state government blunders. There should be some legislation on the table to mandate organ transplant surgeries be paid for through all health care providers, public and private.Transplant boards are still necessary to sort through the amount of transplant candidates but at least someone who's promised a chance at renewed life wouldn't have to worry about that promise being taken away.
Re: No such things as a free organ transplant
Date: 13/12/10 23:08 (UTC)Health. Car insurance in non-mandatory states. Pet insurance.
We didn't have to mandate health insurance because employment basically voluntarily mandated it for us.
And it still does, and we didn't have to mandate insurance. And today we're a step closer to continuing that. Mandating insurance, for what it's worth, hasn't exactly helped markets in Massachusetts.
So yes. The Employer Mandated Health Care was a brilliant scheme. But it's based on an economy that's well into the twilight years. As labor mobility continues, that system is going to have bigger and bigger cracks. The fact that pre-existing conditions is as big a problem as it is, is pretty decent evidence of that.
More to the point, it's based on an economy that was extremely controlled at the top, and that needed some sort of perk to keep employment competitive. More New Deal nonsense.
Pre-existing conditions, however, are an overblown problem. When even 90% of cancer survivors, per the stat elsewhere in this post, can find insurance, it tells me something about the system.
Re: No such things as a free organ transplant
Date: 13/12/10 23:30 (UTC)But most health outcomes are a result of genetic and behavioral traits. Thus the customer will usually be more informed than the insurer.
Also, car insurance is voluntary in one state. And pet insurance, well, it's mostly a scam. I paid for it, and still paid ten grand for my cat's undiagnosed pancreatic mass. The vet that accepted the insurance said that it was outside their expertise and I would have to go to a specialist not-covered by my plan.
Yeah. That was totally a market that provided to it's customers what was advertised.
If you could point to the cancer survivor stat, I'd be grateful. But even that I'll take with a grain of salt. My mom was able to get coverage after getting kidney cancer, but she constantly has to fight with insurers to cover everything. They've decided that her impaired kidney function could be the root cause for just about everything, and thus isn't covered.
When I'm talking about pre-existing conditions, I'm not talking about having health insurance. I'm talking about getting serious health matters covered by insurance. There's a serious difference.
Re: No such things as a free organ transplant
Date: 13/12/10 23:54 (UTC)The lack of ability to ballpark should make them harder, and not easier, to work, though. That we have perfectly workable solutions in those areas seems to tell me something, at least.
If you could point to the cancer survivor stat, I'd be grateful.
What, you couldn't sift through 200+ comments to find it (http://www.kff.org/kaiserpolls/upload/7591.pdf)? d:-)
When I'm talking about pre-existing conditions, I'm not talking about having health insurance. I'm talking about getting serious health matters covered by insurance. There's a serious difference.
We're talking about the same thing. My mother has Alzheimer's - it's been...interesting to deal with the insurers given her relative youth. But at the end of the day, it's still working. We've just had to work at it a bit.
Re: No such things as a free organ transplant
Date: 14/12/10 00:04 (UTC)My dad was opening up his own business when my mom was diagnosed, so no cancer related healthcare is covered under her current insurance.
So while it might be working for your mother, the problem of gaps in insurance means that it's not working for my mother.
And sure. It's my parents fault for allowing that gap in coverage to happen in the first place. But that sort of gap is increasingly a permanent fixture in the American health care system.
Also, your comment regarding risk makes absolutely no sense. It's completely at odds with all economic game theory, so it'd be great if you'd expound a bit on what you mean.
Re: No such things as a free organ transplant
Date: 14/12/10 00:12 (UTC)No, but she had a brain tumor prior, which is part of the hassling. That and 52 year old women aren't supposed to get early onset.
And sure. It's my parents fault for allowing that gap in coverage to happen in the first place. But that sort of gap is increasingly a permanent fixture in the American health care system.
And yet it's a gap that's not creating a significant problem. We talk about it a lot, but at worst, it increases the amount of people who are temporarily without insurance. We forget that the 50m number is for anyone who was without for part of a year.
Also, your comment regarding risk makes absolutely no sense. It's completely at odds with all economic game theory, so it'd be great if you'd expound a bit on what you mean.
If you can't calculate the risk, then it shouldn't work as well. That you can...
Re: No such things as a free organ transplant
Date: 14/12/10 00:17 (UTC)Like I said, the gap is creating a significant problem. By being uninsured, she has an entire host of problems that will never be insured. It doesn't matter that she has health insurance, she will have to pay out of pocket for that malady for the rest of her life.
These gaps follow us into our next phase of life as an insured person. And that's a problem. I don't understand why you can't see that.
Re: No such things as a free organ transplant
Date: 14/12/10 00:21 (UTC)That's kind of opposite, though, unless we're approaching this from a different point to the same end. I remain with health insurance because I can caluclate the risk - I'm fairly sure I'll be using it and that I'll need it for something pricey. I don't, say, have insurance on my cell phone because I can't really figure out if I'll really need it. I can't calculate real risk on it.
Like I said, the gap is creating a significant problem. By being uninsured, she has an entire host of problems that will never be insured. It doesn't matter that she has health insurance, she will have to pay out of pocket for that malady for the rest of her life.
...assuming the insurance won't cover it, and no other insurance will cover it, and that the gap is at fault, etc. There's a lot of variables I feel like you're glossing over.
These gaps follow us into our next phase of life as an insured person. And that's a problem. I don't understand why you can't see that.
Because it appears, to me, that it's one of those overstated problems that a) is, well, overstated and b) is created in part by how we've created "solutions" to the problem. Why have we created a regulatory system, for instance, that makes dropping people from insurance more sane than paying out?
Re: No such things as a free organ transplant
Date: 14/12/10 00:47 (UTC)Knowing my family history, I know that I will probably have all sorts of issues crop up. But not until I'm in my thirties.
When I graduated college, I didn't seek any medical coverage. When I was offered free insurance two years later at a firm, I took it. But when I switched jobs, I didn't bother with the ninety days of cobra before my new job kicked in.
Instead I took the insurance option to get 90 days of my monthly meds (the fancy stuff that retails at 60/mo and I paid ten/mo), and dropped coverage.
When I was included in a string of layoffs last summer, I made the same calculated decision. I went to my doctor for a physical, got a three month supply of meds and dropped coverage. Even with the heavily subsidized COBRA plan, it was simply much cheaper.
That's including the fact that I had to pay out of pocket for two months of meds and a minor ear infection. All told, 250 dollars worth of medical bills compared to 600 dollars worth of health insurance.
Sure. It was a risk. But it was a very calculated risk. One that is devastating to the insurance market and one that was completely rational for me.
That's why knowing your personal risk is a bad thing for insurance markets.
And sure, if I had been wrong, I might have been screwed. That was the story about my mom. But that cost isn't covered by just the individual patient. My mom racked up hundreds of thousands of dollars in medical debt because of this one screw up.
It added months to her healing process, putting her out of work and unproductive. And while everyone was lucky that she had family support that covered the bills, many people who lose that gamble don't. Who pays then?
Everyone. Because even if the government didn't interfere in the market, hospitals would be likely to take on a lot of bad debt. Because when a guy comes into surgery about to die, there's often not time to determine if they're financially eligible to deal with this debt.
Re: No such things as a free organ transplant
Date: 14/12/10 01:18 (UTC)I see where you're going with this now, but it's not devastating to the market, because the market assumes this sort of dropoff. The high number of high-wage unemployed people speak to this - you'd think that if the low-risk folks were that important to the business structure, they'd offer plans to get them on board, after all.
Re: No such things as a free organ transplant
Date: 14/12/10 01:21 (UTC)Typical markets assume this sort of drop-off.
Insurance markets require the low risk to subsidize the high risk to work. If the low risk people *know* they're low risk, they won't.
How do you create a business plan that convinces low-risk folks to subsidize high risk folks? There can be a bit fear-mongering. But considering so many low-risk folk voluntarily decide to go without health insurance, I'd say it's a poor market strategy.
Re: No such things as a free organ transplant
Date: 14/12/10 01:23 (UTC)Yet they do not pursue these people when they're ripe for the picking. Yet they essentially create an incentive for the low risk to drop off the rolls until they reach a higher risk year. You understand why this isn't exactly a logical position to be claiming, right?
How do you create a business plan that convinces low-risk folks to subsidize high risk folks? There can be a bit fear-mongering. But considering so many low-risk folk voluntarily decide to go without health insurance, I'd say it's a poor market strategy.
Or the health of the business doesn't actually rely on that.
Re: No such things as a free organ transplant
Date: 14/12/10 05:52 (UTC)A free market should magically convince people to pay 100 dollars for 70 dollars worth of health care.
That's a logical assertion.