The opposition does not play fair. While we use reason and statistics, they use some dirty weapons in their war against sane, effective universal healthcare. The latest attack comes from a source which has been known to cater to corporate special interests, Associated Press.
Keep in mind that many people read only the headline and first paragraph or two of “news” articles. This allows reporters to compose propaganda pieces in the form of unbiased journalism.
Entitled
Disease prevention often not cost-effective, Carla Johnson’s piece starts out
When it comes to health care spending, an ounce of prevention is seldom worth a pound of cure.
http://hosted.ap.org/dynamic/stories/M/MED_HEALTH_PREVENTION_REALITY_CHECK?SITE=NYBUE&SECTION=HOME&TEMPLATE=DEFAULTThe author then introduces a straw man. She writes about how expensive it would be if we hired a
personal trainer for every person who is overweight. According to her, it would be cheaper to do nothing and let some people develop obesity related diseases.
Pardon me, but I have not heard about any Congressional initiative to hire personal trainers for the 34% of Americans who are obese. In order to do so, we would have to persuade almost every healthy person in America to quit his job and become a personal trainer.
Here is what the American Academy of Family Practice recommends for obesity.
Because of the difficulty in maintaining weight loss over time, prevention continues to be the most viable option for controlling overweight. Physicians have an important role in helping patients prevent the development of obesity by alerting them to the risks of inappropriate weight gain and advocating lifestyles that promote a healthier weight. Such efforts should begin in childhood and include encouraging patients to prevent the initial development of overweight and obesity, to avoid regaining weight following a weight loss and to avoid further weight gain if they are unable to lose weight.
http://www.aafp.org/afp/20010601/2185.htmlThe rest of the article is available on line at no charge. Note that personal trainer is not on the list of medical recommendations. Instead, the AAFP recommends an initial assessment of BMI, dietary and exercise counseling followed by periodic weight checks, plus or minus medication.
I have a theory about the AP article. The author was told that the health insurance industry needed to convince the public that universal preventive care would drive up medical costs in this country, rather than reducing it as so many experts have claimed. She planned to write about how bariatric surgery (e.g. stomach banding, intestinal bypass) is expensive and maybe not particularly cost effective. Her goal was to scare middle America with visions of hordes of obese illegal aliens pouring across the border to get their free stomach stapling. But, she discovered that weight loss surgery has been proven to be economical.
According to the study, health insurers that covered patients who underwent laparoscopic surgery, which has an average cost of $17,000, offset the cost in about 25 months. Health insurers that covered patients who underwent traditional bariatric surgery, which has an average cost of $26,000, offset the cost in about 49 months. Cremieux said, "The most cost-effective treatment for obesity is bariatric surgery," adding, "If you do that, within two to four years, you will get your money back." In addition, he said, "We have identified the break-even point for insurers."
http://www.news-medical.net/news/2008/09/09/41315.aspxThis report is from a managed care journal and the Wall Street Journal.
Faced with a need to turn out an article to refute claims that disease prevention would cut medical costs in the United States (as it has in Western Europe and Canada), Ms. Johnson may have changed surgery to “personal trainer.”
For the record, I have never prescribed a personal trainer for anyone in all the years I have been in practice. Nor have I suggested that every woman over 60 be given her own litter and four muscular manservants to carry her everywhere that she goes---though I have no doubt that this “treatment” would cut down the rate of osteoporotic fractures (and reduce the nation’s unemployment).
This is not the first time that Ms. Johnson has played doctor for the Medical Industrial Complex and health insurance industry. In
Congress can learn from Mass., Tenn. health plans, she writes
In Massachusetts, nearly every resident has health insurance, but doctors are turning away new patients, costs to the state are climbing and thousands have paid tax penalties for being uninsured. In Tennessee, that state's much smaller program hasn't cramped the budget, but few people are buying the new insurance even though premiums are as cheap as a monthly cell phone bill.
http://www.google.com/hostednews/ap/article/ALeqM5gk1hcFdw7GYjQuLKe7VcBAIuw69AD98FCUAO2The moral here is if you make everyone get health insurance, then taxes will go up and those lucky enough already to have insurance will find it more difficult to see a doctor. On the other hand, if you take “baby-steps” (Ms. Johnson’s words) only a handful of people will sign up and we will all live happily ever after.
Anyone who has followed health care in Tennessee knows how medically irresponsible it is to recommend their system for the nation. Here is a second opinion:
"The CoverTN plan is part of a continuing health care disaster for Tennessee residents who struggle to find health care coverage," Ron Pollack, Executive Director of Families USA, said today. "In 2005, the state purged its Medicaid rolls, literally cutting some residents off from life support. Now the state is offering a façade of a health care plan that is so skimpy that BlueCross BlueShield of Tennessee, the plan's administrator, even declines to call it insurance.
"This Tennessee plan serves as a perfect example of how states should NOT go about providing coverage for the uninsured," Pollack said.
http://www.medicalnewstoday.com/articles/151290.phpTwo days after this report came out, Ms. Johnson sang the praises of the Tennessee way.
The new health insurance industry propaganda weapon,
“Preventive Care Will Not Save Money” joins an impressive arsenal of health insurance industry weapons of mass deception. It includes such classics as
“Universal Health Care Will Take Away CHOICE”. That one begs the question, what choice do folks who can not afford health care have? They can die of preventable disease at home or they can go to the Emergency Room and die of preventable disease there. Isn’t that what they mean by being between a rock and a hard place? Some choice. I wrote more about this topic in the journal linked below.
http://journals.democraticunderground.com/McCamy%20Taylor/408Then there was the
“Tea Party/Don’t Raise My Taxes” silliness, in which large crowds of angry people are whipped into a frenzy until they are willing to repeat whatever they are told---and somewhere in the litany of “big government” abuses, universal health care gets inserted. There is nothing more ironic than watching a group of people who can not afford to get a check up proclaiming that they do not want health care. Too bad for them so many folks in the U.S. actually
want health care. The whole point of the Boston Tea Party was to protest taxation without representation. In our representative democracy, the people spoke last fall and they said "Give us health insurance." You can read more about how the health insurance industry directed the “Tea Parties” through the help of paid shills, like Dick Armey, in this journal.
http://journals.democraticunderground.com/McCamy%20Taylor/394 The
“In Canada, They Make You Wait” scare story has been with us for a long time. Here is one example from FOX News. The headline reads
Warning Against National Health Care Canadian brain tumor survivor speaks out. A woman with a history of a pituitary adenoma talks to a Fox Reporter who says that she would have died without prompt treatment in the United States. The woman has the grace to admit that she would not have died from her benign pituitary tumor, but she swears she would have gone blind. Oh! Scary. But wait a second. Here is what the American Academy of Family Practice says about pituitary adenomas.
The most common tumor resulting in hyperprolactinemia is the pituitary prolactinoma, a benign growth of the prolactin-secreting cells of the anterior pituitary gland. Autopsy reports indicate that prolactinomas are present in 10 to 30 percent of the population.4
Pituitary prolactinomas are associated with elevated prolactin levels. Clinical signs and symptoms include headache, galactorrhea, amenorrhea, defects in peripheral vision, hirsutism, acne, and hypogonadism presenting as decreased libido, decreased fertility or decreased bone density. The prognosis for patients with these tumors is excellent. Most pituitary prolactinomas regress or remain stable for many years.
Since the patient had seen her FP, an ophthalmologist and had appointments to see an endocrinologist and a surgeon, she was way ahead of the game compared to the millions of US citizens who have no way to even get in the door of a family doctor to find out what is causing their problems.
Note that while medication is generally very effective:
Medical treatments for prolactinomas include bromocriptine and cabergoline. These agents activate the lactotroph D2-receptor sites and, similar to dopamine, inhibit the synthesis of prolactin. Bromocriptine and cabergoline normalize prolactin levels, rapidly shrink tumors and restore vision, menses and fertility.
Surgery is not always the best option:
Surgery is indicated in patients who cannot tolerate medications, have tumors that are resistant to medication or experience rapid visual loss that does not respond to medical therapy.25 Unfortunately, long-term surgical cure rates for prolactinomas are poor (50 to 60 percent for microadenomas and 25 percent for macroadenomas)
http://www.aafp.org/afp/20010501/1763.htmlThis raises the question, did the woman’s family doctor attempt to spare her unnecessary surgery which has, as a complication, the risk of complete destruction of the pituitary gland, which can wreck havoc with your body’s endocrine system for the rest of your life?
Not every aching lower back needs to be operated on. Not every aching knee needs stat arthroscopic surgery. Hysterectomy is not indicated because women are sick of having normal periods. All of these surgeries can cause complications. While medical malpractice can happen in any country, the rush to the operating room is no guarantee that you have received the best possible medical care. It just means that you are getting very expensive care. And no country wastes as much money to achieve piss poor results than the United States.
For those who are still scared of the Canadian model, here are statistics compiled in Canada. Note that most tests and surgeries are done within a month of being ordered and almost all are completed within three months. Also note that if you live in Canada, chances are you will live longer and your baby will be less likely to be born low birth weight or to die shortly after delivery. Also note that the vast majority of Canadians are happy with their health care providers and that many more U.S. citizens believe that the American system of health care needs to be radically overhauled.
http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2008-fed-comp-indicat/index-eng.php#fig5Fear of undocumented workers from Mexico (aka illegal aliens) is used to attack universal healthcare. Let's call this the
"Unwashed Hordes" weapon of mass deception. We are warned that if we increase access to health professionals, the system will be overrun with people from south of the border. In fact, immigrants tend to be healthy young adults who do not use a lot of medical services. And medical care is so cheap in Mexico that U.S. citizens often travel south of the border for it.
Undocumented adults account for about $6.4 billion a year in national health care expenses, $1.1 billion of which is paid from public funds, according to the study by the Rand Corp., a conservative-leaning think tank. The publicly funded portion represents 1.25% of the total $88 billion in government funds spent on health care for adults other than seniors during 2000.
For comparison, the total cost of upgrades to the wall being constructed on the Mexico-United States border is currently expected to be between $30 and $36 billion and take most of the next decade.
http://www.workpermit.com/news/2006-12-15/us/illegal_immigrants_not_burden_health_care.htmAll this fuss over $1.1 billion? We gave the banks a whole lot more than $1.1 billion last fall. And they do not even mow our grass or pluck our chickens.
Then there is the
"Unchecked Medical Spending " argument. We are told that if Americans have universal access to health care, demand for unnecessary services will rise (this by some of the same folks who point to Canada and say that care in the U.S. will be rationed) This will cripple our economy. These people seem to forget that Medicare entitles every American who reaches the age of 65---or who develops a chronic disabling disease---to feed at the all-you-can-eat banquet of health care for as long as he lives. If we are going to provide unlimited health spending at the end of life, we might as well invest in a little prevention at its beginning.
All is fair in love and war, the saying goes. In the U.S., you have to add business to that list. Where the pursuit money is concerned, Americans have a long tradition of tolerating anything. And there is no industry today that is more profitable than the health care industry, which eats up over 15% of our GNP and which will only continue to grow as our population ages. Since the medical establishment---health insurers, drug companies, specialty surgeons etc.---have no intention of giving up their piece of that $2 trillion a year, they will use any weapon in their arsenal to shoot down health care reform. So, find yourself a Kevlar jacket, arm yourself with the truth and get ready for a nasty fight that will include bribes, lies and endless attacks on reason.
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