Our Health Care System

Boy, does it suck. But at least it's expensive!

Dear Tea Partier

If you only knew. Kaiser Health News (04.22.10), via The Left Coaster:

"And as in previous polls, when people were told the specifics about what the bill does, they approved. Nine in 10 favored new tax credits for small business. Eight out of 10 said they favored provisions to provide free basic preventive care, financial aid to senors with high drug bills, and ending insurance companies' practice of dropping people with pre-existing medical problems."

Poll Finds More Confusion Than Anger Over New Health Law

"All of these provisions kick in this year."

No "death panels" either, no matter what our favorite former half-term governor of Alaska might say.

For All Your Idiot Friends

For the morons who don't have a clue about the new health care law, this might help.

Assuming they know how to read, that is.

Damned Lawyers

Health Net used to pay bonuses based on the number of policy holders who were cancelled. LATimes (02.23.08):

"One of California's largest for-profit insurers stopped a controversial practice of canceling sick policyholders Friday after a judge ordered Health Net Inc. to pay more than $9 million to a breast cancer patient it dropped in the middle of chemotherapy.

The ruling by a private arbitration judge was the first of its kind and the most powerful rebuke to the state's major insurers whose cancellation practices are under fire from the courts, state regulators and elected officials.

Health Net ordered to pay $9 million after canceling cancer patient's policy

"Calling Woodland Hills-based Health Net's actions 'egregious,' Judge Sam Cianchetti, a retired Los Angeles County Superior Court judge, ruled that the company broke state laws and acted in bad faith."

Health Net cancelled Patsy Bates' policy back in January 2004, right in the middle of her treatment. She "was stuck with more than $129,000 in medical bills and was forced to stop chemotherapy for several months until she found a charity to pay for it."

Health Net's CEO "ordered an immediate halt to cancellations and told The Times that the company would be changing its coverage applications and retraining its sales force."

"'I felt bad about what happened to her,' he said. 'I feel bad about the whole situation.'"

There are three other cancellation lawsuits pending, and a class action suit on the way.

Just damn those lawyers.

Commies

Damned that socialized medicine and its fellow travelers. Bloomberg (02.04.08):

"Humana, the second-biggest provider of U.S.-funded health benefits, reported a 57 percent increase in profit, more than analysts estimated, on increased enrollment in Medicare plans for the elderly and lower medical expenses.

Fourth-quarter net income rose to $243.2 million, or $1.43 a share, from $155 million, or 92 cents, a year earlier, Louisville, Kentucky-based Humana said today in a statement on Business Wire. The average estimate of 14 analysts surveyed by Bloomberg was $1.32."

Humana Profit Rises 57% on U.S.-Backed Health Plans

"Humana depends more than rivals such as WellPoint Inc. and Aetna Inc. on Medicare Advantage, a government program that pays insurers to provide health-care benefits. Advantage generates about $10,000 in annual revenue per enrollee, and Humana added more than 100,000 Advantage members last year."

Not only that, they "also raised consumer premiums on Medicare drug plans for more than 3.4 million senior citizens, leading to 'positive year-over-year comparisons all year,' Arnold said."

Well they did get a cost-of-living increase in their Social Security, didn't they?

Frivolity Rears Its Ugly Head

Here we go again. This time it's Mitt. AP (11.20.07):

"'I believe we have to enact federal caps on non-economic and punitive damages related to malpractice,' Romney said. 'These lottery-sized awards and frivolous lawsuits may enrich the trial lawyers but they put a heavy burden on doctors, hospitals and, of course through defensive medicine, they put a burden on the entire health care system.'"

Romney: Cap Medical Malpractice Lawsuits

OK are you ready for it? Here it comes. "'We've got to rein in the incessant cost of medical liability,' he said."

Even though study after study have come to the same conclusion: "the medical malpractice 'crisis' is mostly an invention of insurance companies and their friends in Congress."

So you shouldn't be allowed to ask for punitive damages for frivolity like this? LATimes (11.22.07):

"The case of actor Dennis Quaid's newborn twins, who were reportedly given 1,000 times the intended dosage of a blood thinner at Cedars-Sinai Medical Center, underscores one of the biggest problems facing the healthcare industry: medication errors.

At least 1.5 million Americans a year are injured after receiving the wrong medication or the incorrect dose, according to the Institute of Medicine, part of the National Academies of Science. Such incidents have more than doubled in the last decade."

Hospital drug errors far from uncommon

Not like the mistakes were unavoidable. "The errors are made when pharmacists stock the drugs improperly, nurses don't double-check to make sure they are dispensing the proper medication or doctors' bad handwriting results in the wrong drug being administered, among other causes."

"The events over the last few days at Cedars-Sinai, and a case in Indiana last year in which three babies died after receiving an overdose of the same drug, offer a vivid illustration of the problems hospitals face. In both cases, nurses mistakenly administered a concentration of heparin 1,000 times higher than intended, giving the patients a dose with a concentration of 10,000 units per milliliter instead of the correct dosage of 10 units per milliliter."

You really want to rein in malpractice premiums? Let's start with crap like this.

Then there's always this novel concept: "these anesthesiologists focused on improving patient safety. Their theory: Less harm to patients would mean fewer lawsuits."

Fuckin' duh, eh folks?

Denied!

What? You already have coverage? Well then you're canceled. LATimes (11.20.07):

"When Rudolph W. Giuliani was diagnosed with prostate cancer in the spring of 2000, one thing he did not have to worry about was a lack of medical insurance.

Today, the former New York mayor joins two other cancer survivors in seeking the Republican presidential nomination: Arizona Sen. John McCain has been treated for melanoma, the most serious type of skin malignancy, and former Tennessee Sen. Fred Thompson had lymphoma, a cancer of the immune system."

A gap in GOP candidates' healthcare proposals

"All three have offered proposals with the stated aim of helping the 47 million people in the U.S. who have no health insurance, including those with preexisting medical conditions."

"But under the plans all three have put forward, cancer survivors such as themselves could not be sure of getting coverage -- especially if they were not already covered by a government or job-related plan and had to seek insurance as individuals."

"'Unless it's in a state that has very strong consumer protections, they would likely be denied coverage,' said economist Paul Fronstin of the Employee Benefit Research Institute, who has reviewed the candidates' proposals. 'People with preexisting conditions would not be able to get coverage or would not be able to afford it.'"

Coverage? What Coverage?

Just think how good the bottom line would look if we didn't pay any claims. LATimes (11.09.07):

"One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.

Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006."

Health insurer tied bonuses to dropping sick policyholders

"During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed."

Hooray for Barb! In 2002, Health Net set Barbara Fowler's goal at "15 cancellations a month. She exceeded that, rescinding 275 policies that year -- a monthly average of 22.9."

Double hooray for Barb!! "Her supervisor described 2003 as a 'banner year' for Fowler because the company avoided about '$6 million in unnecessary health care expenses' through her rescission of 301 policies -- one more than her performance goal."

Triple hooray for Barb!!! "In 2005, her goal was to save Health Net at least $6.5 million. Through nearly 300 rescissions, Fowler ended up saving an estimated $7 million, prompting her supervisor to write: 'Barbara's successful execution of her job responsibilities have been vital to the profitability' of individual and family policies."

Though California law "forbids insurance companies from tying any compensation for claims reviewers to their claims decisions", Health Net's lawyer "told the arbitrator in his opening argument Thursday that the law did not apply to the insurer in the case because Fowler was an underwriter -- not a claims reviewer."

So there.

And anyway, it's been a tough month, what with the lawsuits and all.

Speaking of lawsuits, here's an interesting little tidbit from EdgarOnline (03.01.07):

"On August 9, 2005, plaintiffs filed a motion with the District Court seeking sanctions against us for a variety of alleged misconduct, discovery abuses and fraud on the District Court. The District Court held twelve days of hearings on plaintiffs' sanctions motion between October 2005 and March 2006.

During the course of the hearings, and in their post-hearings submissions, plaintiffs also alleged that some of Health Net's witnesses engaged in perjury and obstruction of justice."

HEALTH NET INC - HNT Annual Report (10-K) Item 3. Legal Proceedings.

The Court was not amused. "On December 6, 2006, the District Court issued an opinion and order finding that Health Net's conduct was sanctionable."

In a word, given the number and types of sanctions the Court imposed, the conclusion would be that Health Net was rather naughty, to say the least. How naughty? Considering it was ordered to pay plaintiffs' attorneys' fees, Health Net must have been very, very naughty.

They're Everywhere

Those damned commies and their socialized medicine. Bloomberg (11.02.07):

"Cigna Corp., the U.S. health benefits provider that specializes in handling claims for self-insured employers, said third-quarter earnings rose 22 percent as the company added 902,000 plan members in a year."

Cigna's Profit Rises 22 Percent on Growth of Plans

Pretty good quarter all around for big health. "Cigna's largest rivals last month reported higher third-quarter earnings than a year ago. Profit rose 15 percent at UnitedHealth Group Inc. of Minnetonka, Minnesota; 7 percent at WellPoint Inc. of Indianapolis; 14 percent at Coventry Health Care Inc., of Bethesda, Maryland and 4.3 percent at Aetna Inc. of Hartford, Connecticut; Humana Inc., of Louisville, Kentucky, the second-largest Medicare contractor, soared 90 percent."

Where did the revenue come from? Last year, "Medicare payments fueled growth for the insurance industry". This year, "Medicare will funnel $76.3 billion in premiums to Advantage providers", and "about $50 million more to insurers selling Medicare drug plans."

Well jeepers Wally. That ain't too bad.

Socialized Medicine

Them damned commies know how to make a buck, eh? Bloomberg (10.29.07):

"Humana Inc., the second-largest provider of U.S.-sponsored health plans, said earnings rose 90 percent, and raised its 2007 forecast after gaining customers for its most-profitable managed-care programs.

Humana jumped the most in more than three months in New York trading."

Humana Net Rises 90% on U.S.-Backed Health Plans

"Third-quarter net income climbed to $302.4 million, or $1.78 a share, from $159.2 million, or 95 cents, a year earlier, Louisville, Kentucky-based Humana said today. Profit excluding some items beat analysts' estimates, as did revenue."

"Humana derives about two-thirds of its profit from U.S. Medicare-sponsored plans for the elderly, said Carl McDonald, an analyst with CIBC World Markets in New York. In the past year, Humana switched many of its 3.4 million Medicare drug plan members into the more-lucrative Advantage managed-care plans, which provide lower out-of-pocket costs and discounted drugs."

In case anyone is still confused about the concept, this is how the SCHIP program works: the government puts up the money and "the actual care is typically delivered through private health plans by private doctors and hospitals."

And they can actually turn a profit doing it.

We're All Commies Now

SCHIP's just fine with us.

People just don't give a shit what Republicans call it.

Socialist Bastards

A recent (end of September, 2007) ABC News/Washington Post Poll, via that Commie-pinko Kos.

The question:

"'There's a proposal to increase federal spending on children's health insurance by 35 billion dollars over the next five years. It would be funded by an increase in cigarette taxes. Supporters say this would provide insurance for millions of low-income children who are currently uninsured. Opponents say this goes too far in covering children in families that can afford health insurance on their own. Do you support or oppose this increased funding for this program?'"

The response:

Unsure: 3%

Oppose: 25%

Support: 72%

The end of the world as we know it.

Wash Your Hands, For God's Sake

The Centers for Disease Control and Prevention estimates that "this year that one of every 22 patients would get an infection while hospitalized — 1.7 million cases a year — and that 99,000 would die". What to do about it? "(A) few hospitals have demonstrated that simple screening and isolation of patients, along with a relentless focus on hygiene, can reduce the number of dangerous infections." An example, from the NYTimes (07.27.07):

"At the Veterans Affairs hospital in Pittsburgh, officials say the number of infections with a virulent bacterium known as methicillin-resistant Staphylococcus aureus, or MRSA, dropped to 17 cases last year from an average of 60 before the program started. The 40-bed surgical unit that began the experiment in 2001 has cut its infection rate by 78 percent.

Such results are not unprecedented. Several European countries, including the Netherlands and Finland, have all but eliminated MRSA through similarly aggressive campaigns.

Swabs in Hand, Hospital Cuts Deadly Infections

Back here in the good old USA? "(A)t many American hospitals, experts say, high infection rates have been accepted as a cost of doing business."

Guess requiring the staff to wash their hands a lot is prohibitively expensive. Too bad for you, huh.

A Dick

The lads at LGM think he's a Dick. And they ain't talking about Cheney. Washington Post, via Lawyers, Guns and Money:

"President Bush yesterday rejected entreaties by his Republican allies that he compromise with Democrats on legislation to renew a popular program that provides health coverage to poor children, saying that expanding the program would enlarge the role of the federal government at the expense of private insurance.

The president said he objects on philosophical grounds to a bipartisan Senate proposal to boost the State Children's Health Insurance Program [ed. - aka SCHIP] by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more costly expansion being contemplated in the House."

Bush: No Deal On Children's Health Plan

"'I support the initial intent of the program,' Bush said in an interview with The Washington Post after a factory tour and a discussion on health care with small-business owners in Landover. 'My concern is that when you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government.'"

"The 10-year-old program, which is set to expire on Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford private insurance on their own."

The CBO's take on SCHIP from the commies at CBPP, via Obsidian Wings, via Lawyers, Guns and Money.

Smokers Versus Kids?

Why George would veto this is beyond us. NYTimes (07.15.07):

"The White House said on Saturday that President Bush would veto a bipartisan plan to expand the Children’s Health Insurance Program, drafted over the last six months by senior members of the Senate Finance Committee.

The vow puts Mr. Bush at odds with the Democratic majority in Congress, with a substantial number of Republican lawmakers and with many governors of both parties, who want to expand the popular program to cover some of the nation’s eight million uninsured children."

Bush Is Prepared to Veto Bill to Expand Child Insurance

"The program, which insured 7.4 million people at some time in the last year, is set to expire Sept. 30."

The CBO projects that the expanded program would "reduce the number of uninsured children by 4.1 million." The Senate Finance Committee is proposing a $35 billion increase [ed. - which works out to about three months of what we're spending in Iraq and Afghanistan] over the next five years. It would be financed by raising the tax on cigarettes from $.39 a pack to around a $1.00. Generous souls that they are, George and the boys dont' want more than a $5 billion increase.

"[Tony] Fratto, the White House spokesman, said, 'Tax increases are neither necessary nor advisable to fund the program appropriately.'"

But that's the bogus reason. The real reason is that increasing the number of kids who would become eligible "'will have the effect of encouraging many to drop private coverage, to go on the government-subsidized program.'"

And we certainly can't have that now, can we.

What A Relief

Only 44.8 million folks uninsured as opposed to 46.6 million. LATimes (03.24.07):

"The government's estimate of the number of people in the U.S. without health insurance fell by nearly 2 million Friday, but not because anyone got health coverage.

The Census Bureau said it had been overstating the number of people without health insurance since 1995. The agency blamed the inflated numbers on a computer programming error."

U.S. uninsured figures found to be overstated

"The revised estimates show that 44.8 million people, or 15.3% of the population, had no health insurance in 2005. The original estimate was 46.6 million, or about 15.9% of the population."

Get Ready. Here It Comes

Hey if Walmart and GM line up behind this, it's gonna happen sooner as opposed to later. NYTimes (02.07.07), via WashingtonMonthly:

"They have established one of the fiercest rivalries in the American economy, attacking one another’s organizations through dueling blogs, newspaper advertisements and news conferences.

But this morning, in an extraordinary meeting in Washington, the chiefs of Wal-Mart Stores and the Service Employees International Union will stand together and agree on a series of goals for achieving universal health coverage, according to people briefed on the matter."

Wal-Mart and a Union Unite, at Least on Health Policy

"So during today’s meeting, Mr. Stern and Mr. Scott will announce a campaign to seek public acceptance of several principles of health policy. One goal is universal health coverage by a specific date, somewhere around 2012. Another is the idea of shared responsibility, emphasizing that individuals, businesses and government all play roles in financing health care and expanding coverage."

Big business is very serious about this. Also attending the meeting will be bigshots from AT&T and Intel.

It Ain't Rocket Science Folks

Wall Street Journal (06.21.05), via Washington Monthly:

"The rising cost of medical-malpractice insurance has hit many doctors, especially surgeons and obstetricians. But one specialty has largely shielded itself:

Anesthesiologists pay less for malpractice insurance today, in constant dollars, than they did 20 years ago. That's mainly because some anesthesiologists chose a path many doctors in other specialties did not. Rather than pushing for laws that would protect them against patient lawsuits, these anesthesiologists focused on improving patient safety. Their theory: Less harm to patients would mean fewer lawsuits."

Once Seen as Risky, One Group Of Doctors Changes Its Ways

Now there's a novel concept: the fewer people you kill or injure, the fewer times you'll be sued.

Kevin Drum comments, "(I)f doctors and insurance companies spent half as much time trying to reduce medical errors as they did trying to rig the legal system in their favor, they might save lives and reduce malpractice premiums."

Lawyers Bite Back

If they're not liking lawyers much now, just wait 'til the Connecticut Attorney General works 'em over a little. AP (06.09.05):

"An obstetrician and gynecologist management company has been subpoenaed as part of an investigation into whether it received insurance kickbacks that artificially inflated malpractice insurance rates for Connecticut doctors, state and company officials said.

Women's Health Connecticut of Avon provides management services to more than 140 doctors and other health care providers around the state. It has been one of the most vocal supporters of a cap on awards in medical malpractice cases."

Doctors' Management Company Investigated Over Malpractice Premiums

One of the most vocal supporters of a medical malpractice law cap? Wow. Imagine that.

"Connecticut Attorney General Richard Blumenthal confirmed the subpoena was part of an investigation into whether the company profited from an illegal insurance brokerage deal that drove up premiums for unwitting doctors."

"'The price of their insurance was raised as a result of this scheme,' Blumenthal said. 'We're talking about literally hundreds of doctors who see thousands of patients for ob-gyn services.'"

Nancy Bernstein, the company's president, said they planned to comply. Like they have a choice.

Then there's the question of how much of the premium increases are attributable to insurers' losses in the bond markets from 1998 to 2001.

They'll probably fess right up to that, don't you think?

Medical Malpractice Premiums And The Damned Lawyers

Turns out, again, it ain't the lawyers doing it. In fact, it may be the result of the insurance companies' losses in the bond markets from 1998 to 2001. Though we're sure they'd tell you that if it were the case. The Washington Monthly (06.01.05):

"Just in case you haven't gotten the message yet, here's another study of medical malpractice that comes to the same conclusion as practically every other study done in the past couple of years: the medical malpractice 'crisis' is mostly an invention of insurance companies and their friends in Congress.

The basic numbers are pretty simple: the number of total judgments per physician has gone gradually down, while the total value of payouts has gone gradually up. However, the increase has been small, and matches the overall growth in medical costs."

Malpractice Again And Again And Again

Mr. Drum notes that based on the figures, "malpractice payouts have grown at about the same rate as medical costs in general. In 1992, malpractice payouts amounted to about 0.3% of total healthcare spending and 1.2% of physician and clinical spending. In 2002, the numbers were....0.3% and 1.2%."

Which sounds pretty much the same to us.

Mr. Drum also comments that "before anyone asks, these figures are for both court judgments and out-of-court settlements. The data comes from reporting of malpractice payments to the National Practitioner Data Bank, which has been required by federal law since 1990. It includes everything."

You think it might be the medical malpractice insurance companies? LATimes (06.01.05):

"There may be a medical malpractice crisis, but studies released Tuesday suggested that jackpot jury awards were not the cause.

Many doctors blame such judgments for skyrocketing insurance premiums. But the average malpractice claim payout rose about 4% a year from 1991 to 2003, according to a study published online by the academic journal Health Affairs."

Malpractice Payouts Have Not Soared, Reports Say

Hell, from 2000 to 2003, the claim payout "slowed to less than 2% a year...according to the study of 184,506 claim payments reported to a national databank."

Uhhh, that's a lot of claim payments to survey, isn't it.

"Physicians and insurers may fear multimillion-dollar jury awards, but the average court judgment in 2003 was $461,000, said Amitabh Chandra, a Dartmouth College economist and one of the authors." How many were settled out of court? How about 96%, for an average settlement amount of $257,000.

"The researchers concluded that malpractice payments had risen in line with medical care costs, while doctors' insurance premiums grew far faster — by double-digit percentages for some specialties. They suggest that recent malpractice premium increases may have had more to do with insurers' documented losses in the bond market from 1998 to 2001."

On another note, have you had your annual physical yet?