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Archive for September 2009

Health Care FAQs

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Will health care reform increase the national deficit?

Unclear, as estimates by the Congressional Budget Office differ from plan to plan.  For instance, the CBO projects the plan introduced in the Senate on September 16th by Finance Chairman Max Baucus would increase the deficit by $49 billion in 10 years.  Yet the House plan would increase the deficit by $239 billion in ten years, according to the CBO.

Will reform mean health care would be rationed?

Health care is rationed everyday when insurance companies refuse coverage because of a pre existing condition or exploit a loophole to unexpectedly drop coverage, or when an uninsured person forgoes seeking care due to cost, which recently caused a 22 year old to die of swine flu.  Obama says his reform proposal would not increase such rationing.  Yet his plan would cut $622 billion Medicaid and Medicare “waste” to help pay the estimated bill of $1 trillion+ over ten years.   My question is:  if there is really $622 worth of “waste” to be cut that would not decrease current quality of care, why doesn’t Obama make such cuts first, and tackle other reforms after?

Will more preventive care save money?

Yes and no.  Some preventive care, like promoting better health and wellness, would save money, as preventable causes of death related to poor diets, physical inactivity, smoking, alcohol abuse, etc. result in 900,000 deaths a year, a huge bill for the health care industry.

Expansion of other preventive care, like mammograms and colonoscopies, would increase overall costs, as a small number of people who receive such tests actually have the disease which is being tested for.

What are all these different health reform plans I’m hearing about?

Both the Senate and House are currently working on separate plans, and if both are passed, the bodies will work together to produce a final bill for Obama to sign.  The biggest difference between the two bills will likely be regarding the public option- the House version, at the insistence of Speaker Nancy Pelosi and liberal Democrats, will likely include it, while the Senate version will not.

What are the arguments for and against a public option?

For- A government run insurance program would force private insurers to reduce their costs to remain financially competitive, something that is desperately needed, as employer- sponsored insurance premiums increased 119 percent over the last decade.

Against- Conservatives contend reforms should be made within the current system, and that government should not compete with private industry in such a crucial part of the economy as health care.  RNC Chairman Michael Steele recently said the public option “…goes counter to everything that we know about how markets work and the role that the government plays in those markets.”


[1] http://www.forbes.com/2009/09/16/obamacare-health-care-business-healthcare-baucus-faq.html

[2] http://www.cbsnews.com/stories/2009/08/10/business/moneywatch/main5230656.shtml

[3] http://blogs.ajc.com/jay-bookman-blog/2009/09/27/good-thing-we-dont-ration-health-care-in-the-usa/?cxntfid=blogs_jay_bookman_blog

[4] http://www.nytimes.com/interactive/2009/06/18/us/politics/061809-health-care-proposals.html

[5] http://content.nejm.org/cgi/content/full/358/7/661

[6] http://www.politifact.com/truth-o-meter/statements/2009/sep/09/barack-obama/obama-says-preventive-care-saves-money-it-doesnt/

[7] http://thehill.com/blogs/blog-briefing-room/news/60529-dem-lawmaker-houses-health-bill-wont-depend-on-senate

[8] http://www.washingtonpost.com/wp-dyn/content/article/2009/09/25/AR2009092503868.html?hpid=topnews

[9] http://www.nchc.org/documents/Fact%20Sheets/Fact%20Sheet%20-%20Cost%208-10-09.pdf

[10] http://www.cbsnews.com/blogs/2009/09/09/politics/politicalhotsheet/entry5296598.shtml

Written by Chris Russell

September 29, 2009 at 1:36 am

Posted in Uncategorized

The Massachusetts model for health care

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Massachusetts reformed its health care system in 2006 with a combination of partially subsidized insurance plans and more regulation of private insurance companies, which has given it the lowest uninsured rate in the country.

In 2006 13 percent of Massachusetts’s residents were uninsured, but as of June 2008 this figure was down to 2.6 percent, according to the state Division of Health Care Finance and Policy.  Since insurance is provided to more middle and lower class people through several different subsidized plans, less people are relying on the state’s Health Safety Net fund (HSN), which finances medical visits for those making below 400 percent of the federal poverty line and are not eligible for Mass Health, the state Medicaid program.   During the first two quarters of fiscal year 2008, HSN visits fell by 36 percent, from 770,000 to just under 500,000.

The 2006 health care reform legislation also made private insurance more affordable.  Consumers can now purchase private premiums through Commonwealth Choice, a state program that regulates a group of six private insurance plans, selected by competitive bidding and given the Health Connector’s “Seal of Approval”.  Between 2007 and 2008 premiums available through Commonwealth Choice increased an average of 5 percent, while private insurance premiums before health care reform often had double digit annual percentage increases.[2]

Such cost containment is also needed nationally, as employer- sponsored insurance premiums have increased 119 percent over the last decade. Gloria DiFulvio, a Professor in UMass-Amherst’s Public Health Department, said the “public option” often discussed in the current health care debate would help to contain costs, as insurance companies would have to offer cheaper services to compete with the government sponsored plan.

Right now, many insurance companies have little incentive to produce a product that would do well in a competitive marketplace, as shown by a 2007 study by the American Medical Association- in 94 percent of metropolitan areas across the country, the market is dominated by no more than two insurance companies.


[1]https://www.mahealthconnector.org/portal/site/connector/menuitem.d7b34e88a23468a2dbef6f47d7468a0c?fiShown=default

[2]https://www.mahealthconnector.org/portal/site/connector/menuitem.d7b34e88a23468a2dbef6f47d7468a0c?fiShown=default

[3] http://www.commonwealthfund.org/Content/News/News-Releases/2009/Aug/Employer-Sponsored-Health-Insurance-Premiums-Increase-119-Percent.aspx

[4] http://www.ama-assn.org/ama1/pub/upload/mm/368/compstudy_52006.pdf

Written by Chris Russell

September 27, 2009 at 4:21 am

Posted in Uncategorized

A personal case for healthcare reform

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listen to portions of my interview with Sherry here:

https://udrive.oit.umass.edu/crussell/sherry%20audio3.mp3?uniq=u9040b

Sherry Fortin sat against a mailbox outside Pinocchio’s in downtown Northampton, knitting a winter hat.  On the sidewalk lay her finished products- several hats and scarves, which cost $20, mittens, which cost $15, and bracelets, a bargain at only $1.

A colorful sign advertised her wares: “I have diabetes and need medication.  $1 donation for a bracelet. I can knit anything you want, and will take orders.”

Sherry, 45, has had diabetes for 18 years.  For some of this time she took insulin and prescription pills to manage her blood sugar, as diabetic coma and death, along with minor symptoms, such as dizziness, nausea and extreme sweating, can result from blood sugar that is either too low or too high.

Sherry has not taken insulin or pills since July though, as these symptoms have subsided considerably, which made the medication, at a price of $30 a month through Mass Health, a state program, seem more like a luxury than a necessity.

For someone with a steady income this would obviously not be the case, but Sherry has been out of work for over a year.  On good days she makes about $20 selling her knitted products, enough to buy food and service her addictions to soda and cigarettes.

Although the short term symptoms of diabetes have not manifested themselves in months, Sherry cannot escape the long term health consequences that result from not taking insulin regularly, namely Diabetic neuropathy, where the body does not supply enough blood to nerves in the hands and feet, causing nerve cells to die.

“My feet hurt really bad; they have numb feeling of being asleep, but still ache all the time,” Sherry said.  “They have been threatening to cut my feet off for a while, but I won’t let them.”

Recently her pinkie has also started to feel numb, which has made Sherry especially apprehensive.

“If anything happens to my hands I would really be in trouble,” she said.  “My hands are how I make my living.”

Neuropathy is caused by blood sugar levels that are either too high or too low for long periods of time, evidence that Sherry has had inadequate access to medication over her 18 years with diabetes.

This failure to take regular medication may result in amputation, which epitomizes what is wrong with America’s health care system, according to Gloria DiFulvio, a Professor in UMass- Amherst’s Public Health Department.

DiFulvio said if Sherry had managed her diabetes correctly since she was first diagnosed, which would have included stopping smoking, a healthy diet and regular physical exercise, along with medication as needed, “it would be way cheaper than amputating her leg, if that is what it comes to.”

It would be cheaper to insure everyone adequately rather than underinsuring some, and then treating them when they show up at the emergency room as a result of the underinsurance.

For example, diabetes costs more than $192 million in medical expenses annually, which is significant considering 80 percent of type 2 diabetes, by far the more common version, is preventable through better diet, exercise and taking adequate levels of medicine.


tabl[1] http://diabetes.webmd.com/tc/diabetic-neuropathy-topic-overview

[2] http://www.liebertonline.com/doi/abs/10.1089/pop.2009.12202

[3] http://www.idf.org/sound_bites

Written by Chris Russell

September 27, 2009 at 4:03 am

Posted in Uncategorized

Fark.com: Can the counter-cultural “news” site help save journalism?

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Fark is an example of how the internet, which is often accused of hurting journalism, can help our beleaguered profession. Drew Curtis made an interesting point- many people requested fark cover “serious” news stories, which surprised Curtis, as he assumed people would go to “serious” sites for such news.

Thus, the average fark user will probably not buy a newspaper, but they may check out a story on CNN or NYTimes.com if fark recommends it. This is an important point, as fark helps connect people to traditional news sites who otherwise would not visit them. This is good for journalism, as the more people visiting serious news sites, the better.

This is especially true of young people. According to the Pew Research Center, 34 percent of 18-24 year olds get no news, up from 25 percent in 1998. http://people-press.org/report/444/news-media Today’s young people are the news consumers of the future. For journalism to survive, the industry must find a way to engage this demographic, something fark can definitely help with.

Fark also provides a model of how journalism should evolve as the industry continues to experience what many have termed a “revolution”. Fark relies on stories submitted by readers, engages the audience with wit and humor and makes them feel as if they are part of a community, rather than passive receivers of news. If journalism is to thrive in the “New Media” age it must also incorporate these elements into its day to day operations, something many news sites have begun.

Many reporters are now blogging, and receiving criticism, praise and story ideas from readers. One example is the Boston Globe’s “Metro Desk” blog, which provides constant local news, supplementing the stories that make the daily paper. http://www.boston.com/news/local/breaking_news/

This is a good thing, as it makes readers feel more connected to the news, which will hopefully make them more interested in continuing to receive- and hopefully pay for- high quality journalism. Jay Rosen, author of the PressThink blog, describes this phenomenon as “The People Formerly Known as the Audience.” http://journalism.nyu.edu/pubzone/weblogs/pressthink/2006/06/27/ppl_frmr.html In almost every aspect of journalism, the People Formerly Known as the Audience are using the internet to become citizen journalists, whether it is through blogs, podcasting or video and audio production.

Written by Chris Russell

September 17, 2009 at 8:36 pm

Posted in Uncategorized