Healthcare is Sick

Is there a cure?

Archive for October 2009

A costly stigma around addiction

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[listen to the portion of my interview with sally that corresponds with this blog post here]

News flash: addiction is a disease that some are more predisposed to than others.  Scientists estimate that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction, according to the National Institute on Drug Abuse.

“If my mom or dad was alcoholic or drug dependent at one time… I have an increased risk because of that genetic factor,” said Sally Linowski, Director of the Center for Health Promotion in University Health Services.  “Just like some people have a predisposition to certain types of cancers or certain auto immune diseases.”

She said the genetic predisposition doesn’t directly correlate to alcoholism or drug dependency, “it just means you have a flag.  Your more likely than the average person.”

Linowksi said environmental factors also increase one’s chances for addiction, such as growing up in a household with heavy drinking or drug abuse, poor social control and lack of family rules, or being part of a targeted social group.  Any of these things make one more likely to use drugs and alcohol at an unhealthy level.

“A lot of people think about substance abuse as a poor choice… and a lack of self control,” Linowski said.  “If you think about it as a disease of the brain that actually changes the brain chemistry it invites a different level of understanding…  No one wakes up one day and says ‘I’m going to become an addict.’”

Unfortunately many who suffer from addiction do not receive adequate treatment, according to Department of Health and Human Services data. In 2005-2006, 23.8 percent of 18-25 year olds in Massachusetts were alcohol or drug dependent; of this group 9 percent did not receive needed treatment for drug addiction, and 19 percent for alcohol addiction.

This lack of treatment ends up costing the system in the end, according to the Marin Institute, an alcohol industry watchdog group.   Twenty-five to forty percent of all patients in U.S. general hospital beds (not in maternity or intensive care) are being treated for complications of alcohol-related problems, and untreated alcohol problems waste an estimated $184.6 billion dollars per year in health care, business and criminal justice costs.


Written by Chris Russell

October 30, 2009 at 11:57 pm

Posted in Uncategorized

Good Drugs/ Bad Drugs: Who decides?

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[I interviewed Sally Linowski, Director of the Center for Health Promotion in University Health Services.  Listen to the portion of the interview that corresponds to this blog post here.]

What should determine how different drugs are viewed by our esteemed public representatives in Washington?

Based on health care spending, alcohol and tobacco should be hated.  Alcohol causes $175.9 billion in spending annually, smoking $137 billion, while all other drugs account for $114.2 billion.

Death tolls reach the same conclusion, as tobacco is responsible for 435,000 lives a year and alcohol 85,000, while all other illicit drugs combined cause 17,000 deaths (it should also be noted marijuana causes zero deaths).

Unfortunately for the constituents they claim to be representing, congress cares a lot more about money than the above stats.  The alcohol and drug lobbies have contributed a combined $161,377,999 to political campaigns since 1990, and in return these industries are protected from harsh government regulation.

This began to change in June when congress passed a law that created new regulations on the tobacco industry, which the Congressional Budget Office estimated will reduce youth smoking by eleven percent over the next decade and adult smoking by 2 percent.

Although the bill isn’t perfect its definitely progress, as a bill proposing tougher regulations 11 years ago was defeated by three votes in the senate- after a $40 million lobbying blitz led by Phillip Morris.

Yet people’s priorities about drugs remain misplaced, according to Sally Linowski, Director of the Center for Health Promotion in University Health Services.  Concern is highest over “illicit” drugs, while the deadliest and most expensive drugs are accepted as a fact of life.

“America does the “war on drugs” because people are afraid of drugs,” she said.  “We think of drug addicts and people dealing crack in back alleys… but it’s a distraction from what is really causing a lot of harm, which is alcohol and tobacco.”

Written by Chris Russell

October 28, 2009 at 4:01 am

Posted in Uncategorized

An unexpected champion for universal health care

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“Without adequate health care, no one can make full use of his or her talents and opportunities. It is thus just as important that economic, racial and social barriers not stand in the way of good health care as it is to eliminate those barriers to a good education and a good job.”

Know who said this?  Obama?  Pelosi?  Health and Human Services Director Kathleen Sebelius?  All wrong.  It was Richard Nixon, one of conservatism’s most revered figures (until impeachment forced his resignation), during a January 1974 speech to congress.

The speech promoted his “Assisted Health Insurance” program which was “designed to cover everyone not offered coverage under Employee Health Insurance or Medicare, including the unemployed, the disabled, the self-employed, and those with low incomes.”

What?  Nixon wanted universal health care?

Weird how Fox News hotheads and Republican congress members fawn over Nixon’s economic and foreign policies yet ignore his views on health care.

Why is this?  Health care reform is not inherently “un-conservative”; Nixon would probably argue that reform is more conservative than doing nothing, considering the spending burden health care poses for the government.

Bruce Bartlett cites this troubling CBO data on his Forbes blog:  Medicare spending has risen 2.3 percent faster per year than growth of nominal GDP per capita since 1975.

The conservative philosophy of limiting government interference in the market has benefits- economic growth, innovation, etc.- but the government must ensure some things, like fire protection and public safety, to maintain a civil society.

Why is health care excluded from this list?  Not only would universal coverage saves lives (see earlier posts) but it would also reduce long term spending.

A recent Harvard Medical School study found those without health insurance between 51 and 64 induce $1,000 more Medicaid spending per than those with insurance after age 65.

Nixon would consider containing costs that have risen so precipitously for 30 years straight “conservative”.  How come Republicans today think differently?

Written by Chris Russell

October 24, 2009 at 9:04 pm

Posted in Uncategorized

Racial health disparities cost trillions

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Racial health disparities have been present throughout America’s history, a problem that was not solved by the Civil Rights movement.  Check out these 2005 stats from the Office of Minority Health:

-African Americans and Hispanics were approximately two times as likely to die from diabetes compared to whites

-African Americans had two times the infant mortality rates of whites

-African American men were 30 percent more likely to die of heart disease compared to whites

-African American woman were 34 percent more likely to die from breast cancer compared to white women, even though they were 10 percent less likely to be diagnosed with the disease.

Such disparities result in 83,000 deaths every year.  Besides being a moral stain upon the country, this unequal access to care costs a lot of money.  Between 2003 and 2006, the combined direct and indirect cost of health disparities was $1.24 trillion, according to a study by the Joint Center for Political and Economic Studies.

Minority groups feel current reform plans do not do enough to eliminate these disparities, and they have made their voices heard.  On October 8th, the NAACP launched its 880 campaign, referring to the 880,000 minorities who died over the past decade because of inadequate health care.  The historic organization is urging all Americans to call their congressional representatives and demand equal access to health care.

Women also face inequalities in the health care system, specifically when buying insurance in the individual health care market.  Many states allow insurance companies to charge women higher premiums because they often cost more to insure than men.  According to a recent report by the National Women’s Law Center, a 25-year-old woman could be charged anywhere from 6 to 45 percent more than a 25-year-old man, depending on the insurance company and place of residence.



Written by Chris Russell

October 21, 2009 at 10:14 pm

Posted in Uncategorized

The Depressing State of California’s Prisons

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If you think your health care is bad, be glad you aren’t in prison.  Many states rely on for-profit companies to provide care, which has turned into a $2 billion a year industry.  Not surprisingly, profits tend to be more important than inmate health.  The New York Commission of Corrections found Prison Health Services (PHS)- the largest prison health care system in the country- responsible for 23 deaths between 1995 and 2005.

Even with this record, the company had 86 contracts in 28 states as of 2005, representing 1 out of every 10 inmates.  Providing prison health care is expensive, which is why it has become privatized in recent decades, yet is a cost states brought upon themselves with the massive increase of prisoners in recent decades.

California epitomizes the detrimental effects of unrestrained prison growth.  After the state passed a series of mandatory sentencing policies and ended rehabilitation programs in the late 80s and early 90s, prison spending increased exponentially: 50 percent in the last decade, totaling 10 percent of the state budget, or $8 billion a year.

Even with such immense spending, inmate health care is still atrocious; last year a federal judge ruled it constituted cruel and unusual punishment, and ordered California to spend $8 billion on new construction, more staff and renovating existing facilities.




Written by Chris Russell

October 18, 2009 at 4:14 am

Posted in Uncategorized

What is wrong with egalitarian health care?

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The proposed public health care option has been attacked as evil in a variety of ways: it is “socialism”; it will cost too much; it will put the government in between you and your doctor, etc.

For example, on October 8th, Sean Hannity claimed “Everywhere socialized medicine has been tried, it’s failed. It ends up in rationing… it ends up bankrupting the country.”

Interesting analysis, considering France has “socialized medicine” as well as the world’s best health care system, according to a 2000 report by the World Health Organization.  America ranked 37th in quality of care, but still spent the most of any country.

The disparity between the French and American systems is most obvious when comparing uninsurance rates: .1 percent for France, 15 percent for the good ‘ol US of A.

The result of this rationed care?  Every 12 minutes someone will die because they didn’t have health insurance, totaling 45,000 people every year, which computes to roughly 15 September 11th attacks.

A public option is a logical solution to America’s insurance crisis.  If the private sector cannot provide adequate health care to all Americans, the government has a moral duty to do so.  Many rightfully express concern about the cost, but a public option would actually decrease overall health care costs in several ways.

As i noted in my post “The Massachusetts model for health care”, a public option would force private insurers to contain costs, but would also be more cost efficient than private insurers .  According to economist Paul Krugman, Medicare spends  98 percent of its budget on providing care, while private insurers spend only 80 percent- the other 20 percent goes to marketing, profits and administrative expenses.

Although it would require a substantial up front investment, a public health care plan would end up decreasing long term health care costs through efficiency, cost control and increasing access to preventive care.  Egalitarian education is an option provided through America’s vast system of public schools, and it makes sense to provide a similar option for health insurance.

Written by Chris Russell

October 13, 2009 at 11:39 pm

Posted in Uncategorized

Econ 101: Taxes reduce spending

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Almost everything in our lives is taxed- gasoline, clothes, income, etc.  Yet for some reason the government doesn’t take a cut from employer provided health care, which makes little sense considering these premiums have increased 119 percent over the last decade.  Econ 101: taxes reduce spending; if congress is so adept at taxing every other part of the economy, why do they pussyfoot around healthcare, which now accounts for 17.6 percent of the GDP?

The answer is devilishly complex.  Under the Senate Finance Committee’s proposal, insurers selling plans costing more than $8,000 for individuals and $21,000 for a family would face a 40 percent tax on the excess amount, which doesn’t seem to bad considering the average family policy is currently $13,375.

The proposal may be billed as a tax on “Cadillac” insurance plans, but would also encompass many middle class premiums, as costs can fluctuate widely based on area of the country, size of the company offering the plan and one’s occupation.

Although the tax would be levied against insurers, costs would be passed to consumers in higher premiums.  This has led unions- many of which secured insurance that currently falls into the taxable category, or soon would- to condemn the plan.  Not surprisingly a majority of Democrats, many of whom rely on the financial support of unions, have expressed their opposition to the proposal in a letter delivered today to Speaker Pelosi.

Nearly all Democrats agree that America needs health care reform, yet they oppose the Finance Committee’s proposal to tax premiums, which Chairman Max Baucus said would pay for more than a quarter of his $774 billion plan.  Why? Politics; these Democrats may want health care reform, but they want to keep their jobs more.

It’s understandable that middle class people are apprehensive about paying more for health care, but their premiums are going to increase over the coming years whether they are taxed or not.  The Congressional Budget Office estimates that job-based health insurance could increase 100 percent over the next decade.

Besides raising money, this tax would help decrease long term health care expenditures, as insurance companies would have an incentive to control costs.  The problem is this is a long term benefit, and all anyone is concerned with is how reform will affect them in the short term.  This is unfortunate, as we need reform to prevent America from bankrupting itself on health care costs, which should make sacrifices like health care taxes common sense.






Written by Chris Russell

October 7, 2009 at 4:52 am

Posted in Uncategorized