Healthcare is Sick

Is there a cure?

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Sin taxes and carrots become more prevelant in health care

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States are experimenting with a variety of health care provisions meant to induce healthier lifestyles.  Some charge state employees more for smoking and not trying to quit and for being obese and not trying to lose weight, others impose a monthly smoking surcharge for those on state insurance plans, as reported recently in Time magazine.

Similar policies have appeared in the Senate health care plan, according to the Time article.  Currently, companies administering insurance programs can reward employees with premium reductions of up to 20 percent for meeting certain health guidelines; the Senate plan would increase this figure to 50 percent.

These policies may already be too late.  By 2018 America is projected to spend $344 billion on health care costs attributable to obesity if rates increase at current levels, according to a recent report based on research by Kenneth Thorpe of Emory University.  This projects to about 21 percent of total health care spending.

Thorpe criticized congress for not focusing more on measures to reduce obesity, such as taxing sugary snacks and drinks.

“If we’re interested in bending the cost curve we’ve got to go back to the source of what’s driving spending,” he was quoted as saying in a New York Times health blog. “And if you go back 5 or 10 years it’s not technology at all. It’s the explosion of chronic disease.”

According to the report America spends about $1.8 trillion a year in medical costs associated with chronic diseases such as diabetes, heart disease and cancer; all are linked to smoking and obesity.

 

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Written by Chris Russell

November 20, 2009 at 5:09 am

Posted in Uncategorized

Community reaction to Levasseur discussion

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Students, faculty and others packed Flavin auditorium to hear the panel discussion featuring former United Freedom Front member Pat Levasseur.  Some came in an attempt to understand the UFF’s violence protesting US acceptance of South African apartheid and funding for Nicaraguan death squads.

“The ones we disagree with most strongly are the ones who have a right to speak so we know first hand what it is they think, how they come to the positions they take,” said Tom Lindeman, a retired campus minister.  “Listening to them may also help sharpen your own beliefs about why you disagree.”

Interest in the trial’s significance- the UFF members were some of the few people charged with sedition since WWI- attracted others.  UMass doctoral student John Gibney said recent interest in the Alien and Sedition acts passed under John Adams made him come to the panel discussion.

“I thought the connection between then and now would be interesting,” he said.  “I’m here mostly to hear the lawyers talk about the case, so I can compare [sedition] now to what it was like during the Adams administration.”

Media coverage of the event failed to equally represent all opinions however.  The various Boston and Springfield affiliates reported several falsehoods, including Levasseur was a murder and  tax payer dollars funded the event.

For example, on WHDH’s 11 pm news Thursday night, Victoria Block said protestors felt “taxpayer dollars should not be used to bring a bomber and a murder to the school, nor his wife who supported him during his violent crimes.”

Ray Levasseur was never charged with murder, and UMass President Jack Wilson said “Chancellor Holub and I have instructed that no state funds be used to support this activity” according to Collegian articles prior to the event.

Lack of state and university support of the event made Lillian- who only gave her first name because she works for the University- angry.  “To Deval [Patrick] and [Wison]: stop your BS,” she said, as she believes the governor and university should have supported the panel discussion as an educational experience.  “It relates to resistance, to the Vietnam Era.  We need to learn more, we need to hear what is going on underneath what is said in the media.  I want to know firsthand from the people that are related to this case… it will be another perspective for me.  I think we all should have had a right to listen to this man and what he had to say.”

Sophmore Biology major Andrea Benjamin was also angry that she was denied an educational experience.  “This is a college campus, and a publicly funded one at that.  It seems like the last place that should be censored.”

Lindeman agreed. “Freedom of speech and academic freedom to pursue unpopular themes and try to understand them is what education is all about,” he said.  “And to try to deny people who we don’t agree with their chance to talk is absolutely contrary to what a university is all about”.  He added that this principle should extend across the ideological spectrum.

Written by Chris Russell

November 20, 2009 at 12:46 am

Posted in Uncategorized

Fiscal benefits of health care reform

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The House of Representatives barely passed a health care reform bill late Saturday night by a 220-215 vote.  The bill would extend health care to 36 million uninsured, covering about 96 percent of the population, and forbid insurance companies from denying care based on a pre-existing condition.

Conservatives from both parties opposed the bill’s cost and the public option it would create.  A statement by the Republican National Committee said the bill would “increase the deficit, increase taxes on small businesses and the middle class, and cut Medicare.”

This statement does not reflect reality however.  The bill would levy a 5.4 percent tax on married couples earning more than $1 million a year or individuals making more than $500,000 a year to avoid raising taxes on the middle class.  Also, the Congressional Budget Office estimates the bill would reduce the budget deficit by about $100 billion over 10 years.

Health care reform would also mean higher wages, as Ezra Klein recently explained on his Washington Post blog.  If reform tamed premium increases, companies would transfer the saved money to wages.  Klein said there is a stronger connection between health-care costs and median wages than economic growth and median wages.  When health care costs go up, wages go down, as the chart below shows.

He cites two studies: one reported “about two-thirds of the premium increase is financed out of cash wages and the remaining one-thirds is financed by a reduction in benefits”, while the other said a 10 percent increase in premiums “results in an offsetting decrease in wages of 2.3 percent.”

 

A chart from Ezra Klein’s blog – http://voices.washingtonpost.com/ezra-klein/2009/10/will_lower_health-care_costs_m.html

do_lower_health-care_costs_mean_higher_wages_(2)

Written by Chris Russell

November 11, 2009 at 11:39 pm

Posted in Uncategorized

Unless you’re invincible, you need health insurance

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Kimberley Young graduated from Miami University (Ohio) in December 2008, and was considering enrolling in graduate school or finding work with a non-profit organization.  Only 22 years old, she had her whole life ahead of her- until she contracted swine flu in early September.  As reported by the Dayton Daily News, she lacked health insurance and thus didn’t seek care for two weeks, but by then it was too late.  She died on September 23.

Many young people lack health insurance because they think it’s too expensive and/or believe they don’t need it.  Statistics justify this philosophy somewhat.  According to the Christian Science Monitor, 27 percent of young Americans didn’t have any health-related expenses in 2006, and when they do require care, young Americans’ annual healthcare expenses average $2,200 to $6,800 less than those of older age groups.

Yet as the tragic case of Ms. Young demonstrates, these are poor reasons to forgo health insurance.  Fortunately some states have laws allowing people to stay on their parents’ insurance plan until their late 20s, and the recently passed House bill that would extend coverage till age 27.

Covering young people would also help fund the more expensive health insurance required by older segments of the population, causing even the health care industry to support extending coverage.

Debra Saunders of the San Francisco Chronicle quoted Robert Zirkelbach, press secretary for America’s Health Insurance Plans, as saying it “will have a minimal impact”.  Saunders also reported Joshua Gordon of the Concord Coalition- a non-partisan fiscal watchdog group dedicated to eliminating federal budget deficits- said extending coverage had “very minimal federal budget implications” as there are advantages to insuring “young and healthy people”. “It actually saves costs in a way,” he said.

Written by Chris Russell

November 11, 2009 at 8:43 pm

Posted in Uncategorized

The war on drugs: a costly and ineffective oxymoron

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

The government has fought the ‘war on drugs’ since the 1980s in an attempt to make Americans feel safe.  Unfortunately this ‘war’ made the problem worse as it often treats a disease- drug addiction- with prison.

Sally Linowski, Director of University Health Service’s Center for Health Promotion, said unless an addict receives treatment while in prison, chances are they will start using again upon their release.

“Even if they come out with the best intent and say ‘I’m going to go back home and make a different life for myself’… they have a criminal record, and chances are they haven’t pursued their education, they don’t have anywhere to live, they don’t have an income”, which Linowski said is a dangerous combination for a former addict, as they are likely to seek the substances that brought them pleasure before.

Stats back Linowski up.  For example, only three percent of those who complete New Jersey’s drug rehabilitation program return to prison within three years, compared with a 60 percent rate of recidivism for inmates who do not receive treatment.

Treatment is not only more effective, it is also cheaper.  According to a 1994 study by the Rand Corporation, every dollar invested in substance abuse treatment saves taxpayers more than $7 in societal costs, while additional domestic law enforcement costs 15 times as much as treatment to achieve the same reduction in societal costs.

“We know what works for drug and alcohol prevention,” Linowski said.  “If we increase the protective factors and decrease the risk factors we are going to have less addiction…  If we funded prevention the way we should and had treatment available on demand I think we would have a lot less need for criminal prosecution.”

The National Institute on Drug Abuse provides an exhaustive list of these risk and protective factors.

EXAMPLES OF RISK AND PROTECTIVE FACTORS
Risk Factors Domain Protective Factors
Early Aggressive Behavior Individual Self-Control
Poor Social Skills Individual Positive Relationships
Lack of Parental Supervision Family Parental Monitoring and Support
Substance Abuse Peer Academic Competence
Drug Availability School Anti-Drug Use Policies
Poverty Community Strong Neighborhood Attachment

Written by Chris Russell

November 6, 2009 at 4:30 am

Posted in Uncategorized

Multiple Sclerosis: We have come far, but still have further to go

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[listen to a portion of my interview with Margarita here]

One day in 1987, when Margarita Feliciano was 38 years old, she started feeling “kind of off.”

“My girlfriend told me I was walking like I was drunk,” she said.  “But I wasn’t drinking.”

She was soon diagnosed with Multiple Sclerosis, an often debilitating disease that attacks the central nervous system and impairs muscle movements, such as walking or talking.

“When I found out, my heart went down.  I was miserable,” she said.  “I was ready to give up on life.”

After several months she had to use a walker, and by 1988 she was paralyzed.  An estimated 400,000 Americans are affected by MS in some way.  Some like Margarita are permanently paralyzed, while others are only mildly affected.  There is currently no cure, although drugs developed over the last several decades can slow the disease’s progression.

These medical breakthroughs have been extremely expensive.  In 2004, the National MS Society estimated the disease cost America $23 billion due to medical care and lost wages, averaging out to $57,500 per person.

Margarita said her quality of life is improved by these new treatments.  Beginning in 1996 she began receiving a shot several time a week, which made her condition “much better.”

Mass Health, which provides health insurance for low income people, pays for these treatments and for Margarita to reside in Northampton’s Calvin Coolidge Nursing and Rehabilitation Center full time.    Without this assistance, Margarita said her condition would be unbearable.

Currently 25-30 percent of people with MS are in Medicare nationwide.

Written by Chris Russell

November 5, 2009 at 10:38 pm

Posted in Uncategorized

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