Archive for Monday, January 15, 2007

Universal coverage efforts under observation

Lawrence doctor involved in medical politics interested to see what state can accomplish

January 15, 2007

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A Lawrence physician, who is involved in medical politics at the international level, is closely watching how the state handles health insurance.

"It's going to be a contentious issue," said Donald Hatton, 64, who soon will hold a top post with the American College of Physicians. He has been an internist with the Reed Medical Group in Lawrence for 32 years.

"There are 300,000 Kansans that have no insurance and about 46 million nationwide; it is a problem that we need to address," he said.

Hatton in April will become president-elect of the ACP, which represents about 120,000 internal medicine physicians in the United States, Japan, Canada, Mexico, Chile, Central America, Venezuela and Puerto Rico.

As part of his duties, he helps to form the ACP's national medical policy positions that are presented to Congress and to state legislators.

Gov. Kathleen Sebelius came out in favor of universal health care coverage for Kansans last week - a policy that the ACP has favored for some time, Hatton said.

While Sebelius' plan had no specifics, Hatton said the ACP has proposed a seven-year national plan to Congress that gradually brings about new programs that are part of Medicaid, plus tax credits or subsidies that allow certain groups of people to enter insurance pools.

Hatton said he hasn't seen a formal Republican response to Sebelius' call for universal health care.

But Hatton said he expected Kansas GOP legislators to back a proposal similar to a plan proposed by Sen. Jim Barnett, an Emporia physician who ran against Sebelius in the fall.

Dr. Donald Hatton, a Lawrence internist, this year will become president of  the board of governors of the American College of Physicians, a group that presents national policy positions to Congress.

Dr. Donald Hatton, a Lawrence internist, this year will become president of the board of governors of the American College of Physicians, a group that presents national policy positions to Congress.

Barnett's proposal suggested there be a state clearinghouse where people could buy their own health care insurance that could be carried with them if they changed employers, Hatton said.

Hatton said the Kansas Health Policy Authority, which has been in operation since July, could be the agency that helps the state's health coverage issue.

At the national level, Hatton noted that U.S. Rep. Nancy Boyda, D-Kan., told an audience at Lawrence Memorial Hospital a few months ago that she thought progress toward increasing access to medical care could be done quickly - in about six to nine months.

However, Hatton said he thought a national program would first need to start out with trial, pilot programs before a national system could be put in place.

"If we have something in the next three or four years, I would be pleased," he said.

Hatton said he has been involved in medical organizations and medical politics since he was in medical school at Kansas University.

He has been active in the Kansas Medical Society throughout his career and is still on that group's executive committee.

Two years ago, he was elected governor of the Kansas chapter of the ACP and is currently in the third year of a four-year term. The ACP board of governors meets four times a year in Philadelphia to consider a variety of issues, ranging from consumer health care policy to education requirements for internal medicine physicians, he said.

Hatton said he was honored to become president-elect of that board and will travel to Philadelphia a few times a month. However, he said he will continue his full-time medical practice.

"Most of the time, I will be right here doing what I'm usually doing," he said.

Comments

KS 8 years, 4 months ago

46 million uninsured. How many have tatoos and cell phones (I am not knocking either)? It's not that they can't all afford some insurance, many just don't make it a priority in their lives. For those that truly can't afford it, we have a system already in place. It is called Medicaid. Should the rest of the country be expected to pay for something for others, just because they choose not to make it a priority? This should draw some fire!

just_another_bozo_on_this_bus 8 years, 4 months ago

Your ignorance on this issue is comprehensive, if willful, KS.

KS 8 years, 4 months ago

I call it logic! I don't want to pay for something that others can afford. Did I hit a sore spot with you "just another bozo"?

KS 8 years, 4 months ago

Thank you Kansasdaughter. There are those that are truly in need and we as a society have a responsibility to help them. Glad to know you have coverage now and also take on the responsibilty of being a parent. Good job.

dizzy_from_your_spin 8 years, 4 months ago

I'd be interested in seeing where the 300K figure came from and who it represents before the politicians try to revamp the healthcare system.

Additionally, there is a real difference between not having health insurance and not having access to medical care. There are already free and reduced cost programs in place (both govt and charitable): are you saying these programs are failing and, if so, why?

Simply dangling the idea of more free stuff from the government without supporting the need is cheap, feel-good political posturing.

just_another_bozo_on_this_bus 8 years, 4 months ago

"Did I hit a sore spot with you "just another bozo"?"

Stupidity and willful ignorance as the basis for public policy is most definitely a sore spot for me.

WilburM 8 years, 4 months ago

In the end, we pay immense amounts for insurance companies to administer inferior plans in a setting that simply isn't appropriate for market-based choices. We're headed to single-payer, sooner or later. We ought to make it sooner and more coherent, but that's highly unlikely. So we'll pay 20% of our GDP for health care that doesn't measure up to that offered most of the rest of the world at half the overall cost.

Brilliant.

KS 8 years, 4 months ago

Reality Check - And just how much do you think a government plan will cost every man, woman and child in this country? Are you saying that a governement plan will not have any waste? Talk about passing it on.....surely you realize that the cost of merchandise you buy includes the cost of theft (shoplifting, etc). That is a way of life. All I am saying is that I don't think I should have to pay for something that someone else might be able to afford, but don't want to make it a priority in their lives. I am not arguing the efficiencies or lack thereof of the insurance industry. Two totally seperate issues.

I don't pay anywhere near a $1,000 a month for a plan, family or otherwise. Shop around. Somebody already said it in a previous posting. Most uninsured don't take the time to check out the cost. They expect someone, including their employer to eithr pay in full or subsidize their insurance. What about personal responsiblity? Why is it the employers problem? People are lazy. That is an insult to me that I am expected to pay for them. Get your head together.

just_another_bozo_on_this_bus 8 years, 4 months ago

"And just how much do you think a government plan will cost every man, woman and child in this country?"

If the experience of every other country in the world is any indication, it will cost MUCH LESS than the current, very broken system.

KS 8 years, 4 months ago

In your dreams! And to what country(s) are you referring?

just_another_bozo_on_this_bus 8 years, 4 months ago

Every one which has a universal healthplan, which is just about every western, industrialzed democracy.

SettingTheRecordStraight 8 years, 4 months ago

More government involvement in health care? No, no, no, no, no, no, no.

Stephen Roberts 8 years, 4 months ago

Some countries have "universal insurance: or socialized medicine. germany and Canada are two examples.

In order to move to this option, how people ould be fired from their health care insurance compnaies?

My small employer would subsidize any of my health care costs, so looked elsewhere. I fould similar coverage for my family for abourt $120 less than my employer sponsored plan.

The main key is I TOOK the INTIATIVE and I WOULD RATHER HAVE HEALTH INSURANCE THAN NOT HAVE IT.

For me it was a personal choice. I had to sacrifice to make sure my family had coverage.

budwhysir 8 years, 4 months ago

Great article,

If we universalize the coverage, then universalize the fees, we can universalize the need and cause a universalized compounded problems.

Can you imagine the universalized tax that would be associated with this? And lets not forget the funding for universalized research and development.

I am far from encouraged that health care is moving in a forward direction. This will never be established without the increase of health care costs and development of diminished benefits of the patients.

Kam_Fong_as_Chin_Ho 8 years, 4 months ago

Want to see what government-run health care looks like? Pay a visit to any Veteran's Hospital...it ain't pretty. If you think health care is expensive now, just wait until it's "free." Taxes will skyrocket and quality of health care will plummet.

budwhysir 8 years, 4 months ago

Does anyone know exactly how the government got into the medical business?

I believe that this happened when it was determined that health care could become so expensive people could not afford it and this made it profitable.

Oh by the way, universal is the way to go. If you look at all your bills for water, electric, and natural gas, phones etc, you will find the universal tax listed.

This universal tax is related to the excise tax. This way we are taxed for being part of universal and this lends way to a tax that takes care of us being excesive. I love the excise tax because it is a charge from independent companies but it is a tax.

Kat Christian 8 years, 4 months ago

I was paying for dental insurance BUT when I compared the cost of insurance to the actual cost of my visits to the dentist in one year I was paying more for the insurance. So I dropped it. Same with medical insurance I've paid more into insurance than I have ever paid for actual medical expenses. So I had to drop health insurance for a while because I couldn't afford it. I can barely afford it with my new job but I have it. It won't pay for a lot but it's better than nothing if I do need it. The only ones getting rich off of this are the insurance companies is what I see.
I think we need a system in place like Canada and Swedan and other places like that. I don't know why Doctors get paid as much as they do anyway - most of them aren't trained that well and don't keep up with the latest medical findings. I have a real problem trusting them.

Tom McCune 8 years, 4 months ago

KS: Here is one source. (Any search engine will find it, if you want the full text.) There are many more...

The US spent 14.1% ($1.4 trillion total and $4,914 per capita) of the GDP on health care in 2001. It is forecast that health care expenditure in the United States will rise to $2.08 trillion (16% of GDP) by 2006, and to 18.7% of GDP by 2014 (Centers for Medicare and Medicaid Services 2006). The annual rate of inflation of expenditure on health care 2002-2004 was about 8.4%, which far exceeds the rate of inflation for all other items in the US economy (Gabel et al. 2004; Centers for Medicare and Medicaid Services 2006). By comparison, in 2001 the countries with the next highest percent of the GDP spent on health care were Switzerland (11.1%), Germany (10.7%) and Canada (9.7%), while United Kingdom spent only 7.6% (Reinhardt et al. 2004).

Source: A National Health Service for those without Health Insurance in the United States The National Health Service for the Uninsured Walter G. Bradley DM FRCP Professor and Chairman, Department of Neurology, Miller School of Medicine, University of Miami.

I have said before in these posts that I have lived with the systems in the UK and Canada. I do not think we should blindly copy those systems because of their problems. But we need to come up with something SIMPLE and EFFICIENT that fixes the obvious problems with our patchwork of uncoordinated systems.

Tom McCune 8 years, 4 months ago

budwhysir:

I think the Federal government's first foray into big-time medicine may have been the Veteran's Administration, which was set-up to care for veterans of WWI who had been blinded or disabled by mustard gas, Lewisite (sp?), and other chemical weapons. That noble mission has been debased by filling up the VA with drunks and dope fiends to the point that those veterans who were wounded in the line of duty have difficulty getting the care they so nobly earned.

just_another_bozo_on_this_bus 8 years, 4 months ago

"That noble mission has been debased by filling up the VA with drunks and dope fiends to the point that those veterans who were wounded in the line of duty have difficulty getting the care they so nobly earned."

How many of those drunks and dope fiends are merely displaying symptoms of unacknowledged and therefore untreated PTSD as a result of their military service?

"Switzerland (11.1%), Germany (10.7%) and Canada (9.7%), while United Kingdom spent only 7.6% (Reinhardt et al. 2004)."

Interestingly, of this list, Switzerland and Germany have the least "socialized" systems, and Canada and the UK are more socialized.

Tom McCune 8 years, 4 months ago

Some of them, bozo. Not others. I've done consulting at VAs. Many have never beem within a continent of combat.

Bruce Bertsch 8 years, 4 months ago

If you want to look at an efficient single payor system in the US, look no farther than Medicare. 98% of premiums paid go to care. Now show me a "market place" insurance company that can match that.

In addition, had the recent Republican controlled Congress kept itsw nose out of Medicare and not insisted on managed care, the premiums would be lower.

Universal healthcare does not mean you give up your current physician. It does not mean that the Government runs healthcare. It means that the government is the payor. A single payor is vastly superior to the hodgepodge system that we have now. And who loses if we change? The insurance companies, not the people.

Staci Dark Simpson 8 years, 4 months ago

We don't have insurance, we fall between the cracks. We make too little to buy any, and yes I have checked prices from every company I know of, yet too much for assistance. I agree you can buy high deductible insurance with no maternity coverage or office copays pretty cheaply, but when it comes to needing "good" coverage its gonna run at least $700 a month. By the way I don't have all the luxuries you guys speak of, just trying to get by. So I just owe LMH $50 a month for the rest of my life unless I win the lottery. I do pay for my doctor visits when we go but if anything big happens we are screwed. maybe something is wrong when it cost $400 for my son to be looked at in the ER and told we couldn't stitch that. No test performed or anything, just looked at his mouth and said we can't do anything and charged us 400 bucks for that.

Tom McCune 8 years, 4 months ago

Thank you, moderationman. I have heard that figure elsewhere and also that insurance companies spend up to 30% of premiums on administrative costs. And that doesn't include their profit burden. This is consistent with my own observations working inside an insurance carrier.

Thank you for debunking the myth that all government programs are inefficient messes. I have worked in both government and industry and have seen boondoggles in both places and efficent programs in both places.

I think the government should get out of and stay out of a lot of things with this one exception.

KS 8 years, 4 months ago

What difference does it make what an insurance company spends on administration? It is business and unless you are a stockholder, you have no reason to complain about it. If you think you are being ripped off by them, change companies. Gosh! It certainly appears to me that most of you folks won't be happy until this country is totally socialized.

J Good Good 8 years, 4 months ago

The insurance industry is on the road to killing entrepreunship. To be self-emplyed in this country largely means to be uninsured unless you have a spouse who can get family coverage at their job. That is a huge portion of the uninsured in my experience.

KS 8 years, 4 months ago

Just because you are self employed doesn't mean you can't get insurance. Group insurance is available via trade associations, etc. Having a spouse with coverage helps and one should take the least expensive way out for you, but just because you are self employed, isn't a reason. Get coverage that takes care of the catastrophic versus the regular doctors office visits, etc. If you want coverage to take care of every little sniffle, etc. you can be sure you will pay out the wazoo. I would rather carry coverage for a time when I have to go into a hospital, etc. Even with a $1,000 deductible, I would rather pay that than a $50,000 hospital stay.

just_another_bozo_on_this_bus 8 years, 4 months ago

So to sum up KS's position, we should be willing to pay exhorbitant premiums for little or no coverage just so we can maintain a system of inefficient private insurers whose only purpose is to supply cash to their stockholders, simply because the obviously better choice(s) would violate his sense of ideological purity.

Tom McCune 8 years, 4 months ago

KS:

I am happy for you that you can afford good coverage. I hope you never lose it and become chronically ill. I also hope the laws don't change and allow your carrier to screw you as was done to my family in the bad old days.

The point of the whole administrative cost thing is that IF IT WERE DONE RIGHT, a NHS system could be cheaper to administer in the aggregate for the whole country than the current patchwork of systems.

I don't know this author, but a good summary is:..

http://www.thehealthcareblog.com/WalterBradleyLongVersion.pdf

KS 8 years, 4 months ago

Newell _ I guess I just don't agree. I can't imagine the Government EVER doing anything better than the private sector.

I have been chronically ill. Cancer to be exact. Not exactly a cheap illness. I still deal with it.

Just another BOZO - No, that is not what I said. If you want some coverage, it can be had in the manner that I described. If you don't want to pay for it, fine. The premium on the plan I described would be a lot less than asking for coverage on every little sniffle, etc. You don't have to pay for anything if you don't want to. That is your choice. That is America. Just don't ask me to pay for your insurance when you choose not to buy it yourself. That should also be America.

Tom McCune 8 years, 4 months ago

Many may laugh -- I might even laugh -- but here's an example of a moderately efficient government program....

Try sending some routine business paperwork to Boston. You can choose a 39-cent stamp or an $18 overnight Fed Ex. OK, maybe a $10 2-day Fed Ex. (Can't remember if they still have those rates, but it's something like that.)

Everybody loves to hate the Post Office, but in fact the vast majority of the mail gets to its destination the vast majority of the time. Not perfect, but pretty good considering the volume of stuff they handle and the fact they have to read my handwriting. And the Post Office is actually more reliable than it used to be due, in part, to business-like reforms instituted when Marvin Runyon was Postmaster. One of those reforms is that the US Postal Service is now a quasi-independent "government corporation" that has at least a slight degree of control over its own revenue and expenses, unlike when it was a traditional government agency.

just_another_bozo_on_this_bus 8 years, 4 months ago

"No, that is not what I said."

I said it summed up what you said. And I think I did a very good job of summing up your position.

"The premium on the plan I described would be a lot less than asking for coverage on every little sniffle, etc. You don't have to pay for anything if you don't want to. That is your choice."

So if I send a still sizable premium to this insurance company, they'll pretend to insure me right up to the point where it might cost them some money.

"That is America."

No, that's just legalized fraud and extortion.

"Just don't ask me to pay for your insurance when you choose not to buy it yourself."

We all pay more than anyone else in the world for the healthcare mess we have today. I'd just like to get a little healthcare with that, for everyone, and probably even save you some money in the process.

KS 8 years, 4 months ago

Newell - The Post Office also gets paid to handle junk mail to help offset that cost of a 39 cent stamp Fed Ex doesn't. How much junk mail do you read? How much do you throw out? Do you want junk healthcare included?

Bozo - I still stand that I should not have to pay for your insurance just becasue you choose not to pay for any yourself. You have been reading too many fiction articles on the net. :) You seem to have it out for corporate America regardless.

just_another_bozo_on_this_bus 8 years, 4 months ago

"Do you want junk healthcare included?"

Care to clarify exactly what that means?

"I still stand that I should not have to pay for your insurance just becasue you choose not to pay for any yourself."

You're paying for all of the uninsured and underinsured right now, one way or another, even if you are unaware of that fact.

"You seem to have it out for corporate America regardless."

The current corporate system is seriously broken, so it's no wonder that giving them control of the healthcare system has resulted in a very broken healthcare system. So, yes, I have it "out" for corporate America-- with very good reason.

Godot 8 years, 4 months ago

Put all docs on a government stipend. No more mansions, fast cars and big, fat investment portfolios for them. That will bring the cost of health care in line. Of course, then no one will want to be a doctor; we will get the same quality in health care that we get in public education.

Linda Endicott 8 years, 4 months ago

I don't know that the government could do any worse job at it than the big insurance companies are.

I just got a nice little pamphlet from my insurance company, with a "preferred medication list". I'll bet you that the "preferred" medications are those that will cost the least amount for the insurance company. They don't care what's best for the patient.

Basically, if my doctor thinks a different medication will work better, it may either not be covered at all by my plan, or I would have to get prior authorization from the insurance company. How often do you think they'd actually authorize it?

Since when should paper-pushing insurance executives be allowed to make medical decisions that can affect a person's prognosis, against the recommendations of their own doctor?

just_another_bozo_on_this_bus 8 years, 4 months ago

How about a variation on that, Godot?

Put all docs on govt. stipend for the first 8 years out of med school, including paying for med school training. After that, they can do up to 50% of their practice privately, the rest for the govt. sponsored clinics, and their private fees are levied a 50% tax. Anything above 50% of their practice done privately is assessed a 100% tax on their fees. All taxes collected support the govt. healthcare system.

The superrich still get their special treatment, the doctors who are only in it for the money still get a chance to get rich, and the existing insurance companies can have that market. Everyone else gets adequate medical care for a reasonable rate.

Tom McCune 8 years, 4 months ago

According to the BBC, general practitioners make over 100,000 pounds per year in the UK. That's around $200,000. Since they are effectively government employees, they don't need to buy E&O insurance or pay other costs.

That should be fair enough in a system that is the least expensive of the ones noted in the posts above.

http://news.bbc.co.uk/2/hi/health/6157219.stm

budwhysir 8 years, 4 months ago

Well Im back from my long day of corporate America pulling in my meaningless wages to cover medical expenses and advanced health care research.

KS 8 years, 4 months ago

bozo - You are just such a socialist! Anything to keep someone from reaping a reward for their efforts. 50% tax! That's the way to go. Just see how many people will want to go to med school. Is the glass always half empty with you? Always a way to penalize someone for excelling.

budwhysir 8 years, 4 months ago

Here is my idea.

do away with insurance and make health care affordable. This would be the real definition of affordable health care right?

Affordable meaning it can be afforded and health care meaning care for our health. Put em together and we have affordable health care.

See that wasnt so hard was it. Thanks I am always striving to do my best

just_another_bozo_on_this_bus 8 years, 4 months ago

Your precious "pure" ideology is failing in just about every performance measure, while all those government-run systems are delivering high quality, comprehensive healthcare, to all its citizens, at a much lower cost.

I don't claim to know what the best solution is, but doing the same stupid sh*t over and over and expecting a different result is insanity defined.

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