This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

July 31, 2007

Paul Krugman: The Waiting Game

Being without health insurance is no big deal. Just ask President Bush. “I mean, people have access to health care in America,” he said last week. “After all, you just go to an emergency room.”
This is what you might call callousness with consequences. The White House has announced that Mr. Bush will veto a bipartisan plan that would extend health insurance ... to an estimated 4.1 million currently uninsured children. After all, it’s not as if those kids really need insurance — they can just go to emergency rooms, right?...

Yes, We Can All Be Insured

[T]he public knows the American health-care system is breaking up, no matter how much its backers cheer. For starters, there's the 46 million uninsured (projected to rise to 56 million in five years). There's the shock of the underinsured when they learn that their policies exclude a costly procedure they need—forcing them to run up an unpayable bill, beg for charity care or go without. And think of the millions who plan their lives around health insurance—where to work, whether to start a business, when to retire, even whom to marry (there are "benefits" marriages, just as there are "green card" marriages). It shocks the conscience that those who profit from this mess tell us to suck it up.
. . . .
Right now, Congress is trying to bring 3.3 million uninsured children into the State Children's Health Insurance Program. President George W. Bush says he'll veto the expansion as "the wrong path for our nation." He objects to "government-run health care" (like Medicare?) and says that SCHIP "deprives Americans of ... choice" (like the choice to go uninsured?). Buzzwords like "government run" are supposed to summon up monsters like "socialized medicine" that apparently still lurk under our beds. If these terror tactics work, prepare for another 46 million uninsured.

July 26, 2007

Children’s health must be nation’s priority (John Kerry on SCHIP)

We have been modest where we should have been bold. If we, as senators, don’t stand for insuring every child in America, then what do we stand for? If America can spend $10 billion each month in Iraq, surely we can also spend $10 billion each year on children’s health.
Even more troubling, the president has launched a disinformation campaign to denounce this bill as a larger Democratic strategy or plot to massively expand federalized medicine. He has stubbornly pledged to veto a bill he hasn’t even read. Apparently, confronted with a bipartisan compromise to extend health care coverage to half of the 9 million American children without insurance today, the president sees only a vast, left-wing conspiracy.

Shortage of doctors affects rural U.S.

A national shortage of doctors is hitting poor places the hardest, and efforts to bring in foreign physicians to fill the gap are running into a knot of restrictions from the war on terror and the immigration debate. Doctors recruited from places such as India, the Philippines and sub-Saharan Africa to work in underserved areas like the Mississippi Delta and the lonesome West already face an arduous and expensive gauntlet of agencies, professional tests and background checks to secure work papers and permanent residency. . . .The government estimates that more than 35 million Americans live in underserved areas, and it would take 16,000 doctors to immediately fill that need, according to the American Medical Association. And the gap is expected to widen dramatically over the next several years, reaching 24,000 in 2020 by one government estimate. A 2005 study in the journal Health Affairs said it could hit an astonishing 200,000 by then, based on a rising population and an aging work force.

Express-Lane Medicine (Newsweek)

[By] offering patients quicker, cheaper alternatives to doctors, so-called convenience-care clinics—staffed by nurse practitioners who offer low-cost treatment for easy-to-diagnose conditions—are spreading faster than a cold in a kindergarten.

July 21, 2007

The Politics of Sex

Despite years of evidence clearly showing that these [abstinence] programs are ineffective and harmful, federal funding continues at over $200 million a year and growing. Under the Bush administration, abstinence-only subsidies have gushed forth -- creating a deluge of funding for far-right religious groups, amidst a dearth of federal oversight. . . . In reality 95 percent of Americans do have sex before marriage, most before they reach age 19. We must stop funding harmful and ineffective abstinence-only programs and instead support a more comprehensive approach to sexuality education and reproductive health.

Healing Healthcare (LA Times)

VOTERS IN THE United States rank healthcare second only to Iraq as an issue of concern in the presidential campaign. Close to 45 million people in this country lack healthcare coverage, including 6.5 million in California — roughly 17% of the state's population. Increasingly, Americans realize that our healthcare system, which at $2 trillion a year represents 18% of GDP, with spending expected to double by 2016, is probably unsustainable. That adds up to an economic crisis that must command the attention of the 18 candidates with serious aspirations to become the next president. . . .
The cost question is a painful one because it inevitably leads to the question of sacrifice. If everyone is going to be covered, every treatment probably won't be. Clear conversation on this, however, begins with the recognition that this country already rations healthcare — those without insurance routinely go without care.The complexity of the country's healthcare crisis makes it difficult to debate in the rapid-fire exchanges that too often characterize our modern political campaigns. So it is all the more important that candidates present substantive proposals. America has a chance to grapple with this fundamental issue now. If we succumb instead to slogans, we will long regret it.

Sicko Review (The New Yorker)

Just this year, in my own surgical practice, I have seen a college student who couldn’t afford the radiation treatment she needed for her thyroid cancer, because her insurance coverage maxed out after the surgery; a breast-cancer patient who didn’t have the cash for the hormone therapy she needed; and a man denied Medicare coverage for an ambulance ride, because the chest pain he thought was caused by a heart attack wasn’t—it was caused by a tumor. The universal human experience of falling ill and seeking treatment—frightening and difficult enough—has been warped by our dysfunctional insurance system.

Senate Panel Adds Billions for Health

Defying a veto threat from President Bush, the Senate Finance Committee approved a major expansion of the Children’s Health Insurance Program on Thursday, with a majority of Republicans joining all Democrats on the panel in supporting the legislation.
The vote, 17 to 4, sends the measure to the full Senate, which is expected to take it up within two weeks. Mr. Bush has repeatedly denounced the bill as a step toward “government-run health care for every American,” describing it as a “massive expansion of the federal role” in health care, financed by “a huge tax increase.”

July 14, 2007

Start from ground up to fix health care

Earlier in the week, PricewaterhouseCoopers' Health Research Institute reported that the United States will be short 1 million nurses and 24,000 doctors by 2020. It said that while applications to nursing program had risen, the number of students denied admission had grown six fold since 2002, mostly because of a shortage of instructors. . . . "People in the United States spend $532 billion (a year) on health. That $532 billion is not spent very wisely."

July 12, 2007

Critics Accuse Bush Administration of Trumping Science With Politics

Health experts said Wednesday they agreed with former Surgeon General Richard H. Carmona's claim that the Bush administration has continually silenced medical and scientific opinions in favor of politics and religious dogma.

During his testimony before a Congressional panel on Tuesday, Carmona said that "top Bush administration officials repeatedly tried to weaken or suppress important public health reports because of political considerations,"The New York Timesreported.

It doesn't surprise us to hear that the administration was ignoring science and attempting to silence scientists. That's how they have operated about stem cells for years. . . ."