Middle-Class Americans Join Ranks of Uninsured in 2006 as Private Coverage Shrinks

The U.S. Census Bureau released data today showing that the number of uninsured Americans jumped by 2.2 million in 2006 to 47.0 million people, with nearly all the increase (2.03 million) concentrated among middle-class Americans earning over $50,000 per year, according to an analysis by Physicians for a National Health Program (PNHP). Strikingly, 1.4 million of the newly uninsured were in families making over $75,000 per year. An additional 600,000 were in families earning $50,000 to $75,000 per year. (The median household income in 2006 was $48,200).
"Middle income Americans are now experiencing the human suffering that comes with being uninsured. It makes any illness a potential economic and social catastrophe," said Dr. Steffie Woolhandler, co-founder of Physicians for a National Health Program and Associate Professor of Medicine at Harvard Medical School.

Medical Homes Promote Equity in Health Care

The Commonwealth Fund 2006 Health Care Quality Survey finds that when adults have health insurance coverage and a medical home—defined as a health care setting that provides patients with timely, well-organized care, and enhanced access to providers—racial and ethnic disparities in access and quality are reduced or even eliminated. When adults have a medical home, their access to needed care, receipt of routine preventive screenings, and management of chronic conditions improve substantially.

Why can't Americans give up their guns?

According to the U.S. government's Center for Disease Control and Prevention, in 2004 — the latest year for which such figures are available — a total of 11,624 people were shot dead or murdered. That averages out to 32 a day. In the same year an additional total of 16,750 people shot themselves to death with firearms, 649 people died in gun accidents, and 311 in "legal intervention," that is, shot dead by police. Also, 235 people died for unknown reasons though it was clear that they did so of gun wounds. A grand total of 29,569, or an average of 81 people a day, were killed or died by use of guns.

Romney's rhetoric glosses Massachusetts years

On the presidential campaign trail, Mitt Romney points to healthcare reform as his major achievement as Massachusetts governor, presenting the plan as an example of how he used conservative principles to provide affordable health insurance for all state residents without a government takeover. But he does not mention aspects of the plan that may hold less appeal for his Republican audiences. For example, he decries "socialized medicine" and says the Massachusetts plan is "all a private initiative, a private-based, market-based healthcare" -- omitting the fact that the state and federal governments subsidize much of the overall cost and that a public board negotiated the benefits and prices that private insurers now offer. . . .

Science vs. politics gets down and dirty

Malicious, vindictive and mean-spirited. These are words that might surface in divorce court.
But they have been lobbed in the course of a different estrangement: the standoff between the Bush administration and the nation's scientific community.
The relationship, which has been troubled since the dawn of the Bush presidency, hit a new low last month when Richard Carmona, surgeon general from 2002 to 2006, lashed out at his former colleagues in testimony before a House committee.

Lawmaker Calls for Registry of Drug Firms Paying Doctors

WASHINGTON, Aug. 3 — An influential Republican senator says he will propose legislation requiring drug makers to disclose the payments they make to doctors for services like consulting, lectures and attendance at seminars.
The lawmaker, Charles E. Grassley of Iowa, the senior Republican on the Senate Finance Committee, cited as an example the case of a prominent child psychiatrist, who he said made $180,000 over just two years from the maker of an antipsychotic drug now widely prescribed for children.

Under the influence

For many Americans, a doctor's decision to prescribe medication is something of a sacred transaction. A physician considers the patient and symptoms and chooses the best drug for the job, drawing upon years of training and clinical experience. It is an exchange conducted in a hushed sanctuary, far from the heat and noise of the marketplace -- a place where cool judgment reigns. That sanctuary has been breached. Today, drug manufacturers do everything in their considerable power to ensure that their brand-name prescription medications are on the lips of patients and in the minds of physicians every time the two meet across an exam table. A growing chorus of critics says their efforts have begun to rewrite the dialogue between patient and doctor, influence physicians' judgments and open the act of prescribing to forces more profit-minded than sacred.

Children’s Health Plan Focus of New Struggle

The Children’s Health Insurance Program has suddenly become a vehicle for an ideological struggle between President Bush and Congress over the future of the health care system.
But in the short term, members of both parties say, the broader outline of that struggle is likely to be reduced to a simple question: “Are you for or against children?” . . . . Representative John Shadegg, an influential conservative from Arizona, said, “This debate is the opening salvo in a battle over the future of health care in America.” . . . . Republicans say Mr. Bush’s opposition to the House and Senate bills stems from conviction and principle, not a political calculus. But, they say, he is not running for re-election and appears oblivious to the political risks for Republicans.

Child abuse claims raise queries about Maori culture

The case of a three-year-old girl who was allegedly hung from a washing line and spun in a tumble-dryer has reignited debate in New Zealand about the touchy subject of child abuse within Maori communities. . . . In many such cases, it has emerged that the victim's extended family knew the child was being mistreated. But it is Maori custom that people sort out their problems themselves, rather than report them to the police.

Bill Would Let States Force Drug Discounts

U.S. Rep. Chris Van Hollen is preparing legislation that would allow states to make prescription drugs more affordable for low- and moderate-income Americans, a challenge to Bush administration policies that have thwarted such efforts in Maryland and elsewhere.
Van Hollen (D-Md.) said he will introduce a bill early this week allowing states to use their purchasing power to require drug companies to provide discounts on medications for low-wage workers. Under the proposal, states could negotiate the same breaks they get for people on Medicaid, the state-federal health-care program for the poor.

Skipping doses could be deadly

Consider it the other drug problem: Millions of people don't take their medicine correctly — or quit taking it altogether — and the consequences can be deadly. On average, half of patients with chronic illnesses like heart disease or asthma skip doses or otherwise mess up their medication, says a report being issued later this week that calls the problem a national crisis costing billions of dollars.

The Right Rx for Sadness

. . . [T]here's a growing concern that medicine often goes to people who shouldn't be taking it. And a consensus has formed that the estimate of how many people will develop depression at some point—1 in 6—might be greatly inflated. "There's no question that the availability of these drugs has increased the diagnosis of depression," says Jerome Wakefield, a professor of social work at New York University. Wakefield is coauthor of the new book The Loss of Sadness, which argues that selective serotonin reuptake inhibitors—Prozac, Paxil, Zoloft—are commonly overused to treat sadness, a normal and healthy response to divorce, sudden unemployment, the end of a friendship, a house foreclosure.

Bush Aide Blocked Report

A surgeon general's report in 2006 that called on Americans to help tackle global health problems has been kept from the public by a Bush political appointee without any background or expertise in medicine or public health, chiefly because the report did not promote the administration's policy accomplishments, according to current and former public health officials.

Carmona told lawmakers that, as he fought to release the document, he was "called in and again admonished . . . via a senior official who said, 'You don't get it.' " He said a senior official told him that "this will be a political document, or it will not be released."

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.

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.

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.