The Senate Bill also allows insurance companies to charge older people more for their insurance, even if they’re healthy. Personally, I didn’t have any health problems from age 57 to age 65 when I went on Medicare. It’s not fair! If they’re going to charge some people more, then charge the people who don’t take care of their health. Maybe that will motivate them to do what they can to get well.

They also want to complicate the enrollment process for providers who want to accept Medicare, and charge providers $200 to apply! Fortunately, the AMA has protested this! What you might not know is that currently, each and every insurance company does their own criminal background check, their own call to our licensing board, etc. It can take months to get into a network (so that they can pay us less–that’s the only reason for networks).

I’ve proposed to Reid, Pelosi, and my unhelpful legislators that we create a National Register of providers that ALL third parties must use, so that only one entity is doing the background checks, and it’s all online for anyone to use. CAQH is already doing that, and we help them out by updating our info every three months. But most insurance companies don’t use it. WHy? delaying our getting into their networks benefits them.

The other thing I hope to God they are doing is standardizing billing. This month my first claim to Medicare was denied because I failed to omit the dashes from the patient’s social security number. Silly me entered it just as it is on the card (which all other companies accept). The details drive us nuts.

So please, folks, write to your legislators and ask for some repairs to the Senate Bill, and ask them to return the public option. Without it, this is just another giveaway to insurance companies.

I hope they will restore the public option, but I’m not optimistic.

I agree, early detection and prevention is a moral issue, not just a cost issue. It is odd that there hasn’t been much discussion about that.

Certainly tests for early detection are going to cost. I don’t have the stats to figure it all out myself, of course. For some things, e.g., mammograms, bone density tests, they certainly would appear to save money (and possibly also blood sugar tests, blood pressure checks, etc.). THey are cheap to do and treatment is expensive. Colonscopies are, of course, much more expensive. One costs $1800, I think, and my husband’s treatment (unsuccessful) for colon cancer cost about $150,000 over two plus years. For that amount, about 83 people could have a colonoscopy. That’s not very many. But one only needs one about every ten years, unless there is a family history.

There is an interesting assumption by one commentator that all prevention is a medical intervention, e.g., preventing heart disease by giving statins. Or preventing strokes by giving blood pressure medication. Or preventing osteoporosis by giving expensive medications.

I would have to say that some prevention is just life-style changes. Group education could be cheap and learning to manage weight and exercise doesn’t cost any more than a little education. It is just as effective for osteoporosis to lift weights and increase Vit. D and Calcium intake as it is to take Fosomax, etc., and without the side effects.

Other countries do prevention. In Japan, every single citizen has a complete physical every year. At those physicals they probably decide which tests to use for early detection. In any case, they spend a lot less than we do (their diet is also significantly better).

I will check out politicat more often. THanks for the comment and the tip.

There’s been a lot of discussion about the cost of preventive care. The President earned a False from Politifact.com on this (see http://www.politifact.com/truth-o-meter/statements/2009/sep/09/barack-obama/obama-says-preventive-care-saves-money-it-doesnt/”

What I have not seen discussed is the moral or ethical side of preventive care. So what if it costs more for testing a large population so that a few can be saved? Isn’t that worth it?

Also, as science marches on, the candidate populations for a particular test can be more specific, which will lessen the overall cost.

Politifact.com is a great site, even though they seem to be overly strict when evaluating Obama’s statements as compared to others’.

Pam

Too often, the state programs are underfunded and supervised and staffed by people who don’t have the breadth of training and experience they need, or the time, to do the job right. For example, they often don’t seem to recognize the damage done to a two year old’s development when they remove them from the home for 6 months. They also often don’t seem to have the expertise to recognize a personality disorder when they see one, i.e., a parent who isn’t going to have the capacity or the motivation for change.

Around here, we’ve moved in the direction of less training, not more, allowing volunteer lay people from the community, with little more than common sense, making recommendations to the court about whether to remove kids. I had a case recently where the CASA worker (volunteer) was concerned that the father wasn’t showering every day. I mean, geesh! for that kind of nonsense, the two kids were out for six months (beginning with a temporarily dirty house).

And when kids DO need to be protected, they often are not. I had a case years ago where a 14 year old girl had been severely beaten by her stepfather. CPS knew it, they saw the bruises. He said he’d change, and they left. Personality disordered people don’t change, typically. Her father had to save his money for six months to go to court and get custody. CPS could have easily moved the kid to his house without him having to spend $10,000 in legal fees.

These programs need full time, well trained and experienced clinicians who have the necessary training, at least to supervise, but I’ve never seen it. Maybe in the wealthier states.

Federal programs tend to be more realistic, in their design, about what level of expertise is needed for any particular job, and they provide sufficient funds to make the work load livable and the training excellent. In Head Start, for example, they hire community people who don’t have a lot of training. But they hire enough of them, and provide them with enough training (and very good training), that they do a very good job.

Any hospital that receives federal funding has to treat people. In this Bill, there is a provision that they will have to provide the same care to anyone, regardless of issues unrelated to health care.

Honestly, in my experience, the Feds do a much better job than the states. I don’t fear them at all. I fear what is happening now, i.e., that people with less and less training are being hired to do these very difficult jobs.

Thanks for reading and commenting! Just got the site up today, and you’re my first reader!

Pam