Rep. Anthony Weiner (D-NY) brings up a valid point on Morning Joe: what is the value of private insurers?

The question that needs to be answered before Rep. Weiner’s question can be addressed: how much does a health care routine really cost? Is there a list that says $Y dollars is the cost for treatment X? We know our co-pay, our pre-tax pay check deduction but we really don’t know the pre-tax premium contributions of our employers or “employee group”. Health care is a service we buy, through a non-transparent market, without any broker on our behalf and then hope that whatever deal we implicitly agreed to works for us and our provider when our health goes bad. That isn’t a free market nor is it an equitable one. Private payer to provider market distortions are exposed when you compare “full billed charges” to Medicare payouts to providers:

…a survey by America’s Health Insurance Plans, an industry trade group, which detailed a series of exorbitant physician charges. The survey examined out-of-network bills where — as opposed to in-network services — contracts do not exist between the provider and insurer. Also known as full-billed charges, it’s what the uninsured face every time they see a doctor.

In some cases, patients received charges 34 times what Medicare pays for the same procedure in the same location, the AHIP survey found.

For example, one doctor billed $4,500 for an office visit when Medicare would have paid just $134. Another doctor billed $14,400 for removal of a gallbladder when Medicare would have paid $656. And a hip replacement cost $40,000 when Medicare would have paid $1,558.

via Health Articles | A Little Haggling Might Pay Off at the Hospital | Miller-McCune Online Magazine.

A Novel Idea continues: Our President speaks to Muslims as human beings.

It will be interesting to see how Americans view this YouTube message.
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Ezra Klein recounts Finance Committee members Senator Kent Conrad (D-ND) and Max Baucus (D-MO) tale of how they “Came up” with the co-op plan as a political solution.

In early June, Max Baucus asked Kent Conrad to solve this argument. Conrad came up with the co-op proposal. And I literally mean “came up” with it. Conrad told me that the idea emerged “out of conversations in my office after we were asked to see if we couldn’t come up with some way of bridging this chasm.” To put it bluntly, the co-op does not solve a policy problem so much as it solves a political problem. That political problem was, “How do you finesse a compromise on the public option?”

via Ezra Klein – Co-Ops as an Alternative to the Public Plan .

A June 18, 1993 an article in the Toledo blade entitled: Health Care co-op concept at heart of Clinton reform contradicts Baucus and Conrad’s accounts of their own ingenuity. A as part of a 1993 letter to the Editor of the New York Times, Published October 15, 1993, in response to a William Safire editorial, Senator Jay Rockefeller (D-WV) clearly mentions health care co-ops:

A health care co-op — an alliance under the Clinton plan — will do what co-ops traditionally do: empower consumers as part of a larger buying pool. Competition will be the order of the day as insurance companies compete to sell their services to alliances, the only place they can go to do business.

Conrad’s staff just dug up Bill and Hillary’s old homework from the early 1990’s. All the plans being bandied about as new alternatives existed 15 years ago, to the day. Republicans didn’t vote for this then and they won’t today. Baucus has worked with Grassley since 1981 on the Senate Finance Committee. Most observers would believe he had a good idea of where Grassley stood on these issues prior to building his committee. Since no progress has been made in Senate Finance Committee on health care for the last 16 years, what real work are Red State, Blue Dog democrats Baucus and Conrad (representing the 44th and 48th most populous states, respectively) really accomplishing in these closed door deliberations? What does this say about Baucus?

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Federally Qualified Health Centers are non-profit, community directed, primary care health centers funded under Section 330 of the Public Health Service Act passed in 1946. They are supported by the US HHS Health Resources and Service Administration (HRSA). HRSA describes the main goal of these health centers as:

Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide:

• checkups when you’re well
• treatment when you’re sick
• complete care when you’re pregnant
• immunizations and checkups for your children
• dental care and prescription drugs for your family
• mental health and substance abuse care if you need it

Bob Herbert of the New York Times visits one such center providing essential care in Vermont:

Nearly 10,000 patients are served by the Plainfield center, which is a godsend because there are no other primary care physicians in the vicinity, and very few dentists in private practice will treat poor patients, who usually are covered by Medicaid.

When you look at the number of people who are served by these health centers nationally and then look at the number still in need of the services, you begin to get a sense of the scope of the crisis in health care in the U.S. The centers currently serve about 20 million people and receive approximately $2 billion a year from the federal government. It is estimated that another 40 million people in medically under served areas, primarily rural areas and inner cities, need the services a health center would provide. Continue reading

Mike Davis posits that slums are ground zero for pandemics. Mega-slums are where pandemics gain new life.

Mike Davis, a recipient of the MacArthur “genius” award, is author of The Planet of Slums. The following is adapted from an interview with NPQ editor Nathan Gardels.

The global pandemics we see today tend to originate and spread from impoverished slums that push humans into close proximity with animals and food sources, thus providing an incubator for viruses that would otherwise die out or go dormant. Pandemics are thus closely linked to the emergence of “hot zones” in what I call “the planet of slums.”

Using conservative definitions by the United Nations Habitat office, there are today 1 billion people living in slums globally. A slum is defined by substandard housing with insecurity of tenure and the absence of one or more urban services and infrastructure—sewage treatment, plumbing, clean water, electricity, paved roads and so on.

via NPQ.

Many of the largest slums? Latin America. The biggest such slum in the world? Just south of Mexico City. As H1N1 has to be dealt with, we must begin to realize that it keeps popping up in North America for a reason. Other people’s poverty matters.

10 year old Damon Weaver interviews President Barack Obama.

For once a reporter asks the President about violence and impoverished communities. David Gregory take some notes.

Ezekiel Emanuel, the oncologist and bio-ethicist is the Death Panels Czar according to the crazies. According to medical professionals he is a good doctor and a leading bio ethicist:

“The aim of health care is curing disease, relieving pain and suffering, promoting public health, pursuing research to improve health, and so on,” he wrote. He then laid out principles for achieving these goals, ones that strongly support transparency and autonomy for patients, justified by “the necessity of respecting individuals as rational and autonomous moral agents.” Contrary to the absurd charge that he (and Obama) would limit care to certain patients to save money, Emanuel argued in the article, “While efficiency is a legitimate and important goal in the provision of health care, it is not the only goal. We also demand that the health care system be just.”

For those who would take that last quote to suggest that Emanuel is a socialist who wants to tear down everything we have and adopt single-payer healthcare, wrong again. In a 2008 Hastings article, Emanuel deftly pointed out that it would do little more than maintain the “fragmented, fee-for-service delivery system that provides profligate and bad quality care.” Then he showed how single-payer care would hinder integration of care between different doctors and hospitals, how low administrative costs would perpetuate fraud and how cost control would breed public resentment. He even asked how we would feel if Dick Cheney, and not Ted Kennedy, was the one putting political pressure on any government health service. That kind of thinking shows Emanuel’s ability to think beyond the politics of health reform and focus on finding workable solutions.

via “Death panel doc” is all about life | Salon .

What does Dr. Emanuel think about a Euthanasia and/or Physician Assisted Suicide as a legal medical practice? Suprise, Surprise…the opposite of what folks on the right says he does:

For the vast majority of dying patients, Emanuel wrote, “legalizing euthanasia or physician-assisted suicide would be of no benefit. To the contrary, it would be a way of avoiding the complex and arduous efforts required of doctors and other health-care providers to ensure that dying patients receive humane, dignified care.”

via What Ezekiel Emanuel Wrote on the WSJ Op-Ed Page | WSJ.Com