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Black Children’s Lives Short and Cheap in U.S.

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by BAR editor and columnist Marsha Coleman-Adebayo

Poverty is closer to the norm in the United States than most Americans realize. “More than half of Americans earn $26,000 a year – barely above the poverty level of $22,000 a year.” Yet the U.S. spends 50 percent more per person on health care than Europe, with deplorable results, especially for Black children.

 

Black Children’s Lives Short and Cheap in U.S.

by BAR editor and columnist Marsha Coleman-Adebayo

Pharmaceutical drugs, as an example, are 40 percent costlier here than anywhere else in the world.”

The U.S. spends 50 percent more on healthcare than Europe, yet a black child born in Washington D.C. has less of a chance of reaching his 1st birthday, than a child born in Barbados,” Jonathan Gruber, Massachusetts Institute of Technology economist and adviser to President Barack Obama on the Affordable Health Care Act said this week in Cambridge, Massachusetts.

Reflect on that information – we regularly tell other countries how to conduct their affairs and yet it is clear that we cannot manage ours.

In a New York Times article by Sabrina Tavernise quoting census data, she reported: "The number of Americans living below the official poverty line, 46.2 million people, was the highest number in the 52 years the bureau has been publishing figures on it.... Minorities were hit hardest. Blacks experienced the highest poverty rate, at 27 percent, up from 25 percent in 2009, and Hispanics rose to 26 percent from 25 percent. For whites, 9.9 percent lived in poverty, up from 9.4 percent in 2009. Asians were unchanged at 12.1 percent."

Gruber was speaking at an event organized by an independent Harvard book store to publicize his new book Health Care Reform: What It Is, Why It's Necessary, and How It Works. He pointed out that the USA has been trying to reform health care legislation for one hundred years – our Congressional representatives are not always the niftiest debaters. And on average the issue comes up every 17 years.

 At present more than 50 million Americans have no health insurance – a scary prospect when you consider how much more expensive health care is here than internationally. Pharmaceutical drugs, as an example, are 40 percent costlier here than anywhere else in the world, and law prevents Medicare and Medicaid from negotiating lower prices – an extraordinary situation. In what other sector is negotiation for a better price forbidden? No surprise then that the $800 billion healthcare sector is the most prosperous in the country and recession proof.

The number of Americans living below the official poverty line, 46.2 million people, was the highest number in the 52 years the bureau has been publishing figures on it.”

This is also the only country in the world, but for New Zealand, that allows prescription drug advertising to consumers.

And so we have a situation summed up well by Professor Allan V. Horwitz of Rutgers University who wrote in the New England Journal of Medicine on February 11, 2009,  “Americans have long craved chemical solutions to their problems of living.” And buoyed by an almost total lack of controls over the pharmaceutical industry’s rapacious marketing and a system that, as Gruber notes, “pays doctors according to how much they give you – the so-called fee per pay system, instead of paying physicians according to the health outcomes of patients,” contributes to increasing, instead of discouraging, ill-health.

 The fee per pay system has resulted in ridiculous overtreatment: Los Angeles, as an example, has more MRIs than Canada. This has also become the country with the highest load of prescription drug addicts.  At present prescription drug overdoses are the highest cause of accidental death – 37,000 in 2010 according to the Centers for Disease Control – outranking traffic accidents and death by overdose for all illegal narcotics combined.

Gruber says “a third of what is done [in terms of treatment] is unnecessary.” And yet preventative screenings like pap smears or mammograms are not free and illness places a burden on the economy and families. In 2010 Amnesty International lambasted the United States for a doubling of deaths from pregnancy and childbirth in the past 20 years. In addition, the rights group said, about 1.7 million women a year, one-third of pregnant women in the United States, suffer from pregnancy-related complications, all of which could be avoided by relatively inexpensive free pregnancy screening, something considered a right in most nations of the world, including developing countries.

 Gruber claims “there are too many hospital beds in America” yet access is difficult, Gruber points out that, “a rich person pays a quarter of his or her healthcare costs [because their workplace covers them] but the person who works at McDonalds has to buy his own health insurance – he is paying for 100 percent of his healthcare costs.”

Preventative screenings like pap smears or mammograms are not free and illness places a burden on the economy and families.”

Why are Republicans angrily fighting a law that is based on legislation developed by a Republican – 2012 presidential hopeful – Mitt Romney when he was governor of Massachusetts? In Massachusetts  the law has been successful in cutting costs and improving care, it has a 70 percent approval rating from citizens. In Massachusetts, 90 percent of citizens are covered by health insurance compared to an average of only 60 percent nationwide, according to Gruber.  Some states like Minnesota are already going ahead and implementing on their own, but most remain aloof.

It seems that the answer to Republican opposition to the Obama plan is thinly disguised racism. Gruber, who worked with Romney to create the law in Massachusetts, and then with President Barack Obama, says, “When it was signed it was a Republican plan. On the platform that day was a right wing guy from the Heritage Foundation who extolled it as an example of the best of Republican government – until Obama showed an interest in it and suddenly it became the devil’s work.”

The arguments rage on within the kabuki court of Democratic and Republican operatives. President Obama rode into the presidency with an overwhelming mandate to fight for single-payer healthcare. Within one year of his presidency, Obama had successfully deconstructed the healthcare argument and confined the architecture of the argument to one palatable to corporate sponsored Democratic and Republican operatives.  More importantly, the president had squandered an historic opportunity to transform a corrupt and inefficient healthcare system.

We must demand a healthcare system that will dispense with the economic supremacy enjoyed by the corporate insurance oligarchy.

See Marsha on C-Span Book/TV at:www.marshacoleman-adebayo.org.

Dr. Marsha Coleman-Adebayo is the author of No FEAR: A Whistleblowers Triumph over Corruption and Retaliation at the EPA is available through amazon.com and the National Whistleblower Center. Dr. Coleman-Adebayo worked at the EPA for 18 years and blew the whistle on a US multinational corporation that endangered vanadium mine workers. Marsha's successful lawsuit lead to the introduction and passage of the first civil rights and whistleblower law of the 21st century: the Notification of Federal Employees Anti-discrimination and Retaliation Act of 2002 (No FEAR.)

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RomneyCare Not the Panacea

RomneyCare Not the Panacea Some Think It Is

The following article from Science2.0 (Science20.com) shows the working poor still get the short end of the stick with Romney's healthcare reform.  More evidence that a single payer Medicare Advantage type system is preferable to a hodge podge bureaucratic boondoggle.

Health Care Reform: In Massachusetts, The Working Poor Still Are Not Covered
By News Staff | September 19th 2011

Massachusetts implemented health care reform to increase employer-based insurance and to provide no-cost or low-cost insurance to those unable to afford it but it hasn't worked - the uninsured in Massachusetts remain predominantly the working poor, according to a new study by researchers at Harvard Medical School.

The 2006 comprehensive health care reform was designed to achieve 'universal' health coverage and did so using new laws requiring that employers with more than 10 employees offer insurance but also mandating that all state residents obtain insurance or pay a fine. Free or low-cost, subsidized insurance was offered to state residents with low incomes.  Result: the poorest still had insurance, as did the richest, but the 'working' poor could not afford it.  Estimates put the number of uninsured in the state at high levels - last week the Census Bureau released its survey which found 370,000 people to be uninsured in Massachusetts. That's 5.6 percent of the state's population.

  The study authors also point out that the Massachusetts health care reform law served as the model for the national health reform law, the Affordable Care Act (colloquially called ObamaCare by opponents) and thus may suggest even larger difficulty ahead for nationalized health care.

To understand where it went wrong, the study authors surveyed 431 patients ages 18-64 who were visiting the emergency room of Massachusetts' second largest 'safety-net' hospital. The results were published online in the Journal of General Internal Medicine.

Theyfound that of the 189 patients without health insurance, two-thirds (65.9 percent) were employed, but only a quarter had access to employer-sponsored insurance. One-third (35.2 percent) of uninsured patients reported having lost previous insurance coverage, with the majority of these (51.9 percent) having lost their coverage due to loss of a job or transition from one job to another.

More than 85 percent of the uninsured patients interviewed had incomes low enough to qualify them for free or low-cost, state-subsidized private insurance. Nonetheless, one-third reported being uninsured because they could not find affordable insurance.

The majority of the uninsured were aware of the new legal requirement that they carry health insurance or pay fines but nearly half said that they had been unable to find insurance they could afford. That makes sense; when you require something and penalize people who don't do it, there is no incentive for the cost to come down.

"These findings illustrate that tying insurance to employment can be an unstable mechanism for providing coverage," said the study's lead author, Dr. Rachel Nardin, a neurologist at Cambridge Health Alliance. "We found that employer-based coverage failed the self-employed; those who worked for firms that did not offer insurance, especially small firms exempt from a requirement to offer insurance; and the poor who could not afford employer-sponsored insurance even when it was offered to them. The system of coverage also failed those who lost their job, which is particularly problematic with the current economic downturn."

Senior author Dr. Danny McCormick, an internist at Cambridge Health Alliance, said, "It appears that for people with very low incomes, even state plans with subsidized insurance premiums may be too costly. Also, under the reform law workers who are offered employer sponsored insurance but decline it due to cost are not eligible for state subsidized insurance, no matter how poor they are. If we are serious about the goal of universal coverage, we will need to further reduce or eliminate the financial barriers to getting insurance that still clearly exist in Massachusetts."

Only 5.6 percent of the interviewees were uninsured because they didn't think they needed insurance, which suggested to the authors there were few seeking a so-called free ride.  Indeed, some young people have never carried insurance because in the beginnings of their careers they don't need it and the money would be better spent on other things, rather than subsidizing the health care industry.

"While the reform substantially reduced the number of uninsured in our state, it failed to fully reach the demographic groups it targeted. Our findings emphasize the fragility of a reform requiring voluntary uptake, periodic renewal, dependence on employment and cost-sharing," said McCormick.

Nardin commented, "In Massachusetts, we had about 10 percent uninsured before the reform. In many other states, the uninsured rate is in the 20-25 percent range. If our results are any indicator, the national reform may leave many working poor uncovered.

"Although arguments about political feasibility are a major challenge, our study suggests that a comprehensive reform guaranteeing coverage to all residents without eligibility restrictions — such as that provided by many single-payer systems — would be a more effective way to achieve universal coverage than the Massachusetts reform."

One of many flaws...

"...when you require something and penalize people who don't do it, there is no incentive for the cost to come down."

You are right, beverly, the requirement to purchase insurance is one of several severe (and intentional) flaws in the Healthcare Acts pushed through by Romney, and later Obama.  

I suspect all of the posturing, bluster and hot air on the part of rightwing politicians against so-called "Obamacare" is just theater.  They know as well as Obama that the Healthcare Act is a massive giveaway to the bloated health insurance industry. It is in line with the Republicrats philosophy that private commercial concerns are more important than public good.  

So while they propagandize their weak minded followers against this bill they are secretly loving it and will continue to back it in the legislatures and the courts.



Dr. Radut | blog