Saturday, August 5, 2017

School Scope: Health Care - Educating People Honestly is First Step to Reform By Norm Scott


The WAVE - www.rockawave.com -- Aug. 4, 2017

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School Scope: Health Care - Educating People Honestly is First Step to Reform
By Norm Scott

If you are looking for commentary on education let me remind you this is summer vacation for most ed news, other than to say that the de Blasio/Farina operation of the schools is not as different from BloomKlein. One of the big stories this week was the Susan Edelman expose in the NY Post of the scandals in the principal training Leadership Academy, which spawned our very own Marcella Sills. http://nypost.com/2017/07/29/doe-lost-track-of-101m-given-to-leadership-coaches-audit.

I compare the NYC Leadership Academy training to the Nazi SS - where there are stories that they would give a new recruit a dog when they arrived, allow them to bond, and then order them to kill the dog to complete their training. All too many Lead Acad grads act like they’ve emerged from that type of trauma and feel free to engage in vicious, sadistic behavior.

But let’s get back to an equally vicious and sadistic topic. Health care as a follow-up to last week’s column (School Scope: Why Not Medicare for All?) where I talked about single payer around the world with an emphasis on how health stats in Rwanda may one day, if Republicans remain ascendant, may soon surpass ours.

There has been increasing serious media attention (as opposed to mocking commentary) related to Bernie Sanders bringing up a single payer bill, an idea he was ridiculed for a year ago. It is clear there are problems with Obama Care, many of them exaggerated by eight years of Republican attempts to go back to the pre-Obamacare good old days of death panels. The criticisms of Obamacare from both left and right go deep but come at the issue from two entirely different directions.

One of the attacks on Obama was based on his false promise that people could keep their plans. Seven years ago I was tossed out of my UFT plan and into Medicare by law as I joined everyone who turns 65 . I didn’t cry, as Medicare just happens to be one of the most popular government run programs.

I keep repeating that my wife who worked in billing for a major hospital and dealt with every insurance company maintained that Medicare, staffed with career professionals (as opposed to the often revolving door employees in private insurance) was also the most efficient and well-run. I would say this was one of the biggest issues in former Obama voters moving to Trump.  Goodness, is it possible that the big, bad government which comes under attack by so many can out perform privately run operations?

Boys and girls there is a solution, even if a temporary one to stabilize the market while we work to expand Medicare down to younger people. (Bernie suggests we move people who are 55 into Medicare as a first step.)

Obama abandoned the offer of a public option very quickly to appease the insurance companies who didn’t want to compete with the government. (He also ignored please control drug costs to keep big pharm on board). With so many insurance companies abandoning the market at this time, the biggest immediate fix to Obamacare would be to add a government option in every area that is left with few options or none. I find it funny how all the people who believe in competition don’t want the government to compete with private insurance plans.

Now I want to be clear. In a single payer system everyone would be tossed out of their plan and into the same plan. This would be huuuuge and of course disrupting as even employer based plans would end. Some argue that industry offers these plans as a way to lure workers. And many workers make job choices based on health care. By taking the burden of health care off the table, as would happen in single payer, there would be a major bump in earnings for boss and worker – think of taking the money spent on health care and giving raises.

We also should be clear that single payer would wipe out most of the insurance industry with its overhead and high executive salaries – and all those lobbying costs. How can that be a bad thing?

Let me end with a reference to some correspondence I’ve been having with  a WAVE reader who doesn’t agree with my take but does admire the variation of single payer system in Singapore, which forces everyone to pay something whenever they use a health service. (Google Singapore health care if interested in learning more.) I am open to negotiations on means payments and co-payments. My recent foray into health care related to a urinary tract infection taught me a few things. I had to have a picc line installed in my arm to receive antibiotics and it was done at NYU-Langone where two nurses and a doctor did the job (who knew that the line went  directly from my arm into my heart – ugh). They billed for over $15,000. Medicare paid about $600. It was clear before I went in – there would be no cost to me and they knew what they were going to get. Thus an advantage of single payer even with all the waste and fraud ( and over testing) – there is one place to go to get paid and someone makes a value judgment.

Even under single payer, which would replace everyone’s health care costs with a  --- dare I  say the word – tax, people would come out ahead.

If you want to read a medical horror story, check out the recent NY Times exposure (The Company Behind Many Surprise Emergency Room Bills) of scams where emergency rooms have been privatized by EmCare, a rapacious company. https://www.nytimes.com/2017/07/24/upshot/the-company-behind-many-surprise-emergency-room-bills.html.

Norm blogs about whatever drivel comes into his head at ednotesonline.com.

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