As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Wednesday, May 10, 2006

Some Facts on Health Care

Bill Frist, he of the persistent legislative state, has christened this Health Care Week in the Senate. He obviously came up with the name before getting a vote count on his medical malpractice bills, which failed again, twice. Similarly, Michael Enzi's bill that would reduce coverage for the majority of Americans on a number of routine procedures is wilting on the floor, and Enzi's struggling to walk the bill back before it gets thrown out altogether.

In this environment I thought it'd be instructive to look at some of the real health care problems in the country, rather than the Republican ideas that we have too much coverage and it's all the lawyers' fault. I've collected a number of articles over the past week to illustrate these points.

-The Medicare Part D program is nearing a May 15 deadline for signup that will affect seniors who do not enroll FOR THE REST OF THEIR LIFE with penalties and fees. This is despite the fact that the plan is extremely confusing and a recent finding showed the Medicare helpline is extremely unhelpful.

Federal investigators posing as senior citizens found that Medicare's operators routinely failed to give callers accurate and complete information about the government's new drug benefit, prompting Democratic critics of the Bush administration program to again request an extension of an approaching enrollment deadline.

The investigators said that about one-third of their calls resulted in faulty responses or no response at all because of disconnected calls. The accuracy rates varied a great deal based on the question, but when it came to one of the most important questions, operators provided the right answer only 41 percent of the time. That question concerned which drug plan cost the least for a beneficiary based on certain drug needs.

Despite this the President has rejected any call to extend the deadline for the 7 million eligible seniors currently not enrolled.

-If the seniors can't get basic answers to how to sign up for Medicare Part D, you can be sure they have no idea that this is coming:

Beneficiaries are going to start paying 100 percent rather than 25 percent of their drug expenses once those expenses reach $2,250, and most seniors at risk will be hitting that lower limit close to Election Day.

Some benefit.

-Meanwhile, you would think that since we pay more for health care than any other nation, our overall health would be greater as well. Not so much.

White, middle-aged Americans -- even those who are rich -- are far less healthy than their peers in England, according to stunning new research that erases misconceptions and has experts scratching their heads.

Americans had higher rates of diabetes, heart disease, strokes, lung disease and cancer -- findings that held true no matter what income or education level.

Those dismal results are despite the fact that U.S. health care spending is double what England spends on each of its citizens.

The upper crust in both countries was healthier than middle-class and low-income people in the same country. But richer Americans' health status resembled the health of the low-income English.

Anti-universal health care advocates routinely denigrate the quality of care in England and other nationalized countries. This data seems to disagree.

-So the health care we're getting is more expensive, probably because there are so many middlemen, and less effective. What about the health care we're NOT getting? I'm talking about the 40+ million people who aren't covered by insurance. I'm sure that has a lot to do with this story:

Poor women in America are increasingly likely to have unwanted pregnancies, whereas relatively affluent women are succeeding more and more in getting pregnant only when they want to, according to a study analyzing federal statistics.

Based on nationwide data collected by the National Center for Health Statistics and other sources, the researchers found that from 1994 through 2001, the rate of unplanned pregnancies increased by almost 30 percent for women below the federal poverty line -- now defined as $16,000 annually for a family of three. For women in families comfortably above poverty, the rate of unplanned pregnancies fell by 20 percent during the same period.

The abortion rate also rose among poor women while declining among the more affluent.

Asked what was driving the trends, the authors noted that some state and federal reproductive health programs have been cut or made more restrictive in recent years. State and federal programs have increasingly focused on abstinence rather than contraception, and some analysts have argued that the shift is leading to less use of contraceptives and more unintended pregnancies.

This is cheery to social conservatives who preach abstinence-only education (which doesn't work, we learned this week). But it's also great for economic conservatives, who offer less and less education and health programs to the poor, keeping them ignorant about how to manage family planning.

-And inevitably, at the confluence of those two roads, it leads to this:

An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.

American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.

Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.

So, more poor people are getting pregnant, they lack access to health care, and the result is more babies dying at birth. Anyone else see the causalities there?

The newborn mortality rate in the United States has fallen in recent decades, the report said, but continues to affect minorities disproportionately.

Only 17 percent of all U.S. births were to African-American families, but 33 percent of all low-birthweight babies were African-American, according to the report.

The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality.

Tinker said some nations ranked high in part because they offer free health services for pregnant women and babies, while the United States suffers from disparities in access to health care.

-The Senate, during this Health Care Week, won't even bring stem-cell legislation passed by the House to the floor for a vote.

So that's a decent overview of where we are. Not enough people have health care, those who have it aren't getting a whole lot out of it, and advances in technology and human health are being stymied on moral grounds. Republicans really have no ideas to deal with any of this, as evidenced by their "Health Care Week" priorities. It's time to overhaul this system and come up with some real solutions.