Ill and UNINSURED in Illinois

Emergency! Nov. 4 rally against Cook County health care cuts

2009-11-03T21:30:00.001-06:00

Stroger Hospital Emergency Room

Yesterday, I had surgery at Stroger Hospital. My appointment was for 6:30 a.m. But the hospital was so overwhelmed that didn't get my operation until after 5 p.m.

I spent the whole day lying on a gurney in the pre-op area. Afterward, I was in terrible pain they were unable to get controlled, but they still sent me home because — the nurse said — there were patients in even worse shape that they didn't have beds for.

Now services may be cut further.

Protest at Stroger Hospital

4 p.m. Wednesday, November 4
West Ogden and South Damen avenues, Chicago

From the Chicago Single Payer Action Network:

Our health care system is under attack! Our hospitals and clinics which serve over 80% poor, black, latino and immigrant people are being dismantled. If we don't fight back against these attacks the patients served with be left without healthcare.

Where will we go when we get sick and can’t afford the $10-$50 dollar co-pays per clinic
visit?! What clinics will we go to when they become run by the federal government and bill for their services? Where will we get our medicines when our pharmacies are eliminated because our clinics are sold off? What hospital will we go to when the in-patient services are
eliminated?

This is what CEO Foley and the new governing board is proposing. Already over 300 nurses, doctors and medical staff have received lay off notices and there are still more to come! Every
attack on our health care workers and our hospitals and clinics is ultimately an attack on us.

We cannot remain silent! We have got to fight back. THESE ARE THE PROPOSED CUTS:

Eliminate all of inpatient care at Provident Hospital!
Eliminate all of inpatient care at Oak Forest Hospital!
Close more ACHN clinics and turn others like Robbins Community Clinic and Cottage Grove into Federally Qualified Health Centers
(FQHC's)!
Charge $10 co-pays for every clinic visit!
900 unfilled positions are already eliminated!
500 more lay-offs still to come!

More information from UP.

Health-care activists arrested in Chicago sit-in

2009-10-09T16:30:00.008-05:00

Arrests at Cigna in downtown Chicago yesterday. (Via Illinois Media Progressives.)

Police dragged seven health-care protesters from a pro-reform sit-in at Cigna's downtown Chicago offices yesterday, dragging them by hands and feet. Outside, a rally whose members included Illinois Rep. Mary E. Flowers (D-31st) chanted, "Cigna profits! People die!"

I don't know who the brave individuals who let themselves be arrested were, but they have my profound gratitude. All I know is that they represent the Illinois Single Payer Coalition, the Chicago Single Payer Action Network, Progressive Democrats of America and Physicians for a National Health Care Program.

No news media troubled to report the names of those arrested. AP did a short item on the story, which is all the Chicago Tribune ran. No other mainstream Chicago media covered it at all, so far as I can tell.

"And we will stand with you, as you have stood with us," wrote the Sun-Times today, announcing its new owners. I'm glad the paper will survive.

But where were you yesterday?

RIP Nicholas Skala, Chicago advocate for single-payer

2009-08-11T21:00:00.000-05:00

Single Payer Action interview with Nicholas Skala, June 12, 2009
Dirksen Senate Office Building, Washington, D.C.

I was shocked and saddened to hear of the death of 27-year-old Nicholas Skala. Mr. Skala, who died suddenly of unknown causes in his Chicago home last weekend, was one of the most dedicated campaigners on behalf of single-payer health care. His death is a terrible loss to the movement.

A one-time staff member of Physicians for a National Health Program, Mr. Skala continued to work for the cause as a volunteer even after he had left the organization to go to law school. He was a dedicated and talented advocate.

Dr. Ida Hellander, executive director of PHNP, wrote:

"His incisive mind, wide-ranging knowledge and formidable skills of argument were devoted entirely to bringing about a better world for everyone.

"To his friends and co-workers, he was an extremely witty and compassionate human being, and a great source of inspiration and encouragement.

"Nick had only recently returned to Chicago from two months in Washington, D.C., where he contributed significantly to the cause of single-payer health reform in multiple ways. He was committed to working for PNHP in our Chicago office during the next six weeks prior to his return to his classes at Northwestern University Law School.

"His death is a heavy blow to our organization and to the entire single-payer movement.

"We vow to redouble our efforts to bring about Nick Skala's vision."

I never met Nick Skala or spoke to him, but we exchanged e-mail on several occasions. He was unfailingly polite, interested and prompt in his replies to a random blogger, which made him nearly unique in my experience of trying to communicate with local health-care reformers.

I express my sincere condolences to Mr. Skala's family and friends, to his colleagues at PNHP, to the single-payer cause in general and to society as a whole. We are all poorer for the loss of such a promising young man.

A funeral service for Nicholas Skala will be held at 7:30 p.m. Thursday, Aug. 13, at the Lauterburg-Oehler Funeral Home, 2000 E. Northwest Highway, Arlington Heights. Visitation will take place from 3 p.m. to 7:30 p.m.

According to PHNP, Mr. Skala's parents, Judith and Ronald Skala, have invited all of his friends to attend, and ask that, in lieu of flowers, contributions in his memory be made to Physicians for a National Health Program, 29 E. Madison St., Suite 602, Chicago, IL 60602.

Sympathy cards can be sent to Judith and Ronald Skala, 12215 Lakewood Glen Ct., Cypress, TX 77429. Condolence messages sent to PNHP or the funeral home will be forwarded to the family.

Liar! Liar! Pants on fire! 10 lies about health-care reform

2009-08-09T08:00:00.002-05:00

I'm not normally one to give way to obscenity but WTF?!

It seems as if Republicans like Sarah Palin and Michele Bachmann have gone off the deep end and are trying to make Americans believe that health-care reform is going to create some kind of Soylent Green-like society where the sick will be ground up for bread. According to Palin:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."  

Palin seems to be confusing Obama's plan with our current system in which a "death panel" of insurance-company bureaucrats decides who's worthy of health care based on what will generate the most profits, and anyone who's so unproductive as to be sick and out of a job may as well curl up and die. That's the evil America Sarah Palin knows and loves!

Please note that this isn't coming from some wacko fringe element of the Republican Party. This is coming from a woman whom the party seriously considered suitable to be second-in-command to the leader of the free world.

Anyway, I've decided that if Palin and other Republicans can get away with promulgating sick lies, outrageous untruths and off-the-wall innuendo about health-care reform, so can I.

Here are some of those I'm spreading. Feel free to join in by repeating them as often as possible and coming up with your own.

Health-care reform will cure the common cold.

Republicans masterminded the Twitter denial-of-service attack…in an effort to stop pro-health-care reform tweets.

Under single-payer health care, all Americans will receive an annual free visit to a health spa.

Universal health care means your pets will get free veterinarian visits, too.

A Republican doctor invented a cure for cancer but party members convinced him to suppress it in order to protect insurers' profits.

The health-reform bill will fund construction of 1,000 new medical & nursing schools, creating millions of jobs.

Why are anti-health-care reform Rep. Mark Kirk's divorce records sealed? Is it true about the sheep?

U.S. ballplayers threaten strike if health-care reform isn't passed before the World Series. "Some things are more important than baseball," sluggers say.

Rush Limbaugh says he's now supporting H.R. 676.

Staffers sorting George W. Bush's cast-offs in the White House basement have discovered a huge cache of gold and platinum. The administration says there's enough there to fund heath care for all American for 20 years. The deposit was labeled "Weapons of Mass Destruction."

Dis-invited from White House, Obama's Chicago doctor eloquent on health-care reform

2009-08-03T10:00:00.001-05:00

Dr. David Scheiner, who was Pres. Barack Obama's personal physician for 22 years, until Obama went into the White House, speaks out forcefully for single-payer health care in this video, and he is no fan of the president's plan, or that of those that were being hashed out in the House and Senate, before those legislators gave up and went on vacation. (About 1,800 Americans will die as for lack of health care during the August recess, but what does Congress care?)

"If I had a single point to make about what is going wrong with this health reform is that the public is so uniformed. They think somehow that they get the best care in the world. We know by health statistics we're 37th. Even people with good health insurance don't realize that the health care they get is often not appropriate...."

He's right. And most people haven't a clue as to what "single payer" means.

While single-payer is getting a little more attention at last, it's extremely interesting to see that Scheiner was dis-invited from the recent White House press conference on health-care reform. (I don't supposed that mattered much to the cause of single-payer, since everything that was said at that event was immediately swallowed up in the furor after Chicago Sun-Times Bureau Chief Lynn Sweet asked about Skip Gates.)

I would very much like to know whether the impetus came from Pres. "Small Change" Obama's side or from ABC's.

Journalism is not covering the issue of health-care reform well. I agree with Maggie Mahar: Tbe media are not giving the public the information they need in order to understand all of the sides of this issue, and is failing in their critical role of analysis.

Why is what beer the White House serves worth more ink than H.R. 676?

Health-care reform: The progressives awake!

2009-08-01T10:00:00.006-05:00

Rachel Maddow: The gloves come off on health-care reform.

I feel a little more hopeful about health-care reform today. It looks as if progressives in Congress may be finally waking up from the dead.

New York Rep. Anthony Weiner's move to showcase the hypocrisy of conservative House members on government-run health care was hilarious. He proposed to eliminate Medicare. Of course, not a single congressman voted for it.

House Speaker Nancy Pelosi's strong language painting insurance companies as villains was good to hear.

It also sounds as if House Rep. Barney Frank (D-Mass.) thinks the Blue Dog Democrats can be brought to heel on a public option. In a letter to constituents, Frank wrote:

I am a strong supporter of single payer, and I do reluctantly accept a full public option as the best we can do. So I am strongly committed to a public option and I will not vote for a bill that does not include a nationwide, genuine public plan.

Meanwhile, 57 members of Congress have signed a letter saying, "Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates — not negotiated rates — is unacceptable," and promising not to vote for the Blue Dog "compromise" bill currently on the table.

Signers include Illinois congressmen Luis Gutierrez (D-4th), Phil Hare (D-17th) and Jesse Jackson, Jr. (D-2nd). I'm deeply disappointed not to see the names Danny Davis (D-7th), Bobby Rush (D-1st) and Jan Schakowsky (D-9th) on this list. If your representative's name isn't there, urge him or her to take the pledge.

While you're at it, send a note to Pres. Onamby-pamby urging him to promise he won't to sign any bill without at least a strong public option. Remind him that when we voted for change, we didn't mean small change. Tell him you want real change, like the single-payer option he used to say he supported.

There's also hopeful news on single-payer, perhaps. In order to get
Weiner to withdraw his amendment to replace the House Energy & Commerce Committee's bill with the single-payer H.R. 676, Committee Chairman Henry Waxman (D-Calif.) said that he had spoken with Pelosi, and she had pledged that single-payer would get a debate and floor vote and a debate on single payer in the full House! I'll believe it when I see it, but if it turns out to have been a mere ploy to get Weiner to shut up, Waxman is going to be up against the wall when the revolution comes.

Health-care reform and the living dead

2009-07-30T13:30:00.000-05:00

Zombies take over the streets of Chicago, July 25, 2009

I haven't posted in a while. I've been feeling worse again, and I've been depressed over the way that health-care reform is going. I'm becoming convinced that if anything passes at all, it's going to be so watered down as to be useless, or make matters even worse. And I don't see that any of the plans now being bruited in Congress are going to be any help to me at all.

However, if anyone's still checking in, I wanted to draw your attention to Ellen Beth Gill's post from yesterday. She really said everything I feel about the current political situation.

Basically, health-care reform is pretty much dead, and all that's walking around now is its zombies.

"I am wondering if now we're really off health care and on to political survival. In the last couple of months, the advocates of this plan broke cardinal rule of negotiation #2. (They broke cardinal rule #1 up front when they began negotiations with their base minimum acceptable position.) Cardinal rule #2 is: never fall so in love with the deal so much that you cannot walk away from it. The public option supporters got so invested in it that they either failed to notice or at the very least failed to speak up as their baby lost all the attributes that made it potentially cost saving, a viable alternative to expensive private plans and perhaps a good temporary compromise solution. Now that it's about as far from the original idea as it can get and survive, its advocates might just have to stick with it or go down in a serious defeat, taking many Democrats along with them...."

In a way, I almost wish that McCain and Palin had won. At least then I wouldn't be feeling betrayed, and their administration would have been pretty funny to watch. And you know they say that laughter is the best medicine....

That's a little sick humor for you.

Hell no, we won't hush!

2009-07-15T14:30:00.002-05:00

From Laura Flanders:

"With popular fury at the status quo rising and hunger for a real, public option attracting over 70 percent approval in polls, the White House is urging public-option advocates to hush.

"According to the Washington Post, in a pre-holiday call with half a dozen top House and Senate Democrats, Obama asked health care advocates to ratchet back their pressure for a public option. He's apparently concerned about advertisements and on-line campaigns targeting foot-dragging Democrats....

"When Max Baucus, chairman of the Senate Finance Committee, sat down with health-care lobbyists on June 10, two were his former chiefs of staff. Their aim: to minimize the "damage" in profits to insurers, hospitals and drug makers from any change in approach from government. Specifically, they oppose any even remotely public option, the details of which are right now up for debate."

Mr. President, you ought to be leading the charge, not telling people to hush! The Democratic Party is in the best position it can possibly be in to bring about meaningful health-care reform and it looks like you're going to blow it, for no better reasons than fear of offending Republicans and cutting into the profits of health insurers.

What is wrong with you?

Now we hear that lawmakers aren't going put together a health-reform bill before the August recess:

The administration's Democratic partners in Congress hinted they would not deliver legislation before leaving town for an August recess. Sen. Debbie Stabenow, D-Mich., said Obama should be pleased with lawmakers' progress; Sen. Kent Conrad, D-N.D., said "there really is plenty of time."

Plenty of time? Some 22,000 Americans, more than 60 per day, die just because they have no health coverage! Millions remain in pain or become lamed for life. And Congress wants to go on vacation?

Better fairgrounds treatment than no treatment

2009-07-12T10:00:00.001-05:00

In this video, former health insurance industry executive Wendell Potter, who left the field after almost 20 years to become a health reform advocate, talks to Bill Moyers about what caused him to leave his highly paid job.

My first thought, hearing him describe the "health care exposition" he went to, in which uninsured people lined up to be treated in animal stalls, was to wish such events happened in Chicago.

Chicago doctor walks 700 miles for health care reform

2009-07-02T10:30:00.003-05:00

Dr. Ogan Gurel

To highlight the hardships that plague the uninsured, Chicago docter Ogan Gurel is taking their stories to Washington, D.C. — on foot.

Gurel is adjunct associate professor of bioengineering/bioinformatics at the University of Illinois-Chicago, and chairman of Aesis Group, a medical consulting firm. As a self-employed consultant, the doctor, like nearly 50 million other Americans, lacks health insurance. Inspired by the 167-mile walk around Illinois that Pat Quinn (now governor of Illinois) and Physicians for a National Health Program founder Dr. Quentin Young took in August 2001 to promote health care for everyone, Gurel is on a one-man march to the nation's capital.

On Saturday, June 27, he left from Daley Plaza on a nearly 700-mile hike. He expects to arrive in Washington on July 27. En route, he plans to meet people and share their health-care stories through his blog, Facebook and Twitter.

In his walk, which Gurel says is nonpolitical, he isn't advocating any particular reform policy, he says. That's a pity, because it makes his walk less meaningful. It's clear that some kind of health-care reform will happen. Yet unless we have, at a minimum, a strong public option, it will fall far short of health care for all.

Walk for Healthcare FAQs

$1.4 million per day to derail health-care reform

2009-06-29T13:30:00.002-05:00

Why isn't Congress listening to Americans on health-care reform? This is why.

Health care interests have spent $1.4 million per day this year lobbying Congress, according to Common Cause. Just imagine if that money were spent on health care for the uninsured instead.

Common Cause also reports:

Health industries — including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals — have contributed over $372 million in campaign contributions to members of Congress since 2000.

Political spending by the health industries has increased 73 percent since 2000. Health interests contributed about $94 million to candidates for Congress in the 2008 election cycle, up from about $54 million in the 2000 cycle.

Members serving on committees and subcommittees with jurisdiction over health care reform in the House and Senate received the lion's share of health industries' largesse. Committee members raised $178 million from the industries this decade — roughly half of the industries' contributions to the entire Congress.

Hooray for Mary Flowers!June 25 single-payer hearing, Carbondale

2009-06-22T11:00:00.001-05:00

Mary E. Flowers

Illinois Rep. Mary E. Flowers (D-31st) is still out there talking up her bill for an Illinois single-payer health-care system, H.B. 311.

The Southern Illinoisan reports:

"Flowers said she plans to be in Carbondale next week to discuss the legislation and get feedback from citizens who want to 'make their voice heard' on health care. She will host a hearing at 7 p.m. June 25 at the Carbondale Civic Center.

"'The average family is paying $6,700 a year for health care in Illinois and guess what? They are not better for it, and they are not healthier for it,' she said. 'Other countries pay less, get more and live longer.'"

Given the mess being proposed in Washington by politicians largely bought and sold by the insurance industry and for-profit medicine, it may be that, like the smoking ban, we will have to enact universal health care state-by-state or even city-by-city. (After all, if the Chicago City Council could pass ordinances about the welfare of ducks, you'd think they could do something for people.)

Here's hoping Illinois will be a leader.

Obama's Chicago doctor supports single-payer

2009-06-20T09:00:00.004-05:00

What do you call a man who ignores his doctor's advice?

Barack Obama.

So reports Forbes, which notes that Dr. David Scheiner, the Hyde Park physician who was Obama's internist from 1987 until after the election, is critical of the president's stance on health-care reform.

Forbes, naturally, tried to put as right-wing a spin on Scheiner's criticisms as possible ("Obama's Doctor Knocks ObamaCare"), but what it comes down to is that Scheiner supports single-payer health care.

"'He doesn't see all the pain, it's so tragic out here,' [Scheiner] says. 'Obama's wonderful, but on this one I'm not sure if he's getting the right input.'

"What should the president be focused on? Scheiner thinks that a good health reform would be 'Medicare for all,' a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system. 'A neurosurgeon gets paid $20,000 for cutting into the neck of my patient. Have him get paid $1 million a year instead of $2 million or $3 million. He won't starve,' Scheiner says.

"Scheiner thinks that Obama's 'public plan' reform doesn't go far enough. He supports the idea of that option for people who don't like or can't afford their HMO. But he worries that it will be watered down or not happen at all. "'It's nonsense that the private insurance companies need to be protected,' he says. 'Why? Because they've done such a good job?'

Scheiner actually says he didn't discuss health policy with Obama, but it seems unlikely the latter was unaware of his doctor's views. Scheiner's medical partner, Dr. Quentin Young, founded Physicians for for a National Health Program.

Dr. Scheiner, it's not too late to write your patient a prescription for fixing health-care's ills.

Maher on Obama and health care: Right again

2009-06-19T09:00:00.002-05:00

Bill Maher: Enough with the Obamathon

Sorry if you've seen this already. I don't have cable, so I see these things when they come around on YouTube. Bill Maher is absolutely right here. Pres. "Go with the Flow" Obama is not giving us the leadership we expected or deserve.

The way he and the Democrats in Congress are kowtowing to the GOP in the name of a useless bipartisanship is a crying shame. Now is not the time to turn the other cheek and try to prove how much better your manners are than the Republicans'. Too many lives are on the line. Use your power while you have it.

We should all stop basking in the relief that Bush is gone, and push Obama into doing the things we need him to do.

Stop making nice, Mr. President. Fight for us. History will judge you on what you achieve, not on how you look on TV.

Have you signed on to universal health care?

2009-06-18T09:00:00.009-05:00

Sen. Bernie Sanders (I-Vt.)

Please go to Sanders' Web site right now and sign the petition!

Everybody in. Nobody out.

Chronic recognition

2009-06-17T10:08:00.006-05:00

Ill and Uninsured in Illinois has gotten a tiny bit of recognition lately. The blog was accepted to Blogburst, a blog syndication service, which means a couple of my posts appeared on the Chicago Sun-Times' and Daily Southtown Web site. (This seems to have generated about five click-throughs to the actual blog so far, and there's no compensation, in case you were wondering.) More gratifyingly, Duncan Cross very kindly invited me to participate in the very first Patients for a Moment, a new patient-centered blog carnival, which launched today. It's a fine start. Go take a look.

One of the linked posts that particularly struck me was at Getting Closer to Myself on how to talk about one's illness. This is something I've been struggling with; most of my friends and acquaintances have no idea how sick I've been — what they think about why I've dropped out of sight I don't know. Probably they don't much care. I haven't told many people, in part because I still have hopes of finding a job when I get through all of this, and a reputation as a sickly person in the relatively small circle of my field will be hard to overcome. I never expected to be so ill for so long.

Duncan's comments, which linked my post on retail clinics to a thoughtful post from A Blessed Mess on the financial problems of chronic illness, sent me to look up just what chronic illness is.

I hadn't before now thought of myself as chronically ill. However, since the U.S. National Center for Health Statistics defines a chronic illness as one lasting three months or more, and this bout of decrepitude has lasted since late December, I guess I am. But it's the health-care system that's made me a chronic invalid.

Five years ago, when I had health insurance, I had an episode. It lasted a few weeks — four, maybe six altogether — during which time I had an emergency room visit, a follow-up with a specialist, three outpatient medical procedures and a number of intervening doctor visits. I had to take about a week off work, all told. And then it was all over and I was fine.

This new episode, without insurance, has been pretty much the same, treatment-wise. But the timing has been much different. I became ill in late December. I didn't get to see a specialist until late March. I had the first procedure in late April, with follow-up a month after that. A second procedure took place early this month, and my follow-up isn't until the end of the month. I'm guessing a third procedure will be needed, just like last time, so that'll be another two months. For all of this time, I've been too ill to leave my house, and for much of it, too sick even to work at home. I need a job, and yet I'm in no condition to look for work.

This isn't the fault of the beleaguered Cook County Health and Hospitals System. It isn't my fault. This is America's fault.

Thanks, Duncan, and also thank you to the bloggers who've added me to their blogrolls. Meanwhile, I invite your comments on this blog and suggestions on what I might do to get the word out further. By the way, please note the little star and the green doodad below. The star lets you promote a post on The Windy Citizen, Chicago's version of Digg. The green Share This icon makes it easy to share on Digg, Facebook or a variety of other social networks.

Health-insurance pirates: 'Go ahead and die!'

2009-06-16T10:00:00.010-05:00

Pirates of the Health Care-ibbean.
Music by the Austin Lounge Lizards.

This is brilliant! Why hasn't it gone viral?

Embed it in your blog! Digg it! Post it on Del.ico.us. Please, somebody, put it on national TV!

Chicagoans, of course, will be reminded of the legendary Steve Goodman. Yes, the health-insurance industry is nothing less than the "Lincoln Park Pirates," all growed up:

"I've got mine, and I feel fine, so go ahead and die!"

How Chicago is that? As the late Mike Royko used to say, "Ubi Est Mea."

Funny as it is, though, it's also frighteningly true:

"Senators and congressmen make up my scurvy crew
They swab my decks and cash my checks
And cast a vote or two.
When the universal health-care serpent rears its ugly head
My press gang fires broadsides
And my crew ensures it's dead."

According to the Washington Post:

"Almost 30 key lawmakers helping draft landmark health-care legislation have financial holdings in the industry, totaling nearly $11 million worth of personal investments in a sector that could be dramatically reshaped by this summer's debate.... Their total health-care holdings could be worth $27 million, because congressional financial disclosure forms released yesterday require reporting of only broad ranges of holdings rather than precise values of assets."

Do they really think we're so dumb as to believe that people with such investments in the status quo will vote fairly on reform? And over and above that, of course, are millions in direct donations from insurers and pharmaceutical companies and their PACs accepted by Sen. Max Baucus (D-Mont.) and other key players in the heath-care reform debate. Plus other close relationships, such as the wife of Sen. Chris Dodd (D-Conn.), who, the Post points out, has remunerative positions on the boards of four health-care companies.

Weigh, hey, let's tow 'em away!

Horrifying health ministries: Inspiration for health co-op plan?

2009-06-14T10:30:00.002-05:00

Sen. Chris Dodd's health-reform site, now apparently closed after 26,363 votes on 514 entries from 484 people, got a lot of traffic from members of so-called Christian health ministries, who were apparently coached to post repeating messages (they all used nearly the same language) calling for preserving their private health-care expense-sharing plans and to hell with the rest of us. (I guess we're destined to go there, anyway, in their view, so they don't mind if we suffer here on earth first.)

Since the health cooperative idea proposed by Sen. Kent Conrad (D-N.D.) seems based on the concept of these unregulated health-insurance programs, it's as well to understand how they work.

Typically, the organization publishes a newsletter specifying named individuals' health-care needs every month, and members, who are required to tithe a specified amount monthly, send their donations directly to the sick person of their choice. So not only do you have to tell all your fellow members about your hemorrhoids or prostate trouble, if you're unpopular, I guess you die.

According to the scheme most frequently cited, Peoria-based Samaritan Ministries:

"Whether anyone chooses to pay your medical bills will be totally voluntary. This publication should never be considered as a substitute for an insurance policy. Whether you receive any payment for medical expenses, or whether or not this publication continues to operate, you will always remain liable for any unpaid bills.

"This is not a legally binding agreement to reimburse you for medical expenses you incur...."

To participate in Samaritan Ministries, you must be certified by the pastor of your church as a born-again Christian who attends church three out of every four weeks, and who doesn't drink, smoke or have sex outside of heterosexual marriage. You must also practice undefined "good health measures."

No expense under $300 is covered; payments cap out at $100,000 per illness. No preventative medicine, regular checkups or routine tests, such as colonoscopy. No chiropractic or osteopathic treatments. No treatment for mental illness or resulting suicide attempts.

If you have cancer, diabetes or a heart condition before you join, no expenses related to those conditions will be paid for, ever. A 12-month symptom- and treatment-free period applies to other pre-existing conditions. They also won't cover any sexually transmitted diseases contracted by, er, having sex.

They do, however, cover the expenses of birthing lots of Christian babies.

Health Wonks' health reform roundup

2009-06-13T09:00:00.001-05:00

I'm a little behind on things this week — struggling with two ailments while trying to get a little work done has sapped my energy — so I'm just getting to the latest edition of Health Wonk Review at Managed Care Matters.

This time out, it's a wide-ranging compendium of views on health-care reform, including my own post on retail clinics, which author Joe Paduda links in a flattering way to the eloquent DrRich's discourse on the death of the primary care physician.

I particularly like Paduda's own solution for reform, which goes further than any proposal being considered in Washington now — not "Medicare for All" but Veterans Administration health care for all. Paduda does a good job of refuting the anti-reformers' assertion that the government can't do anything right (which, oddly enough, seems to be promulgated largely by people who were staunch supporters of the government for the past eight years).

It's definitely worth taking a look.

Springfield on health-care reform

2009-06-08T17:30:00.001-05:00

Following health-care reform has made me realize that I don't know as much as I ought to about how my state government works, not when you get down to the nitty-gritty details.

As an excuse, I grew up in another state, so I learned something else when seventh-graders in Illinois learned that stuff, and I haven't had much call to study the state's legislature's detailed workings till now. I used to get all I needed to know from the newspapers, but our local papers no longer seem to employ reporters to cover the daily happenings in Springfield, and the principal news source about the state Capitol is a paid-subscription blog. So I've just been trying to track what I can through the state Web site.

As best as I've been able to determine, here is the status of the various health-care bills that came up in the 96th Illinois General Assembly, now recessed.

What passed

Illinois H.B. 3923, Insurance Rate Fairness
Requires insurance companies to spend atleast 75 percent of premium dollars on medical care rather than on executives' salaries, marketing and profits; establishes an Office of Consumer Health Insurance to conduct reviews of claims and rate increases; streamlines application process with a standard form for individuals and small groups. Passed the House and Senate in different forms. Final action deadline extended till Nov. 30, 2009, so it could still fall apart.

Illinois H.B. 2325, Continuing Coverage
Extends state COBRA rights from nine to 12 months. Passed both houses.

Illinois H.R. 0233, Urge Congress-Universal Health
A House resolution urging the U.S. Congress to enact Rep. John Conyers' Medicare for All Act. Adopted.

What failed

Illinois H.B. 311, Healthy Illinois Act
Single-payer universal health-care. Died in committee. Urge your rep. to reintroduce and support it in the fall veto session.

Illinois S.B. 1331 and Illinois H.B. 1801, Family and Employers Health Care Act
A program to make health insurance plans and HMOs affordable and accessible to small employers and individuals. Died after second reading.

Illinois H.B. 1855, Medicaid Access
Extension of Medicaid to indigents aged 50 to 64 and the disabled. Died after second reading.

For those of you who also need a primer on Illinois government, here's a guide. What's not very clear to me is what causes a bill that's gotten to a second reading to fizzle before it comes to a third reading and final vote. I'm also unsure of what may and may not be reintroduced in the fall session, but e-mail from my state rep. said it was possible H.B. 311 might return then. I hope so.

I suppose we should be urging our representatives and senators to get it together over H.B. 3923, but I can't get too excited over it. The insurance companies will find a way to finagle it somehow.

Frankly, I'm very unhappy with what my legislators have managed to achieve this session, and I don't see the furor over Blagojevich as any excuse.

Tell Chris Dodd to support single-payer!

2009-06-07T09:00:00.007-05:00

UPDATE: After commentary from 484 people, Sen. Dodd has stopped accepting opinions at the YouTube SenateHub site. You can still contact him through more traditional means.

Sen. Chris Dodd (D-CT), a senior member of the Senate Health, Education, Labor and Pensions Committee, invites you to submit your ideas and vote up or down those of others here.

I wonder whether anyone will actually pay attention to this, or whether it's just a political ploy.

Dodd asserts: "Many people like what they have. They don't want to change. They don't want us fooling around with it. And certainly our intention is if you like what you've got, then you keep what you've got."

Yet I've read every one of the 153 ideas that are there as I write, and by far the vast majority are calling for change, and most of those want single-payer.

Anyone who's had any serious illness and had to deal with the denials, the paperwork, the expense and lack of coverage entailed in the private-insurance system doesn't want to keep what they have. Those of us who don't have coverage don't want to keep what we have.

The only people who want to keep what they have are healthy people who haven't had any real interaction with their insurance companies. And, of course, people who work for insurance companies.

Discouragement

2009-06-06T09:00:00.002-05:00

I haven't written about my own situation in a while. Partly because I find writing about myself difficult, especially when there's no good news to report. This week I have good news and bad news.

The good news is that treatment is progressing. Slowly, but it's happening. The bad news is that I now have another ailment on top of the one I started with, and although I got some treatment for that, too, I feel worse. I'm frightened and discouraged, both by my own deteriorating condition and by the fact that health-care "reform" seems to be progressing in ominous ways.

So Max BauCA$H met with single-payer advocates and apologized. But, of course, he said it's too late.

Among other discouraging things that's happened lately is a conversation I had when I was at Stroger Hospital last week, being prepped for treatment. During a lull in the proceedings, I said to the anesthesiologist, "So what do you think about single-payer health care?"

"I never heard of it," she said.

I thought maybe she just wasn't familiar with the term itself and explained. "Oh, socialized medicine," she said. No, I said, and explained further. "I'll have to look into it."

But here we have medical personnel at a large, overburdened public hospital in the hometown of Physicians for a National Health Program ... and they don't know about single-payer? And neither do the patients?

Stroger Hospital, and other places like it, should be a prime recruiting ground for single-payer advocates. There, if anywhere, people understand what's wrong with our health-care system.

Can we have worse health care than today? Yes we can!

2009-06-05T09:00:00.003-05:00

Say it ain't so, Barack. Say it ain't so.

Well, I never would've thought it.

Of all my nightmares over health care, the one I never thought would come to pass is a system worse than we have now. Yet it's looming on the horizon: A system in which everyone is forced to buy health insurance from the big, greedy insurance companies who continue to practice their current deceitful schemes to get out of actually providing coverage. And if you don't pay, you either face fines, or have to fill out a lot of humiliating paperwork detailing your impoverished state in order to qualify for the privilege of doing without decent health care.

That's the plan being considered by senators Max Baucus and Edward Kennedy and, yes, Pres. Barack Obama. And they call themselves Democrats?

I can't write anymore, I'm too appalled.

Please, Barack, say it ain't so.

Retail clinics no answer to medically underserved

2009-06-04T09:00:00.009-05:00

UPDATE: I unfairly maligned Walgreens' nurse-practitioner for not doing any tests; in subsequent research I learned that my new illness is best diagnosed clinically in its early stages. On the other hand, the dosage of antibiotics she prescribed was too little, as I found out when I phoned my doctor. He told me to take the pills twice as often and twice as long, and graciously phoned in another prescription, so I was spared the price of an office visit. However, he said that if that doesn't clear up the symptoms, I will need to see a specialist.

(AP) — "Walk-in retail clinics in grocery and drugstore chains can help the uninsured find health care, proponents say. But a new study suggests most retail clinics aren't in the poorest neighborhoods.

"Like most businesses, they go where the money is — to more affluent neighborhoods, which already happen to be well-served by other medical resources....

"The study's results suggest financial incentives may be needed to lure the clinics to low-income neighborhoods, said study author Dr. Craig Pollack of the University of Pennsylvania....

"Open late and on weekends, the clinics use nurse practitioners to give shots and treat minor ailments such as sore throats and rashes. Visits typically cost $40 to $75, and prices are posted so consumers know what they're paying. People pay cash or use insurance....

"Industry leaders said retail clinics were designed to offer convenient care, not as the health care system's safety net. But they play a role, industry officials acknowledge. The clinics' own research shows 30 to 40 percent of patients say they don't have a primary care provider, said Tine Hansen-Turton of the Convenient Care Association, a trade group representing most of the clinics...."

Retail clinics like Walgreens' Take Care are quick and convenient. They're open evenings and weekends, and you don't need an appointment. If you don't have insurance, they're somewhat less expensive than a visit to most doctors.

Under our present health-care system, they do have a role. But they're a stop-gap, not a replacement for a primary-care physician. If you catch the flu or sprain your ankle on the weekend, they can save you a trip to the emergency room. But if your flu turns into pneumonia, or the ankle remains weak and needs physical therapy, they won't offer you followup care. For that matter, they can't x-ray your ankle to see if it's actually broken. If you have a chronic condition that needs monitoring, they don't do that, either.

* * *

Recently, I visited a Take Care clinic because of an illness I self-diagnosed ... with help from Dr. Google. Dr. G told me that it's one of those things that can get very bad if left untreated, so I thought I'd better get checked out. I didn't want to go to the Stroger Hospital emergency room, and the retail clinic seemed like the least expensive alternative.

The nurse-practitioner took a short medical history, did a very brief exam, listened to my description of my symptoms, said it looked as if I was right, and prescribed antibiotics. It cost $68.

She did no tests. She had to look up the correct antibiotic in a book. I asked about followup care, and she advised me to see a regular doctor once I'd finished the medication.

If Dr. Google and Take Care's APN are right, the pills will likely help me. If they're wrong, I'll have had — at a minimum — an unnecessary course of antibiotics that will do me no good.

Would my treatment have been different had I gone to the doctor I used to see when I had insurance? Perhaps not. But I bet he'd have ordered a test before writing a scrip, and I'd know for certain whether I had the disease I feared, or something else.

Of course, his price would have been higher, too.

* * *

Even for the limited ailments and injuries they diagnose and treat, retail clinics aren't a substitute for having a regular doctor who knows you and your history. If you rely on on such clinics for your medical care, it's very possible that underlying problems will go on unrecognized. And, as this new study notes, they aren't even convenient for the people who most need health care options.

To me, the existence of these clinics is just another symptom of our spotty, patchwork health-care system. Rather than offer financial incentives to create more for-profit retail health clinics in poor, underserved areas, it makes more sense to set up nonprofit or government-run clinics and offer incentives to doctors to work there.

Why don't we have a medical version of ROTC in the United States? In Australia, government scholarships subsidize the training of medical students who agree to spend six years working in underserved areas once they complete their schooling.

Somehow, it seems typical of the state of America now that our government trains young people to make war, but not health care.

Health reformers' calendar

2009-06-03T09:00:00.009-05:00

Upcoming health-care reform events

June 6: Organizing for America Health Care Kickoffs. Rewrite the script!

June 8: Campaign for Better Health Care Summer Celebration, 5:30 p.m., La Decima Musa Restaurant, Chicago, $50.

June 9: Chicago Single Payer Action Network meeting, 6:30 p.m. Access Living, Chicago.

June 14: Town Hall Meeting on Health Care Reform with U.S. Rep. Jan Schakowsky (D-9th), 2 p.m., Niles Senior Center, 999 Civic Center Drive, Room 127, Niles (southeast corner of Oakton Street and Waukegan Road).

June 17: Health-Care Justice Discussion by the Campaign for Better Health Care, 2:30 p.m., Peoria Public Library.

June 23: Chicago Single Payer Action Network meeting, 6:30 p.m. Access Living, Chicago.

June 25: Great American Sickout, National Rally for Health Care for All Now. Those who can, gather at 10 a.m. at the Washington Monument on the National Mall in Washington, D.C. Those who can't, stay home from work and call the White House and all your representatives and senators.

June 27: Organizing for America National Health Care Day of Service.

June 6: Organizing for health care — rewrite the script!

2009-06-01T09:00:00.006-05:00

"On June 6th, thousands of people just like you are beginning to organize for health care reform by hosting or attending a Health Care Organizing Kickoff," says the Democratic National Committee's Organizing for America.

Pres. Obama will join confirmed hosts and attendees in a live conference call. Some 50 events are already planned for the Chicago area. The Web site lets sign up to host or attend a kickoff function, and provides scripts for how it should go.

The kickoffs are intended to organize a June 27 National Health Care Day of Service and to promote Obama's three key health reform principles:

Reduce rising health-care costs
Guarantee choice in keeping or finding a new doctor or insurance
Ensure affordable care for all

It's No. 2 that's the hitch, since by "choice" the administration means your choice to preserve the greedy, corrupt health-insurance companies that are enriching Congress at the expense of Americans' health. It defeats the other two principles.

I don't like that choice. The 50 million of us who are uninsured don't have any health-care choices right now. The millions more who are stuck with whatever plan their employer offers don't have any choice. The people who can't change jobs because they'll lose coverage of their pre-existing conditions don't have a choice, either.

We don't need choice. We need health care!

Yet I definitely think single-payer advocates should sign up to host and attend these organizing events. Just rewrite the script!

Use this as an opportunity to point out that before Washington's sacred cash cows got to him, Pres. Obama was an advocate for single payer universal health care. "That's what I'd like to see," he said. "We may not get immediately, because we've got to take back the White House. We've got to take back the Senate. We've got to take back the House."

Point out that we've done all of those things, now, so it's time to take back health care, too.

Abandoned Cook County health care

2009-05-31T09:30:00.004-05:00

Creepy CPR dummy abandoned at Cook County Hospital.
(Photo by Kyle Telechan, City Eyes Blog, via The Windy Citizen)

Check out City Eyes Blog's series of eerie photographs taken in abandoned Chicago hospitals.

The newer batch of pictures comes from the vacant old Cook County Hospital structure, in the Illinois Medical District near its replacement, Stroger Hospital. The hospital achieved national fame as the inspiration for the County General of the fictional TV series, ER.

I'm not sure of the current status of this building. It was slated for demolition some years ago, and remains on the National Trust for Historic Preservation's list of endangered places.

The land is valuable, and the Classical Revival exterior beautiful, with all that glazed terra cotta ornamentation. Nobody builds hospitals like that anymore. None of the proposals I've seen for rehabbing the structure involve health-care uses.

It's disturbing that the photographer and his friends were able to gain access so easily. As he documents in the blog and the accompanying Flickr stream, parts of the interior were still in fairly good condition in 2008. A few squatters or vandals could do untold amounts of damage. I'm wondering if the cash-strapped county ever called in an architectural salvage firm for bids. Some of the abandoned elements might have value, or at least they would have when the hospital closed seven years ago.

The earlier series is even more disturbing, however. It shows Edgewater Medical Center, birthplace of John Wayne Gacy and Hillary Rodham Clinton, which was shuttered in 2001 after members of its management and medical staff were convicted of massive Medicare fraud. When the building was abandoned, its patients' medical records were apparently just left behind.

That's even creepier than that CPR dummy.

Obama and the meaning of change

2009-05-30T09:00:00.000-05:00

When Barack Obama promised "change," I didn't realize he meant the kind that goes ka-ching ... in the pockets of politicians.

Yet he's done absolutely nothing to resist the influence of monied lobbyists on Washington. I suppose that's too much to ask of an Illinois pol.

First, all the bailouts that paid insurance executives bonuses and let them go on luxury retreats. Now, a retreat from real health-care reform.

Now that he's the seat of all the money and power in Washington, Obama has turned away from the health-reform goals he once told us he believed in. He's barely involved himself personally in the debate, instead turning the crafting of health-care policy over to Sen. Max BauCASH, who's clearly been paid for by Big Medicine and the insurance industry, and he's tolerated the almost complete silencing of advocates for single-payer.

That's wrong. Maybe Congress is so venal that nothing we can say will make them vote for what's best for America's health; maybe they're all bought and paid for. I don't know. But not to permit open speech on the subject, not to let people who represent the opinions of millions of Americans speak on the same platforms as the profiteers who have sickened both our health and our economy, that's criminal.

Far more criminal than the valiant doctors and nurses BauCASH had hauled off to jail for trying to have their say.

Now, Obama says, mealymouthed: "If I were starting a system from scratch then I think that the idea of moving toward a single-payer system could very well make sense. That's the kind of system that you have in most industrialized countries around the world. The only problem is that we're not starting from scratch."

Americans need to let our president know that we won't stand for this. We need to shout — and keep shouting — that we want the single-payer, universal health care that Obama promised us back when he was a state senator — if only we could take back the White House, the Senate and the House. Well, we've done that for him.

As for starting from scratch, isn't that what change is supposed to be about?

The truth about single-payer

2009-05-29T09:00:00.001-05:00

"Up to 30 percent of the costs [of private health insurance] have nothing to do with health care at all...." —Donna Smith

"We could actually do everything we know is useful for every American with what we're spending now." —Dr. David Himmelstein

"If you're afraid of the insurance industry, you're afraid of doing what's right.... We need a culture of courage as opposed to cowardice." —Dr. Sidney Wolfe

If you missed Bill Moyers Journal on health reform when it aired last week, please take the time to watch it online, and then recommend it to everyone you know.

Part One

Part Two

June 2 rally for health care, downtown Chicago

2009-05-28T09:00:00.007-05:00

The National Single-Payer Day of Action is May 30. We're a little behindhand in Chicago. The local rally doesn't take place till June 2, when the Illinois Single-Payer Coalition, Chicago Single-Payer Action Network, Physicians for a National Health Program and others plan a protest outside corporate insurance giant Cigna's downtown Chicago headquarters.

RALLY FOR HEALTH CARE FOR ALL

SINGLE-PAYER NOW!
EVERYBODY IN NOBODY OUT!

DATE: Tuesday, June 2

TIME: 4:30 p.m.

PLACE: Cigna Insurance Company, 525 W. Monroe St., Chicago (corner of Monroe and Canal)

SPEAKERS FROM: Chicago Single-Payer Action Network, California Nurses Association and Physicians for a National Health Program

The crisis in health care is worse than ever. Millions of people have lost their jobs and with it health insurance because of the economic crisis. Now over 50 million have no health insurance. The Institute of Medicine estimates that 22,000 die every year due to lack of access to health care.

President Obama and Senator Max Baucus have excluded the voices of single-payer supporters in the national discussion on health care reform. They said a single-payer system is "off the table" but then say all viewpoints are being heard in Washington. That's why 8 doctors disrupted a recent senate hearing on health care reform and demanded advocates of single-payer be at the table.

The majority of people and doctors in the this country want single-payer, a government financed system that gets rid of the private insurance industry once and for all.

Join us in a national day of action to raise our voices in support of single-payer.

Sponsored by Chicago Single-Payer Action Network (CSPAN) & Physicians
for a National Health Program (PNHP)

Competition? What competition?

2009-05-27T09:00:00.014-05:00

Source: Illinois Health-Plan Premiums Soar As Insurers Face Less Competition (pdf)

Health Care for America Now!'s Illinois chapter struggles with blogging. First, they forgot to turn off the default list of Wordpress links; then, they had a variety of formatting troubles. They post infrequently. They have yet to figure out how to use categories or tags, and currently when you try to leave a comment, the blog reports: "ERROR: It looks like the website administrator hasn't activated the Brians Threaded Comments plugin from the plugin page."

Since I have twice e-mailed them in the past with bug reports and offers to help and haven't received so much as an acknowledgment, I'm not going to bother again.

The post I was trying to reply to is of interest, however. As you may know, one of the stupid ideas floating around Washington right now is a proposal for a "trigger" that would only put a public insurance option in place if competition among private insurance companies drops below a set level. HCAN has a new report showing that we already lack competition in the Illinois health insurance marketplace, leading to skyrocketing premiums for both patients and employers.

"The report shows how a handful of private health insurance companies have built a near-monopoly in the Illinois market, burdening families and businesses with premiums that grew 5.6 times faster than wages from 2000 to 2007. Illinois' two largest health insurers control 67% share of the market. Under a competition rating system used by the U.S. Justice Department, the Illinois market is "concentrated." The local markets are even worse for Rockford (82%), Bloomington-Normal (87%), and Champaign-Urbana (83%) where the US Justice Department considers these local markets 'highly concentrated.'"

HCAN-IL has unfortunately headed this with the title, "New Report Details Need for Competition in Illinois Health Insurance Market," which is not only boring, but also a wrong-headed conclusion. (HCAN, though right in their condemnation of the insurance industry's foul business practices, is cowardly in their proposals for reform. They believe the public option is the best we can hope for, and they don't think one's reach ought to exceed one's grasp.)

Here's the reply I'd have made if they'd had their comments working:

While I'm sure your data is correct, I disagree with your conclusions. What your report indicates is a need to do away with private insurance altogether, and replace it with a cost-effective, comprehensive, single-payer system that avoids the layers of waste and profiteering implicit in the health-insurance industry.

The public option plan is already a weak compromise, not real health reform, and the "trigger" is an abysmal idea that will continue to stop Americans from getting health care.

Beating the drum for health care

2009-05-26T09:00:00.001-05:00

Tomorrow night's 8:30 p.m. show at Martyr's, 3855 N. Lincoln Ave., Chicago, will benefit the Chicago Single-Payer Action Network. Admission is $10.

The line up:

Black Bear Combo

Ami Saraiya

Furious Frank & the Hobocamp Mud Show

DJ Vanessa Beck

Sorry for the late notice, but ChiSPAN just sent this out over the weekend.

Forget sex appeal, all you need is health insurance

2009-05-24T11:00:00.001-05:00

From Runaway Box

Here you go, boys, you don't need to buy her diamonds. Just give her health insurance.

"I don't care about your diamond rings. I don't need none of those fancy things. If you really want to be my man, let me get all up in your health-care plan.

How much is your deductible?"

RNs, doctors arrested speaking out for single-payer health care

2009-05-22T09:00:00.004-05:00

Via Private Health Insurance Must Go!

Thank you, protesters. Bless you all.

We shall overcome.

Who's afraid of the R word?

2009-05-18T09:00:00.004-05:00

I'm not afraid of rationing.

Over at The Covert Rationing Blog, the eccentric DrRich, who likes to refer to himself in the third person, takes a backwards look at the failed health-reform efforts of the Clinton administration, explains why things are different today, and gleefully contemplates the idea that the Obama team may find themselves confronting the R word.

So?

I'm not old enough to have lived through rationing in this country, but I've done a lot of reading, and I don't exactly understand why rationing is such a dirty word, even when applied to health care. It's not something for those of us who aren't insured now to worry about, because any health-care system that formalized rationing would give us more than we're getting now. Some 22,000 of us die each year for no good reason.

If rationing means that more of the terminally ill die with dignity, instead of being subjected to futile extreme measures so their families can quell their consciences, I have no qualms. If it means that, instead of getting elective surgery on demand, some people have to wait a little while, I'm unsympathetic. The poor and the uninsured are waiting much longer now.

As for those who can now buy whatever kind of health care they desire, well, surely no one is naive enough to believe that reforms will stop the rich from getting what they want. Where there is rationing, there are black markets.

No matter what happens in health reform, I assume there will continue to be exclusive private clinics where the wealthy can have their tummies tucked and their boobs lifted, and no doubt some of them will branch out to other services if there's money in it. Medical tourism will continue to boom, too. The rich will always get all the medical treatment they demand, just as they do even in countries with full-blown socialized medicine (a system that no one here is seriously advocating).

And what of the middle-class — that portion of them, anyway, who've managed to hang on to their jobs and benefits? How will reform — with, perhaps, the dreaded rationing — affect them?

Well, right now millions of supposedly well-insured American workers are spending 10 to 25 percent of their income on medical bills, and they're going bankrupt or losing their homes when they get sick.

How could overt health-care rationing possibly be worse?

May 21: Free screening of Do No Harm

2009-05-14T09:00:00.008-05:00

Do No Harm, a documentary about the struggle, against relentless attacks, of two reluctant Georgia whistleblowers to draw national attention to hospital corruption and the plight of the uninsured, gets its Chicago premiere Thursday, May 21, at the Museum of Contemporary Art, 220 E. Chicago Ave., Chicago.

The event opens at 6 p.m. with a reception at Puck's at the MCA. Illinois Attorney General Lisa Madigan will introduce the film. After the screening, a panel discussion will feature Dr. Quentin Young, founder of Physicians for a National Health Program and an advocate for single-payer health care; Mark Rukavina, executive director of The Access Project, whose research has uncovered unfair hospital billing and collection issues; and Donna Smith, founder of American Patients United, an organization whose members believe access to quality health care is a human right.

The film focuses on Phoebe Putney, a nonprofit hospital in Albany, Ga. In 2003, Dr. John Bagnato and accountant Charles Rehberg stumbled on evidence that the hospital overcharged uninsured and indigent patients, using aggressive collections tactics to recover costs. Investigation showed, that despite receiving huge tax breaks, the hospital held millions of dollars in offshore bank accounts and for-profit businesses under its control — and the same went for nonprofit hospitals across the country, while providing minimal charity care. (In other cases, Urbana's Provena Covenant Medical Center lost its tax-exempt status, and the Chicago-area's Advocate Health Care and Resurrection Health Care networks were the subject of class-action lawsuits.)

When they made their discoveries public, Bagnato and Rehberg became the targets of threats and intimidation.

The screening is free, but reservations are required.

Obama's hope = Baucus's nope?

2009-05-11T09:00:00.008-05:00

When I spent 11 hours in the waiting room of Stroger Hospital's emergency department, it was December. The elections were not long over, and many of my fellow patients, waiting so stoically for treatment during the long hours, still sported hats, buttons and other paraphernalia from the campaign. As you might guess, no one needing care at the county hospital was promoting McCain.

Last week, I was at Stroger again, this time for a long-awaited visit to a specialty clinic. I'll save the details for another time, but as I waited there — I noticed that a few other patients were still wearing Obama 2008 gear. Now, when you're sick and standing in in a long, slow line outside a laboratory, waiting your turn to have blood drawn and pee in a cup, it's not the best time to engage in political discussion, but I tried to talk about health reform a little.

And the impression I got is that none of the people I spoke to have the least idea that Barack Obama has reneged on the promise of single-payer, and turned the crafting of a so-called "reform" over to Congress — to rich, old, white men like Sen. Max Baucus (D-Mont.), in the pockets of the insurance lobby and for-profit medicine, who've decided that single-payer is taboo, that its advocates should not even be heard. Just as they wait, patiently and stoically for health care, they're waiting, trustfully, for their president, the president of "Yes We Can," to do the right thing.

It's enough to make anybody sick to think of it.

Why so little media attention to single-payer?

2009-05-08T07:43:00.008-05:00

Washington's cold shoulder to single-payer health care is bad enough, but the media's failure to cover it is inexcusable. Eight people, representing organizations that 20 million Americans belong to, were arrested at Tuesday's Senate Finance Committee hearing — protesting that not one single-payer advocate was invited — and as far as I can tell, no major news organization covered it with more than a few paragraphs, if that. Not nationally, not here in Chicago, where Physicians for a National Health Program, one of the sponsors of the protest, is based, and not in the cities the protesters are from. Of course, I don't know where they're from, because no news account told me. None mentioned that the protesters were arrested, not merely ejected.

This Op-Ed on MSNBC's The Ed Schultz Show is the only major media attention to the event I've been able to find.

I know the media are currently preoccupied with intensive navel gazing over the dying news industry, but let me tell you, journalists, you'd better get out there and cover issues people care about before you're out on the street with no health insurance, like me. Go down to Stroger Hospital and spend a day in the ER seeing what it's like.

Meanwhile, I do wonder how well single-payer advocates are engaging the media on the issue. Were news media alerted this protest was going to happen? Were press releases sent out afterward, detailing who was arrested and their bios? (I'm not seeing this information on the websites of the organization involved.) Were releases sent to hometown newspapers as well as network TV? Are advocates creating relationships with reporters and giving them timely information and news? As in anything else, squeaky wheels get the grease in news coverage.

Cook County's new hospital chief

2009-05-04T19:30:00.006-05:00

William T. Foley

William T. Foley was slated to start today as CEO of the Cook County Health and Hospitals System. That's the newly independent, reorganized Cook County Bureau of Health Services, the organization that runs the county's public hospitals — Stroger, Oak Forest and Provident — and other health services.

According to Crain's, Foley will be paid $500,000 a year. Chi-Town Daily News puts that in a mid-range for the job, and had some positive things to say about Foley's experience. When Foley started as president and CEO of Provena Health in Mokena in 2001, that system was operating at a $28.4 million loss. Under Foley's guidance, it grew to an operating gain of $24.5 million in 2003.

Foley's CV paints him as a turnaround expert. I hope he's as good as he looks. With already overflowing hospitals further stressed by rapidly rising numbers of uninsured Cook County residents, a deficit of so many millions of dollars that system commissioners aren't even sure how deep it goes, and the corruption and conflicts of interest that plague nearly all Illinois public agencies, he's got a huge job.

I haven't the least idea what all is involved in Foley's job. I do hope, however, that his focus will be not only on improving Cook County Health's financial picture but also on expanding its services and level of care. Too many sick people are waiting too long.

Health reformers' calendar (UPDATED)

2009-05-03T21:00:00.000-05:00

Upcoming health-care reform events

May 2: Campaign for Better Health Care "Out in Front for Health Care Justice" events in Downers Grove, Peoria, Bloomington and Champaign.

May 11: The Chicago chapter of the Progressive Democrats of America hosts a discussion, "Which Way to Universal Health Care: Public Option or Single Payer?" with John Gaudette of Health Care for America Now! and Dr. Anne Scheetz of PDA, 6:30 p.m., Brehon Pub, 731 N. Wells St., Chicago. E-mail for more information.

May 13: National Lobby Day and Rally for Single-Payer, Upper Senate Park, Washington D.C.

May 20: Health Care Justice Discussion by the Campaign for Better Health Care, 2:30 p.m., Peoria Public Library.

May 21: Screening of Do No Harm, The Museum of Contemporary Art, 220 E. Chicago Ave., Chicago. Illinois Attorney General Lisa Madigan will introduce the film. A panel discussion afterward features Dr. Quentin Young, advocate for single-payer health care; Mark Rukavina, executive director of The Access Project, researchers on medical debt and unfair hospital billing and collection issues; and Donna Smith, founder of American Patients United. RSVP.

May 30: National Day of Action for single-payer health care.

What does health-care reform mean?

2009-04-30T09:30:00.002-05:00

How the U.K. sold universal health care
Via What is Health Care Insurance?

Over the past few days, I've been discussing health reform on Twitter with various advocates. It's hard to actually discuss anything in 140 characters, but I've been trying to understand the positions of the various factions, and Twitter does give you access you might not get otherwise.

I'm particularly mystified by the antipathy between single-payer advocates and Health Care for America Now. The latter supports a public option, but doesn't believe a single-payer plan can pass. I haven't personally seen anywhere HCAN has said single-payer should be off the table, but clearly many single-payer advocates believe they've said so. I think HCAN's position is second-best by a long shot, but I see them — however half-hearted — as an ally in the reform fight. I hope they're not standing in the way of single-payer, but I confess I don't know.

I really find all the rhetoric flying around confusing — and I'm somebody with a strong interest in the subject. I can't imagine what people who haven't been paying much attention to the topic think. Therefore, I find the video above, made to promote the United Kingdom's National Health Service Act in the 1940s, fascinating.

I remain with the same question posed on Twitter by @Fortitude1913 during Pres. Obama's "100 Days" press conference yesterday:

"I still really want to know what 'health care reform' means. Will it mean that I as a self-employed/unemployed person can get some?"

If you catch swine flu, sneeze on a Republican

2009-04-27T15:00:00.005-05:00

The United States yesterday announced a health emergency due to the swine flu outbreak.

The announcement had to be made by the Secretary of Homeland Security, Janet Napolitano, instead of the Secretary of Health and Human Services or the head of the Centers for Disease Control, because we have no HHS secretary or CDC chief. Last week — when the news of swine flu had already broken — Senate Republicans delayed a vote to confirm Democratic Gov. Kathleen Sebelius of Kansas as HHS secretary, and the HHS secretary appoints the CDC director.

John Nicols, meanwhile, reminds us that the GOP fought to cut funding for pandemic preparedness from the emergency stimulus bill, ridiculing the idea, just as they continue to use misinformation to fight reform efforts that would open government health programs to the general public. Clearly, the Republican Party has no interest in protecting the health of Americans.

It's too early to tell whether this Mexican flu bug will become a pandemic or even spread widely in the United States. The concern expressed by experts worldwide scares me, though. Given the high level of travel between Chicago and Mexico, I'm surprised no cases of swine flu have yet been found here.

I'm particularly nervous because I wonder — since the disease has been so virulent and deadly in Mexico, a country recently embarked on universal health care — what will it be like if it really hits the U.S., with all our uninsured and under-insured millions?

The flu is not, for most people, a disease you go to the doctor for, particularly if you don't have health insurance or have only a catastrophic-coverage policy. The American ethic says that you're supposed to soldier on, toughing it out at work as long as you can, suffering silently. Especially if you don't get much — or any — sick time from your job.

The recent emergence of anti-flu drugs Tamiflu and Relenza, which need to be taken within 48 hours of the onset of symptoms, no doubt has sent some of the well-covered to seek early treatment, but most folks, even with insurance, likely wait till they feel absolutely miserable before considering visiting a doctor — too late for such medicines to be effective.

Each of those drugs costs between $60 and $100, maybe more, even with prescription coverage, plus the price of the doctor visit to get a script, not to mention the time off work to go and be seen — that's a lot of money just for the flu. In the announcements about making the anti-flu drugs available in the current outbreak, I haven't heard anything about making them available free.

If there should be a swine-flu epidemic, what are the uninsured and those with high insurance deductibles likely to do? They're going to get sick, and they're going to spread a deadly disease, because they can't afford to do anything else.

The GOP succeeded in stopping preparation for a possible flu pandemic, and we may all suffer for it. Don't let them stop health-care reform. Too many of us are suffering already.

'Small-group insurance market is simply not working for small business'

2009-04-25T10:00:00.005-05:00

David Borris, owner of Hel's kitchen catering in Northbrook, testified April 22 at a House Ways and Means Committee hearing on his experiences with group insurance: "I will pay approximately the same amount of money to insure half of my full-time staff as I do in rent in 2009. Surely this is deeply broken. There must be a better way.

"The small-group insurance market is simply not working for small business."

Here's Borris's complete testimony:

(Via HCAN-IL)

Yesterday, the Department of Health and Human Services released The Bottom Line: Health Reform and Small Business. The report's key findings include:

Nearly one-third of the uninsured — 13 million people — are employees of firms with less than 100 workers.

In the past two years, more than half of small businesses that offered coverage reported switching to plans with higher out-of-pocket costs in response to rising premiums. Another third switched to a plan that covered fewer services, and 12 percent dropped coverage entirely.

Among small businesses that offer coverage, 40 percent report spending more than 10 percent of their payroll on health care costs.

Why conservatives want to save the status quo

2009-04-24T14:30:00.010-05:00

The state of health care is no joke. But this is pretty funny. (Not family friendly, though.)

Bert Busch, "Health Care"

Why does the insurance industry deserve a 'level playing field'?

2009-04-21T20:52:00.004-05:00

20/20 reports on how AIG spends big on executive perks while denying claims for the injured. How can anyone defend this industry's practices?

Why does anyone think this industry should be preserved? Yes, this report is about disability insurance, but AIG also sells health coverage.

Even if I didn't think a single-payer plan was the best program to cover the millions of uninsured Americans, I'd welcome it as a means for getting rid of the insidious insurance industry. We shouldn't be bailing them out. We should be wiping them out.

Stop the health-reform cat fight!

2009-04-19T16:00:00.004-05:00

There once were two cats of Kilkenny.
Each thought there was one cat too many.
So they fought and they hit
And they scratched and they bit
Till (excepting their nails
And the tips of their tails)
Instead of two cats there weren't any!

Ellen Beth Gill provides the first account I've seen of yesterday's Chicago health-care reform rally and the face-off between single-payer proponents and public-option advocates.

Ellen describes it as a family squabble. Those, often, are the very worst kind.

In case you haven't been following along, the clan of health-reform cats all agree that the current system is broken, that insurance companies are greedy and deceitful and that something must be done to cover the millions of uninsured and underinsured Americans. It's when it comes to the plan that the hissing starts.

Single payer: The single-payer side of the family, represented by such groups as Physicians for a National Health Program, the Chicago Single Payer Action Network and — last and least — me, believes that the best plan is a government-run health-care payment program, essentially extending the umbrella of Medicare to cover everyone, as proposed in legislation such as Medicare for All and the American Health Security Act. Proponents like this plan because it spreads the cost of health coverage across the entire nation; it eliminates unscrupulous, profit-making insurance companies; and it would cover everyone. Alas, some of our cats are sourpusses intent on perpetuating the family feud instead of trying to win the others' support.

Public option: The public-option cousins, such as Health Care for America Now!, deprecate the health-insurance industry at the same time they say we should preserve it as a "choice." They say Medicare or something like it should be extended to cover people who aren't insured now, but that private insurance should continue alongside it, as in the Healthy Americans Act. These ’fraidy cats really want single-payer, but they so fear its opponents, they're not even going to try.

(There are also fat cats like the American Medical Association, who give lip service to reform, but prescribe Band-Aids on the status quo, with an added focus on such self-serving ideas as increasing doctor visits through preventative care, tort reform to limit malpractice suits and dismantling anti-trust laws so they can cuddle up to insurance networks and increase doctors' profits without government oversight. Like so many rich relatives, they only look out for themselves.)

While the reform family has its cat fight, the insurance lobby stands by purring, using every sneaky trick it can to derail real change. "Eschewing any pretense that their primary concern is for medical consumers and taxpayers," as Timothy Noah writes, "they focus on the harm health care reform might bring to private health insurers." They know that, if they defeat extensive health-care reform now, as Drew Altman shows graphically, it might be 20 years till it resurfaces.

Health reform's Kilkenny cats must clan together to fight for universal health care now!

Follow me @illil on Twitter!

2009-04-17T17:28:00.009-05:00

I'm now posting to Twitter. You can follow me there @illil, or see the updates in the sidebar here.

For tweets relating to the health-care crisis, I'm using the hashtag #healthreform. I hope you will, too.

This could be a great tool for activists. I'm not seeing health-reform proponents make as much use of social media as they could be.

Insurance lobby resorts to dirty tricks

2009-04-16T15:30:00.002-05:00

As if we needed more proof that the health-insurance lobby are lying scum, comes this from the North Andover, Mass., Eagle Tribune:

Elderly used as front in letter-writing campaign
'Grass-roots' effort looks more like Astroturf

By Ken Johnson

Across Massachusetts, senior citizens are writing letters to newspapers demanding that their representatives in Congress protect a form of health insurance called Medicare Advantage.

At least that's what newspaper editors are supposed to think.

Some of those seniors are unaware that they have sent any such letters to newspapers. Some of them hadn't even heard of Medicare Advantage.

"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence....

That's right. In their efforts to scuttle health-care reform, insurance companies have resorted to forging letters to the editor from senior citizens.

Caught in the act, the dirty tricksters responsible then try to paint the elderly people whose names they attached to the bogus letters as too senile to remember writing them! On top of that, they have the bald-faced nerve to call their campaign "a transparent, honest and truthful effort"!

Why on earth would anyone want to protect this immoral industry?

Why can't the uninsured and their advocates get it together?

2009-04-14T00:30:00.001-05:00

AP— "If the uninsured were a political lobbying group, they'd have more members than AARP. The National Mall couldn't hold them if they decided to march on Washington.

"But going without health insurance is still seen as a personal issue, a misfortune for many and a choice for some. People who lose coverage often struggle alone instead of turning their frustration into political action...."

A group of 46 million ought to have more clout. Alas, too many of us are too poor, too downtrodden and too ill to mix much on the political scene.

Starting this blog was as much as I could do, and getting any attention for it has been a struggle. To date, not one political-action or health-care activists' site has linked to it, as far as I can tell. That's fine — I'm nobody important — but what gets me is that they mostly don't seem to connect to each other, either. I've tried to assemble a sort of "one-stop shopping" collection of links to prominent sites on health-care reform, particularly those with local connections, but it took some searching.

Of course, part of the problem is that the reformers don't all agree with each other. In fact, it looks like they're getting ready to rumble this Saturday, April 18, at St. Augustine College, when two disparate groups, HCAN-IL and CSPAN, will rally. The Illinois chapter of Health Care for America Now! favors a government-run "public option" system to compete with private insurance, while the Chicago Single-Payer Action Network wants to do away with private insurance and have a single government-run health-care plan for everyone.

Loyal readers will know I lean toward the latter plan, although I can see retaining private insurance under certain conditions. To me, it makes the most sense to push for the most drastic change and be prepared to compromise, rather than asking for crumbs at the outset. Yet I can't help wishing that everybody who wants to do away with the current system could come to some consensus.

I won't be up to attending Saturday's rally. But I hope there's a big turn out and that it ends by bringing the factions closer against the common enemy of the status quo.

Together we stand.

'Legal patient dumping' at local hospitals

2009-04-13T14:15:00.006-05:00

My discharge paperwork from Lutheran General, referring me to Stroger Hospital.

The Chicago Tribune delved into one reason the emergency room at Stroger Hospital is so crowded:

"Indigent and under-insured patients are turning to Cook County's Stroger Hospital after not getting fully treated at non-profit hospitals, swamping the cash-strapped public facility while fueling the county's sky-high sales tax, a Tribune investigation found.

"Some of these patients arrive at Stroger's emergency room bearing discharge slips, prescriptions, even Yahoo and Google maps from non-profit hospitals, according to documents obtained by the Tribune....

"Non-profit hospitals, meanwhile, reap millions of dollars in property and sales tax breaks from the county, based largely on the promise that they'll help the uninsured....

"'This is basically legalized patient dumping,' said Dr. Jesse Pines, an assistant professor of emergency medicine at the University of Pennsylvania School of Medicine...."

The Trib's account mirrors my experience at Lutheran General, which is part of the nonprofit Advocate Health Care system.

The story underscores an important point about the Emergency Medical Treatment and Active Labor Act, which requires most hospitals to treat patients at emergency rooms regardless of ability to pay: All the hospital must to do is diagnose and stabilize you. They don't actually have to treat what's wrong with you.

For most uninsured patients, emergency-room treatment is little more than basic first aid, not health care.

Chicago Health Matters notes that 75 percent of Illinois hospitals report higher numbers of uninsured patients. Stroger is barely able to cope as it is. Patients already wait months for followup care. The county's nonprofits, despite the tax breaks they get, aren't taking on their fair share.

Nonprofit hospitals don't pay taxes. They don't pay stockholders. They receive tax-free grants and donations (and the donors get tax breaks, too). So, as The Wall Street Journal reported last year, they rake in huge revenues.

For example, in its 2007 annual report, Advocate recorded $3.5 billion in gross revenues. The hospital claims that it spent about 7.6 percent of that on "charity care and other uncompensated costs" but that number includes what it calls the "unreimbursed costs of Medicare, Medicaid and other government-sponsored programs." So it's counting as "charity" the difference between what the U.S. government has determined is fair payment and whatever arbitrary rates the hospital charges patients paying out of pocket. And nearly half of the figure is bad debt, grudging "charity" at best.

Advocate's net revenues in excess of expenses for 2007 were $260 million. That's after the "charity" care and after they pay out whopping salaries like CEO James Skogsbergh's — $2.2 million a year plus another $1.35 million in benefits, according to 2007 IRS filings. (Other folks on the payroll do pretty well, too. Bruce Campbell, president of Lutheran General, takes home $1.5 million in wages and benefits. Surgeon Leonard Kranzler makes some $1.6 million from Advocate, plus whatever he nets from his private practice.)

For the tax breaks they get, shouldn't nonprofit hospitals take on a much bigger share of caring for the poor and the uninsured?

Economy dooms uninsured cancer patients

2009-04-10T01:00:00.000-05:00

"I don't want to die. I shouldn't have to die. This is a county hospital. This is for people that, like me, many people have lost their insurance, have not any other resources. I mean, I was a responsible person. I bought my house. I put money away. I raised my two children. And now I have nothing. You know my house isn't worth anything. I have no money. And I said 'What do I do? But what do all these other people do after me?' And they said, 'We don't know.'"

Counting my blessings. I have my troubles, but I'm not one of the thousands of uninsured cancer patients in Nevada who've lost their lifeline. This 60 Minutes story is terrifying.

Via American Patients United

Health is not a 'lifestyle choice'

2009-04-08T08:00:00.003-05:00

Uninsured Myths No. 3: "Doing without health insurance is a lifestyle choice." FALSE.

The Centers for Disease Control reported in 2007 that nearly one in five Americans were doing without needed health care because of costs. "In 2005, more than 40 million adults did not receive 'needed services' because they could not afford them," the report said. "Nearly 15 million adults did not obtain eyeglasses, 25 million did not get dental care, 19 million did not get needed prescribed medicine, and 15 million did not get needed medical care due to cost."

Apologists for the status quo scoff. They like to tell you that people "choose" to go without health coverage and care. Those who say they can't afford it, these generous folks claim, are wastrels and spendthrifts. According to their judgmental thinking, unless you live in a SRO, eat only homemade gruel, get around by public transit and spend all your spare time trying to better yourself, you are frittering away funds that you ought to be spending to enrich insurance companies and the medical establishment. If you have a car, internet access or a cell phone, but no health insurance, they believe you have made poor financial choices.

Typically they have unrealistic ideas about the cost of health insurance and medical expenses vs. these so-called luxuries and uncompassionate attitudes toward the underemployed and the sick.

An upstanding Dayton, Ohio, citizen, responded to a woman who said she had insurance but worried that she would not be able to meet her co-pay should she become seriously ill:

"So because of your economic lifestyle choices you think it's proper to force the rest of us to pay for you? Socialism at it's [sic] ugly best. You are no different than the welfare queens with their multiple children fathered by multiple absent men with their hands out for public assistance.

"You need to give up some non-essential items and save for the possibility of a large medical co-pay. Cell phone and cable tv would be a good start. That's probably over $1500 per year you could save."

Talk about ugly. And $1,500 would cover what? Perhaps, one C-T scan?

Louise, a Colorado insurance broker, often has reasonable things to say on health-care issues, despite her vested interests, but sometimes she lapses into specious self-righteousness: How can people balk at the cost of doctor visits when most of the cars she sees on the streets are less than 10 years old? Louise asks. They must be choosing new automobiles over medical care, she reasons.

Huh? How do you know, Louise, that all those shiny cars aren't being driven by insurance executives, pharmaceutical big-wigs, high-priced doctors and for-profit medical administrators?

Newish cars on the highway say nothing about the circumstances of people who find it hard to cough up high medical fees. Not even if they were the ones behind the wheels. If you had to choose between reliable transportation so you could get to work every day, and money for a doctor you might never need, which would you choose? Most people don't expect to get sick, and few of us are handy enough with a wrench to keep an old beater going. There comes a time when putting more money into auto repairs isn't reasonable.

Computers are another target of the health-care scrooges, who apparently don't shop around for theirs. Haven't you heard of eBay? And I don't know where you are, but our internet service costs $20 a month. For job seekers, these are necessities. (To the nitwit who thinks I must have "means" since I have a blog — Blogger is a free service.)

And how can anyone believe, in 2009, that a cell phone is a luxury item? When was the last time you saw a pay phone?

If you have a 9-to-5 job and regular routines or are on welfare, maybe you can live today without a cell phone. If — like so many of the underemployed and uninsured — you move in the underground economy of temping, on-call gigs, entrepreneurial hustling and day labor, you need to be reachable all the time.

In Chicago, you can get a Blackberry with all the bells and whistles for less than $100 a month and a basic phone for $30. Nobody sells health insurance for that.

What's more, many folks who use cell phones but worry about doctor bills have given up their landlines to save money. According to the Centers for Disease Control, one in six adults lives in a wireless-only household, and the percentage of people without health insurance is twice as high among that group as those with wired phones. In Illinois, the CDC estimates, 16.5 percent of households use only cell phones.

Cell-phone use is highest among young adults, with more than one in three Americans aged 25–29 years and nearly 31 percent of those aged 18–24 years living in households with only wireless telephones.

The anti-reform lobby also likes to make much of the fact that some 29 percent of the uninsured are young people, claiming they're frittering away their incomes instead of making sacrifices to buy insurance. It's unclear how many fall into the category the insurance industry calls "young invincibles" — people in their 20s who gamble on staying healthy — vs. those who truly have no choice. Even if it were true that these young folks choose to buy good times instead of insuring their health, everybody makes dumb decisions in their youth. That's why we don't let people drink till they're 21 or run for the Senate until they're 30. Isn't this another area where America should protect its future?

You'd think the sanctimoniously well-insured would have a little interest in their own well being. Stop worrying about what covering the uninsured might do to your wallet and instead think about what not covering them might do to your own health. Having good health insurance won't stop you from catching a contagious disease.

Large numbers of uninsured people increase America's risk of epidemics (not to mention its vulnerability to biological attacks, such as the anthrax letters of 2001). When the uninsured get sick, they avoid or delay seeking treatment, and just try to go about their business, thereby spreading infection. That uninsured waiter, hairdresser or store clerk could give you strep throat, influenza and tuberculosis.

No one chooses to get sick. But our current health-care system limits millions of Americans' choices when it comes to staying healthy.

Can you say irony? Or, nurses have no sense of humor

2009-04-06T00:00:00.004-05:00

A brilliantly funny post on The Health Care Blog skewers the pending Nursing Relief Act, a peculiar GOP health-care reform idea that proposes — despite rising unemployment — to deal with the nursing shortage not by training more RNs or by increasing wages and benefits to make nursing a more sought-after profession, but by providing visas to hundreds of thousands of nurses from overseas:

"Incidentally, this is just the approach that was so successful in cutting the salaries earned by information technology workers about 10 years ago. Corporate profits were getting impacted by high IT costs, so our brilliant Congress increased the number of H1-B visas, and companies were able to hire cheap workers from India and other places. Thank you, Congress! Later, many of these foreign workers returned to their homelands and brought the work with them. Now, corporate America doesn't have to pay high salaries, and they don't even have to look at the foreigners anymore — they can just write a little check to India. Bravo! Fortunately, information technology salaries have never rebounded to the levels where they were.

"But I digress. Back to nursing. Let's face it, nursing is difficult, degrading work. Nurses sometimes have to wipe feces, for Christ's sake. We're Americans and we're better that that! We can certainly find some Indians, Filipinos, or Chinese to do that work, ridding self-respecting Americans of the need to perform that dirty job...."

Alas, the comments reveal the perils of sarcasm on da internets.

Insurance companies want something for nothing

2009-04-05T07:00:00.000-05:00

Insurers, scrambling to prevent real health-care reform in a public insurance option, or worse, a single-payer system, have come forward with a plan in which they say they'll accept all comers in exchange for a government mandate that everyone must buy insurance.

But as David Lazarus points out, their plan lets them scale prices based on benefits. So, basically, you'll be required to buy a policy, but if you want insurance that actually covers you if you get really sick, you'll still have to spend big bucks:

"If all Americans were required to purchase health insurance from private companies, the industry would still offer as little coverage as possible for the most amount of money. These people have businesses to run, after all, and their track record speaks for itself....

"It wouldn't guarantee the best possible coverage for the public. Nor would it improve things for the millions of people who have insurance but are still one catastrophic illness away from bankruptcy.

"To solve these problems, we'd need clear criteria from the government as to what should be covered and at what prices. And if we're going that far, I have to wonder why private insurers even need to be part of the equation...."

What he said.

Is there anybody — anybody not connected to the insurance industry, that is — who sees a plus in what insurance companies bring to health care?

Universal health-care rally, Monday, Federal Plaza

2009-04-03T14:15:00.003-05:00

A call to action from Health Care for All Illinois / Physicians for A National Health Program / National Nurses Organizing Committee:

Tell President Obama and Congress:

Put single-payer health care on the table!
Don't let the insurance companies dictate health reform

HR 676 & HB 311 NOW!

Rally on Monday, April 6, Noon–1 p.m.
Federal Building Plaza (Adams and Dearborn), Chicago

With Dr. Quentin Young

Bring Your Single-Payer Signs and Gear!

For Questions or to Endorse the Rally:
mark@pnhp.org / 312-782-6006

A news report this week says the heads of five congressional committees have reached consensus about the broad outlines of new health care legislation — and that under the new law, the wasteful, for-profit health insurance industry will remain at the heart of our system.

This would be a disaster. Our nation simply can't afford to keep the big insurance companies in the health care mix. Their skyrocketing premiums, co-pays, deductibles, claim denials, top-heavy bureaucracy and notorious profit-taking are the problem with our present system, not the answer. The economic crisis has only made things worse, much worse.

By moving to a single-payer national health insurance program — an expanded and improved Medicare for All — our country would save $400 billion in administrative costs annually, allowing us to provide comprehensive, quality care for everyone who presently lacks insurance and to eliminate all co-pays and deductibles. Everyone could receive care for with no overall increase in U.S. health spending.

Polls show two-thirds of Americans support such an approach, as do 59 percent of U.S. physicians. A bill in Congress, H.R. 676, the U.S. National Health Care Act, would achieve such a system.

Yet top political leaders say this approach is "not feasible." That's what many — including the health insurers — said about Medicare.

Could the view of these "realistic" political leaders be the result of the millions of dollars they receive in campaign contributions by the big insurance and drug companies?

Call the White House and Congress at (202) 224-3121: It's time to break the stranglehold of the private, for-profit insurance industry on our health care system. Put single-payer health reform on the table. Don't cave in to the insurance and drug lobbies!

Sicko on Showtime through April 25

2009-04-03T08:00:00.000-05:00

I don't have cable TV. I don't often miss it, but I wish I could tune in to Showtime this month to see Michael Moore's documentary on the health-care industry, Sicko.

Wonking it out of the park

2009-04-02T11:30:00.005-05:00

Anthony Wright at Health Access Weblog is on the ball this week with Health Wonk Review, pondering health-care reform as Yogi Berra might have seen it. It's an eclectic selection of perspectives, including my own post, Lutheran General: Pay First and We'll Put a Band-Aid on It," an example of why access to emergency-room treatment isn't the same as access to health care.

Take a look. As Berra said, "You can observe a lot by watching."

My electrifying health-reform plan

2009-04-01T12:00:00.004-05:00

Despite bills in the House, and now the Senate for a single-payer, government-run health-care system, such as is implemented in most other first-world countries, there's no evidence the Obama administration is taking the idea seriously. Sadly, the White House, seems bent on cozying up to stakeholders and distancing itself from meaningful reform efforts.

If we can't cut out the cancer of insurance companies as middlemen between patients and doctors, what's the best cure we can come up with?

My proposal

Everybody in. Nobody out. No one will be refused coverage.

No policy can be terminated for any health-related reason.

Full coverage for individuals at rates on a sliding scale no higher than Medicare's.

All care deemed necessary by a patient's doctor covered — no exclusions, no lifetime caps on expenses.

How to pay for it

Cap salaries for insurance executives at the default pay for a member of Congress ($174,000), with no bonuses and no health-care benefits allowed.

Surely what we pay people to run our country ought to be enough for people who just crunch numbers and shuffle paperwork? Especially since it will be so much easier once they no longer have to devote their time to thinking up ways to deny claims and refuse applicants.

Require health insurance companies to be not-for-profits. No stockholders to pay removes one more layer of expense.

Timing

Obviously, implementing such drastic changes will take time. Yet some 22,000 Americans annually — more than 60 per day — die just for lack of health coverage. So to give the insurance industry an incentive not to drag their feet on taking action....

For every preventable death due to lack of health coverage until the plan is in place, an insurance executive goes to the electric chair.

Happy April Fool's Day!

A little help for a few

2009-03-29T17:00:00.005-05:00

If you suffered the ravages of the Bush administration, you're still SOL, but if you're brand-new to the unemployment rolls, there's a little help on the health-care horizon.

The Take Care clinics at Walgreens are offering limited free care to select, newly out-of-work folks, or "Terminated Persons," as they call them. The plan seems designed for maximum PR value — "Free care!" — while curtailing the actual number of patients they'll accept to a bare minimum. Here are the generous terms:

Only job losses after March 31, 2009, qualify.
Someone in your immediate family must have been treated at Take Care before your job loss.
You must be collecting unemployment.
You must not have COBRA or any other insurance.
Only the Terminated Person, your legal spouse (or official, same-sex domestic partner) and minor children for whom you are legal guardians qualify.
Any prescriptions the practitioner writes will be charged at regular price.

Take Care offers diagnosis and treatment of minor ailments by nurse practitioners and physicians assistants. Not all their services are covered under this plan. There's a lot of rigmarole to get certified, too. Oh, and free treatment is offered only from 11 a.m. to 3 p.m. Mondays through Fridays.

I wouldn't rely on Take Care's services instead of signing up for subsidized COBRA, but if you don't qualify for COBRA and meet the other criteria, it might be worth applying.

Otherwise, a visit will cost you $59 to $80. If you don't have a regular doctor, and you sprain your ankle or come down with the runs, it's better than the emergency room.

The website has details.

Sen. Bernie Sanders introduces single-payer bill

2009-03-28T11:30:00.005-05:00

Yes!

Details at Physicians for a National Health Program.

Newly laid-off are in luck

2009-03-27T07:00:00.011-05:00

If you are among the newly laid off, consider yourself lucky. It may not feel that way, now, but I'll tell you why you're better off than you think: A new federal subsidy will cover 65 percent of COBRA premiums for nine months for workers who lost their jobs after Sept. 1, 2008. So if you're newly out of work and are eligible, sign up for COBRA within 60 days. (Those who already missed that cut-off might be eligible for a second election opportunity.)

Wait more than 60 days, though, and you may not be able to get health insurance at any cost, and if you do, it may not cover any pre-existing conditions.

I don't begrudge this aid to the most recently laid off, though it seems like a backwards way to go about things to help the most recently troubled first. What about those of us who struggled to pay for COBRA until it ran out?

My efforts to keep my health insurance after losing my job, paying for COBRA and then ICHIP, will, I fear, ultimately lead to my losing my house. We juggled insurance and mortgage payments until we couldn't handle either. The insurance is gone. The house is in danger. I can't find a full-time job — and I can scarcely work or look for one in the shape I'm in right now.

There doesn't seem to be any help for people like me.

Working without a safety net

2009-03-26T08:00:00.004-05:00

Uninsured Myths No. 2: "Everybody who works for a living is covered." FALSE.

Some conservatives would have you believe that people without health insurance are mainly indigent bums too ignorant to sign up for Medicaid. Not so. A recent study by Families USA showed that four out of five of the uninsured belong to working families.

Another study from the Robert Wood Johnson Foundation agrees, finding that nearly one in five U.S. workers is uninsured, a significant increase from fewer than one in seven during the mid-1990s, AP reports. "In Illinois, the study found that 16 percent of workers between ages 19 to 64 were uninsured in 2007, the latest year such figures are available. In 1995, 11.6 percent of workers in Illinois were uninsured."

Either their employers don't offer insurance or they can't afford the premiums. And private health insurance is ruinously expensive. According to the foundation, "Average costs for an individual insurance policy have increased 61 percent — from $2,560 in 1996 to $4,118 in 2006. Nationwide, the amount that employees pay for an individual policy has increased 79 percent." That's eight times more than wages have gone up during the same period.

If you can even get private insurance. I couldn't.

If you have any health problems, they won't take you. The video at right tells the story of Dr. Ajit Kesani, a Chicago doctor who can't get affordable health insurance because he has diabetes. Insurance companies may deny you coverage even for less serious conditions that you've recovered from, like a slipped disk or a case of tendinitis.

The state of Illinois sells the Illinois Comprehensive Health Insurance Plan, which is available to laid-off workers who've exhausted their COBRA benefits (which means you had to be able to afford COBRA, first) plus a limited number of people who've been turned down by private insurance. But it costs even more than private insurance. For example, the Chicago Tribune's Judith Graham reported, "In Chicago, a 35-year-old woman would pay $564 a month for a HIPAA plan with a $500 deductible, a 50-year-old woman would pay $871 a month and a 62-year-old man would pay $1,384." Multiply those numbers if you're covering a couple or a family. We couldn't keep up.

Sickbed reading

2009-03-25T14:30:00.010-05:00

I started this blog, in part, to keep from drifting away ... from losing myself in the red sea of pain and the gray fog of painkillers. An exercise to keep my brain working.

Bits of prose I could have dashed off in minutes six months ago now take grueling hours of pecking at the laptop and endless revising and proofreading. Typing is laborious, but so is thinking. Focus requires energy.

Even reading has become effortful. Books have always been one of the chief pleasures of my life — more than a pleasure, a necessity. I've read rabidly, voraciously, since I first learned to read: on average, probably, four or five books a week. Now, novels I once could've finished in an evening take days, or weeks, and I have trouble following the plot. I've been re-reading old favorites and light fiction, but even they take more concentration than I often have.

One of the new books I've got through is The Rainmaker by John Grisham. Maybe it's not new to you. It was a bestseller in 1995, and Francis Ford Coppola made a movie out of it with Matt Damon and Danny DeVito in 1997. We picked a copy up somewhere along the line and apparently lost it in the piles of books around the house.

It resurfaced lately, and it's absorbing enough that it kept my sadly limited attention pretty well through. It moves along. It's written all in the present tense, which gives it a sense of immediacy. And, of course, once I realized what the story was about, I couldn't wait to see what happened next.

The Rainmaker follows a struggling, fledgling ambulance chaser who's landed his first big legal case — a suit against an insurance company that refused to cover a bone-marrow transplant for a leukemia patient, a poor young man now dying for lack of it.

The company has various grounds for denial: The policy didn't cover bone-marrow transplants. (It doesn't say so.) The operation is too experimental. (A half dozen experts say otherwise, and the patient had a perfectly matched donor.) The policy holder failed to disclose a pre-existing condition. (A case of the flu five years before.)

As the case goes on, the insurers and their pack of corporate attorneys dig themselves in deeper, indulging in increasingly desperate dirty tricks as the damning details of company routines come to light. Grisham makes the legal work much more thrilling than I imagine it is in real life.

A couple things are over-the-top — there's a rather gratuitous romance with a woman abused by her husband, and I don't really think all insurance execs are weaselly sexual predators who force themselves on the women who work for them. Yet I absolutely believe nearly everything about insurance industry practices in this book is based on facts. (And that they're even worse today than they were 14 years ago. Grisham was prophetic in some financial details.)

If you don't already, The Rainmaker will make you loathe both lawyers and insurance companies.

I recommend it. If I could afford to, I'd send a copy to every senator and member of Congress.

* * *

The next reading I'm tackling is the broad collection of health-care-related blog posts compiled for this week's Grand Rounds, "the weekly rotating carnival of the best of the medical blogosphere," now up at codeblog. My post "15 hours at Stroger Hospital" got a mention. Some of the posts I've read so far make me angry, and I'll probably write something about it here by and by.

Health-care reformers' calendar

2009-03-24T08:30:00.004-05:00

OK, I was so perturbed by the paucity of events marking Cover the Unisured Week, I made one up:

Bloggers for National Health Care Day, Saturday, March 28

As the culmination of Cover the Uninsured Week, March 22–28, lend your voice to the call for a national health care system that covers all Americans. Though polls show most Americans believe we need a program that covers everyone, health-care reform is in considerable danger of being turned into a Band-Aid on the present system.

Let your readers know that they need to take action now — contact their legislators and tell them we need health care for all, and it can't wait.

I can't say it's getting a whole lot of attention. But this other event, next month, is real:

Rally for Real Health Reform, Saturday, April 18

When: 11 a.m. to 1 p.m. Saturday, April 18
Where: St. Augustine College, 1345 W. Argyle St., Chicago
Sponsors: Rep. Jan Schakowsky (D-9th), Citizen Action/Illinois and Health Care for America Now! — Illinois
For more information: Jessica Palys, (312) 427-2114, ext. 206, or John Gaudette, ext. 208
RSVP

If not now, Mark Kirk, when?

2009-03-23T19:00:00.001-05:00

"The American people are absolutely ready for action by the White House to fix the economy and to put Americans back to work," Rep. Mark Kirk (R-10th) told NPR, a rather extreme understatement. "But other priorities," he said, "nationalizing health care and on climate change, etc. — this may not be the time."

I'm glad that at least he recognizes nationalized health care as a priority. Yet while Kirk gives lip service to efforts for "Health care for all," his record on the issue doesn't back that up. Nearly two million uninsured Illinoisans are scrambling for medical treatment or doing without. And our situation gets worse daily. Lack of health insurance kills 18 Illinois residents every week.

How many of your constituents must die before you act, Congressman Kirk?

Of course, Kirk needn't worry. He already has nationalized health coverage.

As Monica Sanchez at Insurance Company Rules comments, Kirk and other members of Congress currently enjoy the government-run health-care options that he's in no hurry to get for his constituents:

"Members of Congress and Presidents have a long history of also enjoying the socialized medicine taxpayers provide for them. In fact, members of Congress have the choice many of them want to deny you. They can choose a private health insurance plan through the Federal Employees Health Benefits (FEHB) program or they can get top-notch medical care at government facilities, like the Bethesda Naval Medical Center in Maryland.

"Many regularly choose the public option. For example:
"When John McCain (R-AZ) found a discolored blotch on his left temple he headed to the National Naval Medical Center in Bethesda to have the spot checked out.

"Senate Minority Leader Mitch McConnell (R-KY) had his heart bypass surgery at the National Naval Medical Center in Bethesda.

"Former Senator Jesse Helms (R-NC) went to Bethesda Naval Medical Center in Maryland complaining of fatigue and subsequently got a new heart valve there...."

Taxpayers subsidize congressional health-insurance premiums by about 75 percent, plus paying for their free treatment at government-run medical centers, as well as another $2 million annually toward the Congressional pharmacy and the team of doctors, technicians and nurses that stands by at the Capitol to provide urgent care and physicals.

Funny, when congressmen criticize the concept of government-run health care plans, they don't seem to offer any bad examples from the one they use themselves.

Of course, GOP congressmen like Kirk's colleague Zach Wamp (R-Tenn.) believe that health-care is a "privilege," and if you turn down a chance to buy insurance you can't afford, you shouldn't receive medical treatment. "For some people it's a right, but for everyone, frankly, it's not necessarily a right," Wamp said.

Lutheran General: Pay first, and we'll put a Band-Aid on it

2009-03-22T08:00:00.007-05:00

I save Stroger Hospital's painkillers for the very worst times, eking them out with handfuls of ibuprofen, but by January they're all gone. I hear nothing from the specialty clinic. I rarely reach any live people there, and when I do they can't tell me anything.

Meanwhile, somebody suggests Lutheran General Hospital in Park Ridge. They have a charity program, we're told. We call. The lady there says we can't find out whether we qualify ahead of time. "Come in and get treated and then apply. You won't have any trouble," she says.

We owe so much money we'll never dig out — we don't even have enough income to declare bankruptcy — and I'm afraid of adding on medical bills. (And this is before I heard that Advocate Health Care, the Lutheran General's parent company, was the subject of a class-action lawsuit for overcharging uninsured patients.)

Yet the pain remains devastating. I can't sleep. I can't eat. I can't think. I can't do the bits of work I've managed to line up, and I can't look for work. Between the antibiotics and staying curled around a heating pad to try for pain relief, I break out in a livid rash. On top of that, I come down with a fierce respiratory virus, likely contracted during the long bout of waiting around in the crowd at Stroger. I have a hacking cough and can scarcely breathe. I'm feeble and wretched. I know I need help, and I can't face another 11 hours in Stroger's ER purgatory. Plus it's been snowing for days and the roads are treacherous.

So we go to Lutheran General, which isn't nearby but is a lot closer than Stroger. Just getting dressed and out to the car is an ordeal. By the time we get to the ER, I can't stand up and have to be wheeled in. The waiting room is clean, comfortable and all but empty, and I'm fairly quickly taken in back to see doctors. But not, of course, before the financial interview.

When the lady from the charity office comes around, she not only wants all the grim details of our inadequate finances, she wants $500 upfront. "A deposit."

As it happens, a long-awaited check has just arrived and we have it. My spouse is prepared to turn it over. I'm in sad shape, but not so out of it that I can't remember, "If we pay that, we won't be able to pay the electric bill.

"What happens if we don't have the money?" I ask. She settles for $300.

Then she goes on to tell us about the additional proofs of our poverty they'll need, and how only postal mail and no phone calls, faxes or e-mail are permitted in communicating about these matters. The amount of charity we may or may not qualify for is unknown.

Then I get to see a doctor. I've handed over what paperwork I have from my Stroger ER visit, and recounted what they found there, but of course Lutheran General's docs do all the same costly tests over again. With the same results. This lasts about the same length of time as at Stroger, including the requisite time lying on the gurney in the hallway. Just like Stroger, they won't give me anything for pain till they're done testing.

The ER doctor tells me that she's going to admit me "for pain management." She'll send a specialist around, too.

The specialist, when she comes around the next day, tells me bluntly that although I need treatment, there's nothing she can do for me. The facilities she uses aren't owned by the hospital. They're private, and they don't take people without health insurance. Furthermore, she says, the Lutheran General doctors aren't part of the Advocate "charity" program — they're independent operators and will charge me separately.

So they send me home again, with a few nostrums and the promise of bills I can't pay.

More cheap drugs

2009-03-20T21:30:00.005-05:00

With the economy such that many folks are skimping on needed medicines, drugmakers Pfizer Inc., feeling the pinch, want to encourage more people to buy their meds. No doubt they're also hoping to appear less rapacious while lawmakers consider means of cost-cutting in the ongoing debate on health-care reform.

So the drug company has announced an expansion of its Together Rx Access drug discount program for people with no prescription drug coverage. The discount cards offer 25- to 40-percent off on some 300 brand-name prescription drugs at a host of pharmacies.

Among the people needing to use them may be some of Pfizer's laid-off employees. The company cut thousands of jobs early this year, with some 20,000 more layoffs slated in the wake of its merger with Wyeth. Things are so tough that poor Jeffrey B. Kindler, Pfizer CEO, went without his accustomed $3 million bonus last year, and got only a paltry $122,500 raise, bringing his total compensation to just $6.3 million in 2008, according to SEC filings.

You can sign up for Together Rx online and print out a number you can use within an hour; a card will follow by mail. I haven't tried this one yet, so I can't tell you whether the discount is any better than the one from Caremark's RxSavings Plus, which doesn't have any income limits and doesn't ask for so much personal data.

In the Together program's expansion, Pfizer increased the income eligibility from, for example, $60,000 to $90,000 for a family of four. You don't have to provide any proof of income, and I'd guess the income guidelines now encompass most people who don't have prescription coverage, anyway. Since those who have coverage get negotiated discounts, this leads me to wonder, again, why not just reduce the price of the drugs to begin with and dispense with the rigmarole?

Welcome, Health Wonks!

2009-03-19T09:40:00.010-05:00

Health Wonk Review is "a biweekly compendium of the best of the health policy blogs." In today's edition, compiler David Harlow at HealthBlawg focuses on health-care reform, providing links to a wide variety of thought-provoking perspectives. He also links to my very first post, "The wait for Cook County health care," and calls it "eloquent"!

Thanks, David, and welcome to any wonks who've dropped by.

Cover the Uninsured Week, March 22–28

2009-03-18T03:00:00.004-05:00

This annual campaign of the Robert Wood Johnson Foundation spotlights the crisis of uninsured Americans and aims at its solution with consciousness-raising events around the country. The pitiful collection of Illinois activities scheduled so far highlights how far this state has to go.

One important event takes place in Springfield on March 24, Legislative Advocacy Day in support of House Bill 311, The Health Care for All Illinois Act. Go if you can. If not, contact your state representatives.

We can't wait for a federal solution — it will be too little and too late.

Neither snow, nor rain, nor heat, nor gloom of night...

2009-03-17T07:00:00.007-05:00

Bill Maher provides another view on why even the most maligned of government agencies could run a better health-care system.

Via The Health Care Blog

An all-American problem

2009-03-16T20:00:00.006-05:00

Uninsured Myths No. 1: "The uninsured are illegal 'aliens.'" FALSE.

The ranting hatemongers who were so outraged by by poor Mariana de la Torre's theft of medical treatment claim that the uninsured are mostly illegal immigrants who jam emergency rooms and jack up health-care costs for the rest of us. There's just no truth to that.

As the Kaiser Family Foundation reported last year, 79 percent of the uninsured are American citizens. Legal immigrants account for about half of the remainder. The National Institute for Health Care Management estimated the number of uninsured illegal residents at 5.6 million, which means that over 88 percent of the country's 47 million uninsured are American citizens or legal U.S. residents.

In California, home to roughly a quarter of the undocumented immigrants in the U.S, the state hospital association told the New York Times that only 10 percent of uncompensated care was for illegal immigrants. Nationally, illegals account for less than 2 percent of national medical spending, according to Rand Corp.

"A lot of people assume the emergency room overcrowding problem is due to undocumented immigrants," Jan Emerson, a California Hospital Association spokeswoman, said. "That's not what we see. They show up when they truly need emergency care."

I'm a native-born American citizen. So were my parents. I don't have health insurance. I do, however, have a voter's registration card, and I use it.

Hatred, and malice, and all uncharitableness

2009-03-16T12:00:00.004-05:00

Yesterday's Chicago Tribune ran a sad story about a cancer-stricken illegal immigrant who used a convict's stolen identity to obtain medical benefits. The Trib maybe played it bigger than it deserved, but the thing that gets me is the bitter fury of the people commenting.

Crooked CEOs and financiers have bilked the public of untold billions. Incompetent insurance companies are taking hundreds of billions in taxpayer dollars and blowing them on bonuses to their overpaid, mismanaging executives, and oafs from Omaha and Phoenix are so outraged about one poor, desperate woman's abuse of the system that they're spewing enraged hopes for her pain-filled death to the Chicago Tribune? People are hateful.

Whoever they are, wherever they're from, whatever they've done ... the sick deserve care and relief from suffering. That's simple humanity.

Lessons from Massachusetts: Don't wait for feds

2009-03-15T22:00:00.005-05:00

National Lessons from State Health Reform: The Massachusetts Case Study
Capitol Hill briefing, Feb. 25, 2009

Editorializing on what lessons Massachusetts' 2006 health-care reform has for a national plan, The Boston Globe claims that insurance now covers almost 98 percent of state residents, but notes that, "In Massachusetts, reform won such broad support in part because the bill focused solely on expanding access to the uninsured and did not attempt to control health cost inflation at the same time."

In other words, the state's reform policy, which provides insurance subsidies to the poor but fines people who don't buy in, posed no threat to insurance interests, pharmaceutical companies or other medical cash cows, so opposition was slight, unlikely with any national program. Meanwhile, as Massachusetts medical personnel, politicians and others testify in the video above, the state-mandated increases in access to health insurance don't add up to equivalent access to health care, but simply more people paying for expensive, inadequate policies.

Illinois needs to do better. The lesson this state can take from Massachusetts, however, is not to just sit back and wait for whatever the feds dream up. A national plan may take another 10 years to happen, or may never happen. As Capital Times columnist John Nichols points out, Pres. Obama seems to be deliberately leaving serious reformers such as Chicago's Dr. Quentin Young out of the health-care policy discussion.

Meanwhile, more than 1.8 million Illinoisans lack health coverage. Our affordable care options are few and overburdened. Some 40,000 Illinoisans are bankrupted by medical bills every year, and three-quarters of them had insurance when they got sick. People here need help now.

Yet the only action I see on the local horizon is House Bill 311, The Health Care for All Illinois Act, which seems to be getting little attention and will likely face stiff opposition.

Limits on leeches

2009-03-13T13:30:00.002-05:00

Starting next month, uninsured Illinoisans can expect a little alleviation, The News-Gazette reports:

"A new state law set to take effect April 1, the Hospital Patient Uninsured Discount Act, will limit the amount an Illinois hospital can charge an eligible uninsured patient to 35 percent above the cost of care.

"The new law will also limit how much money hospitals can collect from uninsured patients in a single year to 25 percent of their gross annual income...."

What a relief! A hospital can only come after a quarter of my pitiful earnings.

Of course, that's only the hospital itself. It doesn't count the individual doctors, the anesthesiologists, the independent laboratories or all the other bloodsuckers who bill you any time you wind up in the hospital. They can still dun you for all you're worth.

15 hours at Stroger Hospital

2009-03-11T21:00:00.008-05:00

After a week of toughing it out, I couldn't stand the pain. If Stroger Hospital was my only choice, I was going there.

So we set out early that December morning. It took over an hour to get there, but we pulled up at the emergency room before 8:30 a.m. The ER waiting room was already full.

I waited in line, holding on to the admissions desk for dear life — by that point I could barely stand, and there was nowhere to sit — and was ignored until my turn came around. I told the intake nurse I was in intense pain. She gave me a plastic bracelet and told where to wait. And wait. And wait.

Over 11 hours went by before I saw a doctor. Meanwhile, the room got fuller and fuller and fuller.

The pain intensified until I just sat there, weeping, curled as best I could in my hard chair. No one from the hospital ever checked on those waiting, other than occasionally calling out names from the front. After two hours, I was called to have vital signs taken and later to discuss what I could pay for treatment. (A sign in the waiting room warns that the hospital is not free.) After another five or six hours, they took my temp and blood pressure again.

After several hours, my companion went to ask if I could get something for pain. No. Told, about seven hours in, that I was near to rolling on the floor shrieking, a nurse advised that if I got escalated to the next triage level, I could expect to wait even longer.

Several other patients, seeing me suffer, asked if they could do anything to help; a young woman offered me some Tylenol. It was easy to tell the experienced hands. They'd brought their own nostrums, reading materials, games, cushions and packed lunches.

I hadn't known what to expect of the patient base — I suppose I'd pictured bag ladies and CHA residents. There were some who might have fit that description, but mostly the patients seemed much like those at other urban hospitals I have visited, diversely ethnic and largely working class. They all waited very, very patiently, no matter what was wrong with them.

In some cases, it wasn't an urgent problem. I was shocked when a pretty blonde who looked like a college student told me she'd come because she thought she had strep throat. I wondered whether she'd considered getting treatment somewhere else. "I came here because it's where I've always come," she said. "I didn't know where else to go."

Patients wait in long rows of uncomfortable chairs with arms to keep you from lying down — like an airport, but filthier. The room was the dirtiest place I've ever seen in a medical setting, chairs and tables grimed in the ground-in, stuck-on sticky grunge that denotes long periods of no serious cleaning. During that whole long day, I never saw anyone cleaning.

Once I finally got back to the medical areas, they were cleaner, but not as pristine as at other hospitals. The treatment seemed much like that at other emergency rooms, perhaps a little slower, but they did all the expected things. Once the tests came back, they gave me morphine — at last! — and things get hazy after that.

The upshot was that my problem was even worse than I'd thought. It wasn't, however, yet life threatening, so they were going to send me home to wait for an appointment with a specialist. "It takes a couple of weeks," the ER doctor said.

Then she gave me a prescription for five days' worth of painkillers.

It took two return trips to the hospital pharmacy to get them. And, more than two months later, I'm still waiting to see the specialist.

Call now!

2009-03-10T14:00:00.004-05:00

There's still time to take part in National Call-in Day for Single-Payer Healthcare today. Just go to the link, type in your zip code and follow the directions.

I'm late posting this because I just found out about it, but please do it today before 5 p.m. Eastern Time if you can. If you can't, call tomorrow or whenever you can. Activists are also asking folks to fax your health insurance bill or letter of denial to Congress.

Washington doesn't so far seem to be seriously considering a single-payer plan, but that's what we really need.

Universal health care 'unfair to the rich'

2009-03-10T06:00:00.002-05:00

Stephen Colbert channels FOX News:

The Colbert ReportMon - Thurs 11:30pm / 10:30c
The Word - Share the Wealth
Colbert Report Full Episodes
Political Humor
Rap Battle
Joke of the Day

Via Schwitzer health news blog.

Insurance doesn't mean you can stop worrying

2009-03-09T16:29:00.014-05:00

Even Forbes, in between its stories about billionaires, is reporting on concerns over health-care costs, noting that most Americans with health insurance are anxious over what getting sick will cost them.

"MONDAY, March 9 (HealthDay News) -- More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and nearly 50 percent say they're 'very' or 'extremely' worried about the issue, a new Harris Interactive/HealthDay poll shows.

"More than half (57 percent) of those polled said they feared losing their health insurance sometime in the future, which may explain another key finding in the poll — sizeable numbers of Americans said they're skipping doctor visits or not getting prescriptions filled to save money...."

They're right to be worried. Some 25 million Americans were underinsured in 2007, according to one study, three times as many as in 2003. "Underinsured" means your health insurance won't cover enough of the costs of a serious illness or that your deductible is so high you can't afford routine medical care.

Even George Ryan could run a better health-care plan

2009-03-07T23:00:00.016-06:00

TPM reports on today's Republican weekly address, quoting Rep. Roy Blunt (R-Mo.) about proposals to create a government-run health care agency:

"Just imagine a health care system that looks like a government run operation most of us are all too familiar with — the local DMV. Lines, paperwork, taking a number."

I'd sure like to have access to the medical providers Blunt has. Even when I had insurance, I endured long waits at the doctor's office and all kinds of paperwork. Blunt clearly has no clue as to what most of us have to put up with. As a member of Congress, "when he gets an owie, he just trots over to Walter Reed and gets it taken care of, gratis," erichayes noted. As fpie put it:

"Just imagine a health-care system run by corporations that overcharge for insurance, refuse to pay legitimate claims, drive everybody crazy with unnecessary paperwork and wreck the economy! And by the way provide lousy health care."

I don't think that any of the plans being considered in Washington now go far enough, but even our latest crooked governor but one, George Ryan, currently behind bars for taking bribes for drivers' licenses while Illinois Secretary of State, could run a better health-care system than we've got now.

86.7 million uninsured: 'worse than an epidemic'

2009-03-04T16:30:00.017-06:00

(CNN) — "One out of three Americans under 65 were without health insurance at some point during 2007 and 2008, according to a report released Wednesday.

"The study, commissioned by the consumer health advocacy group Families USA, found 86.7 million Americans were uninsured at one point during the past two years.

"Among the report's key findings:
Nearly three out of four uninsured Americans were without health insurance for at least six months.
Almost two-thirds were uninsured for nine months or more.
Four out of five of the uninsured were in working families.
People without health insurance are less likely to have a usual doctor and often go without screenings or preventative care.
'The huge number of people without health coverage is worse than an epidemic,' Ron Pollack, executive director of Families USA, said...."

Add to this an estimated 40 percent of Americans who have insurance that's inadequate to cover catastrophic illness, or which have deductibles so high they can't afford routine health care.

Learning to live without health insurance

2009-03-03T21:00:00.006-06:00

I write this from my bed, curled fetally around my laptop. It's hard to type this way, but it's the only position in which I can tolerate the pain.

In December, when I first felt this stabbing, throbbing, agonizing pain, I hoped it would pass on its own. I knew what it was. I had been through it once before.

The difference between now and then: Then I had health insurance. (I also had a full-time job, money in the bank and many other things I don't have anymore, but the most relevant difference is health insurance.) I went to doctors; they did various incredibly costly things that were covered 80 percent by my health coverage; and the pain went away.

This time, I prayed, the problem would cure itself. No such luck.

I called the specialist who had treated me the last time. "I don't have medical insurance anymore," I said to the receptionist. "What are my options?" He put me on hold. I expected to hear about payment plans or perhaps be referred to a low-cost clinic.

"The only thing we can suggest," he said, sounding dubious, "is to go to Cook County Hospital."

I made a few more calls. No one had any other suggestions. I didn't know anything about Cook County Hospital, so I turned to my friend Google. But for once, Google let me down.

I learned that the old Cook County Hospital was replaced in 2002 by John H. Stroger, Jr. Hospital of Cook County. I found out that it is at 1901 W. Harrison St., Chicago, an hour's drive from my house. I found out that it's one of two full-service hospitals run by the county but the other one, Provident, is even farther away. I read that Stroger "brings the most up-to-date technology, efficient and contemporary environment to the five million residents of Cook County."

What I did not find was anything official about what it might cost to be treated there, what I could expect as a patient, or how to make an appointment. (Ultimately, I learned that you can't make an appointment.) The only clues as to what treatment might be like, I found on Yelp. Not exactly authoritative.

I phoned, without much better results. I would just have to go there.

Cheap drugs

2009-03-02T21:05:00.019-06:00

Well, not cheap, but a little cheaper.

If you don't have health insurance or your coverage doesn't include prescriptions, you can pay a whopping amount for medicines. (One of the few good things Illinois' latest crooked governor tried to do for this state was to address health care, including the cost of drugs. He made a mess of it, but at least he tried to do something.)

Cook County offers residents a free prescription discount card from Caremark that lets users save an average of 20 percent off pharmacies' regular price. How to get one? The county's Web site directs:

Click to go to the Caremark-NACo Website for more information visit your Cook County Board Commissioner's district office or at the lobby information desk at the Cook County Building, 118 N. Clark Street.
Call toll free 1-877-321-2652.

No list of offices is supplied. I clicked the Caremark link. That got me to a page that tells you to click for a list of participating counties. That link goes to a .pdf. Scroll down to Cook County, Illinois, and what do you get? A link back to the Cook County web site.

So I called the number. And the receptionist said that to get a card, I needed to go in person to a Cook County Board Commissioner's district office. Did she have a list? No. With some searching, I did find this list of commissioners with links to their district offices. But you don't have to go there.

Probing a little further, I discovered that you can get exactly the same discounts with Caremark's free RxSavingPlus card. It won't have the Cook County seal on it (which you may think of as a drawback or an added benefit), but you can sign up for the card online and print it out at home.

Walgreens, CVS, Osco, Dominick's, Target and a number of other stores participate in this discount program, which is open to everyone. I can vouch that the card works at Walgreens.

Yet I can't help wondering — if all these pharmacies are willing to give anybody 20-percent off just for printing out one of these cards, doesn't that mean regular price is at least 20 percent too high?

The wait for Cook County health care

2009-02-27T17:00:00.006-06:00

The pain fluctuates from level 6 (barely tolerable) to 9 (writhe on the floor moaning). Desperate for help, I reach for the phone.

       1 - 3 1 2 - 8 6 4 - 6 6 1 0

Thank you for calling the Ambulatory and Community Health Network Call Center. For English, press 1.

       1

If this is a medical emergency, please hang up and call 911. If you are calling for dental services, press 1. To inquire about a pending referral request, press 2.

Patient direct requests for appointments are accepted only to selected clinics....

       2

This line will allow you to check the appointment status of an IRIS referral you have received from your provider. Please be prepared to copy down your appointment information. Please enter the six-digit referral confirmation number printed on your confirmation form, followed by the pound sign.

       • • • • • • #

This referral request has not yet been processed. Please call back at a later date. Thank you. Goodbye. (Click. Dial tone.)

Again.

       1 - 3 1 2 - 8 6 4 - 6 6 1 0

Thank you for calling the Ambulatory and Community Health Network Call Center. For English....

       1

... requests for appointments are accepted only to selected clinics. If you are calling about your pregnancy, seeking adult birth control, pediatric general care or lead poisoning, press 3.

All other clinics require a referral from a Cook County physician or a Cook County partner physician. If you have seen a county physician in the past year, you should contact them regarding your medical needs. If you do not have a primary care physician that you can contact and wish to make an appointment with the primary care physician, press 4.

To cancel or reschedule an existing appointment, press 5. For a follow-up appointment and you have been seen by a county physician in the past year, press 6....

       6

(Click. Dial tone.)

Again.

1 - 3 1 2 - 8 6 4 - 6 6 1 0

Thank you for calling....

1 ... 6 ....

I've been through this about 15 times in the last two months. The appointment I need is with a specialist at the Cook County Bureau of Health Services, the only place I can find that I can afford. After a few more disconnects and time on hold, eventually I get to a human. Each one says something different.

The emergency-room doctor who made the referral in December said it would take "a couple of weeks." At first, no one could even tell me if I was even on the list; the couple of weeks must have meant the time to process the referral. The waiting time starts after that. At that point, a call-center operator told me, "It takes 21 days." At three weeks, it became "21 working days."

After that, they just said, "You have to wait." A few times, an operator transferred me to the specialty clinic ... which answers with a recording. The message says someone will call back in three days. It lies. No one ever calls.

Back at No. 6: "It takes six weeks." "It takes six to eight weeks." "You have to wait." From time to time, they advise me that if the pain becomes too bad, to go back to the emergency room. (That's a story for another day.)

Today, I got lucky. For the first time, the operator put me through to the appointment nurse. After only maybe 20 minutes on hold, she answered.

"Oh no," she said. "We're only making appointments for referrals from September 2008."