Tuesday, May 29, 2012

Health Care Cost Rip Offs

Here is more proof that Republicans, conservatives, and the wealthy don't really believe in the free market ideal, and that they instead purposely manipulate the markets for their personal gain, and screw over the consumer in the process.

This article comes from Forbes.com. No, this article isn't directly related to homelessness, but homelessness is related to a poor economy and the purposeful mistreatment of people by others.
This article comes from Forbes.com by Avik Roy

State Sen. Nancy Barto (R., Ariz.) introduced a bill to bring price transparency to Arizona health-care providers, only to be stymied by members of her own party. One of the main criticisms of consumer-driven health care is that, today, consumers have no way of figuring out how much a particular health care service costs. Indeed, one of the reasons that health care is so expensive in America is because people have no idea what they’re paying for it. Hence, it’s important for reformers to encourage hospitals and doctors to become more transparent about the prices they charge for these services. But an Arizona bill to do just that was killed—by the state’s Republican legislature.

Yesterday, Chad Terhune of the Los Angeles Times told the story of Jo Ann Synder, a woman who was charged $6,707 for a CT scan, after she had undergone colon surgery. Her insurance plan, Blue Shield of California, billed her for $2,336, and paid for the rest. But Snyder was shocked to discover that, if she had paid for the scan herself, out-of-pocket, she would have only had to pay $1,054. “I couldn’t believe it,” she told the Times. “I was really upset that I got charged so much and Blue Shield allowed that. You expect them to work harder for you and negotiate a better deal.” Los Alamitos Medical Center, Terhune found, charges $4,423 for an abdominal CT scan. Blue Shield’s negotiated rate is about $2,400. But Los Alamitos told Terhune that its cash price for the scan would be $250.

The failure of reform in Arizona In Arizona, a state senator named Nancy Barto (R.), who chairs the senate’s Health Care and Medical Liability Reform Committee, sponsored a bill, SB 1384, targeted directly at this problem. The bill would require health care facilities to “make available to the public on request in a single document the direct pay price for at least the fifty most used diagnosis-related group codes…and at least the fifty most used outpatient service codes…for the facility.” Doctors would be similarly required to publish the direct-pay prices for their 25 most common services. The idea is that patients who have health savings accounts need to know what various doctors and hospitals charge for their services, so that they can shop for value when they need care. Sen. Barto’s bill passed the Arizona Senate, but it died in March in the state’s House of Representatives, where Republicans in the House Judiciary Committee refused to send the bill to the full House for a vote. (Republicans control both houses of the Arizona state legislature, along with the governorship.)

“Do we want free market health care?” Sen. Barto asked in a recent blog post. “Then why have common sense reforms that will produce one been opposed, defeated and/or vetoed at the legislature for the last 2 years—even though we have a Republican Governor and Republican supermajority?” It’s a good question. “The short answer,” she writes, “is swarms of lobbyists. The longer answer is legislators succumbing to lobbyists on issues that should be rather plain.” Price transparency seems like the kind of thing that everyone should be able to rally around. But you’d be wrong. Pretty much everyone in the health-care world—other than the patient—has an interest in keeping prices opaque.

 Eric Novack, an orthopedic surgeon in Glendale, Arizona, fought a lonely crusade for Barto’s bill. According to Novack, it was a miracle that the Arizona bill passed the state Senate. Senate Majority Whip Steve Pierce, alleges Novack, “slowed the bill down at the strong suggestion of representatives from the Governor’s office.” (Gov. Jan Brewer’s chief of staff has ties to the health care industry.) In fairness, the state’s Democrats were nearly uniformly opposed to the measure, as well. Lobbyists, says Sen. Barto, “nearly killed [the bill] in the Senate, where, after passing the Senate Committee, opponents descended upon Senate leadership personally and the bill nearly didn’t come to the floor. Obviously there is something more at stake.”

Most doctors and hospitals would rather not post their prices, because then patients would shop around, placing pressure on their incomes. Insurers don’t like price transparency, because they view the rates they negotiate with hospitals and doctors as proprietary trade secrets that give them an advantage over their competitors. Suppliers of medical products, of course, also benefit from high prices. “At the final stakeholder meeting,” says Novack, “it was 50 representatives of the health-care industry against one person: me.” You can guess who won. “One physician that was there, representing the Mayo Clinic, claimed that disclosing prices would confuse patients since they might choose cost over quality,” says Novack. “This got a near-collective head nod from all.”

Wait. So if patients got to see how much health care actually cost, they’d be “confused.” As compared to the clear-as-mud system we have today? It’s not a credible argument. When it comes to health care, patients will be even more demanding of quality than they are in other aspects of their lives. It’s the providers who aren’t providing high-quality care who should be afraid. Transparency dramatically reduces health-care costs

Not all providers everywhere are against price transparency. The pioneering Surgery Center of Oklahoma, led by G. Keith Smith, posts prices online for the full range of surgical procedures that they perform. “Our prices are so low in comparison to what others are charging,” says Smith, “that our competitors are feeling the pressure, and are beginning to lower their prices as well.” Observes Daniel Anderson, “The clinic simply posts their prices on their website, and those prices are often [50 to 75 percent] lower than [those of] most major hospitals. The clinic is drawing in both the insured and uninsured, not to mention out-of-state and even foreign patients.”

Some libertarians argue that it’s not kosher for free-marketeers to force health care providers to post prices. People should be free, they say, to hide their prices if they want to. After all, we don’t seem to need to force Best Buy or Amazon to post their prices. And it’s true that, in a dream world where everyone buys insurance for themselves, and everyone has a health savings account, such measures might be less necessary. But that’s not the world we live in today. Today, if you try to buy health care on your own, government policies and industry stakeholders do everything possible to make your life miserable. Transparency is the sort of thing that Republicans and Democrats should be able to agree on. But instead, they’ve agreed to let industry lobbyists preserve the status quo.

Saturday, May 26, 2012

Memorial Day

I really do get tired of all the memorial day propaganda. For one, it's memorial "day", not memorial weekend, or memorial week, or memorial month, although to hear some talk about it... Well they say "lest we forget". Is there really ever a chance to forget? The media constantly reminds us that we are constantly at war, our government constantly reminds us of the honor of serving and dying for the country, every major public park space in every major city has monuments to the fallen, our public offices have the names of the fallen listed in bronze on large plaques listed according to which war they died in, even our national anthem is a war anthem. War, and more importantly, the glorification of war is so very prominent in our culture. There's no chance in hell anyone could every forget. And I think that's just as important to remember.

Wednesday, May 23, 2012

God Is Awesome

EXACTLY! As I prayed to God for protection of my family, and as I asked other good Christians to do the same, whole congregations even, God still allowed the asshole who was my exwife's boyfriend to beat my kids and nearly kill my ex. Thank you God, you're so awesome!

Home Of The Brave

Democrat Vs Republican

Here I will briefly outline the two main differences I see between Democrats and Republicans.

Democrats do not create regulations just for the sake of having regulations.   Businesses, big and small, will do things that are harmful to others and the environment for the sake of making more profits.  They will pour poisonous chemicals into our water supply, they will make products that are dangerous or defective, etc, all so to increase their profits (cause taking short cuts is easier and less expensive).  And the ONLY entity that can stop businesses from doing these kinds of things is the government.   That is why we have regulations.   Republicans on the other hand don't think that polluting the air and water and ground, and making the world a more dangerous place to live is a bad thing, so long as profits are being made.   Where Republicans are focused on making as much money as possible, Democrats are focused on creating a livable sustainable world for everyone to live in.

And Democrats not about creating a nanny state, but about keeping the playing field of life fair and level for everyone.   Ever play poker?   Although people playing against each other may have equal skills at the game, the person with the most chips has a clear advantage over those with fewer chips.  This makes it more difficult for the players with fewer chips, creating fewer opportunities for the less fortunate to compete.    And this advantage over other people is something the wealthy, and their Republican puppets try to maintain.   They don't want a level playing field.  They want to have and keep an advantage over others.  They really don't want fair competition.  They only want competition where the game is slanted in their favor.   Democrats want every one to have an equal chance at achieving the American dream, and they are working to make that happen.

 This is why  many people are Democrats or vote on the Left side of the spectrum.   It's because they believe that people are more important than profits

Tuesday, May 22, 2012

Teach A Man To Fish

"Give a man a fish and he will eat for a day. 
   Teach a man how to fish, and he will eat for life."  

Society is built on an individual responsibility and access to opportunity.  A Republican will then slash fishing education, vilify fishing teachers, reward corporate fisheries, gut regulations that protect the fishing industry, and all the while will whine that teaching a man how to fish is socialism.

Monday, May 21, 2012

What Jesus Said

"Give to Caesar what is Caesar's, and give to God what is God's."
 ~  Mark 12:17

There is no greater endorsement of the Separation of Church and State than that.  Even God agrees.   Sure some of you may reply that Jesus was only talking about paying taxes, and you would be right, to a point.   But, Jesus had a tendency of  addressing much wider and all encompassing paradigms, when talking about smaller, less significant issues.

Friday, May 11, 2012

When Homeless People Die

In the homelessness industry it is pretty well known that homeless people do not live as long as non-homeless people, and studies have confirmed as much.   And, occasionally in my writing, and in talks I've given on homelessness, I have echoed that fact  

One day, though, someone challenged me this.  It was a simple yet compelling argument, but I let it go without further investigation.   I mean, why should I investigate facts?  I am the leading authority on all things homeless, right?

Anyway, I've been reading some articles on the subject, and I'm beginning to change my view on this.   Lets take a look at this article from last year that ran in the Guardian. http://www.guardian.co.uk/  (Although this article concerns homelessness in the UK, I suspect the differences between homelessness there and in the US are minimal.) At the very beginning of the article it states very clearly the life expectancy of homeless people, and what exactly contributes to that - being alcohol and drug abuse.   Pretty simple.   Taking too many drugs, or drinking excessively over an extended period will kill people.  The article quotes findings in a recent study which you can download at http://www.crisis.org.uk/data/files/publications/Homelessness%20-%20a%20silent%20killer.pdf 

But look at what happens in the article.   Though the first couple paragraphs discuss the effects of alcohol and drug abuse, and the complications that arise from them, as being the cause of death among homeless people, the commentary that follows moves the discussion away from alcohol and drugs and onto the difficulties and stresses of living homeless.

The question becomes clear:  Is the low average life expectancy of a homeless person (between 45 and 50 years of age) due to alcoholism and drug abuse, or is it due to the harsh environment of homelessness?

Compare that article to this one in the NY Times which states that alcoholism can reduce a person's life expectancy by 10 to 12 years.  No mention of homelessness is involved, although certain aspects of alcoholism is confirmed in both articles, such as a higher rate of accidents and suicides.   The Guardian article attributes accidents and suicides to the stresses of homelessness, where as the NY Times article says that it's the alcohol to blame.  

The Guardian article says that homeless people die 30 years younger than non-homeless people, and the NYTimes article says that alcoholics die 10-12 years younger than non-alcoholics.  The difference between the two could be attributed to  homeless alcoholics drink a great deal more than non-homeless alcoholics.   I don't have facts to back that idea, but it seems pretty obvious that homeless alcoholics have less constraints on their drinking.  Their primary focus is on drinking, where as alcoholics with homes still have to maintain a certain level of functionality so to maintain their standard of living.

I think the biggest difficulty in answering this question outright, is that people become homeless at all different ages, and become alcoholics and drug addicts at different ages as well.    I have known a great many people who have died while on the streets, and I know there are a great many elderly homeless people.   And I cannot think of one elderly homeless person who is also an alcoholic or drug addict.

There is no doubt that living homeless is very stressful, but as they say, those things that don't kill you only make you stronger.   Alcohol and drugs are known killers, but homelessness?  I'm starting to doubt it.

Certainly more studies need to be done to determine the real effects of homelessness on individuals, studies that differentiate between different types of homeless people.  Is it really homelessness that kills, or is it just the alcohol and drugs?

Monday, May 7, 2012

Where Did He Go

Sometimes people will ask me about a particular homeless person they had gotten to know.  They will say they hadn't seen so-n-so in a while and wondered what happened to him/sher.

Here's the deal.  When homeless people decide to leave a place, they just go.   Most of the time anyway.   Some will make the rounds and say good bye to those they've known, but not usually.  It's funny too, that people will just show up, seemingly out of no where, they will be a part of the homeless landscape for a while, and then they're gone without a trace. The homeless population ebbs and flows that way.

I think it has something to do with the ugliness that is homelessness. When people get an opportunity to leave, they don't want any attachments to what they are leaving behind.   They just want to forget the whole mess.   There is nothing much to be proud of, or be nostalgic about, concerning homelessness.   Especially knowing how the non-homeless judge the homeless, homelessness is better left and forgotten, never to be mentioned aloud to anyone.

That's the main issue involved.

There is another issue to be considered too.   More and more I see the signs of Asperger Syndrome in the homeless population.  The big issue being that people with Aspergers lack "proper" social skills, and are not aware of what people expect of them behaviorally in a social context.  They just don't know that people would appreciate a "good-bye" when they leave.

I have had to work on that myself.   Like when I used  to volunteer to wash dishes after a homeless lunch.  When my particular job was done, I'd just leave without saying a word to anyone.   Though I might have been chatting it up with the other volunteers while doing the job, I didn't know that I should let them know that I was leaving.

People are funny like that.