Friday, January 8, 2010

Burned Again By a Handmaiden of the FIRE Economy.

Below is masterpiece of bedbug letter writing from the office of Massachusett's Senator John Kerry. Notice that, for all the verbiage spewed, it manages to say little to nothing of substance, and-take my word for it- doesn't even begin to address the specific criticisms I levied against the Senate's newly minted and monstrous health care plan. Perhaps that's because, reading between the vapid lines asserting that we need to have "better this" and "more of that", Senator Kerry makes it reasonably clear that he is right on board with the "government's" delivery of tens of millions of the uninsured, and surely uniformed, into the clutches of the nation's grifting insurance industry.

Dear Mr...

Thank you for contacting me to express your opinions on the health care crisis in our country and on health care reform legislation. I appreciate hearing from you on this important matter. Reforming our country's health care system and ensuring that all Americans have access to affordable health insurance is a top priority. Today, the United States spends more on health care than other developed countries, yet we have a shorter life expectancy and higher infant mortality. Health care spending represents nearly 17 percent of our economy, totaling over $2 trillion a year. Still, approximately 87 million people-one in three Americans-went without health insurance for some period during 2007 and 2008. This is unacceptable. As a member of the Senate Finance Committee, I am working to enact comprehensive health care reform that improves the access and delivery of health care for millions of Americans.

According to researchers, about $700 billion is spent each year on health care that fails to improve outcomes. I believe we should eliminate this excess spending and transform how we pay for health services. Payments should be based on the quality of care delivered instead the quantity of services performed. We need to reward providers who coordinate care and improve health outcomes. New investments must be made in our health care workforce to meet the needs of a fully insured population. Through better access to providers as well as prevention and wellness programs, individuals will be able to lead healthier lifestyles, reduce the likelihood of chronic disease and reduce costs. Health reform should also include better access to home and community-based services for those needing long-term care.

The Massachusetts experience with health reform holds valuable lessons for federal reform. Our state has the lowest number of uninsured in the nation due to reform efforts that included: expanded public programs; the development of new insurance standards; subsidized insurance to those with low income, the creation of an insurance exchange for private plans; maintaining safety net hospitals and health centers; and a requirement that individuals and employers each have a responsibility to contribute to health care costs.

Too many individuals cannot afford insurance as health insurance premiums continue to rise faster than inflation and wages. We must control skyrocketing health costs that push families into bankruptcy and place our businesses at a disadvantage in the global economy. Families deserve affordable options when choosing a health plan, which is why I support a public plan option like the one included in the bill passed out of Senator Kennedy's HELP Committee. Under that plan, all Senators and their staff would be required to use the public option as their health insurance. Every American has the right to high quality and affordable health care, regardless of age, income or health status. That is why I recently introduced the Women's Health Insurance Fairness Act to prevent insurers from charging women higher premiums than men for health insurance policies.

As a strong supporter of improving health insurance coverage to children, I introduced Kids First, a bill that would guarantee health coverage to the currently nine million uninsured children in America. In these uncertain economic times, families should never be forced to forgo health insurance for their children. I also supported improvements to the Children's Health Insurance Program, which became law in February 2009. This new public law will strengthen and expand health coverage to an additional four million children, nearly halving the number of uninsured children over the next five years. This new law included legislation that I wrote, the Children's Mental Health Parity Act, which will ensure that children served by this program will also have access to critical mental health services.

A modernized health system must take full advantage of electronic prescribing and health information technology. Electronic prescribing not only saves money through improved efficiency, but more importantly, it reduces medical errors and saves lives. According to the Institute of Medicine, one-third of written prescriptions require follow-up clarification, with medication mistakes causing 7,000 deaths and 1.5 million injuries per year. The Medicare Improvements for Patients and Providers Act that was enacted into law in July 2008, included provisions from my electronic prescribing legislation. This law creates incentives for physicians to implement electronic prescribing within their offices.

While I strongly believe there are many things that need to be changed within our current health care system, it is equally important to preserve the parts of our system that work. As we move to make health insurance more affordable, those who are satisfied with their current insurance should be able to keep what they have. The issue of health reform has been the center of many debates and conversations across the country. I support a transparent process that involves the public and provides open access to the facts regarding reform efforts.

As we continue to move forward with health reform I will keep your thoughts and concerns in mind. Thank you again for writing me. Please do not hesitate to contact me about this issue or any other matter of importance to you.


Thai said...

Now if there is something I do know a great deal about, it is IT in medicine (let's say it is very intimately related to what I do for a living) and all I have to say is the institute of medicine's conclusions are a joke.

Perhaps we should add IT economy to the FIRE and change the term to FIIRE economy.

IT in medicine is a VERY complex issue.

Taken from your letter:

"A modernized health system must take full advantage of electronic prescribing and health information technology."

Does Kerry even know what he is talking about???????

So I ask you to explain to me why the major Health Care IT initiative of the UK, the Care Records Service, failed?

Perhaps it is only "crazy" profit driven American doctors and incompetent Brits who can't get this thing right.

Federal policy wonks don't suffer from our incompetence.

How many times have we been told by the proponents of the Obamacare system that the biggest hindrance to high quality/low cost medical care is the fact that we are not a "centralized"/single payor systems?

How much more centralized/single payor can you get than the NHS? Yet they can't get it to work either?

Kerry's misunderstanding of this issue is bordering on the neglegent in my opinion and he is going to kill people if he is not careful.

In fact, as a general rule, you can take anything the Institute of Medicine says with a BIG grain of salt! For if you ever look at a great many assumptions they use in their "studies" or "recommendations", you would be stunned.

Institute of medicine (IM) policy statements are no better than a magic eight ball (and possibly worse) and I can back this strong statement with a great MANY links if you want.

I have never bothered to tease out the political connections between the IM and whoever they works closely with to figure out where the so called "revolving door" is strongest (you see it frequently in Washington) but I suspect it would not be pretty.

... Note I am not anti-IT in health care in any way, but to claim it is a low hanging fruit issue is bizarre.

The Feds forcing the issue will not make it better one bit.

Thai said...

... This letter actually tells you quite a bit ;-)

1. If Mass is a model, god help us all. Mass does have less uninsured-kudos- yet you also spend more per person than almost anyone else on this planet (there are a few places like NY and Miami that are beating you- barely)

2. If women don't pay more, then does that mean that men make up the difference?

3. If we spend $700 billion unnecessarily, then who will we not spend this money on tomorrow once you have figured out where it is and how to get rid of it? Doctors haven't been able to decide how to stop this problem to date but you apparently feel you know who can decide/do it well?

Care to share with us who that person will be?

...And since Mass is apparently worse at it than anyone else, how does this bode for the idea the Mass be a leader in this effort? Or that a Mass model will show us how to accomplish this?

4. If we are to keep the parts of our system which work, but jettison those that don't, would you care to tell us which parts would these are?

Get rid of the Mass model of high costs?
Spend EVEN MORE on an IT infrastructure which has never been show to translate into better care or lower costs?

Or is it just charging men more?

Please share Mr. Kerry

... Somehow I suspect it is just the latter ;-)

Thai said...

Just one example of the revolving door. ;-)

Thai said...

Re-reading my statement on the Institute of Medicine, I may sound a little stronger than I intend.

To be fair, IM does a lot of good work. But the way some of their studies get reported, such as this requires that you often look at their methodologies to see what they are saying and whether the report is being published correctly.

For press bias never seems to report that how the IM itself has published other papers like this which show that disparity studies have major limitations by their very nature as it is impossible to account for other variables.

... And please note I AM NOT commenting on race, I just use this particular NLM link as one example of where IM reports can contradict other IM reports and the press misses this.

This is why I say "take them with a grain of salt".

But I do have an enormous amount of respect for the people of the National Academy of Sciences.

AND as per our discussion on global warming, scientists do have their own personal biases.

AND, I think there are some revolving doors. ;-)

Edwardo said...

You win the prize, Thai. The IT economy, the Institute of Medicine, and the entire ethos that underlies the very existence of such an entity, seem to represent a problem unto themselves.

I suspect the "institute" exists, to some degree, just so clueless political hacks like John Kerry can have access to "findings" that they will deploy to fool hoi polloi into thinking that the political class know something about that which they speak.

The more I think about this particular problem, "the health care problem" that is, the more I am put in mind of Tom Stoppard's play Arcadia, where the main idea centers on people's immense and overpowering need to provide answers to things they have no way of ascertaining.

Neil Postman's book, Technopoly, also comes to mind, since, ultimately, outfits like the Institute of Medicine appear to be nothing so much as glorified tools that, where public policy is concerned, have (been allowed to) run amok.

It's a funny thing- well, not really- but in my experience, when the term institute is used to describe some group's formal endeavor, whether it's a drama school or a medical research outfit, it's wise to treat it as something of a red flag.

Thanks very much for your professional opnion and for all the links.

Now, since you brought it up, what do you do for a living, Thai? I thought you were a practicing physician.

Thai said...
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Thai said...


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Anonymous said...

I hate to burst your balloon on this but I just received (Feb 19, 2010) exactly the same email response from Senator Kerry. It is obvious your email, my email and many others like it expressing total disatisfaction with his performance in pursuit of "the people's business" is falling on deaf ears and is being tossed in a large bucket scheduled for a generic response sent out by an overpaid office staff. Do a Google phrase search on his email to you and you will find a number of hits identifying other people who received the exactly same "Dear John Doe" email. He, like many others in Congress don't read the bills they vote on so why would you expect he has read your email? After all, what do you expect from someone who only makes $174K plus a long, long list of fringe benefits ( It time to vote clowns like him out of office. Scott Brown's election obviously didn't make him think twice about what he is doing to our country.