MFC Editorial

Chronic challenges to healthcare policy

There were several news stories this week worth commenting on here. Each involved the relationship between medicines and the chronically ill, and each served to highlight the fact that conventional allopathic, Big Pharma-created and FDA-approved “drugs” are not getting the job done – at least not to the satisfaction of those who most need the relief they promise. The implications of this may range much further than that segment of our society.

The first was a Reuters piece on how dietary supplements are being used by our society; as it turns out, their most common use is among those with chronic disease, who’ve apparently discovered they get at least as much benefit from naturopathy as from more accepted methods. According to the article, “Having one or more chronic illness [sic] is the primary factor associated with the use of dietary supplements. Cancer survivors also use supplements to treat chronic medical conditions … a new study shows.”

Of course, after these two introductory sentences, the Reuters story goes immediately into dutiful obeisance to the conventional idols of regulation and orthodoxy, quoting a National Cancer Institute representative (who led the study) on her concerns about the “dangers” of permitting such free choices on the part of patients. As Dr. Melissa Farmer Miller reportedly puts it, “We really are just beginning to build an evidence base on the benefits of dietary supplements.” She then adds the kicker: “Even if there’s not a benefit, there is a potential for them to cause harm.” In other words, the assumption is of the negative effects of these supplements, rather than of their possible value – in spite of the obvious market evidence of their widespread use by the chronically ill.
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One toe into the water

First off, a disclaimer of sorts, addressed to those who read this page regularly: This “editorial” space has been pretty inactive of late, due to several factors (including a bout with that lovely flu bug that’s been laying others – including many who “got the flu-shot”? — so low this season). The most significant of these has been the editor’s attempt to restore his financial position, which required taking on two more jobs of varying size and schedule. It is hoped that these conditions will soon let up allowing for the weekly entry of a fresh editorial; at very least you should see no more unchanged page-content in our regular (Mon-Fri) updates. We now return you to our regular programming.

Well, I finally did it, at least in some sense of the word. As of sometime this next week, your editor should be at least partially “covered” for medical emergencies, and even some routine procedures. Long story short, one of several working opportunities includes a basic health plan (even a rider for dental and vision, which is at present far more useful), at a very affordable price, so after some hemming and hawing I signed up, and will begin being covered for both some catastrophic events and some regular processes, when my next paycheck arrives.

After all the ranting and raving in this space and elsewhere about the evils of employer-based health insurance, does this make me a hypocrite? Perhaps in some part, although the level of the premiums and the copays involved certainly justify some consideration here. For about $30-35 every two weeks (taken straight off the top of the paycheck for the part-time job in question), I have a limited policy that’s supposed to allow me the annual checkups and preventive care that I’ve been searching for all these years, at a sharply reduced rate, with a ceiling of sorts on potential expenses.

(Barring a major catastrophe, or extended hospitalization, I should be able to breathe a bit easier in paying for doctor visits in the future; I should also feel much freer to avail myself of such visits if I encounter some otherwise ignorable, suffer-through-it malady like this season’s creeping crud – the one that turned out to be a flu-strain different from the one so may got “inoculations” against over the last few months.)
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“Treat it like car insurance …”

In almost every cry for “nationalized healthcare” these days, there seem to be one of two basic mindsets advanced for such a program. One camp continues to advocate the “Medicare model,” seeking to base an expansion of health insurance on this overblown and bloated methodology, which is already very near the point of bankruptcy or drastic cutback on services in order to continue to function at all. Enough has been said, both here and elsewhere, about how absurd this system is as prototype for broader “coverage.”

However, even among those who recognize the serious faults in the present Medicare model, there are many who see health insurance as just another mismanaged program, which if only it were better regulated would answer all the problems it now presents. These folks point to the “automobile insurance” paradigm as something the healthcare industry should emulate. They also use the fact that mandatory auto insurance has become the rule rather than the exception, to indicate how easily health mandates could be applied across the board.

What they fail to consider is how different insuring an automobile is from the personal health and wellness realm. Herewith is an attempt to define some of those differences.
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ED is for everybody … or is it?

If you own a TV or radio, read magazines or newspapers, surf the Net or even just get e-mail … you’ve doubtless been inundated with advertising from the “male enhancement” industry. Most of it’s about FDA-sanctioned Big Pharma concoctions — the “little blue pill” and its fellow agents of artificial priapism, each designed to restore youth and vitality to the most flaccid of male appurtenances. However, alongside these approved “medical” options, there are countless other things being advertised, ranging from the stuff that fills up our SPAM filters to that “natural” item that puts the goofy smile on the face of “Bob” (and his lady-friend, neighbors and everyone else he meets on the street).

Back in the day, there used to be a televised Public Service Announcement from some well-intended source called the American Social Health Association about venereal disease, featuring the following jingle (thank you, Google!):

VD is for everybody …Not just for the few
Anyone can share VD …With someone nice as you
VD is for everybody … Darlin’ have no doubt
That anyone can get VD … That’s what it’s all about

Considering how much ad-space is currently being taken up with pitches for one remedy or another for “erectile dysfunction,” and how many hit songs from every genre have been turned into ad-jingles (That Elvis rendition of Viva Las Vegas has lost its appeal forever!), it’s perhaps surprising they haven’t grabbed this one yet. The message being presented does seem to imply that this “lack of firmness” issue is not only widespread, but generally based on some horrid string of physiological and biochemical symptoms requiring a “cure” from the medical establishment. We are thus confronted with an array of options, most featuring a roster of these Big Pharma “cures,” and all making cautionary promises about such “abnormal reactions” as “erections lasting longer than four hours,” should prompt immediate contact with your physician … and all that stuff.

Why is this such an issue to this editor? Full disclosure requires me to confess a personal stake in this one: Having recently taken up a new relationship, with a delightful (and very desirable) woman, to whom I’m both emotionally and spiritually attached, I sought to also reawaken my rather long-dormant physical component, in order to better share myself with her. (Note: It had been about two years since my last non-virtual relationship, whose intricacies had in themselves left me a bit “short” near the end, anyway.
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Medicare as a model? Heaven forfend!

The day-job’s at an end – suddenly and abruptly. Suffice to say that the combination of working corporate, and reporting early for extra hours at holiday-times, proved to be my undoing. Back to the drawing-board, but at least there’s a small cushion and no overdue bills outstanding.

Perhaps it’s a good time to comment on some more things I learned in that venue, about how the current ethos of “entitlement” will surely be our undoing, unless it is reversed very soon. Full disclosure: The gig I just left, not entirely of my own will, involved processing Medicare forms, and the experience has only strengthened my already-adamant opposition to any ideas being circulated about expanding that benighted program as a model for nationalized health insurance!

As noted in previous columns, the practices of medical professionals and their administrative staff, in complying with the intricacies and absurdities of the Medicare reimbursement system, are apparently driven far more by redundancy and inefficiency than by what would normally be considered good business procedures (were it not for the incentive from the IRS systems to waste resources in printing, mailing and such). Meanwhile, the impetus toward what Arnold Kling at the Cato Institute calls “premium medicine” often leads them to look at a patient’s ailment as a chance to try out all their new expensive diagnostic toys (CAT scans, MRIs, biopsies, etc.), rather than just identifying and treating the illness or malady as simply as possible, and sending the person back into the world.
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Why true healthcare “reform” may be doomed

The temporary day-job continues to enlighten your editor. This week, a new insight: When in doubt, blame the IRS!

Let me explain: The other day, while engaged in my current duties of opening envelopes, pulling staples and prepping paperwork for scanning and further processing, I came across something that almost made me laugh out loud. In one batch of mail (whose source, identity and type shall remain undisclosed) I found about 50 envelopes, all from the same return-address, with ONE two-page enclosure in each — all involving the same subject, though concerning different cases — and each one bearing a first-class stamp.

Alongside these were perhaps another 30 or 40 envelopes, all from that very same source, containing TWO such submissions, and each also with a stamp attached. Only now, in addition to the extra two sheets of paper (still easily weighing in under the single-stamp barrier), there was stapled to the first page of each submission a small slip of paper containing the following message:

We have enclosed two [forms] since we didn’t receive envelopes for every [form].

These were done on lavender paper, carefully cut into strips (with wide top/bottom margins, as shown by the occasional thicker strip, with space above or below the message). This was obviously the result of a brainstorm (or other suffix?) on the part of some clerical worker at that facility, perhaps even with the okay of the proprietor. Apparently, the thought of stacking all those requests for further consideration (identical in each case, except for the specifics of particular cases), then placing them all into ONE ENVELOPE (with appropriate and much-cheaper postage for the package … never occurred to these rocket-surgeons.
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Forms processing: How to shift the gears

This editorial has taken a while to write — not because the motivation wasn’t there (though that was certainly a minor factor), but because your esteemed editor was a bit concerned about the “security” issues involved.

You see, for the past two weeks (and expected to be well into the immediate future) yr. obt. sert. has been engaged in a full-time job, back in the conventional workplace for the first time in nearly a decade. Since his skill-set, though highly esteemed in some circles, is a bit harder to demonstrate out there in corporate meatspace, he’s taken on a data-entry/clerical position in order to get some bills paid.

However, even in only two weeks of observing and training, he’s repeatedly noticed a number of common errors committed, by those submitting official forms for processing. (Note: Further details of the place of employment are neither relevant nor properly disclosable; suffice to say it involves government paperwork servicing the healthcare industry.)

As a result of this newfound knowledge, he considers it only fair to pass along some tips on how to streamline the process of getting the desired effect from such transactions (assuming that desired end to be the efficient handling of the question, reimbursement or contract fulfillment involved). If your livelihood involves (even in a small part) communicating with a bureaucratic entity, be it governmental or corporate in nature, there are undoubtedly forms to fill out and mail, fax or otherwise transmit to some agency or office – one which probably has hired a staff of clerical workers and supervisors with the sole mandate of opening, sorting and directing each missive to its proper destination.

Assuming your intention is to get prompt responses, your best bet is to follow the often-convoluted set of instructions for filling out such forms … to the letter. Most folks do this fairly well, but they also often seem to forget how such a mass of paperwork is handled, even before it reaches the actual processing stage. The people who first handle your transmissions have specific rules to follow in opening and routing for processing, each day, several thousand individual envelopes. As a guide to getting your request processed more effectively, herewith, one of those “top ten” lists so popular on the late-night talkshows:

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The REAL “uninsured” situation

With all the claims from nationalized healthcare advocates, about the huge number of “uninsured Americans,” and how their socialistic panacea is going to cure all of this, it’s easy to overlook the fact that even the vast majority of those of us who DO have health insurance policies are often also playing Russian roulette about our wellness, anyway.

Fortunately, there’s at least one “progressive” writer who addresses this issue head on, rather than hiding behind the “statistics” about the alleged nearly 50 million Americans who “lack” health insurance. In a Boston Globe column this past week, Boston University professor Laurence J. Kotlikoff advances a rather interesting plan for healthcare reform.

Titled “We are all uninsured now”,” the piece presents a rather intriguing perspective on how poorly even the folks who HAVE health insurance are faring under the current system. And it is here that he makes his strongest case, just as Michael Moore did in SiCKO on the same issue (despite that film’s many problems and inaccuracies on other aspects of the question).
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SCHIP: Focusing on the target-audience?

The battle should be over by now, but it’s not. Congress has still not passed the bill that revises and reconstitutes the State Children’s Health Insurance Program (SCHIP), since it recessed for summer vacation – umm, excuse us, constituent services travel – before reconciling the House and Senate versions of the legislation. However, as a final step in at least attempting to insulate this impending legislation from simply becoming another clandestine step to nationalized health insurance, the Bush administration has added what Reuters called “new standards” to limit the applicability of that healthcare subsidy to truly low-income recipients.

If a state wants to offer subsidies to families with incomes above 250 percent of the poverty-level, they must first prove that they have already extended the offer to at least 95 percent of those families earning below the 200 percent amount, providing for those children through either Medicare or the child health program. (There are other conditions, but this is the one raising the most unwarranted controversy.) Since none of the 50 states have thus far come anywhere near that level of coverage for the truly indigent, the expectation is that efforts to raise the bar will now be considered to be in violation of both spirit and letter of the SCHIP authorization.

Why this is exactly wrong somehow … well, that remains to be seen. If the intended beneficiaries of a “hand-up” program (aiding the children of poor families) are not being served adequately, it’s hard to argue that funds aimed at that target population should somehow be diverted to helping those who are somewhat less hamstrung by their economic status. The charge that advocates of such a “middle-class handout” are merely using the SCHIP reauthorization to promote their intended socialization of healthcare seems pretty valid. But immediately following the news of the Bush regime’s rule-change, the barrage began.
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A question of priorities?

The lead news story kicking off this week’s editions of Medical Freedom Channel is an Associated Press news-analysis entitled, “Pain medicine use has nearly doubled.” As noted in the editor’s note on the blurb, the most significant fact in this account is that this account is based, not on studies and surveys performed by physicians and other health professionals, but on “statistics from the Drug Enforcement Administration.”

In other words, the focus is on “drug abuse” by those who misuse painkillers (presumably illegally), rather than on the prescribed recommendations of pain management physicians and others caring for those afflicted with chronic ailments, involving constant or acute physical agony, for whom such substances as are in existence should (in a humane society) be readily available to ease their distress, by any means.

Well, that’s the conclusion we should be drawing, were we living in any kind of sane culture!
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