HealthyConcerns.com

Employer-based health care

As I sit her breathing my germs on no one, because I work alone at home, I do think about how I got this stupid gunky whatever that I have. Someone was walking around with something when they should have been hermetically sealed at home. I'm hardly one to talk, because although I've been homebound for a good portion of the last week, there were times I had to get out and do things.

I say this to remind my good friend ShortWoman.com that one doesn't have to be uninsured to be spreading germs...one can also have a deductible one doesn't feel like contributing to right now, or one can have a OB/GYN as one's primary physician and not feel up to trying to find out who they should go see when they're actually sick!

But ShortWoman's post is about something else in the main: the valifity of employer-based healthcare as a way to insure the bulk of Americans. And she finds herself surprised to be agreeing with Wal*Mart's CEO when he says that legislation is not the way to solve our national health care problems.

But in case you were buying wholeheartedly into the idea that the answer is simply consumer-directed health care and HSAs, she gladly pokes some holes in that idea too.

Malcolm Gladwell, well-reputed author and New Yorker columnist, but new blogger, spins an interesting analogy to make you re-think employer-based health care:

The closest I can come is to imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course, if you lost your job you would need the subway more than ever, because you couldn't afford taxis and you would need to travel around looking for work. Right? In any case, what logical connection is there between employment and transporation?

Check out the huge number of comments he's gotten on the post too.

See it pays to be a Best-selling author before you become a blogger!

Why I've been quiet...

Because yet again I am fighting off being sick. What is up with that? I had my >2 weeks of misery back in late December/early January. Here we are a mere six or seven weeks later, and my throat is sore, my head feels all fuzzy and heavy...all the same warning signs.

This time around I'm trying to be more proactive, using ZiCam (no idea if it works) taking medicine at night to make sure I sleep a reasonable amount of time.

I actually bought some Airborne a few weeks ago, but since I wasn't getting on a plane or being around large groups of people, I didn't take any.

Seriously, it will be very frustrating if this becomes some full-blown thing again.

I know, I know...why am I sitting typing away at my computer instead of lying down and resting?

Point taken. Whine over now.

Wal*Mart seeing the health care/P.R. connection

We've mentioned it here before: Wal*Mart's health care policies are a huge public relations black eye. Obviously they realize it to. They've announced vague changes to their health care plan.

Vague because they say things like they'll "shorten" the waiting period for part-time employees to get on a health plan (from its current two-year waiting period!!!) but they haven't yet determined by how much.

You know, stuff like that...the kind of stuff that makes people cynical about companies like Wal*Mart.

Hope what they're doing represents actual improvements for their employees, but of course their critics think it provides little substantive help to employees and is more about improving their reputation.

Grand Rounds is up at Dr. Andy

Dr. Andy hosts this week's Grand Rounds, and offer a nice compromise between those who think submissions should be limited, and those who think (like I do) that blog carnivals are about the spirit of inclusivity and broad choice.

Dr. Andy has identified his favorite posts...a Top 10 list as it were...at the beginning of the post. He has then posted every other submissions, grouped into categories.

I like it!

(And he kindly included my post about the Canadian doctors refusing to operate on a smoker because smokers have issues with post-surgical healing. I can't tell, but I think Dr. Andy disagrees with me!)

Couple more posts caught my eye:

Are you like me and very VERY skeptical of recent reports that low-fat diets don't make you healthier? Well, you will really enjoy the Ten Reasons to Keep Eating Healthy Foods post from Disease Proof.

Bet you've never thought about the life of a "transplant coordinator." Get a glimpse into the world of the person who goes and asks grieving families for their loved ones' organs. Heartbreaking.

Great job on Grand Rounds, Doctor Andy.

Getting men to the doctor

Thanks to Kevin MD for pointing us to this article about how to get men to the doctor.

I've blogged before about men not calling their doctors, including my own S.O. It was with some personal interest, therefore, that I read this article.

And I find myself frustrated.

The advice in the article seems patronizing to both men and women. We women shouldn't be nags or mommies or threatening. Yet, we should build them up as manly men and providers who are needed to stay alive and healthy so that they can protect and provide for their families. Men, if we are to believe this article, just can't handle the truth. And the job of the woman is to accommodate this illogical inaction. And try to cater to it. I mean I know the article is probably accurate about what will and will not motivate the majority of men, but I'm thinking of telling my very bright engineer S.O. that he and his refusal to follow up on health issues is simply an example of Darwin at work. I'll add that I somehow expected he'd be one of the fittest, not one of those doomed to die out through their own stupid (in)actions.

Think that'll work?

You may not have noticed...

...but there have been a few cosmetic changes around HealthyConcerns. And one significant commercial change. So in the bloggy spirit of full disclosure, here's the latest.

Almost a year ago eHealthInsurance.com signed on to a six-month contract to be the exclusive sponsor of HealthyConcerns. The idea was for them to have a window into the conversations going on about health care out in the world of people like me: a layperson, a mere patient.

They would have no control or say about the content, but they would help me by sending me various newsletters, research reports, customer stories...designed to educate me and bolster the content. And most appealing to me, since blogs are all about the interactivity, a big part of our sponsorship relationship was meant to have them as a resource for health coverage Q&A for consumers...

A blogger would like to update us

Almost eight months ago I blogged about an interesting post over at Joe Paduda's Managed Care Matters.

Basically Joe was saying that current health care debates are a waste of time because we're debating processes, not how to measure outcomes. I commented that his post didn't say how we scale or define "positive outcomes" since everybody eventually dies, and some treatments are really designed to extend life or make the end of life more comfortable. I wondered how such treatments would be considered in a system that was operated based positive outcomes.

Joe emailed me yesterday, having found my post, and wants to clarify that he has indeed, in other posts, talked about defining positive outcomes. And he forwarded me a link to this post, written after the post I wrote.

OK. So there you go. Please read his post and learn more about his vision of outcome-based health care policies.

[For future reference: I believe Joe could/should have just left the relevant link in a comment on that old post he found if he wanted to clarify his position.]

I point to Joe's work fairly regularly, usually admiringly. I've got this post bookmarked right now to do exactly that. Key priceless line in the comments of this post, from Joe himself:

And I shall reply, "he who fails to understand the nuances of health care economics will always walk with his head up his ass."

Doesn't that make you want to read the post? It should.

More doctors refusing treatment...still money-driven at its heart

Kevin MD has another example of doctors who don't want to give treatment to a bad patient. Basically the guy is a smoker. Smoking impedes post-surgical healing. Therefore the doctors don't want to operate on his banged-up knee.

And although one might think (hope) that this is a decision driven by the medical reasons behind it, it is happening in Canada, with their public health care system, and at least one of Kevin's commenters avers that if the guy was paying for the operation himself, then he should be entitled, but that the system shouldn't pay for it.

Here's a key excerpt from the source article:

He has had several operations already, but a scheduled surgery to complete the repairs was cancelled by his orthopedic surgeon, Dr. Steven Massoeurs.

[snip]

"He told me I would heal slower and I would be more prone to infection," Randall said Friday. "But I've been through three surgeries already and I've never had any trouble with infections or anything like that."

It seems particularly icky to refuse him a surgery that is meant to "complete" these repairs. No?

Well, since we seem to like the rich getting richer and the poor getting poorer, why wouldn't we like the healthy getting healthier and the unhealthy just being left to get unhealthier?

Wanna be in a Michael Moore movie?

Hey, I'm not asking if you wanna be his best friend, just if you wanna be in his movie. If so, here's how:

How would you like to be in my next movie? I know you've probably heard I'm making a documentary about the health care industry (but the HMOs don't know this, so don't tell them -- they think I'm making a romantic comedy.)

If you've followed my work over the years, you know that I keep a pretty low profile while I'm making my movies. I don't give interviews, I don't go on TV and I don't defrost my refrigerator. I do keep my website updated on a daily basis (there's been something like 4,000,000 visitors just this week alone) and the rest of the time I'm... well, I can't tell you what I'm doing, but you can pretty much guess. It gets harder and harder sneaking into corporate headquarters, but I've found that just dying my hair black and wearing a skort really helps.

Back to my invitation to be in my movie. Have you ever found yourself getting ready to file for bankruptcy because you can't pay your kid's hospital bill, and then you say to yourself, "Boy, I sure would like to be in Michael Moore's health care movie!"?

Or, after being turned down for the third time by your HMO for an operation they should be paying for, do you ever think to yourself, "Now THIS travesty should be in that 'Sicko' movie!"?

Or maybe you've just been told that your father is going to have to just, well, die because he can't afford the drugs he needs to get better -- and it's then that you say, "Damn, what did I do with Michael Moore's home number?!"

OK, here's your chance. As you can imagine, we've got the goods on these crooks. All we need now is to put a few of you in the movie and let the world see what the greatest country ever in the history of the universe does to its own people, simply because they have the misfortune of getting sick. Because getting sick, unless you are rich, is a crime -- a crime for which you must pay, sometimes with your own life.

About four hundred years from now, historians will look back at us like we were some sort of barbarians, but for now we're just the laughing stock of the Western world.

So, if you'd like me to know what you've been through with your insurance company, or what it's been like to have no insurance at all, or how the hospitals and doctors wouldn't treat you (or if they did, how they sent you into poverty trying to pay their crazy bills) ...if you have been abused in any way by this sick, greedy, grubby system and it has caused you or your loved ones great sorrow and pain, let me know.

Send me a short, factual account of what has happened to you -- and what IS happening to you right now if you have been unable to get the health care you need. Send it to michael@michaelmoore.com. I will read every single one of them (even if I can't respond to or help everyone, I will be able to bring to light a few of your stories).

Thank you in advance for sharing them with me and trusting me to try and do something about a very corrupt system that simply has to go.

Oh, and if you happen to work for an HMO or a pharmaceutical company or a profit-making hospital and you have simply seen too much abuse of your fellow human beings and can't take it any longer -- and you would like the truth to be told -- please write me at michael@michaelmoore.com. I will protect your privacy and I will tell the world what you are unable to tell. I am looking for a few heroes with a conscience. I know you are out there.

Thank you, all of you, for your help and your continued support through the years. I promise you that with "Sicko" we will do our best to give you not only a great movie, but a chance to bring down this evil empire, once and for all.

In the meantime, stay well. I hear fruits and vegetables help.

Yours,
Michael Moore
michael@michaelmoore.com
www.michaelmoore.com

Now, come on, if you didn't laugh at "...I've found that just dying my hair black and wearing a skort really helps." you are not human!

So you want to be a doctor?

The Cheerful Oncologist has some wise words for you about what it takes...at least to be a good one.

Now read my previous post and then read the CO's #6 requirement:

6. A great doctor has no hidden agenda. He starts each day as a tabula rasa, and does not prejudge anyone based on their look (or smell for that matter), or their attitude, or their beliefs. His job is to serve those who are sick whether he would ever invite them over for a cuppa or not.

Wow, that makes it sound like the CO would serve an obese patient who needed a hip replacement, or a lung cancer patient who smoke for 20 years.

Silly, fiscally irresponsible wabbit.