Food and Drug Administration--Press Releases

Wednesday, September 3, 2008

We may finally get universal health care

August 11, 2008 New York Times
Can It Happen Here?

The draft Democratic Party platform that was sent out last week puts health care reform front and center. “If one thing came through in the platform hearings,” says the document, “it was that Democrats are united around a commitment to provide every American access to affordable, comprehensive health care.”

Can Democrats deliver on that commitment? In principle, it should be easy. In practice, supporters of health care reform, myself included, will be hanging on by their fingernails until legislation is actually passed.

What’s easy about guaranteed health care for all? For one thing, we know that it’s economically feasible: every wealthy country except the United States already has some form of guaranteed health care. The hazards Americans treat as facts of life — the risk of losing your insurance, the risk that you won’t be able to afford necessary care, the chance that you’ll be financially ruined by medical costs — would be considered unthinkable in any other advanced nation.

The politics of guaranteed care are also easy, at least in one sense: if the Democrats do manage to establish a system of universal coverage, the nation will love it.

I know that’s not what everyone says; some pundits claim that the United States has a uniquely individualistic culture, and that Americans won’t accept any system that makes health care a collective responsibility. Those who say this, however, seem to forget that we already have a program — you may have heard of it — called Medicare. It’s a program that collects money from every worker’s paycheck and uses it to pay the medical bills of everyone 65 and older. And it’s immensely popular.

There’s every reason to believe that a program that extends universal coverage to the nonelderly would soon become equally popular. Consider the case of Massachusetts, which passed a state-level plan for universal coverage two years ago.

The Massachusetts plan has come in for a lot of criticism. It includes individual mandates — that is, people are required to buy coverage, even if they’d prefer to take their chances. And its costs are running much higher than expected, mainly because it turns out that there were more people without insurance than anyone realized.

Yet recent polls show overwhelming support for the plan — support that has grown stronger since it went into effect, despite the new system’s teething troubles. Once a system of universal health coverage exists, it seems, people want to keep it.

So why be nervous about the prospects for reform? Because it’s hard to get universal care established in the first place. There are, I’d argue, three big hurdles.

First, the Democrats have to win the election — and win it by enough to face down Republicans, who are still, 42 years after Medicare went into operation, denouncing “socialized medicine.”

Second, they have to overcome the public’s fear of change.

Some health care reformers wanted the Democrats to endorse a single-payer, Medicare-type system for all. On the sheer economic merits, they’re right: single-payer would be more efficient than a system that preserves a role for private insurance companies.

But it’s better to have an imperfect universal health care plan than none at all — and the only way to get a universal health care plan passed soon is to inoculate it against Harry-and-Louise-type claims that people will be forced into plans “designed by government bureaucrats.” So the Democratic platform emphasizes choice, declaring that Americans “should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan.” We’ll see if that’s enough.

The final hurdle facing health care reform is the risk that the next president and Congress will lose focus. There will be many problems crying out for solutions, from a weak economy to foreign policy crises. It will be easy and tempting to put health care on the back burner for a bit — and then forget about it.

So I’m nervous. The history of the pursuit of universal health care in America is one of missed chances, of political opportunities frittered away. Let’s hope that this time is different.

One more thing: if we do get real health care reform, a lot of people will owe a debt of gratitude to none other than John Edwards. When Mr. Edwards dropped out of the presidential race, I credited him with making universal health care a “possible dream for the next administration.” Mr. Edwards’s political career is over — but perhaps he and his family can take some solace from the fact that his party is still trying to make that dream come true.

Saturday, July 26, 2008

Should the Government Provide Free Universal Health Care for All Americans?


It's no secret that health care costs are spiraling out of control in this country. On average, we now spend more per person on health care than both food and housing. Insurance premiums are multiplying much faster than inflation, which prevents economic growth and leaves businesses with less money to give raises or hire more workers. While the quality and availability of medical care in the United States remains among the best in the world, many wonder whether we'd be better off adopting a universal government-controlled health care system like the one used in Canada.
The number of uninsured citizens has grown to over 40 million. Since health care premiums continue to grow at several times the rate of inflation, many businesses are simply choosing to not offer a health plan, or if they do, to pass on more of the cost to employees. Employees facing higher costs themselves are often choosing to go without health coverage. No health insurance doesn't necessarily mean no health care since there are many clinics and services that are free to indigent individuals. However, any costs not covered by insurance must be absorbed by all the rest of us, which means even higher premiums.

Health care has become increasingly unaffordable for businesses and individuals. Businesses and individuals that choose to keep their health plans still must pay a much higher amount. Remember, businesses only have a certain amount of money they can spend on labor. If they must spend more on health insurance premiums, they will have less money to spend on raises, new hires, investment, and so on. Individuals who must pay more for premiums have less money to spend on rent, food, and consumer goods; in other words, less money is pumped back into the economy. Thus, health care prevents the country from making a robust economic recovery. A simpler government-controlled system that reduces costs would go a long way in helping that recovery.

We can eliminate wasteful inefficiencies such as duplicate paper work, claim approval, insurance submission, etc. Think back to all the times in your life you've had to fill out a medical history, answering the same questions over and over. Think about all the insurance paperwork you've had to fill out and submit. Our current health care system generates an enormous amount of overhead. Every time we go to the doctor, a claim must be submitted, an approval department has to go over the claim, checks have to be mailed, patients are sent co-pay bills, and so on. The thing that's especially wasteful is that each doctor's office usually maintains their own record-keeping system. A universal healthcare plan would allow us to build one centralized system. There would be no need for maintaining insurance information or wasting time submitting claims. The work savings in the banking and postal areas alone would be worth billions every year.

We can develop a centralized national database which makes diagnosis and treatment easier for doctors. Most doctor's offices maintain a separate record-keeping system. This is why you always have to fill out a lengthy health history whenever you go to a new physician. This is a problem for several reasons. First of all, it's wasteful of both time and money. Second of all, patients may lie, forget, or do a poor job of explaining past medical problems. Doctors need accurate information to make a proper diagnosis. Last of all, separate systems means we have a tougher time analyzing data at a national level. For example, are incidents of a certain disease dropping? How often is a certain illness associated with a specific set of symptoms? A centralized national system would allow us to do data analysis that we never dreamed possible, leading to medical advances and increased diagnosis efficiency. The main argument against a centralized database is that certain insurance providers may deny coverage if they find certain past medical problems. However, if the government is paying for everything, that should never be a problem.

Medical professionals can concentrate on healing the patient rather than on insurance procedures, malpractice liability, etc. Doctors have to take classes now simply to understand all the insurance plans out there; they are often restricted by insurance practices, such as what tests can be ordered. Doctors must practice defensive medicine to avoid getting sued. Some physicians are even leaving the profession rather than deal with all these non-medical headaches. A simplified universal health system would allow doctors, nurses, and other medical professions to simply focus on doing what's best for the patient. Medicine is a complex enough subject as it is. Our current system just adds to an already mentally-draining profession.

Free medical services would encourage patients to practice preventive medicine and inquire about problems early when treatment will be light; currently, patients often avoid physicals and other preventive measures because of the costs. Because many people are uninsured and those that do have insurance face high deductibles, Americans often forego doctor visits for minor health problems or for preventive medicine. Thus, health problems that could be caught at an early stage or prevented altogether become major illnesses. Things like routine physicals, mammograms, and HIV tests could prevent major problems. This not only affects the health of the patient but the overall cost of the system, since preventive medicine costs only a small fraction of a full blown disease. A government-provided system would remove the disincentive patients have for visiting a medical professional.

There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care? Quick, try to think of one government office that runs efficiently. The Department of Transportation? Social Security Administration? Department of Education? There isn't a single government office that squeezes efficiency out of every dollar the way the private sector can. We've all heard stories of government waste such as million-dollar cow flatulence studies or the Pentagon's 14 billion dollar Bradley design project that resulted in a vehicle which when struck by a mortar produced a gas that killed every man inside. How about the U.S. income tax system? When originally implemented, it collected 1 percent from the highest income citizens. Look at it today. A few years back to government published a "Tax Simplification Guide", and the guide itself was over 1,000 pages long! This is what happens when politicians mess with something that should be simple. Think about the Department of Motor Vehicles. This isn't rocket science--they have to keep track of licenses and basic database information for state residents. However, the costs to support the department are enormous, and when was the last time you went to the DMV and didn't have to stand in a long line? If it can't handle things this simple, how can we expect the government to handle all the complex nuances of the medical system?

"Free" health care isn't really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc. There's an entitlement mentality in this country that believes the government should give us a number of benefits such as "free" health care. But the government must pay for this somehow. What good would it do to wipe out a few hundred dollars of monthly health insurance premiums if our taxes go up by that much or more? If we have to cut AIDS research or education spending, is it worth it?

Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness. Government workers have fewer incentives to do well. They have a set hourly schedule, cost-of-living raises, and few promotion opportunities. Compare this to private sector workers who can receive large raises, earn promotions, and work overtime. Government workers have iron-clad job security; private sector workers must always worry about keeping their jobs, and private businesses must always worry about cutting costs enough to survive.

Government-controlled health care would lead to a decrease in patient flexibility. At first glance, it would appear universal health care would increase flexibility. After all, if government paid for everything under one plan, you could in theory go to any doctor. However, some controls are going to have to be put in to keep costs from exploding. For example, would "elective" surgeries such as breast implants, wart removal, hair restoration, and lasik eye surgery be covered? Then you may say, that's easy, make patients pay for elective surgery. Although some procedures are obviously not needed, who decides what is elective and what is required? What about a breast reduction for back problems? What about a hysterectomy for fibroid problems? What about a nose job to fix a septum problem caused in an accident? Whenever you have government control of something, you have one item added to the equation that will most definitely screw things up--politics. Suddenly, every medical procedure and situation is going to come down to a political battle. The compromises that result will put in controls that limit patient options. The universal system in Canada forces patients to wait over 6 months for a routine pap smear. Canada residents will often go to the U.S. or offer additional money to get their health care needs taken care of.

Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now. Co-pays and deductibles were put in place because there are medical problems that are more minor annoyances than anything else. Sure, it would be nice if we had the medical staff and resources to treat every ache and pain experienced by an American, but we don't. For example, what if a patient is having trouble sleeping? What if a patient has a minor cold, flu, or headache? There are scores of problems that we wouldn't go to a doctor to solve if we had to pay for it; however, if everything is free, why not go? The result is that doctors must spend more time on non-critical care, and the patients that really need immediate help must wait. In fact, for a number of problems, it's better if no medical care is given whatsoever. The body's immune system is designed to fight off infections and other illnesses. It becomes stronger when it can fight things off on its own. Treating the symptoms can prolong the underlying problem, in addition to the societal side effects such as the growing antibiotic resistance of certain infections.

Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance. While uninsured Americans are a problem in regards to total system cost, it doesn't mean health care isn't available. This issue shouldn't be as emotional since there are plenty of government and private medical practices designed to help the uninsured. It is illegal to refuse emergency treatment, even if the patient is an illegal immigrant.

Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care. When government controls things, politics always seep into the decision-making. Steps will have to be taken to keep costs under control. Rules will be put in place as to when doctors can perform certain expensive tests or when drugs can be given. Insurance companies are already tying the hands of doctors somewhat. Government influence will only make things worse, leading to decreased doctor flexibility and poor patient care.

Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc. Universal health care means the costs will be spread to all Americans, regardless of your health or your need for medical care, which is fundamentally unfair. Your health is greatly determined by your lifestyle. Those who exercise, eat right, don't smoke, don't drink, etc. have far fewer health problems than the smoking couch potatoes. Some healthy people don't even feel the need for health insurance since they never go to the doctor. Why should we punish those that live a healthy lifestyle and reward the ones who don't?

A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation. A universal health plan means the entire health insurance industry would be unnecessary. All companies in that area would have to go out of business, meaning all people employed in the industry would be out of work. A number of hospital record clerks that dealt with insurance would also be out of work. A number of these unemployed would be able to get jobs in the new government bureaucracy, but it would still be a long, painful transition. We'd also have to once again go through a whole new round of patient record creation and database construction, which would cost huge amounts of both time and money.

Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession. Government jobs currently have statute-mandated salaries and civil service tests required for getting hired. There isn't a lot of flexibility built in to reward the best performing workers. Imagine how this would limit the options of medical professionals. Doctors who attract scores of patients and do the best work would likely be paid the same as those that perform poorly and drive patients away. The private practice options and flexibility of specialties is one of things that attracts students to the profession. If you take that away, you may discourage would-be students from putting themselves through the torture of medical school and residency.

Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits. When you're dealing with any business, for example a privately-funded hospital, if an employee negligently causes an injury, the employer is ultimately liable in a lawsuit. If government funds all health care, that would mean the U.S. government, an organization with enormous amounts of cash at its disposal, would be ultimately responsible for the mistakes of health care workers. Whether or not a doctor has made a mistake, he or she is always a target for frivolous lawsuits by money-hungry lawyers & clients that smell deep pockets. Even if the health care quality is the same as in a government-funded system, the level of lawsuits is likely to increase simply because attorneys know the government has the money to make settlements and massive payouts. Try to imagine potential punitive damages alone. When the government has the ability to spend several trillion dollars per year, how much will a jury be willing to give a wronged individual who is feeble, disfigured, or dying?

Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms. With government-paid health care, any risky or healthy lifestyle will raise the dollar cost to society. Thus, politicians will be in a strong position to pass more "sin" taxes on things like alcohol, high-fat food, smoking, etc. They could ban trans fat, limit msg, eliminate high-fructose corn syrup, and so on. For some health nuts, this may sound like a good thing. But pretty soon, people will find they no longer have the option to enjoy their favorite foods, even in moderation, or alternatively, the cost of the items will be sky high. Also, it just gives the government yet another method of controlling our lives, further eroding the very definition of America, Land of the Free.

Like social security, any government benefit eventually is taken as a "right" by the public, meaning that it's politically near impossible to remove or curtail it later on when costs get out of control. Social security was originally put in place to help seniors live the last few years of their lives; however, the retirement age of 65 was set when average life spans were dramactically shorter. Now that people are regular living into their 90s or longer, costs are skyrocketing out of control, making the program unsustainable. Despite the fact that all politicians know the system is heading for bankruptcy in a couple decades, no one is rushing to fix it. When President Bush tried to re-structure it with private accounts, the Democrats ran a scare campaign about Bush's intention to "take away your social security". Even though he promised no change in benefits, the fact that he was proposing change at all was enough to kill the effort, despite the fact that Democrats offered zero alternative plan to fix it. Despite Republican control of the presidency and both houses, Bush was not even close to having the political support to fix something that has to be fixed ASAP; politicians simply didn't want to risk their re-elections. The same pattern is true with virtually all government spending programs. Do you think politicians will ever be able to cut education spending or unemployment insurance?...Only if they have a political death wish. In time, the same would be true of universal health care spending. As costs skyrocket because of government inefficiency and an aging population, politicians will never be able to re-structure the system, remove benefits, or put private practice options back in the system....that is, unless they want to give up hope of re-election. With record debt levels already in place, we can't afford to put in another "untouchable" spending program, especially one with the capacity to easily pass defense and social security in cost.

Obama Plan for a Healthy America

“We now face an opportunity — and an obligation — to turn the page on the failed politics of yesterday's health care debates… My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”

— Barack Obama, Speech in Iowa City, IA, May 29, 2007

Saturday, July 12, 2008

Universal health : Ideal Health care

Universal Health Care: The Ideal Health Care
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There are various theories floating around about health care at the moment. Each and every single one has an ideal attached to it, in which every single individual gets accessible health care whenever they need it at an affordable rate. However, very few of them actually put a plan into action that dictates how the ideal would be achieved. One of those that does is universal health care. It does imply that every person in the world should have access to basic health care, which would raise the health level of the world. Universal health care also refuses to take factors like age, location and status into account. However, it is slightly optimistic considering the third world does not even have access to basic utilities yet.

However, the idea of universal health care is backed by several ideas as to how it can be carried out. Universal health care should in fact be administered via a series of insurance policies that are controlled by the government of any given time. In this way, universal health care will give everyone access to health care whenever they need it at very little personal cost, thus ensuring that every single person can actually call a doctor out whenever necessary. Universal health care may also be administered through a series of clinics and other medical establishments to ensure that lower class individuals that cannot afford private health care can just drop by.

Universal health care could actually be administered by any number of schemes in effect, but at least there are ideas in place to ensure that it could work if governments in power at the moment changed their policies. The ideal behind universal health care are valid as preventative as well as remedial because it would actually encourage everyone to have regular health checks to ensure that they stay in the best of health. This would include testing g younger people for STIs and monitoring their progress as they grow up via a series of vaccinations against diseases that may cut their lives short. Similarly, under universal health care would actually allow older people to be tested for ailments like diabetes on a regular basis too. For more info see on United Health Care Insurance.

Universal health care could provide treatment for every individual, whether they could afford it on paper or not. This would provide great positives for all of humanity and make for a much better world. There is so much more resting on universal health care than just health care alone. If we want a better world, we have to take the chance whenever we can. Universal is one of the chances we should take.

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Sunday, July 6, 2008