Posts Tagged ‘health care reform’

Steamrolled!

September 30, 2009

Yep – the Congenital Heart Futures Act is getting steamrolled, and there isn’t a heck of a lot we can do about it.

Health Care Reform is pretty much THE topic of discussion in the halls of Congress these days. Nothing else matters, everything else is off the table until the Health Care issue is settled. I don’t know enough about Congressional procedure to know if a bill “expires”, so I don’t know if we’ll have to trek back to Washington and lobby for it again. My contact person who would know these things is on vacation; she deserves a break, her organization just finished a major meeting and lobbying effort of their own. Like the McDonald’s advertisment, she deserves a break today!

But if it turns out that we have to get in there and do it again, count me in! And I’ll take my laptop with me and bring Funky Heart readers along for the ride. And hopefully we’ll answer the question, How many funky hearts does it take to move Congress?

But what I am worried about is the aftermath of the Health Care Reform debate. Battle lines are being drawn and it looks like both sides are getting ready for a fight. I’m concerned that after the reform effort the atmosphere  is going to be so toxic, that nothing even remotely connected to health care will seriously be considered. And that could leave us out in the cold – for quite a while. And we don’t need that to happen.

But that’s why mechanics explore junkyards – sometimes a part borrowed from that wrecked clunker is exactly what you need to rebuild that dream car and make it run. Our surgeons cut us open, looked at our defective hearts, and figured out a way to made them work correctly. It ain’t perfect, and some of us seem to be held together with “baling wire and  bubble gum” – but we’re still going!

We’ve been down this road before, and if we have to, we’ll piece something together and make it work!

This won’t work

September 1, 2009

Insureblog has an analysis of a U.S. News and World Report article about the pending health care legislation, HR 3200. It’s scary. Reading the U.S. News article, we learn that health care “reform” isn’t reform… it’s almost a tax. The cost of insurance for a 25 year old healthy man, for example, can be purchased now for US $500 to US $600 per year. Under the new plan, his premium is going to be closer to US $4,000 per year.

Holy cow.

Insureblog looks at the problem from a different angle: “Health care for all” includes insuring those of us with pre-existing conditions and not dropping us when we get sick. Don’t be fooled – that’s going to be expensive. Think double premiums, and that is just a start , Insureblog reports.

But we aren’t talking about that – everything else is, trying to distract us from a basic fact. Rather than trying to demonize doctors, we need to stop and think about something that is very important: The United States is broke.

This is crazy. Did the Administration and the members of Congress seriously think that they could insure everyone in the country and it would cost less than what is being paid now? What planet does that happen on?

Spending > Income = GAME OVER. Think about that for a while.

Hearts aren’t White

August 6, 2009

Here’s an article abstract from a recent issue of the journal Circulation: Cardiovascular Quality and Outcomes that compares prenatal diagnosis of Congenital Heart Disease (CHD) with socioeconomic position, their level of insurance, and even their race. Race was not a direct factor, but socioeconomic position and insurance was… the better off you are, the better the chances of a CHD being picked up during a prenatal ultrasound.

Which brings me to a subject that I’ve been wanting to discuss for a while but never felt comfortable approaching: By far, most of the CHD Survivors I have had the honor of meeting are Caucasian. And I don’t mean just more than 50%, the number has to be close to 85% and possibly higher.

One of the biggest points of Health Care Reform, in my opinion, should be equalizing care. This probably falls under the umbrella of making sure everyone is covered, but I have never heard the point expressed as I see it: A heart defect, we know, strikes 1 out of every 125 live births. It doesn’t care if you are White, Black, Asian, Native American,  rich or poor… if you are number 125, you’re it. And your parents better be able to generate a lot of resources because your treatment is going to be expensive. Not just right after birth, but throughout your lifetime.

We do need to control healthcare costs and we do need to make sure everyone is covered, and we need to make sure that everyone has a chance to get the medical care they need, no matter if they are born with a disease or acquire it later in life. Because hearts don’t have a race.

And every heart deserves to live a lifetime.

Fight for your rights

July 21, 2009

An article abstract I found this morning seems to fit in with our previous post. This report notes that from 1998 to 2005, the number of adults with a Congenital Heart Defect (CHD) being hospitalized rose 67%. Thankfully, the inpatient mortality is going down, but the cost of care is going up – to an estimated total of 3.1 Billion dollars in 2005.

$3,100,000,000… I think it might be time to take up a collection!

Obviously, medical technology is working – heart defects are not the death sentence that they once were. We can almost be considered a Chronic Illness: with proper management, we can live full lives.

In a way, it’s a good problem to have: Even though we’re still fragile, more of us are leaving the hospital and going back to our lives. But Heart Defects have never been recognized as a Chronic Illness. Even though CHDs are the number one birth defect in the United States, it’s still seen as “one of those sad things that happen every now and then.”

If you want something done right, you need to do it yourself. That’s why it’s up to those of us with Heart Defects to get the Congenital Heart Futures Act out of committee and passed. It has been laid aside as the Health Care Reform debate rages; so it’s up to us to get it back to the forefront. We may have to wait until the Reform debate plays out, which means that the bill could die in committee. If that happens, we have to reset, reload, and try again. Make your plans – we could be heading back to Washington. But if that is what it takes, we’ve got to be willing to get back in there and fight for it.

Chronic Care in a new Healthcare System

January 25, 2009

Today’s entry is going to walk a fine line. I promised myself when I started this blog that I would not get political: after all, a Congenital Heart Defect develops long before a person’s political philosophy does. But there is an ill wind blowing…

Laurie Edwards over at A Chronic Dose has a great post on the need for chronic illness care. A healthy person’s need for usually has a finite beginning and ending date. They fall in the bathtub, for example, and break their leg. There’s a need for surgery and rehab and pain medication, but under normal circumstances that will end. The doctor will say that your leg looks good, there is no need to come back unless there is a problem. Chronic care patients, on the other hand, make continual trips to the well. Medications, treatments, supplies, the occasional hospitalization – the costs keep coming.

Lots of ideas are being tossed around for national health care reform. Kevin, MD contends that Medicare for all isn’t the answer. One reason, according to the Happy Hospitalist, is that FREE=MORE. Put a free soda pop dispenser on every floor of your hospital, and your customer satisfaction survey numbers go up! Dr. Wes agrees with Happy – give a little, and people tend to take a lot.

The Covert Rationing Blog thinks the decision has already been made, and we’ll eventually become a single payer system. The real fight is going to be if citizens are allowed to spend their own money to pursue healthcare. Apparently the answer is “no”… the State of Maryland is already considering  steps to make Private Pay illegal. Kevin, MD even goes so far as to call it “Health Care prohibition.”

When you are in control of the wallet, you get to choose what the money is spent on. Think about it – your child wants a piece of bubble gum, he comes running to you to ask for a quarter for the bubble gum machine. If you don’t want your child to have gum, you say no.

Mr. Government Health Man? Sir, I need to have my pacemaker replaced, the battery is running dry. Can I have a new one?

No, I’m afraid not. You see the doctor six times a year and you take 15 different medications. You’re draining the system. I’m sorry.

I’m draining the system? Mr. Government Health Man, Bill went to the doctor for pain in his ankle last year, and he had a bone scan, and an MRI, and X-Rays, just to prove that he had twisted it! I need my pacemaker, why don’t you go yell at Bill?

Obviously, these last paragraphs are an exaggeration. And I wish I was smart enough to say “This is the way you should reform health care…” but I have no idea where to even start.

But I know what scares me.

Hey doc, where are you?

December 22, 2008

You enter a long, difficult, and expensive (very expensive!) educational program. During this educational program, you choose from one of two options: Option A means that you will serve a lot of clients, but you will only be able to charge each one of them $100. With Option B, you serve fewer clients, but will be allowed to charge each client $500. Which option would you choose?

The “educational program”, if you haven’t figured it out already,  is a very simplified version of medical school. Option B are the doctors who choose to specialize: Cardiologists, Neurosurgeons, Orthopedics, etc. Option A are the doctors who choose Primary Care.

Less work and more money? It’s a wonder that anyone chooses Primary Care. But these doctors are the people we usually see first. Medicine’s “Jack of all Trades”, they seem to know a little bit about everything. And with our insurance companies almost demanding a Referral Form before you can see a specialist, these doctors are usually the ones who can get that process started. The problem is – and it is a major problem – there are fewer and fewer of these doctors.

One of the reasons there is more specialization is financial: all those medical school student loans have to be paid back, you know. Two percent of medical school graduates choose primary care, and the debt incurred by a young doctor could be one of the reasons why. Beverly Hills may be full of  “swimmin’ pools and movie stars”, but the Primary Care doctors there are up to their ears in debt.

It’s almost as if these doctors are just disappearing into thin air. The crisis is already building in Idaho. And if you think the Primary Care shortage is confined to rural areas, think again:  A Primary Care shortage is overwhelming Massachusetts. Statewide health care reform increased the number of insured, as intended, but now those new patients are looking for a doctor. One hospital reports that 1600 people are on the waiting list and it takes about four months to get an appointment. Four months is a bit long, don’t you think?

When you think “Health Care Reform”, most Americans usually think of Universal Healthcare and/or various  payment options. But that’s only a part of it. President-Elect Obama’s proposed health care plan will increase the workload of our Primary Care Physicans. Where will we find these doctors?