Who Will Be In Congress in 2020?

Did you know that the Federal Employees Health Benefits (FEHB) didn’t cover contraception until 1998—decades after most Americans had accepted “the Pill”?  FEHB did cover other prescription drugs and devices, but not birth control. Congress just didn’t approve. 

The government does not provide insurance to federal employees directly. It contracts with hundreds of private sector insurers to provide a menu of policies—some good, some not so good.. But Congress does lay done some rules.  As Naomi notes in her post below the plans cannot pay for abortions—even though many other private sector plans do provide coverage.

This is one reason why I like the idea of a hybrid health care system, private sector alternatives competing with Medicare E (for everyone).

Are Views On Abortion Changing?

For the first time since 1995, it appears that Americans who describe themselves as “pro-life”  outnumber those who call themselves “pro-choice”  At least, that’s what a recent Gallup poll suggests. Gallup has been asking the question for fourteen years, and this time around 51% of those polled identified themselves as “pro-life” versus 42% who said they were “pro-choice.” These findings came out just days before President Obama delivered a controversial speech at the University of Notre Dame’s commencement where he reiterated his support for reproductive choice, while asking that both sides of the abortion issue establish common ground and “make sure that all of our health care policies are grounded in clear ethics and sound science, as well as respect for the equality of women."

How those stirring words will translate into policy remains to be seen.  As Sonia Sotomayor, Obama’s choice for the Supreme Court, faces confirmation hearings, the country is sure to be consumed once again by abortion politics as legislators scrutinize each and every one of her judicial decisions.

Meanwhile, the Gallup poll is not the only sign that Americans remain very conflicted about abortion and how it should be regulated.  A week after Gallup’s findings were announced, CNN and Opinion Research Corp. framed the issue a different way by focusing on Roe versus Wade:

Truth Squad: Spotlight on Dick Morris (Remember Him?)

HealthBeat readers who responded to my invitation to join the “truth squad” have sent in a number of superb examples of how the opponents of reform distort the truth. I’m starting with a piece by Dick Morris because it includes some of the most common false claims that are clouding the debate on healthcare reform. (Hat Tip to reader Harry Wetzler for calling my attention to Morris’ column.) In future posts, I’ll be spotlighting other, attacks on reform. Please keep the submissions coming. The only way to defeat campaigns of disinformation is to be as tireless as they are. 

Very likely, the name “Dick Morris” sounds familiar. This is because Morris was Bill Clinton’s campaign manager when Clinton ran for re-election in 1996—until the papers broke the news that Morris had allowed a prostitute to listen in on his conversations with the president on more than one occasion.  (The morning after, even the hooker raised an eyebrow: “Someone as intelligent as he is should have kept his lip buttoned when he unzipped his pants,” she told the Washington Post. “I mean, how can you maneuver worlds, and he can't even control what he's doing in his own room with a paid lady?")  The New York Times reported that Morris also gave the prostitute sneak previews of speeches that First Lady Hillary Rodham Clinton would be delivering.

Morris was known as a “spin doctor,” and not well liked by some of Clinton’s advisers. Former White House Chief of staff Leon Panetta later blamed Morris for advising Bill Clinton to lie about Monica Lewinsky: “All Clinton needed to do was to tell the truth at once, instead of listening to the advice of his double-crossing ex-consultant Dick Morrris,” Panetta told a reporter. “It was Morris, immediately after the scandal exploded a year ago, who explained to Clinton that America would never forgive him for his escapades with Monica. I had warned Clinton from the beginning about the bad influence of that man, who cares only about opinion polls, bends with the wind of the moment, and doesn't give a damn about moral and is still on the scene political principles."

Dr. Atul Gawande on the “Fight for the Soul of American Medicine”

McAllen, Texas likes to think of itself as the Square Dance Capital of the World. McAllen doesn’t like to think of itself as the home of the most over-priced health care in the U.S..

Yet it is, as surgeon/author Dr. Atul Gawande reports in the June 1, issue of The New Yorker. (Thanks to reader Jim Jaffe for calling my attention to the article when it first hit the blogosphere)

McAllen seems an unlikely spot for Gold-Coast Medicine.  “Lonesome Dove was set around here,” Gawande writes.  “McAllen is in Hidalgo County, which has the lowest household income in the country.”  Nevertheless, if you have the patience to pore over nationwide Medicare data, you’ll discover that “only Miami—which has much higher labor and living costs—spends more [than McAllen] per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average,” Gawande notes. “The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.”

To All Readers—Let’s Form a “Truth Squad”

As the campaign against health care reform heats up, I would like to ask for your help.

As I have suggested in earlier posts here and here, those who would defeat reform show little respect for the truth.  In their effort to confuse and frighten their audience, they will continue to spread misinformation and disinformation.  They will rely on “big lies” –lies so colossal that people will believe that they must be true. (Who would dare make up such a whopper and repeat it on television, online or in print?)

The only way to combat a deliberate campaign of misinformation is to expose the lies —again and again. I plan to use this blog to do just that. But I need your help. If you read or hear someone assert something about health care reform that you know isn’t true –or suspect isn’t true—please send the quote, citing who said it, when and where, to maggiemahar@yahoo.com. If you have evidence that debunks the false claim, send that too. If you don’t, I can probably find the facts needed to set the record straight.

Beyond Wikipedia

No surprise, these days more and more doctors are searching online for medical information. What is surprising, however, is that in a recent study, nearly 50% of physicians indicated that they use Wikipedia—the open-access encyclopedia that allows anyone to edit articles—as their source for medical information.

The study, conducted by Manhattan Research, and reported on here found that although physicians were visiting Wikipedia for medical conditions and other health information, only about 10% of the 1,900 physicians surveyed created new posts or edited existing posts on the encyclopedia.

“The number of physicians turning to Wikipedia for medical information has doubled in the past year alone,’ said Meredith Abreu Ressi, vice president of research at Manhattan Research. ‘Physicians, just like consumers, are heavily search engine reliant, and often Wikipedia results are what come up in the top of the organic results.’

Abreu Ressi noted the concern about accuracy regarding Wikipedia, which allows its users to create content for the site essentially without restriction. Articles are subject to perpetual editing by Wikipedia's readers. Inevitably, false information sometimes slips through the cracks.”

Wikipedia is not a reliable source of medical information for doctors.

Demystifying Death: Compassionate, Practical Advice for Patients and Families

Did you know that when there is “no hope of recovery” there are still things for the patient to hope for?

Did you know that a “living will” is not a legal document in New York State or Massachusetts?  

Did you know that environmentalists have created nature preserves where you can be buried?  “What we are doing is basically land conservation,” says Dr. Billy Campbell, who has created a preserve along Ramsey Creek in South Carolina. “By setting aside woods for natural burials, we protect it from development. At the same time, I think we put death in its rightful place, as part of the cycle of life. Our burials honor the idea of ‘dust to dust.’”  Ramsey Creek is just one place where families can arrange “green burials.”

These are a few of the things I learned yesterday at a “Leadership Connection” lunch for women in business, politics and the non-profit sector.  There, New York Times health editor Jane Brody spoke about her new book : Jane Brody’s Guide to the Great Beyond: A Practical Primer to Help You and Your Loved Ones Prepare, Medically, Legally, and Emotionally for the End of Life.

He Said What?

When Brandeis professor Stuart Altman appeared before the Senate Finance Committee last week, he acknowledged, “I’m reluctant to mention it--- but,  why waste money on in-depth treatment for people who won’t live long anyway? Better to warehouse them and save the resources for the young.”

At least, that’s what hotair.com says Altman said.  

Writing on “Hot Air,” Ed Morrissey takes his interpretation of Altman’s testimony and runs with it: “What happens when the state controls all the resources? New resources do not develop, and the government winds up rationing care based on its own priorities, and not the priorities of the patients or caregivers. . . . Anyone whose value does not show a positive “cost-benefit” ratio to the state will also likely wind up without the kind of care necessary to stay alive and healthy. . . . We’ve essentially returned to the eugenics arguments of the early 20th century, a dark period of human history we should be avoiding rather than embracing on the floor of the Senate.”

Torture: “Cherchez la Femme”

            

               Torture may not seem a HealthBeat topic. But I’m willing to declare torture a medical problem. (Whether the victim or the torturer suffers from the greater problem is open to debate).            

            As regular readers know, I could go on at length.  But let me just say this. Why has the media focused on Nancy Pelosi?  Was she the Secretary of Defense at the time? Was she the director of the CIA?  Was she the president?  Could she possibly have  been  responsible for authorizing the torture?

         No. 

         Did she receive information from those responsible that should have told her that the U.S was engaging in inhumane behavior? I don’t know. But Pelosi is just one of many members of Congress who may well have known what was going on, and given the Bush administration’s stubborn refusal to share power with Congress  I doubt any of them could have stopped it.

       More importantly, as Washington Post's Greg Sargent pointed out yesterday, “Nancy Pelosi's claims about what she was told and when about torture are getting far more intense media scrutiny than the CIA's claims are. Simple fairness demands that both side’s claims get treated with a similar level of skepticism,” Sargent continues. “And they’re not. Sargent also notes that most news reports omit the fact that two other senior Democrats--Bob Graham and Jay Rockefeller--have publicly claimed that the CIA didn’t brief them about the use of torture in the manner the agency has claimed.

        Why, then, the focus on Pelosi?  The answer: “Cherchez la Femme”

       “Find the woman” is based on the Medieval belief that women are the root of all evil.  In Eden, Eve committed the first sin by succumbing to Satan and eating the apple. (Or at least that is what Genesis tells us.)  In the Middle Ages, religious scholars took this as a justification for primal misogyny.  More recently, the 1854 book The Mohicans of Paris by Alexandre Dumas warned: Il y a une femme dans toutes les affaires; aussitôt qu'on me fait un rapport, je dis: Cherchez la femme (There is a woman in every case; as soon as they bring me a report, I say, 'Look for the woman')

The phrase then became a truism for both the detective novel and film noir: no matter what the problem, a dame is probably at the bottom of it.

 Little wonder then, that when a great crime has been committed, many still believe that here is only one solution: Cherchez la Femme.

Thus, the media’s “expose” of torture zeroes in on Nancy Pelosi—distracting everyone from who in the Bush administration knew about the torture, when they knew about it, and who authorized it.

Money-Driven Medicine—N.Y. Premiere of Film, June 11

At last, Money-Driven Medicine is finished.  This  90-minute documentary was produced by Alex Gibney, best known for his 2005 film, Enron: The Smartest Guys in the Room  and his 2007 Academy Award Winning documentary, Taxi to the Dark Side.

The film was directed by Andy Fredericks, and is based on my book, Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper Collins).

The Century Foundation and the New York Society for Ethical Culture are co-hosting the New York premiere on June11,  7p.m.  at the New York Society for Ethical Culture, 2 West 64th Street at Central Park West. Doors open at 6:30.  Admission is free.  If you’re planning to attend, please RSVP  Loretta Ahlrich, ahlrich@tcf.org  or (212) 452-7722 so that we can have a rough idea of how many people will be coming.