Thursday, August 13, 2009

A Little Self Responsibility, Please

I wouldn't go as far as comic/satirist Bill Maher saying the American public is stupid. Rather, a large percentage is gullible as we have seen time and again on the town hall video clips Congressmen are conducting this August recess.

Wrote Maher in The Huffington Post: I’m the bad guy for saying it’s a stupid country, yet polls show that a majority of Americans cannot name a single branch of government, or explain what the Bill of Rights is. Twenty-four percent could not name the country America fought in the Revolutionary War. More than two-thirds of Americans don’t know what’s in Roe v. Wade. Two-thirds don’t know what the Food and Drug Administration does.

What I see in what is wistfully described as a health care reform debate is a bunch of angry old white men and women passionately defending the Medicare benefits they believe they are entitled. Your guess is as good as mine how they reached that conclusion.

One piece of evidence is a draft bill in Congress that would reduce $2 billion in Medicare "savings" and shift it to MediCaid.

Not to worry, soothes President Barack Obama at his Portsmouth, New Hampshire, hearing earlier this week. The AARP endorses the administration's plans for health reform, he claimed.


The president was politely repudiated by AARP executives, saying the 40-million members have not judged the plans as of yet but its top brass is working closely on the issue with the White House.

If you can't believe Obama, whom do you trust? I would offer no one, based on the fragmentation of the proposed legislation now in both houses of Congress.

I would take this a step further. I wouldn't trust the outcome of the AARP member polling if the sentiment is close to that we have seen at the town hall meetings. These are the activists, the loud mouths, the ones driven by fear and passion. They are the ones responding to the polls in greater numbers than those whose minds are still open or undecided. Old people are leery of change and are driven to oppose something just like the rest of the population than rising up to challenge the world of health care delivery as we know it.

I'll take it another step. One of the cornerstones of the Obama health reform plan is to offer no copay for preventive medicine screening. That sounds good but will people who will benefit most -- the young and indestructible -- actually partake. The verdict is inconclusive.

It goes to the heart of the problem. That is the American people must take responsibility for their own welfare and stop passing the costs onto others whether covered by government or private insurance.

The health insurance industry is opposed saying some health experts caution that not all preventive services have been proven to save lives, and even fewer can limit health spending. Kaiser Health Plan advocates report:

"In the field of prevention, few areas save a lot of lives and money," Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health, said in an interview. While most childhood immunizations and smoking cessation programs are cost-efficient, the answer is less clear for screenings for breast and cervical cancer, he said. He stressed that screening tests such as these can still be worthwhile in saving lives, even though they may not save money over the long run.

It points out a Congressional Budget Office analysis of the House bill that the removal of copayments and deductibles will cost Medicare $2.8 billion and Medicaid $7.1 billion over the next 10 years.

Under the House plan, patients could receive free an initial physical exam, diabetes screening tests, blood tests for heart disease, mammography, pap smears, bone mass measurements, flu and pneumonia vaccines, screenings for colon and rectal cancer, and ultrasound screenings for abdominal aortic aneurysm.

The Kaiser report did have the honesty of reporting a Brown University study that the number of women receiving free mammograms fell 8% when they had to pay $12 for screening. Some insurance carriers such as Aetna introduced plans for small employers this year for no copay preventive routine physicals, vision and gynecological exams in addition to well-child visits.

America’s Health Insurance Plans, the industry’s top lobbying group, opposes the mandate. Spokesman Robert Zirkelbach cited the need to give insurers flexibility in designing benefit packages.

With child obesity and juvenile diabetes becoming close to epidemic proportions, even the most jaundiced observer would agree that early childhood screening and prevention would save billions of dollars in disease-related heart, circulatory, lung and kidney ailments sometimes requiring amputation of one's feet.

But these so-called free preventive programs don't do a damned bit of good of the patient doesn't take responsibility for himself.

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