Thinking Of Health Insurance/Care As A Reward For Working Is An American Problem

As the year 2016 comes to an end, many Americans are worried about the future of the Affordable Care Act (aka, Obamacare). Those who want to see the Act survive the likely oncoming assault by Congress and the new Administration are mobilizing to make their repeal objections heard. They are creating or joining social media groups, attending rallies, organizing events and writing campaigns, supporting related non-profits and calling and writing their elected representatives to voice their opposition to repealing the law.

Even some non-supporters of Obamacare have concerns about a full repeal. Many have insurance because of Obamacare, and they like some of the Act's provisions such as prohibiting the denial of insurance or treatment due to a preexisting medical condition. But then there is the hardcore minority who want full repeal of the law even if it means losing their insurance coverage. And one of the main reasons for their discontent with the law is that it provides free or subsidized coverage to the non-working poor. A
recent article in The Atlantic captured these sentiments when it quoted two central Pennsylvania, Trump voters:

“but everybody's gotta get out there and get a job to help pay for it.”

“I’m worried about people being willing to work hard and stopping being dependent on the government,”
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America's Cruel Health Care System


Most Americans may read British writer, Adrian Gill's last column before his death from cancer and label him a fool or a socialist out to get a last bit of attention. I read it and thought of a man that looked at his options and decided he'd rather die humanely than live a little longer chasing expensive health care services. This notion that people would do anything and pay any amount of money to access medical care is not universally held after all. Some people prefer universal health care even if it means they may wait longer to see a doctor or die a few weeks before their time.

Americans don't have to agree with Mr. Gill that universal health care with all its warts is better than the alternative—American-style health care. But we should have the option of accessing health care at the same base level, instead of the country club system we have now. We are fooling ourselves if we think that America's private system of health care is better than the national system in the United Kingdom. It's not. The system may not provide access to some prescriptions that are available in the U.S., but at least what they do offer is available to everyone. And besides, what's the point of having available prescriptions, if you cannot afford them.

We like to paint the national health insurance programs offered in other industrialized countries as lotteries or death panels, but they are neither, and we know it. They are egalitarian systems where access to health care is not dependent on social class, income, race or geography, and many Americans think it should be. We not only think it should be, but we also make sure that it is by placing poor people in one health care program and signaling to doctors that it's okay if these people get less care or no care at all.

As explained in a
recent article by Virgil Dickson, a survey by the Cancer Support Community concluded that "cancer patients with Medicaid coverage receive poorer quality and less healthcare than those with employer-sponsored, Medicare or other private insurance." Low reimbursement rates and required prior authorization make it hard for these patients to find a cancer doctor who will treat them in a timely fashion. How is this any different from having to wait weeks to see a doctor in the U.K. or Canada?

So, we go on pretending that we have the best health care system in the world. But that depends on how you define "best." By many accounts, it is one of the worst and least humane systems anywhere. As Gill said, there are treatments that allow you to
"stretch more life, a considerable bit of life. More life with your kids, more life with your friends, more life holding hands, more life shared, more life spent on earth—but only if you can pay."

But the cruelest thing about the American health care system is how it is forced upon us by well-funded and well-organized groups who have duped us all into paying for a system that most benefits the wealthy. Let them pay for unbridled health care innovation; the rest of us deserve the option of basic universal health care.

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Rx Drug Price Reform Is Not A Question Of Price Vs. Innovation, But One Of Public Vs. Private Innovation


Last week, Sarah Kliff wrote an interesting piece about why prescription drug prices in America are so high compared to other industrialized countries. The international comparisons aren't new, but the conclusion that Americans have to choose between high drug prices and innovation is interesting. In a nutshell, Sarah reports that America subsidizes the world's prescription drug costs to incentivize investment in drug innovation by pharmaceutical companies and financial investors.

Sarah's article was a timely piece because also last week, the U.S. Congress passed the
21st Century Cures Act. This Act's been in the making for about two years and is the largest health care reform Act since Obamacare. It is nearly 1,000 pages, with a price tag of over $6 billion. And guess what, it includes lots of stuff about health care innovation as well as reducing approval standards for Big Pharma to bring their drugs to market. And just yesterday, the Senate, with a vote of 85-13, ended debate on the bill.

You can read the entire act
here (it's at least worth a quick review).

Most of the Act's provisions, which President Obama will sign in the next few days, are uncontroversial and good. The Act provides more money for drug therapy and cancer research, mental health research and care, state opioid abuse programs and more. But not everyone's happy with the Act, including prominent Democratic Senators, Elizabeth Warren and Bernie Sanders. Both see this bill as a handout to pharmaceutical companies because of the provisions that may allow them to bring products to the market quicker than they can currently and with less attention to drug safety and efficacy.

But even Senators like
Al Franken who approved the bill, lament that it does nothing to address high prescription drug prices. And the total elimination of anything to address prescription drug prices in such a relevant and related piece of legislation is more disheartening than Sarah Kliff's high cost or innovation conclusion.

The 21
st Century Cures Act could easily have been, The Pharmaceutical Innovation And Price Reduction Act. Continue Reading...