Insurance Reform not Healthcare Reform

How much do you pay for your total healthcare? I've been asking that question to many of our customers, curious if the average American cost I researched for my Economics 201 class was true. Instead of getting numbers, I have been getting sad stories, and scary questions, so I feel it's time to expose my opinion, I've been carefully keeping to myself lately.

I have opinions for and against the nationalized system, and I'm not naive enough to believe that the insurance corporations are not writing this bill via the leftwing in Congress. Growing up near D.C., and having an uncle who was an Economic Lawyer for the Congressional Ways and Means Committee, I learned at an early age that both sides are bought and paid for by corporations. This is why I am a registered Independent.

My dad, a retired pharmacist, has long believed we needed a nationalized healthcare system for decades. I know of many physicians who believe the same, but the problem to change over to this system breaks down to Economics. The biggest question of all should be how do you reimburse all the doctors, pharmacists, nurses, etc. for their HUGE student loans when the government knocks down their reimbursement for services?

First of all, let me get it into the open that I cannot stand the outright lies the rightwing has been scaring people with. If a national healthcare system is socialist and illegal, then we must do away with Medicare. Medicare is simply socialized medicine for retired Americans. Medicare does not pay for everything, like the rightwing likes to claim, and is not deducted from retired Americans' SSI checks. The myth that seniors have paid for Medicare is another falsehood created to make Americans believe that Medicare is not a socialized healthcare system, the deduction from your paycheck goes strictly to Social Security, and Medicare is not deducted from your Social Security.

See, what's going on is that the right wing politicians know that they cannot let the public know that Medicare is a socialist system, because their arguement against a total system would be void. They cannot get rid of Medicare, because they would have the AARP and all of their constituents that hastily had to move in their elderly parents rioting at their doors. But the spin that even Obama's watered down plan is Nazi-esc brings us to the next big question - What is more Nazi, taking care of all the sick and elderly people, or leaving them to die uninsured in their homes?

And if there is an outbreak of a serious disease, what will we do about the people with insurance that do not go to the hospital or doctor because they can't afford their copays? What about all the kids who don't even get well child check-ups, because their parents can't afford the after-insurance bill, but make too much to qualify for the Children's Healthcare Insurance Program?

Which leads me to my next big question - why healthcare reform? If we can't all agree on how it is done, then why not insurance reform? I'm not just refering to health insurance, but home, car and life insurance as well. Does your state require that you have car insurance? Ours does. Does your bank require you have homeowners insurance with your mortgage? Ours does. So if it is all required by law and policy, tell me why they should have unlimited profits.

Insurance was non-profit for decades until it was deregulated little by little through the 70's and 80's. So what are the figures? Let's go to my FAVORITE Economic resource, Executive Paywatch. The CEO of Medco (a pharmaceutical third party payor), David B. Snow made $14 million the last 2 years, while the CEO of Aetna (a health insurer) made $18 million. The CEO of State Farm made $13.66 million last year, and the CEO of MetLife made $22.4 million last year. Anyone else feeling had?

The next problem that needs to be nailed down is the aggressive marketing by Pharmaceutical companies. Whatever happened to doctors deciding you had a condition, and not you? The government banned cigarrette commercials in the 70's and should do the same for pharmaceutical companies. Many cholesterol drugs cause liver damage, but yet most of them are advertised on t.v. How is that not dangerous marketing? Doctors are not allowed to tell their patients they are fat and need to go on a low-fat diet, but are pressured by their patients to give them Lipitor. You can get a coupon for Ambien in Reader's Digest that has all the insurance processing information for a free 7 day supply. If someone forged a prescription and took it to an understaffed Rite Aid, they would get free drugs, and most likely not get caught. Scary?

Let's talk about their CEO's compensation - the CEO of Merck & Co. made $25 million last year, the CEO of Bristol-Meyers Squibb made $24 million, and the CEO of Mylan (a strictly generics producer) made $13 million. I know my doctor didn't even make close to that, and our pharmacists - pocket change compared to these market drug pushers. There are so many things that need fixed in our healthcare system, a hastily passed bill this fall will not even begin to fix. So I have written my Congressmen/women to tell them to stop the easyspeak, and get down to the real healthcare problem.

We paid over $11,000 in insurance premiums (which my employer pays 2/3), copays and your-share/non-covered services last year. How much did you pay?

O9 and Oh my Head Hurts

Have you ever tried to explain to an 87 year old woman with dementia that her Medicare Part D plan has changed and you can't deliver her medicine unless she gives you her new information?

Yeah, that's been my start to 2009. I've worked 6 out of the last 8 days, mostly 9 hour days, and I'm beat. I've also spent my 2 days off working on essays for a scholarship and my entrance essay for the Huxley College of the Environment at WWU, and catching up on laundry.

Today is the beginning of a whole two days off in a row, and I'm going shopping. I have some Christmas money to burn and Joe's end of the year sale is calling my name. Let's see, Lady Carharts, hmmm, new hiking boots, snow shoes. Just kidding about the last one, but they would be practical right now.

Speaking of wild storms, it's supposed to warm up to almost 50 on Wednesday along with heavy rain in the foothills. This could be really serious, since we are at 500 feet in elevation, and the snow level is supposed to go all the way up to 3 or 4,000 feet. We still have over 2 feet of snow on the ground, here, so the creeks and rivers will be flooding. My only way home if the highway closes for flooding is also closed for avalanche and mudslide danger.

The good news about the snow is that it seemed to have insulated the fruit trees, and they have sprouted some gnarly growth knobs for spring. Mmmm...apples, and pears, and plums. Oh my.

Why I’m Getting Out

Between my regular homework in ECON 201 and Espanol, working 32 hours a week, kids, etc. I have been working on a Healthcare group project for Econ. It is disheartening to see the stone cold facts about our healthcare system, and the stone cold facts about Universal Healthcare. As much as citizens of the UK complain about the wait for specialty care, most Americans on HMO's have to wait just as long for appeals, and the biggest fact of them all – 46 million Americans have NO coverage whatsoever, and the number grows with the rising Unemployment rate. But politicians must be careful as to what kind of Universal Coverage they impose.

I have had professors and colleagues ask me why I won't take the MCAT's or the PCAT's, and here is my answer. The American healthcare system is broken, and I cannot work in the field anymore and watch low income people continue to die. I can't do it anymore. Between my group project, and my discussion board posting this week, here are my facts to back up my feelings.

Country	% GDP Spent on Health-care	Average Annual Government Healthcare Spending	Average Annual Employer Healthcare Spending	Average Annual Citizen Health-care Spending
US	15.30%	$2,884	$1391	$2126
UK	8.30%	$2,371		$352
Canada	10%	$3,839		$1645
Germany	10.70%	$349	$1259	$1806
Japan	8%	$1,927		$431

Total Annual Average Spent per Person	Average Annual Gross Income	Average Annual Disposable Income	% AADI Spent on Healthcare
$6,401	$42028	$31410	6.8%
$2,723	$32602	$24612	1.4%
$5,484	$37872	$22512	7.3%
$3,414	$34895	$24078	7.5%
$2,358	$29882	$25184	1.7%

Working as a pharmacy technician for over 10 years, I have personally seen the demand for brand name drugs increase as marketing by drug companies has increased. I don't think I have bought a pen in the last 10 years, since we receive free pens and paper sporting ads for such drugs as Viagra, Vytorin, Advair, Nexium, Lantus, Celebrex, etc. on a regular basis. Many doctors practice what pharmacists call poly-pharmacy, meaning that the patient is receiving one or more drugs working against eachother, or causing other problems and symptoms. They prescribe them anyway. Why? Patients are demanding them because of an ad on tv or in a magazine, or because drug companies are giving the doctors kickbacks such as free continuing education classes, weekend getaways, ties, tee-shirts, clocks and watches. These sales are good for the drug companies and wholesalers, but are marginally small sales for the pharmacies themselves.

Insurance companies prefer to cover less expensive generic drugs that many times work just as well as "designer drugs" as we like to call them in the pharmacy. Pharmacies also rely on generic sales that they can buy low and mark-up significantly, while still maintaining a low sale price for the patient. The wholesalers make deals for bulk sales from the drug companies, then the pharmacies negotiate contract prices with the wholesalers. The pharmacies also negotiate contract payments with insurance companies based on the average wholesale price of each drug (which McKesson has been accused of falsely inflating), minus a contracted percentage. The more the pharmacy pays for the drug from the wholesaler, the less they make on the sale because of the pre-negotiated contract price from the insurer. The patient pays higher prices for a result they may have achieved from a much less expensive generic drug, but some doctors won't budge on the patient's prescribed drugs.

When American politicians promise to allow re-importation from Canada of drugs, they are taking away a pre-bought supply of drugs from Canadian citizens, creating a shortage of prescriptions in rural, non-border areas of Canada. The drug companies and insurers have a cash cow business in America that more than universal healthcare is going to solve. At least some companies are rethinking their marketing strategies due to politicians investigating just where their profits are being reinvested.

Basic Health Statistics
Sources: CIA.gov/the-World-Factbook and www.npr.org/news/specials/healthcare-profiles

U.S.A. – Population: 303,824,640 (July 2008)
Average Spent on Healthcare per Person per Year: $6,402
Life Expectancy: 78.14 years
Infant Mortality Rate: 6.3 per every 1,000 births
HIV Rate: 0.6% - 18,229,478 citizens

United Kingdom – Population: 60,943,912 (July 2008)
Average Spent on Healthcare per Person per Year: $2,723
Life Expectancy: 78.85 years
Infant Mortality Rate: 4.93 per every 1,000 births
HIV Rate: 0.2% - 1,218,878 citizens

Canada – Population: 33,212,696 (July 2008)
Average Spent on Healthcare per Person per Year: $5,484
Life Expectancy: 81.16 years
Infant Mortality Rate: 5.8 per every 1,000 births
HIV Rate: 0.3% - 996,381 citizens

Germany – Population: 82,369,532 (July 2008)
Average Spent on Healthcare per Person per Year: $3,673
Life Expectancy: 79.1 years
Infant Mortality Rate: 4.03 per every 1,000 births
HIV Rate: 0.1% - 823,695 citizens

Japan – Population: 127,288,416 (July 2008)
Average Spent on Healthcare per Person per Year: $2,358
Life Expectancy: 82 years
Infant Mortality Rate: 2.8 per every 1,000 births
HIV Rate: less than 0.1% - less than 1,000,000 citizens