Comments for AAPS News of the Day

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by Lawrence Mallette MD PhD

Lawrence Mallette MD PhD — Sat, 04 Jul 2009 17:51:50 +0000

Dr. Graller wrote, “ALL YOU ARE IS A LOBBY FOR THE AMA!”
This gave me a big chuckle.
I don’t belong to the AMA specifically because they do not represent the best interests of American physicians, in my opinion. Otherwise the AMA would oppose managed care participation and electronic health records. They would have come out soundly against Medicare some 20+ years ago when the government abandoned their promise that it would be INSURANCE and began to tell us what we could charge for our services. (Note: Medicare is NOT insurance. It is managed care. There is a big difference.)

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by admin

admin — Sat, 04 Jul 2009 03:44:13 +0000

There is a confusion of numbers in the various sources quoted for the number of total bankruptcies in 2007: one source gives 822,590 (AHN News). Megan McArdle used 727,167 for total bankruptcies in 2007 in calculating the 220,000 drop in medical bankruptcies between 2001 and 2007. She used the percentages for medical bankruptcies asserted by Himmelstein, Thorne, Warren, and Woolhandler in the article cited as the foundation for the latest alarmist figures (46% in 2001 and 62% in 2007, or 50% and 70%, depending on whether you read Am J Med or reports about it), and total bankruptcies of 1.45 million in 2001. Obviously, Himmelstein et al. and Zhu have very different definitions of “medical bankruptcy.” My number of 41,000 medical bankruptcies was calculated by Zhu’s definition. It is obviously very different from the “one medical bankruptcy every 30 seconds” used by Obama, which would give a number of medical bankruptcies far exceeding the total number of bankruptcies from all causes. You can read Himmelstein et al. from the Am J Med article posted on the PNHP website, and the highly critical analysis by McArdle in The Atlantic, and draw your own conclusions. Himmelstein et al. were funded by the Robert Wood Johnson Foundation and claim to have no conflict of interest. They are among the most prominent advocates of a government takeover of medicine, and have a fervid ideological dedication to demonstrating that medical costs are the most important reason for bankruptcy.

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by admin

admin — Fri, 03 Jul 2009 21:32:50 +0000

Note from the editor:
Hamish is correct. The UC Davis study reported by Ning Zhu concerned bankruptcies in 2003. The number of bankruptcies in 2007 (822,590) was from a different source, which has now been added to the posting, along with a link to Zhu’s 2008 statement that medical problems caused just 5% of bankruptcies.

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by Kitty Antonik Wakfer

Kitty Antonik Wakfer — Fri, 03 Jul 2009 18:16:54 +0000

In regard to the message from Hamish, I too see no reference to any 2007 data in the linked paper by Ning Zhu at the University of California. However, his data for the 2005 total of 2,039,214 personal bankruptcies that he does note in his introduction comes from the American Bankruptcy Institute. Checking their website for personal bankruptcies quarterly filing – http://www.abiworld.org/am/template.cfm?section=Bankruptcy_Statistics1 – I found a graph from 1992 (1st quarter) to 2007 (4th quarter). Simply by estimating the total for 2007, the number quoted in this AAPS News Item of 822,590 does not appear to be incorrect. The only thing that is incorrect is that this data was contained in the paper referenced. I suggest that a correcting statement is highly warranted by the author(s) of this news item – exactly which site and what tables/graphs were used for any data stated.

It is reasonable for anyone on the opposite side of an argument to seek out errors and often accuse the writer of bad intent. It is important, particularly for those in the minority position, to avoid any such possibilities by scrupulously identifying the sources and extraction methods of their presented data and avoiding errors. Rushing to print is a recipe for disaster when readership includes those who are strongly opposed.

Hamish, mistakes are far more common than intentional falsehood – exception for politicians ;>) Therefore I suggest that you look further before before claiming the leadership and members of AAPS have “other motives”. It does not appear that you have read very much about and by members of AAPS; I suggest that you do some reading beyond this one item.

Comment on Deliveries available for $2,300 by Steven Ford

Steven Ford — Fri, 03 Jul 2009 15:59:33 +0000

Definitely a no brainer unfair practice to the taxpayors and US citizens with many negative implications on the economics of this country!!!!

Comment on Deliveries available for $2,300 by Kitty Antonik Wakfer

Kitty Antonik Wakfer — Fri, 03 Jul 2009 15:40:03 +0000

Thank you for a very informative item of immediate practical use by many – at least a great number in Arizona or willing to travel there.

Following the link to Tucson Medical Center’s (TMC’s) website regarding their Prepayment Package Programs, I was pleased to see that bone density exams (DEXA) are only $200! This is considerably less than the $642 I was quoted twice in the past year by Desert Reflections Imaging Center, the outpatient radiology facility affiliated with Casa Grande Regional Medical Center (CGRMC), less than 100 miles north of Tucson. Even with the 20% discount CGRMC will give for a self-pay patient and the addition of the radiologists separate bill, the $200 TMC charge (required 2 weeks ahead) plus their radiologist fee is $213.60 less. I am assuming that the radiologists’ fees would be approximately the same.

While there is also the cost involved in making the approximate 90 minute drive to Tucson from Casa Grande, I will further investigate this pre-packaged plan at TMC when we return to Arizona, my legal residence, in November. I last had a bone density scan done in Toronto in 2002 when husband Paul’s legal residence was there instead of in rural Ontario 3 hours away, where we are now. My results at that time, when 57 was a T score at L2-L4 of 0.8 and 1.8 at the femur neck – average for age 20-48 on the first and average for age 20 on the second. (The fee was only a bit less than what TMC is now charging prepaid.) I take measures to prevent osteopenia and have no outward indications of any, so I’ve not been in any hurry to pay the price at the local facility since I am a self-paying individual (not covered by any medical insurance). However this information provides me with a cost effective option – and we can always combine the drive to Tucson for the DEXA with our major grocery shopping at the branches of our favorite stores there rather than Chandler and Tempe :>)

Lastly, I suspect that since TMC can afford to have these prepaid arrangements, that CGRMC could do so also – and most (?all?) other hospitals. It seems to me that the cost savings involved with not having to deal with insurance companies can go much further than this – and even to procedures that are not elective in nature. And most important, being self-insured (or only with a very high deductible, if such a policy can be obtained at a reasonable price) can be highly cost effective to the individual who strongly practices health degeneration prevention.

Comment on Deliveries available for $2,300 by Kenneth Christman, M.D.

Kenneth Christman, M.D. — Fri, 03 Jul 2009 14:09:20 +0000

Hospitals’ practice of widely varying facility charges has wreaked havoc at the marketplace. AAPS has a White Paper on this very topic. Why should not these hospitals, most of which are supposedly “non-profit”, function like supermarkets, charging one fair price to everybody? By artificially manipulating hospital pricing, are not hospitals forcing both patients and physicians into subservience to the large managed care companies and hospitals? With fair hospital pricing, medical insurance would not be necessary for many people. We hear the constant outcry for the “uninsured”, when, in fact, we should all be self-insured. I never have quite figured out why all physicians aren’t self-insured. If we cannot take care of each other, we are in deep trouble. It would also encourage physicians to speak out against the overcharging of hospitals!

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by john l'ecuyer, md

john l'ecuyer, md — Fri, 03 Jul 2009 13:56:55 +0000

There seems to be something wrong with your numbers. If there were 220,000 less medical bankruptcies over that 6 year period, that would average to about 39,000 less per year. Yet in 2007 you cite a figure of 41,000 for the year–are you suggesting that medical bankruptcies have decreased by close to 50% during that 6 year period? This seems unlikely.

Comment on Deliveries available for $2,300 by J.S.Hochman MD

J.S.Hochman MD — Fri, 03 Jul 2009 12:58:19 +0000

It is amusing to note how many forget that all of us are the children of immigrants. The current xenophobia is just another knee-jerk, tabloid response to fear, stress and anxiety. The solution to the immigrant issue with Mexico is to help that nation restore its economic and social stability. That will not happen until the illegal drug business (currently well over 40% of the GNP of Mexico) is put out of business. That will only happen when the US decriminalizes drugs. Then we can settle down to identifying and treating the small percentage of drug users who have addictive disorders.

Mexican nationals illegally enter the US because they have no ecomonic alternatives. You can build a wall 15 feet tall and they will still get in, if the alternative is starvation. So here we are, trying to interdict human beings. Just like interdicting drugs – the “supply side” strategy is and will always be, a calamitous failure.

We need rationality instead of emotionality. It makes for better, and more successful, planning.

Comment on Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.” by JJohn Fournier, M.D., F.A.C.S.

JJohn Fournier, M.D., F.A.C.S. — Fri, 03 Jul 2009 12:41:39 +0000

Health care is not a right despite what the politicians tell us! It is a priviledge like obtaining a driver’s license. All pols sell their votes! we have the best Congress money can buy. The pander and prostitute themselves for personal aggrandizment and enrichment. You do not have the right to expect your neighbour to pay for your illness because you demonstrate high risk behaviour such as unprotected sex, not wearing a helmet while riding a motorcycle, eating junk food, being overweight and in general self inflicted diseases. Keeping in mind that 40% of Americans are freeloaders and do not pay any Federal Income taxes but have the power of the vote which they sell to the pols how can you expect any progress in stopping national health care whcih is a vote and power getter for the pols? I am not optimistic that we will prevail. Only the insanity and economic restrictions will stop them for no one wants to pay more taxes for the free loaders to have healthcare and bankrupcy of the US like California would result fron a single payer option. I have practiced for 34 years and am the last ofthe free physicians. I stopped my son from going into medicine and interupted a family tradition (my father was a general surgeon) because I did not want him sacrificed on the altar of corporate or government medicine. I have never joined an HMO and treated PA patients for free! There are only two reasons to chose medicine as an occupation, one to make money (an income commesurate with the cost and time spent to acquire the skill set and reflected in a higher standard of living), by the way the lifetime earnings of Canadian truckdrivers is higher than physicians because they have a better union and two, to make a difference and make this a better world to effect cures and save lives….with cookbook medicine, rationing and controls with national drug formularies omitting the more effective expensive pharmaca and limiting MRIs etc. this will not be possible and professional satisfaction will evaporate. We can take a pay cut but not professional satisfaction that we made a difference in the lives of our fellowman. In London, private practice is alive and well! England the mother of NHS, imagine that. I have a friend Nadey Hakim, M.D., a Harley street physician who performs organ transplants and does very very well! In the final analysis, despite all this insanity yours and my healthcare will be determined by our ability to pay not by the government. There will always be two classes of people the haves and the havenots! It is better to be in the former than the later as your live expectancy may very well depend on your economic status. I fear we will not be heard, but we must still try before we are silenced forever to get the word out. I do not regret stopping my children from entering medicine with today’s events it reinforces my convictions that it was the right thing to do.