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U.S. must provide free health care for all citizens

    It is unbelievable to me that so many countries provide free universal health care to every citizen, regardless of income level or employment status, and the United States does not. If I were running for, or currently in office, I would be embarrassed by our nation. How can Cuba afford to give their (and our) citizens what we cannot?
    I believe that my fellow Americans would be willing to pay more in taxes for our entire country to be provided with health care.
    I cannot believe the cowardly ways of our government, making Americans fear them and allowing the citizens of their country to be harmed and abandoned while they receive ridiculous amounts of money for their continued silence. How can you sleep at night knowing that your constituents are being thrown out on the streets every day because they can’t pay their medical bills? It’s because they’re not voting.
    Things need to change.
    DANIELLE MARION
    Schenectady

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U.S. must provide free health care for all citizens

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There are quite a few people who don't have health-care but could afford it but prefer to spend that money on other things like boats, cars, vacations, and other toys that they consider more important than health-care.

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EDITORIALS More evidence of a sick health system

    Anyone doubting the need for an overhaul of this nation’s health care system should have had those doubts erased by two events last week.
    In one, the Schenectady County Legislature voted to accept a payment of $57,000 from Bristol-Myers-Squibb to settle a lawsuit over $15 million in fraudulent Medicaid drug overcharges. In the other, New York Attorney General Andrew Cuomo launched a suit against the state’s largest health insurer, UnitedHealth Group, claiming it had defrauded customers who use doctors or hospitals out of its regular network by intentionally understating the value of “reasonable and customary” charges that determine how much those customers subsequently have to pay out of pocket to make up the difference.
    Both cases illustrate the tendency of players in this industry to inflate or deflate the value of their products and services, depending on how it suits them.
    When one is trying to extract money from a payer — as Bristol-Myers-Squibb was with the county — the idea is to overstate the product’s price. That’s what Bristol-Myers-Squibb and dozens of other drug companies apparently did, lying to Schenectady County (among others) about how much pharmacists had been paying for their drugs. They did that to inflate the prices they subsequently negotiated with the counties.
    The settlement with Bristol-Myers-Squibb is the first of what county officials hope will be scores; it sued a total of 77 drug companies, alleging similar overcharges, two years ago, engaging a law firm that has had considerable success with comparable cases.
    The attorney general’s case illustrates what happens when the tables are turned: when the company is doing the paying. Here, it was in the insurance company’s interest to claim that the “reasonable and customary” charges in the (out-of-plan) doctor’s geographic area were far lower than what he or she billed. That way, it could force the customer to make up a greater part of the difference, rather than getting stuck with it itself.
    What’s going on — in both of these disputes, as in most others involving health-care providers and insurance companies these days — seems like one big game. Everyone’s trying to make more money, or spend less, and is rigging the rules as they see fit (or can get away with) in the process. One can only imagine how much effort — time and money — is going into this game, and how much better the country’s health-care needs would be served, and for how much less money, if it were to cease. Unfortunately, without a universal, single-payer system, there’s probably no way that it ever will.

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Health care should be provided to all citizens

First published: Wednesday, February 27, 2008
Raymond Kidalowski's Feb. 15 letter warns readers that universal health care will lead to restricted health care and higher taxes, and thus should be abandoned. He cites figures from the Times Union detailing the higher amounts we spend in the U.S. per person on health compared to Europe and Japan, and states the excess cost cannot be due to "greedy insurance companies."
He is only partially correct. In fact, Medicare spends less than 5 cents per dollar on overhead (administrative) costs; private insurers spend 20 cents or more. This money covers, among other things, executive salaries. A switch to a Medicare system would immediately save about 15 percent of health care expenditures in the U.S.
     
Mr. Kidalowski thinks this would lead to restricted care: For example, grandma will no longer get a hip replacement. Currently, most hip replacements occur in the elderly and are, in fact, paid for by Medicare.
He also cites losing access to higher-priced drugs. Europe and Japan pay far, far less than we do in the U.S. for the same drugs. Why? Because their universal systems are able to bargain with the pharmaceuticals for lower prices; we see this with our own VA system (another government program).
Mr. Kidalowski seems to think private insurers do not restrict access. As a physician, I have firsthand experience that this absolutely is not the case. Every day I come across instances where a patient's private insurer has placed restrictions on procedures or drugs I wish to prescribe.
Part of the overall cost for health care in the U.S. includes the uninsured. They ultimately end up in emergency rooms and hospitals, where delayed treatment becomes even more expensive. Hospitals, and ultimately taxpayers and the privately insured, bear the cost.
Will taxes go up with universal care? There would be a shift in cost to a more efficient system: Instead of paying your insurer $500 to $1,000 a month for coverage, that money would be a tax. But think about it: We have "socialized" police, fire departments, highway construction and education. Why should basic health care not be something we provide to all our citizens?
MATTHEW LEINUNG, M.D. Menands

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Health care should be provided to all citizens

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True socialized medicine proven not to work
First published: Monday, March 10, 2008

I hope Matthew Leinung, M.D. ("Health care should be provided to all citizens," Feb. 27) practices medicine better than he understands political science definitions.
He argues we already have "socialized" police, fire departments, highway construction and education, so why not health care? This is not true. None of the aforementioned programs is funded and administered by the federal government, which must be the case for a program to be "socialized." Police and fire departments are not divisions of a federal agency, but instead are local agencies run by city and state governments. Highway construction is also not federal, unless it is a federally owned highway. Education is also handled on a local level, despite many federal and state regulations.
     
Medicare is not more efficient -- they just hide their figures all over the federal budget, making it impossible to measure apples-to-apples. Our current system may be broken, but that does not mean we should adopt another proven broken system.
"Medicare for all," or a mandatory federal health care program, is socialist, inefficient and unconstitutional.
CHAD CURRIN Glenville

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Family questions hospital's treatment refusal
Pamela Cowan, The Leader-Post
Published: Thursday, March 06, 2008
An elderly Leader man, who died in a Medicine Hat hospital, was refused treatment in a Calgary hospital because he was a Saskatchewan resident, family members believe.

Jack Hintz, 85, died on Feb. 22 -- a day after Medicine Hat physician Dr. Alison Cameron requested that he be transferred to Calgary for hip surgery. Doctors considered it a high-risk procedure because Hintz had also suffered a heart attack.

"Nobody has ever heard of anything so ridiculous," said Doreen Miskiw, Hintz's daughter. "We don't want this to happen to somebody else. Our health system needs to smarten up. Health care is universal and it shouldn't matter what province you come from, you should be accepted. It's upsetting that Dad didn't get that chance. He may not have made it but nobody knows."

However Don Stewart, the Calgary Health Region's manager of communications, said that was "absolutely not" the case.

According to a statement issued on Wednesday, the Calgary Health Region recommended that the patient be transferred to a Saskatchewan hospital "based on ensuring this patient had access to the most immediate and appropriate medical care."

In a phone interview, Stewart said the recommendation was made because Calgary's three adult acute care sites on Feb. 21 were over capacity.

"We had 18- to 24-hour approximate wait times so this patient would have potentially ended up in a hallway or an area that's been created as a holding unit because there were a number of patients waiting for admission into the hospitals," Stewart said.

On Feb. 21, Hintz was transferred from Leader's hospital to Medicine Hat for surgery on his fractured hip. Cameron said it's routine for patients who live in towns along the Saskatchewan-Alberta border to be transferred to Medicine Hat for specialized care.

"He arrived sometime in the middle of the night and the next morning when we did some tests we discovered that the patient had likely had a heart attack during the process of falling and breaking his hip," she said.

Hintz was examined by a Medicine Hat orthopedic surgeon who then consulted an anesthetist, Cameron said.

"They both felt that because of the heart attack that he was too high risk for us to do any surgery on him in Medicine Hat," she said. "Then it was determined that he should be transferred to Calgary."

At the surgeon's request, Cameron phoned the Southern Alberta Referral & Co-ordination Centre, which handles transfer requests to Calgary. Cameron outlined the man's condition to a receptionist and then to a nurse. An hour later, Cameron spoke to a Calgary orthopedic surgeon who agreed to take the patient.

"Knowing the circumstances of the fractured hip and the heart attack, he knew that he was too high-risk for Medicine Hat," Cameron said. "Then we just had to wait for the OK, because we don't want to call the air ambulance until we're sure that the bed is available. That's what we were waiting for, but about four hours later SARCC phoned and left a message that they weren't taking the patient because he was from Saskatchewan."

Cameron phoned the centre back to ask why the referral was refused.

"They told me that they would not be taking the gentleman because he was from Saskatchewan, they had a bed shortage, and the beds that they had available were going to go to Albertans," Cameron said. "I asked if there was some way to appeal this decision and they told me that if my hospital administrator talked to their hospital administrator perhaps they could review the decision at that point in time."

In the meantime, Hintz's condition worsened and he was transferred to the Medicine Hat hospital's intensive care unit where he died.

Cameron said there's no way to predict if Hintz would have survived had he been transferred to Calgary.

"The basic principles of the Canada Health Act are that health care is portable -- you can go to any province and receive health care, no matter where you're from," she said. "That's a basic principle and that didn't work in this instance."

The media statement issued by the Calgary Health Region ends stating: "Given the nature of the patient's medical condition, SARCC provided a clear recommendation to Medicine Hat medical staff that they should contact the Saskatchewan Co-ordination Centre to request the patient be transferred to an appropriate hospital in that province. This action was considered to be the most effective way for the patient to receive the fastest possible medical treatment."

Stewart added that the Calgary Health Region did 1,300 surgeries for non-Albertans last year and 750 day procedures.

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"Knowing the circumstances of the fractured hip and the heart attack, he knew that he was too high-risk for Medicine Hat," Cameron said. "Then we just had to wait for the OK, because we don't want to call the air ambulance until we're sure that the bed is available. That's what we were waiting for, but about four hours later SARCC phoned and left a message that they weren't taking the patient because he was from Saskatchewan."