By Elizabeth Cooney
Boston Globe
October 20, 2009

Uninsured people are also more likely to have undiagnosed and undertreated medical conditions, according to a new study comparing chronic illnesses among Americans with and without health coverage. The results offer possible clues to a recently reported higher death rate among people who lack insurance.

Researchers from Cambridge Health Alliance and Boston Medical Center tracked diabetes, high blood pressure, and high cholesterol in a national survey of more than 15,000 working-age adults. Based on questionnaires, medical exams, and lab test results, they found that about half of uninsured people who had diabetes or high cholesterol were unaware of it, compared with just under one-quarter of insured people who did not know they had these conditions. High blood pressure, however, was undiagnosed in about a quarter of both uninsured and insured people.

Once diagnosed, hypertension was poorly controlled in 58 percent of uninsured people and 51 percent of those with insurance. The treatment gap was larger for high cholesterol: 77 percent of uninsured versus 60 percent of insured people had inadequately treated levels.

For diabetes control, the difference in treatment was not as clear. Insurance status did not matter in achieving good diabetes control, as defined by the national survey conducted by the US Centers for Disease Control and Prevention. But using less stringent measures that the authors say are more commonly used by physicians, 31 percent of uninsured diabetics were in poor control of their blood sugar levels, compared with 25 percent of insured diabetics.

“The diagnosis and control of chronic illness is substandard even in people with insurance,” Dr. Steffie Woolhandler, co-author of the article appearing online today in Health Affairs, said in an interview. “But it’s much, much worse for the uninsured.”

Woolhandler said the study results fit with research published last month linking 45,000 deaths each year to the lack of insurance. The same group wrote both articles.

“We know that you can prevent deaths through good treatments for high blood pressure, for diabetes, and for high cholesterol,” she said. “These common conditions are easily treated, but if you don’t treat them, they can turn lethal.”

Chronic conditions are diagnosed and treated through regular doctors’ visits and medication regimens, both of which can be out of reach for the uninsured, Woolhandler said.

The study’s conclusions are not surprising, according to Lindsey Tucker, Health Reform Policy Manager for the advocacy group Health Care For All.

“This paper demonstrates yet again the importance of having and retaining health insurance,” she said in an e-mail interview. “As we know from our policy work as well as from our HelpLine callers, uninsurance is costly not only for the individual but also for the state and the health care system.”

http://www.boston.com/news/health/blog/2009/10/post_33.html

By Clyde Winter
Hearts and Minds Blog
http://clydewinter.wordpress.com/
October 9, 2009

All of the grassroots efforts for the substantive, effective health care reform that is so needed by American families, have been attacked — for months, for years, and for decades — by insurance corporations, their corporate allies, and now the crass strategists within both major political parties. A health care crisis has thus materialized and been getting worse fast.

The words “public option”, have received overwhelming public support in national polls this year when contrasted with the status quo in health care. However, the public option plan(s) proved vulnerable to certain attacks from the professional spin-meisters who are working to derail any substantive health care reform. Here are three of the most effective attacks recently made on “public option” health care reform efforts. The response that is necessary concludes this essay.

1. The public option would mean a government takeover of health care. They ask, “Do you want the government getting between you, your doctor, and your health care?”

2. The public option, and the bills currently being talked about by politicians and talking heads, will cost lots more than what is currently being spent on health care in America, and that would make the already horrendous deficit even worse. They ask, “Who’s going to pay for this?”.

3. The public option and the bills currently talked about in the newspapers and TV and radio, will cause Medicare to be robbed, and health care for elders to be curtailed. They ask, “Do you want these reformers to establish death panels and pull the plug on Granny?”

What should be our answers to these ridiculous, phony attacks on the health care reform needed in America? These attacks on the public option plan have clearly shown a major mistake was made in allowing the Medicare for All solution to the health care crisis to be taken “off the table” before there was even a public discussion of it. Eliminating the Medicare for All solution from the public discussion for meaningful health care reform has (so far) kept us from neutralizing those attacks. It is plain stupid (or a betrayal) to leave only one confusing, undefined, flip-flopping proposal on the table to be attacked from all directions. The people can’t fight the odds against true reform with one hand tied behind our back and the other hand not knowing how to punch.

It is easy for anyone to explain or quickly understand the Medicare for All solution to the health care crisis. It proposes to strengthen and enhance Medicare, and expand it to provide comprehensive health care to ALL Americans, throughout life, with no co-pays and no deductibles. The Congressional Budget Office has reported that the amount of money that would be saved by changing the administration of the existing health care system from for-profit insurance corporations to Medicare would be more than enough to provide universal coverage for everyone. Medicare for All is supported by a wide majority of nurses and physicians that provide primary health care, and by a majority of American families (despite the powerful efforts to put it “off the table” and keep it out of view). Medicare for All (HR 676) clearly defines the health care crisis, identifies the primary reason for it, and presents a simple, understandable, proven workable solution, in a 15-page bill that anyone can read. So here are (or should be) our answers to the attacks levied against the public option and health care reform:

First, the government did not “take over” and harm the health care of those over 65, or the disabled, when Medicare was established in 1965, or the health care of those who now serve or have served in the armed forces, or the excellent health care provided by these military facilities to our Presidents, members of Congress, and their families. Caregivers providing health care today are faced with intervention and interference from insurance corporations, but not from Medicare. Where would American families be today, and where would elders and the disabled be, if the insurance corporations had continued to administer and be the gatekeepers of their health care, instead of Medicare? How many elders would have lived and died uninsured, under-insured, and without needed care, and how many more families would have gone bankrupt trying to help their elder members get the health care they need? Everyone needs to be reminded that health insurance corporations and their allies interfere with families’ choice of providers, and with needed treatment plans and prescriptions. The excellent active duty military family medical care system (which IS a completely government owned and operated system of “socialized medicine”) and Medicare (which is NOT) do not let administrators get between the doctors and their patients, like the insurance corporations do, who insist it is their right. We should loudly and clearly say that, “American families have a right to get health care we need without insurance corporations getting anywhere between health care providers and the people”.

Second, with regards to projected financial costs, we should simply and clearly say, “Hey, if you don’t like the up front cost of the ‘public option’ then look at Medicare for All! HR 676 would save four hundred billion annually in unnecessary, wasted expenditures, easily providing universal comprehensive health care with no deductibles or co-payments, and no increased outlay. Enhanced Medicare for All is clearly the most fiscally conservative solution to the health care crisis, from both the standpoint of individual American families, and from the standpoint of the American economy (to say nothing of providing the best health care outcomes).” If you insist on keeping the insurance corporations in the role of gatekeeper and administrator, then America will be forced to pay a costly premium. Let American families (not behind-the-scenes corrupt and greedy power brokers) make the choice between Medicare for All and the new, compromise public option idea, which retains insurance corporations as gatekeepers and administrators, and does nothing to end the costly, complicated billing procedures and eligibility determinations, the gross profits and outrageous pay to executives.

Third, orchestrated astroturf opposition surged this summer against the changing, confusing varieties of the thousand-plus page HR 3200, or the unspecified “President’s plan”, or the “Kennedy memorial” plan, or the ironically solo/bipartisan “Baucus/lobbyists plan”. This opposition to health care reform planted and exploited fear that Medicare would be fleeced, health care for elders pinched, and “the plug would be pulled on Granny” to pay for the costs of whatever plan might emerge from the confusion. This fear is obviously and easily countered by HR 676, Medicare for All, which simply proposes to enhance and strengthen Medicare, and extend it to all Americans of all ages. That would both make Medicare stronger, and protect health care for seniors against future possible attempts to impose budget cuts on it. (And budget cuts will continue to be promoted if Medicare continues to be only for the elderly and the disabled.) True health care reformers need to say, “So you think the ‘public option’ proposal threatens health care for seniors? Then check out Medicare for All. If you really want to protect Medicare and health care for seniors and the disabled, then adopt Enhanced Medicare for All. Nobody is going to get away with cutting Medicare for elders if Medicare covers every member of the family.”

A so-called “reform” that leaves the insurance corporations in place as the administrators in charge of the health care system in America, while even further increasing their massive power and wealth by mandating everyone in America to purchase their flawed products (with their profits further enhanced by taxpayer funded subsidies) is regarded as nothing but a sham and a fraud by everyone except the insurance corporations and their lobbyists and allies, and a very small percentage of the public that is best described as woefully uninformed.

Deciding that Medicare for All (HR 676) should be marginalized and dismissed because it is deemed to currently “not have the votes in Congress to pass” is a self-fulfilling prophecy, an abject surrender to corruption, and a losers way to play a winning hand. It should now be clear to all that discarding the trump card of Medicare for All is such an obvious and continuing mistake, that the old maxim, “follow the money”, provides the only possible explanation. And a sad and sorry one it is, implying pervasive corruption in both major political parties and unwillingness by both parties to reject government that is by and for the corporations and the lobbyists, instead of the people. Over a million dollars is being spent every single day by corporate vested interests just in lobbying the 535 members of Congress to prevent the people from getting the health care reform all America so badly needs. And this is on top of the billions in campaign and PAC “contributions” that have greased elected officials, candidates, and strategists of both major parties, and the billions more to come. That is just part of the huge hidden cost of compromised health care and of corrupted government that American families will have to keep paying — until we ourselves put an end to it.

The people should have a choice between a strong public option and enhanced Medicare for All, and should be provide accurate, understandable information about each. Such information about the Medicare for All, solution to the health care crisis has long been available, but has been taken “off-the-table” by corporate lobbyists, by the mass media and by corrupted strategists running both major parties. American families don’t need a choice in health insurance plans and policies. (Most people don’t really have one now, anyway, and will not have one with any public option proposal that emerges.) We want choice of health care providers. We need lower costs, more financial and health security, better health care outcomes, and a stronger economy for the people. And we will get it, with Enhanced Medicare for All (HR 676).

If we truly want to get the health care America needs, we will also need to get a government that is of, by, and for the people, instead of government that is by and for the corporations and the lobbyists. Contact your choice of the following national organizations now to see what you can do to help the grassroots effort to get the health care America needs.

http://clydewinter.wordpress.com/2009/10/09/a-government-takeover-of-health-care/