At 6:15 AM today, on National Public Radio, I heard the word. A scientist was describing the conditions she encountered at the BP oil environmental catasrophe site and she said that she experienced a strong smell of benzene in the air.
Benzene causes bone marrow damage and cancer. Exposure of children, pregnant women, adults and the elderly to toxic benzene will have serious long term effects, including leukemia and other diseases caused by benzene's capacity to cause mutations. The problems BP has created will not be gone by Christmas; BP's gift will create catastrophes for our people for many years.
Read for yourself and then start writing the White House and your Congress people, since both should shoulder the blame for allowing BP to cause this mess. Ask them to tell the truth about the environmental catastrophe BP has caused for people's health, not just the health of fish and birds and shrimp. Demand that the United States Public Health Service be responsible for tracking and publicly reporting the downstream health effects of BP's polution. Demand that BP pay all of the health care costs resulting from their pollution of the ocean and air, and not dump the costs on the government and its taxpayers. Demand that Congress adequately fund the agencies responsible for regulating oil drilling and that the White House staff the agencies, not with political cronies who will rubber stamp "APPROVED" on every harebrained idea proposed by oil companies which buy unregulated freedom through political contributions.
This was not just BP's failure. It was a failure of our government (the political and administrative actors are attempting to distance themselves from responsibility). Our children, men and women, workforce and industry are suffering from BP's destruction of our environment and continuing American government willful incompetence. Demand accountability.
Showing posts with label Government. Show all posts
Showing posts with label Government. Show all posts
Monday, June 7, 2010
Tuesday, January 26, 2010
Suck It Up: Medical License = Government Franchise + Obligations
A license to practice medicine, or function as a health care professional in any of the allied fields which require government certification, is a franchise. It gives the holder the unique ability - in the furtherance of public interest - to provide personal and technical health services in exchange for payment - to people within its jurisdiction. Non-licensed persons cannot hold themselves out as able to provide and charge for those services. A franchise protects its holder from competetition.
The report that a nationally recognized medical organization has refused to provide further or future care to Medicare beneficiaries is disturbing. It is inconsistent with the essential caring spirit of physicians, nurses and other health care professionals and institutions and and contrary to the public service requirement that the franchise invokes. Systematic exclusion from receipt of services because one is a Medicare beneficiary is un-American and wrong.
The United States needs a reformed national health care system, not parochial local or state operations. The essential requirement for critical health care services, such as obstetrics, cancer treatment, fracture care, treatment of devastating infections and the skills, equipment and facilities necessary to deliver these services doesn't change from rural Georgia to Arizona or Ohio. State licensure of health care personnel is an anachronism: if a physician has the requisite evidence of competence and personal conduct qualifications to provide care in New York, why should that person be forbidden to practice medicine in Utah without going through an entirely new, expensive, time consuming and resource wasting evaluation. If a physician in Florida has practiced competently for fifteen years and moves to Minnesota, why impede that change by measures which are formulated specifically to reduce competition in the guise of "licensure quality"? Why not have federal licensing in full recognition that the federal government is the major funder of health care services and facilities? Why not have federal standards which will protect every patient and every provider in the United States rather than the wasteful duplication of political-administrative functions in every jurisdiction in our nation?
Physicians and other providers know that dealing with health care insurers is more disruptive to their practices, in terms of inadequate compensation, bureaucratic bottlenecks and denial of essential services to patients, than dealing with the federal government. The federal government, hamstrung by political contributions and lobbying, has not engaged with insurers to set matters right except for patients covered by Medicare. There is no fair uniform protection of patients and health care providers from financial ruin in the event of medical malpractice or the determination that malpractice has occurred (the public is not aware of the extraordinary cost of medical malpractice insurance to many practitioners, including those who have never lost a malpractice lawsuit). Our government has failed to deal with inflation in pharmaceutical costs and its impact on health care providers, patients and their families. The federal government has cost-shifted its drug war by imposing $500 fees on providers for a 3-year Drug Enforcement Administration license, using health care providers as cash-cows rather than as a vital part of our system of health care.
The government grants a franchise. Providers have to provide necessary health services to all of the public that the franchise envisions. And government has to reasonably protect health care providers, and all Americans, from being financially gouged by parasitic uncontrolled interests including those masquerading as government agencies or licensees or contractors. If not, as is the case today, we all lose.
The report that a nationally recognized medical organization has refused to provide further or future care to Medicare beneficiaries is disturbing. It is inconsistent with the essential caring spirit of physicians, nurses and other health care professionals and institutions and and contrary to the public service requirement that the franchise invokes. Systematic exclusion from receipt of services because one is a Medicare beneficiary is un-American and wrong.
The United States needs a reformed national health care system, not parochial local or state operations. The essential requirement for critical health care services, such as obstetrics, cancer treatment, fracture care, treatment of devastating infections and the skills, equipment and facilities necessary to deliver these services doesn't change from rural Georgia to Arizona or Ohio. State licensure of health care personnel is an anachronism: if a physician has the requisite evidence of competence and personal conduct qualifications to provide care in New York, why should that person be forbidden to practice medicine in Utah without going through an entirely new, expensive, time consuming and resource wasting evaluation. If a physician in Florida has practiced competently for fifteen years and moves to Minnesota, why impede that change by measures which are formulated specifically to reduce competition in the guise of "licensure quality"? Why not have federal licensing in full recognition that the federal government is the major funder of health care services and facilities? Why not have federal standards which will protect every patient and every provider in the United States rather than the wasteful duplication of political-administrative functions in every jurisdiction in our nation?
Physicians and other providers know that dealing with health care insurers is more disruptive to their practices, in terms of inadequate compensation, bureaucratic bottlenecks and denial of essential services to patients, than dealing with the federal government. The federal government, hamstrung by political contributions and lobbying, has not engaged with insurers to set matters right except for patients covered by Medicare. There is no fair uniform protection of patients and health care providers from financial ruin in the event of medical malpractice or the determination that malpractice has occurred (the public is not aware of the extraordinary cost of medical malpractice insurance to many practitioners, including those who have never lost a malpractice lawsuit). Our government has failed to deal with inflation in pharmaceutical costs and its impact on health care providers, patients and their families. The federal government has cost-shifted its drug war by imposing $500 fees on providers for a 3-year Drug Enforcement Administration license, using health care providers as cash-cows rather than as a vital part of our system of health care.
The government grants a franchise. Providers have to provide necessary health services to all of the public that the franchise envisions. And government has to reasonably protect health care providers, and all Americans, from being financially gouged by parasitic uncontrolled interests including those masquerading as government agencies or licensees or contractors. If not, as is the case today, we all lose.
Tuesday, August 11, 2009
It Wasn't The Government Saying Goodbye Too Soon
I recall one of our Thursday lunches, to which the physician organizer invited representatives of a local hospice to talk about hospices and specifically about their hospice's services to patients and their families. It was an informative interesting talk, enlivened by a lot of questions from doctors. But the really interesting conversation came after the hospice people left.
Several cancer specialists angrily complained about a local hospital. These physicians found that immediately upon a patient's diagnosis of cancer, someone in the hospital (perhaps social services?) arranged for a prompt hospice consult before a cancer specialist could review the case with the patient, his or her family, the patient's primary physician, pathologists, radiologists, and other experts. Patients and their families were having "the crepe" hung for them, with the gloomiest possible prognosis. The cancer specialists said that patients were being whisked out of the hospital, consigned to hospice care, when they could have been treated palliatively (even during hospice care), to relieve pain and suffering and perhaps to prolong life, or could have explored the possibility of an effort at curative treatment.
Now, this wasn't the government convening a "let's shorten your life" committee. The physicians felt this was an apparent hospital policy.
Before we again shake our fingers at Senators and Representatives, and accuse our government of rushing people off to die to save money, let's think about other actors: insurers, hospitals and institutions which - if there are no ethical safeguards - could be advantaged by hastening the process of dying.
Several cancer specialists angrily complained about a local hospital. These physicians found that immediately upon a patient's diagnosis of cancer, someone in the hospital (perhaps social services?) arranged for a prompt hospice consult before a cancer specialist could review the case with the patient, his or her family, the patient's primary physician, pathologists, radiologists, and other experts. Patients and their families were having "the crepe" hung for them, with the gloomiest possible prognosis. The cancer specialists said that patients were being whisked out of the hospital, consigned to hospice care, when they could have been treated palliatively (even during hospice care), to relieve pain and suffering and perhaps to prolong life, or could have explored the possibility of an effort at curative treatment.
Now, this wasn't the government convening a "let's shorten your life" committee. The physicians felt this was an apparent hospital policy.
Before we again shake our fingers at Senators and Representatives, and accuse our government of rushing people off to die to save money, let's think about other actors: insurers, hospitals and institutions which - if there are no ethical safeguards - could be advantaged by hastening the process of dying.
Tuesday, March 25, 2008
Health Insurers, HMOs and Automotive History
After World War II, a Democratic presidential economic advisor observed that mergers and acquisitions in the auto industry left concentrated power in fewer companies (GM, Ford and Chrysler) which made them much easier for the government to control. Government controlled and regulated them, competitors have appeared, and the big three are struggling to survive.
We have seen merger and acquisition after merger and acquisition in the health insurance industry with relatively few major players still standing. Well-paid industry executives and advisors forgot to study industrial history, and their own vulnerability, when they reduced the number of viable insurers and HMOs. As they hungrily gobbled each other up, they did not recognize they were committing industrial suicide. If the election in November of 2008 results in a Democratic victory, the health insurance industry is ripe, as never before, for much tougher government control and regulation. And who is going to speak in behalf of the health insurance industry? Certainly not employers and unions who have seen unfilled promises of cost control and more appropriate provision of health care to their employees. Certainly not religious organizations and small governmental entities which are struggling to provide care to the uninsured and poor. Certainly not the public which readily expresses its anger and skepticism (go to a movie and hear the audience snicker when the "HMO" is used disparagingly). Not the physicians and other health care providers who have seen the quality of the service that they are paid to provide slide under the financial pressure of health insurers which cost-shift their way out paying for reasonably expected and necessary health services.
The industry insurance/ppo industry has set itself up for control by government on government's terms (regulators do not make fancy salaries and are not particularly sympathetic to those who do) and has, through its expression of greed, has made itself as vulnerable - as GM, Ford and Chrysler were in post-war America. Oh, if they had only paid attention to history!
We have seen merger and acquisition after merger and acquisition in the health insurance industry with relatively few major players still standing. Well-paid industry executives and advisors forgot to study industrial history, and their own vulnerability, when they reduced the number of viable insurers and HMOs. As they hungrily gobbled each other up, they did not recognize they were committing industrial suicide. If the election in November of 2008 results in a Democratic victory, the health insurance industry is ripe, as never before, for much tougher government control and regulation. And who is going to speak in behalf of the health insurance industry? Certainly not employers and unions who have seen unfilled promises of cost control and more appropriate provision of health care to their employees. Certainly not religious organizations and small governmental entities which are struggling to provide care to the uninsured and poor. Certainly not the public which readily expresses its anger and skepticism (go to a movie and hear the audience snicker when the "HMO" is used disparagingly). Not the physicians and other health care providers who have seen the quality of the service that they are paid to provide slide under the financial pressure of health insurers which cost-shift their way out paying for reasonably expected and necessary health services.
The industry insurance/ppo industry has set itself up for control by government on government's terms (regulators do not make fancy salaries and are not particularly sympathetic to those who do) and has, through its expression of greed, has made itself as vulnerable - as GM, Ford and Chrysler were in post-war America. Oh, if they had only paid attention to history!
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