To begin with this Proposal is a casual document. It is a proposal and not a bill. There is nothing legal or binding to it EXCEPT it is issued by the President and Vice President of the USA and carries the brevity of those offices.
In other words, it is meant to be taken seriously and not simply as a political volley.
The Executive Branch produced this proposal to begin a process that is suppose to culminate in PRODUCTIVE measures at the White House Summit on Health Care.
BARACK OBAMA AND JOE BIDEN’S PLAN TO LOWER HEALTH CARE COSTS
AND ENSURE AFFORDABLE, ACCESSIBLE HEALTH COVERAGE FOR ALL
That's the title. None of this is a simple or inconsequential matter as it can effect the wellness of every citizen of the country. The Executive Branch is attempting to 'move this issue along' because IF it is not addressed SOON, it will not only cause great hardship to the American people, it will destroy any fragile recovery that is now underway in the USA economy. The issue HAS to be resolved and soon.
Health care costs are skyrocketing.
There are some interesting statistics within this paragraph. I am not going to quote them, but, they say basically what most Americans understand about health care insurance. The companies that deal in this commodity are out to make a profit and while that is what drives the USA economy, there has to be a fine balance between the profits HEALTH CARE INSURERS make and the benefits their clients receive.
It is NOT like Life Insurance. Life Insurance is a single issue in the lives of folks. Either the insured is alive or dead. That's pretty simple.
Health Care is completely different. The QUALITY OF THE INSURED'S LIFE is the issue and where that is not adequately addressed the insured does die. If that death is caused by the INSURER, then there is a "Breach of Contract."
- Death is NOT suppose to occur and when it does because of denial of benefits due to 'so called' experimental medicine that is a CHANCE to save a life there is something grossly "W"rong. In any understanding of medicine and/or surgery there is a profound definition that goes along with it in that an MD 'PRACTICES' their craft. That means if an MD states there is a new medicine currently issued by the CDC that is considered 'INVESTIGATIONAL' and is believed to produce a benefit to extend life (as Chemotherapy does) or save life then that is a valid treatment. End of Discussion. There is no Health Care Insurer that is suppose to be PRACTICING medicine and denying coverage of valid orders by MDs. That is MALPRACTICE of the license to insure. Even if a Health Care Insurance Company has an MD on staff it doesn't mean a DAMN thing. Their client has a physician that is treating them and allowed to receive the benefit of payment under their insurance policy. If there are unreasonable clauses in the policy then the State Licensing Board is not doing its job. The CDC does make decisions regarding investigation drugs and treatments lightly. There is a lot of taxpayer monies that go into these classifications by the CDC and there is no authority in existence that has any right to refuse the treatment to patients offered as 'HOPE' to a citizen. The people of the USA have stated loud and clear we want to LIVE. Not only do we want to live, we want EVERY chance that our scientists and doctors can give us and we have put government authority behind that understanding about life. Therefore, when the CDC comes out and states, there is reason to believe a medication has potential to save lives and we do not have any reason to believe this is a harmful measure that carries great brevity in the medical and surgical community. Doctors and Surgeons want to help people and when there is new hope they want to practice that hope. ANY Insurer that stands in the way of that is practicing against the wishes of the American people and should be eliminated as an insurer at any State Licensing venue. End of this discussion.
- If that death occurs because of the lack of access while folks are insured that is in my opinion WRONGFUL DEATH. If people are denied access to health care while having health care insurance, those denying them access are liable. No one should be denied access and this entire idea of 'in network' or 'out of network' is one of the most hideous concepts in any contract written. Literally, people could have a health care policy that list dearly few 'in network' practitioners and no specialists and they are excluded from care. Unknown to them until it is too late. The 'in network' or 'out of network' contract issue is an Insurers dream come true, it is a money making deal and it discriminates against any practitioner that is licensed by any State. It is a form of fraud and is a BARRIER to care. It is illegal and should be eliminated by State Licensing Boards. If a practitioner is licensed they are valid to receive payment by insurance companies. END OF THAT DISCUSSION.
- If death occurs because a person has been denied coverage because they have a pre-existing condition, THAT in my opinion, is gross malpractice of the insurance laws of any state and also is extremely poor management of an insurance company. Any state that allows such practice within its borders is threatening the lives of its citizens and has issue with human rights. Pandering to health care insurers so they can 'gain' profit by accepting CERTAIN citizens is discrimination. The SICK and/or those that have been SICK is what health care insurance is all about. The insurance exists for the UNFORTUNATE need that an insured needs help. Hello? To state those afflicted by the 'very reason' these CORPORATIONS exist are allowed to be ostracized of benefits is not only conflict of interest, it is fraud. One cannot state, "We are going to insure people in case they have health care needs" and then not do it and still have a license. The 'contract for payment of insurance benefits' has become an instrument of fraud and deception. In order for people to understand their RIGHTS under the contract, they have to now obtain prior authority from the insurance company to save their own lives. That should not be happening under any insurance laws that issue licenses in any state. There is no PRE-CONDITION to saving lives in this country, yet, the very 'lifeline' people pay large amounts of money they earn to have THE RIGHT TO LIVE in the USA is an instrument of fraud through the contracts allowed by the licensed practioners of health insurance. That is outrageous and extremely egregious of the Public Trust. Since when is the STATE a partner to the death of Americans?
DEATH by Insurance is not an option in this country, however, it is a reality.
That is not only malpractice of the licensed insurance companies it is extremely poor performance by these companies managers. It is not only bad PR, that they don't care about because of their power over people's lives, it is a lot of money uncollected to their companies stockholders.
In 1997 I was diagnosed with Cancer. It was successfully treated with surgery. Two day in the hospital, about 30 minutes under the scalpel of a trained and experienced surgeon, about 2 hours with OR and PACU staff to take me into a stupor to allow the surgery and then bring me out of it safely and then two days on 'the floor' to insure I received sufficient IV fluids to rehydrate me and establish my 'homeostasis' was stable in order to be discharged.
The bills were paid and I am fine. That was nearly 13 years ago. Thirteen years of premiums that more than paid for the INVESTMENT that health care insurance company made of me to save my life. I would have died otherwise. Thirteen years of simply vigilance and wellness programs that would not necessarily cost me what premiums cost me and my insurer/employer.
I have a friend that runs a transportation company. Fancy name for trucking firm. He runs trailers out of Port Elizabeth, New Jersey. He needed a driver for one of his tractors. This guy applies. My friend is a devoted Christian after several years of drug addiction. He is a successful business man now with a wife and child. Happy guy. So, this guy shows up looking for a job. He is very experienced. Lots and lots of road experience, but, he is unemployed. My friend is attracted to the application, it is an exceptional application for his size operation and interviews the fella. He asks is there anything I need to know that you care to tell me that might effect your employment in a way that I might misunderstand. Interesting question, huh? Remember, my friend is a recovered addict. He isn't interested in the 'status quo' application, okay? Also remember, he is extremely successful in his business. I mean successful. Private boat and all sorts of toys. The man applying for the job didn't have to say another word. He was about to be hired, or so he thought and he wasn't required to tell my friend anything else. But, he did, because he wanted a friend, too. An employer that would appreciate him as a human being and not just a number on a flow sheet. My friend could be considered a small business owner. This one time long-haul truck driver was in renal failure and went to dialysis three times a week. He was on a list for a kidney transplant and his attendance to his health needs might interfer with his work schedule. My friend hired him and scheduled him for work on the days when he was not receiving dialysis. He provided health insurance to him and when the day came for his transplant my friend took the run and looked for another drive, BUT, only until he was recovered and received clearance from his doctor to return to work. That man did not miss one day of work, worked what was asked of him and attended the small holiday parties at the house. He and my friend are not only acquainted with each other they are good friends. My friend stated to me, "one life saved, like mine was saved."
THAT is an American. We give a damn about each other and will watch each other's lives in vigilance of the outcomes. We don't need insurance companies that don't do the same thing. There is no reason for any insurance company in the United States of America to refuse treatment by any MD order. None. There is no good reason for refusal of coverage or enrollment. Any manager currently engaged in such a practice is in violation of any clear understanding of human rights in this country and should have their licenses pulled. I don't want to hear how Americans are being cheated out of life saving measures, even if that means having root canal on an infected tooth. There is no reason for it, except managers that carve out artificial short term gains for bonus dollars over the long term reward of managing a respectable company.
Americans have been abused by health care, period. They have been abused by the CEOs of heath care and I don't care if it is the CEO of health care systems. Those CEOs of Health Care Systems throughout the USA seem to believe they have to accept insurance company contracts over that of the demands of their physicians and patients. They are as much a part of the problem as the insurance companies themselves. CEOs of health care systems pander to insurance companies when they should be refusing to do business with the wealth merchants. The CEOs of Health Care Systems want to paint themselves as 'saints' to the 'sinners of health care insurance companies' and need to make necessary cuts in their budgets in order for their patients to receive care. Huh? Since when do the people that provide the services answer to those that seek to make money off those services. Since when are patients and physicians pawns in the market place of wealth merchants? The relationship is backwards and should not be rewarded. The health care systems, ungainly as they are, have the commodity. They set the price, they allow the insurance and they moderate the outcomes. NOT, the other way around. When a patient is given 'health care' it should be timely, appropriate and in measure that matters, not ONLY WHAT IS ALLOWED. When an MD makes an order, those 'in service' to the order need to ask how high they have to jump and not how high the ? patient ? has to jump. No, no. I don't think so. Patients are in NEED, physicians are in PRACTICE and those that MANAGE the insurance and facilities need to be in servatude. End of that discussion.
About 100,000
Americans die from medical errors in hospitals every year.3 One-quarter of all medical spending goes to administrative and overhead costs, and reliance on antiquated paper-based record and information systems needlessly increases these costs.4
Peer review and licensing issues for malpractice and neglegence INCLUDING a review of the Health Care System and their failings in providing 'error free' venues of care. In other words, the medical errors that occur have a reason and they sometimes occur due to the management of the 'care environment.' What I mean by that is addressed in understanding that physicians practice and have to practice in large health care systems where 'cutbacks' and all sorts of 'staffing' issues, including, under staffing exists. That is due to the 'backward' reimbursement systems and the profits made by CEOs all along the line. Health care is provided by human beings. There is no better way of doing it. A person is a unique living entity with a history and assessment at the time of need. That assessment and understanding of a patient's health history has to be conducted by physicians. It just does. As a result there are issues that fix certain understandings that human beings do not have endless capacity to deliver 'good care' in any environment offered to them. They can, ie Haiti, but, the American 'delivery' system should not be viewed through its 'finest hour' in Haiti as a daily diet. That is unrealistic. If that were the case all surgery in the USA would be done in tents to save on electricity and provide more patient rooms rather than surgical suites if CEOs had their choice. That is an extreme example, however, it underlies the 'reason' why medical errors can exist. When a practitoner of health care is brought into question regarding their license what also needs to accompany that (BY STATE MANDATE) are statistics and quality assessments of the care environment where the errors occur. What I am saying is that errors are simply the tip of the iceberg and calling 'health care delivery' into the picture will 'fix' the issue far quicker than simply taking it 'case by case.' If the Peer Review system of regulating poor practitioners continues in the venue it is today, it will result in nothing more than a revolving door of people. It isn't a good review system without that component. It will call into question the CEO choices to the 'care environment' that effects any practice at any level. That said, changing 'record keeping' to computer systems may help to make the practice quicker and more efficient IF that ever reaches the pinnacle it is intended to achieve, HOWEVER, it is not ONLY the computerization that will eliminate the issues. It will only resolve ONE 'care environment' issue. It won't matter if the computers are working well if the HUMAN BEINGS at the end of the computer are overwhelmed with an unsatisfactory 'patient ratio' and/or 'hostile care environment.' The entire 'delivery system' has to be PEER reviewed, given the way it has been sadly effected to date.
Well. That was a long paragraph of 'get down to it.' I'm taking a break.
