Two awfully interesting points brought up by a C-Span caller this morning (Health Care)

Caller into Washington Journal, approximately 7:15 this morning.

A fellow called into C-Span this morning identifying himself as a one-time registered nurse (now involved in policy) from Tennessee who had comments on cost in our Health Care system. He noted a couple of interesting things that I had been wondering about, key things that are totally absent from the current debate - but shouldn't be.

First he said that up until about 1980-82 (Reagan era) health care was reasonably affordable. At that time, he noted, hospitals were run by religious institutions, educational institutions, and local Governments and were not over priced. he said the problem began with the intrusion of for-profit hospitals. He said he remembered the first of these, Humana, that opened facilities in Kentucky and of course they spread like diarrhea in west africa (my comment, not his). He also noted that at that time there were roughly 16 major drug companies, now through consolidation there are 6.

About that time the moderator cut him off and changed the subject, but think about what he said. The problems began with for-profit hospitals and consolidation of the drug industry. Sound familiar? Not to me, I haven't heard a word about this in the current debate. Why not?

and then when the Clintons tried to change things things changed and the change was copays and more elevated prices. Maybe this third time will be a charm though, maybe.

this is true.

did the mod cut him off apparently to stop this line of thought?

i remember when our local hospital, formerly run by nuns, went private, about ten years after reagan became pres.

the hype = save money!!

yuck yuck.

edit: i think what happened is med became a profit center to make up for deindustrialization. most medical now gov't paid - corps just kept inflating costs & creaming off tax dollars.

with the collusion of gov't, i believe.

have heard these arguments, but not enough. Obama is asking for a non-profit public option, with rates, etc, to make private competitive.

The article actually blames a Supreme Court decision made in 1975 that allowed "doctor owned hospitals". The motive changed from healing to profit:

Did Warren Burger Create the Health Care Mess?
The 1975 antitrust decision that gave you physician-owned hospitals.

On May 15, a 25-year-old woman named Hilary Carpenter had an operation at the Colorado Orthopaedic and Surgical Hospital in Denver to replace a shunt valve in her brain. After the surgery, Carpenter experienced a severe headache and nausea. After consulting with a physician on duty, a registered nurse at the hospital administered Demerol, but the dosage was wrong, and Carpenter's heart stopped. In a scene that state investigators later described as "chaotic," hospital staff was unable to locate quickly the equipment needed to revive Carpenter. According to the investigators, there were only a few people on hand that day to deal with the crisis, and those present lacked training to handle such emergencies. Eventually the staff did something you wouldn't normally expect a hospital to do: They called 911. A paramedic team took Carpenter to a different hospital, where she died.

A July 17 news story about this incident in the Denver Post prompted an immediate outcry from Sens. Max Baucus of Montana and Chuck Grassley of Iowa, Democratic chairman and ranking Republican member of the finance committee, then as now struggling to craft a bipartisan health reform bill. The occasion for their outrage was that the Colorado Orthopaedic and Surgical Hospital is one of about 230 hospitals in the United States that are owned by doctors, nearly all of them so-called "specialty hospitals" that steer clear of the seriously ill or uninsured. "Sen. Baucus and I have worked for years now to address the concerns that come with physician-owned hospitals," Grassley said, "including inherent conflicts of interests for physician-owners and, more importantly, patient safety. I remain concerned about the ability of these facilities to address emergency situations." The senators have written into their still-incomplete reform bill that any new doctor-owned hospitals will be barred from participating in Medicare and that existing doctor-owned hospitals must increase safety precautions. The House bill (which has finally won support from Blue Dog Democrats with what appear to be minor concessions) contains a similar provision.


The rest is here, It's a short read:
http://www.slate.com:80/id/2223841/

I haven't thouroghly weighed this yet as I feel blame is secondary to fixing the problem. Hopefully, these institutions will be outlawed or fail.

Medical care was a means to an end. The end being, to break the back of the middle class and make the US a two class system.

Under Reagan we also had the push to bust unions. When Americans did not fight back against that push, and when too many bought the fable that 'greed is good' the middle class pretty much was given a fatal disease, the disease that would work, over time, to dissolve any real possibility of people pulling themselves to a better economic station.

Think about it. Now, we have pols in D.C. making remarks to the effect that incomes of $250,000 is just barely middle class. They don't recognize a real middle anymore.

edited to add: Medical care is something even the most prudent of shoppers will tend to buy if they possibly can. Sure fire way to separate middle class people from their hard earned income and move those funds up into fewer and fewer hands.

Kill real worker bargaining power. Drain the savings of any workers who were able to set money aside. Bankrupt and take the assets at pennies on the dollar. Yep, attack on the middle class.

Of the "middle class" is the reason I avoid the term. I now use the term middle incomed - in other words, the percentile based figures that define who earns what.

The median income even in Marin County was only $ 42,300 bucks in the early nineties (Marin County is the second or third wealthiest county in America.) The notion that people making $ 250,000 are numerous, and are of the middle class is obscene, even though it does cost at least half that much to afford the sort of neighborhood that many of us grew up in during the fifties and sixties with only one parent working, and making less than $ 25K.

isn't taken in to account.

I think it is better to classify it by wealth. Wealth owners and debt payers. Although that leads to a whole other discussion...

Saying.

I had a girlfriend who invited me to visit her. She was living in a trailer while her husband was building them their dream house. My son let it slip that we were paying $ 650 a month for our apartment. (This was back in the mid eighties)

So she is envisioning this gorgeous penthouse apartment like she would have in her neighborhood in Oregon for that amount.

Meanwhile, all I could think of was how nice her digs were. They were nicer than our $ 650 a month apartment, as we did not have an adjoining four acre lot complete with vegetable garden and greenhouse.

and have been waiting to see it mentioned as well. not out there. hmmm.

we need to get this info out there and talked about.

and there was a hospital owned by the Catholic Church, but open to all, and one 'professional' hospital. The answer became that 'for profit' hospitals would be more efficient, and available to all. So, all the cities turned them into corporation type operations, and we see the results.

for the birth or my aunt or uncle. it was not even a full size piece of paper. no itemization for this or that. just the room, nurse, + dr i think. and it was like $100 or $50.

hospital cost a total of $300. Since we didn't have insurance, my mother had to sell our car to pay for it. Many of my friends never went to the doctor because their families didn't have insurance or a way to pay, so it wasn't a perfect system by any means.

there was a small shift in coverage in the 80's..but it really stayed the same until the 90's..then we started getting this reasonable and customary crap...i remember getting very confused by this..and angry..i would get an insurance letter saying my bill exceeded the "reasonable and customary" coverage..

so i would call the insurance company and say..well damn it..this is the same doctor i have had all along and nothing has changed but your new "reasonable and customary " bullshit..

The insurance rep i had always had said..turn the paper over and write just that..that it was the same doctor and same bill as always ..then they would pay it..

so for several years , every time i got a insurance payment document ..it would say "reasonable and customary" crap..and i would turn it over and write.pay this !

The INSURANCE REP I HAVE HAD FOR OVER 25+ YEARS whispered to me on the phone one day..that you would be surprised how many people pay the extra without complaining and it saves the insurance company lots of $$ by doing the reasonable customary crap..

well I wouldn't pay it as I knew what my insurance always covered before and that is what i was paying them for.

But we were never in a "network" or any of that stuff..until late 90's..like 97-99..timeframe..it used to be straight insurance..go to doc they paid 80%..80% of meds..100% hospital.it was easy and we knew what it was..

now?? it is complicated as all get out..this doc is in network..that one is not..

I just had a problem with my foot ..i went to the doc in the "network" and he told me I had to have surgery on my achilles tendon that i had a bone spur pushing on achilles tendon..and that after the surgery i would not be able to walk for almost 6 months..they put me in this boot that cost $1,400.00 that i could not wear..

I went for second opinion ..and the doc is excellent but out of network..that doc said i didn't have bone spur and he sent me to foot specialist ( i won't go into details..but it was the sack under the achilles tendon that had burcitis)..not in network..and he gave me a series of 3 shots in my foot..and said i didn't need any surgery..and after the shots my foot is fine! I need a thing for in my shoe that they would only pay a little on..

so end of story..if i went to their wack job doctor i would have had horrible surgery cutting my achilles tendon..and been unable to walk the same again..and been laid up for well over 6 months..and it would have been covered 100%...but since i went to another doctor "out of network" that the fee was way way less than a major surgery ..they paid very little ..

Like i stated ..we never had this network crap from 1970..until 1997-98...

we are seriously being fleeced now..unlike for many many years before.

and i tend to agree with that caller..about the hospitals now being corporately owned.


Go read about Tenet corporation and what they did to so many at the Shasta Hospital in Redding Calif..there is alot about it in the archives here at DU..
My father in law was one of the unlucky ones who was operated on his brain.. by one of these corrupt corporate doctors...needlessly...it was criminal! These Corporate whores who took over our medical hospitals and Pharm's are what has destroyed our system of care.


http://allnurses.com/nursing-activism-healthcare/tenet-healthcare-paying-42620.html
Tenet Healthcare Paying $54 Million in Fraud Settlement over Redding CA heart care

The Tenet Healthcare Corporation agreed yesterday to pay $54 million to resolve government accusations that doctors at a hospital in Northern California conducted unnecessary heart procedures and operations on hundreds of patients.
The settlement is the largest in a case involving what is known as medical necessity fraud, or billing government health programs for tests and treatments that the patient's condition did not require.

Wish I could recommend just that. Thanks for posting. It's been passed along to a few friends on the fence about the reform bill that need to be reminded where we came from in a personal sense.

also being one of them. I worked for a Catholic hospital in the late fifties and early sixties, however, they had turned the non-profit status into a corporation much earlier than that in the sixties.

companies - formed for the benefit of the members - not to make a profit. For-profit insurers are also a big part of this problem

Exactly! Back in the day (the 50's) Blue Cross/Blue Shield were non-profit. My Dad's employer and my Mom's employer provided our insurance. I hate to say it, but they hospitalized me (also a non-profit) for some illness I can't remember when I was a child and MADE MONEY! Not right, just sayin'.

and if you do any serious research, you'll find that 99.99% of all medicare fraud is done by corporations. I guess the copays and the premiums just aren't enough to keep the gravy train rollin.:banghead:

my partner, after leaving Vietnam as a medic in the 70's, worked in hospitals for 20 years and he remembers... he suggested we look into the part the Frist family (and others) played in all this.

http://www.heartland.org/publications/health%20care/article/11508/Frists_Big_Vision_Gets_Bigger.html
http://www.portfolio.com/executives/features/2008/10/15/Frist-Funds-New-Private-School
http://www.forbes.com/lists/2006/10/XA34.html

I just thought a few of you night people would like to see this.

I was trying to explain it to my son the other night. It sounded so foreign to him.

Back in the day, we had a not-for-profit community hospital, a county hospital, the VA, and a Catholic hospital. Insured by a non-profit Blue Cross, and paying 20% of the bill did not break us.

Greed broke the system.

Because the American People are being extorted (pay up or you will be destroyed and die) by the Health, Pharmaceutical, and Insurance Industries.

I became a diabetic in the early 80s, and I have seen first hand, the effect "for profit" industries have had on health care since then. It's why I tell my doctor to go back 30 years, because that is how I wish to be treated. Sorry... I do not trust "studies" from the "for profit" industries and they all have a stake in making you their golden goose.

As doctors did thirty years ago.

Instead, more and more, our care is decided by the code number for whatever disease we have, and what prescription meds will fit that code.

No doctors out there seem to care as to what may be causing the disease. Also, doctors are moving millions of people off reliable pain meds and putting them on anti-depressants. Doctors are inserting their religious beliefs into the Matrix as well.

All of this adds up to a very horrible system, one that will not be solved simply by insuring everyone. (Although that is a start, of course.)