Discussion Question post- “Social Conditions as Fundamental Causes of Health Inequalities”

According to Jo C. Phelan, Bruce G. Link and Parisa Tehranifar

“if we redistribute resources in the population so as to reduce the degree of resource inequality, inequalities in health should also decrease. Policies relevant to fundamental causes of disease form a major part of the national agenda, whether this involves the minimum wage, housing for homeless and low-income people, capital-gains and estate taxes, parenting leave, social security, head-start programs and college-admission policies, regulation of lending practices, or other initiatives of this type.”

Is it still possible to improve the health care system and health outcomes for Americans without taking on all of this? Do we have to re-create our whole system just to fix this part of it?

Which is the Best Health Care System that Can Serve as a Base for Health Care Reform in the US? Or Would A Hybrid System Work the Best?

After watching the video “Sick Around the World” on my own time. I wonder if the US has any intentions to possibly use one of these different health care systems as a new base for health care reform in our country. Its been shown that each of these health care system delivers health care for everyone and still has better health outcomes and spends less money on health care than the US. The question I pose is if we had to choose one of these health care systems as a replacement system in the US, which one would be the best for our citizens? Or if we could create a hybrid version of a health care system, in which we would pick and choose what aspects of each health care system we want from each country to implement in ours, which elements would we choose to create an “ideal” health care system?

Continue reading “Which is the Best Health Care System that Can Serve as a Base for Health Care Reform in the US? Or Would A Hybrid System Work the Best?”

How Much of Big Pharma’s Massive Profits Are Used to Influence Politicians?

Earlier this morning, Mike Ludwig, from Truthout, wrote about how pharmaceutical companies use their massive profits, among other things, to quiet/ lobby politicians in their favor. Ludwig started the article by bringing up the so called “defense” all pharmaceutical companies use when prices of medicines go up. Similarly to what the gentleman in the video said yesterday in class, these companies claim that the money is needed for further development of drugs or research. Ludwig then questioned why a company like Turing Pharmaceuticals needed to increase the price of an anti-parasitic drug almost $700 overnight, it most definitely was not due to a need for research funding. Ludwig began to then investigate where these pharmaceutical companies really spent their money. Continue reading “How Much of Big Pharma’s Massive Profits Are Used to Influence Politicians?”

Could a Single Payer System Exist in the United States?

In Sarah Wheaton’s article “ Why single payer died in Vermont,” the point is brought up that besides financial constraints, there is a good deal of political opposition to the single payer system including push back from existing insurance companies that will be kicked out of the market, and a general understanding that Americans inherently distrust government-run anything. The suggestion was made that there has to “be so much pressure that it’s like a volcano goes off and it happens.” Continue reading “Could a Single Payer System Exist in the United States?”

Government Intervention in Our Health Care “System”

In Atual Gawande’s article “Testing Testing” he highlights what he believes to be the two main problems of America’s fragmented health care system, cost and coverage. Not all Americans have access health insurance and even with coverage out of pocket medical costs continue to soar. With the passage of the Affordable Health Care Act more Americans have insurance coverage but the bill has done little to make “significant long-term cost reductions.” According to Gawande, if costs continue to rise at the current rate more than a fifth of every dollar Americans earn will go to health care costs.

Gawande goes on in the article to give a brief history of the United States agricultural system, essentially comparing it to the current state of our health care system. In the 1900’s there was an agricultural crisis in America, there were limited crop options at high prices with differing qualities. However, through government intervention the USDA was able to implement pilot programs that improved the quality of farms county by county by providing technical assistance to local framers. This system was effective in that it standardized quality of crops, lowered prices and increased availability. The government was able to be involved in improving the country’s agricultural system without taking control away from the farmers. Additionally, this process did not happen over night, it took years to standardized the US agricultural system. It also required trial and error as far determining which farming techniques were better than others and which techniques produced the highest quality products at the lowest prices.

The history of America’s agricultural system tells us that government intervention may be the logical next step in response to the health care crisis. Because at this point we are in crisis and continuing to let big pharma, hospitals, insurance companies, and the AMA control our health care system is not a logical option. Answering to the government may not be physicians, pharmaceutical, and insurance companies want because it threatens their autonomy, but if they are not willing to come up with a standardized system the government will need to do so. There is no reason for the United States to continue to be an outlier when it comes to the amount we spend on health care. The cost of health care in other parts of the developed world like Switzerland and Norway pale in comparison to what Americans are paying. There are other less fractured and more organized systems that are working in other countries around the world. The United States needs to find another system that works without the high costs and low coverage that we are currently experiencing. Our current system is not going to get any better unless something is done because as of now it is not matter of whether or not our existing health care system will bankrupt our country but when.

http://www.newyorker.com/magazine/2009/12/14/testing-testing-2

Why do Non-Profit Hospital Organizations make Extremely Lucrative Profits?

In the article “Bitter Pill: Why Medical Bills are Killing Us”, the author Steven Brill compiles research and data on bills from hospitals all over the country. There is a trend where non-profit hospitals are turning around huge profits.

To quote Brill, “Its nearly half­billion dollars in revenue also makes Stamford Hospital (non-profit) by far the city’s largest business serving only local residents. In fact, the hospital’s revenue exceeded all money paid to the city of Stamford in taxes and fees. The hospital is a bigger business than its host city.” …. “There is nothing special about the hospital’s fortunes. Its operating profit margin is about the same as the average for all nonprofit hospitals, 11.7%, even when those that lose money are included. And Stamford’s 12.7% was tallied after the hospital paid a slew of high salaries to its management, including $744,000 to its chief financial officer and $1,860,000 to CEO Grissler.”

Meanwhile, taking a definition from google for a non-profit organization, “A nonprofit organization (NPO, also known as a non-business entity) is an organization that uses its surplus revenues to further achieve its purpose or mission, rather than distributing its surplus income to the organization’s directors (or equivalents) as profit or dividends.”

-https://en.wikipedia.org/wiki/Nonprofit_organization

Is there some loophole in this system where these non-profit hospitals get around this stringent definition?

The Endless Obstacles to Passing Healthcare Legislation

Now that the affordable care act has brought health care insurance coverage to millions of people, another issue prevails for the US healthcare system: the rising costs of drug prices. In response, front-line presidential candidates are proposing plans to change the way drugs are sold and financed. A recent New York Times article discusses Hilary’s plan to cap patients’ drug prices to 250/month, to require most drug makers to spend a portion of profits on research, and to discount the price of drugs sold to the federal government. In contrast, Bernie Sanders is pushing for a more radical change: a Medicare for all single payer system – a plan that pushes the US to catch up to peer countries that provide guaranteed healthcare.

Continue reading “The Endless Obstacles to Passing Healthcare Legislation”