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HEALTHPLANUSA. NET |
QUARTERLY NEWSLETTER |
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Community For Affordable Health Care |
Vol IV, No 4, January, 2006 |
Utilizing the $1.4 Trillion Information Technology Industry
In This Issue:
1.Featured Article: Would you want to live in a world
reduced to hard facts? by Ken
Myers
2.In the News: Let Your Own Epidermis Become a Medical Monitor – Fast Company
3.International Medicine: Access to New Medications Delayed In
Europe – Galen Institute
4.Governmental Health Plans: Waiting for Surgery by Basil Peabody, London
5.Lean HealthCare: LEAN SOLUTIONS, a book by James P Womack and Daniel T Jones
6.Insurance Myths: People are uninsured because they
can’t afford insurance.
7.Overheard on Capital Hill: Subsidies Help Farmers,
Business, Medicine-Everyone - Reason
8.What's New in
Health Care: HealthPlan4Life by Steve Barchet
9.Health Plan USA: Where are we now? Ideal HealthPlan:
Portability? HSA Revolution.
* * * * *
1.Feature Article: Would you want to live in a world reduced to hard
facts?
By Ken Myers, President, Mars Hill Audio
Twenty years ago, writing in
The Wilson Quarterly, the literary critic Cleanth
Brooks noted that: “A world reduced to hard facts would thereby become a
dehumanized world, a world in which few of us would want to live. We are
intensely interested in how our fellow human beings behave—in their actions, to
be sure, but also in the feelings, motives, purposes that lead them into these
actions.”
Most of us don’t believe in a
world reduced to hard facts, but for some time, Western societies have found it
virtually impossible to order public life around anything other than hard
facts. The Canadian philosopher George Parkin Grant,
in an essay written in the 1960s, commented on the widely held assumption in
modern societies that the only knowledge that is properly considered objective
and public is scientific knowledge, that is, knowledge of hard facts. Grant
posed three questions that flowed from this assumption: “(a) whether there is
any knowledge other than that reached by quantifying and experimental methods,
(b) whether, as such methods cannot provide knowledge of the proper purposes of
human life, the very idea of there being better and worse purposes has any
sense to it, (c) whether, indeed, purpose is not merely what we will in power
from the midst of chaos. The effect of these questionings on the humanities
could not but be enormous.”
The work of Michael Polanyi is a valuable resource in combatting the assumptions about the unique worth of scientific knowledge. Polanyi, who lived from 1891 to 1976, was a scientist, an accomplished physical chemist, who turned to philosophy later in his life in order to address some of the social crises prompted by the misleading ideals of objectivity derived from science. Several years ago, MARS HILL AUDIO produced a lengthy audio documentary about Polanyi’s life and work, and one of the experts we interviewed was Dr. Martin X. Moleski. Now a new biography of Polanyi co-written by Moleski has just been published. The book is called simply, Michael Polanyi: Scientist and Philosopher . . .
Professor Martin X. Moleski explains why Michael Polanyi (1891-1976) left his career in science to become a philosopher . . . Polanyi was trained and worked as a scientist and physical chemist until he realized the totalitarian regimes of Europe were basing their destructive and dehumanizing view of humanity on a faulty definition of knowledge. Polanyi knew the definition was inadequate; he became a philosopher in order to study why. He dedicated himself, notes Moleski, to explicating a system of personal knowledge that considers the body important and attends to what knowing the world through the body entails. He also espoused the dignity of the person, the love of truth, and—among other goods—justice.
Ken
Myers, President, Mars Hill Audio. To hear the entire dialogue, subscribe at www.marshillaudio.org/. To see the
segment file and the gateway to this series, please go to
www.marshillaudio.org/resources/segment_detail.asp?ID=453054480&TABLE=segments.
Central to Michael Polanyi's
thinking was the belief that creative acts (especially acts of discovery) are
shot-through or charged with strong personal feelings and commitments (hence
the title of his most famous work Personal Knowledge). Arguing against
the then dominant position that science was somehow value-free, Michael Polanyi sought to bring into creative tension a concern
with reasoned and critical interrogation with other, more 'tacit', forms of
knowing.
Polanyi's argument was that the
informed guesses, hunches and imaginings that are part of exploratory acts are
motivated by what he describes as 'passions'. They might well be aimed at
discovering 'truth', but they are not necessarily in a form that can be stated
in propositional or formal terms. As Michael Polanyi
(1967: 4) wrote in The Tacit Dimension, we should start from the fact
that 'we can know more than we can tell'. He termed this pre-logical
phase of knowing as 'tacit knowledge'. Tacit knowledge comprises a range
of conceptual and sensory information and images that can be brought to bear in
an attempt to make sense of something (see Hodgkin 1991). Many bits of tacit
knowledge can be brought together to help form a new model or theory. This
inevitably led him to explore connoisseurship and the process of discovery
(rather than with the validation or refutation of theories and models - in
contrast with Popper, for example).
We must conclude
that the paradigmatic case of scientific knowledge, in which all faculties that
are necessary for finding and holding scientific knowledge are fully developed,
is the knowledge of approaching discovery.
To hold such
knowledge is an act deeply committed to the conviction that there is something
there to be discovered. It is personal, in the sense of involving the
personality of him who holds it, and also in the sense of being, as a rule,
solitary; but there is no trace in it of self-indulgence. The discoverer is
filled with a compelling sense of responsibility for the pursuit of a hidden
truth, which demands his services for revealing it. His act of knowing
exercises a personal judgement in relating evidence
to an external reality, an aspect of which he is seeking to apprehend. (Polanyi 1967: 24-5)
Michael Polanyi
placed a strong emphasis on dialogue
within an open community (a theme taken up later strongly by the physicist David Bohm).
He recognized the strength by which we hold opinions and understandings and our
resistance to changing them. Unlike many of his contemporaries he placed his
thinking within an appreciation of God and of the power of worship
- especially in his later writing (see, for example, Meaning). In
his earlier work (especially in Personal Knowledge) Polanyi seems to be preoccupied with 'setting forth ways to
think about religious meaning as an articulate system or framework related to
other articulate systems' (Mullins undated). Later Michael Polanyi
attempted to extend his model to describe the nature of human knowledge found
in art, myth and religion.
Conclusion
In respect of the philosophy of science, it can be
argued that Michael Polanyi helped to pave the way
for Thomas Kuhn's groundbreaking work on the structure of scientific
revolutions. Perhaps the strongest echo of his work that we encounter as educators
comes through the work of Donald
Schön and Chris Argyris
on knowing in action, and in Eisner's
consistent arguments for connoisseurship and criticism in evaluation. It also
has parallels in Jerome
Bruner's (1960) distinction between mediated and immediate cognition or apprehension.
By paying attention to Polanyi's
conception of the tacit dimension we can begin to make sense of the
place of intuition and hunches in informal education practice - and how we can
come a better understanding of what might be going on in different situations.
Significantly, his attention to passions and commitments throws fresh light on
the praxis (informed,
committed actions) that stand at the heart of informal
education.
To read more, go to www.infed.org/thinkers/polanyi.htm#cite.
* * * * *
2.In the News: Let Your Own Epidermis Become a
Medical Monitor
A new concept could let
your own epidermis become a medical monitor. By: Joseph
Manez, In Fast Company, January 2006 Page 35.
The future of health care? It may be this
concept for programmable video displays embedded just under the surface of your
epidermis, made possible by billions of microscopic robots.
Robert A. Freitas Jr., a fellow at the
Institute for Molecular Manufacturing, says the robots, one-billionth of a
meter small, would emit minuscule amounts of light. Together they could form
text and graphics, recognizing finger-tap instructions to scroll and change
menus. Other nanorobots throughout your body would gather medical data and
transmit it to the display.
Dartmouth and MIT researchers have
already built tiny, wirelessly controlled robots. Freitas says the machines he
envisions, a thousandth the size of those critters, will take another 20 years
to perfect. The goal, he says, is to empower people "to take control of
their own personal medical destiny" with constantly updated data at their
fingertips (and in them).
To read the entire article
(Subscription required), go to www.fastcompany.com/magazine/102/next-artifact.html.
* * * * *
3. International Medicine: Access to New Medications Delayed in
One of the hidden costs to patients of controlling prescription
drug prices -- ostensibly to make them more "affordable" -- can be
doing without new drug therapies. For many years, the U.S. Food & Drug
Administration has been criticized for delaying final approval of new drugs'
safety and effectiveness after the completion of clinical trials.
But in many European countries, after new drugs have been approved
by the national ministries of health in each country or by the European Agency for
the Evaluation of Medicines, patients must wait while drugs clear another
hurdle.
This additional regulatory delay is a side effect of drug price
controls. Before they can market a new medicine, pharmaceutical companies must
obtain approval from each national government for the prices they charge. Then,
in an often in a separate process, they must get approval of reimbursement
rates without which the drugs are inaccessible to most patients.
As a result, access to breakthrough drugs is delayed sometimes
four years or more in many European Union countries, according to two new
studies by the London-based research organization, Europe Economics. For
example,
In 1995,
EU Members began a centralized, marketing
authorization process intended to ensure "rapid access" to new
medications. But centralized approval has not reduced delays in the pricing and
reimbursement processes.
To read
the entire article and sources, go to www.ncpa.org/pi/health/pd100300e.html.
Source:
"In Europe, Access to New Medications Takes Time," September 28,
2000, Galen Institute, P.O. Box 19080, Alexandria, Va. 22320, (703) 299-8900;
"Patient Access to Major Pharmaceutical Products in EU Member
States," and "Patient Access to Pharmaceuticals Approved through
Mutual Recognition," Europe Economics, Chancery House, 53-64 Chancery
Lane, London, WC2A 1QU, United Kingdom, +44 (0)20 7831-4717.
For Galen
text: www.galen.org/healthabroad.asp?docID=113
For more
on International Health Care: www.ncpa.org/iss/hea/
* * * * *
4.Governmental
Health Plans: Waiting for Surgery by Basil Peabody,
Sir
- Like Tony Blair, I, too, suffer from an irregular heartbeat (News,
January 3). As a fit 37 year old, my condition has had a catastrophic
impact on my life; while not being life threatening, it is lifestyle
threatening.
I was released from
On
weighing up the pros and cons of the wait versus the loan, I decided to opt for
the wait, despite the fact that the condition had reduced my exercise output
from three gym visits a week to the odd slow set of stairs.
Thankfully, I managed to secure a slot for
the procedure on the NHS after a modest six-month wait and am now recovering.
To be put in the position of having to
decide whether to take a loan or suffer in silence is a quite farcical state of
affairs for an apparently first world country with an allegedly exemplary
medical service that is the envy of the world.
Read more: www.news.telegraph.co.uk/opinion/main.jhtml?xml=/opinion/2006/01/05/dt0501.xml#top
It is absolutely beyond
comprehension to think that what Mr. Peabody describes as the envy of the world
would be considered as third-world medicine? Is there someway we can enlarge
the horizons of the British?
Meanwhile,
Working
together on health care,
WHILE
It’s a noble goal that comes loaded with
potential benefits and drawbacks. Supervisor Tom Ammiano
pushed forward the idea in November, but it contained a jaw-dropping price tag of
$345 per month per employee that a business would have to pay.
Not surprisingly, the idea fueled outrage
among employers. The standoff seemed headed to a winner-take-all ballot
showdown between business and liberal-interest groups.
Ammiano,
sensibly, is now calling for a timeout to negotiate. He’s dumping the original
deluxe coverage for a cheaper model priced at $50 to $75 that he plans to debut
Wednesday. This package aims at basic coverage, such as checkups and preventive
care, for a population of 35,000 to 40,000 uninsured, who typically work in
small shops and restaurants.
Ammiano
has supplied other missing ingredients to clarify his plan. Employees who live
outside the city wouldn’t be covered, and part-time workers would cost
employers less. Spouses and partners covered by other health plans may be
exempted. Firms that already pay for health care wouldn’t need to chip in more.
These changes may greatly reduce employer
worries. “If this is a way to get everyone to put down their guns, then it’s
positive,” said Chamber of Commerce CEO Steve Falk, who opposed the first
version.
It’s a welcome fresh start, though plenty
of questions remain. Ammiano, who plans to meet with
Falk today, hopes he can craft a compromise within the next few months. He’s
avoided the easy game of demonizing his critics and played down the nuclear
option of taking his plans directly to voters. That’s the last place a
detail-filled package should be decided.
There are still plenty of unanswered
questions over the level of care, cost, eligibility and access. On a parallel
track, Mayor Gavin Newsom is also speeding up a plan to use the city’s health
clinics to offer coverage to a pool of uninsured residents, though the details
are unclear.
With business, the mayor and Ammiano all advocating plans or ideas, it makes sense to
pause and consider. The unknowns could be cleared up with a fuller study, not
just deal-making among major players.
Ammiano
and supporters of expanded health care think such a study will only delay their
plan and isn’t needed. He favors passing the concept of basic health coverage
with the details and price worked out later by a commission appointed by the
mayor and Board of Supervisors.
Sorry, this isn’t good enough. If ever
there was a complicated undertaking in need of thorough study, health care is
it. Due-diligence homework shouldn’t penalize any side. Asking questions,
interviewing experts and collecting data is not tantamount to killing a
promising idea.
But these same voters also approved a
rule in 2004 requiring economic analysis of board actions that impact the local
economy, as this concept surely would. Small-business operators, who may be the
chief targets of the health-care proposal, complain the extra costs will
severely hamper operations or drive them out of town.
Right now, thousands of
The city needs to face an important
challenge in caring for this populace, who hold down jobs without a key fringe
benefit. Reaching them should be a top priority, and so should full knowledge
of the costs and conditions that go with supplying health care.
URL: http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2006/01/30/EDG5TG18R11.DTL
Coverage
for checkups and preventive care without hospital care is like having car
insurance for oil changes and preventive maintenance but not collision. The
former are not insurable items either on your car or your health. No wonder
health care is in such a predicament.
There
seems to be a lack of understanding of the basic concept of insurance.
Let’s
join Jeff Daniels in singing, “If I weren’t so stupid, you wouldn’t be so
smart.”
* * * * *
1.Lean HealthCare: LEAN SOLUTIONS,
a book by
James P Womack and Daniel T Jones
How
Companies And Customers Can Create Value And Wealth
Together
[A Lesson for Health Care. Read
this review thinking of health care providers as physicians and patients as
consumers. The answers to our health care problems lie in Lean Thinking, Lean
Consumption, Lean Solutions and Lean Provisions.]
A massive disconnect exists between consumers and
providers today. Consumers have a greater selection of higher quality goods to
choose from and can obtain these items from a growing number of sources. Computers,
cars, and even big-box retail sites promise to solve our every need. So why
aren’t consumers any happier? Because everything surrounding
the process of obtaining and using all these products causes us frustration and
disappointment. Why is it that, when our computers or our cell phones
fail to satisfy our needs, virtually every interaction with help lines, support
centers, or any organization providing service is marked with wasted time and
extra hassle? And who among us hasn’t spent countless hours in the waiting room
at the doctor’s office, or driven away from the mechanic only to have the “fix
engine” light go on?
In
their bestselling business classic Lean Thinking, James Womack and
Daniel Jones introduced the world to the principles of lean production—principles
for eliminating waste during production. Now, in Lean Solutions, the
authors establish the groundbreaking principles of lean consumption, showing
companies how to eliminate inefficiency during consumption.
The
problem is neither that companies don’t care nor that the people trying to fix
our broken products are inept. Rather, it’s that few companies today see consumption
as a process—a series of linked goods and services, all of which must occur
seamlessly for the consumer to be satisfied. Buying a home computer, for
example, involves researching, purchasing, integrating, maintaining, upgrading,
and, ultimately, replacing it.
In
this landmark new book, James Womack and Daniel Jones deconstruct this broken
producer-consumer model and show businesses how to repair it. Across all
industries, companies that apply the principles of lean consumption will learn how
to provide the full value consumers desire from products without wasting time
or effort—theirs or the consumers’—and as a result these companies will be more
profitable and competitive. . . .
From
Lean Solutions
"Consumption should be easier and more satisfying due to better, cheaper
products. Instead it requires growing time and hassle to get all of our goods
and services to work properly and work together. And this seems very strange
when we stop to consider that satisfying consumption is the whole point of lean
production."
Womack
and Jones address this issue by expanding their principles to the next
logical area, staying true to the heart of lean. “As we grasped the situation,
we realized that we needed to heed our principles of lean production by
returning to the starting point, the question of value. We needed to ask what
consumers really want in the era ahead. Then we needed to rethink consumption
from first principles as a process—like production, but from the opposite
direction—in order to discover a better way from consumers to obtain the goods
and services they want now. We call this process lean consumption.
“Lean consumption must have
a companion process. Companies must provide the goods and services consumers
actually want, when and where they are wanted, without burdening the consumer.
We’ve used the term ‘lean production’ in the past, but too many managers act as
if production stops at the office door or the factory gate. So we now use the
term lean provision, which comprises all of the steps required to
deliver the desired value from producer to customer, often running through a
number of organizations.
“Most of us find it easy to
think about consumption when we are consumers and easy to think about provision
when we are at work. But all of us find it difficult to see these interlocking
processes together as a unified value stream. As we have walked through a range
of industries in recent years, from airlines to healthcare to automotive repair
services, we have repeatedly observed consumers and employees struggling
valiantly with misaligned consumption and provision processes that alienate
customers, drain away profits, and burden staff with feelings of rage and
despair. Yet they soldier on in a fog of mutual incomprehension.
“As we continued our
investigations—visiting many companies in many industries in many countries—we
began to see that if truly lean provision can be married to truly lean
consumption, life can be better for consumers, more satisfying for employees,
and more profitable for providers. A win-win-win is possible in which
providers, employees, and consumers create lean solutions together. This
fundamental insight led directly to this book.”
www.lean.org/Bookstore/ProductDetails.cfm?SelectedProductID=131
* * * * *
2.Insurance
Myths: People are uninsured because they can’t afford insurance.
Characteristics
of an Ideal Health Care System, by John C. Goodman, PhD, President, NCPA.
Why should government be involved at all in our
health care system? Aside from providing care for low-income families, the most
persuasive argument is that in the absence of coercion people will have an
incentive to be uninsured “free riders.” In our society, people who choose not
to pay for insurance know that they are likely to get health care anyway — even
if they can’t pay for it. The reason is that there is a tacit, widely shared
agreement that no one will be allowed to go without care. As a result, the
willfully uninsured impose external costs on others — through the higher taxes
or higher prices which subsidize the cost of their care.
What evidence is there that free riders are a
problem? One piece of evidence is the number of uninsured:
_ According to the Census Bureau, in 1999 there were 42.6 million people
who were uninsured at any one time, a larger percentage of the population than
a decade ago.
_ The rise in the number of uninsured has occurred during
a time when per capita income and wealth, however measured, have been rising.
Although it is common to think of the uninsured as
having low incomes, many families who lack insurance are solidly middle class.
And the largest increase in the number of uninsured in recent years has
occurred among higher-income families:
_ About one in seven uninsured persons lives in a
family with an income between $50,000 and $75,000, and almost one in six earns
more than $75,000.
_ Further, between 1993 and 1999, the bulk of the increase in the number
of uninsured was among the households earning more than $50,000.
_ By contrast, in households earning less than $50,000 the number of
uninsured decreased by about 5 percent.
In deciding to be uninsured by choice, many healthy
individuals are undoubtedly responding to perverse incentives created by
government policies.
_ On the one hand, we make an enormous amount of free care available to
the uninsured; in
_ Also, federal and state laws are making it increasingly easy for people
to obtain insurance after they get sick — thus removing the incentive to buy
insurance when they are healthy.
_ Finally, although the federal government generously
subsidizes employer-provided insurance, most of the uninsured are not eligible
for an employer plan, and they get virtually no tax relief when they buy
insurance on their own.
Far from solving the free rider problem, most
government interventions these days are making the problem worse. Indeed, we
might be better off under a policy of laissez faire.
If we accept the free rider argument, however, what
policy implications logically follow from it?
One commonly proposed solution is to have government
require people to purchase insurance. However, this is neither necessary nor
sufficient. Instead, a complete solution would have 10 characteristics.
Adhering to each of them would lead to a system that provides a reasonable form
of universal coverage for everyone without adding to national health care
spending and without intrusive and unenforceable government mandates.
To read the entire Executive
Summary, please to go www.ncpa.org/pub/st/st242/st242.pdf.
Insurance Fact: Most People Are Uninsured By Choice
What To
Consider When Making An Application For Health Insurance. The Monetary Authority of
Your duty to
provide information
An insurance
contract is based on trust. When you apply for health insurance, you must
provide all the information asked for. Such information would include your age
and occupation, and any history of illnesses, medical conditions or disability.
If you do not
provide important information when you apply for health insurance, the policy
you take up may not actually cover you. If you are not sure whether certain
information is important, you should still provide the details. This includes
any information you may have given to the financial adviser or insurance
intermediary but not included in your application.
Accepting your application
The insurer will
assess the information you have given them, and decide whether or not to accept
your application. If you are not in good health, the insurer may refuse to
provide certain benefits, or increase the premium charged, or reject your
application.
When you are in
hospital
In
So when you need
to go into hospital you should:
• check the ward
charges and the costs of medical treatment recommended by your doctor;
• check whether
the benefits under your health insurance will cover all the costs;
• consider the
options available to you; and
• choose your ward
or treatment according to what you can afford.
* * * * *
3.Overheard on Capital Hill: Subsidies Help Farmers,
Business, Medicine-Everyone
Six
Reasons to Kill Farm Subsidies and Trade Barriers - A no-nonsense reform
strategy. In Reason,
By Daniel Griswold, Stephen Slivinski,
Christopher Preble
The time is ripe for unilaterally removing those distorting trade policies. In 2006 Congress will begin to write a new farm bill to replace the protectionist and subsidy-laden 2002 legislation that is set to expire in 2007. Meanwhile, the Bush administration will be negotiating with 147 other members of the World Trade Organization to conclude the Doha Round before the president’s trade promotion authority expires in mid-2007. Congress and the administration should seize the opportunity to do ourselves a big favor by eliminating farm subsidies and trade barriers, a change that would benefit all Americans in six important ways.
1. Lower Food Prices for American Families
The foremost reason to
curtail farm protectionism is to benefit American consumers. By shielding the
domestic market from global competition, government farm programs raise the
cost of food and with it the overall cost of living. According to the
Organization for Economic Co-operation and Development, the higher domestic
food prices caused by
American consumers pay more
than double the world price for sugar. The federal sugar program guarantees
domestic producers a take of 22.9 cents per pound for beet sugar and 18 cents
for cane sugar, while the world spot price for raw cane sugar is currently
about 10 cents per pound. A 2000 study by the General Accounting Office
estimated that Americans paid an extra $1.9 billion a year for sugar due to
import quotas alone.
American families also pay
more for their milk, butter, and cheese, thanks to federal dairy price supports
and trade barriers. The federal government administers a byzantine
system of domestic price supports, marketing orders, import controls, export
subsidies, and domestic and international giveaway programs. According to the
U.S. International Trade Commission, between 2000 and 2002 the average domestic
price of nonfat dry milk was 23 percent higher than the world price, cheese 37
percent higher, and butter more than double. Trade policies also drive up
prices for peanuts, cotton, beef, orange juice, canned tuna, and other
products.
These costs are compounded
by escalating tariffs based on the amount of processing embodied in a product.
If the government allowed lower, market prices for commodity inputs, processed
foods would be substantially cheaper. Lifting sugar protection, for example,
would apply downward pressure on the prices we pay for candy, soft drinks,
bakery goods, and other sugar-containing products.
The burden of higher
domestic food costs falls disproportionately on poor households. Farm
protections act as a regressive tax, with higher prices at the grocery store
negating some or all of the income support the government seeks to deliver via
programs such as food stamps.
If American farm subsidies
and trade barriers were significantly reduced, millions of American households
would enjoy higher real incomes.
2. Lower Costs and Increased Exports for American
Companies
Producers who export goods
to the rest of the world and manufacturers who use agricultural inputs would
also stand to benefit significantly from farm reform. So would their employees.
When government intervention
raises domestic prices for raw materials and other commodities, it imposes higher
costs on “downstream” users in the supply chain. Those higher costs can mean
higher prices for consumers, reduced global competitiveness for American
exporters, lower sales, less investment, and ultimately fewer employment
opportunities and lower pay in the affected industries. Artificially high
commodity prices drive domestic producers abroad to seek cheaper inputs—or out
of business altogether.
In the last two decades, the
number of sugar refineries in the
Enterprises outside the food
business would benefit from farm reform as well. Rich countries’ agricultural
trade barriers remain the single greatest obstacle to a comprehensive World
Trade Organization (WTO) agreement on trade liberalization. The current round
of talks, the Doha Development Round, came to a halt in
A successful Doha Round
would lower trade barriers for a whole swath of industrial products and
services. A 2001 study by Drusilla Brown at Tufts University and Alan Deardorff and Robert Stern at the University of Michigan
estimated that even a one-third cut in tariffs on agriculture, industry, and
services would boost annual global production by $613 billion, including $177
billion in the United States—or about $1,700 per American household. Some of
the country’s most competitive sectors, including information technology,
financial services, insurance, and consulting, probably would increase their
share of global markets if the Doha Round were successful. Farm reform remains
the key.
A common argument against
liberalization is that the
But reducing protectionism
would not primarily be a “concession” to other countries. It would be a favor
to ourselves. In the process we would set a good
example and create good will in global negotiations, inviting other countries
to join us in realizing the benefits of lower domestic food costs.
3. Budget Savings and Equity for
To
read the other benefits, go www.reason.com/0602/fe.dg.six.shtml.
* * * * *
4.What's New in US Health Care: HealthPlan4Life, Steve Barchet, Coordinator
[At
a recent breakfast forum on HSA/CDHPs, I shared with
some physicians the attached brief set of 7 reasons HSAs might benefit subscribers,
patients, and their clinicians. I wish the thoughts were totally original but
they are not -- hence giving attribution to Ms. Charlotte Williamson who in
1995 sent a letter to the Editor/British Medical Journal offering reasons why
giving clinical guidelines to patients may benefit both patients and
clinicians. Hence my decision to adapt her assertions to reasons HSAs might
benefit subscribers and patients – and physicians. From Steve Barchet,
Coordinator HP4Life]
With
passage of the Medicare Modernization Act in 2003, Health Savings Accounts and
their companion qualified high deductible insurance advocates and opponents
have registered widely varying assertions for and against this financing
strategy and tactic.
Advocates
assert the positive benefits gained by engaging people in useful decisions
involving optimal management of their health and health risks through purchase
of and enrollment in “Consumer Driven Health Plans”.
Much
has been reported and discussed about the potential for positive benefits, but
for our purposes of discussion at this early AM Breakfast Forum:
Why
might Health Savings Accounts be beneficial for subscribers/patients?
1.
HSAs help subscribers gain a sense of control over medical
interventions and patient interactions with a physician and the members of the
healthcare team.
2.
HSAs encourage patient-physician discussion thereby enhancing for each
a sense of personal freedom. It has been stated “…clinicians should be
responsible to their patients, not for them.”
3.
HSAs add to improved informed consent and the choices resulting from
increased patient-clinician discussion.
4.
HSAs are likely to contribute to patient safety by encouraging patient
involvement and engagement in their own best interest when undergoing clinical
transactions.
5.
HSA subscribers are likely to engage in increased compliance with
directions for treatments and prescribed pharmaceuticals.
6.
HSA subscribers are likely to be more sensitive to their clinical care
experiences.
7.
HSA subscribers are likely to continue and maintain positive behaviors.
To review the
extensive HealthPlan4Life, please go to www.effwa.org/main/page.php?number=210.
To review the
final report, please go to www.effwa.org/HPL/report9.pdf.
5. Health
Plan
Steve Barchet
has introduced us to some important concepts for our personal health plan,
which should stand us in good favor for a healthy life. Please refer to the
first four pages of the “Final Report” above to get the over view.
Characteristics of an Ideal Health Care System by John Goodman, PhD, President, NCPA
This has been
discussed in section six above.
Making Health Insurance Portable
One
of the strange features of the
For further background information on Making Health Insurance
Portable, please go to www.ncpa.org/pub/special/20060130-sp.html?PHPSESSID=ff65cd949b16d902dc639768592ed5e7.
Health Savings Accounts Will Revolutionize American Health Care:
The
idea behind Health Savings Accounts (HSAs) is quite simple. Individuals should
be able to manage
some of their own health care dollars through accounts they own and
control. They should be able to use
these funds to pay expenses not
paid by third party insurance, including the cost of out-of network doctors and
diagnostic tests. They should be able to profit from being wise consumers of
medical care by having account balances grow tax-free and eventually be
available for nonmedical purchases. As of
catastrophic insurance.
Creating
a Level Playing Field for Individual Self Insurance. Health Savings Accounts Are
Designed To Help Correct A Major Flaw In Tax Law That Distorts Our Entire
Health Care System. Every Dollar An
Employer Pays For Employee Health Insurance Premiums Avoids Income And Payroll
Taxes. For A Middle-Income Employee, This Generous Tax Subsidy Means That
Government Is Effectively Paying For Almost Half The Cost Of The Health
Insurance. [See Figure I.] On The Other Hand, The Government Taxes Away Almost
Half Of Every Dollar Employers Put Into Savings Accounts For Employees To Pay
Their Medical Expenses Directly. The Result Is A Tax Law That Lavishly
Subsidizes Third-Party Insurance And Severely Penalizes Individual Self-Insurance. This Encourages People To
Use Third-Party Bureaucracies To Pay Every Medical Bill, Even Though It Often
Makes More Sense For Patients To Manage Discretionary Expenses Themselves.
A Brief History of Health Savings Accounts:
As
of January 2004, 250 million non-elderly Americans have access in principle to
health savings accounts (HSAs). Individuals will now be able to self insure for
some of their own medical needs and manage some of their own health care
dollars.
Be sure to read a Brief
Analysis of the history at www.ncpa.org/pub/ba/ba481/ba481.pdf.
* * * * *
6.Doctors
Restoring Accountability in Medical Practice by Non Participation in Insurance
and Government Programs
·
PRIVATE NEUROLOGY is a Third-Party-Free
Practice in
* * * * *
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Please note:
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Del Meyer
Del Meyer, MD, CEO & Founder
HealthPlanUSA, LLC
Words
of Wisdom
Allan Bloom: "Today man believes
there is nothing in him, so he accepts anything" (Mind, 81)
Some
Recent Postings
Medicare Reform: Pharmacy Benefit Program—What Must Be
Done a Clinician’s Point of View: http://www.delmeyer.net/hmc2005.htm
On
New Year’s Day in History
Three American Revolutionary
heroes were born:
In 1735: Silversmith
Paul Revere
In 1752: Flag
maker Betsy Ross
In 1745: General “Mad” Anthony Wayne
On this New Year’s Date in 1808:
The
In 1863: President Lincoln issued the Emancipation Proclamation
In 1898:
In 1905: The Trans-Siberian Railway started its maiden voyage
In 1909: Barry Goldwater was born
In 1935: The colonies of
In 1942: Twenty-six nations signed the United Nations Declaration