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Thursday, 15 February 2007
Tell it, Paul
For the sake of those of you who have not yet gotten to your op-ed page today, this is a heads-up to make sure you don't miss the excellent piece from our own Paul DeMarco, M.D.
As usual, Dr. DeMarco sets out the issues fairly, intelligently and with impeccable intellectual honesty. Some who don't know him would be surprised that he seems to find some fault within his own worthy profession. Not I, and not anyone who knows him.
Paul DeMarco will always tell it straight.
Posted by Brad Warthen at 04:06 PM in Blogosphere, Character, Feedback, Health, The State
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Comments
I posted this on the "Questions for DeMint and Graham" post but it seems appropriate here:
I enjoyed Dr. Demarco's editorial in today's paper. Today I had to deal with our medical system. Although today's incident was minor it seems like there is always something to deal with.
I took my child to the doctor for a bad sore throat. Since he's prone to strep-throat we usually don't wait. It wasn't long before the lady at the desk asks if I have the latest BC/BS card. I didn't because my son is on my wife's insurance. So in order to get credited for the money we spent we have to fax or bring by the new card. Apparently the old cards are invalid because they use the SSN as the patient ID number and that is no longer allowable. So the new cards have assigned numbers. And that is what is needed in order to get credit for the money we spent (in order to meet the deductible).
Why can't we come up with some national health care system that simply does away with all this mess? Private insurance, medicaid, medicare, age limits, income limits, uninsured children, doctors and hospitals go unpaid because people simply can't pay, counties fund hospitals, states fund medicaid. And try reading those sheets explaining what is covered and what is isn't. Some things are others aren't. And on and on.
Can't we just establish a single payer system that guarantees everyone has at least a minimal amount of coverage? Every other developed nation in the world does that and there are far fewer complications. I think this mess contributes to our lower life expectancy as compared to other developed nations. It has to. And this is what we rejected the Clinton plan for? Give me a break.
Posted by: bud | Feb 15, 2007 4:19:31 PM
Two things:
Does anyone really believe the government can manage an effective health care "system";
And where does it say that health care is a "right".
Posted by: Trajan | Feb 15, 2007 4:55:19 PM
I agree with Brad. An excellent piece.
I tend to relate these "big issues" to my personal experiences. For example, a very good friend of mine, an orthopedic surgeon, was involved in a high profile malpractice case in Lexington last summer. Even though he did nothing wrong, to protect himself, his family, and his practice, his insurance company worked out a deal to pay $1M to the plaintiff even if he was found innocent. Sitting in the courtroom and watching a supposed jury of ones peers try and comprehend all the medical jargon was disappointing. These types of cases should be heard by an independent board of experts, not Joe Plumber or Jane Housewife.
We also need some real tort reform/award limits/etc. to stop the lawyers from turning every unfortunate event (there's a difference between incompetence and an honest mistake) into a cash cow.
In December, my father had surgery for an aneurysm and never woke up following it. He was in a coma in intensive care for twelve days before dying. I got to see far too much of the way hospitals work during that period. The nurses are fantastic. The doctors are stretched too thin to spend enough time with patients and family members to explain things. It seems to be a bad mix of supply and demand for surgical services combined with all the regulation and convoluted insurance payment schemes that force doctors to do more procedures than they should. What does Medicare pay -- 30% of the typical cost? All that does is artificially inflate the costs for people who have better insurance.
Then we have the decision recently (supported by The State) to stop Lexington Medical from creating their own heart center. From my experience with my father's medical condition, the demand for cardiac services exceeds the capacity. The three and four hour waiting room experiences were quite common. Let the hospitals decide what services they want to provide.
Then yesterday an ad in USA Today happened to catch my eye. A company called Zimmer was actually marketing a knee replacement geared toward women. The tagline was "the first and only knee replacement shaped to fit a woman's anatomy". Does that need to be marketed in USA Today? All that does is inflate the cost. The whole marketing aspect of healthcare, especially for the drug companies, impacts the system as well.
Just as with the teaching profession, our government restricts highly skilled people from doing what they are trained to do.
I don't expect much to be done. There's too much money involved and too much bureacracy to untangle.
Posted by: Doug | Feb 15, 2007 6:00:45 PM
"If you think health care's expensive now, just wait till it's free."
Posted by: Trajan | Feb 15, 2007 6:24:21 PM
If you think the emergency rooms are busy now, just wait until the Boomers old age problems kick in.
Posted by: Randy Ewart | Feb 15, 2007 9:02:00 PM
Brad,
Kind words. Thanks.
Trajan,
Whether health care is a right is certainly debatable, but I believe it is. If you don't have decent health, than how can you enjoy your other basic rights to live freely and pursue happiness? If it’s not a right, then it seems possible to deny care capriciously, say on the basis of income (a policy which assumes that poor people, by some character defect, haven't earned the right to care). Taken to the extreme, that allows the poor to die needless and painful deaths from preventable disease (as they often still do in many Third World countries). That's much less common in the US, but the cost of care is so frightening to some of our neighbors without insurance that they sacrifice their health or even their lives trying to avoid financial ruin. I love my county men too much to treat them that way.
Health care, in my view should be a social contract with all of us committing to pay our share so that all have access to care.
You raise an interesting point about increased usage with universal health care (UHC). This does occur and can be factored into the new system.
But you are right to imply that we can't offer everything to everybody in UHC. As we advocate for UHC, we must be careful not to over promise. UHC will entail some limits-restricted formularies for drug plans (the VA uses one now that works quite well), exclusion criteria for certain procedures (for example, we may decide to limit the placement of feeding tubes in profoundly demented patients or put an age limit on dialysis).
But I think most people would opt for a UHC program that provided decent health care for all (with some limitations that would be the subject of much debate, I'm sure) than the current system.
I'd rather debate the evidence supporting whether a new drug or procedure should be added to our UHC plan any day than continue the decades-old debate about why so many millions of our fellow citizens are still uninsured.
Posted by: Paul DeMarco | Feb 15, 2007 10:49:25 PM
I think Paul is right. But I fear whether politicians will get it right, and not mortgage the whole future in order to make people happy. You do have to have everybody paying into it, or it doesn't work.
At the same time, you can easily kill the goose that lays the golden egg, and its no secret in Europe that (or at least it used to be--but that is changing too, I think) if you need the latest and best in health care, you have to go to the U.S. for it. My health insurance in Germany would pay for seriously ill patients, under the right circumstances, to be sent to the U.S. for treatment. The reason is obvious--there was a lot of money here for research and new ideas. So if a child had a certain form of leukemia, it was not unusual for them to send them here, despite the high cost.
Whether this is still true, I'm not sure; if it isn't, then it's another indication that our system is broken and getting worse--we don't even have that advantage any more. I know that we have never been ahead in ophthalmology--our eye doctor over there pleaded with us not to let an American surgeon operate on one of our kid's eyes--they wanted to do it here at age 3 or 4, but we waited until 12, like the Germans asked. Couldn't have afforded it here, anyway.
One interesting tidbit--not particularly relevant to this discussion--the FDA always seemed to wait until drugs were tested on the European market, before allowing them here. The Europeans were our guinea pigs for a long time; again, I don't know if they still are, but doctors over there were well aware of it.
Posted by: Herb Brasher | Feb 16, 2007 7:12:32 AM
And just for Trajan--nobody, I don't think, is arguing that health care should be free. We don't need the British national health system. But there are other models; the German one being one of the better ones, but not when politicians start using it to promise everybody everything. It goes broke fast that way.
Posted by: Herb Brasher | Feb 16, 2007 7:17:17 AM
So many people miss the most important point in the health care debate. We already have a de-facto universal health care in this country. We long ago made the decision that people in need of medical attention will get it. Nobody with a life threatening condition is turned away from a hospital. Paul made that point in his article. There is no serious debate on that point. We currently have universal health care. That's a fact.
The debate is how to best distribute that care. The current system allows indigent patients without "official" coverage (medicaid, medicare or private insurance) to have mostly free treatment for serious conditions. Paul's cancer patient is an example. Someone paid for her treatments. But preventive care or minor ailments may go unattended. The result is 18,000 unnecessary deaths.
I propose that we officially recognize that we already have a clumsy form of universal health care. Then let's put a plan in place that makes it less clumsy and more efficient. Perhaps more preventive care will bring down the cost. Ideally, I'd have a single payer system with the U.S. government footing the bill along with co-payments by the patients. If a person wishes to purchase additional insurance to fund the copays that would be fine.
Posted by: bud | Feb 16, 2007 9:16:51 AM
A tough issue that's much like the debate over public education; health care is something we all need, but can we trust the government to manage it? I have my doubts.
To me the essence of government provided services is the economic economy of scale allowing us to "purchase" with our taxes those things which are necessary for life but otherwise too costly to provide for ourselves.
However, with health care, private industry, motivated by profit, does in fact meet the health care needs of the overwhelming majority of US citizens. It's the profit motive which drives the innovation and advancement in medical science and the profit motive which builds and expands hospitals and private practices. This continuous improvement (new drugs, new procedures, new devices, etc) and expansion is, I would argue, just as essential to our continued collective health as the basic care is.
Would anyone here seriously trade the potential for increased life spans, improved geriatric quality of life, new cancer drugs, improved natal and neonatal care, etc. in order to have the government manage our health care? How about turning back the clock to a time when you could get a house call by the local GP, and pay for it with a chicken, but average life expectancy was just over 40 years?
To a large extent, Herb made this same point in his comments about the lack of innovation and cutting edge care available in Europe. I submit that far from being our "guinea pigs," the Europeans and, for that matter, the rest of the world have been largely subsidized in their "universal health care systems" by US health care consumers. We are the ones paying for the global health care industry’s innovation and advancement which allows other countries to provide care for much lower costs than here. (But I digress.)
However, as bud says above, the precedent has been long established here in the US that health care, while maybe not a "Constitutional Right," is certainly an expected entitlement (Medicare, Medicaid, laws against hospitals turning away patients, etc). Surely, as the wealthiest nation on the planet, we can afford to provide a "universal" minimum amount of care to everyone.
So I agree there’s really not much to debate over whether universal health care is a “right” or not; it’s already here, just very poorly executed. The real debate is just how do we make it happen without losing the best that we get from free-market incentives and not create another cumbersome and inefficient bureaucracy like we’ve managed to make out of our public education system?
Maybe we could start with the prescription drug and medical device industries and pass a law that required them to sell their products here in the US for the same lowest price (to include negotiated government purchases) that they sell them anywhere else overseas. That would immediately start to balance and spread the costs of research and development to all markets equally. The companies could still make as much profit as the market would bear, retaining the incentives to innovate, but US consumer costs should come down as foreign costs go up.
Posted by: SGM (ret.) | Feb 16, 2007 9:33:17 AM
Can anyone point me to a HUGE, COMPLICATED, RLEATIVLY NEW government program that is not a total mess?
My problem is not the philosophical...but the logistical. I think if the US government was to become involved in a wholesale fashion our health care would be crushed under the weight of special interest, expense, unions, and ineptitude.
Whatever the merits of the policy…we just can not do it.
Chris
Posted by: chris | Feb 16, 2007 11:09:50 AM
chris plays the "incompetent federal government" card. But I'll bite. I think social security has worked very well for the last 70 years.
But chris misses (or didn't read the above) the relevant. We already have universal health care with heavy government involvment. That's already been established. It would be like someone arguing for an increase in the Pentagon budget and someone who opposes it says ... "Can anyone point me to a HUGE, COMPLICATED, RLEATIVLY NEW government program that is not a total mess?" If we want a laissez-faire health care system then we're going to have to allow people without money to go untreated and die. Otherwise we just need to acknowledge that we already have socialized medicine and try to make it better.
Posted by: bud | Feb 16, 2007 11:26:52 AM
I did not mean to imply the incompetence is a federal issue. I have been studying state and local government mechanisms for the last 8 months, and let me just say that my findings are shocking. I was completely unaware of the breakdown of our governmental abilities.
Bud, you missed my point. I did not make a stand about whether or not changing the system was good thing. What I said was that we could not effectively administer a far reaching and comprehensive medical program…and that is a far different point.
My contention is that government is broken, and that the hyper-political atmosphere of the last 30 years has destroyed the very essence of our contract with the government. And as we see the failures of government (Katrina, Iraq, immigration…) we often confuse them with philosophical problems or differences, but in reality…our government is just plain inept.
Posted by: chris | Feb 16, 2007 1:18:49 PM
Chris,
We already have government-run health care. It's called Medicare and its serves those over 65 fairly well. My experience is that patients and physicians are just as satisfied with Medicare as private insurance. The big difference is that the overhead for Medicare is in the low single-digits (3-5%) while the overhead for private insurance is in the high teens (15-20%).
Like you, I favor the private sector providing a service rather than the government when possible. But in health care the government is providing the service more efficiently than the private sector and has being doing so for decades.
SGM,
It's an open question as to whether innovation would suffer much under a government run program. A significant portion (I think I’ve read about one-third) of research funding in the medical field is already provided by the government (NIH, etc.).
Of that other two-thirds, which is provided by private industry, much is poorly spent. Private companies research for drugs/devices that will make a profit, not necessarily what's best for patient care. The proliferation of "Me-too" drugs demonstrates this well. Company #1 comes out with a new drug (i.e., Pfizer discovers Viagra). That drug is really all the world needs. But it's so lucrative that companies then spend millions to develop very similar drugs simply to capture part of the market share-witness Levitra and Cialis and the massive marketing campaigns that followed. Meanwhile, less lucrative drugs that would be much more beneficial for patients, such as new antibiotics, are neglected because they will never generate huge profits for the company.
Posted by: Paul DeMarco | Feb 16, 2007 3:09:06 PM
Well, Paul, I don't have any philosophical objections to a government provided universal health insurance type program.
As you pointed out, Medicare has been working pretty successfully for a long time. I personally have Tricare which is another federally administered program and am generally well served and satisfied. I do, however, have to pay premiums and co-pays just like any other insurance program. (For those who've never heard of it, it's the DoD health insurance program used by military retirees and dependents of Active Duty Service Members.)
Of course, Tricare is actually managed by a private corporation that has a contract with the government, so as a practical matter there is a relatively low amount of direct gov. involvement. Again, it seems to me that the profit motive goes a long way towards the efficiency of the administration.
Your points about the funding of medical research are good ones. I didn't actually realize that so much money was directly provided by the federal gov. I would have guessed maybe low double digits for a percentage, certainly not as much as 30%. But again, it seems to me that the profit motive is what drives most of the innovation, even for incremental improvements of existing things.
I would also suspect that the federal gov. directs how and on what most of its research money goes towards, and would further suspect that much of it is spent on those less lucrative projects that you mention (for that exact reason).
I suppose my concerns are really more in the area of bureaucratic inertia and waste that seems to grow exponentially as government programs expand. Your 3-5% overhead figure for Medicare is really astonishing, but I'll take your word for it.
My question would be if the program was expanded (or another created) to serve 300 million health care consumers, would its overhead remain any where close to that? (And where would all those out of work private health care insurance company employees go, anyway?)
Posted by: SGM (ret.) | Feb 16, 2007 3:53:00 PM
"Health care, in my view should be a social contract with all of us committing to pay our share so that all have access to care."
And this, Paul, I imagine, is the root of a lot of disagreements we would have.
As a doctor with a six-figure income, it's much easier to dictate to others what their positions 'should" be, rather than what is actually right. Who determines "our share?" That sounds eerily Marxist.
The only reason I and my wife and kids have great insurance is because I have worked hard to provide for it through working. My health insurance through my firm costs me over $700 per month. With two small kids, and a 38 year old wife, and as a 45 year old male, I need insurance.
What I don't want to do is have dictated to me, as a US citizen, what type of coverage I have, am entitled to, or if I can see a doctor at all, which is what happens when more and more government control is exerted.
I have no problem with providing care for those in need. We undoubtedly disagree, however, with whom those "needy" are, and why they're needy.
Posted by: Trajan | Feb 16, 2007 5:31:07 PM
Remove the illegal aliens from the free health care and government schools, then come back and tell us the real cost to real Americans.
Most of "the uninsured" are not the same "41 million" that are bandied about as if it were a real fact. Most real Americans without health insurance are just temporarily changing their insurance plans, or choose not to buy the insurance they can easily afford.
The rest are illegal aliens, who don't count in serious analysis of this alleged problem.
Dr. DeMarco forgets to mention that those who pay cash for medical services are charged a much lower rate than those promising payment from Medicare, Medicaid, or some insurance company, because the doctor knows all of those plans plan to cheat the doctor.
Posted by: Lee | Feb 16, 2007 11:03:27 PM
Lee, could you direct me to those medical services that charge much less for cash customers? My experience has been the opposite. My family has a Health Savings Account (more later on why HSAs are NOT the answer) and a policy with a $5500 deductible that we've never hit, so we essentially pay all of our medical expenses in cash. Every time we get a medical bill, we're charged "full retail," and my wife or I has to call our insurer, give them the codes for the procedures, find out what the insurer would pay, then negotiate that rate with the provider. And I'm pretty sure that rate is not as low as the Medicare rate, because my family doctor has stopped taking on new Medicare patients.
I don't doubt your claim that illegals contribute to rising health care costs, but at only 3-4% of the total population, their expense doesn't explain why Americans 50% more for health care than other developed nations.
Incidentally, a single-payer system, in which health care "premiums" are collected like taxes, would eliminate a lot of the deadbeat problem you mentioned.
Economist Paul Krugman wrote an interesting article on health care cost in the Friday (2/17) New York Times. He cited a >report by the McKinsey Global Institute that examined the components of the $477 billion annual premium that Americans pay compared to our economic peer countries. The report attributed $98 billion to excess administrative fees, half of which came from insurers advertising and efforts to deny claims and weed out the people who might actually need health care. A single-payer system would eliminate most of that expense.
The report also found that Americans pay $66 billion more annually for drugs (adjusted for population and wealth differences) than our peers. This is hardly surprising, when we grant drug companies monopolies (patents) and don't regulate prices (as we do with other state-granted monopolies, such as electric and gas utilities).
McKinsey estimated a cost of $77 billion annually to provide full coverage for the country's uninsured. The cost savings from switching to a single-payer system and negotiating drug prices the way our peers do would more than cover the cost of extending insurance to all Americans.
I don't know that I would consider health care a "right" any more than a full belly is a "right," but, thankfully, most Americans still have the heart not to stand by while those less fortunate than us die of hunger or disease.
From a purely economic standpoint, health care for everyone is a good investment. Everybody loses when adults are too sick to work and kids are too sick to learn. Why do you think businesses started paying for worker health care in the first place?
The incentives and mechanics of the private insurance model are just too twisted to be functional. It's time we adopt a single-payer system of universal coverage.
Posted by: McDoogle | Feb 17, 2007 7:16:23 AM
Why Health Savings Accounts are NOT the answer.
President Bush and a lot of folks trying desperately to preserve profiteering in the health care industry have been selling the idea of Health Savings Accounts as a way to use individual consumer pressure to drive down health care cost. I can tell you from my family's personal experience that HSAs are NOT the answer to America's health care crisis.
My family has had an HSA (or predecessor MSA) and high-deductible major medical insurance for over 10 years. In a good year (no major health issues or accidents in the family) the HSA saves us a little (hundreds, not thousands) off the standard coverage that my employer offers. On average we're probably saving a bit, and we gain the flexibility of not worrying if our doctor of choice is on the "preferred provider" list.
But my family is young and healthy. We have never in those 10+ years exceeded our $5500 family deductible (so we have never gotten a penny of reimbursement from our insurer). We have had a string of years in which obscenely-priced prescription drugs and mind-boggling emergency room visit bills (kids will be kids!) have wiped out our HSA balance. So there's no medical "nest egg."
I suspect that many Americans, specially with our aging population, would fare far worse under the HSA than we have, hitting their deductible (plus 80/20!) every year and watching independent policy premiums skyrocket.
The HSA option does nothing to address the absurdity that insurers, who are paid presumably to pool risk, can maximize their profit by excluding the people most likely to need care, thereby transferring risk to providers and taxpayers.
As for HSAs encouraging price reductions through "smart shopping", I suppose that paying all of our medical expenses out of pocket does make us think twice about minor things. But when your loved one is in pain or in danger of growing complications, you don't take time to price shop.
I've seen several studies showing that Americans don't voluntarily over-use health care, compared to other countries. Our hospital stays and doctor visits are shorter than in peer countries. I do believe our fee-for-service pay structure encourages providers to over-prescribe services, and we'll need to address that regardless of how we restructure the payer side of the equation.
The bottom line on Health Savings Accounts is that they are useless for people too poor to pay for coverage now, they don't offer any investment benefit to people serious health issues, and they won't drive down costs significantly, even for the healthiest Americans.
Posted by: McDoogle | Feb 17, 2007 8:08:51 AM
"Single payer system" is a deceptive euphemism for a system when a minority of millions of productive citizens pays all the bills for many more millions who have no incentive to control their doctor visits or their appetites for unhealthy living.
"Negotiating drug prices" is a deceptive euphemism for government dictating to drug companies to hand over their intellectual property for much less than it is worth.
Such stupid, destructive and greedy desires, when converted into public policy, are disincentives for those who create innovative treatments and the wealth to deliver them the sick.
The only way socialist medical care can reduce costs is by cheating the caregivers, stealing from those who pay their own way, and denying care to those in critical need.
Posted by: Lee | Feb 18, 2007 12:07:49 AM
Medicare is currently 200 times the cost that it was originally projected to be on this date.
It is a miserable, corrupt failure.
Only those who are milking the system would dare to defend it.
Posted by: Lee | Feb 18, 2007 12:10:51 AM
Lee writes:
"
The only way socialist medical care can reduce costs is by cheating the caregivers, stealing from those who pay their own way, and denying care to those in critical need.
"
Again we have a conservative writer that fails to understand something very important -- We have already agreed as a nation that we want socialized medicine. That is a fact. Free market health care is something we have long ago rejected as a nation. The only question for debate is how to best manage our American brand of socialized medicine.
As for medicare, it certainly has it's share of corruption and inefficiency. But the same thing can be said for the United States military. It's a red herring to continue to point out the fact that socialized health care has inefficiencies. I accept that it does. What I would like to see is a system that keeps these to a minimum while ensuring everyone has access to a reasonable level of health care.
Posted by: bud | Feb 18, 2007 11:25:33 AM
McDoogle,
Your comments are appreciated and right on point. HSAs are a smoke screen. Most of uninsured are low wage workers who don't pay enough taxes to benefit from an HSA. It's a non-solution. It strikes me as a cynical attempt to appear to be addressing health care (i.e. to give Republicans something to talk about) while making almost no dent in the problem.
Lee,
Most of my patients who lack insurance are similar to the woman I describe in the article, people who have lost jobs as the textile economy has crumbled or who have lost coverage when their employer raised their premium out of reach.
You have a very distorted view of how medicine is actually practiced. I would invite you to come to my practice for a day to understand the inescapable hole some of my uninsured patients find themselves in.
Do I have some deadbeat uninsured patients-alcoholics, drug addicts, people who have made a mess of their lives? Sure, but that's the minority.
And I share your anger and resentment of them not pulling their weight. I believe strongly in personal autonomy and free will. I believe even in a distressed county like Marion, anyone who really applies himself can have a decent life.
But whether I approve of the alcoholic or not is beside the point. Someone must pay for his care. Unless you advocate stepping over alcoholics as they bleed to death in the streets, someone is going to have to pay.
And that someone would be you and me. One way or another, through higher Blue Cross premiums, higher taxes to support Medicaid, higher Medicare premiums, etc. all the rest of us who can will be forced to pay the bill.
Since we must pay the bill anyway, why not streamline the healthcare system so that there is only one payer and all that unnecessary paperwork, all the insurance company denials and appeals, all the outrageous CEO pay go away. Imagine visiting a hospital or an ER and not receiving a bill. Hospitals would receive an annual budget allocation from the government and would be forced to live within that.
That would provide the kind of incentive you appreciate-to deliver care in the most efficient way. I imagine that as soon as this occurred, hospitals would take a hard look at their most expensive procedures and establish guidelines to ensure they were only offered to those who had evidence-based indications. So you might not get that MRI of the brain for your headache, which is often done just to placate a patient.
If you and Trajan didn’t want to be subject to these limitations, I’m sure you could count on the private sector to provide supplementary insurance fro you.
I think this fact is telling. According a 2003 Families USA report on CEO compensation,
the top administrator of Medicare earns about $130,000 a year. The average compensation for the top 20 insurance executives that year was over $11 million dollars, not to mention tens of millions more in stock options. Still think the private sector is leaner than government run health care?
Posted by: Paul DeMarco | Feb 18, 2007 6:14:44 PM
Yes, Paul, thank you! Your input wise, thoughtful, and obviously factual, right out of every day practice. It deserves a front-line heading in every major newspaper and news magazine in this country. And speaking from an evangelical Christian perspective, I sincerely hope that many of my Christian brothers and sisters who tend to espouse right-wing politics will re-think this issue, and begin to see the need for what it is. In times past, Christians were on the cutting edge of social reform. Now we have too often been suckered by the false prophets of greed (no pun intended!).
One thing I really appreciated about my German insurance: every year, after age 45 (for me; age 30 for my wife) I got a "coupon" from the insurance for a yearly medical exam, including occult blood in stool, electrocardiogram, etc. (don't know all the right terms, but you get the idea). What I can't understand is that insurance companies here seem to have little interest in preventative medicine. Even the group we belong to (which is not a fraud, as some think, though there are fraudulent schemes out there--but it is simply Christians wanting to put NT Christianity into practice, doesn’t emphasize preventative medicine. Why do insurance companies, and even sharing programs like CCM, prefer to treat people after they get sick, instead of trying to prevent illness in the first place?
Posted by: Herb Brasher | Feb 18, 2007 8:36:49 PM
P. S. I nominate Paul DeMarco for Surgeon General--though maybe that really isn't the best "bully pulpit" for him--but hopefully he will be heard!
Posted by: Herb Brasher | Feb 18, 2007 8:40:28 PM
