Saturday, December 22, 2007

For Profit Health Care claims another victim


Nataline Sarkisyan, 17, dead because her insurer Cigna HealthCare's profit margin is dependent on finding excuses to deny the care it's customers pay their premiums for.


After first approving the liver transplant she needed to survive her illness, on the medical advice of her doctors, Cigna then claimed the procedure was 'experimental' and said they wouldn't pay for it. Nurses at the hospital where Nataline was being cared for rallied for her care, the story spread across the blogosphere and Cigna facing a tidal wave of fury over their callousness relented.

Too late. Because of the time wasted fighting the insurance company Nataline died 6 PM Thursday at the University of California, Los Angeles Medical Center only hours after Cigna relented and finally approved the treatment the Sarkisyan family's insurance covered and her doctor's said was necessary to save her. They had managed to stall long enough to avoid the lifetime of expensive care Nataline would have required.

Presidential candidate John Edwards was clearly furious, speaking about the case yesterday:
"Are you telling me that we're gonna sit at a table and negotiate with those people?" asked a visibly angered Edwards, challenging the health care companies. "We're gonna take their power away and we're not gonna have this kind of problem again."
It is my fervent hope that letting Nataline die will ultimately cost Cigna many thousands of times as much as keeping her alive would have. In a just world their corporate board would spend the rest of their lives in prison.

This is what the 'free market solutions' that people like the Fraser Institute and the Conservative Party push for Canadian health care would mean.

12 comments:

Adam said...

"This is what the 'free market solutions' that people like the Fraser Institute and the Conservative Party push for Canadian health care would mean."

It is? You have links peppered throughout your post, but none to back up this statement. Why is that? My guess is because nobody in this country, that I know of, is proposing American style health care, not even those scary conservatives or the fraser institute (insert obligatory reference to a "right wing thinktank" here).

Rather, the private-public parallel systems which consistently rate higher than our system, are usually the model on which groups like that want to base our new and improved health care system.

This is a terrible story, but there is no need to add more fear and misinformation to the debate. There is plenty of that already floating around.

Cliff said...

"Rather, the private-public parallel systems which consistently rate higher than our system, are usually the model on which groups like that want to base our new and improved health care system."

Except that's completely unambiguously false. The private-public parallel systems cost more, don't work as well, and are a sub rosa pathway to the American style pay for care model.

Ireland, England, Sweden, Australia, wherever it's been tried the two tier model has led to increased bureaucracy, greater expense and longer wait lists as doctors abandon the public system and cherry-pick it for easy lucrative cases.

It's a giant step back and a recipe for failure and ever increasing inequality. The proponents of American style for profit care know it's unsellable, hence the promotion of a blended system in a conscious manipulation of the fallacy of the golden mean

'It's halfway between the two extremes - it must be the best!'

Fortunately the majority of Canadians still realize its a crock.

Mushroom said...

We had this discussion before. Can't believe that you dismissed the Swedish health care system while supporting the Canadian-Cuban health care system.

What you should be saying is that the problem to poor health care is a lack of wealth redistribution and the national government should pursue a renationalization policy as soon as possible.

Your motto should be: "If you tolerate this, then your children will be next."

Cliff said...

You're ignoring that the Swedes abandoned their two-tier experiments because they were an utter failure. Two-tier has a record of expensive disaster stretching around the globe - it's just that it's proponents put their hands over their ears and go 'LLALALALALA I CAN'T HEAR YOU' whenever these abject failures are pointed out.

Adam said...

Canada spends 9.9% of its GDP on health care, compared to 8.3% for the UK, 9.2% for Australia, 8.0% for Japan, etc all of which have blended systems.

Why is it that Canada is unique among developed nations as the only one with a completely public health care system?

You say that parallel systems are a pathway to American style delivery of care, but most countries in the developed world have parallel systems. Are you saying that all of these countries are on their way to having a US style system?

I believe that we should have a blended system and I want us to avoid the problems that are quite evident in the States' system. The promotion of a blended system has nothing to do with wanting the American system, but simply wanting the most efficient system so that Canadians can get better care. A health care system should not be access to a waiting list.

Sorry that I dont have more time to better respond to your comments. Maybe later I can provide some links for your reading enjoyment.

Mushroom said...

Okay, but the Swedish healthcare system is NOT free at the point of delivery. User fees are charged although the state funds 85 per cent of the cost.

I presume you are a proponent of user fees whenever you go and see a doctor.

Cliff said...

Adam read the link in my reply to your first comment. Introducing the private sector has increased costs where ever it's been tried, in the words of former British Health Minister Frank Dobson:
The result has been a mess. The new system was supposed to introduce fiscal discipline, but in its first year the NHS overspent its budget for the first time in 60 years. Hospitals cut back on services to clear deficits, resulting in major backlashes against the Labour party government all over the country.

So unambiguously the introduction of the blended system increased costs. That's not a result that can be wished away no matter how much proponents of privatization wish it could be.

Mushroom you are very fond of the argument of false equivalency. 'If you believe this, clearly you must believe this.' How about you leave expressing what I believe up to me, and simply try to justify what you believe?

In fact user fees are a bad idea, whether in Sweden or here. In Sweden they were a political compromise to get universal healthcare set up in the first place and:
Swedish researchers conclude that fees discourage Swedes, especially the poor, from making timely doctor visits. This is consistent with research in other countries – and in Saskatchewan, before doctor and hospital fees were dropped and eventually outlawed by the Canada Health Act.

So no, I don't believe in user fees because the evidence shows they are a bad idea wherever they've been implemented.

Alison said...

Adam says : "This is what the 'free market solutions' that people like the Fraser Institute and the Conservative Party push for Canadian health care would mean."

It is? You have links peppered throughout your post, but none to back up this statement.


Will this do, Adam?
It's from the Executive Director of the Fraser Institute :

Health Care is an Economic Activity Like Any Other

Cliff said...

Thank you Alison.

Additionally, as I've pointed out before to the 'Privatization, yay!' folks (Come on, all the cool kids are trying it!) Canada is in a different position from other nations experimenting with two-tier healthcare:

We are right next door to the world's largest and most voracious private healthcare market and are signatories to various trade agreements, most importantly NAFTA that 'protect' our public universal system only so long and so far as it remains public and universal.

There are no half measures, no experiments with healthcare privatization, just irreversible fundamental chages that we can be forced to keep and expand upon by trade courts regardless of the national will.

This is the result of the economic Neo-Liberals long term efforts to 'democracy proof' the economy.

Adam said...

Sorry Alison, the article that you linked to says nothing of instituting a system like the US has. It speaks of reform, something that is badly needed with our system. It does say that free market solutions are an important aspect of reform, but never indicates that completely privatizing the system should be the outcome of those reforms. The article talks about often misunderstood "two tier system", not a US style system.

Cliff, you are making the assumption that any privatization will result in the complete and utter destruction of public health care. Just because we live next door to the big bad Americans doesn't mean that we can't redefine the limits of public/private involvement. We can make meaningful reforms to the system without compromising public care.

Why couldn't we take advantage of the fact that we live next door to the US? If there are people/corporations/greedy stuffy old guys waiting to take over our health care system, why couldn't we allow them to provide the private aspect of our two tier European style health care system?

Cliff said...
This comment has been removed by the author.
Cliff said...

corrected some clumsy phrasing.

"Cliff, you are making the assumption that any privatization will result in the complete and utter destruction of public health care. Just because we live next door to the big bad Americans doesn't mean that we can't redefine the limits of public/private involvement. We can make meaningful reforms to the system without compromising public care."

Certainly we can make meaningful reforms - within the wholly public model. A model which has been enormously successful, costs less, works better and covers everyone.

If every scrap of evidence everywhere in the world didn't show that any increase in privatization in healthcare didn't correspond with an increase in costs and a decrease in quality of sevice you might have a point.

But it does show that and you don't.

Oh, and the best illustration of people like the Fraser Institutes's and Brian Day's real views is to take a look at the kind of stuff they say to American audiences. They don't promote American style cut-throat medicine in Canada because that's a completely unpalatable model to Canadians well aware how abysmal it is. Hence the privatization through the back door approach of horror stories about wait lists (That were created by conservative policies in the first place) and the privatization in sheep's clothing of two-tier.

Not that they even have the intellectual honesty of calling it two-tier - preferring weasel words like 'blended' and 'parallel public/private'.

As if were all too stupid to realize this just means that the rich get to jump to the head of the line and get the quick treatment from the shiny machines that go bing! while the rest of us get ever longer wait lines as doctors jump ship to the private sector. The result everywhere it's been tried.

And again, once we make these kind of changes we can't go back any degree of privatization we allow we are stuck with even after it's inevitably revealed to be an expensive failure when the public will is thwarted by restraint of trade complaints in NAFTA courts by American HMOs.

No thanks

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